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dc.contributor.authorHaran, John P
dc.contributor.authorWard, Doyle V.
dc.contributor.authorBhattarai, Shakti K.
dc.contributor.authorLoew, Ethan
dc.contributor.authorDutta, Protiva
dc.contributor.authorHiggins, Amanda
dc.contributor.authorMcCormick, Beth A.
dc.contributor.authorBucci, Vanni
dc.date2022-08-11T08:08:26.000
dc.date.accessioned2022-08-23T15:55:24Z
dc.date.available2022-08-23T15:55:24Z
dc.date.issued2021-03-25
dc.date.submitted2021-04-23
dc.identifier.citation<p>Haran JP, Ward DV, Bhattarai SK, Loew E, Dutta P, Higgins A, McCormick BA, Bucci V. The high prevalence of <em>Clostridioides difficile</em> among nursing home elders associates with a dysbiotic microbiome. Gut Microbes. 2021 Jan-Dec;13(1):1-15. doi: 10.1080/19490976.2021.1897209. PMID: 33764826; PMCID: PMC8007149. <a href="https://doi.org/10.1080/19490976.2021.1897209">Link to article on publisher's site</a></p>
dc.identifier.issn1949-0976 (Linking)
dc.identifier.doi10.1080/19490976.2021.1897209
dc.identifier.pmid33764826
dc.identifier.urihttp://hdl.handle.net/20.500.14038/29746
dc.description.abstractClostridioides difficile disproportionally affects the elderly living in nursing homes (NHs). Our objective was to explore the prevalence of C. difficile in NH elders, over time and to determine whether the microbiome or other clinical factors are associated with C. difficile colonization. We collected serial stool samples from NH residents. C. difficile prevalence was determined by quantitative polymerase-chain reaction detection of Toxin genes tcdA and tcdB; microbiome composition was determined by shotgun metagenomic sequencing. We used mixed-effect random forest modeling machine to determine bacterial taxa whose abundance is associated with C. difficile prevalence while controlling for clinical covariates including demographics, medications, and past medical history. We enrolled 167 NH elders who contributed 506 stool samples. Of the 123 elders providing multiple samples, 30 (24.4%) elders yielded multiple samples in which C. difficile was detected and 78 (46.7%) had at least one C. difficile positive sample. Elders with C. difficile positive samples were characterized by increased abundances of pathogenic or inflammatory-associated bacterial taxa and by lower abundances of taxa with anti-inflammatory or symbiotic properties. Proton pump inhibitor (PPI) use is associated with lower prevalence of C. difficile (Odds Ratio 0.46; 95%CI, 0.22-0.99) and the abundance of bacterial species with known beneficial effects was higher in PPI users and markedly lower in elders with high C. difficile prevalence.C. difficile is prevalent among NH elders and a dysbiotic gut microbiome associates with C. difficile colonization status. Manipulating the gut microbiome may prove to be a key strategy in the reduction of C. difficile in the NH.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=33764826&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rightsCopyright © 2021 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectClostridioides difficile colonization
dc.subjectbile acids
dc.subjectdysbiosis
dc.subjectgut microbiome
dc.subjectnursing home elders
dc.subjectproton pump inhibitor
dc.subjectBacteria
dc.subjectBacterial Infections and Mycoses
dc.subjectDigestive System
dc.subjectGeriatrics
dc.subjectMicrobiology
dc.titleThe high prevalence of Clostridioides difficile among nursing home elders associates with a dysbiotic microbiome
dc.typeJournal Article
dc.source.journaltitleGut microbes
dc.source.volume13
dc.source.issue1
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=2978&amp;context=faculty_pubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/1959
dc.identifier.contextkey22628117
refterms.dateFOA2022-08-23T15:55:24Z
html.description.abstract<p>Clostridioides difficile disproportionally affects the elderly living in nursing homes (NHs). Our objective was to explore the prevalence of C. difficile in NH elders, over time and to determine whether the microbiome or other clinical factors are associated with C. difficile colonization. We collected serial stool samples from NH residents. C. difficile prevalence was determined by quantitative polymerase-chain reaction detection of Toxin genes tcdA and tcdB; microbiome composition was determined by shotgun metagenomic sequencing. We used mixed-effect random forest modeling machine to determine bacterial taxa whose abundance is associated with C. difficile prevalence while controlling for clinical covariates including demographics, medications, and past medical history. We enrolled 167 NH elders who contributed 506 stool samples. Of the 123 elders providing multiple samples, 30 (24.4%) elders yielded multiple samples in which C. difficile was detected and 78 (46.7%) had at least one C. difficile positive sample. Elders with C. difficile positive samples were characterized by increased abundances of pathogenic or inflammatory-associated bacterial taxa and by lower abundances of taxa with anti-inflammatory or symbiotic properties. Proton pump inhibitor (PPI) use is associated with lower prevalence of C. difficile (Odds Ratio 0.46; 95%CI, 0.22-0.99) and the abundance of bacterial species with known beneficial effects was higher in PPI users and markedly lower in elders with high C. difficile prevalence.C. difficile is prevalent among NH elders and a dysbiotic gut microbiome associates with C. difficile colonization status. Manipulating the gut microbiome may prove to be a key strategy in the reduction of C. difficile in the NH.</p>
dc.identifier.submissionpathfaculty_pubs/1959
dc.contributor.departmentGraduate School of Biomedical Sciences
dc.contributor.departmentProgram in Microbiome Dynamics
dc.contributor.departmentDepartment of Microbiology and Physiological Systems
dc.contributor.departmentDepartment of Emergency Medicine
dc.source.pages1-15


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Copyright © 2021 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as Copyright © 2021 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.