TY - JOUR
T1 - Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics
AU - the ANTICIPATE study group
AU - van Werkhoven, Cornelis H.
AU - Ducher, Annie
AU - Berkell, Matilda
AU - Mysara, Mohamed
AU - Lammens, Christine
AU - Torre-Cisneros, Julian
AU - Rodríguez-Baño, Jesús
AU - Herghea, Delia
AU - Cornely, Oliver A.
AU - Biehl, Lena M.
AU - Bernard, Louis
AU - Dominguez-Luzon, M. Angeles
AU - Maraki, Sofia
AU - Barraud, Olivier
AU - Nica, Maria
AU - Jazmati, Nathalie
AU - Sablier-Gallis, Frederique
AU - de Gunzburg, Jean
AU - Mentré, France
AU - Malhotra-Kumar, Surbhi
AU - Bonten, Marc J.M.
AU - Vehreschild, Maria J.G.T.
AU - Engbers, Annemarie M.S.
AU - de Regt, Marieke J.A.
AU - Goossens, Herman
AU - Xavier, Basil Britto
AU - Bouverne, Marie Noelle
AU - Monsieurs, Pieter
AU - Merle, Uta
AU - Stallmach, Andreas
AU - Rupp, Jan
AU - Bogner, Johannes
AU - Lübbert, Christoph
AU - Silling, Gerda
AU - Witzke, Oliver
AU - Gikas, Achilleas
AU - Daikos, George
AU - Tsiodras, Sotirios
AU - Skoutelis, Athanasios
AU - Sambatakou, Helen
AU - Pujol, Miquel
AU - Aguado, Jose M.
AU - Bouza, Emilio
AU - Cobo, Javier
AU - Almirante, Benito
AU - Florescu, Simin A.
AU - Vata, Andrei
AU - Hristea, Adriana
AU - Lupse, Mihaela
AU - Postil, Deborah
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85104389097&partnerID=8YFLogxK
U2 - 10.1038/s41467-021-22269-y
DO - 10.1038/s41467-021-22269-y
M3 - Journal articles
C2 - 33854064
AN - SCOPUS:85104389097
SN - 1751-8628
VL - 12
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 2240
ER -
