title: Rheological properties of erythrocytes in patients infected with Clostridium difficile.
abstract: BACKGROUND
  Clostridium difficile infection (CDI) is a bacterial infection of the digestive tract. Acute infections are accompanied by increased risk for venous thromboembolism (VTE). To date, there have been no studies of the rheological properties of blood during the course of digestive tract infections. The aim of our study was to examine the effects of CDI on red blood cell (RBC) rheology, specifically RBC deformability, RBC aggregation, and plasma viscosity. In addition, the activity of glucose 6 phosphate dehydrogenase (G6PD) and acetylcholinesterase (AChE) in RBC was studied.
  
  
  METHODS
  Our study group included 20 patients with CDI, 20 healthy persons comprised the control group. We examined the effects of CDI on the rheology of RBCs, their deformability and aggregation, using a Laser-assisted Optical Rotational Cell Analyzer (LORCA). Plasma viscosity was determined using a capillary tube plasma viscosymeter. Moreover, we estimated the activity of AChE and G6PD in RBC using spectrophotometric method.
  
  
  RESULTS
  A statistically significant increase was found in the aggregation index, viscosity and activity of G6PD whereas the amount of time to reach half of maximum aggregation (t½) and the amplitude of aggregation (AMP) both showed statistically significantly decreases among patients with CDI compared to the control group. We also observed that the Elongation Index (EI) was decreased when shear stress values were low, between 0.3 Pa and 0.58 Pa, whereas EI was increased for shear stress in the range of 1.13-59.97 Pa. These observations were statistically significant.
  
  
  CONCLUSIONS
  We report for the first time that acute infection of the gastrointestinal tract with Clostridium difficile is associated with abnormalities in rheological properties of blood, increased serum viscosity as well as increased aggregation of RBCs, which correlated with severity of inflammation. These abnormalities may be an additional mechanism causing increased incidence of VTE in CDI.
authors.affiliation: Department of Infectious Diseases, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Czepiel
authors.affiliation: Department of Hematology, University Hospital, Krakow, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Jurczyszyn
authors.affiliation: Department of Infectious Diseases, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Biesiada
authors.affiliation: Department of Infectious Diseases, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Sobczyk-Krupiarz
authors.affiliation: Students' Scientific Society Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Jałowiecka
authors.affiliation: Students' Scientific Society Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Świstek
authors.affiliation: Students' Scientific Society Jagiellonian University Medical College, Krakow, Poland.
authors.forename: William
authors.initials: W
authors.lastname: Perucki
authors.affiliation: Motoral Pathology Laboratory, Department of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Teległów
authors.affiliation: Motoral Pathology Laboratory, Department of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Marchewka
authors.affiliation: Motoral Pathology Laboratory, Department of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Dąbrowski
authors.affiliation: Department of Infectious Diseases, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mach
authors.affiliation: Department of Infectious Diseases, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Garlicki
mesh_terms: D000110:Acetylcholinesterase / Q000378:metabolism; D001809:Blood Viscosity; D016360:Clostridioides difficile / Q000472:pathogenicity*; D004761:Enterocolitis, Pseudomembranous / Q000097:blood* / Q000382:microbiology*; D004903:Erythrocyte Aggregation; D004907:Erythrocyte Deformability; D004912:Erythrocytes / Q000201:enzymology / Q000502:physiology*; D041981:Gastrointestinal Tract / Q000382:microbiology* / Q000503:physiopathology*; D005954:Glucosephosphate Dehydrogenase / Q000378:metabolism; D018056:Hemorheology; D006801:Humans; D012016:Reference Values
chemical_list: D005954:Glucosephosphate Dehydrogenase; D000110:Acetylcholinesterase