Risk for <i>Clostridiodes difficile</i> Infection among Older Adults with Cancer

Kamboj, Mini; Gennarelli, Renee L.; Brite, Jennifer; Sepkowitz, Kent A.; Lipitz‐Snyderman, Allison

doi:10.3201/eid2509.181142

Cited by 5 publications

(8 citation statements)

References 22 publications

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“…Through our prospective genomics study of two hospital wards, we were able to identify the connections between contamination of different surfaces and the strains carried by hospitalized patients and quantify some spread between carriers. Our estimates of the prevalence of patients with CDI (3.8%) agree with other estimates of 2%–4% CDI in patients with cancer ( 58 – 60 ). While many studies have quantified surface contamination, few have had the genomic resolution to identify clonality between isolates indicating transmission or patient shedding ( 61 – 63 ).…”

Section: Discussionsupporting

confidence: 90%

Genomic surveillance of Clostridioides difficile transmission and virulence in a healthcare setting

Newcomer,

Fishbein,

Zhang

et al. 2024

mBio

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Clostridioides difficile infection remains a leading cause of hospital-associated diarrhea, despite increased antibiotic stewardship and transmission prevention strategies. This suggests a changing genomic landscape of C. difficile . Our study provides insight into the nature of prevalent C. difficile strains in a hospital setting and transmission patterns among carriers. Longitudinal sampling of surfaces and patient stool revealed that both toxigenic and nontoxigenic strains of C. difficile clade 1 dominate these two wards. Moreover, quantification of transmission in carriers of these clade 1 isolates underscores the need to revisit infection prevention measures in this patient group. We identified unique genetic signatures associated with virulence in this clade. Our data highlight the complexities of preventing transmission of this pathogen in a hospital setting and the need to investigate the mechanisms of in vivo persistence and virulence of prevalent lineages in the host gut microbiome.

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Section: Discussionsupporting

confidence: 90%

Genomic surveillance of Clostridioides difficile transmission and virulence in a healthcare setting

Newcomer,

Fishbein,

Zhang

et al. 2024

mBio

View full text Add to dashboard Cite

show abstract

“…Through our prospective genomics study of two hospital wards, we were able to identify connections between the contamination of different surfaces and the strains carried by hospitalized patients and quantify some spread between carriers. Our estimates of the prevalence of patients with CDI (3.8%) agree with other estimates of 2-4% CDI in patients with cancer 61–63 . While many studies have quantified surface contamination, few have had the genomic resolution to identify clonality between isolates indicating transmission or patient shedding 64–66 .…”

Section: Discussionsupporting

confidence: 90%

“…Through our prospective genomics study of two hospital wards, we were able to identify connections between contamination of different surfaces and the strains carried by hospitalized patients and quantify some spread between carriers. Our estimates of the prevalence of patients with CDI (3.8%) agree with other estimates of 2-4% CDI in patients with cancer [58][59][60] .…”

Section: Discussionsupporting

confidence: 89%

Genomic surveillance ofClostridioides difficiletransmission and virulence in a healthcare setting

Newcomer,

Fishbein,

Zhang

et al. 2023

Preprint

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Clostridioides difficileinfection (CDI) is a major cause of healthcare-associated diarrhea, despite the widespread implementation of contact precautions for patients with CDI. Here, we investigate strain contamination in a hospital setting and genomic determinants of disease outcomes. Across two wards over six months, we selectively culturedC. difficilefrom patients (n=384) and their environments. Whole-genome sequencing (WGS) of 146 isolates revealed that mostC. difficileisolates were from clade 1 (131/146, 89.7%), while only one isolate of the hypervirulent ST1 was recovered. Of culture-positive admissions, 17% of patients were diagnosed with CDI upon admission. We defined 29 strain networks at ≤ 2 core gene SNPs; 2 of these networks contain strains from different patients. Strain networks were temporally linked (p<0.0001). Across networks and over time, we found a minority of networks contained differences in phage populations. To understand genomic correlates of disease, we conducted WGS on an additional cohort ofC. difficile(n=102 isolates) from the same hospital and confirmed that clade 1 isolates are responsible for most CDI cases. We found that while toxigenicC. difficileisolates are associated with the presence ofcdtR, nontoxigenic isolates have an increased abundance of prophages. Our pangenomic analysis of clade 1 isolates suggests that while toxin genes (tcdABER and cdtR) were associated with CDI symptoms, they are dispensable for patient colonization. These data indicate toxigenic and nontoxigenicC. difficilecontamination persists in a hospital setting and highlight further investigation into how accessory genomic repertoires contribute toC. difficilecolonization and disease.

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“… 14 Another study by the Memorial Sloan Kettering Cancer Center in New York revealed that patients with comorbidities, such as hematologic malignancies are at a higher risk of developing CDI. 15 This finding is evident in our study, in which more than 63% of the diagnosed patients were immunocompromised. An Oxford University study suggests that immunocompromised patients experience a high incidence of CDI, ranging from 6% to 33% distributed over cancers, HIV patients and solid organ transplant recipients.…”

Section: Discussionsupporting

confidence: 58%

Characteristics, Risk Factors, and Prevalence of Clostridioides difficile Among Hospitalized Patients in a Tertiary Care Hospital in Palestine

Abukhalil

AbuKhdeir

Hamed

et al. 2021

IDR

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Risk for Clostridiodes difficile Infection among Older Adults with Cancer

Abstract: Incidence was higher for patients with cancer, independent of prior healthcare-associated exposure.

Cited by 5 publications

References 22 publications

Genomic surveillance of Clostridioides difficile transmission and virulence in a healthcare setting

Genomic surveillance of Clostridioides difficile transmission and virulence in a healthcare setting

Genomic surveillance ofClostridioides difficiletransmission and virulence in a healthcare setting

Characteristics, Risk Factors, and Prevalence of Clostridioides difficile Among Hospitalized Patients in a Tertiary Care Hospital in Palestine

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