Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile
Whole-genome sequencing was used to determine whether the reductions in recurrence of <em>Clostridium difficile</em> 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 prev...
| Main Authors: | , , , , , , , , |
|---|---|
| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
University of Chicago Press
2013
|
| Subjects: |
| _version_ | 1826270624675266560 |
|---|---|
| author | Eyre, D Babakhani, F Griffiths, D Seddon, J Del Ojo Elias, C Gorbach, S Peto, T Crook, D Walker, A |
| author2 | Infectious Diseases Society of America |
| author_facet | Infectious Diseases Society of America Eyre, D Babakhani, F Griffiths, D Seddon, J Del Ojo Elias, C Gorbach, S Peto, T Crook, D Walker, A |
| author_sort | Eyre, D |
| collection | OXFORD |
| description | Whole-genome sequencing was used to determine whether the reductions in recurrence of <em>Clostridium difficile</em> 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 <em>C. difficile</em> were available from 93 of 199 participants with recurrences (28 were treated with fidaxomicin, and 65 were treated with vancomycin). Given <em>C. difficile</em> 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). |
| first_indexed | 2024-03-06T21:43:46Z |
| format | Journal article |
| id | oxford-uuid:48d7252a-3daa-44e3-b809-edf7c98d792a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:43:46Z |
| publishDate | 2013 |
| publisher | University of Chicago Press |
| record_format | dspace |
| spelling | oxford-uuid:48d7252a-3daa-44e3-b809-edf7c98d792a2022-03-26T15:28:06ZWhole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficileJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:48d7252a-3daa-44e3-b809-edf7c98d792aMedical sciencesInfectious diseasesImmunologyEnglishSymplectic Elements at OxfordUniversity of Chicago Press2013Eyre, DBabakhani, FGriffiths, DSeddon, JDel Ojo Elias, CGorbach, SPeto, TCrook, DWalker, AInfectious Diseases Society of AmericaWhole-genome sequencing was used to determine whether the reductions in recurrence of <em>Clostridium difficile</em> 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 <em>C. difficile</em> were available from 93 of 199 participants with recurrences (28 were treated with fidaxomicin, and 65 were treated with vancomycin). Given <em>C. difficile</em> 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). |
| spellingShingle | Medical sciences Infectious diseases Immunology Eyre, D Babakhani, F Griffiths, D Seddon, J Del Ojo Elias, C Gorbach, S Peto, T Crook, D Walker, A Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile |
| title | Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile |
| title_full | Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile |
| title_fullStr | Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile |
| title_full_unstemmed | Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile |
| title_short | Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile |
| title_sort | whole genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with clostridium difficile |
| topic | Medical sciences Infectious diseases Immunology |
| work_keys_str_mv | AT eyred wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT babakhanif wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT griffithsd wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT seddonj wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT delojoeliasc wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT gorbachs wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT petot wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT crookd wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile AT walkera wholegenomesequencingdemonstratesthatfidaxomicinissuperiortovancomycinforpreventingreinfectionandrelapseofinfectionwithclostridiumdifficile |