Related Experiment Video
Updated: May 14, 2025
09:12
A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
10.0K
Management and Outcomes of Clostridioides difficile Infection in Patients on Immune Checkpoint Inhibitors
Patrick T Magahis1, Deepika Satish2, Mini Kamboj3,4
1Weill Cornell Medical College of Cornell University, New York, NY.
Summary
Clostridioides difficile infection (CDI) affects 18% of patients on immune checkpoint inhibitors (ICIs) with diarrhea. While most respond to antibiotics, 24% need immunosuppression for immune-related enterocolitis (irEC), and 20% experience CDI recurrence.
Area of Science:
- Oncology
- Gastroenterology
- Infectious Diseases
Background:
- Limited data exists on Clostridioides difficile infection (CDI) in patients receiving immune checkpoint inhibitors (ICIs).
- Understanding CDI in this population is crucial due to potential overlap with immune-related enterocolitis (irEC).
Purpose of the Study:
- To evaluate the clinical course of CDI in patients treated with ICIs presenting with diarrhea.
- To assess the frequency of CDI and concurrent irEC in this patient group.
Main Methods:
- Retrospective cohort study of 605 patients treated with ICIs who presented with diarrhea.
- Patients underwent stool nucleic acid amplification PCR testing for CDI.
- Outcomes included CDI frequency, treatment, and need for immunosuppression for irEC.
Main Results:
- 18% (111/605) of patients tested positive for CDI.
- 84% (76%) of CDI patients were treated with antibiotics alone; 24% required additional immunosuppression for irEC.
- CDI patients had higher rates of prior antibiotic exposure and more severe gastrointestinal symptoms; CDI recurrence was 20%.
Conclusions:
- CDI is common in ICI-treated patients with diarrhea, often linked to prior antibiotic use.
- While most CDI cases respond to antibiotics, a significant portion requires immunosuppression for irEC.
- Prompt CDI diagnosis and management, alongside monitoring for irEC, are vital for improving outcomes.
Related Concept Videos
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
106
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
106
01:29Inflammatory Bowel Disease IV: Pharmacological Management
80
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
80
01:27Tumor Immunotherapy
406
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
406
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
251
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
251
01:25Immunodeficiency Diseases
840
Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency...
There are three main causes of immunodeficiency...
840
01:27Cytotoxic T Cells-mediated Immune Response
737
Cytotoxic T cells are a vital component of the immune system. They have the remarkable ability to identify and target antigens on infected or abnormal cells. These antigens often originate from intracellular pathogens such as viruses or abnormal proteins cancer cells produce.
Immunological surveillance is the ability of immune cells to monitor and eliminate infected cells with intracellular pathogens, neoplastically transformed cells, and cells with non-self antigens. Cytotoxic T cells and NK...
Immunological surveillance is the ability of immune cells to monitor and eliminate infected cells with intracellular pathogens, neoplastically transformed cells, and cells with non-self antigens. Cytotoxic T cells and NK...
737