Infectious Inequity: How the Gut Microbiome and Social Determinants of Health May Contribute to Clostridioides difficile Infection Among Racial and Ethnic Minorities

Author:

Reveles Kelly R12,Strey Kelsey A12,Abdul-Mutakabbir Jacinda C34,Mendoza V Mateo12,Carreno Joseph J5

Affiliation:

1. Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin , Austin, Texas , USA

2. Pharmacotherapy Education & Research Center, University of Texas Health San Antonio , San Antonio, Texas , USA

3. Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California–San Diego , La Jolla, California , USA

4. Division of the Black Diaspora and African American Studies, University of California–San Diego , La Jolla, California , USA

5. Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences , Albany, New York , USA

Abstract

Abstract Infectious diseases are a leading contributor to death in the United States, and racial differences in clinical outcomes have been increasingly reported. Clostridioides difficile infection (CDI) is a growing public health concern, as it causes nearly half a million infections per year and considerable excess hospital costs. Concurrent with other infectious diseases, recent literature denotes racial disparities in CDI incidence rates, mortality, and associated morbidity. Of note, investigations into CDI and causative factors suggest that inequities in health-related social needs and other social determinants of health (SDoH) may cause disruption to the gut microbiome, thereby contributing to the observed deleterious outcomes in racially and ethnically minoritized individuals. Despite these discoveries, there is limited literature that provides context for the recognized racial disparities in CDI, particularly the influence of structural and systemic barriers. Here, we synthesize the available literature describing racial inequities in CDI outcomes and discuss the interrelationship of SDoH on microbiome dysregulation. Finally, we provide actionable considerations for infectious diseases professionals to aid in narrowing CDI equity gaps.

Funder

NIH)

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference50 articles.

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