Development of Innovative Scoring Systems for Sickness and Tissue Damage From Clostridium difficile Colitis
Gail Besner, MD, Chief, Pediatric Surgery
Two novel scoring systems consistently and efficiently assess sickness and tissue injury during antibiotic-associated Clostridium difficile colitis in a murine model, researchers at the Abigail Wexner Research Institute at Nationwide Children’s Hospital report in the Journal of Investigative Surgery.
The serious health threat causes approximately 500,000 infections in patients of all ages and over 30,000 deaths, and results in an estimated $4.8 billion for associated health care costs in the United States annually. To address the threat, Gail Besner, MD, chief of Pediatric Surgery at Nationwide Children’s, teamed with colleagues with expertise in various backgrounds.
After establishing reproducible infection in the model, the team scored signs of sickness using their novel clinical sickness score (CSS; range 0–12). Scores of 6 or higher were consistent with C. difficile colitis.
Intestinal tissue was then analyzed to define a histologic injury score (HIS; range 0-9) to assess tissue damage. Scores of 4 or higher were consistent with C. difficile colitis.
Twenty-three percent of mice receiving antibiotics alone and 65% receiving antibiotics and C. difficile showed signs of sickness. Eight percent of mice receiving antibiotics alone and 75% receiving antibiotics and C. difficile had histologic injury.
“My laboratory has collaborated for several years with those of Dr. Steven Goodman and Dr. Michael Bailey. Each one has expertise in different areas: animal models of human diseases; the biofilms and probiotics; and the microbiome,” says Dr. Besner, who is also a professor of Surgery and Pediatrics at The Ohio State University College of Medicine and senior author of the study.
“The sum of what we can accomplish working together is more than just the additive effects of three laboratories had we been working independently. We have discovered that a novel probiotic delivery system, in which we administer the probiotic Lactobacillus reuteri in its biofilm state, can protect the intestines from injury.”
Dr. Besner says the team is completing an analysis, using these grading systems, demonstrating that this novel probiotic delivery system can both prevent and treat the disease.
CITATION:
Shelby RD, Tengberg N, Conces M, Olson JK, Navarro JB, Bailey MT, Goodman SD, Besner GE. Development of a Standardized Scoring System to Assess a Murine Model of Clostridium difficile Colitis. Journal of Investigative Surgery. 2019 Mar 20:1-9.
