Bezlotoxumab for prevention of Clostridium difficile infection recurrence: Distinguishing relapse from reinfection with whole genome sequencing.
Anaerobe
; 61: 102137, 2020 Feb.
Article
em En
| MEDLINE
| ID: mdl-31846705
ABSTRACT
BACKGROUND:
Bezlotoxumab has been shown to prevent Clostridium difficile infection recurrence (rCDI) in high-risk patients.METHODS:
We used whole genome sequencing to estimate the impact of bezlotoxumab on same-strain relapse or new-strain reinfection in MODIFY I/II trials. Reinfection with a new strain and relapse with the same strain were differentiated by the comparison of ribotype (RT) and pair-wise single-nucleotide whole genome sequencing (WGS) variations (PWSNV). Relapse was assigned if the baseline RT and the RT isolated during rCDI were the same, and if PWSNVs were ≤ 2. Reinfection was assigned if the baseline RT and the RT isolated during rCDI were different, or if the RT was the same but PWSNVs were > 10. Unknown status was assigned if the RT was the same but PWSNVs were 3-10.RESULTS:
259 rCDI events were evaluable (50 [19.3%] reinfection; 198 [76.4%] relapse). The proportion of relapses was higher for ribotype 027 (84.5%) compared with other ribotypes (74.1%). Cumulative incidence of relapse was significantly lower for bezlotoxumab versus no bezlotoxumab (pâ¯<â¯0.0001), with a non-significant trend towards reduction for reinfection (pâ¯=â¯0.14).CONCLUSION:
Bezlotoxumab treatment significantly reduced the rate of CDI relapse versus a regimen without bezlotoxumab. (NCT01241552/NCT01513239).Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Clostridioides difficile
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Genoma Bacteriano
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Infecções por Clostridium
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Sequenciamento Completo do Genoma
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Anticorpos Amplamente Neutralizantes
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Antibacterianos
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Anticorpos Monoclonais
Tipo de estudo:
Clinical_trials
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Incidence_studies
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Prognostic_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article