van Werkhoven, Cornelis H.Ducher, AnnieBerkell, MatildaMysara, MohamedLammens, ChristineTorre Cisneros, JulianRodríguez Baño, JesúsHerghera, DeliaCornely, Oliver A.Biehl, Lena M.Bernard, LouisDomínguez Luzón, Ma. Ángeles (María Ángeles)Maraki, SofiaBarraud, OlivierNica, MariaJazmati, NathalieSablier, FrederiqueGunzburg, Jean deMentré, FranceMalhotra-Kumar, SurbhiBonten, Marc J. M.Vehreschild, Maria J. G. T.Pujol Rojo, MiquelANTICIPATE Study Group2021-05-192021-05-1920212041-1723https://hdl.handle.net/2445/177408Trial 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.10 p.application/pdfengcc-by (c) van Werkhoven et al., 2021http://creativecommons.org/licenses/by/3.0/es/Malalties bacterianesAntibiòticsMicrobiotaBacterial diseasesAntibioticsMicrobiotainfo:eu-repo/semantics/article7119342021-05-19info:eu-repo/semantics/openAccess33854064