ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Ultrasensitive and Quantitative Toxin Measurement Correlates With Baseline Severity, Severe Outcomes, and Recurrence Among Hospitalized Patients With Clostridioides difficile Infection.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- The Patients' Voice inOpen forum infectious diseases · 2026Article
- The Patients' Voice inmedRxiv : the preprint server for health sciences · 2026Article
- Establishment and Comparison of High-Throughput Immunoassays for Quantifying Clostridioides difficile Infection Biomarkers.Biotechnology journal · 2026Article
- Modeling Clostridioides difficile toxin pathogenesis and antiserum protection in an immunocompetent intestine-on-chip platform.Scientific reports · 2026Article
- Development of Peptide Glucosyltransferase Inhibitors With Comprehensive Coverage Across Clostridioides difficile Toxin B Sub-Types.Biotechnology and bioengineering · 2026Article
- Emerging Diagnostics inInternational journal of molecular sciences · 2024Review
- Diagnostic Guidance for C. difficile Infections.Advances in experimental medicine and biology · 2024Article
- Novel insights into phage biology of the pathogenFrontiers in microbiology · 2024Article
- Baseline stool toxin concentration is associated with risk of recurrence in children withInfection control and hospital epidemiology · 2023Article
- Virulence and genomic diversity among clinical isolates of ST1 (BI/NAP1/027) Clostridioides difficile.Cell reports · 2023Article
- Microbiome-Related and Infection Control Approaches to Primary and Secondary Prevention ofMicroorganisms · 2023Review
- Preservation of the Innate Immune Response toOpen forum infectious diseases · 2023Article
- Stool Interleukin-1β Differentiates Clostridioides difficile Infection (CDI) From Asymptomatic Carriage and Non-CDI Diarrhea.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Virulence and genomic diversity among clinical isolates of ST1 (BI/NAP1/027)bioRxiv : the preprint server for biology · 2023Article
- Stool Toxin Concentration Does Not Distinguish Clostridioides difficile Infection from Colonization in Children Less Than 3 Years of Age.Journal of the Pediatric Infectious Diseases Society · 2022Article
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Abstract
backgroundStool toxin concentrations may impact Clostridioides difficile infection (CDI) severity and outcomes. We correlated fecal C difficile toxin concentrations, measured by an ultrasensitive and quantitative assay, with CDI baseline severity, attributable outcomes, and recurrence.
methodsWe enrolled 615 hospitalized adults (≥18 years) with CDI (acute diarrhea, positive stool nucleic acid amplification testing, and decision to treat). Baseline stool toxin A and B concentrations were measured by single molecule array. Subjects were classified by baseline CDI severity (4 scoring methods) and outcomes within 40 days (death, intensive care unit stay, colectomy, and recurrence).
resultsAmong 615 patients (median, 68.0 years), in all scoring systems, subjects with severe baseline disease had higher stool toxin A+B concentrations than those without (P < .01). Nineteen subjects (3.1%) had a severe outcome primarily attributed to CDI (group 1). This group had higher median toxin A+B (14 303 pg/mL [interquartile range, 416.0, 141 967]) than subjects in whom CDI only contributed to the outcome (group 2, 163.2 pg/mL [0.0, 8423.3]), subjects with severe outcome unrelated to CDI (group 3, 158.6 pg/mL [0.0, 1795.2]), or no severe outcome (group 4, 209.5 pg/mL [0.0, 8566.3]) (P = .003). Group 1 was more likely to have detectable toxin (94.7%) than groups 2-4 (60.5%-66.1%) (P = .02). Individuals with recurrence had higher toxin A+B (2266.8 pg/mL [188.8, 29411]) than those without (154.0 pg/mL [0.0, 5864.3]) (P < .001) and higher rates of detectable toxin (85.7% versus 64.0%, P = .004).
conclusionsIn CDI patients, ultrasensitive stool toxin detection and concentration correlated with severe baseline disease, severe CDI-attributable outcomes, and recurrence, confirming the contribution of toxin quantity to disease presentation and clinical course.
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