The Clostridium bacterial genus comprises many Gram-positive, anaerobic bacterial species belonging to the Firmicutes phylum. Clostridium spp. live and act in various environments, from the soil to the human gastrointestinal tract. Although the Clostridium genus is known for its association with certain human diseases, such as tetanus, botulism, and colitis, it also includes many bacteria that produce a variety of metabolites and enzymes that may have potential benefits within the realms of human health, agroecology, and biotechnology. (1)
Within the human microbiome, Clostridium spp. represent 10-40% of the total gut bacterial load. This article will consider the biodiversity of the Clostridium genus, discussing its potential positive impact on human health and the risk associated with pathogenic species. (1)
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What Is Clostridium spp.?
Clostridium spp. is a genus of rod-shaped, Gram-positive, spore-forming anaerobic bacteria belonging to the Firmicutes phylum. The genus contains more than 100 species of bacteria, most of which are commensal to the gut microbiome. The genus is split into 19 clusters, which exist due to historical issues with taxonomic classification. Clostridium clusters IV and XIVa represent the gut's predominant Clostridial bacterial species. (2-4)
What Is the Role of Clostridium spp. in the Gut Microbiome?
Clostridium spp. may play a role in gut health by interacting with the immune system and producing metabolites through the metabolism of starch, fiber, and proteins. Research suggests that species belonging to Clostridium clusters IV and XIVa can influence the lymphocyte profile and support mucosal regulatory T cells within the large intestine. These findings indicate that Clostridium spp. may be important for maintaining immune balance, potentially contributing to the management of autoimmunity, allergy, and inflammation. (3, 5)
Clostridium spp. are also known to produce short-chain fatty acids (SCFA), predominantly butyrate, through carbohydrate fermentation. Butyrate serves as an energy source for colonic epithelial cells, may help support anti-inflammatory processes, reduce intestinal pH, and support intestinal immune function and gastrointestinal barrier function. (4, 5)
Clostridium spp. are among the commensal bacteria that may help deconjugate bile acids in the last portion of the small intestine and colon. Evidence suggests that secondary bile acids may help manage pathogenic C. difficile spore germination and cellular growth, potentially reducing the risk of C. diff infection. (5)
What Are the Health Consequences of Unbalanced Clostridium spp. in the Gut Microbiome?
Given the potential benefits provided by certain species of Clostridium bacteria, an imbalance and undergrowth of these bacteria may contribute to the development of inflammatory and allergic bowel conditions, as well as challenges with intestinal barrier and immune function. Interestingly, an overabundance of Clostridium cluster XIVa species has been associated with irritable bowel syndrome. (4, 11)
Despite the potential benefits of commensal species, it is important to be aware of the disease-causing pathogenic Clostridium species.
Clostridium perfringens
C. perfringens is a spore-forming bacteria and one of the most common causes of foodborne illness due to its ability to survive cooking temperatures. Toxins produced by C. perfringens are associated with gastrointestinal issues that range in severity from mild to severe. Symptoms of foodborne illness typically include abdominal pain, watery and non-bloody diarrhea, and vomiting within 8-16 hours of consuming raw or undercooked meat or poultry. In rare cases, an infection can progress to more severe conditions. (6, 7)
Clostrioides difficile
Clostrioides difficile (formerly Clostridium difficile) infection typically occurs after antibiotic therapy. Toxin-induced damage of the colon results in diarrhea of varying severity. In severe cases, a patient may experience frequent episodes of diarrhea, abdominal pain, nausea, rapid heart rate, fever, dehydration, and weight loss. Symptoms of infection usually develop within 5-10 days of starting antibiotics. Some people are C. diff carriers; they are asymptomatic but can potentially spread the infection to others. (8)
Clostridium botulinum
C. botulinum produces spores, which, when ingested, can grow and produce botulinum toxin in the gastrointestinal tract, potentially leading to botulism. This toxin is also produced by C. butyricum and C. baratii bacteria. Botulinum toxin is a neurotoxin that affects nerve function, leading to muscle paralysis. Improperly canned, preserved, and fermented foods are common sources of foodborne botulism. (9, 10)
What Causes Low Levels of Clostridium spp.?
The growth and metabolic activity of beneficial bacteria, including Clostridium spp., depend on the fermentation of fibrous carbohydrates. Low-fiber and Western dietary patterns are associated with a decreased relative abundance of these beneficial bacteria in the gut microbiome. Studies suggest that dietary interventions, such as probiotics, prebiotics, and fiber, may influence the abundance of Clostridium and other beneficial bacteria. (5, 11)
What Causes High Levels of Clostridium spp.?
Certain lifestyle factors, such as cigarette smoking, coffee consumption, and high-beef diets, have been associated with increased relative abundance of Clostridium spp. in human studies (2). Additionally, Clostridium infections are associated with contaminated food/soil and antibiotic use.
How to Test Clostridium spp. Levels
Comprehensive stool analyses, such as Genova's GI Effects with Microbiomix, offer in-depth evaluation and profiling of the gut microbiome. This can be helpful to assess the growth of Clostridium spp. in relation to other commensal microbiota. Stool tests, like the GI-MAP + Zonulin test by Diagnostic Solutions, the GI Effects® Comprehensive Profile from Genova Diagnostics, and the Microbiome Labs BiomeFx, can identify and quantify the presence of beneficial Clostridium species and clusters for a more detailed evaluation of Clostridium growth in the large intestine.
Doctor's Data offers an anaerobic Clostridium stool culture that can detect various beneficial and pathogenic species within the bacterial genus.
Pathogenic Clostridium infections can alternatively be assessed by measuring their toxins in the stool. The Access Medical Labs' C.Difficile Toxin A&B is one example that can be used to test for C. diff infection.
How to Address Clostridium spp. Imbalance
Avoidance of unnecessary antibiotics, careful handwashing, barrier use in hospitals and nursing homes, and implementing good household and cooking hygiene methods are all preventive measures for managing pathogenic Clostridium infections. (6, 8)
Addressing Clostridium imbalance and supporting a healthy microbiome may involve discontinuing the inciting antibiotic for C. diff infection, considering antimicrobial agents (natural or pharmaceutical) with probiotics, and supportive measures to manage symptoms. (12)
For individuals with recurrent C. diff infection, fecal microbiota transplant (FMT) is an emerging approach that aims to restore healthy intestinal bacteria by introducing donor stool into the colon. FMT has shown promise in managing recurrent C. diff infection. (12)
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Summary
While some Clostridium bacterial species are associated with negative health outcomes, many are commensal to the human gut microbiome and may support intestinal health, immune function, and overall well-being. Good hygiene and antibiotic practices can help manage the risk of pathogenic Clostridium infection. Exploring antimicrobial and probiotic therapies may be beneficial in addressing Clostridium-related gut health issues. As research continues, more insights into the roles of beneficial Clostridium spp. in the gut microbiome are expected to emerge.
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