Microbiota-based markers predictive of development of Clostridioides difficile infection. Microbiota-based markers predictive of development of Clostridioides difficile infection

Clostridioides difficile infection (CDI) is the most common form of infectious antibiotic-associated diarrhea (AAD) causing considerable morbidity and mortality in acute-care facilities. Identification of early markers predictive of CDI in hospitalized patients could substantially contribute to decreasing the burden of CDI. In this European prospective longitudinal cohort-study including 1,007 patients at increased risk of CDI, we characterized fecal samples using high-resolution, single-nucleotide 16S rRNA gene profiling before (D1, n=945) and after antibiotic treatment (D6, n=737), and at diarrheal onset (S1, n=32). Our finding of a distinct, low-diversity CDI-associated microbiota can be exploited for identifying high-risk patients in prospective clinical trials, and for the development of predictive, microbiota-based diagnostics for clinical management of patients at high risk of CDI.