Dataset Information

Persistent Systemic Microbial Translocation, Inflammation, and Intestinal Damage During Clostridioides difficile Infection.

ABSTRACT:

Background

Clostridioides difficile infection (CDI) might be complicated by the development of nosocomial bloodstream infection (n-BSI). Based on the hypothesis that alteration of the normal gut integrity is present during CDI, we evaluated markers of microbial translocation, inflammation, and intestinal damage in patients with CDI.

Methods

Patients with documented CDI were enrolled in the study. For each subject, plasma samples were collected at T0 and T1 (before and after CDI therapy, respectively), and the following markers were evaluated: lipopolysaccharide-binding protein (LPB), EndoCab IgM, interleukin-6, intestinal fatty acid binding protein (I-FABP). Samples from nonhospitalized healthy controls were also included. The study population was divided into BSI+/BSI- and fecal microbiota transplantation (FMT) +/FMT- groups, according to the development of n-BSI and the receipt of FMT, respectively.

Results

Overall, 45 subjects were included; 8 (17.7%) developed primary n-BSI. Markers of microbial translocation and intestinal damage significantly decreased between T0 and T1, however, without reaching values similar to controls (P < .0001). Compared with BSI-, a persistent high level of microbial translocation in the BSI+ group was observed. In the FMT+ group, markers of microbial translocation and inflammation at T1 tended to reach control values.

Conclusions

CDI is associated with high levels of microbial translocation, inflammation, and intestinal damage, which are still present at clinical resolution of CDI. The role of residual mucosal perturbation and persistence of intestinal cell damage in the development of n-BSI following CDI, as well as the possible effect of FMT in the restoration of mucosal integrity, should be further investigated.

SUBMITTER: Oliva A

PROVIDER: S-EPMC6954488 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

Persistent Systemic Microbial Translocation, Inflammation, and Intestinal Damage During <i>Clostridioides difficile</i> Infection.

Oliva Alessandra A Aversano Lucia L De Angelis Massimiliano M Mascellino Maria Teresa MT Miele Maria Claudia MC Morelli Sergio S Battaglia Riccardo R Iera Jessica J Bruno Giovanni G Corazziari Enrico Stefano ES Ciardi Maria Rosa MR Venditti Mario M Mastroianni Claudio Maria CM Vullo Vincenzo V

Open forum infectious diseases 20191203 1

<h4>Background</h4><i>Clostridioides difficile</i> infection (CDI) might be complicated by the development of nosocomial bloodstream infection (n-BSI). Based on the hypothesis that alteration of the normal gut integrity is present during CDI, we evaluated markers of microbial translocation, inflammation, and intestinal damage in patients with CDI.<h4>Methods</h4>Patients with documented CDI were enrolled in the study. For each subject, plasma samples were collected at T0 and T1 (before and after ...[more]

PMID: 31950071

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