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Title: Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics
Author: van Werkhoven, Cornelis H.
Ducher, Annie
Berkell, Matilda
Mysara, Mohamed
Lammens, Christine
Torre Cisneros, Julian
Rodríguez Baño, Jesús
Herghera, Delia
Cornely, Oliver A.
Biehl, Lena M.
Bernard, Louis
Domínguez Luzón, Ma. Ángeles (María Ángeles)
Maraki, Sofia
Barraud, Olivier
Nica, Maria
Jazmati, Nathalie
Sablier, Frederique
Gunzburg, Jean de
Mentré, France
Malhotra-Kumar, Surbhi
Bonten, Marc J. M.
Vehreschild, Maria J. G. T.
Pujol Rojo, Miquel
Keywords: Malalties bacterianes
Bacterial diseases
Issue Date: 2021
Publisher: Nature Publishing Group
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 nor- malized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk.
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It is part of: Nature Communications, 2021, vol. 12
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ISSN: 2041-1723
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Patologia i Terapèutica Experimental)

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