Evidence map›Paper›PMID 27158839›Full record

ReviewNature reviews. Disease primers2016

Clostridium difficile infection.

Wiep Klaas Smits, Dena Lyras, D Borden Lacy, Mark H Wilcox, Ed J Kuijper

Open access · greenAbstract readReview
In one paragraph

Review in Nature reviews. Disease primers, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 535 papers.

0numbers the graph read from it
0cells of the map it votes in
535citing papers in PubMed
41.7field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

535 citing papers in PubMed, 850 citations in OpenAlex.

  1. Trial
  2. Trial
  3. BeyondEmerging microbes & infections · 2026
    Article
  4. Genomic and phenotypic insight intoEmerging microbes & infections · 2026
    Article
  5. Article
  6. Outcomes of Clostridium difficile infection in liver transplant patients: A systematic review and meta-analysis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Review
  7. Review
  8. Review
  9. Laboratory-DetectedHealth science reports · 2026
    Article
  10. Article
  11. Influence of COVID-19 on Clinical Outcomes ofAntibiotics (Basel, Switzerland) · 2026
    Article
  12. Review
  13. Burden of Clostridioides difficile infection in China, 1990-2021: an analysis based on the global burden of disease study 2021.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  14. Review
  15. Phase variable colony morphotypes ofInfection and immunity · 2026
    Article
  16. Biomarkers for Early Severity Prediction inMedicina (Kaunas, Lithuania) · 2026
    Review
  17. Article
  18. Article
  19. Monoclonal Antibodies Targeting Bacterial Infections: A Broad Review of the Field.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2026
    Review
  20. Review

475 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 4 countries.

Wiep Klaas SmitsSection Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Dena LyrasInfection and Immunity Program, Monash Biomedicine Discovery Institute, and Department of Microbiology, Monash University, Victoria, Australia.
D Borden LacyDepartment of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, and The Veterans Affairs Tennessee Valley Healthcare System, Nashville Tennessee, USA.
Mark H WilcoxInstitute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK.
Ed J KuijperSection Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Leiden University Medical Center · NLMonash University · AUUniversity of Leeds · GBVanderbilt University Medical Center · US

Funding

Structural mechanisms of Clostridium difficile pathogenesisR01AI095755 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI LACY, DANA BORDEN · 2011 to 2020
$3.9M
Structural Mechanisms of Clostridioides difficile pathogenesisR37AI095755 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Dana Borden Lacy · 2021 to 2026
$3.2M
The role of toxins in Clostridium difficile infection pathogenesisI01BX002943 · VA · VETERANS HEALTH ADMINISTRATION · PI LACY, DANA BORDEN · 2016 to 2025
–
BLRD VA I01 BX002943NIAID NIH HHS R01 AI095755NIAID NIH HHS R37 AI095755
6 · The paper itself

Abstract

Infection of the colon with the Gram-positive bacterium Clostridium difficile is potentially life threatening, especially in elderly people and in patients who have dysbiosis of the gut microbiota following antimicrobial drug exposure. C. difficile is the leading cause of health-care-associated infective diarrhoea. The life cycle of C. difficile is influenced by antimicrobial agents, the host immune system, and the host microbiota and its associated metabolites. The primary mediators of inflammation in C. difficile infection (CDI) are large clostridial toxins, toxin A (TcdA) and toxin B (TcdB), and, in some bacterial strains, the binary toxin CDT. The toxins trigger a complex cascade of host cellular responses to cause diarrhoea, inflammation and tissue necrosis - the major symptoms of CDI. The factors responsible for the epidemic of some C. difficile strains are poorly understood. Recurrent infections are common and can be debilitating. Toxin detection for diagnosis is important for accurate epidemiological study, and for optimal management and prevention strategies. Infections are commonly treated with specific antimicrobial agents, but faecal microbiota transplants have shown promise for recurrent infections. Future biotherapies for C. difficile infections are likely to involve defined combinations of key gut microbiota.

Indexed as

AmpicillinAnti-Bacterial AgentsBacterial ToxinsClindamycinClostridioides difficileClostridium InfectionsDiarrheaEnterotoxinsGastrointestinal MicrobiomeHumansRisk FactorsSugar Alcohol DehydrogenasesAmpicillinAnti-Bacterial AgentsBacterial ToxinsClindamycinEnterotoxinsgalactitol 2-dehydrogenaseSugar Alcohol DehydrogenasestcdA protein, Clostridium difficile

Identifiers

PMID27158839
PMCPMC5453186
OpenAlexW2182683962

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.