Back to Search
Start Over
Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics
- Source :
- Digital.CSIC. Repositorio Institucional del CSIC, instname, Nature communications, Dipòsit Digital de la UB, Universidad de Barcelona, Nature Communications, Vol 12, Iss 1, Pp 1-10 (2021), Nature Communications
- Publication Year :
- 2021
- Publisher :
- Springer Nature, 2021.
-
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, 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.<br />Here, the authors report the incidence of Clostridioides difficile infection (CDI) and assess potential clinical characteristics and biomarkers to predict CDI in 1,007 patients of 50 years and above receiving newly initiated antibiotic treatment.
- Subjects :
- Male
0301 basic medicine
Carbapenem
genetic structures
Antibiotics
Medizin
General Physics and Astronomy
law.invention
0302 clinical medicine
Randomized controlled trial
law
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Multidisciplinary
Incidence
Incidence (epidemiology)
Microbiota
Hazard ratio
Middle Aged
Anti-Bacterial Agents
Hospitalization
Drug Therapy, Combination
Female
Engineering sciences. Technology
Fluoroquinolones
Cohort study
medicine.drug
medicine.medical_specialty
medicine.drug_class
Science
030106 microbiology
Bacterial diseases
Antibiòtics
Penicillins
Predictive markers
Article
General Biochemistry, Genetics and Molecular Biology
03 medical and health sciences
Internal medicine
medicine
Humans
Aged
Malalties bacterianes
Clostridioides difficile
business.industry
Clindamycin
Clostridium difficile
General Chemistry
Cephalosporins
Gastrointestinal Microbiome
Carbapenems
Clostridium Infections
Human medicine
business
Biomarkers
Follow-Up Studies
Subjects
Details
- ISSN :
- 20411723
- Database :
- OpenAIRE
- Journal :
- Digital.CSIC. Repositorio Institucional del CSIC, instname, Nature communications, Dipòsit Digital de la UB, Universidad de Barcelona, Nature Communications, Vol 12, Iss 1, Pp 1-10 (2021), Nature Communications
- Accession number :
- edsair.doi.dedup.....2acae65093249b4533af205a3413b256