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    Antibodies to Toxin B Are Protective Against Clostridium difficile Infection Recurrence

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    Authors
    Gupta, Swati B.
    Mehta, Vinay
    Dubberke, Erik R.
    Zhao, Xuemei
    Dorr, Mary Beth
    Guris, Dalya
    Molrine, Deborah C.
    Leney, Mark
    Miller, Mark
    Dupin, Marilyne
    Mast, T. Christopher
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    UMass Chan Affiliations
    Department of Medicine
    MassBiologics
    Department of Pediatrics, Division of Immunology/Infectious Disease
    Document Type
    Journal Article
    Publication Date
    2016-09-15
    Keywords
    antibodies
    epidemiology
    risk factors
    serology
    toxin A
    Bacterial Infections and Mycoses
    Immunology and Infectious Disease
    Infectious Disease
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1093/cid/ciw364
    Abstract
    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 metronidazole 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. CLINICAL TRIALS REGISTRATION: NCT00350298.
    Source
    Clin Infect Dis. 2016 Sep 15;63(6):730-4. doi: 10.1093/cid/ciw364. Epub 2016 Jun 30. Link to article on publisher's site
    DOI
    10.1093/cid/ciw364
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/43782
    PubMed ID
    27365387
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1093/cid/ciw364
    Scopus Count
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