ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014
NAP1 strain type predicts outcomes from Clostridium difficile infection.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 3 of them syntheses 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
81 citing papers in PubMed, 3 syntheses or guidelines pooled it, 170 citations in OpenAlex.
- Pooled it
- Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Guideline
- Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections.World journal of gastroenterology · 2016Pooled it
- 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
- Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection in Patients at Increased Risk for Recurrence.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Thirty-Day Readmissions in Hospitalized Patients Who Received Bezlotoxumab With Antibacterial Drug Treatment for Clostridium difficile Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Trial
- 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
- Burden and Mortality Outcomes ofJournal of clinical medicine · 2026Article
- Global Practice Variation in the Management ofOpen forum infectious diseases · 2025Article
- Allele-linked divergence in SlpA and TcdB drives distinct immune and cytotoxic responses that distinguish ST01 from non-ST01 strains in Clade 2 Clostridioides difficile.Access microbiology · 2025Article
- Review
- Mortality in clostridioides difficile infection among patients hospitalized at the university clinical hospital in Wroclaw, Poland - a 3-year observational study.BMC infectious diseases · 2024Observational
- "Antibiotics (Basel, Switzerland) · 2024Article
- Article
- Virulence and genomic diversity among clinical isolates of ST1 (BI/NAP1/027) Clostridioides difficile.Cell reports · 2023Article
- Insights into the Evolving Epidemiology ofAntibiotics (Basel, Switzerland) · 2023Review
- Virulence and genomic diversity among clinical isolates of ST1 (BI/NAP1/027)bioRxiv : the preprint server for biology · 2023Article
- Diversity of binary toxin positive Clostridioides difficile in Korea.Scientific reports · 2023Article
- Higher In Vivo Fecal Concentrations of Clostridioides difficile Toxins A and B in Patients With North American Pulsed-Field Gel Electrophoresis Type 1/Ribotype 027 Strain Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Treatment and Outcomes ofJournal of clinical medicine · 2022Article
21 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors at 12 institutions in 1 country.
Funding
Abstract
backgroundStudies are conflicting regarding the importance of the fluoroquinolone-resistant North American pulsed-field gel electrophoresis type 1 (NAP1) strain in Clostridium difficile infection (CDI) outcome. We describe strain types causing CDI and evaluate their association with patient outcomes.
methodsCDI cases were identified from population-based surveillance. Multivariate regression models were used to evaluate the associations of strain type with severe disease (ileus, toxic megacolon, or pseudomembranous colitis within 5 days; or white blood cell count ≥15 000 cells/µL within 1 day of positive test), severe outcome (intensive care unit admission after positive test, colectomy for C. difficile infection, or death within 30 days of positive test), and death within 14 days of positive test.
resultsStrain typing results were available for 2057 cases. Severe disease occurred in 363 (17.7%) cases, severe outcome in 100 (4.9%), and death within 14 days in 56 (2.7%). The most common strain types were NAP1 (28.4%), NAP4 (10.2%), and NAP11 (9.1%). In unadjusted analysis, NAP1 was associated with greater odds of severe disease than other strains. After controlling for patient risk factors, healthcare exposure, and antibiotic use, NAP1 was associated with severe disease (adjusted odds ratio [AOR], 1.74; 95% confidence interval [CI], 1.36-2.22), severe outcome (AOR, 1.66; 95% CI, 1.09-2.54), and death within 14 days (AOR, 2.12; 95% CI, 1.22-3.68).
conclusionsNAP1 was the most prevalent strain and a predictor of severe disease, severe outcome, and death. Strategies to reduce NAP1 prevalence, such as antibiotic stewardship to reduce fluoroquinolone use, might reduce CDI morbidity.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.