ArticleDigestive diseases and sciences2020
Clinical Predictors of Recurrence After Primary Clostridioides difficile Infection: A Prospective Cohort Study.
Article in Digestive diseases and sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 41 citations in OpenAlex.
- Mechanisms by which proline reductase ofmBio · 2026Article
- Epidemiology ofAntibiotics (Basel, Switzerland) · 2026Article
- Predictive Modeling for Clostridioides difficile Infection: Current State of the Science, Clinical Applications, and Future Directions.Infectious disease clinics of North America · 2025Review
- Dietary Prebiotics Modulate Omeprazole-Induced Alterations in the Gut Microbial Signature.Molecular nutrition & food research · 2025Article
- Review
- The role of Frailty Index Laboratory in predicting clinical outcomes in patients withJAC-antimicrobial resistance · 2025Article
- Integrated Safety and Efficacy Analyses of Phase 3 Trials of a Microbiome Therapeutic for Recurrent CDI.Infectious diseases and therapy · 2024Article
- Review
- Approaching pathogenicbioRxiv : the preprint server for biology · 2024Article
- The Effect of Subinhibitory Concentration of Metronidazole on the Growth and Biofilm Formation on ToxigenicPathogens (Basel, Switzerland) · 2023Article
- Butyrate enhancesJournal of bacteriology · 2023Article
- Patient Experiences with Clostridioides difficile Infection and Its Treatment: A Systematic Literature Review.Infectious diseases and therapy · 2023Review
- Platelets promote human macrophages-mediated macropinocytosis ofFrontiers in cellular and infection microbiology · 2023Article
- A systematic review of real-world healthcare resource use and costs ofAntimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Gut metabolites predict Clostridioides difficile recurrence.Microbiome · 2022Article
- In vivo commensal control of Clostridioides difficile virulence.Cell host & microbe · 2021Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRecurrent Clostridioides difficile infection (CDI) is a major public health threat. While clinical prediction tools exist, they do not incorporate the newest Infectious Diseases Society of America guidelines.
methodsThis was a prospective longitudinal study of patients experiencing their first episode of uncomplicated CDI. Patients were followed from diagnosis through 8 weeks post-completion of their anti-CDI therapy to assess recurrence. Stool was collected at diagnosis and weekly for 8 weeks following treatment. Recurrence was defined as diarrhea as well as a positive stool test by toxin EIA (EIA) for C. difficile. Fisher's exact test for binary variables and Student's t test for continuous variables were performed. Cox regression was performed to assess for predictors of CDI recurrence.
resultsSeventy-five patients were enrolled between August 1, 2015, and September 1, 2018. Mean age 58.1 years ± 15.5, 69.3% female, 74.7% were white, 11.3% had baseline irritable bowel syndrome, and 54.7% were actively using PPIs. Over the 8-week follow-up period, 22 patients developed a confirmed CDI recurrence. Univariate predictors of recurrence included treatment with metronidazole (40.9% vs 15.1%, p = 0.03), initially diagnosis by EIA (77.3% vs 43.4%, p = 0.007) and platelet count (206 ± 72.1 vs 270.9 ± 114.8, p = 0.03). A Cox regression model revealed primary diagnosis by EIA (HR 3.39, 95% CI 1.23, 9.31, p = 0.018) and treatment with metronidazole (HR 3.27 95% CI 1.31-8.19, p = 0.01) remain predictors for CDI recurrence.
conclusionIn a large prospective longitudinal cohort of uncomplicated CDI patients, treatment with metronidazole and diagnosis via EIA were the most robust predictors of CDI recurrence.
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