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SEROPREVALENCE OF ANTIBODIES TO CLOSTRIDIOIDES DIFFICILE TOXINS. PRELIMINARY RESULTS OF THE PREVADIFF STUDY
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International audience. BACKGROUND AND AIMSData on the seroprevalence of antibodies to Clostridioides difficile (Cd) surface proteins and toxins are scarce. In 1983, Viscidi et al. were the first to show that antibodies to Cd toxins A and B were widely detected in adult population (60-70%). However, these results were only qualitative and did not reveal inter-individual variations. Several studies have since shown that not all antibodies detected have a neutralizing capacity on the action of toxins and were therefore not all protective. The aim of this study was to determine seroprevalence of antibodies directed to both TcdA and TcdB in a large population of adults and to stratify it according to age group, gender, and the main risk factors for Clostridioides difficile infection. This study also aims characterize the antibodies detected and in particular their neutralizing capacity and identify categories of patients at greater risk of not developing protective antibodies.METHODSPREVADIFF is a prospective, multicenter study conducted in three regions of France. All adult patients (≥ 18 years) hospitalized in selected short-stay and long-term care wards for each of the five hospitals were eligible to be included in the study. Moreover, volunteers from the Blood Donors Bank (EFS) of the same three regions were also included for the community section of this study. Sera and clinico-demographic data were collected from hospitalized patients and volunteers. IgG concentrations against TcdA and TcdB were determined by quantitative ELISA.RESULTS To date all the community section was enrolled and a total of 642 patients were included. We presented the preliminary data from the analysis of the 191 first cases. 16/35 (45.7%) of hospitalized patients and 88/156 (56.4%) of EFS donors had mean anti-TcdA IgG concentrations above five times the detection limit, with significant inter-individual variability at 0.7 mg/L (IQR: 0.4-1) and 1.2 mg/l (IQR: 0.5-1.5), respectively. CONCLUSIONThese preliminary results, based on the analysis of the first samples from one center and on antibodies directed against TcdA, show significant seroprevalence in both the hospitalized population and in the healthy volunteers of blood donors. These initial results confirm those already published and suggest that we are regularly exposed to Clostridioides difficile throughout life and in particular to its toxins.
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