van Werkhoven, Cornelis H., Ducher, Annie, Berkell, Matilda ORCID: 0000-0002-7096-7896, Mysara, Mohamed ORCID: 0000-0001-5746-4330, Lammens, Christine, Torre-Cisneros, Julian, Rodriguez-Bano, Jesus ORCID: 0000-0001-6732-9001, Herghea, Delia, Cornely, Oliver A., Biehl, Lena M., Bernard, Louis, Dominguez-Luzon, M. Angeles, Maraki, Sofia, Barraud, Olivier, Nica, Maria, Jazmati, Nathalie, Sablier-Gallis, Frederique, de Gunzburg, Jean, Mentre, France, Malhotra-Kumar, Surbhi, Bonten, Marc J. M. and Vehreschild, Maria J. G. T. (2021). Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics. Nat. Commun., 12 (1). BERLIN: NATURE PORTFOLIO. ISSN 2041-1723

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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, 3(rd)/4(th) 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 16S rRNA gene profiling (9.7 (3.2-29.7)), but not normalized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk. 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
van Werkhoven, Cornelis H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ducher, AnnieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berkell, MatildaUNSPECIFIEDorcid.org/0000-0002-7096-7896UNSPECIFIED
Mysara, MohamedUNSPECIFIEDorcid.org/0000-0001-5746-4330UNSPECIFIED
Lammens, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Torre-Cisneros, JulianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rodriguez-Bano, JesusUNSPECIFIEDorcid.org/0000-0001-6732-9001UNSPECIFIED
Herghea, DeliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, Oliver A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Biehl, Lena M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bernard, LouisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dominguez-Luzon, M. AngelesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maraki, SofiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barraud, OlivierUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nica, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jazmati, NathalieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sablier-Gallis, FrederiqueUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Gunzburg, JeanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mentre, FranceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Malhotra-Kumar, SurbhiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonten, Marc J. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Maria J. G. T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-605786
DOI: 10.1038/s41467-021-22269-y
Journal or Publication Title: Nat. Commun.
Volume: 12
Number: 1
Date: 2021
Publisher: NATURE PORTFOLIO
Place of Publication: BERLIN
ISSN: 2041-1723
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Multidisciplinary SciencesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60578

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