Ultrasensitive and Quantitative Toxin Measurement Correlates With Baseline Severity, Severe Outcomes, and Recurrence...

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Diagnostics

Background:

• Clostridioides difficile infection (CDI) severity and outcomes may be influenced by fecal toxin concentrations.
• Quantifying toxin levels offers potential insights into disease progression.

Purpose of the Study:

• To correlate fecal C. difficile toxin A and B concentrations with CDI baseline severity, attributable outcomes, and recurrence.
• To evaluate the utility of an ultrasensitive, quantitative assay for toxin measurement.

Main Methods:

• 615 hospitalized adults with CDI were enrolled.
• Baseline stool toxin A and B concentrations were measured using single molecule array.
• Patients were classified by CDI severity and outcomes within 40 days.

Main Results:

• Higher stool toxin A+B concentrations were observed in patients with severe baseline CDI across all scoring systems.
• Patients with severe CDI-attributable outcomes or recurrence exhibited significantly higher median toxin concentrations compared to those without.
• Detectable toxin was more prevalent in patients with severe CDI-attributable outcomes and recurrence.

Conclusions:

• Ultrasensitive stool toxin detection and concentration correlate with severe baseline CDI, CDI-attributable outcomes, and recurrence.
• Toxin quantity is a significant factor in CDI presentation and clinical course.