ArticleJournal of clinical microbiology2006
Correlation of disease severity with fecal toxin levels in patients with Clostridium difficile-associated diarrhea and distribution of PCR ribotypes and toxin yields in vitro of corresponding isolates.
Article in Journal of clinical microbiology, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
66 citing papers in PubMed, 1 synthesis or guideline pooled it, 131 citations in OpenAlex.
- Clostridium difficile: epidemiology, diagnostic and therapeutic possibilities-a systematic review.Techniques in coloproctology · 2014Pooled it
- Probiotics Ameliorate Histological Alterations and Prevent Increases in Cytokine and Toxin Levels in Mice Infected with Various Clostridioides difficile Strains.Probiotics and antimicrobial proteins · 2026Article
- Gut Microbiota and New Microbiome-Targeted Drugs forAntibiotics (Basel, Switzerland) · 2024Review
- Pre-colonization with the fungusmSphere · 2023Article
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- The Environment, Farm Animals and Foods as Sources ofFoods (Basel, Switzerland) · 2023Article
- Ultrasensitive and Quantitative Toxin Measurement Correlates With Baseline Severity, Severe Outcomes, and Recurrence Among Hospitalized Patients With Clostridioides difficile Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Rapid Quantification ofAnalytical chemistry · 2022Article
- Multi-omics investigation ofeLife · 2022Article
- Clinical Significance of Toxigenic Clostridioides difficile Growth in Stool Cultures during the Era of Nonculture Methods for the Diagnosis of C. difficile Infection.Microbiology spectrum · 2021Article
- Large Clostridial Toxins: Mechanisms and Roles in Disease.Microbiology and molecular biology reviews : MMBR · 2021Review
- The Cytopathic Effect of Different Toxin Concentrations From DifferentFrontiers in microbiology · 2021Article
- Defining the black box: a narrative review of factors associated with adverse outcomes from severeTherapeutic advances in gastroenterology · 2021Review
- Characterization of Clostridioides difficile DSM 101085 with A-B-CDT+ Phenotype from a Late Recurrent Colonization.Genome biology and evolution · 2020Article
- Laboratory Tests for the Diagnosis ofClinics in colon and rectal surgery · 2020Review
- Epidemic ribotypes of Clostridium (now Clostridioides) difficile are likely to be more virulent than non-epidemic ribotypes in animal models.BMC microbiology · 2020Article
- Increased Clinical Specificity with Ultrasensitive Detection of Clostridioides difficile Toxins: Reduction of Overdiagnosis Compared to Nucleic Acid Amplification Tests.Journal of clinical microbiology · 2019Article
- [Recommendations from a panel of experts on the usefulness of fidaxomicin for the treatment of infections caused by Clostridium difficile].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2019Article
- Prevalence of Clostridium Difficile-Associated Diarrhoea in Hospitalised Patients (Results of a Russian Prospective Multicentre Study).Infectious diseases and therapy · 2018Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We investigated in vivo and in vitro yields of toxins A and B from and PCR ribotypes of Clostridium difficile isolates from 164 patients with differing severities of C. difficile-associated diarrhea (CDAD) (patients were grouped as follows: <3 loose stools per day, n = 45; 3 to 10 per day, n = 97; >10 per day, n = 22). The median fecal toxin levels in each group were 0.5, 6.8, and 149 U/g feces (P < 0.001), respectively. Patients with severe diarrhea also had more-frequent occurrence of blood in stool and vomiting, but there was no association with fecal toxin levels per se. There was no correlation between fecal toxin level and toxin yield in vitro for the corresponding C. difficile isolate or between its PCR ribotype and disease severity. A broad range of toxin yields among isolates belonging to major PCR ribotypes indicated a presence of many subtypes. We hypothesize that bacterial and host factors that affect C. difficile toxin levels in feces are important determinants of symptoms in CDAD patients. An inverse correlation between toxin yield and spore count (r = 0.66) in stationary-phase cultures supported the notion that toxin production and sporulation represent opposite alternative survival strategies for C. difficile cells facing nutrient shortage.
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