ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Stool Interleukin-1β Differentiates Clostridioides difficile Infection (CDI) From Asymptomatic Carriage and Non-CDI Diarrhea.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Clinical significance of toxin EIA positivity in patients with suspectedJournal of clinical microbiology · 2025Pooled it
- Phase variable colony morphotypes ofInfection and immunity · 2026Article
- Current status and future perspectives of fecal immunological markers in the differential diagnosis of Clostridioides difficile infection in children.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- Addressing Unmet Needs inCurrent medicinal chemistry · 2026Review
- Network pharmacology and experimental validation of Compound Kushen Powder for the treatment of diarrhea in vivo.Veterinary and animal science · 2025Article
- Best Practices in the Management ofTropical medicine and infectious disease · 2024Review
- Review
- Diagnostic Guidance for C. difficile Infections.Advances in experimental medicine and biology · 2024Article
- Clostridioides difficile Infection in Children: Recent Updates on Epidemiology, Diagnosis, Therapy.Pediatrics · 2023Review
- Reply to Ito.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Preservation of the Innate Immune Response toOpen forum infectious diseases · 2023Article
- Virulence and genomic diversity among clinical isolates of ST1 (BI/NAP1/027)bioRxiv : the preprint server for biology · 2023Article
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15 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundDespite advances in the understanding and diagnosis of Clostridioides difficile infection (CDI), clinical distinction within the colonization-infection continuum remains an unmet need.
methodsBy measuring stool cytokines and antitoxin antibodies in well-characterized cohorts of CDI (diarrhea, nucleic acid amplification test [NAAT] positive), non-CDI diarrhea (NCD; diarrhea, NAAT negative), asymptomatic carriers (ASC; no diarrhea, NAAT positive) and hospital controls (CON; no diarrhea, NAAT negative), we aim to discover novel biological markers to distinguish between these cohorts. We also explore the relationship of these stool cytokines and antitoxin antibody with stool toxin concentrations and disease severity.
resultsStool interleukin (IL) 1β, stool immunoglobulin A (IgA), and immunoglobulin G (IgG) anti-toxin A had higher (P < .0001) concentrations in CDI (n = 120) vs ASC (n = 43), whereas toxins A, B, and fecal calprotectin did not. Areas under the receiver operating characteristic curve (ROC-AUCs) for IL-1β, IgA, and IgG anti-toxin A were 0.88, 0.83, and 0.83, respectively. A multipredictor model including IL-1β and IgA anti-toxin A achieved an ROC-AUC of 0.93. Stool IL-1β concentrations were higher in CDI compared to NCD (n = 75) (P < .0001) and NCD + ASC+ CON (CON, n = 75) (P < .0001), with ROC-AUCs of 0.83 and 0.86, respectively. Stool IL-1β had positive correlations with toxins A (ρA = +0.55) and B (ρB = +0.49) in CDI (P < .0001) but not in ASC (P > .05).
conclusionsStool concentrations of the inflammasome pathway, proinflammatory cytokine IL-1β, can accurately differentiate CDI from asymptomatic carriage and NCD, making it a promising biomarker for CDI diagnosis. Significant positive correlations exist between stool toxins and stool IL-1β in CDI but not in asymptomatic carriers.
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