Inhibition of Clostridium difficile in Mice Using a Mixture of Potential Probiotic Strains Enterococcus faecalis NM815, E. faecalis NM915, and E. faecium NM1015: Novel Candidates to Control C. difficile Infection (CDI).

This study is aimed at the isolation, identification, and characterization of potential probiotic strains capable of inhibiting Clostridium difficile in vitro and in vivo. Twenty isolates were isolated from infant fecal samples and screened against C. difficile using their cell-free supernatant. Only three isolates showed maximum inhibition from 56.05 to 60.60%, thus they were characterized for probiotic properties and safety. The results obtained approved their tolerance to the gastrointestinal tract conditions and safety profile. They were identified by sequencing 16S rRNA as Enterococcus faecalis NM815, E. faecalis NM915, and Enterococcus faecium NM1015. For in vivo evaluation, a viable mixture of these three strains (109  CFU/mL) was administrated to a group of mice (treated group) in daily dose for 14 days, then followed by challenge with viable C. difficile (105  CFU/mL) in daily dose for 7 days, then a second administration of a viable mixture of the three strains was done daily for 7 days. In addition, the control group was administered PBS buffer only and the untreated group received PBS buffer instead of the probiotic mixture before and after the challenge with C. difficile. The results obtained from histological analysis confirmed the effectiveness of our three potential probiotic strains which expressed inhibition of C. difficile and maintained the structural integrity of the liver and intestinal cells.