ArticleInfection control and hospital epidemiology2015
In the Endemic Setting, Clostridium difficile Ribotype 027 Is Virulent But Not Hypervirulent.
Article in Infection control and hospital epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers.
What it found
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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.
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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
24 citing papers in PubMed, 33 citations in OpenAlex.
- 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
- Bridging the gap in AMR research: validation of a standardizedFrontiers in pharmacology · 2026Article
- The Clinical Effectiveness of Fidaxomicin Compared to Vancomycin in the Treatment of Clostridioides difficile Infection, A Single-Center Real-World Experience.The Journal of infectious diseases · 2024Article
- Genomic surveillance ofmBio · 2024Article
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- A multisite genomic epidemiology study ofMicrobial genomics · 2021Article
- PCR ribotypes ofEmerging microbes & infections · 2020Article
- Eosinopenia and Binary Toxin Increase Mortality in Hospitalized Patients WithOpen forum infectious diseases · 2020Article
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- Clostridioides (Formerly Clostridium) difficile Infection During Hospitalization Increases the Likelihood of Nonhome Patient Discharge.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- To Lump or To Split: Does Strain Lineage for Clostridioides difficile Matter?Journal of clinical microbiology · 2019Article
- EpidemicOpen forum infectious diseases · 2019Article
- Proteotyping ofFrontiers in microbiology · 2019Article
- Outcomes associated with Clostridium difficile infection in patients with chronic liver disease.Epidemiology and infection · 2018Observational
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- Control ofMicrobiology spectrum · 2017Review
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- A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment.Journal of visualized experiments : JoVE · 2017Article
- Evolutionary clade affects resistance of Clostridium difficile spores to Cold Atmospheric Plasma.Scientific reports · 2017Article
Corrections and comments
- Erratum issuedIn the Endemic Setting, Clostridium difficile Ribotype 027 Is Virulent But Not Hypervirulent - ERRATUM.2016 · Khaleduzzuman, Mohammed [corrected to Khaleduzzaman, Mohammed]
Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundConflicting reports have been published on the association between Clostridium difficile ribotypes and severe disease outcomes in patients with C. difficile infection (CDI); several so-called hypervirulent ribotypes have been described. We performed a multicenter study to assess severe disease presentation and severe outcomes among CDI patients infected with different ribotypes.
methodsStool samples that tested positive for C. difficile toxin were collected and cultured from patients who presented to any of 7 different hospitals in Houston, Texas (2011-2013). C. difficile was characterized using a fluorescent PCR ribotyping method. Medical records were reviewed to determine clinical characteristics and ribotype association with severe CDI presentation (ie, leukocytosis and/or hypoalbuminemia) and severe CDI outcomes (ie, ICU admission, ileus, toxic megacolon, colectomy, and/or in-hospital death).
resultsOur study included 715 patients aged 61±18 years (female: 63%; median Charlson comorbidity index: 2.5±2.4; hospital-onset CDI: 45%; severe CDI: 36.7%; severe CDI outcomes: 12.3%). The most common ribotypes were 027, 014-020, FP311, 002, 078-126, and 001. Ribotype 027 was a significant independent predictor of severe disease (adjusted odds ratio [aOR], 2.24; 95% confidence interval [CI], 1.53-3.29; P<.001) and severe CDI outcomes (aOR, 1.71; 95% CI, 1.02-2.85; P=.041) compared with all other ribotypes in aggregate. However, in an analysis using all common ribotypes as individual variables, ribotype 027 was not associated with severe CDI outcomes more often than other ribotypes.
conclusionRibotype 027 showed virulence equal to that of other ribotypes identified in this endemic setting. Clinical severity markers of CDI may be more predictive of severe CDI outcomes than a particular ribotype.
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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.