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

Author

Listed:
  • Cornelis H. Werkhoven

    (University Medical Center Utrecht, Utrecht University)

  • Annie Ducher

    (Da Volterra)

  • Matilda Berkell

    (Vaccine & Infectious Disease Institute, University of Antwerp)

  • Mohamed Mysara

    (Vaccine & Infectious Disease Institute, University of Antwerp
    Belgian Nuclear Research Centre, SCK.CEN)

  • Christine Lammens

    (Vaccine & Infectious Disease Institute, University of Antwerp)

  • Julian Torre-Cisneros

    (Reina Sofia University Hospital, University of Cordoba (UCO))

  • Jesús Rodríguez-Baño

    (Hospital Universitario Virgen Macarena
    Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBiS))

  • Delia Herghea

    (Oncology Institute Prof. Dr. I Chiricuta)

  • Oliver A. Cornely

    (Faculty of Medicine and University Hospital of Cologne, University of Cologne
    University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD)
    Partner Site Bonn-Cologne)

  • Lena M. Biehl

    (Faculty of Medicine and University Hospital of Cologne, University of Cologne
    Partner Site Bonn-Cologne)

  • Louis Bernard

    (Centre hospitalo-universitaire de Tours)

  • M. Angeles Dominguez-Luzon

    (Universitat de Barcelona)

  • Sofia Maraki

    (University Hospital of Heraklion)

  • Olivier Barraud

    (Université Limoges, INSERM U1092, Centre Hospitalier Universitaire de Limoges)

  • Maria Nica

    (Infectious and Tropical Diseases Hospital “Dr. Victor Babes”)

  • Nathalie Jazmati

    (Immunology and Hygiene, University of Cologne
    Labor Dr. Wisplinghoff)

  • Frederique Sablier-Gallis

    (Da Volterra)

  • Jean Gunzburg

    (Da Volterra)

  • France Mentré

    (Université de Paris, INSERM, IAME)

  • Surbhi Malhotra-Kumar

    (Vaccine & Infectious Disease Institute, University of Antwerp)

  • Marc J. M. Bonten

    (University Medical Center Utrecht, Utrecht University
    University Medical Center Utrecht, Utrecht University)

  • Maria J. G. T. Vehreschild

    (Faculty of Medicine and University Hospital of Cologne, University of Cologne
    Partner Site Bonn-Cologne
    University Hospital Frankfurt, Goethe University Frankfurt)

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.

Suggested Citation

  • Cornelis H. Werkhoven & Annie Ducher & Matilda Berkell & Mohamed Mysara & Christine Lammens & Julian Torre-Cisneros & Jesús Rodríguez-Baño & Delia Herghea & Oliver A. Cornely & Lena M. Biehl & Louis B, 2021. "Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics," Nature Communications, Nature, vol. 12(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-22269-y
    DOI: 10.1038/s41467-021-22269-y
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    Cited by:

    1. Chencheng Qin & Yi Yang & Xiaodong Wu & Long Chen & Zhaoli Liu & Lin Tang & Lai Lyu & Danlian Huang & Dongbo Wang & Chang Zhang & Xingzhong Yuan & Wen Liu & Hou Wang, 2023. "Twistedly hydrophobic basis with suitable aromatic metrics in covalent organic networks govern micropollutant decontamination," Nature Communications, Nature, vol. 14(1), pages 1-11, December.

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