Article
Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics
Author/s | Van Werkhoven, C. H.
Ducher, A. Berkell, M. Mysara, M. Lammens, C. Torre-Cisneros, J. Rodríguez-Baño, Jesús Vehreschild, M. J. G. T. |
Department | Universidad de Sevilla. Departamento de Medicina |
Publication Date | 2021 |
Deposit Date | 2022-10-24 |
Published in |
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Abstract | Trial enrichment using gut microbiota derived biomarkers by high-risk individuals can
improve the feasibility of randomized controlled trials for prevention of Clostridioides difficile
infection (CDI). Here, we report ... Trial enrichment using gut microbiota derived biomarkers by high-risk individuals can improve the feasibility of randomized controlled trials for prevention of Clostridioides difficile infection (CDI). Here, we report in a prospective observational cohort study the incidence of CDI and assess potential clinical characteristics and biomarkers to predict CDI in 1,007 patients ≥ 50 years receiving newly initiated antibiotic treatment with penicillins plus a beta lactamase inhibitor, 3rd/4th generation cephalosporins, carbapenems, fluoroquinolones or clindamycin from 34 European hospitals. The estimated 90-day cumulative incidences of a first CDI episode is 1.9% (95% CI 1.1-3.0). Carbapenem treatment (Hazard Ratio (95% CI): 5.3 (1.7-16.6)), toxigenic C. difficile rectal carriage (10.3 (3.2-33.1)), high intestinal abundance of Enterococcus spp. relative to Ruminococcus spp. (5.4 (2.1-18.7)), and low Shannon alpha diversity index as determined by 16 S rRNA gene profiling (9.7 (3.2-29.7)), but not nor malized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk. |
Citation | Van Werkhoven, C.H., Ducher, A., Berkell, M., Mysara, M., Lammens, C., Torre-Cisneros, J.,...,Vehreschild, M.J.G.T. (2021). Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics. Nature Communications, 12 (1), 2240. https://doi.org/10.1038/s41467-021-22269-y. |
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