The Systemic Inflammatory Response to Clostridium Difficile Infection

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 Mar 20

PMID 24643077

Citations 33

Authors

Krishna Rao

John R Erb-Downward

Seth T Walk

Dejan Micic

Nicole Falkowski

Kavitha Santhosh

Jill A Mogle

Cathrin Ring

Vincent B Young

Gary B Huffnagle

David M Aronoff

Affiliations

Soon will be listed here.

Abstract

Background: The systemic inflammatory response to Clostridium difficile infection (CDI) is incompletely defined, particularly for patients with severe disease.

Methods: Analysis of 315 blood samples from 78 inpatients with CDI (cases), 100 inpatients with diarrhea without CDI (inpatient controls), and 137 asymptomatic outpatient controls without CDI was performed. Serum or plasma was obtained from subjects at the time of CDI testing or shortly thereafter. Severe cases had intensive care unit admission, colectomy, or death due to CDI within 30 days after diagnosis. Thirty different circulating inflammatory mediators were quantified using an antibody-linked bead array. Principal component analysis (PCA), multivariate analysis of variance (MANOVA), and logistic regression were used for analysis.

Results: Based on MANOVA, cases had a significantly different inflammatory profile from outpatient controls but not from inpatient controls. In logistic regression, only chemokine (C-C motif) ligand 5 (CCL5) levels were associated with cases vs. inpatient controls. Several mediators were associated with cases vs. outpatient controls, especially hepatocyte growth factor, CCL5, and epithelial growth factor (inversely associated). Eight cases were severe and associated with elevations in IL-8, IL-6, and eotaxin.

Conclusions: A broad systemic inflammatory response occurs during CDI and severe cases appear to differ from non-severe infections.

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