Work

Smoking and Clostridioides difficile Colonization in Adults Aged ≥40 Years: Findings from a Community-Based Gut Microbiota Study

Year: 2026

Type: article

Abstract: Background: Asymptomatic Clostridioides difficile colonization (CdC) serves as a reservoir for pathogen transmission and may precede clinical infection. While risk factors for CdC have been well described in hospitalized populations, community-based data—particularly regarding lifestyle-associated factors and gut microbiota alterations—remain limited in Taiwan. This study aimed to determine the prevalence and risk factors of community-acquired CdC and to explore associated gut microbiota differences. Materials and Methods: We conducted a cross-sectional study analyzing 250 residual stool samples from adults aged ≥ 40 years who participated in community health screenings in Tainan City between 2006 and 2009. CdC was detected by polymerase chain reaction targeting the triosephosphate isomerase ( tpi ) gene. Demographic characteristics, lifestyle factors, and laboratory parameters were collected and analyzed. Exploratory 16S rRNA gene sequencing was performed on selected samples to compare gut microbiota composition between CdC and non-CdC groups. Results: The prevalence of CdC was 11.6% (29/250). Cigarette smoking was identified as the sole independent factor associated with CdC (adjusted OR 2.35, 95% CI 1.05– 5.28; P = 0.038). Exploratory microbiota analysis revealed differences in community composition between CdC and non-CdC samples, including increased relative abundance of Proteobacteria in CdC. Conclusion: Cigarette smoking was associated with an increased likelihood of community-acquired CdC in southern Taiwan. Distinct gut microbiota profiles were observed in individuals with CdC, supporting a potential link between smoking-related microbiota alterations and susceptibility to asymptomatic colonization. These findings underscore the relevance of modifiable lifestyle factors in the epidemiology of community CdC and warrant further investigation. Keywords: Clostridioides difficile colonization, smoking, gut microbiota, community, Taiwan

Source: Infection and Drug Resistance

DOI: 10.2147/idr.s571988

Authors: Hong-Ming Chen, Te-Wei Yang, Wen-Chien Ko, Yuan-Pin Hung, Chin-Shiang Tsai, Pei-Jane Tsai

Institutions: National Cheng Kung University, National Cheng Kung University Hospital, Tainan Hospital

Language: English

Topic: Clostridium difficile and Clostridium perfringens research

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836