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Anti-toxin antibody is not associated with recurrent Clostridium difficile infection
- Source :
- Anaerobe
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Clostridium difficile infection (CDI) recurs in ∼20% of patients. Prior studies indicated that antibody responses directed against the C. difficile toxins A and B were potentially associated with lower risk of recurrent CDI. Here we tested the hypothesis that circulating anti-toxin IgG antibody levels associate with reduced risk of recurrent CDI. A cohort study with prospective enrollment and retrospective data abstraction examined antibody levels in 275 adult patients at the University of Michigan with CDI. We developed an enzyme linked immunosorbent assay to detect IgG antibodies against toxin A and toxin B in sera obtained at the time of diagnosis. Logistic regression examined the relationship between antibody levels and recurrence, and sensitivity tests evaluated for follow-up and survivor biases, history of CDI, and PCR ribotype. Follow-up data were available for 174 subjects, of whom 36 (20.7%) had recurrence. Comparing antibody levels vs. recurrence and CDI history, anti-toxin A levels were similar, while anti-toxin B levels had a greater range of values. In unadjusted analysis, detection of anti-toxin A antibodies, but not anti-toxin B antibodies, associated with an increased risk of recurrence (OR 2.71 [1.06, 8.37], P = .053). Adjusting for confounders weakened this association. The results were the same in sensitivity analyses. We observed a borderline increased risk of recurrence in patients positive for anti-toxin A antibodies, and sensitivity analyses showed this was not simply a reflection of prior exposure status. Future studies are needed to assess how neutralizing antibody or levels after treatment associate with recurrence.
- Subjects :
- Adult
Male
medicine.medical_specialty
Bacterial Toxins
Clostridium difficile toxin A
Enzyme-Linked Immunosorbent Assay
Clostridium difficile toxin B
Lower risk
Polymerase Chain Reaction
Ribotyping
Microbiology
Gastroenterology
Article
03 medical and health sciences
Bacterial Proteins
Recurrence
Risk Factors
Internal medicine
medicine
Humans
Prospective Studies
Neutralizing antibody
Aged
Retrospective Studies
030304 developmental biology
0303 health sciences
biology
Clostridioides difficile
030306 microbiology
business.industry
Confounding
Middle Aged
Clostridium difficile
Prognosis
Antibodies, Bacterial
Antibodies, Neutralizing
Logistic Models
Infectious Diseases
Immunoglobulin G
Clostridium Infections
biology.protein
Female
Antibody
business
Cohort study
Subjects
Details
- ISSN :
- 10759964
- Volume :
- 67
- Database :
- OpenAIRE
- Journal :
- Anaerobe
- Accession number :
- edsair.doi.dedup.....a23a12e888417f64500c7e335a7bf706