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Trends Microbiol. 2014 Jul;22(7):406-16. doi: 10.1016/j.tim.2014.04.003. Epub 2014 May 7.

Clostridium difficile spore biology: sporulation, germination, and spore structural proteins.

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Laboratorio de Mecanismos de Patogénesis Bacteriana, Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andrés Bello, Santiago, Chile; Department of Biomedical Sciences, Oregon State University, Corvallis, OR, USA. Electronic address:
Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT, USA.
Department of Biology, Texas A&M University, College Station, TX, USA.


Clostridium difficile is a Gram-positive, spore-forming obligate anaerobe and a major nosocomial pathogen of worldwide concern. Owing to its strict anaerobic requirements, the infectious and transmissible morphotype is the dormant spore. In susceptible patients, C. difficile spores germinate in the colon to form the vegetative cells that initiate Clostridium difficile infections (CDI). During CDI, C. difficile induces a sporulation pathway that produces more spores; these spores are responsible for the persistence of C. difficile in patients and horizontal transmission between hospitalized patients. Although important to the C. difficile lifecycle, the C. difficile spore proteome is poorly conserved when compared to members of the Bacillus genus. Further, recent studies have revealed significant differences between C. difficile and Bacillus subtilis at the level of sporulation, germination, and spore coat and exosporium morphogenesis. In this review, the regulation of the sporulation and germination pathways and the morphogenesis of the spore coat and exosporium will be discussed.


C. difficile spores; exosporium; germination; spore coat; sporulation

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