Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 215, Issue 7, Pages 1117-1123Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jix011
Keywords
Clostridium difficile; microbiome; Bacteroidetes; Lachnospiraceae; Ruminococcaceae
Categories
Funding
- National Institutes of Health [K23 AI095398-01, R01 AI42135, U01 AI124275-01, P30 CA008748]
- Lucille Castori Center for Microbes, Inflammation, and Cancer
- Tow Foundation
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Background. Clostridium difficile infection (CDI) is a frequent complication in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT), who receive intensive treatments that significantly disrupt the intestinal microbiota. In this study, we examined the microbiota composition of allo-HSCT recipients to identify bacterial colonizers that confer protection against CDI after engraftment. Methods. Feces collected from adult recipients allo-HSCT at engraftment were analyzed; 16S ribosomal RNA genes were sequenced and analyzed from each sample. Bacterial taxa with protective effects against development of CDI were identified by means of linear discriminant analysis effect size analysis and then further assessed with clinical predictors of CDI using survival analysis. Results. A total of 234 allo-HSCT recipients were studied; postengraftment CDI developed in 53 (22.6%). Within the composition of the microbiota, the presence of 3 distinct bacterial taxa was correlated with protection against CDI: Bacteroidetes, Lachnospiraceae, and Ruminococcaceae. Colonization with these groups at engraftment was associated with a 60% lower risk of CDI, independent of clinical factors. Conclusions. Colonization with these 3 bacterial groups is associated with a lower risk of CDI. These groups have been shown to be vital components of the intestinal microbiota. Targeted efforts to maintain them may help minimize the risk of CDI in this at-risk population.
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