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recurrent clostridium difficile

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https://www.readbyqxmd.com/read/28649413/identification-of-donor-microbe-species-that-colonize-and-persist-long-term-in-the-recipient-after-fecal-transplant-for-recurrent-clostridium-difficile
#1
Ranjit Kumar, Nengjun Yi, Degui Zhi, Peter Eipers, Kelly T Goldsmith, Paula Dixon, David K Crossman, Michael R Crowley, Elliot J Lefkowitz, J Martin Rodriguez, Casey D Morrow
Fecal microbiota transplantation has been shown to be an effective treatment for patients with recurrent C. difficile colitis. Although fecal microbiota transplantation helps to re-establish a normal gut function in patients, the extent of the repopulation of the recipient microbial community varies. To further understand this variation, it is important to determine the fate of donor microbes in the patients following fecal microbiota transplantation. We have developed a new method that utilizes the unique single nucleotide variants of gut microbes to accurately identify microbes in paired fecal samples from the same individual taken at different times...
2017: NPJ Biofilms and Microbiomes
https://www.readbyqxmd.com/read/28646951/fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-children
#2
Becky Chen, Vishal Avinashi, Simon Dobson
Fecal microbiota transplantation (FMT) is a relatively simple, promising treatment for recurrent Clostridium difficile infection. While there are a wide variety of approaches including mode of delivery, the results are nonetheless encouraging, even amongst younger children. Experience with FMT in the pediatric population is increasing, showing similar success compared to adults. This article will provide an overview of C. difficile infection along with review of the rationale, methods and complications of FMT including the current experience of FMT in children...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28645479/impact-of-the-nap-1-strain-on-disease-severity-mortality-and-recurrence-of-healthcare-associated-clostridium-difficile-infection
#3
Karri A Bauer, Jessica E W Johnston, Eric Wenzler, Debra A Goff, Charles H Cook, Joan-Miquel Balada-Llasat, Preeti Pancholi, Julie E Mangino
OBJECTIVES: Studies are conflicting regarding the association of the North American pulsed-field gel electrophoresis type 1 (NAP1) strain in Clostridium difficile infection (CDI) and outcomes. We evaluated the association of NAP1 with healthcare-associated CDI disease severity, mortality, and recurrence at our academic medical center. METHODS: Healthcare-associated CDI cases were identified from November 1, 2011 through January 31, 2013. Multivariable regression models were used to evaluate the associations of NAP1 with severe disease (based on the Hines VA severity score index), mortality, and recurrence...
June 20, 2017: Anaerobe
https://www.readbyqxmd.com/read/28642147/the-role-of-tigecycline-in-the-management-of-clostridium-difficile-infection-a-retrospective-cohort-study
#4
Eliza Manea, Jesús Sojo-Dorado, Raluca E Jipa, Serban N Benea, Jesús Rodríguez-Baño, Adriana Hristea
OBJECTIVE: We aimed to compare the outcomes of patients with C.difficile infection (CDI) treated either with tigecycline associated with vancomycin, or with vancomycin alone. METHODS: This single-centre retrospective cohort study included all adults hospitalized from September 2014 through August 2015 for symptomatic, incident CDI confirmed by polymerase chain reaction for C.difficile toxin in stools. The primary outcome was the rate of favourable outcome, defined as a composite of clinical response (resolution of symptoms without need for additional CDI therapy) and achieving discharge without CDI-related surgery or intensive care; a secondary outcome was CDI recurrence...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28637570/risk-factors-that-predict-recurrent-clostridium-difficile-infections-in-surgical-patients
#5
Craig A Messick, Jeff P Hammel, Tracy Hull
Clostridium difficile (C. difficile) infection (CDI) is a serious problem mostly studied during patients' index infections. The aim of this study is to define the incidence of primary and recurrent postoperative (postop) CDI in a single institution's entire surgical population and to identify risk factors that influence disease recurrence. Using electronic medical records from 2002 to 2012, charts were reviewed from all patients with laboratory-proven (enzyme-linked immunosorbent assay or polymerase chain reaction methods) C...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636484/bezlotoxumab-anti-toxin-b-monoclonal-antibody-to-prevent-recurrence-of-clostridium-difficile-infection
#6
Javier A Villafuerte Gálvez, Ciarán P Kelly
Clostridium difficile infection (CDI) is the most common nosocomial infection in the U.S. 25% of CDI patients go on to develop recurrent CDI (rCDI) following current standard of care (SOC) therapy, leading to morbidity, mortality and economic loss. The first passive immunotherapy drug targeting C.difficile toxin B (bezlotoxumab) has been approved recently by the FDA and EMA for prevention of rCDI. Areas covered: A body of key studies was selected and reviewed by the authors. The unmet needs in CDI care were ascertained with emphasis in rCDI, including the epidemiology, pathophysiology and current management...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28633368/impact-of-recurrent-clostridium-difficile-infection-hospitalization-and-patient-quality-of-life
#7
Mark H Wilcox, Harblas Ahir, John E Coia, Andrew Dodgson, Susan Hopkins, Martin J Llewelyn, Chris Settle, Susan Mclain-Smith, Stephen W Marcella
Objectives: Data quantifying outcomes of recurrent Clostridium difficile infection (rCDI) are lacking. We sought to determine the UK hospital resource use and health-related quality of life (HRQoL) associated with rCDI hospitalizations. Patients and methods: A non-interventional study in six UK acute hospitals collected retrospective clinical and resource use data from medical records of 64 adults hospitalized for rCDI and 64 matched inpatient controls with a first episode only (f)CDI...
June 13, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28623367/bovine-antibodies-targeting-primary-and-recurrent-clostridium-difficile-disease-are-a-potent-antibiotic-alternative
#8
Melanie L Hutton, Bliss A Cunningham, Kate E Mackin, Shelley A Lyon, Meagan L James, Julian I Rood, Dena Lyras
The increased incidence of antibiotic resistant 'superbugs' has amplified the use of broad spectrum antibiotics worldwide. An unintended consequence of antimicrobial treatment is disruption of the gastrointestinal microbiota, resulting in susceptibility to opportunistic pathogens, such as Clostridium difficile. Paradoxically, treatment of C. difficile infections (CDI) also involves antibiotic use, leaving patients susceptible to re-infection. This serious health threat has led to an urgent call for the development of new therapeutics to reduce or replace the use of antibiotics to treat bacterial infections...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28607673/risk-factors-for-clostridium-difficile-infections-an-overview-of-the-evidence-base-and-challenges-in-data-synthesis
#9
Paul Eze, Evelyn Balsells, Moe H Kyaw, Harish Nair
BACKGROUND: Recognition of a broad spectrum of disease and development of Clostridium difficile infection (CDI) and recurrent CDI (rCDI) in populations previously considered to be at low risk has renewed attention on differences in the risk profile of patients. In the absence of primary prevention for CDI and limited treatment options, it is important to achieve a deep understanding of the multiple factors that influence the risk of developing CDI and rCDI. METHODS: We conducted a review of systematic reviews and meta-analyses on risk factors for CDI and rCDI published between 1990 and October 2016...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28602517/is-frozen-fecal-microbiota-transplantation-as-effective-as-fresh-fecal-microbiota-transplantation-in-patients-with-recurrent-or-refractory-clostridium-difficile-infection-a-meta-analysis
#10
REVIEW
Guihua Tang, Wen Yin, Wenen Liu
Fecal microbiota transplantation (FMT) is a remarkably efficacious therapy for recurrent or refractory Clostridium difficile infection (CDI), but not standardized. This work is to determine whether frozen FMT is as effective as fresh FMT. Meta-analysis showed that frozen FMT was as effective as fresh FMT, both pooled first effective rate (65.0% (95% CI 57.0-73.0%) vs. 65.0% (95% CI 57.0-73.0%), P=0.962) and pooled second effective rate (95.0% (95% CI 91.0-99.0%) vs. 95.0% (95% CI 92.0-99.0%), P=0.880). In conclusion, among patients with recurrent or refractory CDI, frozen FMT is as effective as fresh FMT...
May 18, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28592348/distinguishing-clostridium-difficile-recurrence-from-reinfection-independent-validation-of-current-recommendations
#11
Ana Durovic, Andreas F Widmer, Reno Frei, Sarah Tschudin-Sutter
OBJECTIVE Distinguishing recurrent Clostridium difficile infection (CDI), defined as CDI caused by the same genotype, from reinfection with a different genotype, has important implications for surveillance and clinical trials investigating treatment effectiveness. We validated the proposed 8-week period for distinguishing "same genotype CDI" from "different genotype CDI," and we aimed to identify clinical variables with distinctiveness to propose an improved definition. METHODS From January 2004 to December 2013, a cohort of all inpatients with CDI at the University Hospital Basel, Switzerland, was established, and respective strains were collected...
June 8, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28591789/vancomycin-taper-and-pulsed-regimen-with-careful-follow-up-for-patients-with-recurrent-clostridium-difficile-infection
#12
Benjamin D Sirbu, Melinda M Soriano, Carl Manzo, Jessica Lum, Dale N Gerding, Stuart Johnson
We retrospectively studied vancomycin taper and pulse treatment on 100 consecutive, evaluable patients with recurrent C. difficile infection. Following taper to once-daily vancomycin dosing, 22 of 36 patients (61%) who received every-other-day (QOD) and 50 of 64 (81%) who received QOD followed by every-third-day dosing were cured (P = 0.03).
June 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28589238/repeat-rifaximin-for-irritable-bowel-syndrome-no-clinically-significant-changes-in-stool-microbial-antibiotic-sensitivity
#13
M Pimentel, B D Cash, A Lembo, R A Wolf, R J Israel, P Schoenfeld
BACKGROUND: Rifaximin has demonstrated efficacy and safety for diarrhea-predominant irritable bowel syndrome (IBS-D). AIM: To determine the rifaximin repeat treatment effect on fecal bacterial antibiotic susceptibility. METHODS: Patients with IBS in Trial 3 (TARGET 3) study who responded to open-label rifaximin 550 mg three times daily for 2 weeks, with symptom recurrence within 18 weeks, were randomized to double-blind treatment: two 2-week repeat courses of rifaximin or placebo, separated by 10 weeks...
June 6, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28589214/-individualized-treatment-strategies-for-clostridium-difficile-infections
#14
REVIEW
P Solbach, P Dersch, O Bachmann
Upon hospitalization, up to 15.5% of patients are already colonized with a toxigenic Clostridium difficile strain (TCD). The rate of asymptomatic colonization is 0-3% in healthy adults and up to 20-40% in hospitalized patients. The incidence and mortality of C. difficile infection (CDI) has significantly increased during recent years. Mortality lies between 3 and 14%. CDI is generally caused by intestinal dysbiosis, which can be triggered by various factors, including antibiotics or immune suppressants. If CDI occurs, ongoing antibiotic therapy should be discontinued...
June 6, 2017: Der Internist
https://www.readbyqxmd.com/read/28584140/safety-tolerability-systemic-exposure-and-metabolism-of-crs3123-a-methionyl-trna-synthetase-inhibitor-developed-for-treatment-of-clostridium-difficile-infections-in-a-phase-i-study
#15
Seema U Nayak, J McLeod Griffiss, Jeffrey Blumer, Mary Ann O'Riordan, Wesley Gray, Robin McKenzie, Robert A Jurao, Amanda T An, Melissa Le, Stacie J Bell, Urs A Ochsner, Thale C Jarvis, Nebojsa Janjic, Jonathan M Zenilman
Clostridium difficile causes antibiotic associated diarrhea and is a major public health concern. Current therapies disrupt the protective intestinal flora, do not reliably prevent recurrent infections and will be decreasingly effective should less susceptible strains emerge. CRS3123 is an oral agent that inhibits bacterial methionyl-tRNA synthetase, has potent activity against C. difficile and aerobic Gram positive bacteria, but little activity against Gram negative bacteria, including anaerobes. This first-in-human, double-blind, placebo-controlled, dose-escalation study evaluated the safety and systemic exposure of CRS3123 after a single oral dose in healthy adults...
June 5, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28577158/adherence-to-clinical-practice-guidelines-for-the-management-of-clostridium-difficile-infection-in-japan-a-multicenter-retrospective-study
#16
K Kobayashi, N Sekiya, Y Ainoda, H Kurai, A Imamura
This study was conducted to investigate the adherence to clinical practice guidelines (CPGs) for Clostridium difficile infection (CDI). A retrospective multicenter observational study was conducted via chart review at four teaching hospitals in Japan from April 2012 through September 2013. CDI was diagnosed based on positive identification of CD toxin by enzyme immunoassay testing. CDI patients were divided into non-severe and severe groups according to the severity criteria of four published guidelines (SHEA/IDSA 2010, ACG 2013, ESCMID 2009, HPA/DH 2008)...
June 2, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28575523/safety-and-pharmacokinetic-study-of-fidaxomicin-in-children-with-clostridium-difficile-associated-diarrhea-a-phase-2a-multicenter-clinical-trial
#17
Molly A O'Gorman, Marian G Michaels, Sheldon L Kaplan, Anthony Otley, Larry K Kociolek, Edward J Hoffenberg, Kwang Sik Kim, Sharon Nachman, Marian D Pfefferkorn, Timothy Sentongo, Janice E Sullivan, Pamela Sears
Background.: Fidaxomicin is an approved therapy for Clostridium difficile-associated diarrhea (CDAD) in adults. The safety of fidaxomicin in children has not been reported. Methods.: In this study (ClinicalTrials.gov identifier NCT01591863), pediatric patients with CDAD received twice-daily oral fidaxomicin at a dose of 16 mg/kg per day (up to 200 mg) for 10 days in an open-label study. Plasma and fecal samples were collected for pharmacokinetic assessments. The primary outcome measure was safety, which was assessed by adverse-event (AE), laboratory, and physical examination/vital-sign monitoring...
May 31, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28575220/vancomycin-taper-and-risk-of-failure-of-fecal-microbiota-transplant-in-patients-with-recurrent-clostridium-difficile-infection
#18
Roberto L Patron, Carlos A Hartmann, Sorcha Allen, Cheryl L Griesbach, Heidi E Kosiorek, John K DiBaise, Robert Orenstein
We retrospectively analyzed a cohort of 109 subjects treated for rCDI with FMT at tertiary referral center between 2011 and 2014 to determine risk factors for FMT failure.. In a multivariate analysis, failure to use an oral vancomycin taper preceding FMT was associated with a significant risk of FMT failure (odds ratio [95% CI], 0.15 [0.007-0.40]).
June 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28572645/editorial-making-fecal-microbiota-transplantation-easier-to-swallow-freeze-dried-preparation-for-recurrent-clostridium-difficile-infections
#19
Ilan Youngster, Dale N Gerding
Fecal microbiota transplant (FMT) has emerged as an effective and increasingly popular therapy for recurrent Clostridium difficile infections in patients that have failed standard antimicrobial treatment. Patient access to FMT is hampered by the logistics of manufacturing, storing, and delivering the inocula. An observational study describes the development and clinical efficacy of freeze-dried FMT capsules for oral administration. While awaiting the emergence of defined bacterial therapeutics for Clostridium difficile infections, this refinement of FMT is an encouraging step toward simplifying FMT treatment...
June 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28569200/faecal-transplantation-for-the-treatment-of-clostridium-difficile-infection-in-a-marmoset
#20
Yumiko Yamazaki, Shinpei Kawarai, Hidetoshi Morita, Takefumi Kikusui, Atsushi Iriki
BACKGROUND: The common marmoset has been used as an experimental animal for various purposes. Because its average weight ranges from 250 to 500 g, weight loss quickly becomes critical for sick animals. Therefore, effective and non-stressful treatment for chronic diseases, including diarrhoea, is essential. CASE PRESENTATION: We report a case in which faecal microbiota transplantation (FMT) led to immediate recovery from chronic and recurrent diarrhoea caused by Clostridium difficile infection...
May 31, 2017: BMC Veterinary Research
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