Questioning Colonization

Eubank Awarded ACCP Grant to Predict Mortality Risk of C. difficile Infection when Colonized with Enterococcus

Outnumbering human cells by 10 to 1, body sites such as the mouth, nose, skin and lower intestine are each inhabited by organisms as different as those in the Amazon rainforest and the Sahara Desert. Most of the time, microorganisms live in harmony with their human hosts. But some pathogens, microorganisms known to cause illnesses, turn deadly. This is the case with Clostridioides difficile infection (CDI) and certain Enterococcus species.

Backed by a one-year, $40,000 grant from the American College of Clinical Pharmacy, UHCOP Research Assistant Professor Taryn A. Eubank, Pharm.D., BCIDP, is investigating the severity and mortality risk of C. difficile infection (CDI) when colonized with Enterococcus.

“We simply can’t sequence every stool sample to determine the patients’ baseline microbiota - it’s too expensive and timely to do in clinical practice,” Eubank said. “But, what we can do is test for certain metabolites or markers representative of Enterococcus colonization to help us predict mortality and stratify treatment options at the time of CDI diagnosis.”

Clinical practice guidelines by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) classify CDI severity into three categories: non-severe/mild, severe, and fulminant. “Severe” refers to a more serious presentation of CDI with symptoms like high white blood cell count and elevated creatinine, while “fulminant” describes the most severe form of CDI, characterized by life-threatening complications like septic shock, toxic megacolon, ICU admission, and death. Eubank is diving into the severe and fulminant categories in her research.

“Within 30 days of CDI diagnosis, 10-15% of patients die,” Eubank said. “We do know there is a higher risk of mortality linked to Enterococcus colonization, and this project will provide insight on that mortality risk.”

As part of another funded project, Eubank is investigating how Enterococcus colonization during CDI impacts disease severity in hospitalized patients. Together, these early career grants allow Eubank to build preliminary data making her eligible for larger grants in the future.