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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Detalhes bibliográficos
Autores: van Werkhoven, C. H., Ducher, Annie, Berkell, Matilda, Mysara, Mohamed, Lammens, Christine, Torre-Cisneros, Julián, Rodríguez-Baño, Jesús, Herghe, Delia, Cornely, Oliver A., Biehl, Lena M., Bernard, Louis, Domínguez-Luzón, M. Ángels, Maraki, Sofia, Barraud, Olivier, Nica, María, Jazmati, Nathalie, Sablier-Gallis, Frederique, de Gunzburg, Jean, Mentré, France, Malhotra-Kumar, Surbhi, Bonten, Marc J. M., Vehreschild, Maria J. G. T., ANTICIPATE Study Group
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/261889
Acesso em linha:http://hdl.handle.net/10261/261889
Access Level:acceso abierto
Descrição
Resumo: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 normalized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk.

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