{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T22:54:20Z","timestamp":1772232860988,"version":"3.50.1"},"reference-count":62,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"DOI":"10.1186\/s12876-025-04227-w","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T07:33:45Z","timestamp":1756107225000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Investigating the relationship between Helicobacter pylori and intestinal Clostridioides difficile infection: evidence from a cross-sectional study"],"prefix":"10.1186","volume":"25","author":[{"given":"Linlin","family":"Yin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongfei","family":"Tu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Qian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengliang","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"issue":"4","key":"4227_CR1","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1053\/j.gastro.2023.12.022","volume":"166","author":"YC Chen","year":"2024","unstructured":"Chen YC, Malfertheiner P, Yu HT, Kuo CL, Chang YY, Meng FT, Wu YX, Hsiao JL, Chen MJ, Lin KP, et al. Global prevalence of Helicobacter pylori infection and incidence of gastric cancer between 1980 and 2022. Gastroenterology. 2024;166(4):605\u201319.","journal-title":"Gastroenterology"},{"issue":"6","key":"4227_CR2","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/S2468-1253(23)00070-5","volume":"8","author":"Y Li","year":"2023","unstructured":"Li Y, Choi H, Leung K, Jiang F, Graham DY, Leung WK. Global prevalence of Helicobacter pylori infection between 1980 and 2022: a systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology. 2023;8(6):553\u201364.","journal-title":"The Lancet Gastroenterology & Hepatology"},{"issue":"3","key":"4227_CR3","doi-asserted-by":"publisher","first-page":"238","DOI":"10.7704\/kjhugr.2024.0031","volume":"24","author":"JY Ahn","year":"2024","unstructured":"Ahn JY. Prevention of gastric cancer: Helicobacter pylori treatment. Korean J Helicobacter Up Gastrointest Res. 2024;24(3):238\u201342.","journal-title":"Korean J Helicobacter Up Gastrointest Res"},{"issue":"1","key":"4227_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-025-04034-3","volume":"25","author":"K Sugano","year":"2025","unstructured":"Sugano K, Suzuki C, Ota M, Iwakiri R. Gastric cancer risk after Helicobacter pylori eradication in gastritis and peptic ulcer: a retrospective cohort study in Japan. BMC Gastroenterol. 2025;25(1): 463.","journal-title":"BMC Gastroenterol"},{"issue":"1","key":"4227_CR5","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-00713-z","volume":"15","author":"A Ono","year":"2025","unstructured":"Ono A, Tanaka S, Sawada N, Goto A, Tsugane S, Muraki I, Yamagishi K, Sasaki Y, Abe Y, Kayama T, et al. Helicobacter pylori eradication and gastric cancer prevention in a pooled analysis of large-scale cohort studies in Japan. Sci Rep. 2025;15(1): 21307.","journal-title":"Sci Rep"},{"key":"4227_CR6","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s12038-023-00387-7","volume":"49","author":"DE Amrousy","year":"2024","unstructured":"Amrousy DE, Ashry HE, Maher S, Abdelhai D, Hassan S. Helicobacter pylori infection and gut microbiota in adolescents: is there a relation? J Biosci. 2024;49:7.","journal-title":"J Biosci"},{"issue":"1","key":"4227_CR7","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-56631-4","volume":"9","author":"F Frost","year":"2019","unstructured":"Frost F, Kacprowski T, R\u00fchlemann M, Bang C, Franke A, Zimmermann K, Nauck M, V\u00f6lker U, V\u00f6lzke H, Biffar R, et al. Helicobacter pylori infection associates with fecal microbiota composition and diversity. Sci Rep. 2019;9(1): 20100.","journal-title":"Sci Rep"},{"issue":"1","key":"4227_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/19490976.2021.1909459","volume":"13","author":"CC Chen","year":"2021","unstructured":"Chen CC, Liou JM, Lee YC, Hong TC, El-Omar EM, Wu MS. The interplay between Helicobacter pylori and gastrointestinal microbiota. Gut Microbes. 2021;13(1):1\u201322.","journal-title":"Gut Microbes"},{"issue":"14","key":"4227_CR9","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1056\/NEJMoa1910215","volume":"382","author":"AY Guh","year":"2020","unstructured":"Guh AY, Mu Y, Winston LG, Johnston H, Olson D, Farley MM, Wilson LE, Holzbauer SM, Phipps EC, Dumyati GK, et al. Trends in U.S. burden of clostridioides difficile infection and outcomes. N Engl J Med. 2020;382(14):1320\u201330.","journal-title":"N Engl J Med"},{"key":"4227_CR10","doi-asserted-by":"publisher","DOI":"10.3390\/idr17020031","author":"RAA Akorful","year":"2025","unstructured":"Akorful RAA, Odoom A, Awere-Duodu A, Donkor ES. The global burden of clostridioides difficile infections, 2016\u20132024: a systematic review and meta-analysis. Infect Dis Rep. 2025. https:\/\/doi.org\/10.3390\/idr17020031.","journal-title":"Infect Dis Rep"},{"key":"4227_CR11","doi-asserted-by":"publisher","DOI":"10.1177\/17562848211016248","volume":"14","author":"Y Fu","year":"2021","unstructured":"Fu Y, Luo Y, Grinspan AM. Epidemiology of community-acquired and recurrent clostridioides difficile infection. Ther Adv Gastroenterol. 2021;14: 17562848211016248.","journal-title":"Ther Adv Gastroenterol"},{"issue":"10","key":"4227_CR12","doi-asserted-by":"publisher","first-page":"758","DOI":"10.7326\/0003-4819-145-10-200611210-00008","volume":"145","author":"JG Bartlett","year":"2006","unstructured":"Bartlett JG. Narrative review: the new epidemic of clostridium difficile-associated enteric disease. Ann Intern Med. 2006;145(10):758\u201364.","journal-title":"Ann Intern Med"},{"issue":"7","key":"4227_CR13","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1093\/cid\/ciy149","volume":"66","author":"LC McDonald","year":"2018","unstructured":"McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, et al. Clinical practice guidelines for clostridium difficile infection in adults and children: 2017 update by the infectious diseases society of America (IDSA) and society for healthcare epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):987\u201394.","journal-title":"Clin Infect Dis"},{"issue":"2","key":"4227_CR14","doi-asserted-by":"publisher","first-page":"e0013523","DOI":"10.1128\/cmr.00135-23","volume":"37","author":"S Di Bella","year":"2024","unstructured":"Di Bella S, Sanson G, Monticelli J, Zerbato V, Principe L, Giuffr\u00e8 M, Pipitone G, Luzzati R. Clostridioides difficile infection: history, epidemiology, risk factors, prevention, clinical manifestations, treatment, and future options. Clin Microbiol Rev. 2024;37(2):e0013523.","journal-title":"Clin Microbiol Rev"},{"issue":"7","key":"4227_CR15","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1038\/ajg.2012.108","volume":"107","author":"CS Kwok","year":"2012","unstructured":"Kwok CS, Arthur AK, Anibueze CI, Singh S, Cavallazzi R, Loke YK. Risk of clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. Am J Gastroenterol. 2012;107(7):1011\u20139.","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"4227_CR16","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1001\/jamainternmed.2015.42","volume":"175","author":"EG McDonald","year":"2015","unstructured":"McDonald EG, Milligan J, Frenette C, Lee TC. Continuous proton pump inhibitor therapy and the associated risk of recurrent clostridium difficile infection. JAMA Intern Med. 2015;175(5):784\u201391.","journal-title":"JAMA Intern Med"},{"issue":"35","key":"4227_CR17","doi-asserted-by":"publisher","first-page":"6500","DOI":"10.3748\/wjg.v23.i35.6500","volume":"23","author":"A Trifan","year":"2017","unstructured":"Trifan A, Stanciu C, Girleanu I, Stoica OC, Singeap AM, Maxim R, Chiriac SA, Ciobica A, Boiculese L. Proton pump inhibitors therapy and risk of clostridium difficile infection: systematic review and meta-analysis. World J Gastroenterol. 2017;23(35):6500\u201315.","journal-title":"World J Gastroenterol"},{"issue":"5","key":"4227_CR18","doi-asserted-by":"publisher","first-page":"716","DOI":"10.14309\/ajg.0000000000000626","volume":"115","author":"S Kumar","year":"2020","unstructured":"Kumar S, Metz DC, Kaplan DE, Goldberg DS. Treatment of Helicobacter pylori is not associated with future Clostridium difficile infection. Am J Gastroenterol. 2020;115(5):716\u201322.","journal-title":"Am J Gastroenterol"},{"key":"4227_CR19","doi-asserted-by":"crossref","unstructured":"Abd Rahim MA, Johani FH, Shah SA, Hassan MR, Abdul Manaf MR. (13)C-Urea breath test accuracy for Helicobacter pylori infection in the Asian population: A Meta-Analysis. Ann Glob Health. 2019;85(1):110.","DOI":"10.5334\/aogh.2570"},{"issue":"1","key":"4227_CR20","doi-asserted-by":"publisher","first-page":"18","DOI":"10.4103\/2229-516X.174003","volume":"6","author":"AD Roy","year":"2016","unstructured":"Roy AD, Deuri S, Dutta UC. The diagnostic accuracy of rapid urease biopsy test compared to histopathology in implementing test and treat policy for Helicobacter pylori. Int J Appl Basic Med Res. 2016;6(1):18\u201322.","journal-title":"Int J Appl Basic Med Res"},{"key":"4227_CR21","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2022.106657","volume":"204","author":"M Zangiabadian","year":"2023","unstructured":"Zangiabadian M, Ghorbani A, Nojookambari NY, Ahmadbeigi Y, Hosseini SS, Karimi-Yazdi M, Goudarzi M, Chirani AS, Nasiri MJ. Accuracy of diagnostic assays for the detection of clostridioides difficile: a systematic review and meta-analysis. J Microbiol Methods. 2023;204: 106657.","journal-title":"J Microbiol Methods"},{"key":"4227_CR22","doi-asserted-by":"crossref","unstructured":"Viprey VF, Clark E, Davies KA. Diagnosis of clostridioides difficile infection and impact of testing. J Med Microbiol. 2024;73(12):001939.","DOI":"10.1099\/jmm.0.001939"},{"issue":"2","key":"4227_CR23","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1053\/j.gastro.2017.04.022","volume":"153","author":"JKY Hooi","year":"2017","unstructured":"Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, Malfertheiner P, Graham DY, Wong VWS, Wu JCY, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153(2):420\u20139.","journal-title":"Gastroenterology"},{"issue":"1","key":"4227_CR24","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-023-00431-8","volume":"9","author":"P Malfertheiner","year":"2023","unstructured":"Malfertheiner P, Camargo MC, El-Omar E, Liou JM, Peek R, Schulz C, Smith SI, Suerbaum S. Helicobacter pylori infection. Nat Rev Dis Primers. 2023;9(1): 19.","journal-title":"Nat Rev Dis Primers"},{"issue":"6","key":"4227_CR25","doi-asserted-by":"publisher","first-page":"e0129024","DOI":"10.1128\/spectrum.01290-24","volume":"13","author":"J Zhou","year":"2025","unstructured":"Zhou J, Zhu J, Zhang P, Tao C, Hong X, Zhang Z. Global, regional, and national burdens of clostridioides difficile infection over recent decades: a trend analysis informed by the global burden of disease study. Microbiol Spectr. 2025;13(6):e0129024.","journal-title":"Microbiol Spectr"},{"issue":"1","key":"4227_CR26","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2025.2451762","volume":"57","author":"J Xia","year":"2025","unstructured":"Xia J, Liu T, Wan R, Zhang J, Fu Q. Global burden and trends of the clostridioides difficile infection-associated diseases from 1990 to 2021: an observational trend study. Ann Med. 2025;57(1): 2451762.","journal-title":"Ann Med"},{"issue":"4","key":"4227_CR27","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1159\/000500634","volume":"101","author":"C Iino","year":"2020","unstructured":"Iino C, Shimoyama T, Chinda D, Sakuraba H, Fukuda S, Nakaji S. Influence of Helicobacter pylori infection and atrophic gastritis on the gut microbiota in a Japanese population. Digestion. 2020;101(4):422\u201332.","journal-title":"Digestion"},{"issue":"4","key":"4227_CR28","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12590","volume":"24","author":"C He","year":"2019","unstructured":"He C, Peng C, Wang H, Ouyang Y, Zhu Z, Shu X, Zhu Y, Lu N. The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults. Helicobacter. 2019;24(4): e12590.","journal-title":"Helicobacter"},{"key":"4227_CR29","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2024.106458","volume":"193","author":"M Sun","year":"2024","unstructured":"Sun M, Chen H, Dong S, Zhang G, Zhou X, Cheng H. Alteration of gut microbiota in post-stroke depression patients with Helicobacter pylori infection. Neurobiol Dis. 2024;193: 106458.","journal-title":"Neurobiol Dis"},{"issue":"3","key":"4227_CR30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0213548","volume":"14","author":"GM Mart\u00edn-N\u00fa\u00f1ez","year":"2019","unstructured":"Mart\u00edn-N\u00fa\u00f1ez GM, Cornejo-Pareja I, Coin-Arag\u00fcez L, Roca-Rodr\u00edguez MDM, Mu\u00f1oz-Garach A, Clemente-Postigo M, Cardona F, Moreno-Indias I, Tinahones FJ. H. pylori eradication with antibiotic treatment causes changes in glucose homeostasis related to modifications in the gut microbiota. PLoS One. 2019;14(3): e0213548.","journal-title":"PLoS One"},{"issue":"1","key":"4227_CR31","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-025-03631-6","volume":"25","author":"S Cui","year":"2025","unstructured":"Cui S, Liu X, Han F, Zhang L, Bu J, Wu S, Wang J. Helicobacter pylori CagA\u2009+\u2009strains modulate colorectal pathology by regulating intestinal flora. BMC Gastroenterol. 2025;25(1): 54.","journal-title":"BMC Gastroenterol"},{"issue":"3","key":"4227_CR32","doi-asserted-by":"publisher","DOI":"10.1111\/hel.70047","volume":"30","author":"Y Wang","year":"2025","unstructured":"Wang Y, Zhou K, Zhang Y, Li C, Zhang Y, Ren X, Mi C, Ma L, Duan Y, Liu M, et al. The systemic impact of Helicobacter pylori infection on the microbiome of whole digestive tract based on mucosal, gastric juice, and fecal specimens. Helicobacter. 2025;30(3): e70047.","journal-title":"Helicobacter"},{"issue":"11","key":"4227_CR33","doi-asserted-by":"publisher","first-page":"C979","DOI":"10.1152\/ajpcell.00228.2014","volume":"307","author":"N Natarajan","year":"2014","unstructured":"Natarajan N, Pluznick JL. From microbe to man: the role of microbial short chain fatty acid metabolites in host cell biology. Am J Physiol Cell Physiol. 2014;307(11):C979\u2013985.","journal-title":"Am J Physiol Cell Physiol"},{"issue":"6","key":"4227_CR34","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1038\/s41564-018-0150-6","volume":"3","author":"AJ Hryckowian","year":"2018","unstructured":"Hryckowian AJ, Van Treuren W, Smits SA, Davis NM, Gardner JO, Bouley DM, Sonnenburg JL. Microbiota-accessible carbohydrates suppress clostridium difficile infection in a murine model. Nat Microbiol. 2018;3(6):662\u20139.","journal-title":"Nat Microbiol"},{"issue":"3","key":"4227_CR35","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.02535-23","volume":"15","author":"DA Pensinger","year":"2024","unstructured":"Pensinger DA, Dobrila HA, Stevenson DM, Hryckowian ND, Amador-Noguez D, Hryckowian AJ. Exogenous butyrate inhibits butyrogenic metabolism and alters virulence phenotypes in clostridioides difficile. mBio. 2024;15(3): e0253523.","journal-title":"mBio"},{"key":"4227_CR36","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.anaerobe.2018.04.001","volume":"53","author":"AM Seekatz","year":"2018","unstructured":"Seekatz AM, Theriot CM, Rao K, Chang YM, Freeman AE, Kao JY, Young VB. Restoration of short chain fatty acid and bile acid metabolism following fecal microbiota transplantation in patients with recurrent clostridium difficile infection. Anaerobe. 2018;53:64\u201373.","journal-title":"Anaerobe"},{"issue":"2","key":"4227_CR37","doi-asserted-by":"publisher","first-page":"e0057022","DOI":"10.1128\/iai.00570-22","volume":"91","author":"DA Pensinger","year":"2023","unstructured":"Pensinger DA, Fisher AT, Dobrila HA, Van Treuren W, Gardner JO, Higginbottom SK, Carter MM, Schumann B, Bertozzi CR, Anikst V, et al. Butyrate differentiates permissiveness to clostridioides difficile infection and influences growth of diverse C. difficile isolates. Infect Immun. 2023;91(2):e0057022.","journal-title":"Infect Immun"},{"key":"4227_CR38","doi-asserted-by":"publisher","DOI":"10.1016\/j.anaerobe.2022.102585","volume":"75","author":"ZR Ouyang","year":"2022","unstructured":"Ouyang ZR, Niu XR, Wang WG, Zhao JH. The role of short-chain fatty acids in clostridioides difficile infection: a review. Anaerobe. 2022;75: 102585.","journal-title":"Anaerobe"},{"key":"4227_CR39","doi-asserted-by":"crossref","unstructured":"Fachi JL, S\u00e9cca C, Rodrigues PB, Mato FCP, Di Luccia B, Felipe JS, Pral LP, Rungue M, Rocha VM, Sato FT et al. Acetate coordinates neutrophil and ILC3 responses against C. difficile through FFAR2. J Exp Med. 2020;217(3):jem.20190489.","DOI":"10.1084\/jem.20190489"},{"key":"4227_CR40","doi-asserted-by":"publisher","DOI":"10.1016\/j.micres.2024.127739","volume":"285","author":"G Herrera","year":"2024","unstructured":"Herrera G, Casta\u00f1eda S, Arboleda JC, P\u00e9rez-Jaramillo JE, Patarroyo MA, Ram\u00edrez JD, Mu\u00f1oz M. Metagenome-assembled genomes (MAGs) suggest an acetate-driven protective role in gut microbiota disrupted by clostridioides difficile. Microbiol Res. 2024;285: 127739.","journal-title":"Microbiol Res"},{"issue":"3","key":"4227_CR41","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.jiac.2019.10.021","volume":"26","author":"T Nei","year":"2020","unstructured":"Nei T, Hagiwara J, Takiguchi T, Yokobori S, Shiei K, Yokota H, Senoh M, Kato H. Fatal fulminant clostridioides difficile colitis caused by Helicobacter pylori eradication therapy; a case report. J Infect Chemother. 2020;26(3):305\u20138.","journal-title":"J Infect Chemother"},{"issue":"3","key":"4227_CR42","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1046\/j.1365-2796.1998.00272.x","volume":"243","author":"A Archimandritis","year":"1998","unstructured":"Archimandritis A, Souyioultzis S, Katsorida M, Tzivras M. Clostridium difficile colitis associated with a \u2018triple\u2019 regimen, containing clarithromycin and metronidazole, to eradicate Helicobacter pylori. J Intern Med. 1998;243(3):251\u20133.","journal-title":"J Intern Med"},{"issue":"7","key":"4227_CR43","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1111\/j.1572-0241.1998.00358.x","volume":"93","author":"A Nawaz","year":"1998","unstructured":"Nawaz A, Mohammed I, Ahsan K, Karakurum A, Hadjiyane C, Pellecchia C. Clostridium difficile colitis associated with treatment of Helicobacter pylori infection. Am J Gastroenterol. 1998;93(7):1175\u20136.","journal-title":"Am J Gastroenterol"},{"issue":"7","key":"4227_CR44","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.gastrohep.2019.01.012","volume":"42","author":"M Castro-Fern\u00e1ndez","year":"2019","unstructured":"Castro-Fern\u00e1ndez M, Marqu\u00e9s-Ruiz A, C\u00e1mara-Baena S, Grande-Santamar\u00eda L. Clostridium difficile infection associated with bismuth-based quadruple therapy (Pylera(\u00ae)) for Helicobacter pylori eradication. Gastroenterol Hepatol. 2019;42(7):459\u201360.","journal-title":"Gastroenterol Hepatol"},{"issue":"8","key":"4227_CR45","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/j.gastrohep.2019.05.001","volume":"42","author":"JM Prieto de Paula","year":"2019","unstructured":"Prieto de Paula JM, Garc\u00eda Colodro J, Prieto Dehesa M, Franco Hidalgo S. Clostridium difficile infection associated with metronidazole-based treatment for Helicobacter pylori eradication. Gastroenterol Hepatol. 2019;42(8):524.","journal-title":"Gastroenterol Hepatol"},{"issue":"1","key":"4227_CR46","doi-asserted-by":"publisher","first-page":"e12668","DOI":"10.1111\/hel.12668","volume":"25","author":"K Muhsen","year":"2020","unstructured":"Muhsen K, Na\u2019amnih W, Adler A, Carmeli Y, Cohen D. Clostridium difficile-associated disease and Helicobacter pylori seroprevalence: a case-control study. Helicobacter. 2020;25(1):e12668.","journal-title":"Helicobacter"},{"issue":"11","key":"4227_CR47","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1016\/j.cub.2016.04.016","volume":"26","author":"E Biagi","year":"2016","unstructured":"Biagi E, Franceschi C, Rampelli S, Severgnini M, Ostan R, Turroni S, Consolandi C, Quercia S, Scurti M, Monti D, et al. Gut microbiota and extreme longevity. Curr Biol. 2016;26(11):1480\u20135.","journal-title":"Curr Biol"},{"issue":"6","key":"4227_CR48","doi-asserted-by":"publisher","first-page":"e295","DOI":"10.1016\/S1470-2045(18)30095-0","volume":"19","author":"A Biragyn","year":"2018","unstructured":"Biragyn A, Ferrucci L. Gut dysbiosis: a potential link between increased cancer risk in ageing and inflammaging. Lancet Oncol. 2018;19(6):e295\u2013304.","journal-title":"Lancet Oncol"},{"issue":"6","key":"4227_CR49","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s10522-019-09830-5","volume":"20","author":"T Zeng","year":"2019","unstructured":"Zeng T, Cui H, Tang D, Garside GB, Wang Y, Wu J, Tao Z, Zhang L, Tao S. Short-term dietary restriction in old mice rejuvenates the aging-induced structural imbalance of gut microbiota. Biogerontology. 2019;20(6):837\u201348.","journal-title":"Biogerontology"},{"issue":"12","key":"4227_CR50","first-page":"e75071","volume":"16","author":"I Ishanvi","year":"2024","unstructured":"Ishanvi I, Patro S, Sharma V, Sandeep C, Mohapatra S, Sabat S, Panigrahi K, Pathi BK. Incidence and risk factors of clostridium difficile infection among adult patients admitted to the inpatient department of a tertiary care hospital: A Hospital-Based observational study. Cureus. 2024;16(12):e75071.","journal-title":"Cureus"},{"issue":"2","key":"4227_CR51","doi-asserted-by":"publisher","first-page":"221","DOI":"10.4103\/0377-4929.208383","volume":"60","author":"L Segar","year":"2017","unstructured":"Segar L, Easow JM, Srirangaraj S, Hanifah M, Joseph NM, Seetha KS. Prevalence of clostridium difficile infection among the patients attending a tertiary care teaching hospital. Indian J Pathol Microbiol. 2017;60(2):221\u20135.","journal-title":"Indian J Pathol Microbiol"},{"issue":"1","key":"4227_CR52","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.dld.2004.09.007","volume":"37","author":"F Mana","year":"2005","unstructured":"Mana F, Van Laer W, Bossuyt A, Urbain D. The early effect of proton pump inhibitor therapy on the accuracy of the 13\u00a0C-urea breath test. Dig Liver Dis. 2005;37(1):28\u201332.","journal-title":"Dig Liver Dis"},{"issue":"5","key":"4227_CR53","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1111\/j.1572-0241.2003.07426.x","volume":"98","author":"DY Graham","year":"2003","unstructured":"Graham DY, Opekun AR, Hammoud F, Yamaoka Y, Reddy R, Osato MS, El-Zimaity HM. Studies regarding the mechanism of false negative urea breath tests with proton pump inhibitors. Am J Gastroenterol. 2003;98(5):1005\u20139.","journal-title":"Am J Gastroenterol"},{"issue":"2","key":"4227_CR54","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/S1473-3099(16)30397-8","volume":"17","author":"T Lawes","year":"2017","unstructured":"Lawes T, Lopez-Lozano JM, Nebot CA, Macartney G, Subbarao-Sharma R, Wares KD, Sinclair C, Gould IM. Effect of a National 4 C antibiotic stewardship intervention on the clinical and molecular epidemiology of clostridium difficile infections in a region of scotland: a non-linear time-series analysis. Lancet Infect Dis. 2017;17(2):194\u2013206.","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"4227_CR55","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1001\/jamainternmed.2014.8273","volume":"175","author":"K Brown","year":"2015","unstructured":"Brown K, Valenta K, Fisman D, Simor A, Daneman N. Hospital ward antibiotic prescribing and the risks of clostridium difficile infection. JAMA Intern Med. 2015;175(4):626\u201333.","journal-title":"JAMA Intern Med"},{"issue":"5","key":"4227_CR56","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1093\/cid\/ciaa124","volume":"72","author":"KA Brown","year":"2021","unstructured":"Brown KA, Langford B, Schwartz KL, Diong C, Garber G, Daneman N. Antibiotic prescribing choices and their comparative C. difficile infection risks: a longitudinal case-cohort study. Clin Infect Dis. 2021;72(5):836\u201344.","journal-title":"Clin Infect Dis"},{"issue":"9","key":"4227_CR57","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.14309\/ajg.0000000000002968","volume":"119","author":"WD Chey","year":"2024","unstructured":"Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, Shah SC. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2024;119(9):1730\u201353.","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"4227_CR58","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1093\/jac\/dkac404","volume":"78","author":"EJ Bishop","year":"2022","unstructured":"Bishop EJ, Tiruvoipati R. Management of clostridioides difficile infection in adults and challenges in clinical practice: review and comparison of current IDSA\/SHEA, ESCMID and ASID guidelines. J Antimicrob Chemother. 2022;78(1):21\u201330.","journal-title":"J Antimicrob Chemother"},{"issue":"6","key":"4227_CR59","doi-asserted-by":"publisher","DOI":"10.14309\/crj.0000000000001369","volume":"11","author":"Y Abboud","year":"2024","unstructured":"Abboud Y, Richter B, Malhotra R, Vossough-Teehan S. Treating Helicobacter pylori and recurrent clostridioides difficile coinfection: a delicate balance in management and a need for guidelines. ACG Case Rep J. 2024;11(6): e01369.","journal-title":"ACG Case Rep J"},{"key":"4227_CR60","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00125-17","author":"KM Shea","year":"2017","unstructured":"Shea KM, Hobbs ALV, Jaso TC, Bissett JD, Cruz CM, Douglass ET, Garey KW. Effect of a health care system respiratory fluoroquinolone restriction program to alter utilization and impact rates of clostridium difficile infection. Antimicrob Agents Chemother. 2017. https:\/\/doi.org\/10.1128\/AAC.00125-17.","journal-title":"Antimicrob Agents Chemother"},{"issue":"2","key":"4227_CR61","doi-asserted-by":"publisher","first-page":"e210361","DOI":"10.1001\/jamanetworkopen.2021.0361","volume":"4","author":"E Scaria","year":"2021","unstructured":"Scaria E, Barker AK, Alagoz O, Safdar N. Association of visitor contact precautions with estimated hospital-onset clostridioides difficile infection rates in acute care hospitals. JAMA Netw Open. 2021;4(2):e210361.","journal-title":"JAMA Netw Open"},{"issue":"3","key":"4227_CR62","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1017\/ice.2022.84","volume":"44","author":"PC Carling","year":"2023","unstructured":"Carling PC, O\u2019Hara LM, Harris AD, Olmsted R. Mitigating hospital-onset clostridioides difficile: the impact of an optimized environmental hygiene program in eight hospitals. Infect Control Hosp Epidemiol. 2023;44(3):440\u20136.","journal-title":"Infect Control Hosp Epidemiol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-04227-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-025-04227-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-04227-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T22:12:38Z","timestamp":1757455958000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-025-04227-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":62,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4227"],"URL":"https:\/\/doi.org\/10.1186\/s12876-025-04227-w","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]},"assertion":[{"value":"8 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the guidelines of the Declaration of Helsinki. The requirement for ethics approval and informed consent was waived by the Medical Ethics Committee of the Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, due to its retrospective design and use of deidentified data. Patients were assigned serial numbers according to the order of data entry. After collecting the required variables, all direct identifiers (such as names, identification numbers, and medical record numbers) were removed. Additionally, no patient-identifiable information is presented anywhere in the manuscript, ensuring the protection of patient privacy.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"616"}}