Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, School of Molecular Medical Sciences, Centre for Biomolecular Sciences, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
J Microbiol Methods. 2011 Nov;87(2):133-8. doi: 10.1016/j.mimet.2011.07.017. Epub 2011 Aug 16.
Clostridium difficile is a leading cause of healthcare-associated diarrhoea. In recent years, certain C. difficile types have become highly represented among clinical isolates and are associated with outbreaks of increased disease severity, higher relapse rates and an expanded repertoire of antibiotic resistance. Endospores, produced during sporulation, play a pivotal role in infection and disease transmission and it has been suggested in the literature that these so-called 'hypervirulent' C. difficile types are more prolific in terms of sporulation in vitro. However, work in our laboratory has provided evidence to the contrary suggesting that although there is significant strain-to-strain variation in C. difficile sporulation characteristics this variation does not appear to be type-associated. On analysis of the literature, it is apparent that the methods used to quantify sporulation in previous studies have varied greatly and sample sizes have remained small. The conflicting data in the literature may, therefore, not necessarily be generally representative of C. difficile sporulation. Instead, these inconsistencies may reflect differences in the experimental design of each study. In this review, the need for further investigations of C. difficile sporulation rates is highlighted. Specifically, the advantages and disadvantages of the different experimental approaches previously used are discussed and a standard set of principles for measuring C. difficile sporulation in the future is proposed.
艰难梭菌是导致医疗保健相关腹泻的主要原因。近年来，某些艰难梭菌类型在临床分离株中高度存在，与疾病严重程度增加、更高的复发率和扩展的抗生素耐药性有关。在孢子形成过程中产生的芽孢在感染和疾病传播中起着关键作用，文献中提出，这些所谓的“高毒力”艰难梭菌类型在体外孢子形成方面更为丰富。然而，我们实验室的工作提供了相反的证据，表明尽管艰难梭菌孢子形成特征存在显著的菌株间变异，但这种变异似乎与类型无关。对文献的分析表明，以前研究中用于定量孢子形成的方法差异很大，样本量仍然很小。因此，文献中的矛盾数据不一定能代表艰难梭菌的孢子形成情况。相反，这些不一致可能反映了每个研究的实验设计的差异。在这篇综述中，强调了进一步研究艰难梭菌孢子形成率的必要性。具体来说，讨论了以前使用的不同实验方法的优缺点，并提出了未来测量艰难梭菌孢子形成的一套标准原则。
