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C difficile colitis

Brintha Parasumanna Girinathan, Junjun Ou, Bruno Dupuy, Revathi Govind
Clostridium difficile is the primary cause of nosocomial diarrhea and pseudomembranous colitis. It produces dormant spores, which serve as an infectious vehicle responsible for transmission of the disease and persistence of the organism in the environment. In Bacillus subtilis, the sin locus coding SinR (113 aa) and SinI (57 aa) is responsible for sporulation inhibition. In B. subtilis, SinR mainly acts as a repressor of its target genes to control sporulation, biofilm formation, and autolysis. SinI is an inhibitor of SinR, so their interaction determines whether SinR can inhibit its target gene expression...
March 12, 2018: PLoS Pathogens
Klaus Aktories, Panagiotis Papatheodorou, Carsten Schwan
Clostridium difficile infection causes antibiotics-associated diarrhea and pseudomembranous colitis. Major virulence factors of C. difficile are the Rho-glucosylating toxins TcdA and TcdB. In addition, many, so-called hypervirulent C. difficile strains produce the binary actin-ADP-ribosylating toxin CDT. CDT causes depolymerization of F-actin and rearrangement of the actin cytoskeleton. Thereby, many cellular functions, which depend on actin, are altered. CDT disturbs the dynamic balance between actin and microtubules in target cells...
March 7, 2018: Anaerobe
Jeffrey Baron, Shuntao Cai, Natalie Klein, Burke A Cunha
OBJECTIVE: The clinical effectiveness of tigecycline depends on appropriate use, and PK/PD (pharmacokinetic/pharmacodynamic) parameters related to dose and dosing interval. METHODS: In our 600-bed university-affiliated teaching hospital, we conducted a tigecycline efficacy review over a three-month period in 34 evaluable patients. Parameters assessed included clinical response, cure or treatment failure, once daily as q12h dosing, maintenance dosing, high dose vs...
March 9, 2018: Journal of Clinical Medicine
Roy J Hopkins, Robert B Wilson
Clostridium difficile is a gram-positive, spore-forming, obligate anaerobic bacillus that was originally isolated from the stool of a healthy neonate in 1935. In high-income countries, C. difficile is the most common cause of infectious diarrhoea in hospitalized patients. The incidence of C. difficile infection in the USA has increased markedly since 2000, with hospitalizations for C. difficile infections in non-pregnant adults doubling between 2000 and 2010. Between 20% and 35% of patients with C. difficile infection will fail initial antibiotic treatment and, of these, 40-60% will have a second recurrence...
February 2018: Gastroenterology Report
Fenfen Zhou, Therwa Hamza, Ashley S Fleur, Yongrong Zhang, Hua Yu, Kevin Chen, Jonathon E Heath, Ye Chen, Haihui Huang, Hanping Feng
Background: Over the past several decades, there has been a significant increase in the incidence of Clostridium difficile infection (CDI) in patients suffering from inflammatory bowel disease (IBD). However, a wild-type animal model is not available to study these comorbid diseases. Methods: We evaluated the susceptibility to CDI of mice with dextran sulfate sodium salt (DSS)-induced colitis (IBD mice) with or without antibiotic exposure; we examined the histopathology and cytokine response in the concomitant diseases after the model was created...
February 15, 2018: Inflammatory Bowel Diseases
P Martínez-Ayala, L A González-Hernández, F Amador-Lara, J Andrade-Villanueva, M Ramos-Solano
No abstract text is available yet for this article.
February 12, 2018: Revista de Gastroenterología de México
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
Kosaku Nanki, Shinta Mizuno, Katsuyoshi Matsuoka, Keiko Ono, Shinya Sugimoto, Hiroki Kiyohara, Mari Arai, Moeko Nakashima, Kozue Takeshita, Keiichiro Saigusa, Mitsutoshi Senoh, Tadashi Fukuda, Makoto Naganuma, Haru Kato, Wataru Suda, Masahira Hattori, Takanori Kanai
Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent Clostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT...
January 2018: Intestinal Research
Dejan Micic, Andres Yarur, Alex Gonsalves, Vijaya L Rao, Susan Broadaway, Russell Cohen, Sushila Dalal, John N Gaetano, Laura R Glick, Ayal Hirsch, Joel Pekow, Atsushi Sakuraba, Seth T Walk, David T Rubin
INTRODUCTION: Clostridium difficile is the most commonly isolated stool pathogen in inflammatory bowel disease (IBD). Traditional risk factors for C. difficile may not exist in patients with IBD, and no prior studies have assessed the risk factors for the isolation of C. difficile in both symptomatic and asymptomatic IBD outpatients. METHODS: We prospectively recruited consecutive IBD patients presenting to our outpatient clinic between April 2015 and February 2016...
February 8, 2018: Digestive Diseases and Sciences
Bhagyashri D Navalkele, Teena Chopra
Clostridium difficile infection (CDI) is the most common health care-acquired infection associated with high hospital expenditures. The incidence of subsequent recurrent CDI increases with prior episodes of CDI, 15%-35% risk after primary CDI to 35%-65% risk after the first recurrent episode. Recurrent CDI is one of the most challenging and a very difficult to treat infections. Standard guidelines provide recommendations on treatment of primary CDI. However, treatment choices for recurrent CDI are limited. Recent research studies have focused on the discovery of newer alternatives for prevention of recurrent CDI targeting prime virulence factors involved in C...
2018: Biologics: Targets & Therapy
Nadav Sahar, Richard A Kozarek, Zaheer S Kanji, Shingo Chihara, S Ian Gan, Michael Gluck, Michael Larsen, Andrew S Ross, Shayan Irani
BACKGROUND AND AIMS: Although society guidelines recommend a short course of antibiotics after drainage of walled-off necrosis (WON), the exact duration is unclear. METHODS: This is a retrospective review of patients with no prior antibiotic exposure who underwent dual modality drainage (DMD) for sterile WON from 2008 to 2017. Patients were grouped into- short duration (SD, ≤5 days) vs. long duration (LD, >5 days). The main outcome was the frequency of recurrent infections...
February 2, 2018: Journal of Gastroenterology and Hepatology
Michael Mintz, Shanawaj Khair, Suman Grewal, Joseph F LaComb, Jiyhe Park, Breana Channer, Ramona Rajapakse, Juan Carlos Bucobo, Jonathan M Buscaglia, Farah Monzur, Anupama Chawla, Jie Yang, Charlie E Robertson, Daniel N Frank, Ellen Li
BACKGROUND: Studies of colonoscopic fecal microbiota transplant (FMT) in patients with recurrent CDI, indicate that this is a very effective treatment for preventing further relapses. In order to provide this service at Stony Brook University Hospital, we initiated an open-label prospective study of single colonoscopic FMT among patients with ≥ 2 recurrences of CDI, with the intention of monitoring microbial composition in the recipient before and after FMT, as compared with their respective donor...
2018: PloS One
Panagiotis Papatheodorou, Holger Barth, Nigel Minton, Klaus Aktories
Research on the human gut pathogen Clostridium difficile and its toxins has gained much attention, particularly as a consequence of the increasing threat to human health presented by emerging hypervirulent strains. Toxin A (TcdA) and B (TcdB) are the two major virulence determinants of C. difficile. Both are single-chain proteins with a similar multidomain architecture. Certain hypervirulent C. difficile strains also produce a third toxin, namely binary toxin CDT (Clostridium difficile transferase). As C. difficile toxins are the causative agents of C...
2018: Advances in Experimental Medicine and Biology
Juveria Siddiqui, Thomas Campion, Rui Wei, Siarhei Kuzmich
While imaging appearances of pseudomembranous colitis are commonly recognised, radiological manifestations of Clostridium difficile -associated enteritis are poorly understood which, combined with the rarity of this infection involving small bowel, makes establishing the correct diagnosis challenging. Therefore, in order to encourage awareness of readers, we present a case of C. difficile enteritis that manifested as abdominal sepsis complicating the postoperative period in a middle-aged woman with fistulating Crohn's disease and defunctioning ileostomy...
January 26, 2018: BMJ Case Reports
Regina Lamendella, Justin R Wright, Jada Hackman, Christopher McLimans, David R Toole, William Bernard Rubio, Rebecca Drucker, Hoi Tong Wong, Kate Sabey, John P Hegarty, David B Stewart
Clostridium difficile infection (CDI) is the most common nosocomial infection in the United States, being associated with high recurrence and persistence rates. Though the relationship between intestinal dysbiosis and CDI is well known, it is unclear whether different forms of dysbiosis may potentially affect the course of CDI. How this is further influenced by C. difficile-directed antibiotics is virtually uninvestigated. In this study, diarrheal stool samples were collected from 20 hospitalized patients, half of whom were confirmed to have CDI...
January 2018: MSphere
Jacob Ruiter-Ligeti, Sophie Vincent, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
OBJECTIVE: To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection. METHODS: We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression...
January 9, 2018: Obstetrics and Gynecology
Niloufar Roshan, Katherine A Hammer, Thomas V Riley
Clostridium difficile is an anaerobic, Gram-positive, spore-forming bacillus that causes disease ranging from self-limiting diarrhoea to severe pseudomembranous colitis. C. difficile infection (CDI) commonly affects hospitalised patients and is increasingly identified in patients in the community with no hospital contact. For the last 15 years the incidence of CDI worldwide has been rising, especially in the northern hemisphere. The yearly average number of hospitalizations as a result of this disease is estimated to be over a quarter of a million per year in the United States alone...
January 6, 2018: Anaerobe
Ronald E Delanois, Nicole E George, Jennifer I Etcheson, Chukwuweike U Gwam, Jaydev B Mistry, Michael A Mont
BACKGROUND: With the increased demand for primary total hip arthroplasty (THA) and corresponding rise in revision procedures, it is imperative to understand the factors contributing to the development of Clostridium difficile colitis. We aimed to provide a detailed analysis of: (1) the incidence of; (2) the demographics, lengths of stay, and total costs for; and (3) the risk factors and mortality associated with the development of C. difficile colitis after revision THA. METHODS: The National Inpatient Sample database was queried for all individuals diagnosed with a periprosthetic joint infection and who underwent all-component revision THA between 2009 and 2013 (n = 40,876)...
December 2, 2017: Journal of Arthroplasty
Malihe Kheradmand, Somayeh Jalilian, Amirhooshang Alvandi, Ramin Abiri
Background and Objectives: Clostridium difficile is the leading cause of nosocomial diarrhea and pseudomembranous colitis. The prevalence of C. difficile infection differs in various geographical areas. The aim of this study was to determine the prevalence of C. difficile isolates and the prevalence of cdd3, tcdA and tcdB genes in beef samples in Kermanshah Province. Materials and Methods: One hundred ground beef samples were randomly collected from the butchers of Kermanshah province during March 2014 to March 2015...
June 2017: Iranian Journal of Microbiology
Raseen Tariq, Cindy C Y Law, Sahil Khanna, Sanjay Murthy, Jeffrey D McCurdy
BACKGROUND AND AIMS: Clostridium difficile infection (CDI) has been associated with an increased mortality risk among patients with inflammatory bowel disease (IBD) in multiple observational studies. We performed a systematic review and meta-analysis to help clearly define the magnitude of risk in IBD patients with and without CDI, and to assess the risk in individual IBD subtypes. METHODS: A systematic search of multiple electronic databases was conducted for observational studies reporting the risk of mortality in IBD, stratified by the presence of CDI...
December 4, 2017: Journal of Clinical Gastroenterology
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