|
Title
|
|
|
|
Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics
| |
|
Author
|
|
|
|
| |
|
Institution/Organisation
|
|
|
|
ANTICIPATE Study Group
| |
|
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 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, 3 rd /4 th 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 normalized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
Nature communications
| |
|
Publication
|
|
|
|
2021
| |
|
ISSN
|
|
|
|
2041-1723
| |
|
DOI
|
|
|
|
10.1038/S41467-021-22269-Y
| |
|
Volume/pages
|
|
|
|
12
:1
(2021)
, 10 p.
| |
|
Article Reference
|
|
|
|
2240
| |
|
ISI
|
|
|
|
000640561300004
| |
|
Pubmed ID
|
|
|
|
33854064
| |
|
Medium
|
|
|
|
E-only publicatie
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|
Full text (open access)
|
|
|
|
| |
|