Protective factors in the intestinal microbiome against Clostridium difficile infection in recipients of allogeneic hematopoietic stem cell transplantation Journal Article
| Authors: | Lee, Y. J.; Arguello, E. S.; Jenq, R. R.; Littmann, E.; Kim, G. J.; Miller, L. C.; Ling, L.; Figueroa, C.; Robilotti, E.; Perales, M. A.; Barker, J. N.; Giralt, S.; Van Den Brink, M. R. M.; Pamer, E. G.; Taur, Y. |
| Article Title: | Protective factors in the intestinal microbiome against Clostridium difficile infection in recipients of allogeneic hematopoietic stem cell transplantation |
| Abstract: | Background. Clostridium difficile infection (CDI) is a frequent complication in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT), who receive intensive treatments that significantly disrupt the intestinal microbiota. In this study, we examined the microbiota composition of allo-HSCT recipients to identify bacterial colonizers that confer protection against CDI after engraftment. Methods. Feces collected from adult recipients allo-HSCT at engraftment were analyzed; 16S ribosomal RNA genes were sequenced and analyzed from each sample. Bacterial taxa with protective effects against development of CDI were identified by means of linear discriminant analysis effect size analysis and then further assessed with clinical predictors of CDI using survival analysis. Results. A total of 234 allo-HSCT recipients were studied; postengraftment CDI developed in 53 (22.6%). Within the composition of the microbiota, the presence of 3 distinct bacterial taxa was correlated with protection against CDI: Bacteroidetes, Lachnospiraceae, and Ruminococcaceae. Colonization with these groups at engraftment was associated with a 60% lower risk of CDI, independent of clinical factors. Conclusions. Colonization with these 3 bacterial groups is associated with a lower risk of CDI. These groups have been shown to be vital components of the intestinal microbiota. Targeted efforts to maintain them may help minimize the risk of CDI in this at-risk population. |
| Keywords: | adult; controlled study; survival analysis; gene sequence; major clinical study; clinical feature; disease course; nonhuman; disease association; engraftment; allogeneic hematopoietic stem cell transplantation; predictor variable; clostridium difficile infection; high risk population; infection prevention; intestine flora; rna 16s; clostridium difficile; infection risk; graft recipient; feces analysis; correlational study; microflora; bacteroidetes; microbiome; bacterium colony; human; male; female; priority journal; article; lachnospiraceae; ruminococcaceae; rna gene |
| Journal Title: | Journal of Infectious Diseases |
| Volume: | 215 |
| Issue: | 7 |
| ISSN: | 0022-1899 |
| Publisher: | Oxford University Press |
| Date Published: | 2017-04-01 |
| Start Page: | 1117 |
| End Page: | 1123 |
| Language: | English |
| DOI: | 10.1093/infdis/jix011 |
| PUBMED: | 28498996 |
| PROVIDER: | scopus |
| PMCID: | PMC5426375 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 July 2017 -- Source: Scopus |
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