Microbiota-based markers predictive of development of Clostridioides difficile infection

Matilda Berkell, Mohamed Ahmed, Britto Xavier, Cornelis H. van Werkhoven, Pieter Monsieurs, Christine Lammens, Annie Ducher, Maria J.G.T. Vehreschild, Herman Goossens, Jean De Gunzburg, Marc J.M. Bonten, Surbhi Malhotra-kumar

    Research outputpeer-review


    Antibiotic-induced modulation of the intestinal microbiota can lead to Clostridioides difficile infection (CDI), which is associated with considerable morbidity, mortality, and healthcarecosts globally. Therefore, identification of markers predictive of CDI could substantially contribute to guiding therapy and decreasing the infection burden. Here, we analyze the intestinal microbiota of hospitalized patients at increased CDI risk in a prospective, 90-day cohort-study before and after antibiotic treatment and at diarrhea onset. We show that patients developing CDI already exhibit significantly lower diversity before antibiotic treatment and a distinct microbiota enriched in Enterococcus and depleted of Ruminococcus, Blautia, Prevotella and Bifidobacterium compared to non-CDI patients. We find that antibiotic treatment-induced dysbiosis is class-specific with beta-lactams further increasing enterococcal abundance. Our findings, validated in an independent prospective patient cohort developing CDI, can be exploited to enrich for high-risk patients in prospective clinical trials, and to develop predictive microbiota-based diagnostics for management of patients at risk for CDI.
    Original languageEnglish
    Article number2241
    Pages (from-to)1-14
    Number of pages14
    JournalNature Communications
    StatePublished - 14 Apr 2021

    Cite this