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recurrent clostridium difficile

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https://www.readbyqxmd.com/read/28542111/clostridium-difficile-infection-in-solid-organ-transplant-recipients
#1
Deepa Nanayakkara, Neha Nanda
PURPOSE OF REVIEW: Clostridium difficile infection (CDI) is a major healthcare-associated infection that causes significant morbidity and an economic impact in the United States. In this review, we provide an overview of Clostridium difficile infection in solid organ transplant recipients with an emphasis on recent literature. RECENT FINDINGS: C. difficile in solid organ transplant population has unique risk factors. Fecal microbiota transplantation has shown favorable results in treatment of recurrent C...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28539351/bacteriophage-transfer-during-faecal-microbiota-transplantation-in-clostridium-difficile-infection-is-associated-with-treatment-outcome
#2
Tao Zuo, Sunny H Wong, Kelvin Lam, Rashid Lui, Kitty Cheung, Whitney Tang, Jessica Y L Ching, Paul K S Chan, Martin C W Chan, Justin C Y Wu, Francis K L Chan, Jun Yu, Joseph J Y Sung, Siew C Ng
OBJECTIVE: Faecal microbiota transplantation (FMT) is effective for the treatment of recurrent Clostridium difficile infection (CDI). Studies have shown bacterial colonisation after FMT, but data on viral alterations in CDI are scarce. We investigated enteric virome alterations in CDI and the association between viral transfer and clinical outcome in patients with CDI. DESIGN: Ultra-deep metagenomic sequencing of virus-like particle preparations and bacterial 16S rRNA sequencing were performed on stool samples from 24 subjects with CDI and 20 healthy controls...
May 24, 2017: Gut
https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#3
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28529025/how-to-establish-and-run-a-stool-bank
#4
REVIEW
Elisabeth M Terveer, Yvette H van Beurden, Abraham Goorhuis, Jos F M L Seegers, Martijn P Bauer, E van Nood, Marcel G W Dijkgraaf, Chris J J Mulder, Christina M J E Vandenbroucke-Grauls, Hein W Verspaget, Josbert J Keller, Ed J Kuijper
Since 2013, several stool banks have been developed following publications reporting on clinical success of "Fecal Microbiota Transplantation" (FMT) for recurrent Clostridium difficile infections (CDI). However, protocols for donor screening, fecal suspension preparation and transfer of the fecal suspension differ between various countries and institutions. Moreover, no European consensus exists regarding the legislative aspects of the fecal suspension product. Internationally standardized recommendations about the above mentioned aspects have not yet been established...
May 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28513974/fecal-microbiota-transplantation-outcomes-in-immunocompetent-and-immunocompromised-patients-a-single-center-experience
#5
Sally Alrabaa, Ripal Jariwala, Kristen Zeitler, Jose Montero
BACKGROUND: Clostridium difficile infection (CDI) is a major infectious disease focus for which fecal microbiota transplantation (FMT) has been used with success in various patient populations. METHODS: We conducted a retrospective study of FMT in immunocompetent and immunocompromised patients to review outcomes at our center, with a focus on identifying risk factors for FMT failure in solid organ transplant (SOT) patients. FMT was conducted using universal banked frozen stool via naso-duodenal tube in patients with recurrent CDI of 3 or more episodes per our institutional protocol...
May 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28506317/changes-in-microbial-ecology-after-fecal-microbiota-transplantation-for-recurrent-c-difficile-infection-affected-by-underlying-inflammatory-bowel-disease
#6
Sahil Khanna, Yoshiki Vazquez-Baeza, Antonio González, Sophie Weiss, Bradley Schmidt, David A Muñiz-Pedrogo, John F Rainey, Patricia Kammer, Heidi Nelson, Michael Sadowsky, Alexander Khoruts, Stefan L Farrugia, Rob Knight, Darrell S Pardi, Purna C Kashyap
BACKGROUND: Gut microbiota play a key role in maintaining homeostasis in the human gut. Alterations in the gut microbial ecosystem predispose to Clostridium difficile infection (CDI) and gut inflammatory disorders such as inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) from a healthy donor can restore gut microbial diversity and pathogen colonization resistance; consequently, it is now being investigated for its ability to improve inflammatory gut conditions such as IBD...
May 15, 2017: Microbiome
https://www.readbyqxmd.com/read/28506071/fecal-microbiota-transplantation-in-recurrent-clostridium-difficile-infection-in-a-patient-with-concomitant-inflammatory-bowel-disease
#7
Marta Gravito-Soares, Elisa Gravito-Soares, Francisco Portela, Manuela Ferreira, Carlos Sofia
The use of fecal microbiota transplantation in recurrent Clostridium difficile infection and coexistent inflammatory bowel disease remains unclear. A 61-year-old man with ulcerative pancolitis was diagnosed with a third recurrence of Clostridium difficile infection, previously treated with metronidazole, vancomycin and fidaxomicin. Fecal microbiota transplantation of an unrelated healthy donor was performed by the lower route. After a twelve month follow-up, the patient remains asymptomatic without Clostridium difficile infection relapses or inflammatory bowel disease flare-ups...
May 16, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28501926/an-outbreak-of-clostridium-difficile-pcr-ribotype-027-in-spain-risk-factors-for-recurrence-and-a-novel-treatment-strategy
#8
E Bouza, L Alcalá, M Marín, M Valerio, E Reigadas, P Muñoz, M González-Del Vecchio, V de Egea
An outbreak of Clostridium difficile infection (CDI) caused by ribotype 027 (B1/NAP1) began in our hospital in November 2014, and produced 141 episodes in the following months. The aim of this study is to describe this outbreak, assess risk factors for recurrence of CDI-027 and to analyze the implementation of a novel treatment strategy. This is a prospective study of all patients with CDI-027, from November 2014 to November 2015. The epidemiological data were collected daily for each patient. We compared clinical characteristics and treatment between patients with and without recurrence of CDI-027...
May 13, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28491142/current-challenges-in-the-treatment-of-severe-clostridium-difficile-infection-early-treatment-potential-of-fecal-microbiota-transplantation
#9
REVIEW
Yvette H van Beurden, Max Nieuwdorp, Pablo J E J van de Berg, Chris J J Mulder, Abraham Goorhuis
Fecal microbiota transplantation (FMT) is a very effective treatment for recurrent Clostridium difficile infection (CDI). Less is known about the application of FMT as a curative treatment of severe or complicated CDI. In this review, we present and discuss evidence supporting the curative use of FMT in severe or complicated CDI. We performed a literature search in PubMed and Embase for studies on the curative use of FMT in severe or complicated CDI. In addition, we describe a patient with severe CDI not responding to initial antibiotic treatment, who was successfully treated with curative FMT...
April 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28480750/bezlotoxumab-could-this-b-the-answer-for-clostridium-difficile-recurrence
#10
Ryan W Chapin, Tiffany Lee, Christopher McCoy, Carolyn D Alonso, Monica V Mahoney
OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, safety, and place in therapy of bezlotoxumab (BEZ), a novel monoclonal antibody against Clostridium difficile toxin B. DATA SOURCES: A PubMed search was conducted for data between 1946 and April 2017 using MeSH terms bezlotoxumab, MK-6072, or MDX-1388 alone and the terms Clostridium difficile combined with monoclonal antibody or antitoxin. STUDY SELECTION AND DATA EXTRACTION: The literature search was limited to English-language studies that described clinical efficacy, safety, and pharmacokinetics in humans and animals...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28480267/primary-outcomes-from-a-phase-3-randomized-double-blind-active-controlled-trial-of-surotomycin-in-subjects-with-clostridium-difficile-infection
#11
Vicente Boix, Richard N Fedorak, Kathleen M Mullane, Yves Pesant, Uschi Stoutenburgh, Mandy Jin, Adedayo Adedoyin, Laurent Chesnel, Dalya Guris, Kajal B Larson, Yoshihiko Murata
BACKGROUND: Although the incidence of Clostridium difficile infection (CDI) is increasing, available CDI treatment options are limited in terms of sustained response after treatment. This phase 3 trial assessed the efficacy and safety of surotomycin, a novel bactericidal cyclic lipopeptide, versus oral vancomycin in subjects with CDI. METHODS: In this randomized, double-blind, active-controlled, multicenter, international trial, subjects with CDI confirmed by a positive toxin result were randomized to receive surotomycin (250 mg twice daily) or vancomycin (125 mg 4 times daily) orally for 10 days...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28473000/tracking-microbial-colonization-in-fecal-microbiota-transplantation-experiments-via-genome-resolved-metagenomics
#12
Sonny T M Lee, Stacy A Kahn, Tom O Delmont, Alon Shaiber, Özcan C Esen, Nathaniel A Hubert, Hilary G Morrison, Dionysios A Antonopoulos, David T Rubin, A Murat Eren
BACKGROUND: Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection and shows promise for treating other medical conditions associated with intestinal dysbioses. However, we lack a sufficient understanding of which microbial populations successfully colonize the recipient gut, and the widely used approaches to study the microbial ecology of FMT experiments fail to provide enough resolution to identify populations that are likely responsible for FMT-derived benefits...
May 4, 2017: Microbiome
https://www.readbyqxmd.com/read/28471618/a-retrospective-comparison-of-fecal-microbial-transplantation-methods-for-recurrent-clostridium-difficile-infection
#13
Nathaniel A Cohen, Dan M Livovsky, Shir Yaakobovitch, Merav Ben Yehoyada, Ronen Ben Ami, Amos Adler, Hanan Guzner-Gur, Eran Goldin, Moshe E Santo, Zamir Halpern, Kalman Paz, Nitsan Maharshak
BACKGROUND: Antibiotic treatment of Clostridium difficile infection (CDI) has a high failure rate. Fecal microbiota transplantation (FMT) has proven very effective in treating these recurrences. OBJECTIVES: To determine which method of fecal microbiota transplantation (upper or lower gastrointestinal) and which type of donor (a relative or unrelated) is superior. METHODS: This is a retrospective analysis of treatment protocols and outcomes in 22 patients with refractory or recurrent CDI who underwent FMT at two Israeli facilities...
October 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28465256/a-combination-of-the-probiotic-and-prebiotic-product-can-prevent-the-germination-of-clostridium-difficile-spores-and-infection
#14
M Rätsep, S Kõljalg, E Sepp, I Smidt, K Truusalu, E Songisepp, J Stsepetova, P Naaber, R H Mikelsaar, M Mikelsaar
Clostridium difficile infection (CDI) is one of the most prevalent healthcare associated infections in hospitals and nursing homes. Different approaches are used for prevention of CDI. Absence of intestinal lactobacilli and bifidobacteria has been associated with C. difficile colonization in hospitalized patients. Our aim was to test a) the susceptibility of C. difficile strains of different origin and the intestinal probiotic Lactobacillus plantarum Inducia (DSM 21379) to various antimicrobial preparations incl...
April 29, 2017: Anaerobe
https://www.readbyqxmd.com/read/28461207/efficacy-and-safety-of-ridinilazole-compared-with-vancomycin-for-the-treatment-of-clostridium-difficile-infection-a-phase-2-randomised-double-blind-active-controlled-non-inferiority-study
#15
Richard J Vickers, Glenn S Tillotson, Richard Nathan, Sabine Hazan, John Pullman, Christopher Lucasti, Kenneth Deck, Bruce Yacyshyn, Benedict Maliakkal, Yves Pesant, Bina Tejura, David Roblin, Dale N Gerding, Mark H Wilcox
BACKGROUND: Clostridium difficile infection is the most common health-care-associated infection in the USA. We assessed the safety and efficacy of ridinilazole versus vancomycin for treatment of C difficile infection. METHODS: We did a phase 2, randomised, double-blind, active-controlled, non-inferiority study. Participants with signs and symptoms of C difficile infection and a positive diagnostic test result were recruited from 33 centres in the USA and Canada and randomly assigned (1:1) to receive oral ridinilazole (200 mg every 12 h) or oral vancomycin (125 mg every 6 h) for 10 days...
April 28, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28453386/collateral-damage-during-antibiotic-treatment-of-c-difficile-infection-in-the-aged-host-insights-into-why-recurrent-disease-happens
#16
Jae Hyun Shin, Cirle A Warren
Clostridium difficile infection (CDI) is one of the most common causes of healthcare-associated infections but an even bigger problem for the aging population. Advanced age leads to higher incidence, higher mortality, and higher recurrences. In our study, recently published in the Journal of Infectious Diseases, we investigated the effect of aging on CDI using a mouse model. We were able to demonstrate that aging leads to worse clinical outcomes, as well as lead to changes in microbiota composition and lower antibody production against C...
April 28, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28451916/outcomes-of-fecal-microbiota-transplantation-for-clostridium-difficile-infection-in-patients-with-inflammatory-bowel-disease
#17
Alireza Meighani, Benjamin R Hart, Kassem Bourgi, Nichole Miller, Ajin John, Mayur Ramesh
BACKGROUND AND AIMS: Fecal microbiota transplantation (FMT) has recently been shown to be a promising therapy for recurrent and refractory Clostridium difficile infections (CDI) despite lack of protocol standardization. Patients with inflammatory bowel disease (IBD) present a particular challenge to CDI therapy as they are reported to have worse clinical outcomes, including higher colectomy rates and increased mortality. We aimed to assess the outcomes of FMT for recurrent CDI in patients with IBD at our healthcare system...
April 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28449424/fecal-microbiota-transplantation-for-refractory-and-recurrent-clostridium-difficile-infection-a-case-series-of-nine-patients
#18
Byoung Wook Bang, Jin Seok Park, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon, Hea Yoon Kwon, Ji Hyeon Baek, Jin Soo Lee
Background/Aims: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. Methods: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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
#19
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
#20
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
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