Reductions in intestinal Clostridiales precede the development of nosocomial Clostridium difficile infection

Table 2 Multivariable analysis of epidemiologic exposures and intestinal bacterial taxa related to Clostridium difficile infection (CDI) development

Variable	Phylum-level analysis
	V1-V3 sequence set		V3-V5 sequence set
	P value^a	Coefficient sign^b	P value^a	Coefficient sign^b
Bacterial phylum
Bacteroidetes	0.048	-	0.061	-
Shannon diversity	0.187	-	0.455	-
Medication use^c
H2 blocker	0.319	-	0.271	-
Nonsteroidal anti-inflammatory drug	0.684	+	0.989	+
Proton-pump inhibitor	0.443	-	0.467	-
Cephalosporin	0.016	+	0.009	+
Fluoroquinolone	0.038	+	0.018	+
Penicillin with β-lactamase inhibitor	0.228	+	0.424	+
Vancomycin^d	0.278	+	0.116	+
	Family-level analysis
	V1-V3 sequence set		V3-V5 sequence set
	P value ^a	Coefficient sign ^b	P value ^a	Coefficient sign ^b
Bacterial family
Bacteroidaceae	0.073	-	0.051	-
Clostridiales Incertae Sedis XI	0.015	-	0.025	-
Enterococcaceae	0.942	+	0.246	+
Shannon diversity	0.728	+	0.238	+
Medication use^c
H2 blocker	0.384	-	0.318	-
Nonsteroidal anti-inflammatory drug	0.921	+	0.605	+
Proton-pump inhibitor	0.674	-	0.558	-
Cephalosporin	0.020	+	0.027	+
Fluoroquinolone	0.045	+	0.061	+
Penicillin with β-lactamase inhibitor	0.692	+	0.850	-
Vancomycin^d	0.423	+	0.193	+

^aP values were determined by multivariate logistic regression. ^bA positive sign indicates that 16S sequence abundance (for bacterial taxa) or number of patients exposed (for medications) was higher among patients with CDI than among controls, while a negative sign indicates that 16S sequence abundance or number of patients exposed was lower among patients with CDI. ^cDefined as use within 8 weeks before or during hospitalization, until stool collection. ^dIntravenous administration.