Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile
| Autor: | Jaime Seddon, Farah Babakhani, A. Sarah Walker, David W Eyre, Derrick W. Crook, Carlos del Ojo Elias, Tim E. A. Peto, Sherwood L. Gorbach, David Griffiths |
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| Přispěvatelé: | America, Infectious Diseases Society of |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
DNA
Bacterial medicine.medical_specialty recurrence Immunology Biology Relapse prevention Medical sciences Polymorphism Single Nucleotide Gastroenterology Major Articles and Brief Reports Double-Blind Method Vancomycin Internal medicine Drug Resistance Bacterial Secondary Prevention medicine Humans Immunology and Allergy Fidaxomicin Survival analysis Whole genome sequencing whole genome sequencing Bacteria Clostridioides difficile fidaxomicin Hazard ratio Clostridium difficile Sequence Analysis DNA Confidence interval Anti-Bacterial Agents 3. Good health Aminoglycosides Clostridium Infections Infectious diseases Genome Bacterial medicine.drug |
| Zdroj: | The Journal of Infectious Diseases |
| ISSN: | 1537-6613 0022-1899 |
| Popis: | Whole-genome sequencing was used to determine whether the reductions in recurrence of Clostridium difficile infection observed with fidaxomicin in pivotal phase 3 trials occurred by preventing relapse of the same infection, by preventing reinfection with a new strain, or by preventing both outcomes. Paired isolates of C. difficile were available from 93 of 199 participants with recurrences (28 were treated with fidaxomicin, and 65 were treated with vancomycin). Given C. difficile evolutionary rates, paired samples ≤2 single-nucleotide variants (SNVs) apart were considered relapses, paired samples >10 SNVs apart were considered reinfection, and those 3–10 SNVs apart (or without whole-genome sequences) were considered indeterminate in a competing risks survival analysis. Fidaxomicin reduced the risk of both relapse (competing risks hazard ratio [HR], 0.40 [95% confidence interval {CI}, .25–.66]; P = .0003) and reinfection (competing risks HR, 0.33 [95% CI, 0.11–1.01]; P = .05). |
| Databáze: | OpenAIRE |
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