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Although there was not a prevalent yeast species in CDI patients, <jats:italic>C. albicans<\/jats:italic> was the species significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) associated to both the infections sustained by the non-hypervirulent <jats:italic>C<\/jats:italic>. <jats:italic>difficile<\/jats:italic> strains and those caused by the hypervirulent strain (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). The biofilm production by the yeasts isolated from the CDI patients and from non-CDI diarrheic patients did not differ significantly. However, a significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.007) higher biofilm production was observed in the <jats:italic>Candida<\/jats:italic> strains, particularly <jats:italic>C. albicans<\/jats:italic>, isolated from healthy donors compared to that of the yeasts cultured from CDI patients. Seasonal occurrence was observed in the isolation rate of CDI and non-CDI diarrheic cases (<jats:italic>p<\/jats:italic>\u2009=\u20090.0019), peaking in winter for CDI patients and in spring for non-CDI diarrheic patients. Furthermore, seasonality emerged in the gut colonization by <jats:italic>Candida<\/jats:italic> of CDI patients in the winter. It seems, therefore, that the reduced capacity of biofilm production by <jats:italic>Candida<\/jats:italic> strains isolated from CDI patients might have a role in the development of <jats:italic>C. difficile<\/jats:italic> infection, probably facilitating the spread of the bacteria into the gut thus amplifying their pathogenic action.<\/jats:p>","DOI":"10.1007\/s42770-021-00512-4","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T09:03:48Z","timestamp":1626339828000},"page":"1845-1852","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Candida gut colonization, yeast species distribution, and biofilm production in Clostridioides difficile infected patients: a comparison between three populations in two different time periods"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0037-3216","authenticated-orcid":false,"given":"Grazia","family":"Brunetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4640-804X","authenticated-orcid":false,"given":"Alessandro","family":"Giuliani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Sara","family":"Navazio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Paradisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Raponi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9466-5473","authenticated-orcid":false,"given":"Libenzio Adrian","family":"Conti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9665-0811","authenticated-orcid":false,"given":"Giammarco","family":"Raponi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"512_CR1","doi-asserted-by":"publisher","first-page":"16020","DOI":"10.1038\/nrdp.2016.20","volume":"2","author":"WK Smits","year":"2016","unstructured":"Smits WK, Lyras D, Lacy DB, Wilcox MH, Kuijper EJ (2016) Clostridium difficile infection. 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