Dynamics of the fecal microbiome in patients with recurrent and nonrecurrent Clostridium difficile infectionReport as inadecuate

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Genome Medicine

, 8:47

Translating the microbiome: health and disease


BackgroundRecurrent Clostridium difficile infection CDI remains problematic, with up to 30 % of individuals diagnosed with primary CDI experiencing at least one episode of recurrence. The success of microbial-based therapeutics, such as fecal microbiota transplantation, for the treatment of recurrent CDI underscores the importance of restoring the microbiota. However, few studies have looked at the microbial factors that contribute to the development of recurrent disease. Here we compare microbial changes over time in patients with or without recurrence to identify microbial signatures associated with the development of recurrence.

MethodsWe used 16S rRNA-encoding gene sequence analysis to compare the fecal microbiota of 93 patients with recurrent and nonrecurrent CDI, sampled longitudinally. Cross-group and intra-individual differences in microbial community diversity and similarity were compared prior to the development of recurrent disease and over time.

ResultsSamples from these patient groups exhibited variable community profiles, clustering into four distinct community groups. Cross-group comparison of the index sample collected from patients that did or did not develop recurrence revealed differences in diversity and community structure analysis of molecular variance, p < 0.05. Intra-individual comparisons of the microbiota were more informative and samples from recurrent patients were less likely to recover in diversity Chi-square test, p < 0.005, exhibiting less community similarity overall Kruskal–Wallis test, p < 0.05. Interestingly, patients with severe disease harbored a significantly less diverse community, a trend that was observed across both nonrecurrent and recurrent patient groups Wilcoxon test, p < 0.05.

ConclusionsTo date, this study represents one of the largest studies focused on the relationship between predictive signals from the gut microbiota and the development of recurrent CDI. Our data demonstrate that specific microbiota-derived characteristics associate with disease severity and recurrence and that future studies could incorporate these characteristics into predictive models.

AbbreviationsθYCYue and Clayton distance

λinverse Simpson index

AMOVAanalysis of molecular variance

CDIClostridium difficile infection

ERINEnterics Research Investigational Network

FMTfecal microbiota transplantation

GDHglutamate dehydrogenase

GEEgeneralized estimating equation

IDSAInfectious Diseases Society of America

LDAlinear discriminant analysis

LEfSelinear discriminant analysis effect size

OTUoperational taxonomic unit

PAMPartitioning Around Medoids

PCoAPrincipal coordinates analysis

PCRpolymerase chain reaction

TCCFAtaurocholate cycloserine cefoxitin fructose agar

Electronic supplementary materialThe online version of this article doi:10.1186-s13073-016-0298-8 contains supplementary material, which is available to authorized users.

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Author: Anna Maria Seekatz - Krishna Rao - Kavitha Santhosh - Vincent Bensan Young

Source: https://link.springer.com/

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