Hi everyone!

For those of you who don’t know me already, my name is Stewart (@Stewart_Barker on Twitter), and i am a final year Biology BSc student at Sheffield Hallam University. I have been active with #microtwjc for a few months now, and it is my turn to lead a discussion session!

This week’s paper –

Correlation between virulence gene expression and proton pump inhibitors and ambient pH in C. difficile: Results of an in vitro study 

The paper has very kindly been made open access by the Society for General Microbiology from 27th September to 2nd October here: http://jmm.sgmjournals.org/content/early/2013/06/25/jmm.0.059709-0.full.pdf+html

Proton pump inhibitors (PPIs), such as Omeprazole and Lansoprazole are frequently prescribed as outpatient medication and are even prescribed over the counter. They produce an antacid effect in the stomach, used to treat diseases caused by excess acid, like Peptic ulcers. As gut microorganisms are highly adapted to survive in the low pH, a change in the environment will alter their physiology and virulence. This has long been thought to be a secondary cause of Clostridium difficile infections, after the use of broad spectrum antibiotics.

The authors look beyond just the manipulation of stomach pH – at the direct effect of PPIs on the expression of toxins and their regulators. Considering the growing issue with antibiotic resistance, and the continuous use of orally administered broad-spectrum antibiotics, it is crucial to investigate other options to inhibit C. difficile infections.


  1. Is the paper well written, easy to understand and thoroughly explained?
  2. Are the methods appropriate?
  3. What do the results tell us – how significant is the impact of this research?
  4. What research can and should this follow on to?