ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015
Clostridium difficile ribotype 027: relationship to age, detectability of toxins A or B in stool with rapid testing, severe infection, and mortality.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
72 citing papers in PubMed, 1 synthesis or guideline pooled it, 130 citations in OpenAlex.
- Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes.Frontiers in medicine · 2021Pooled it
- 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
- Antibiotic resistance patterns, toxin profiles, and toxin gene expression levels among Clostridioides difficile PCR ribotypes isolated from patients scheduled for colonoscopy.Molecular biology reports · 2025Article
- Use of PCR cycle threshold values for toxins A and B quantification in Clostridioides difficile infections.Scientific reports · 2025Article
- Washed microbiota transplantation for ribotype 027Journal of biomedical research · 2025Article
- Clostridioides difficile infections caused by hypervirulent strains: a single-centre real-life study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- PREVENTION OF HEALTH CARE-ASSOCIATED INFECTIONS IN U.S. HEALTH SYSTEMS: HARNESSING THE GUT MICROBIOME TO COMBAT INFECTION.Transactions of the American Clinical and Climatological Association · 2025Review
- Use of PCR Cycle Threshold and Clinical Interventions to Aid in the Management of PediatricMicroorganisms · 2024Article
- Comparison of fidaxomicin, metronidazole and vancomycin for initial episode and recurrence ofHeliyon · 2024Article
- "Antibiotics (Basel, Switzerland) · 2024Article
- The Strain and the Clinical Outcome ofOpen forum infectious diseases · 2024Article
- Advances in Therapeutic Strategies for the Management ofJournal of clinical medicine · 2024Review
- 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
- Novel Biomarkers, IncludingInfection and immunity · 2023Article
- A Predictive Model to Identify ComplicatedOpen forum infectious diseases · 2023Article
- Virulence and genomic diversity among clinical isolates of ST1 (BI/NAP1/027)bioRxiv : the preprint server for biology · 2023Article
- Prevalence of diagnostically-discrepantFrontiers in medicine · 2023Article
- Low-toxinEmerging microbes & infections · 2022Article
- Proton Pump Inhibitor-Induced Gut Dysbiosis Increases Mortality Rates for Patients with Clostridioides difficile Infection.Microbiology spectrum · 2022Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
13 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundClostridium difficile infection (CDI) can cause severe disease and death, especially in older adults. A better understanding of risk factors for adverse outcomes is needed. This study tests the hypotheses that infection with specific ribotypes and presence of stool toxins independently associate with severity and constructs predictive models of adverse outcomes.
methodsCases of non-recurrent CDI were prospectively included after positive stool tests for toxins A and/or B by enzyme immunoassay (EIA) or tcdB by polymerase chain reaction. Outcomes included severe CDI (intensive care unit admission, colectomy, or death attributable to CDI within 30 days of diagnosis) and 30-day all-cause mortality. Adjusted models were developed to test hypotheses and predict outcomes.
resultsIn total, 1144 cases were included. The toxin EIA was positive in 37.2% and 35.6% of patients were of age >65 years. One of the 137 unique ribotypes was ribotype 027 (16.2%). Detectable stool toxin did not associate with outcomes. Adjusting for covariates, including age, Ribotype 027 was a significant predictor of severe CDI (90 cases; odds ratio [OR], 1.73; 95% confidence interval [CI], 1.03-2.89; P = .037) and mortality (89 cases; OR, 2.02; 95% CI, 1.19-3.43; P = .009). Concurrent antibiotic use associated with both outcomes. Both multivariable predictive models had excellent performance (area under the curve >0.8).
conclusionsDetection of stool toxin A and/or B by EIA does not predict severe CDI or mortality. Infection with ribotype 027 independently predicts severe CDI and mortality. Use of concurrent antibiotics is a potentially modifiable risk factor for severe CDI.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.