L Cussó1,2,3,4, E Reigadas2,5,6, P Muñoz2,5,6,7, Manuel Desco8,9,10,11, E Bouza2,5,6,7. 1. Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avenida de la Universidad 30, 28911, Leganés, Madrid, Spain. 2. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. 3. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. 4. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. 5. Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 6. Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain. 7. CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain. 8. Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avenida de la Universidad 30, 28911, Leganés, Madrid, Spain. desco@hggm.es. 9. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. desco@hggm.es. 10. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. desco@hggm.es. 11. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. desco@hggm.es.
Abstract
PURPOSE: Existing clinical or microbiological scores are not sensitive enough to obtain prompt identification of patients at risk of complicated Clostridium difficile infection (CDI). Our aim was to use a CDI animal model to evaluate 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET) as a marker of severe course of infection. PROCEDURES: CDI was induced with cefoperazone for 10 days followed by clindamycin 1 day before C. difficile inoculation. Mice were divided into wild type (n = 6), antibiotic without infection (AC n = 4), h001-infected (n = 5, ribotype 001), and h027-infected (n = 5, ribotype 027). Two days after inoculation, [18F]FDG-PET was acquired. Weight, general animal condition, and survival were monitored daily for 9 days. RESULTS: h001 group showed symptoms for 4 days with 0 % mortality and a similar colon uptake than control animals (h001 0.52 ± 0.20, WT 0.42 ± 0.07, and AC 0.36 ± 0.06). The h027 group showed symptoms up to 7 days, with 66.7 % of mortality 4 days after infection, and significantly higher colon uptake (0.93 ± 0.38, p < 0.05). Clinical score was associated to colon and cecum uptake (rho = 0.78, p = 0.0001) (rho = 0.73, p = 0.0003). CONCLUSION: High toxin producer ribotype 027 induced more severe CDI infections, correlating with higher colon and cecum [18F]FDG uptake. Colon uptake may purportedly serve as early predictor of CDI severity.
PURPOSE: Existing clinical or microbiological scores are not sensitive enough to obtain prompt identification of patients at risk of complicated Clostridium difficileinfection (CDI). Our aim was to use a CDI animal model to evaluate 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET) as a marker of severe course of infection. PROCEDURES: CDI was induced with cefoperazone for 10 days followed by clindamycin 1 day before C. difficile inoculation. Mice were divided into wild type (n = 6), antibiotic without infection (AC n = 4), h001-infected (n = 5, ribotype 001), and h027-infected (n = 5, ribotype 027). Two days after inoculation, [18F]FDG-PET was acquired. Weight, general animal condition, and survival were monitored daily for 9 days. RESULTS: h001 group showed symptoms for 4 days with 0 % mortality and a similar colon uptake than control animals (h001 0.52 ± 0.20, WT 0.42 ± 0.07, and AC 0.36 ± 0.06). The h027 group showed symptoms up to 7 days, with 66.7 % of mortality 4 days after infection, and significantly higher colon uptake (0.93 ± 0.38, p < 0.05). Clinical score was associated to colon and cecum uptake (rho = 0.78, p = 0.0001) (rho = 0.73, p = 0.0003). CONCLUSION: High toxin producer ribotype 027 induced more severe CDI infections, correlating with higher colon and cecum [18F]FDG uptake. Colon uptake may purportedly serve as early predictor of CDI severity.
Entities:
Keywords:
C. difficile; CT; Imaging; Mouse model; PET; Severe; [18F]FDG
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