Fecal Biomarkers in Clostridium difficile Infection
Abstract
Fiscal Year 2015 Peer Reviewed Medical Research Program Topic Area: Healthcare-acquired infection reduction. Clostridium difficile (C. diff) is a bacteria that exists as a spore in the intestines of many humans. In many individuals, C diff grows and releases toxins, causing diarrhea; in a certain subgroup of these individuals, the toxins also severely damage the colon, forcing doctors to remove it, and cause life-threatening disease. Over the last decade or so, C. diff has become the most common infection acquired by patients who are hospitalized, costing hospitals $4.8 billion per year. As well, C. diff is responsible for around 29,000 deaths each year in the United States alone. In recent years, a substantial number of C. diff cases occurred in people who have never been to a hospital or who have not recently taken antibiotics. Clearly, C. diff is a major threat to human health. Why do some people with C. diff remain well without symptoms, while others develop only diarrhea and still others develop severe disease? Research focusing on the bacteria has identified how C. diff causes disease in general, as well as the importance of having "healthy bacteria" in the intestines to prevent C. diff from causing problems. On the other hand, little research has gone into understanding how the body responds to C. diff infection. What elements of the body s immune response to C. diff determine if the person remains without symptoms or develops disease? In those who develop disease, what components of the body s immune response determine if the person will develop mild or severe disease? One approach to answer these questions is to look for biomarkers. Biomarkers are proteins (or fragments of proteins) produced by the body at the time of infection. Most of the research for biomarkers in C. diff have searched for only a few proteins and have looked in the blood. Unfortunately, many of the results found by this approach have identified biomarkers that can become abnormal from a variety of conditions, not just infection with C. diff. When they are abnormal in patients with C. diff, the patients are already very sick, so they are not very helpful in predicting who will get bad disease with C. diff. Other approaches are desperately needed. C. diff is an infection that occurs in the intestines. The intestines are able to generate their own immune response, producing proteins that can be measured in stool. Collecting stool is not invasive or dangerous to a patient, especially one who is having diarrhea. This application proposes to take the very unique approach of looking for biomarkers directly in the stool of patients with C. diff diarrhea. By comparing these biomarkers to the biomarker profile obtained from stool of healthy individuals as well as stool caused by diarrhea that is not caused by C. diff, this work will try to identify a specific biomarker profile that is only seen in C. diff. Importantly, this research will compare the biomarker profiles from severe C. diff cases to non-severe cases to identify unique biomarkers that will predict who will get bad disease with C. diff. It is hoped that the findings from this work will not only help doctors in managing their patients, but will lay the groundwork for developing new treatments for C. diff.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610281
Entities
People
- Donald C Vinh
Organizations
- McGill University Health Centre
- United States Army