Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics

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 potent...

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Detalles Bibliográficos
Autores: van Werkhoven, Cornelis H., Ducher, Annie, Berkell, Matilda, Mysara, Mohamed, Lammens, Christine, Torre Cisneros, Julian, Rodríguez Baño, Jesús, Herghera, Delia, Cornely, Oliver A., Biehl, Lena M., Bernard, Louis, Domínguez Luzón, Ma. Ángeles (María Ángeles), Maraki, Sofia, Barraud, Olivier, Nica, Maria, Jazmati, Nathalie, Sablier, Frederique, Gunzburg, Jean de, Mentré, France, Malhotra-Kumar, Surbhi, Bonten, Marc J. M., Vehreschild, Maria J. G. T., Pujol Rojo, Miquel, ANTICIPATE Study Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/177408
Acceso en línea:https://hdl.handle.net/2445/177408
Access Level:acceso abierto
Palabra clave:Malalties bacterianes
Antibiòtics
Microbiota
Bacterial diseases
Antibiotics
Descripción
Sumario: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.

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