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10.1111/apt.13750 http://scihub22266oqcxt.onion/10.1111/apt.13750 27481036/?report=reader!5012905!27481036     free     free     free Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Aliment+Pharmacol+Ther 2016 ; 44 (7): 715-727 Nephropedia Template TP {{tp|p=27481036|t=2016. Gut microbiome predictors of treatment response and recurrence in primary Clostridium difficile infection |pdf=|usr=}}{{27481036}} gab.com Text Gut microbiome predictors of treatment response and recurrence in primary Clostridium difficile infection JO: Aliment Pharmacol Ther http://www.kidney.de/pget.php?&tw=1&pmid=27481036 #FOAvip BACKGROUND: Clostridium difficile infection (CDI) may not respond to initial therapy and frequently recurs, but predictors of response and recurrence are inconsistent. The impact of specific alterations in the gut microbiota determining treatment response and recurrence in patients with CDI is unknown. AIM: To assess microbial signatures as predictors of treatment response and recurrence in CDI. METHODS: Pre-treatment stool samples and clinical metadata including outcomes were collected prospectively from patients with their first CDI episode. Next generation 16s rRNA sequencing using MiSeq Illumina platform was performed and changes in microbial community structure were correlated with CDI outcomes. RESULTS: Eighty-eight patients (median age 52.7 years, 60.2% female) were included. Treatment failure occurred in 12.5% and recurrence after response in 28.5%. Patients who responded to treatment had an increase in Ruminococcaceae, Rikenellaceae, Clostridiaceae, Bacteroides, Faecalibacterium and Rothia compared to nonresponders. A risk-index built from this panel of microbes differentiated responders (mean 0.07 +/- 0.24) from nonresponders (0.52 +/- 0.42; P = 0.0002). Receiver operating characteristic (ROC) curve demonstrated that risk-index was a strong predictor of treatment response with an area under the curve (AUC) of 0.85. Among clinical parameters tested, only proton pump inhibitor use predicted recurrent CDI (OR 3.75, 95% CI 1.27-11.1, P = 0.01). Patients with recurrent CDI had statistically significant increases in Veillonella, Enterobacteriaceae, Streptococci, Parabacteroides and Lachnospiraceae compared to patients without recurrence and a risk index was able to predict recurrence (AUC = 0.78). CONCLUSION: Gut microbiota signatures predict treatment response and recurrence potentially, allowing identification of patients with Clostridium difficile infection that may benefit from early institution of alternate therapies. Twit Text FOAVip Gut microbiome predictors of treatment response and recurrence in primary Clostridium difficile infection ????Aliment Pharmacol Ther http://www.kidney.de/pget.php?&tw=1&pmid=27481036 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27481036 #FOAvip English Wikipedia <ref>{{Cite pmid|27481036}}</ref> Gut microbiome predictors of treatment response and recurrence in primary Clostridium difficile infection #MMPMID27481036 Khanna S; Montassier E; Schmidt B; Patel R; Knights D; Pardi DS; Kashyap P Aliment Pharmacol Ther 2016[Oct]; 44 (7): 715-727 PMID27481036show ga BACKGROUND: Clostridium difficile infection (CDI) may not respond to initial therapy and frequently recurs, but predictors of response and recurrence are inconsistent. The impact of specific alterations in the gut microbiota determining treatment response and recurrence in patients with CDI is unknown. AIM: To assess microbial signatures as predictors of treatment response and recurrence in CDI. METHODS: Pre-treatment stool samples and clinical metadata including outcomes were collected prospectively from patients with their first CDI episode. Next generation 16s rRNA sequencing using MiSeq Illumina platform was performed and changes in microbial community structure were correlated with CDI outcomes. RESULTS: Eighty-eight patients (median age 52.7 years, 60.2% female) were included. Treatment failure occurred in 12.5% and recurrence after response in 28.5%. Patients who responded to treatment had an increase in Ruminococcaceae, Rikenellaceae, Clostridiaceae, Bacteroides, Faecalibacterium and Rothia compared to nonresponders. A risk-index built from this panel of microbes differentiated responders (mean 0.07 +/- 0.24) from nonresponders (0.52 +/- 0.42; P = 0.0002). Receiver operating characteristic (ROC) curve demonstrated that risk-index was a strong predictor of treatment response with an area under the curve (AUC) of 0.85. Among clinical parameters tested, only proton pump inhibitor use predicted recurrent CDI (OR 3.75, 95% CI 1.27-11.1, P = 0.01). Patients with recurrent CDI had statistically significant increases in Veillonella, Enterobacteriaceae, Streptococci, Parabacteroides and Lachnospiraceae compared to patients without recurrence and a risk index was able to predict recurrence (AUC = 0.78). CONCLUSION: Gut microbiota signatures predict treatment response and recurrence potentially, allowing identification of patients with Clostridium difficile infection that may benefit from early institution of alternate therapies. |*Gastrointestinal Microbiome[MESH] |Adult[MESH] |Aged[MESH] |Clostridioides difficile/genetics/*isolation & purification[MESH] |Clostridium Infections/*microbiology[MESH] |Female[MESH] |Humans[MESH] |Male[MESH] |Middle Aged[MESH] |Prospective Studies[MESH] |Proton Pump Inhibitors/administration & dosage[MESH] |RNA, Ribosomal, 16S/genetics[MESH] |Recurrence[MESH]Gut microbiome predictors of treatment response and recurrence in prim(epmc).pdf DeepDyve Pubget Overpricing