Evidence map›Paper›PMID 28116592›Full record

ArticleDigestive diseases and sciences2017

Clostridium difficile Infection and Patient-Specific Antimicrobial Resistance Testing Reveals a High Metronidazole Resistance Rate.

Jodie A Barkin, Daniel A Sussman, Nimita Fifadara, Jamie S Barkin

Abstract read
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In one paragraph

Article in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
3.7field-weighted citation impact, top 6% 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

11 citing papers in PubMed, 32 citations in OpenAlex.

  1. Wolf in Sheep's Clothing:Microorganisms · 2021
    Review
  2. Induction of a Specific Humoral Immune Response by Nasal Delivery of Bcla2International journal of molecular sciences · 2020
    Article
  3. Article
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  6. Distribution ofOpen access Macedonian journal of medical sciences · 2019
    Article
  7. The structure of the S-layer of Clostridium difficile.Journal of cell communication and signaling · 2018
    Review
  8. Article
  9. Article
  10. Article
  11. Review
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

4 authors at 1 institution in 1 country.

Jodie A BarkinDivision of Gastroenterology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Clinical Research Building, Suite 1116, Miami, FL, 33136, USA. jabarkin@med.miami.edu.
Daniel A SussmanDivision of Gastroenterology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Clinical Research Building, Suite 1116, Miami, FL, 33136, USA.
Nimita FifadaraDRG Laboratory, 2001 Westside Parkway, Suite 240, Alpharetta, GA, 30004, USA.
Jamie S BarkinDivision of Gastroenterology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Clinical Research Building, Suite 1116, Miami, FL, 33136, USA.
University of Miami · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClostridium difficile (CD) infection (CDI) causes marked morbidity and mortality, accounting for large healthcare expenditures annually. Current CDI treatment guidelines focus on clinical markers of patient severity to determine the preferred antibiotic regimen of metronidazole versus vancomycin. The antimicrobial resistance patterns for patients with CD are currently unknown.

aimThe aim of this study was to define the antimicrobial resistance patterns for CD.

methodsThis study included all patients with stools sent for CD testing to a private laboratory (DRG Laboratory, Alpharetta, Georgia) in a 6-month period from across the USA. Patient data was de-identified, with only age, gender, and zip-code available per laboratory protocol. All samples underwent PCR testing followed by hybridization for CD toxin regions A and B. Only patients with CD-positive PCR were analyzed. Antimicrobial resistance testing using stool genomic DNA evaluated presence of imidazole- and vancomycin-resistant genes using multiplex PCR gene detection.

resultsOf 2743, 288 (10.5%) stool samples were positive for CD. Six were excluded per protocol. Of 282, 193 (69.4%) were women, and average age was 49.4 ± 18.7 years. Of 282, 62 were PCR positive for toxins A and B, 160 for toxin A positive alone, and 60 for toxin B positive alone. Antimicrobial resistance testing revealed 134/282 (47.5%) patients resistant to imidazole, 17 (6.1%) resistant to vancomycin, and 9 (3.2%) resistant to imidazole and vancomycin.

conclusionsCD-positive patients with presence of imidazole-resistant genes from stool DNA extract was a common phenomenon, while vancomycin resistance was uncommon. Similar to treatment of other infections, antimicrobial resistance testing should play a role in CDI clinical decision-making algorithms to enable more expedited and cost-effective delivery of patient care.

Indexed as

AdolescentAdultAgedAged, 80 and overAnti-Infective AgentsChildChild, PreschoolClostridioides difficileClostridium InfectionsDrug Resistance, MicrobialFecesFemaleHumansInfantMaleMetronidazoleAnti-Infective AgentsMetronidazoleAntimicrobial resistanceClostridium difficileInfectionTreatment

Identifiers

PMID28116592
OpenAlexW2579890404

What OpenQuestion holds

Textmetadata
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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.