Associations of motility and auto-aggregation with biofilm-formation capacity levels in Clostridioides difficile

Maya Azrad, Layan Abu-Rahmoun, Zohar Hamo, Avi Peretz

Research output: Contribution to journalArticlepeer-review


Clostridioides difficile (C. difficile) is responsible for one of the most common nosocomial infections worldwide. This work assessed associations between biofilm-formation capacity levels of C. difficile and cell viability, motility, flagella, motility and auto-aggregation in 118 clinical isolates. Biofilm production was assessed by the crystal violet method. Cell viability was determined by BacTiter-Glo™ Microbial Cell Viability Assay and live-imaging microscopy. Expression levels of LuxS, Cwp84, Spo0A, PilA, and FliC were measured by real-time PCR. Motility was visually assessed in agar tubes. Auto-aggregation levels were determined by OD600 measurements. Out of 118 isolates, 66 (56 %) were biofilm producers, with most being strong or moderate producers. Cell viability, motility and auto-aggregation positively correlated with biofilm-production capacity (p = 0.0001, p = 0.036 and p < 0.0001, respectively). Positive associations were found between pilA, fliC and luxS expression levels and biofilm-production capacity (p = 0.04, p = 0.01, p = 0.036, respectively). This is the first report of associations between biofilm-formation capacity and cell viability, pilA, fliC, and luxS gene expression, auto-aggregation and motility. These correlations should be further explored to expand knowledge on the regulation of C. difficile biofilm formation, and pathogenesis, which will have notable implications on treatment options.

Original languageEnglish
Article number106490
JournalMicrobial Pathogenesis
StatePublished - Jan 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 Elsevier Ltd


  • Auto-aggregation
  • Biofilm capacity levels
  • C. difficile
  • Cell viability
  • Flagella
  • Motility


Dive into the research topics of 'Associations of motility and auto-aggregation with biofilm-formation capacity levels in Clostridioides difficile'. Together they form a unique fingerprint.

Cite this