We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Stool Interleukin-1β Differentiates Clostridioides difficile Infection (CDI) From Asymptomatic Carriage and Non-CDI Diarrhea.
- Authors
Gálvez, Javier A Villafuerte; Pollock, Nira R; Alonso, Carolyn D; Chen, Xinhua; Xu, Hua; Wang, Lamei; White, Nicole; Banz, Alice; Miller, Mark; Daugherty, Kaitlyn; Gonzalez-Luna, Anne J; Barrett, Caitlin; Sprague, Rebecca; Garey, Kevin W; Kelly, Ciaran P
- Abstract
Background Despite advances in the understanding and diagnosis of Clostridioides difficile infection (CDI), clinical distinction within the colonization–infection continuum remains an unmet need. Methods By measuring stool cytokines and antitoxin antibodies in well-characterized cohorts of CDI (diarrhea, nucleic acid amplification test [NAAT] positive), non-CDI diarrhea (NCD; diarrhea, NAAT negative), asymptomatic carriers (ASC; no diarrhea, NAAT positive) and hospital controls (CON; no diarrhea, NAAT negative), we aim to discover novel biological markers to distinguish between these cohorts. We also explore the relationship of these stool cytokines and antitoxin antibody with stool toxin concentrations and disease severity. Results Stool interleukin (IL) 1β, stool immunoglobulin A (IgA), and immunoglobulin G (IgG) anti–toxin A had higher (P <.0001) concentrations in CDI (n = 120) vs ASC (n = 43), whereas toxins A, B, and fecal calprotectin did not. Areas under the receiver operating characteristic curve (ROC-AUCs) for IL-1β, IgA, and IgG anti–toxin A were 0.88, 0.83, and 0.83, respectively. A multipredictor model including IL-1β and IgA anti–toxin A achieved an ROC-AUC of 0.93. Stool IL-1β concentrations were higher in CDI compared to NCD (n = 75) (P <.0001) and NCD + ASC+ CON (CON, n = 75) (P <.0001), with ROC-AUCs of 0.83 and 0.86, respectively. Stool IL-1β had positive correlations with toxins A (ρA = +0.55) and B (ρB = +0.49) in CDI (P <.0001) but not in ASC (P >.05). Conclusions Stool concentrations of the inflammasome pathway, proinflammatory cytokine IL-1β, can accurately differentiate CDI from asymptomatic carriage and NCD, making it a promising biomarker for CDI diagnosis. Significant positive correlations exist between stool toxins and stool IL-1β in CDI but not in asymptomatic carriers.
- Subjects
DIAGNOSIS of diarrhea; ANTIGEN analysis; FECAL analysis; IMMUNOGLOBULIN analysis; INTERLEUKINS; BIOMARKERS; DIARRHEA; NERVE tissue proteins; MICROBIAL genetics; DIFFERENTIAL diagnosis; CLOSTRIDIUM diseases; SEVERITY of illness index; COMPARATIVE studies; FECES; RESEARCH funding; CARRIER state (Communicable diseases); CALCIUM-binding proteins; RECEIVER operating characteristic curves; PREDICTION models; STATISTICAL correlation; ANTITOXINS; LONGITUDINAL method; NUCLEIC acid amplification techniques; EVALUATION
- Publication
Clinical Infectious Diseases, 2023, Vol 76, Issue 3, pe1467
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciac624