Tuesday, September 30, 2025 9/30/2025

Role of C difficile Colonization in Risk of Disease

Award Number: K23AI177941
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 08/08/2025
PERIOD OF PERFORMANCE END DATE: 07/31/2030

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Role of C difficile Colonization in Risk of Disease - Project Summary Clostridioides difficile is a leading cause of healthcare-associated infection with >450,000 cases yearly in the United States. Infection prevention strategies have had limited success at curtailing C. difficile infection rates. Making matters more difficult, individuals can also carry C. difficile asymptomatically. While carriage is both highly prevalent and associated with increased risk of subsequent disease, only a minority of carriers actually progress to disease. The factors responsible for preventing or promoting progression from carriage to disease remain largely unclear. By combining recent improvements in clinical testing algorithms, statistical modeling, and bioinformatics, we aim to undertake a more innovative and comprehensive approach to modeling C. difficile infection. The advent of two-step testing helps to distinguish carriage from disease. Time-to-event models permit accurate and efficient handling of longitudinal outcomes. Finally, advances in bioinformatics facilitate additional insight into the roles of the metagenome and metabolome. Using this multi-modal approach, we seek to improve the current understanding of progression from C. difficile carriage to disease through the following aims: 1) Identify metagenomic/metabolomic risk factors present at time of carriage that are associated with later progression to C. difficile disease; 2) Assess for changes in the metagenome/metabolome temporally associated with progression from carriage to C. difficile disease. 3) Identify C. difficile strain attributes (particularly those related to toxin regulation) associated with risk of progression from carriage to disease; An improved understanding of the factors that prevent or promote progression to disease could inform novel targets for C. difficile prevention and better direct potential therapies to those at highest risk. My short-term goal is to develop a skillset for the analysis of metagenomic and metabolomic data. My long-term goal is to become adept at incorporating metagenomic and metabolomic data into prospective studies of C. difficile acquisition and progression to disease. This proposal is designed to cultivate my development as a future leader in incorporating metagenomic/metabolomic data into studies of infectious disease transmission and prevention.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $184,651 )
2025	2025	DUKE UNIVERSITY	2200 W MAIN ST	DURHAM	NC	27705	DURHAM	USA	Allergy and Infectious Diseases Research	000	1	8/8/2025	NEW	$184,651
														Subtotal = $184,651

Grand Total All Awards = $184,651

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Role of C difficile Colonization in Risk of Disease

Award Number: K23AI177941

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 08/08/2025

PERIOD OF PERFORMANCE END DATE: 07/31/2030

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