Overview of Gut Microbiome

Stuart Johnson, MD: Hello and welcome to this HCPLive® Peer Exchange titled, “Advances in Microbiome-Based Therapies for Recurrent C Difficile Infection.” I am Dr Stuart Johnson, emeritus professor of medicine at Loyola University, Stritch School of Medicine, and researcher at the Hines VA Hospital in Chicago, Illinois. Joining me today in this discussion are Dr Joseph Riley, pharmacy residents program director and clinical pharmacist specialist at AtlantiCare Health Systems in Galloway, New Jersey. Next to him is Candace Cotto, a clinical research nurse at Medical Research Center of Connecticut in Hamden. And on my left, Andrew Skinner, clinical assistant professor of medicine at Loyola University, Stritch School of Medicine, in Chicago. Today’s discussion will focus on the gut microbiota, current and emerging microbiome-based therapies for Clostridioides difficile, and practical ways to incorporate these treatments into your clinical practice. Welcome, and let’s get started. Our first question here is, can you describe, Joseph, the gut microbiota, its composition, and its role in nutrition and health?

Joseph Reilly, BS, PharmD, BCGP: Yes. The microbiota is a collection of microbes that comprise the microbiome. These bacteria that are present in the microbiome particularly come from 2 phyla, Bacteroides and Firmicutes. The bacteria work together with our body and are involved in numerous processes that are essential for health and human development. The Bacteroides and Firmicutes bacteria are beneficial in many ways for our existence, for digestion, extraction of nutrients from food, the regulation of our immune system. They work in concert, often cooperatively, and competitively with different regulatory processes that make sure other bacteria, potentially pathogenic bacteria, do not colonize the lower GI [gastrointestinal] tract.

Stuart Johnson, MD: Excellent. What could cause dysregulation of the gut microbiota, and what are some common consequences of this dysregulation?

Joseph Reilly, BS, PharmD, BCGP: Dysregulation is something to consider when we think about our microbiome. The term that’s often used is dysbiosis. Many things can affect our microbiota and result in this dysregulation, such as genetic factors, depending on the person, lifestyle changes, your diet, how much sugar or fiber you eat, even things such as artificial sweeteners, where you live, cohabitation with pets can affect your microbiome. Drugs can certainly impact the bacteria content of our microbiome.

Stuart Johnson, MD: Antibiotics are a major factor in this disruption, of course. Thank you.

Transcript edited for clarity