Antibodies to Toxin B Are Protective Against Clostridium difficile Infection Recurrence
Antibodies to Toxin B Are Protective Against Clostridium difficile Infection Recurrence
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DOI：
10.1093/cid/ciw364
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发表时间：
2016-09-15
影响因子：
11.8
通讯作者：
Mast, T. Christopher
中科院分区：
文献类型：
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作者：
Gupta, Swati B.;Mehta, Vinay;Mast, T. Christopher
背景虽然新的研究已经评估了复发性艰难梭菌感染（CDI）的风险因素，但绝大多数研究没有测量重要的生物标志物，如内源性抗毒素A和抗毒素B抗体水平。数据来自一项测试抗C.分析用于预防CDI复发（rCDI）的艰难梭菌毒素A和B以评估与rCDI相关的风险因素。招募了服用艾曲硝唑或万古霉素的症状性CDI患者。主要结局是治疗开始后84天内的rCDI。采用单变量和多变量logistic回归分析潜在危险因素与rCDI之间的相关性。在基线时，记录人口统计学和临床特征;使用2种酶联免疫吸附试验评估内源性抗体水平。复发的预测因子是年龄≥ 65岁，并且抗体介导的对毒素B的免疫应答似乎对rCDI具有保护作用。我们的研究结果证明了临床和免疫学风险因素在rCDI中的重要性，并为毒素B抗体在预防rCDI中的保护作用提供了更有力的证据。
Background. Although newer studies have evaluated risk factors for recurrent Clostridium difficile infection (CDI), the vast majority did not measure important biomarkers such as endogenous anti-toxin A and anti-toxin B antibody levels.Methods. Data from the placebo group of a phase 2 trial testing monoclonal antibodies to C. difficile toxins A and B for preventing CDI recurrence (rCDI) were analyzed to assess risk factors associated with rCDI. Patients with symptomatic CDI taking etronidazole or vancomycin were enrolled. The primary outcome was rCDI within 84 days of treatment start. Univariate and multivariate logistic regression was used to examine associations between potential risk factors and rCDI. At baseline, demographic and clinical characteristics were recorded; endogenous antibody levels were assessed using 2 enzyme-linked immunosorbent assays.Results. A predictor of recurrence was age >= 65 years, and an antibody-mediated immune response to toxin B appears to be protective against rCDI.Conclusions. Our findings demonstrate the importance of clinical as well as immunological risk factors in rCDI and provide more robust evidence for the protective effects of antibody to toxin B in the prevention of rCDI.