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recurrent clostridium difficile

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https://www.readbyqxmd.com/read/28433406/results-of-the-implementation-of-a-multidisciplinary-programme-of-faecal-microbiota-transplantation-by-colonoscopy-for-the-treatment-of-recurrent-clostridium-difficile-infection
#1
Antonio López-Sanromán, Enrique Rodríguez de Santiago, Javier Cobo Reinoso, Rosa Del Campo Moreno, José Ramón Foruny Olcina, Sergio García Fernández, Ana García García de Paredes, Lara Aguilera Castro, Carlos Ferre Aracil, Agustín Albillos Martínez
INTRODUCTION: Recurrent Clostridium difficile infection (CDI) is common and often difficult to manage. Faecal microbiota transplant (FMT) is an effective therapeutic tool in these cases, although its applicability and effectiveness in Spain is currently unknown. AIM: To analyse the technical aspects, safety and effectiveness of the first consolidated FMT programme in Spain. METHODS: Retrospective descriptive study of all patients with recurrent CDI treated with FMT performed by colonoscopy in a tertiary centre after the implementation of a multidisciplinary protocol between March 2015 and September 2016...
April 19, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28431238/reducing-recurrence-of-c-difficile-infection
#2
Michael G Dieterle, Vincent B Young
Clostridium difficile infection (CDI) is facilitated by alteration of the microbiome following antibiotic administration. Antimicrobial therapy directed against the pathogen can treat CDI. Unfortunately, ∼20% of successfully treated patients will suffer recurrence. Bezlotoxumab, a human monoclonal antibody, binds to C. difficile toxin B (TcdB), reducing recurrence presumably by limiting epithelial damage and facilitating microbiome recovery.
April 20, 2017: Cell
https://www.readbyqxmd.com/read/28430065/ethical-issues-in-fecal-microbiota-transplantation-in-practice
#3
Yonghui Ma, Jiayu Liu, Catherine Rhodes, Yongzhan Nie, Faming Zhang
Fecal microbiota transplantation (FMT) has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: (1) informed consent and the vulnerability of patients; (2) determining what a "suitable healthy donor" is; (3) safety and risk; (4) commercialization and potential exploitation of vulnerable patients; and (5) public health implications...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28421185/changes-in-composition-of-the-gut-bacterial-microbiome-after-fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-a-pediatric-heart-transplant-patient
#4
Kyle L Flannigan, Taylor Rajbar, Andrew Moffat, Leanna S McKenzie, Frank Dicke, Kevin Rioux, Matthew L Workentine, Thomas J Louie, Simon A Hirota, Steven C Greenway
The microbiome is increasingly recognized as an important influence on human health and many of the comorbidities that affect patients after solid organ transplantation (SOT) have been shown to involve changes in gut bacterial populations. Thus, microbiome changes in an individual patient may have important health implications after SOT but this area remains understudied. We describe changes in the composition of the fecal microbiome from a pediatric heart transplant recipient before and >2.5 years after he underwent repeated fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection (CDI)...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28417271/antimicrobial-effects-of-manuka-honey-on-in-vitro-biofilm-formation-by-clostridium-difficile
#5
M Piotrowski, P Karpiński, H Pituch, A van Belkum, P Obuch-Woszczatyński
Clostridium difficile is the cause of the nosocomial C. difficile infection (CDI). The conventional antibiotics used in CDI therapy are often unsuccessful, and recurrent infections may occur. Biofilm formation by C. difficile is associated with chronic or recurrent infections; biofilms may contribute to virulence and impaired antimicrobial efficacy. Manuka honey, derived from the Manuka tree (Leptospermum scoparium), is known to exhibit antimicrobial properties that are associated with its significant content of methylglyoxal, a natural antibiotic...
April 18, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28402634/synthesis-and-biological-evaluation-of-bile-acid-analogues-inhibitory-to-clostridium-difficile-spore-germination
#6
Kristen L Stoltz, Raymond Erickson, Christopher Staley, Alexa R Weingarden, Erin Romens, Clifford J Steer, Alexander Khoruts, Michael J Sadowsky, Peter I Dosa
Standard antibiotic-based strategies for the treatment of Clostridium difficile infections disrupt indigenous microbiota and commonly fail to eradicate bacterial spores, two key factors that allow recurrence of infection. As an alternative approach to controlling C. difficile infection, a series of bile acid derivatives have been prepared that inhibit taurocholate-induced spore germination. These analogues have been evaluated in a highly virulent NAP1 strain using optical density and phase-contrast microscopy assays...
April 12, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28372875/microbiota
#7
Rosa Del Campo-Moreno, Teresa Alarcón-Cavero, Giuseppe D'Auria, Susana Delgado-Palacio, Manuel Ferrer-Martínez
The human microbiota comprises all the microorganisms of our body, which can also be categorised as commensals, mutualists and pathogens according to their behaviour. Our knowledge of the human microbiota has considerably increased since the introduction of 16S rRNA next generation sequencing (16S rDNA gene). This technological breakthrough has seen a revolution in the knowledge of the microbiota composition and its implications in human health. This article details the different human bacterial ecosystems and the scientific evidence of their involvement in different diseases...
March 31, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28365900/invasive-listeriosis-in-a-patient-with-several-episodes-of-antibiotic-associated-colitis-presumably-due-to-clostridium-difficile
#8
Novella Carannante, Pasquale Pagliano, Marco Rossi, Vittorio Attanasio, Carolina Rescigno, Laura Corte, Carlo Tascini, Gianluigi Cardinali
A 62-year-old man developed a blood stream infection and meningitis due to Listeria monocytogenes, 20 days after an episode of pseudo-membranous colitis. The patient, hospitalized for the first time for transurethral prostatectomy, was readmitted 20 days later with watery diarrhea. Pseudo-membranous colitis was diagnosed and treated successfully, without testing for Clostridium difficile infection (CDI). After 15 more days, the patient developed again diarrhea, fever and confusion. Hospitalized again, blood and cerebrospinal fluid cultures resulted positive for L...
April 1, 2017: Infection
https://www.readbyqxmd.com/read/28346596/withholding-proton-pump-inhibitors-to-prevent-recurrent-clostridium-difficile-time-for-a-randomized-trial
#9
Scott R Bauer, Patrick O'Malley
No abstract text is available yet for this article.
March 27, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28346595/association-of-gastric-acid-suppression-with-recurrent-clostridium-difficile-infection-a-systematic-review-and-meta-analysis
#10
Raseen Tariq, Siddharth Singh, Arjun Gupta, Darrell S Pardi, Sahil Khanna
Importance: Gastric acid suppression has been associated with an increased risk of primary Clostridium difficile infection (CDI), but the risk of recurrent CDI in patients taking gastric acid suppressant medications is unclear. Objective: To perform a systematic review and meta-analysis to evaluate the association between gastric acid suppressants and recurrent CDI. Data Sources: MEDLINE, EMBASE, the Cochrane Central Register, the Cochrane Database, and Web of Science were searched from January 1, 1995, to September 30, 2015, for studies assessing the association between gastric acid suppressant exposure and recurrent CDI...
March 27, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28345530/fecal-microbiota-transplantation-methods-of-treatment-of-recurrent-clostridium-difficile-infections-and-other-diseases
#11
Klaudia Juszczuk, Katarzyna Grudlewska, Agnieszka Mikucka, Eugenia Gospodarek
Clostridium difficile is a serious epidemiological problem and particularly dangerous microorganism causing hospital infections. Currently, the treatment of C. difficile infections is the use of metronidazole or vancomycin. However, in some patients, recurrent infection difficult to treat occurs. Fecal microbiota transplantation (FMT) is a new method used to treat the recurrent CDI. FMT consists in the infusion of the fecal suspension from a healthy donor into the gastrointestinal tract of a patient with CDI to restore the natural intestinal microflora...
March 27, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28336757/development-of-a-bedside-scoring-system-for-predicting-a-first-recurrence-of-clostridium-difficile-associated-diarrhea
#12
Velliyur Viswesh, Ana L Hincapie, Marie Yu, Linda Khatchatourian, Michael A Nowak
PURPOSE: A scoring system for identifying patients at high or low risk for recurrent Clostridium difficile-associated diarrhea (CDAD) is described. METHODS: A retrospective cohort study was performed using data on adults with CDAD admitted to a 3-hospital system from 2009 to 2014. The primary endpoint was the rate of recurrent CDAD within 60 days of clinical cure of CDAD. Risk factors for CDAD recurrence were identified, and a risk prediction tool was developed using multivariate logistic regression...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28323808/bezlotoxumab-zinplava-for-prevention-of-recurrent-clostridium-difficile-infection
#13
(no author information available yet)
No abstract text is available yet for this article.
March 27, 2017: Medical Letter on Drugs and Therapeutics
https://www.readbyqxmd.com/read/28322899/permanent-bulbar-urethral-ligation-emerging-treatment-option-for-incontinent-men-with-end-stage-urethra
#14
Maia E VanDyke, Boyd R Viers, Travis J Pagliara, Jeremy M Scott, Nabeel Shakir, Daniel D Dugi, Billy H Cordon, Matthias D Hofer, Allen F Morey
OBJECTIVE: To report our experience with permanent urethral ligation for severe incontinence among men with end-stage urethra. METHODS: From our institutional Artificial Urethral Sphincter (AUS) database of 512 patients from 2010-2016, 10 men underwent permanent urethral ligation with concurrent suprapubic tube (SPT) diversion following recurrent AUS cuff erosion. Clinical characteristics and outcomes were evaluated. Quality of life (QOL) was assessed using the Michigan Incontinence Symptom Index (M-ISI) and the Patient Global Index of Improvement (PGI-I)...
March 16, 2017: Urology
https://www.readbyqxmd.com/read/28315032/novel-indications-for-fecal-microbial-transplantation-update-and-review-of-the-literature
#15
REVIEW
Nathaniel Aviv Cohen, Nitsan Maharshak
BACKGROUND AND AIMS: Fecal microbial transplantation (FMT) is an established successful treatment modality for recurrent Clostridium difficile infection (CDI). The safety profile and potential therapeutic advantages of FMT for diseases associated with dysbiosis and immune dysfunction have led to many publications, mainly case series, and while many studies and reviews have been published on the use of FMT for inflammatory bowel disease (IBD), its potential use for other disease conditions has not been thoroughly reviewed...
May 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28306141/the-attributable-burden-of-clostridium-difficile-infection-to-long-term-care-facilities-stay-a-clinical-study
#16
Styliani Karanika, Christos Grigoras, Myrto E Flokas, Michail Alevizakos, Tori Kinamon, Erna M Kojic, Eleftherios Mylonakis
BACKGROUND: Advanced age, history of hospitalization, and antibiotic consumption are associated with the pathogenesis of Clostridium difficile infection (CDI). Long-term care facilities (LTCFs) represent a setting where CDI has been increasingly reported. We aimed to estimate the actual attributable burden of CDI to LTCF stay and determine the characteristics of the disease epidemiology in this setting. DESIGN: IRB-approved retrospective cohort study. SETTING: LTCF and community...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28299963/cost-effectiveness-analysis-on-the-use-of-fidaxomicin-and-vancomycin-to-treat-clostridium-difficile-infection-in-france
#17
Maureen Watt, Aurélien Dinh, Alban Le Monnier, Patrick Tilleul
BACKGROUND: Fidaxomicin is a macrocyclic antibiotic with proven efficacy against Clostridium difficile infection (CDI) in adults. It was licensed in France in 2012, but, due to higher acquisition costs compared with existing treatments, healthcare providers require information on its cost/benefit profile. OBJECTIVE: To compare healthcare costs and health outcomes of fidaxomicin and vancomycin, as reference treatment for CDI. METHODS: A Markov model was used to simulate the treatment pathway, over 1 year, of adult patients with CDI receiving fidaxomicin or vancomycin...
March 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28286992/cadazolid-for-the-treatment-of-clostridium-difficile
#18
REVIEW
Bradley T Endres, Eugénie Bassères, M Jahangir Alam, Kevin W Garey
Antibiotic development goals for CDI include potent antimicrobial effect against C. difficile, limited killing of host microbiota, potential effect on spores, and ability to interfere with toxin production. Cadazolid, a novel, non-absorbable hybrid antibiotic has many of these criteria. In phase I and II clinical trials, cadazolid was shown to be safe, well tolerated, and efficacious positioning itself as a potential future viable therapeutic option for CDI. Areas covered: This review provides an in-depth evaluation of the chemistry, microbiology, pharmacodynamics, pharmacokinetics, and clinical trial results for cadazolid...
April 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28282270/community-dynamics-drive-punctuated-engraftment-of-the-fecal-microbiome-following-transplantation-using-freeze-dried-encapsulated-fecal-microbiota
#19
Christopher Staley, Byron P Vaughn, Carolyn T Graiziger, Stephanie Singroy, Matthew J Hamilton, Dan Yao, Chi Chen, Alexander Khoruts, Michael J Sadowsky
Fecal microbiota transplantation (FMT) is a highly effective treatment of recurrent and recalcitrant Clostridium difficile infection (rCDI). In a recent study oral-delivery of encapsulated, freeze-dried donor material, resulted in comparable rates of cure to colonoscopic approaches. Here we characterize shifts in the fecal bacterial community structure of patients treated for rCDI using encapsulated donor material. Prior to FMT, patient fecal samples showed declines in diversity and abundance of Firmicutes and Bacteroidetes, with concurrent increases in members of the Proteobacteria, specifically Enterobacteriaceae...
February 28, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28274145/emerging-monoclonal-antibodies-against-clostridium-difficile-infection
#20
Séverine Péchiné, Claire Janoir, Anne Collignon
Clostridium difficile infections are characterized by a high recurrence rate despite antibiotic treatments and there is an urgent need to develop new treatments such as fecal transplantation and immonotherapy. Besides active immunotherapy with vaccines, passive immunotherapy has shown promise, especially with monoclonal antibodies. Areas covered: Herein, the authors review the different assays performed with monoclonal antibodies against C. difficile toxins and surface proteins to treat or prevent primary or recurrent episodes of C...
April 2017: Expert Opinion on Biological Therapy
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