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C difficile colitis

Manli Y Davis, Husen Zhang, Lera E Brannan, Robert J Carman, James H Boone
BACKGROUND: Clostridium difficile is the most common known cause of antibiotic-associated diarrhea. Upon the disturbance of gut microbiota by antibiotics, C. difficile establishes growth and releases toxins A and B, which cause tissue damage in the host. The symptoms of C. difficile infection disease range from mild diarrhea to pseudomembranous colitis and toxic megacolon. Interestingly, 10-50 % of infants are asymptomatic carriers of C. difficile. This longitudinal study of the C. difficile colonization in an infant revealed the dynamics of C...
October 7, 2016: Microbiome
Elena A Usacheva, Jian-P Jin, Lance R Peterson
Clostridium difficile infection (CDI) is a significant healthcare concern worldwide, and C. difficile is recognised as the most frequent aetiological agent of infectious healthcare-associated diarrhoea in hospitalised adult patients. The clinical manifestation of CDI varies from self-limited diarrhoea to life-threatening colitis. Such a broad disease spectrum can be explained by the impact of host factors. Currently, a complex CDI aetiology is widely accepted, acknowledging the interaction between bacteria and the host...
September 20, 2016: Journal of Global Antimicrobial Resistance
Abhinav Goyal, Moiz Salahuddin, Yogesh Govil
A 31-year-old female with a history of lupus nephritis on Hydroxychloroquine, Prednisone, and Mycophenolate Mofetil (MMF) for 10 years presented to the hospital for ankle swelling. On day four, she started to have severe, nonbloody, watery diarrhea with abdominal distension and tenderness. Stool PCR was negative for C. difficile. CT abdomen/pelvis showed gaseous distension of the colon without any obstruction. Flexible sigmoidoscopy revealed a normal looking mucosa. Histopathology showed crypt atrophy and increased crypt apoptosis, consistent with MMF colitis...
2016: Case Reports in Gastrointestinal Medicine
Bing Wang, Samantha M Powell, Neda Hessami, Fares Z Najar, Leonard M Thomas, Elizabeth A Karr, Ann H West, George B Richter-Addo
Nitroreductases (NRs) are flavin mononucleotide (FMN)-dependent enzymes that catalyze the biotransformation of organic nitro compounds (RNO2; R = alkyl, aryl) to the nitroso RN=O, hydroxylamino RNHOH, or amine RNH2 derivatives. Metronidazole (Mtz) is a nitro-containing antibiotic that is commonly prescribed for lower-gut infections caused by the anaerobic bacterium Clostridium difficile. C. difficile infections rank number one among hospital acquired infections, and can result in diarrhea, severe colitis, or even death...
September 10, 2016: Nitric Oxide: Biology and Chemistry
Nicholas Horton, Xianrui Wu, Jessica Philpott, Ari Garber, Jean-Paul Achkar, Aaron Brzezinski, Bret A Lashner, Bo Shen
BACKGROUND: Inflammatory bowel diseases (IBDs) are considered immune-mediated disorders with dysregulated innate and adaptive immunities. Secondary immunogloblin deficiency can occur in IBD and its impact on the disease course of IBD is not clear. AIMS: We sought to determine associations between low IgG/G1 levels and poor clinical outcomes in IBD patients. METHODS: This historic cohort study was performed on IBD patients with obtained IgG/IgG1 levels...
November 2016: Digestive Diseases and Sciences
Eric M Fountain, Maggie C Moses, Lawrence P Park, Christopher W Woods, Gowthami M Arepally
Clostridium difficile infection (CDI) is a common cause of nosocomial diarrhea and colitis. The incidence and prognostic significance of thrombocytopenia as related to mode of acquisition (hospital vs. community), NAP1/027 strain, and disease severity has not been examined. We performed a single-institution retrospective analysis of all adult inpatients from 2013 to 2014 diagnosed with CDI during their hospitalization to document the incidence/prevalence of thrombocytopenia and associated outcomes. Severe disease was defined by a composite endpoint of inpatient death, death within 30 days of discharge, presence of septic shock, or need for colectomy during hospitalization...
September 10, 2016: Journal of Thrombosis and Thrombolysis
Peter Moono, Niki F Foster, David J Hampson, Daniel R Knight, Lauren E Bloomfield, Thomas V Riley
Clostridium difficile is the leading cause of antibiotic-associated diarrhea and colitis in hospitalized humans. Recently, C. difficile infection (CDI) has been increasingly recognized as a cause of neonatal enteritis in food animals such as pigs, resulting in stunted growth, delays in weaning, and mortality, as well as colitis in large birds such as ostriches. C. difficile is a strictly anaerobic spore-forming bacterium, which produces two toxins A (TcdA) and B (TcdB) as its main virulence factors. The majority of strains isolated from animals produce an additional binary toxin (C...
September 7, 2016: Foodborne Pathogens and Disease
Stefano Grandesso, Fabio Arena, Franklin Esoka Eseme, Sandro Panese, Lucia Henrici De Angelis, Patrizia Spigaglia, Fabrizio Barbanti, Gian Maria Rossolini
This report describes a case of Clostridium difficile ribotype 033 colitis in a patient treated with multiple antibiotics for KPC-producing Klebsiella pneumoniae pancreatitis. Diagnostic, clinical and therapeutic features are discussed. To the best of our knowledge, this is the first case of C. difficile ribotype 033 clinical infection reported from Italy.
September 2016: New Microbiologica
Alexander Link, Tim Lachmund, Christian Schulz, Jochen Weigt, Peter Malfertheiner
BACKGROUND: Fecal microbiota transplantation (FMT) is a valuable treatment modality for recurrent Clostridium difficile (C. difficile) colitis. Multiple questions including the best delivery route and volume remain unanswered. Here, we report a case series of high-volume FMT using endoscopic jejunal application route. METHODS: In prospective observational study, FMT was performed using fresh specimen from healthy unrelated donors to the patients with recurrent or refractory C...
August 12, 2016: Digestive and Liver Disease
Michael C Abt, Peter T McKenney, Eric G Pamer
Clostridium difficile is a major cause of intestinal infection and diarrhoea in individuals following antibiotic treatment. Recent studies have begun to elucidate the mechanisms that induce spore formation and germination and have determined the roles of C. difficile toxins in disease pathogenesis. Exciting progress has also been made in defining the role of the microbiome, specific commensal bacterial species and host immunity in defence against infection with C. difficile. This Review will summarize the recent discoveries and developments in our understanding of C...
October 2016: Nature Reviews. Microbiology
Emma C Stevenson, Giles A Major, Robin C Spiller, Sarah A Kuehne, Nigel P Minton
Clostridium difficile (Peptoclostridium difficile) is a common health care associated infection with a disproportionately high incidence in elderly patients. Disease symptoms range from mild diarrhoea through to life threatening pseudomembranous colitis. Around 20% of patients may suffer recurrent disease which often requires re-hospitalisation of patients.C. difficile was isolated from stool samples from a patient with two recurrent C. difficile infections. PCR-ribotyping, whole genome sequencing and phenotypic assays were used to characterise these isolates...
August 24, 2016: Journal of Clinical Microbiology
Shuyi Chen, Haiying Wang, Huawei Gu, Chunli Sun, Shan Li, Hanping Feng, Jufang Wang
Clostridium difficile toxin A (TcdA) and toxin B (TcdB) are the major virulence factors involved in C. difficile-associated diarrhea and pseudomembranous colitis. TcdA and TcdB both contain at least four distinct domains: the glucosyltransferase domain, cysteine protease domain, receptor binding domain, and translocation domain. Few studies have investigated the translocation domain and its mechanism of action. Recently, it was demonstrated that a segment of 97 amino acids (AA 1756-1852, designated D97) within the translocation domain of TcdB is essential for the in vitro and in vivo toxicity of TcdB...
2016: Toxins
Michael Kwan-Lung Ko, Siew C Ng, Lung-Yi Mak, Michael K Li, Fu Hang Lo, Carmen Ka Man Ng, Wai Cheung Lao, Steve Tsang, Kam Hon Chan, Yee Tak Hui, Edwin Hok Shing Shan, Ching Kong Loo, Aric J Hui, Wai Pan To, Ivan F Hung, Wai K Leung
AIM: With the rapid increase in the incidence of inflammatory bowel disease (IBD) in Asia, the natural course of these patients during the early phase of disease remains poorly defined. We determined the incidence and characteristics of infection related hospitalization in the first year of patients newly diagnosed with IBD in Hong Kong. METHODS: Patients newly diagnosed with IBD and enrolled in the territory-wide Hong Kong IBD Registry were identified. Details of their hospitalization within the first 12 months after diagnosis were retrieved and analyzed...
August 17, 2016: Journal of Digestive Diseases
Séverine Péchiné, Cécile Denève-Larrazet, Anne Collignon
Clostridium difficile is responsible for a large spectrum of intestinal diseases ranging from mild diarrhea to fatal colitis depending on the one hand on the strain virulence and on the other on the host. The pathogenesis of C. difficile infection could be seen as a three-step process that takes place after disruption of the digestive microbiota by antibiotics: (1) contamination by and germination of spores; (2) multiplication of vegetative cells in the colonic niche using colonization factors; (3) production of the two toxins TcdA and TcdB and for some strains an additional toxin, the binary toxin CDT...
2016: Methods in Molecular Biology
Zhiyong Yang, Lianfa Shi, Hua Yu, Yongrong Zhang, Kevin Chen, Ashley Saint Fleur, Guang Bai, Hanping Feng
Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea and colitis in developed countries. The disease is mainly mediated via two major exotoxins TcdA and TcdB secreted by the bacterium. We have previously developed a novel, potently neutralizing, tetravalent and bispecific heavy-chain-only single domain (VHH) antibody to both TcdA and TcdB (designated as ABA) that reverses fulminant CDI in mice. Since ABA has a short serum half-life, in this study a replication-deficient recombinant adenovirus expressing ABA was generated and the long-lasting expression of functional ABA was demonstrated in vitro and in vivo Mice transduced with one dose of the adenovirus displayed high levels of serum ABA for more than1 month and were fully protected against systemic toxin challenges...
October 2016: Pathogens and Disease
Evon Zoog, Kristin C Turza, G Ralston Major, J Daniel Stanley
No abstract text is available yet for this article.
July 2016: American Surgeon
S Pandey, K Senthilguru, K Uvanesh, Sai S Sagiri, B Behera, N Babu, Mrinanl K Bhattacharyya, K Pal, I Banerjee
Single formulation based delivery of probiotic-drug combination is envisioned as a superior therapeutic modalities for the diseases like Crohn's diseases, ulceritive colitis and Recurrent Clostridium difficile-Associated Diarrhoea (RCDAD). Keeping this perspective in mind, here we have developed natural gums [using a combination of aqueous solution of xantham gum (X) and guar gum (G)] modified sunflower oil based emulsion gels for the delivery of probiotics-drugs combination. FT-IR analysis and fluorescence microscopy together confirmed the formation of oil-in-water type emulsion gel by physical gelation in presence of the physical gelator sorbitan monopalmitate (SM)...
July 15, 2016: International Journal of Biological Macromolecules
András Telekes
Clostridium difficile infection is one of the most frequent among cancer patients. Its diagnosis is complicated by the fact that the symptoms of the infection and the side effects of the anticancer treatments could be similar. Chemotherapy itself might facilitate Clostridium difficile infection. Several risk factors are known but Clostridium difficile infection can develop in the absence of these. Neutreopenia is a risk factor for fatal Clostridium difficile infection and also the side effect of chemotherapy...
July 2016: Orvosi Hetilap
Mahdi Malekpour, Kelly Bridgham, Nina Neuhaus, Kenneth Widom, Megan Rapp, Diane Leonard, Susan Baro, James Dove, Marie Hunsinger, Joseph Blansfield, Mohsen Shabahang, Denise Torres, Jeffrey Wild
Facial fractures are commonly managed nonoperatively. Patients with facial fractures involving sinus cavities commonly receive 7 to 10 days of prophylactic antibiotics, yet no literature exists to support or refute this practice. The aim of this study was to compare the administration and duration of antibiotic prophylaxis on the incidence of soft tissue infection in nonoperative facial fractures. A total number of 289 patients who were admitted to our level I trauma center with nonoperative facial fractures from the beginning of 2012 to the end of 2014 were studied...
July 8, 2016: Journal of Craniofacial Surgery
Imad Kansau, Amira Barketi-Klai, Marc Monot, Sandra Hoys, Bruno Dupuy, Claire Janoir, Anne Collignon
Clostridium difficile is responsible for a wide spectrum of infection from asymptomatic carriage to severe, relapsing colitis. Since 2003, C. difficile infections have increased with a higher morbidity and mortality due to the emergence of epidemic and hypervirulent C. difficile strains such as those of the epidemic lineage 027/BI/NAP1. To decipher the hypervirulence and epidemicity of 027 strains, we analyzed gene expression profiles of the R20291 027 strain using a monoxenic mouse model during the first 38h of infection...
2016: PloS One
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