C. Difficile

What is Clostridium Difficile (C. Diff) ?

02/10/2023

Clostridium Difficile

Clostridium difficile is a species of pathogenic bacteria that accounts for more health-care associated infections than any other in the USA¹, while in Canada it also represents a leading infectious cause of death and disease².

Health-care associated infections are those acquired during the course of being treated in a medical facility and, as a result, Clostridium difficile infections are considered to be a significant burden to the healthcare systems³ and thus a topic of great interest in the medical community. 

The spread and acquisition of C. Diff is not exclusive to medical settings, however, with recent years seeing a rise in community spread and overall increase in both incidence and severity of infection⁴.

The Risks & Symptoms of C. Diff

According to the American Center For Disease Control (CDC) C. diff is a major health threat⁵.

It causes life-threatening diarrhea and often occurs as a consequence of antibiotic use, usually within days or weeks of use.

It spreads easily between people with other symptoms include fever, nausea, stomach pain and appetite loss.

Those at greatest risk include individuals aged 65+ who received antibiotics in a medical care setting, have extended hospital or nursing home stays as well as those with compromised immune systems including a previous history of Clostridium difficile infection5.

Recurrence is a major topic of concern in the management of C. Diff infections, which is precisely where probiotic use may have a role to play.

The Role Of Probiotics Like S. Boulardii

Given that C. Diff infection is brought about in large part by antibiotic use in specific populations and further characterized by severe diarrhea, it is perhaps unsurprising that probiotic use has been studied as a complimentary management strategy.

This is where S. Boulardii comes into play.

Figure 1 : Prevention of C. difficile-associated diarrhea by the yeast probiotic Saccharomyces boulardii CNCM I-74511

A scientifically proven efficacy

Let’s take a closer look at the scientific evidence surrounding its use in individuals with Clostridium Difficile infections.

An experimental trial out of JAMA found that S Boulardii significantly reduced the recurrence rate of C. Diff infection with 64.7% of those provided a placebo experiencing infection recurrence as compared to only 34.6% of those taking S Boulardii⁶.   

Similar results were found in another experimental trial out of Clinical Infectious Diseases where infection recurrence rate was 16.7% in the S. Boulardii group as compared to 50% in the placebo group⁷.

The efficacy of S. Boulardii for reducing the recurrence rate of C. Diff infection was further confirmed through the findings of a recently published systematic review and meta-analysis out of The American Journal Of Gastroenterolgy.

In Canada Florastor is the only probiotic with Saccharomyces boulardii CNCM I-745 with over 65 years of use and research worldwide. The Florastor® Max quickly promotes a favorable gut flora to help support gastrointestinal health and reduces recurrent C. Diff associated diarrhea.

Additionally, a 2016 systematic review and meta-analysis out of the International Journal Of General Medicine identified S. Boulardii as reducing risk of antibiotic associated diarrhea caused by C. Diff by 58.5%⁹ , findings that were supported by a Cochrane Database review published one year later¹⁰.

Furthermore Saccharomyces boulardii CNCMI-745 has been recommended by :

  • The World Gastroenterology Organization (WGO) in the treatment of C.Difficile in adults.
  • The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) in the treatment of C.Difficile in children.


Final Thoughts

Clostridium difficile infection is a significant concern in the medical community and emerging evidence points strongly to a role for S. Boulardii in the management of AAD causes by this pathogenic bacteria including reducing the risk of a recurrence of C. Diff infection in those with a previous history.

In Canada, Florastor is the only probiotic with Saccharomyces boulardii CNCM I-745 with over 65 years of use and research worldwide. The Florastor® Max quickly promotes a favorable gut flora to help support gastrointestinal health and reduces recurrent C. Diff associated diarrhea. 

Andy De Santis,

Registered Dietitian

@AndyTheRD

andytherd.com