Calprotectin levels may predict risk of recurrent Clostridioides difficile infection

Clostridioides difficile infection (CDI) has long been a leading cause of nosocomial diarrhea, posing a significant challenge to healthcare systems. Recurrent CDI (R-CDI), affecting 20%-30% of patients, extends hospital stays and increases costs. A recent study published in Frontiers in Cellular and Infection Microbiology suggests that the abundance of specific bacterial genera and fecal calprotectin levels could serve as vital biomarkers in identifying patients at risk of developing R-CDI, ultimately leading to better-tailored treatments and improved patient outcomes

The study, aimed at exploring the role of the microbiome and calprotectin levels as predictive biomarkers for R-CDI, included 200 patients with a primary episode of CDI. Researchers collected clinical data and fecal samples and performed microbiome analysis through 16S rRNA gene sequencing.

Of the 200 patients, 54 went on to develop R-CDI, while 146 did not. The analysis of 200 primary samples revealed distinct microbial patterns. Fusobacterium was found to increase in abundance in patients with recurrent disease, while Collinsella, Senegalimassilia, Prevotella, and Ruminococcus decreased. Additionally, elevated calprotectin levels were significantly correlated with R-CDI.

Building on these findings, the researchers constructed a risk index for R-CDI. This index factored in various prognostic elements, including age, sex, immunosuppression, toxin B amplification cycle, creatinine levels, and fecal calprotectin levels. The resulting model demonstrated an overall accuracy of 79%.

The significance of this research lies in its potential to identify early markers for R-CDI. By measuring calprotectin levels and examining the abundance of specific microbial genera like Fusobacterium and Prevotella during primary CDI episodes, healthcare providers may have a tool for predicting the risk of recurrent infection.

This predictive model could revolutionize the way CDI is managed. By identifying patients at higher risk for R-CDI at the initial CDI episode, healthcare professionals can better tailor their treatment strategies. This, in turn, may lead to more effective interventions, shorter hospital stays, and reduced healthcare costs.

Reference:

Vázquez-Cuesta, S., Lozano García, N., Fernández, A. I., Olmedo, M., Kestler, M., Alcalá, L., Marín, M., Bermejo, J., Bouza, E., & Reigadas, E. (2023). Microbiome profile and calprotectin levels as markers of risk of recurrent Clostridioides difficile infection. In Frontiers in Cellular and Infection Microbiology (Vol. 13). Frontiers Media SA. https://doi.org/10.3389/fcimb.2023.1237500