Methods: Stool was collected within 72 h of admission from patients who provided consent and assayed for C. difficile colonization by glutamate dehydrogenase (GDH); microbiome analysis was performed by 16S rRNA sequencing. Clinical and demographic data were obtained from the EMR.
Results: 106 unique patients (pts.) provided a sample for analysis. Sixty-nine were categorized as high-risk, including 32 SCD pts. C. diff colonization rates were 22% and 19% in the high-risk and low-risk groups, respectively, but highest in the subset of SCD patients on penicillin prophylaxis (33%). The high-risk group had a trend towards lower microbial diversity than controls, and SCD patients exhibited a diversity index greater than other high-risk patients. Antibiotic use in the last 3 months and PPI use were associated with decreased microbial diversity across the entire study population (p=0.004, p=0.007, respectively). Among children with SCD, those on penicillin prophylaxis had a trend toward decreased alpha diversity while folic acid was associated with increased diversity (p=0.02). SCD patients had greater quantities of Bacteroides and Parabacteroides and fewer Escherichia and Shigella than the other cohorts.
SCD and penicillin prophylaxis might be risk factors for C. diff colonization and intestinal dysbiosis. The implications of these findings require further, longitudinal study.
T. Ambooken, None
D. Goldman, None
D. N. Tran, None
G. Weinstock, None
E. Sodergren, None
B. C. Herold, None