Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2012
Decreased cure and increased recurrence rates for Clostridium difficile infection caused by the epidemic C. difficile BI strain.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 1 of them a synthesis that pooled it.
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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
91 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.PloS one · 2014Pooled it
- Trial
- Extended-pulsed fidaxomicin versus vancomycin for Clostridium difficile infection: EXTEND study subgroup analyses.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Trial
- Fecal microbiota transplant for relapsing Clostridium difficile infection using a frozen inoculum from unrelated donors: a randomized, open-label, controlled pilot study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Trial
- Relapse versus reinfection: recurrent Clostridium difficile infection following treatment with fidaxomicin or vancomycin.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2012Trial
- Effect of the ribotype 027 strain on Clostridioides difficile infection outcomes and recurrence in the Veterans Affairs healthcare system: a propensity scores matching study.BMC infectious diseases · 2026Article
- Reliable delineation ofMicrobiology spectrum · 2026Article
- Carbadox, a veterinary growth promoter exhibits anticlostridial activity through induction of oxidative stress in Clostridioides difficile.Gut pathogens · 2026Article
- Clinical outcomes of toxin-positive versus toxin-negative/NAAT-positive Clostridioides difficile infection in South Korea: a single-center retrospective cohort study.BMC infectious diseases · 2026Article
- Nanobodies against Clostridioides difficile CDTb provide a toolkit for potent toxin neutralization and highly sensitive quantitation.The Journal of biological chemistry · 2026Article
- Evaluation of the antibacterial activity of the natural product α-mangostin against Clostridioides difficile.PloS one · 2026Article
- What's New and What's Next in Fecal Microbiota Transplantation?Biologics : targets & therapy · 2025Review
- Reduced Vancomycin Susceptibility in Clostridioides difficile Is Associated With Lower Rates of Initial Cure and Sustained Clinical Response.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- The Strain and the Clinical Outcome ofOpen forum infectious diseases · 2024Article
- Effect of the COVID-19 Pandemic on Rates and Epidemiology ofAntibiotics (Basel, Switzerland) · 2023Article
- Controversies in the Prevention and Treatment ofMicroorganisms · 2023Review
- The Efficacy of Bezlotoxumab in the Prevention of Recurrent Clostridium difficile: A Systematic Review.Cureus · 2022Review
- Which is the Preferred Regimen for Non-SevereInfection & chemotherapy · 2022Review
- Characterization of the Effects of Candida Gastrointestinal Colonization on Clostridioides difficile Infection in a Murine Model.Methods in molecular biology (Clifton, N.J.) · 2022Article
- The Integrity of Heme Is Essential for Reproducible Detection of Metronidazole-Resistant Clostridioides difficile by Agar Dilution Susceptibility Tests.Journal of clinical microbiology · 2021Article
31 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundAn epidemic strain of Clostridium difficile designated by restriction endonuclease analysis (REA) as group BI has caused multiple outbreaks of severe C. difficile infection (CDI). The treatment response of patients infected with this strain is uncertain.
methodsClostridium difficile isolates were collected from 2 phase 3 clinical trials comparing fidaxomicin to vancomycin and typed using REA. Clinical cure and recurrence outcomes were analyzed by strain type of the infecting organism, BI and non-BI, using both univariate and multivariate analyses.
resultsFrom 999 patients, 719 isolates were available for typing (356 fidaxomicin treated and 363 vancomycin treated). BI was the most common REA group (34% of isolates). Patients infected with BI had lower cure rates (86.6%; 214 of 247) than those infected with non-BI strains (94.3%; 445 of 472) (P < .001). The cure rate difference between the BI and non-BI patients was significant for both vancomycin (P = .02) and fidaxomicin (P = .007). BI patients had a recurrence rate of 27.4% (51 of 186), compared with a recurrence rate of 16.6% (66 of 397) in non-BI patients (P = .002). By multivariate analysis, BI infection was statistically significant as a risk factor for reduced cure (odds ratio [OR], 0.48; 95% confidence interval [CI], .27-.85; P = .030) and for increased recurrence (OR, 1.57; 95% CI, 1.01-2.45; P = .046).
conclusionsThe clinical cure rate of patients infected with the epidemic BI C. difficile strain is lower than the cure rate of those infected with non-BI strains whether treated with fidaxomicin or vancomycin. Similarly, the CDI recurrence rate is increased in patients with the BI strain compared with patients with other C. difficile strains.
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