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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2023; 29(22): 3385-3399
Published online Jun 14, 2023. doi: 10.3748/wjg.v29.i22.3385
Overview of current detection methods and microRNA potential in Clostridioides difficile infection screening
Marco Bocchetti, Maria Grazia Ferraro, Federica Melisi, Piera Grisolia, Marianna Scrima, Alessia Maria Cossu, Tung On Yau
Marco Bocchetti, Federica Melisi, Piera Grisolia, Alessia Maria Cossu, Department of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples 80138, Italy
Marco Bocchetti, Federica Melisi, Piera Grisolia, Marianna Scrima, Alessia Maria Cossu, Department of Molecular Oncology, Precision Medicine Laboratory and COVID19 Laboratory, Biogem Scarl, Ariano Irpino 83031, Italy
Maria Grazia Ferraro, School of Infection and Immunity, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, United Kingdom
Maria Grazia Ferraro, Department of Pharmacy, School of Medicine and Surgery, University of Naples “Federico II,” Naples 80131, Italy
Tung On Yau, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, United Kingdom
Tung On Yau, Department of Rural Land Use, Scotland’s Rural College, Aberdeen AB21 9YA, Scotland, United Kingdom
Tung On Yau, Department of Health Science, University of the People, Pasadena, CA 9110112, United States
Author contributions: Yau TO and Bocchetti M contributed to conceptualisation; Yau TO, Bocchetti M and Ferraro MG wrote the original draft; Yau TO, Bocchetti M, Ferraro MG, Melisi F, Grisolia P, Scrima M and Cossu AM wrote the review and contributed to editing; Yau TO and Bocchetti M contributed to visualisation; Yau TO performed the project administration and funding acquisition; All authors read and agreed to the published version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tung On Yau, BSc, MSc, PhD, Instructor, Lecturer, Researcher, School of Science and Technology, Nottingham Trent University, Clifton Lane, Clifton, Nottingham NG11 8NS, United Kingdom. payton.yau@ntu.ac.uk
Received: January 25, 2023
Peer-review started: January 25, 2023
First decision: March 15, 2023
Revised: March 23, 2023
Accepted: May 4, 2023
Article in press: May 4, 2023
Published online: June 14, 2023
Processing time: 132 Days and 14.8 Hours
Abstract

Clostridioides difficile (formerly called Clostridium difficile, C. difficile) infection (CDI) is listed as an urgent threat on the 2019 antibiotic resistance threats report in the United States by the Centers for Disease Control and Prevention. Early detection and appropriate disease management appear to be essential. Meanwhile, although the majority of cases are hospital-acquired CDI, community-acquired CDI cases are also on the rise, and this vulnerability is not limited to immunocompromised patients. Gastrointestinal treatments and/or gastrointestinal tract surgeries may be required for patients diagnosed with digestive diseases. Such treatments could suppress or interfere with the patient’s immune system and disrupt gut flora homeostasis, creating a suitable microecosystem for C. difficile overgrowth. Currently, stool-based non-invasive screening is the first-line approach to CDI diagnosis, but the accuracy is varied due to different clinical microbiology detection methods; therefore, improving reliability is clearly required. In this review, we briefly summarised the life cycle and toxicity of C. difficile, and we examined existing diagnostic approaches with an emphasis on novel biomarkers such as microRNAs. These biomarkers can be easily detected through non-invasive liquid biopsy and can yield crucial information about ongoing pathological phenomena, particularly in CDI.

Keywords: Clostridioides difficile; microRNA; Diagnostic; Prognostic; Biomarker

Core Tip:Clostridioides difficile infection (CDI) is listed as an urgent threat, and early detection and appropriate disease management from hospital-acquired or community-acquired CDI appear to be essential. Currently, stool-based non-invasive screening is the first-line approach to CDI diagnosis, but the accuracy is varied due to different clinical microbiology detection methods. Therefore, improving reliability is clearly required. This review summarised the life cycle and toxicity of Clostridioides difficile and examined existing diagnostic potentials on microRNA as novel biomarkers. MicroRNAs can be easily detected through non-invasive liquid biopsy and can yield crucial information about ongoing pathological phenomena, particularly in CDI.