Risk factors for recurrence in patients with Clostridium difficile infection due to 027 and non-027 ribotypes

Falcone, Marco; Tiseo, Giusy; Iraci, Federica; Raponi, Giammarco; Goldoni, Paola; Rose, D. Delle; Santino, Iolanda; Carfagna, Paolo; Murri, Rita; Fantoni, Massimo; Fontana, Carla; Sanguinetti, Maurizio; Farcomeni, Alessio; Antonelli, Guido; Aceti, Antonio; Mastroianni, Claudio Maria; Andreoni, Massimo; Cauda, Roberto; Petrosillo, Nicola; Venditti, Mario

doi:10.1016/j.cmi.2018.06.020

Cited by 18 publications

(13 citation statements)

References 33 publications

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“…Eight studies reported on non-CDI antibiotic use after initial CDI diagnosis as a risk factor, but results were inconsistent [12,124,130,137,142,146,147,149]; 4/6 studies found an association between non-CDI antibiotic use and rCDI in univariate analysis, and 2/5 studies in multivariable analysis. A high-quality prospective study showed no significant association between antibiotic use and rCDI in both uni-and multivariate analysis [137].…”

Section: Prognostic Factors For Recurrent CDImentioning

confidence: 99%

“…The ribotype 027 strain was not clearly associated with recurrence. However, only five studies reported on this ribotype as a possible risk factor [112,124,130,146,149]; 2/5 studies found that the presence of a RT027 strain was associated with sCDI in univariate analysis, and only 1/3 studies in multivariable analysis. Since these results were inconsistent when compared to a previous systematic review, results were re-assessed by a third researcher [163].…”

Section: Prognostic Factors For Recurrent CDImentioning

confidence: 99%

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Prognostic factors for severe and recurrent Clostridioides difficile infection: a systematic review

Rossen

Ooijevaar

Vandenbroucke-Grauls

et al. 2022

Clinical Microbiology and Infection

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Prognostic Factors For Recurrent CDImentioning

confidence: 99%

Section: Prognostic Factors For Recurrent CDImentioning

confidence: 99%

Prognostic factors for severe and recurrent Clostridioides difficile infection: a systematic review

Rossen

Ooijevaar

Vandenbroucke-Grauls

et al. 2022

Clinical Microbiology and Infection

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“…Considering some particular patient-related aspects of CDI infection in potential FMT recipients in Romania, such as increased age [4] and also the prevalence of ribotype 027 [3], the working group discussed the opportunity for the use of FMT among patients with one CDI recurrence and risk factors for other recurrences. We considered the risk factors identified in literature, namely antibiotics use for non-C. difficile after CDI diagnosis, long term gastric acid suppression, severe underlying disease and/or renal insufficiency/ severe illness by Horn index, previous severe CDI, prolonged hospital stays, severe underlying disease and/or renal insufficiency, a history of previous CDI, previous CDI severity, prolonged hospital stay hypervirulent strain, NAP1/BI/027 [39,40]. Although there is limited evidence in RCTs, experts agreed that FMT could be indicated after one recurrence for those with features of severe disease or risk factors for recurrence.…”

Section: Which Patients With CDI Should Be Considered For Fmt?mentioning

confidence: 99%

Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice

Gîlcă-Blanariu

Ştefănescu

Gîrleanu

et al. 2021

JGLD

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Fecal microbiota transplantation involves the infusion of intestinal microorganisms via the transfer of a stool from a healthy individual into a diseased individual, with the intent of restoring normal intestinal flora. Fecal transplant is proposed for the treatment of refractory Clostridioides difficile infection. At present, recurrent Clostridioides difficile infection is the only indication supported by solid scientific evidence. Regulations by healthcare authorities vary among different countries. Considering that Romania does not have an available national guideline to offer standardization, this paper aimed to create a national fecal microbiota transplantation guideline concerning indications, techniques and donor screening, developed by international and local scientific working groups.

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“…Eight studies reported on non-CDI antibiotic use after initial CDI diagnosis as a risk factor, but results were inconsistent (12,123,129,136,141,145,146,148); 4/6 studies found an association between non-CDI antibiotic use and rCDI in univariate analysis, and 2/5 studies in multivariable analysis. A high-quality prospective study showed no significant association between antibiotic use and rCDI in both uni-and multivariate analysis (136).…”

Section: Prognostic Factors For Recurrent CDImentioning

confidence: 99%

“…The ribotype 027 strain was not clearly associated with recurrence. However, only five studies reported on this ribotype as a possible risk factor (111,123,129,145,148); 2/5 studies found that the presence of a RT027 strain was associated with sCDI in univariate analysis, and only 1/3 studies in multivariable analysis. Since these results were inconsistent when compared to a previous systematic review, results were re-assessed by a third researcher (162).…”

Section: Prognostic Factors For Recurrent CDImentioning

confidence: 99%

GRADING prognostic factors for severe and recurrentClostridioides difficileinfection: expected and unexpected findings. A systematic review

et al. 2021

Preprint

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BackgroundClostridioides difficile infection (CDI), its subsequent recurrences (rCDI), and severe CDI (sCDI) provide a significant burden for both patients and the healthcare system. Treatment consists of oral antibiotics. Fidaxomicin, bezlotoxumab and fecal microbiota transplantion (FMT) reduce the number of recurrences compared to vancomycin, but are more costly. Identifying patients diagnosed with initial CDI who are at increased risk of developing sCDI/rCDI could lead to more cost-effective therapeutic choices.ObjectivesIn this systematic review we aimed to identify clinical prognostic factors associated with an increased risk of developing sCDI or rCDI.MethodsPubMed, Embase, Emcare, Web of Science and COCHRANE Library databases were searched from database inception through March, 2021. Study selection was performed by two independent reviewers on the basis of predefined selection criteria; conflicts were resolved by consensus. Cohort and case-control studies providing an analysis of clinical or laboratory data to predict sCDI/rCDI in patients ≥18 years diagnosed with CDI, were included. Risk of bias was assessed with the Quality in Prognostic Research (QUIPS) tool and the quality of evidence by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool, modified for prognostic studies. Overview tables of prognostic factors were constructed to assess the number of studies and the respective direction of an association (positive, negative, or no association).Results and conclusions136 studies were included for final analysis. Higher age and the presence of multiple comorbidities were prognostic factors for sCDI. Identified risk factors for rCDI were higher age, healthcare-associated CDI, prior hospitalization, PPIs started during/after CDI diagnosis and previous rCDI. Some variables that were found as risk factors for sCDI/rCDI in previous reviews were not confirmed in the current review, which can be attributed to differences in methodology. Risk stratification for sCDI/rCDI may contribute to a more personalized and optimal treatment for patients with CDI.

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Risk factors for recurrence in patients with Clostridium difficile infection due to 027 and non-027 ribotypes

Abstract: Compared to vancomycin, metronidazole monotherapy appears less effective in curing CDI without relapse in the 027+ patient group, independently of disease severity.

Cited by 18 publications

References 33 publications

Prognostic factors for severe and recurrent Clostridioides difficile infection: a systematic review

Prognostic factors for severe and recurrent Clostridioides difficile infection: a systematic review

Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice

GRADING prognostic factors for severe and recurrentClostridioides difficileinfection: expected and unexpected findings. A systematic review

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