Universität zu Köln

Solbach, Philipp, Chhatwal, Patrick, Woltemate, Sabrina, Tacconelli, Evelina, Buhl, Michael, Autenrieth, Ingo B., Vehreschild, Maria J. G. T., Jazmati, Nathalie, Gerhard, Markus ORCID: 0000-0001-9110-3950, Stein-Thoeringer, Christoph K., Rupp, Jan ORCID: 0000-0001-8722-1233, Ulm, Kurt, Ott, Armin, Lasch, Florian, Koch, Armin, Manns, Michael P., Suerbaum, Sebastian and Bachmann, Oliver ORCID: 0000-0002-6830-2975 (2021). Microbiota-associated Risk Factors for Clostridioides difficile Acquisition in Hospitalized Patients: A Prospective, Multicentric Study. Clin. Infect. Dis., 73 (9). S. E2625 - 10. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background Asymptomatic C. difficile colonization is believed to predispose to subsequent C. difficile infection (CDI). While emerging insights into the role of the commensal microbiota in mediating colonization resistance against C. difficile have associated CDI with specific microbial components, corresponding prospectively collected data on colonization with C. difficile are largely unavailable. Methods C. difficile status was assessed by GDH EIA and real-time PCR targeting the toxin A (tcdA) and B (tcdB) genes. 16S V3 and V4 gene sequencing results from fecal samples of patients tested positive for C. difficile were analyzed by assessing alpha and beta diversity, LefSe, and the Piphillin functional inference approach to estimate functional capacity. Results 1506 patients were recruited into a prospective observational study (DRKS00005335) upon admission into one of five academic hospitals. 936 of them provided fecal samples on admission and at discharge and were thus available for longitudinal analysis. Upon hospital admission, 5.5% (83/1506) and 3.7% (56/1506) of patients were colonized with toxigenic (TCD) and non-toxigenic C. difficile (NTCD), respectively. During hospitalization, 1.7% (16/936) acquired TCD. Risk factors for acquisition of TCD included pre-existing lung diseases, lower GI endoscopy and antibiotics. Species protecting against hospital-related C. difficile acquisition included Gemmiger spp., Odoribacter splanchnicus, Ruminococcus bromii and other Ruminococcus spp. Metagenomic pathway analysis identified steroid biosynthesis as the most underrepresented metabolic pathway in patients who later acquire C. difficile colonization. Conclusions Gemmiger spp., Odoribacter splanchnicus, Ruminococcus bromii and other Ruminococci were associated with a decreased risk of C. difficile acquisition. In this prospective, multicentric study Gemmiger spp., Odoribacter splanchnicus, Ruminococcus bromii, and other Ruminococcus spp. could be identified as biomarkers for hospital-acquired C. difficile colonization. In silico metagenomics showed metabolic pathways for steroid biosynthesis to be protective against C. difficile.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Solbach, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Chhatwal, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Woltemate, Sabrina UNSPECIFIED UNSPECIFIED UNSPECIFIED Tacconelli, Evelina UNSPECIFIED UNSPECIFIED UNSPECIFIED Buhl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Autenrieth, Ingo B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jazmati, Nathalie UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerhard, Markus UNSPECIFIED orcid.org/0000-0001-9110-3950 UNSPECIFIED Stein-Thoeringer, Christoph K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rupp, Jan UNSPECIFIED orcid.org/0000-0001-8722-1233 UNSPECIFIED Ulm, Kurt UNSPECIFIED UNSPECIFIED UNSPECIFIED Ott, Armin UNSPECIFIED UNSPECIFIED UNSPECIFIED Lasch, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Armin UNSPECIFIED UNSPECIFIED UNSPECIFIED Manns, Michael P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Suerbaum, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Oliver UNSPECIFIED orcid.org/0000-0002-6830-2975 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-601547
DOI:	10.1093/cid/ciaa871
Journal or Publication Title:	Clin. Infect. Dis.
Volume:	73
Number:	9
Page Range:	S. E2625 - 10
Date:	2021
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1537-6591
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEM-CELL TRANSPLANT; REAL-TIME PCR; GUT MICROBIOTA; INFECTION; COLONIZATION; EPIDEMIOLOGY; DIAGNOSIS; STRAINS; RATES Multiple languages Immunology; Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60154