Clearance of Clostridioides difficile Colonization Is Associated with Antibiotic-Specific Bacterial Changes.

The gut bacterial community prevents many pathogens from colonizing the intestine. Previous studies have associated specific bacteria with clearing colonization across different community perturbations. However, those bacteria alone have been unable to clear colonization. To elucidate the changes necessary to clear colonization, we compared differences in bacterial abundance between communities able and unable to clear colonization. We treated mice with titrated doses of antibiotics prior to challenge, resulting in no colonization, colonization and clearance, or persistent colonization. Previously, we observed that clindamycin-treated mice were susceptible to colonization but spontaneously cleared Therefore, we investigated whether other antibiotics would show the same result. We found that reduced doses of cefoperazone and streptomycin permitted colonization and clearance of Mice that cleared colonization had antibiotic-specific community changes and predicted interactions with Clindamycin treatment led to a bloom in populations related to Clearance of was concurrent with the reduction of those blooming populations and the restoration of community members related to the and Cefoperazone created a susceptible community characterized by drastic reductions in the community diversity and interactions and a sustained increase in the abundance of many facultative anaerobes. Lastly, clearance in streptomycin-treated mice was associated with the recovery of multiple members of the , with little overlap in the specific observed in the clindamycin treatment. Further elucidation of how colonization is cleared from different gut bacterial communities will improve infection treatments. The community of microorganisms, or microbiota, in our intestines prevents pathogens like from colonizing and causing infection. However, antibiotics can disturb the gut microbiota, which allows to colonize. infections (CDI) are primarily treated with antibiotics, which frequently leads to recurrent infections because the microbiota has not yet returned to a resistant state. The recurrent infection cycle often ends when the fecal microbiota from a presumed resistant person is transplanted into the susceptible person. Although this treatment is highly effective, we do not understand the mechanism. We hope to improve the treatment of CDI through elucidating how the bacterial community eliminates CDI. We found that colonized susceptible mice but was spontaneously eliminated in an antibiotic treatment-specific manner. These data indicate that each community had different requirements for clearing colonization. Understanding how different communities clear colonization will reveal targets to improve CDI treatments.