Serum anti-toxin B antibody correlates with protection from recurrent Clostridium difficile infection (CDI)
VaccinePublished 25 November 2009
Brett Leav, Barbra M. Blair, Mark D. Leney, Michael Knauber, Courtney Reilly, Israel Lowy
Citations244
SJR quartileQ1
SJR score1.25
SNIP0.97
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Lower concentrations of neutralizing anti-toxin B and anti-Toxin A antibody and infection with the BI/NAP1/027 strain of C. difficile were significantly associated with recurrence of CDI.
Abstract
In this prospective study, lower concentrations of neutralizing anti-toxin B and anti-toxin A antibody and infection with the BI/NAP1/027 strain of C. difficile were significantly associated with recurrence of CDI.
Keywords
Medicine
New England Journal of MedicineAn Epidemic, Toxin Gene–Variant Strain of <i>Clostridium difficile</i>
1,993 Citations2005L. Clifford McDonald, George Killgore +6 more
A previously uncommon strain of C. difficile with variations in toxin genes has become more resistant to fluoroquinolones and has emerged as a cause of geographically dispersed outbreaks of C.'s Difficile-associated disease.
New England Journal of MedicineA Predominantly Clonal Multi-Institutional Outbreak of<i>Clostridium difficile</i>–Associated Diarrhea with High Morbidity and Mortality
1,945 Citations2005Vivian G. Loo, Louise Poirier +17 more
A strain of C. difficile that was resistant to fluoroquinolones and had binary toxin and a partial deletion of the tcdC gene was responsible for this outbreak ofC.difficile-associated diarrhea.
The LancetToxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe
1,428 Citations2005Michel Warny, Jean‐Louis Pépin +6 more
The severity of C difficile-associated disease caused by NAP1/027 could result from hyperproduction of toxins A and B, and dissemination of this strain in North America and Europe could lead to important changes in the epidemiology of C diffusion disease.
New England Journal of MedicineAsymptomatic Carriage of<i>Clostridium difficile</i>and Serum Levels of IgG Antibody against Toxin A
935 Citations2000Lorraine Kyne, Michel Warny +2 more
There is no evidence of immune protection against colonization by C. difficile in hospitalized patients who were receiving antibiotics, but after colonization there is an association between a systemic anamnestic response to toxin A, as evidenced by increased serum levels of IgG antibody against toxins A, and asymptomatic carriage of C.difficile.
The LancetAssociation between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea
798 Citations2001Lorraine Kyne, Michel Warny +2 more
A serum antibody response to toxin A, during an initial episode of C. difficile diarrhoea, is associated with protection against recurrence, and this response isomersally associated with higher concentrations of serum IgM against toxin A.
NatureToxin B is essential for virulence of Clostridium difficile
753 Citations2009Dena Lyras, Jennifer R. O’Connor +10 more
The construction of isogenic tcdA and tcdB mutants of a virulent C. difficile strain are described and their use in the hamster disease model is used to show that toxin B is a key virulence determinant.
Emerging infectious diseases<i>Clostridium difficile</i>Infection in Patients Discharged from US Short-stay Hospitals, 1996–20031
734 Citations2006L. Clifford McDonald, Maria Owings +1 more
Clinicians should be aware of the increasing risk of C. difficile–associated disease and make efforts to control its transmission.
Canadian Medical Association JournalMortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec
608 Citations2005Jean‐Louis Pépin
A high attributable mortality among elderly patients with CDAD mostly caused by a hypervirulent strain is documented, which represents a dramatic change in the severity of this infection.
Emerging infectious diseases<i>Clostridium difficile</i>Infection in Patients Discharged from US Short-stay Hospitals, 1996–20031
543 Citations2006L. Clifford McDonald, Maria Owings +1 more
Emerging infectious diseasesIncrease in<i>Clostridium difficile</i>–related Mortality Rates, United States, 1999<b>–</b>2004
431 Citations2007Matthew D. Redelings, Frank Sorvillo +1 more
Reported mortality rates from Clostridium difficile disease in the United States increased from 5.7 per million population in 1999 to 23.8 per million in 2004, with rates higher for whites than for other racial/ethnic groups.
Journal of Clinical MicrobiologyComparison of Seven Techniques for Typing International Epidemic Strains of <i>Clostridium difficile</i> : Restriction Endonuclease Analysis, Pulsed-Field Gel Electrophoresis, PCR-Ribotyping, Multilocus Sequence Typing, Multilocus Variable-Number Tandem-Repeat Analysis, Amplified Fragment Length Polymorphism, and Surface Layer Protein A Gene Sequence Typing
338 Citations2007George Killgore, Angela Thompson +15 more
All techniques appear to be capable of detecting outbreak strains, but only REA and MLVA showed sufficient discrimination to distinguish strains from different outbreaks.
GutIntravenous immunoglobulin therapy for severe <i>Clostridium difficile</i> colitis
265 Citations1997José R. Salcedo, Sarah Keates +5 more
Infection and ImmunityHuman Monoclonal Antibodies Directed against Toxins A and B Prevent <i>Clostridium difficile</i> -Induced Mortality in Hamsters
256 Citations2006Gregory J. Babcock, Teresa J. Broering +10 more
Full human monoclonal antibodies (HuMAbs) that neutralize these toxins and prevent disease in hamsters are described and compared to controls, combination therapy reduced mortality in hamster models and offered enhanced protection.
Infection Control and Hospital EpidemiologyUnderlying Disease Severity as a Major Risk Factor for Nosocomial <i>Clostridium difficile</i> Diarrhea
243 Citations2002Lorraine Kyne, Stavros Sougioultzis +2 more
These findings provide a means of early stratification of hospitalized patients receiving antibiotics according to their risk for nosocomial C. difficile diarrhea, and patients with severe to extremely severe disease at the time of admission may benefit from careful monitoring of antibiotic prescribing and early attention to infection control issues.
Infection and ImmunityHuman antibody response to Clostridium difficile toxin A in relation to clinical course of infection
231 Citations1994Michel Warny, J P Vaerman +2 more
Data suggest an association between a defective humoral response to toxin A and a more severe form of C. difficile infection and indicate that other host-related factors control the severity of CDAD and remain to be elucidated.
The Journal of Infectious DiseasesSerum Antibody Response to Toxins A and B of Clostridium difficile
204 Citations1983Raphael P. Viscidi, Barbara E. Laughon +5 more
The data presented suggest that antibodies to toxins A and B are present in the majority of older children and adults and that patients with C difficile-induced disease develop serologic responses to one or both toxins.
Diseases of the Colon & RectumIntravenous Immunoglobulin for the Treatment of Severe, Refractory, and Recurrent Clostridium difficile Diarrhea
203 Citations2006Stuart McPherson, Colin Rees +3 more
Intravenous immunoglobulin may be effective for severe, refractory, or recurrent Clostridium difficile diarrhea after failed conventional treatment.
Journal of Clinical Microbiology<i>tcdC</i> Genotypes Associated with Severe TcdC Truncation in an Epidemic Clone and Other Strains of <i>Clostridium difficile</i>
203 Citations2006Scott Curry, Jane W. Marsh +4 more
Describing tcdC genotypes from a collection of C. difficile isolates from a hospital that experienced an outbreak caused by the recently described BI/NAP1 epidemic clone suggests that severe truncation of TcdC is responsible for the increased toxin production observed in strains belonging to the BI/ NAP1 clone.
Journal of Antimicrobial ChemotherapyDescriptive study of intravenous immunoglobulin for the treatment of recurrent Clostridium difficile diarrhoea
200 Citations2004Mark H. Wilcox
Intravenous immunoglobulin is useful for the treatment of intractable and severe CDD and controlled studies are needed to assess the true value of this and other forms of passive immunotherapy.
Clinical Infectious DiseasesA Portrait of the Geographic Dissemination of the Clostridium difficile North American Pulsed-Field Type 1 Strain and the Epidemiology of C. difficile-Associated Disease in Quebec
198 Citations2006Bruno Hubert, Vivian G. Loo +6 more
This study helped to quantify the impact of strain NAP1 on the incidence and severity of C. difficile-associated disease in Québec in 2005 and identified the geographic dissemination of this predominant strain to help to focus regional infection-control efforts.
The American Journal of GastroenterologyOutcomes of Clostridium difficile-Associated Disease Treated With Metronidazole or Vancomycin Before and After the Emergence of NAP1/027
174 Citations2007Jean‐Louis Pépin, Louis Valiquette +3 more
Loss of superiority of vancomycin over metronidazole coincided with the emergence of NAP1/027, which might be such that the disease follows its natural course.
Clinical Infectious DiseasesA Hospital Outbreak of Clostridium difficile Disease Associated with Isolates Carrying Binary Toxin Genes
174 Citations2004M. Catherine McEllistrem, Robert J. Carman +3 more
The binary toxin genes were present in nearly two-thirds of the C. difficile strains, and they were correlated with the REA group, and larger studies are needed to discern whether a true association exists and whether the binary toxin alters the pathogenicity of theC.
Journal of Clinical MicrobiologyDevelopment of a rapid and efficient restriction endonuclease analysis typing system for Clostridium difficile and correlation with other typing systems
171 Citations1993Connie Clabots, Stuart Johnson +6 more
REA typing is a sensitive, discriminating, reproducible, and rapid method for differentiating C. difficile strains and is suitable for large-scale epidemiologic studies.
Infection and ImmunityAntibodies to Recombinant<i>Clostridium difficile</i>Toxins A and B Are an Effective Treatment and Prevent Relapse of<i>C. difficile</i>-Associated Disease in a Hamster Model of Infection
158 Citations1998John A. Kink, Jim A. Williams
Results indicate that CDAD antitoxin may be effective in the treatment and management of CDAD in humans.
Infection and ImmunityImmunization of adult hamsters against Clostridium difficile-associated ileocecitis and transfer of protection to infant hamsters
140 Citations1987P H Kim, Joseph P. Iaconis +1 more
The results suggest that toxin A may play a more important role in the pathogenesis of C. difficile-associated ileocecitis in hamsters than toxin B, and variations in the severity in infants and adults may reflect the lack or presence of passively or actively acquired immunity against C. diffuse toxins.
Infection and ImmunitySerum Antitoxin Antibodies Mediate Systemic and Mucosal Protection from <i>Clostridium difficile</i> Disease in Hamsters
116 Citations1999Paul J. Giannasca, Zhenxi Zhang +5 more
Prophylactic parenteral vaccination or intravenous immunotherapy could provide protection from C. difficiledisease in humans, and the principal role of circulating antitoxin antibodies in immunity from this toxin-mediated mucosal disease is demonstrated.
InfectionSerum antibody response to clostridium difficile toxins in patients with clostridium difficile diarrhoea
115 Citations1985B. Aronsson, Marta Granström +2 more
It is concluded that the ELISA for detection of serum antibodies to C. difficile toxins may be of diagnostic value in combination with the conventional tissue culture assay for cytotoxin in stool.
Diagnostic Microbiology and Infectious DiseaseImmunoglobulin G directed against toxins A and B of Clostridium difficile in the general population and patients with antibiotic-associated diarrhea
64 Citations1994Alfred E. Bacon, Robert Fekety
Serum immunoglobulin G (IgG) class antibodies directed against toxins A and B of Clostridium difficile were studied using an enzyme-linked immunosorbent assay and a serum-neutralizing assay based on the MRC-5 tissue cytotoxicity assay.
VaccineOpen-label, dose escalation phase I study in healthy volunteers to evaluate the safety and pharmacokinetics of a human monoclonal antibody to Clostridium difficile toxin A
53 Citations2008Claribel P. Taylor, Sanjeev Tummala +7 more
The safety and pharmacokinetics of a novel neutralizing human monoclonal antibody against C. difficile toxin A in healthy adults was examined and administration of CDA1 as a single intravenous infusion was safe and well tolerated.