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Journal of Bacteriology, April 2008, p. 2505-2512, Vol. 190, No. 7
0021-9193/08/$08.00+0     doi:10.1128/JB.01765-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Bile Salts and Glycine as Cogerminants for Clostridium difficile Spores

Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, Massachusetts

Received 6 November 2007/ Accepted 25 January 2008

Spore formation by Clostridium difficile is a significant obstacle to overcoming hospital-acquired C. difficile-associated disease. Spores are resistant to heat, radiation, chemicals, and antibiotics, making a contaminated environment difficult to clean. To cause disease, however, spores must germinate and grow out as vegetative cells. The germination of C. difficile spores has not been examined in detail. In an effort to understand the germination of C. difficile spores, we characterized the response of C. difficile spores to bile. We found that cholate derivatives and the amino acid glycine act as cogerminants. Deoxycholate, a metabolite of cholate produced by the normal intestinal flora, also induced germination of C. difficile spores but prevented the growth of vegetative C. difficile. A model of resistance to C. difficile colonization mediated by the normal bacterial flora is proposed.

Published ahead of print on 1 February 2008.

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