ArticlePloS one2015
Identification of toxemia in patients with Clostridium difficile infection.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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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
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Nonmammalian models to study Clostridioides difficile infection; a systematic review.Anaerobe · 2023Pooled it
- Predictors of RecurrentDiagnostics (Basel, Switzerland) · 2026Article
- Therapeutic activation of IL-22-producing innate lymphoid cells enhances host defenses to Clostridioides difficile infection.Cell reports · 2025Article
- Article
- Exploring the Toxin-Mediated Mechanisms inMicroorganisms · 2024Review
- Probiotics for Prevention and Treatment of Clostridium difficile Infection.Advances in experimental medicine and biology · 2024Article
- A fine-tuned yeast surface-display/secretion platform enables the rapid discovery of neutralizing antibodies against Clostridioides difficile toxins.Microbial cell factories · 2023Article
- Impact of enteric bacterial infections at and beyond the epithelial barrier.Nature reviews. Microbiology · 2023Review
- The Current Knowledge onPathogens (Basel, Switzerland) · 2022Review
- Establishment of a gnotobiotic pig model of Clostridioides difficile infection and disease.Gut pathogens · 2022Article
- Absence of Toxemia in Clostridioides difficile Infection: Results from Ultrasensitive Toxin Assay of Serum.Digestive diseases and sciences · 2021Article
- High Serum Levels of Toxin A Correlate with Disease Severity in Patients withAntibiotics (Basel, Switzerland) · 2021Article
- Proinflammatory Cytokines: Possible Accomplices for the Systemic Effects ofJournal of inflammation research · 2021Article
- Article
- Extra-Intestinal Effects ofCells · 2020Article
- Human C. difficile toxin-specific memory B cell repertoires encode poorly neutralizing antibodies.JCI insight · 2020Article
- Enterotoxic Clostridia:Microbiology spectrum · 2019Review
- Whole-Cell Multiparameter Assay for Ricin and Abrin Activity-Based Digital Holographic Microscopy.Toxins · 2019Article
- Clostridium difficile toxins induce VEGF-A and vascular permeability to promote disease pathogenesis.Nature microbiology · 2019Article
- Investigation of the Effects of Antibiotic Application on the Intestinal Flora in Elderly Hypertension Patients with Infectious Diseases.Iranian journal of public health · 2018Article
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
Toxemia can develop in Clostridium difficile-infected animals, and correlates with severe and fulminant disease outcomes. Circumstantial evidence suggests that toxemia may occur in patients with C. difficile infection (CDI), but positive diagnosis is extremely rare. We analyzed the potential for C. difficile toxemia in patients, determined its characteristics, and assessed challenges. C. difficile toxins in serum from patients were tested using an ultrasensitive cell-based assay and further confirmed by Rac1 glucosylation assay. The factors that hinder a diagnosis of toxemia were assessed, including investigation of toxin stability, the level of toxins-specific neutralizing antibodies in sera and its effect on diagnosis limits. CDI patients develop detectable toxemia in some cases (2.3%). Toxins were relatively stable in stored sera. Neutralizing anti-toxin antibodies were present during infection and positively correlated with the diagnosis limits. Thus, the masking effect of toxin-specific neutralizing antibodies is the major obstacle in diagnosing C. difficile toxemia using cell-based bioassays.
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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.