New Research Confirms High Toxin Levels Linked to More Severe C. Difficile Infection

The concentration of C. diff toxins in the stool was linked to how sick patients were at the time of diagnosis and was associated with adverse outcomes, including the risk of infection returning after treatment.

Researcher-physicians at Beth Israel Deaconess Medical Center (BIDMC) used a novel, highly sensitive test to measure the amount of toxin produced by Clostridioides difficile

(C. diff) in the stool of patients with suspected infections, according to a press release.

The team followed patients with who C. diff were hospitalized at BIDMC and at Texas Medical Center in Houston for 40 days after the onset of infection. The concentration of C. diff toxins in the stool was linked to how sick patients were at the time of diagnosis and was associated with adverse outcomes, including the risk of infection returning after treatment.

“Disease-causing C. difficile strains produce toxins that directly damage the tissues of the large intestine, leading to the symptoms of C. difficile infection, including severe diarrhea, nausea and stomach pain,” said first study author Carolyn D. Alonso, MD, in the press release. “While prior studies had shown a possible association between stool toxin levels and clinical outcomes, this study was the first of its kind to convincingly demonstrate that the concentration of C. difficile toxins influences disease severity.”

Senior/corresponding author Nira R. Pollock, MD, PhD, added that this new research lays the foundation for developing a highly accurate, single-step test to better diagnose C. diff infection and predict clinical outcomes.

“The next steps for the research will combine this ultrasensitive and quantitative stool toxin test with other biomarkers to try to create a test that can determine who really has C. difficile infection and who is most likely to have worse clinical outcomes,” Pollock said in the press release.

Further, co-lead author Ciarán P. Kelly, MD, said that although it is well-recognized that C. diff-associated diarrhea and colitis are caused by toxins A and B, this new study shows in a clear manner that toxin quantities are associated with baseline disease severity as well as negative outcomes, such as a need for admission to the ICU and/or death.

“Hence, measuring toxin concentrations in stool can help physicians to predict the likely course of the illness and plan their management steps accordingly,” Kelly said in the press release.

REFERENCE

BIDMC researchers confirm high toxin levels linked to more severe C. difficile infection. Beth Israel Lahey Health- Deaconess Medical Center. October 12, 2021. Accessed October 13, 2021. https://www.bidmc.org/about-bidmc/news/2021/10/bidmc-researchers-confirm-high-toxin-levels-linked-to-more-severe-c-difficile-infection