Serum Mannose-Binding Lectin Concentration, but Not Genotype, Is Associated With Clostridium difficile Infection Recurrence: A Prospective Cohort Study

Background. Mannose-binding lectin (MBL) plays a key role in the activation of the lectin-complement pathway of innate immunity, and its deficiency has been linked with several acute infections. However, its role in predisposing to, or modulating disease severity in, Clostridium difficile infection...

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Bibliographic Details
Published in:Clinical infectious diseases 2014-11, Vol.59 (10), p.1429-1436
Main Authors: Swale, Andrew, Miyajima, Fabio, Kolamunnage-Dona, Ruwanthi, Roberts, Paul, Little, Margaret, Beeching, Nicholas J., Beadsworth, Mike B. J., Liloglou, Triantafillos, Pirmohamed, Munir
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
and Commentaries
Antibiotics
ARTICLES AND COMMENTARIES
Bacterial diseases
Bacterial diseases of the digestive system and abdomen
Bacterial infections
Biological and medical sciences
Case-Control Studies
Clostridioides difficile
Clostridium difficile
Clostridium Infections - blood
Clostridium Infections - microbiology
Comorbidity
Diarrhea
Enterocolitis, Pseudomembranous - blood
Enterocolitis, Pseudomembranous - etiology
Enterocolitis, Pseudomembranous - microbiology
Female
Gastroenterology. Liver. Pancreas. Abdomen
Gene Frequency
Gene Order
Genetic Loci
Genotype
Genotype & phenotype
Genotypes
Haplotypes
Health outcomes
Human bacterial diseases
Humans
Immunoassay
Infections
Infectious diseases
Lectins
Male
Mannose-Binding Lectin - blood
Mannose-Binding Lectin - genetics
Medical genetics
Medical sciences
Middle Aged
Other diseases. Semiology
Patient Outcome Assessment
Polymorphism, Genetic
Prospective Studies
Protein Isoforms
Proteins
Recurrence
Reference Values
Relapse
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Symptoms
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Summary:Background. Mannose-binding lectin (MBL) plays a key role in the activation of the lectin-complement pathway of innate immunity, and its deficiency has been linked with several acute infections. However, its role in predisposing to, or modulating disease severity in, Clostridium difficile infection (CDI) has not been investigated. Methods. We prospectively recruited 308 CDI case patients and 145 control patients with antibiotic-associated diarrhea (AAD). CDI outcome measures were disease severity, duration of symptoms, 30-day mortality, and 90-day recurrence. Serum concentrations of MBL were determined using a commercial enzyme-linked immunosorbent assay transferred to an electrochemiluminescence–based platform. MBL2 polymorphisms were typed using a combination of pyrosequencing and TaqMan genotyping assays. Results. The frequency of the MBL2 genetic variants was similar to that reported in other white populations. MBL serum concentrations in CDI and AAD subjects were determined by MBL2 exonic variants B, C, and D and the haplotypes (LYPB, LYQC, and HYPD). There was no difference in either MBL concentrations or genotypes between cases and controls. MBL concentration, but not genotype, was a determinant of CDI recurrence (odds ratios, 3.18 [95% confidence interval {CI}, 1.40–7.24] and 2.61 [95% CI, 1.35–5.04] at the
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciu666