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https://www.readbyqxmd.com/read/28103289/cost-effectiveness-analysis-of-five-competing-strategies-for-the-management-of-multiple-recurrent-community-onset-clostridium-difficile-infection-in-france
#1
Emilie Baro, Tatiana Galperine, Fanette Denies, Damien Lannoy, Xavier Lenne, Pascal Odou, Benoit Guery, Benoit Dervaux
BACKGROUND: Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the management of second recurrence of community-onset CDI in France. METHODS: We developed a decision-analytic simulation model to compare 5 treatments for the management of second recurrence of community-onset CDI: pulsed-tapered vancomycin, fidaxomicin, fecal microbiota transplantation (FMT) via colonoscopy, FMT via duodenal infusion, and FMT via enema...
2017: PloS One
https://www.readbyqxmd.com/read/28102756/treatment-of-recurrent-clostridium-difficile-infection-using-fecal-microbiota-transplantation-in-patients-with-inflammatory-bowel-disease
#2
Krista M Newman, Kevin M Rank, Byron P Vaughn, Alexander Khoruts
We recently compared results of fecal microbiota transplantation (FMT) in patients with refractory, recurrent Clostridium difficile infection (rCDI), with and without underlying inflammatory bowel disease (IBD). Here we extend this cohort and analyze outcomes in greater detail by subtype of IBD. We find that FMT is generally effective in breaking the cycle of CDI recurrence, but its effects on overall IBD progression are much less predictable. We discuss a number of challenges intrinsic to this complex clinical situation and outline the next steps that can address these challenges going forward...
January 19, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28096487/a-clostridium-difficile-specific-gel-forming-protein-required-for-optimal-spore-germination
#3
M Lauren Donnelly, William Li, Yong-Qing Li, Lauren Hinkel, Peter Setlow, Aimee Shen
: Clostridium difficile is a Gram-positive spore-forming obligate anaerobe that is a leading cause of antibiotic-associated diarrhea worldwide. In order for C. difficile to initiate infection, its aerotolerant spore form must germinate in the gut of mammalian hosts. While almost all spore-forming organisms use transmembrane germinant receptors to trigger germination, C. difficile uses the pseudoprotease CspC to sense bile salt germinants. CspC activates the related subtilisin-like protease CspB, which then proteolytically activates the cortex hydrolase SleC...
January 17, 2017: MBio
https://www.readbyqxmd.com/read/28092627/the-effect-of-surface-transport-on-water-desalination-by-porous-electrodes-undergoing-capacitive-charging
#4
Amit N Shocron, Matthew E Suss
Capacitive deionization (CDI) is a technology in which water is desalinated by ion electrosorption into the electric double layers (EDLs) of charging porous electrodes. In recent years significant advances have been made in modeling the charge and salt dynamics in a CDI cell, but the possible effect of surface transport within diffuse EDLs on these dynamics has not been investigated. We here present theory which includes surface transport in describing the dynamics of a charging CDI cell. Through our numerical solution to the presented models, the possible effect of surface transport on the CDI process is elucidated...
January 16, 2017: Journal of Physics. Condensed Matter: An Institute of Physics Journal
https://www.readbyqxmd.com/read/28089675/burden-of-clostridium-difficile-infection-associated-hospitalization-in-a-cohort-of-middle-aged-and-older-adults
#5
Yingxi Chen, Kathryn Glass, Bette Liu, Rosemary J Korda, Thomas V Riley, Martyn D Kirk
BACKGROUND: Clostridium difficile is the principal cause of infectious diarrhea in hospitalized patients. The aim of this study was to describe and compare length of stay (LOS), costs, and in-hospital deaths for C difficile infection (CDI) and non-CDI hospitalizations, in a cohort of middle-aged and older Australians. METHODS: We used survey data from the 45 and Up Study, linked to hospitalization and death data. We calculated the average LOS and costs per hospitalization, and the proportion of in-hospital deaths for CDI and non-CDI hospitalizations...
January 13, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28089100/community-onset-clostridium-difficile-infection-at-a-tertiary-medical-center-in-southern-taiwan-2007-2015
#6
Chin-Shiang Tsai, Yuan-Pin Hung, Jen-Chieh Lee, Nan-Yao Lee, Po-Lin Chen, Ling-Shan Syue, Ming-Chi Li, Chia-Wen Li, Wen-Chien Ko
BACKGROUND: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. METHODS: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI)...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28087725/neurodevelopmental-outcomes-of-extremely-low-birthweight-infants-randomised-to-different-pco2-targets-the-phelbi-follow-up-study
#7
Ulrich H Thome, Orsolya Genzel-Boroviczeny, Bettina Bohnhorst, Manuel Schmid, Hans Fuchs, Oliver Rohde, Stefan Avenarius, Hans-Georg Topf, Andrea Zimmermann, Dirk Faas, Katharina Timme, Barbara Kleinlein, Horst Buxmann, Wilfried Schenk, Hugo Segerer, Norbert Teig, Annett Bläser, Roland Hentschel, Matthias Heckmann, Rolf Schlösser, Jochen Peters, Rainer Rossi, Wolfgang Rascher, Ralf Böttger, Jürgen Seidenberg, Gesine Hansen, Maria Zernickel, Harald Bode, Jens Dreyhaupt, Rainer Muche, Helmut D Hummler
BACKGROUND: Tolerating higher partial pressures of carbon dioxide (PCO2) in mechanically ventilated extremely low birthweight infants to reduce ventilator-induced lung injury may have long-term neurodevelopmental side effects. This study analyses the results of neurodevelopmental follow-up of infants enrolled in a randomised multicentre trial. METHODS: Infants (n=359) between 400 and 1000 g birth weight and 23 0/7-28 6/7 weeks gestational age who required endotracheal intubation and mechanical ventilation within 24 hours of birth were randomly assigned to high PCO2 or to a control group with mildly elevated PCO2 targets...
January 13, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28087170/clostridium-difficile-rates-in-asymptomatic-and-symptomatic-hospitalized-patients-using-nucleic-acid-testing
#8
Cynthia Truong, Lee F Schroeder, Rajiv Gaur, Victoria Emma Anikst, Ikuko Komo, Colleen Watters, Erin McCalley, Carole Kulik, David Pickham, Nancy J Lee, Niaz Banaei
BACKGROUND: The Clostridium difficile rate in symptomatic patients represents both those with C. difficile infection (CDI) and those with colonization. To predict the extent of CDI overdiagnosis, we compared the asymptomatic colonization rate to the symptomatic positivity rate in hospitalized patients using nucleic acid testing. METHODS: Between July 2014 and April 2015, formed stool samples were collected from asymptomatic patients after admission to 3 hospital wards at the Stanford Hospital...
January 3, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28081326/the-effect-of-deep-sclerectomy-on-ocular-blood-flow-a-6-month-clinical-trial
#9
Arzu Özsoy, Murat Sinan Sarıcaoğlu, Mehtap Çavuşoğlu
BACKGROUND/AIM: To investigate the effect of deep sclerectomy on retrobulbar blood flow. MATERIALS AND METHODS: This prospective study included 20 eyes of 20 patients with open angle glaucoma. Color Doppler imaging (CDI) examinations were performed before and 2, 12, and 24 weeks after deep sclerectomy. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were measured for the ophthalmic artery (OA), central retinal artery (CRA), and temporal and nasal short posterior ciliary arteries (SPCAs) at each examination and the results were compared...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28079620/clostridium-difficile-infection-and-risk-of-colectomy-in-patients-with-inflammatory-bowel-disease-a-bias-adjusted-meta-analysis
#10
Yingxi Chen, Luis Furuya-Kanamori, Suhail A Doi, Ashwin N Ananthakrishnan, Martyn Kirk
BACKGROUND: Clostridium difficile infection (CDI) is a common complication of inflammatory bowel diseases (IBDs) and is associated with worse outcome. Variable rates of colectomy have been reported among IBD complicated by CDI. We conducted a systematic review and meta-analysis of studies to assess the association between CDI and colectomy among patients with IBD. METHODS: The literature was systematically searched using PubMed from inception through April 2016...
February 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28078087/clostridium-difficile-infection-in-cystic-fibrosis-an-uncommon-but-life-threatening-complication
#11
Francesco Piccolo, Anna Sze Tai, Hooi Ee, Siobhain Mulrennan, Scott Bell, Gerard Ryan
Adults with cystic fibrosis (CF) have significant rates of asymptomatic Clostridium difficile carriage and are frequently exposed to risk factors for C. difficile infection (CDI). Despite this, the rate of reported CDI in CF is low. We describe three cases of near fatal CDI in adults with CF and review the literature regarding presentation, management, and recurrence prevention. Early recognition is important as the clinical presentation may be atypical and the illness can be severe and even life-threatening...
January 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28077697/point-counterpoint-what-is-the-optimal-approach-for-detection-of-clostridium-difficile-infection
#12
Ferric C Fang, Christopher R Polage, Mark H Wilcox
In 2010, we published an initial point-counterpoint on laboratory diagnosis of C. difficile infection (CDI). At that time, nucleic acid amplification tests (NAATs) were just becoming commercially available, and the idea of algorithmic approaches to CDI was being explored. Now there are numerous NAATs in the marketplace and based on recent proficiency test surveys, they have become the predominant method used for CDI diagnosis in the United States. At the same time, there is a body of literature that suggests that NAATs lack clinical specificity and thus inflate CDI rates...
January 11, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#13
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28075419/surveillance-of-clostridium-difficile-infections-results-from-a-six-year-retrospective-study-in-nine-hospitals-of-a-north-italian-local-health-authority
#14
Greta Roncarati, Laura Dallolio, Erica Leoni, Manuela Panico, Angela Zanni, Patrizia Farruggia
Clostridium difficile is an emerging cause of healthcare associated infections. In nine hospitals of an Italian Local Health Authority the episodes of C. difficile infection (CDI) were identified using the data registered by the centralized Laboratory Information System, from 2010 to 2015. CDI incidence (positive patients for A and/or B toxins per patients-days) was analysed per year, hospital, and ward. A number of cases approximately equivalent to the mean of identified cases per year were studied retrospectively to highlight the risk factors associated to CDI and their severity...
January 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28065332/clostridium-difficile-contamination-of-health-care-workers-hands-and-its-potential-contribution-to-the-spread-of-infection-review-of-the-literature
#15
REVIEW
Ingrid Jullian-Desayes, Caroline Landelle, Marie-Reine Mallaret, Christian Brun-Buisson, Frédéric Barbut
BACKGROUND: Clostridium difficile infection (CDI) can be transmitted from patient to patient by the hands of health care workers (HCWs); however, the relative importance of this route in the spread of C difficile in the hospital is currently unknown. Our aim was to review studies examining HCWs' hand carriage and its potential role in CDI transmission. METHODS: First, English-speaking references addressing HCWs' hand sampling obtained from the PubMed database were reviewed...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28060888/the-association-between-gaba-modulators-and-clostridium-difficile-infection-a-matched-retrospective-case-control-study
#16
Jonathan Ström, Johan Tham, Fredrik Månsson, Jonas Ahl, Tor C Savidge, Sara M Dann, Fredrik Resman
OBJECTIVE: Recently, metabolomics studies have suggested that the neurotransmitter γ-amino butyric acid (GABA) may modulate C. difficile infection (CDI) pathogenesis. In the present study, we investigated the association between GABA-modulating pharmaceuticals and CDI development. METHODS: In July-December 2013, we performed a matched, retrospective case-control study in Skåne county, Sweden, to assess the association between the use of GABA-modulators (defined as regular use of at least one of the following: zolpidem, zopiclone, benzodiazepines, gabapentin, pregabalin or baclofen) and CDI...
2017: PloS One
https://www.readbyqxmd.com/read/28060346/cefoperazone-treated-mouse-model-of-clinically-relevant-clostridium-difficile-strain-r20291
#17
Jenessa A Winston, Rajani Thanissery, Stephanie A Montgomery, Casey M Theriot
Clostridium difficile is an anaerobic, gram-positive, spore-forming enteric pathogen that is associated with increasing morbidity and mortality and consequently poses an urgent threat to public health. Recurrence of a C. difficile infection (CDI) after successful treatment with antibiotics is high, occurring in 20-30% of patients, thus necessitating the discovery of novel therapeutics against this pathogen. Current animal models of CDI result in high mortality rates and thus do not approximate the chronic, insidious disease manifestations seen in humans with CDI...
December 10, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28059704/cooperative-and-acute-inhibitionby-multiple-c-terminal-motifs-of-l-type-ca-2-channels
#18
Nan Liu, Yaxiong Yang, Lin Ge, Min Liu, Henry M Colecraft, Xiaodong Liu
Inhibitions and antagonists of L-type Ca(2+) channels are important to both research and therapeutics. Here, we report C-terminus mediated inhibition (CMI) for CaV1.3 that multiple motifs coordinate to tune down Ca(2+) current and Ca(2+) influx toward the lower limits determined by end-stage CDI (Ca(2+)-dependent inactivation). Among IQV (preIQ3-IQ domain), PCRD and DCRD (proximal or distal C-terminal regulatory domain), spatial closeness of any two modules, e.g., by constitutive fusion, facilitates the trio to form the complex, compete against calmodulin, and alter the gating...
January 6, 2017: ELife
https://www.readbyqxmd.com/read/28059612/fecal-microbial-transplantation-as-a-therapeutic-option-in-patients-colonized-with-antibiotic-resistant-organisms
#19
Michael Laffin, Braden Millan, Karen L Madsen
Despite increasing interest in fecal microbiota transplantation (FMT), its full therapeutic potential has yet to be determined. Since its increase in popularity, FMT has been shown to be highly effective in the treatment of both Clostridium difficile infection (CDI) and its recurrent form. Interest in FMT now expands well beyond the treatment of CDI to other processes with known associations to the microbiota such as antibiotic resistant infections, inflammatory bowel disease (IBD), hepatic encephalopathy, neuropsychiatric disorders, and metabolic disease...
January 6, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28057949/impact-of-targeted-educational-interventions-on-clostridium-difficile-infection-treatment-in-critically-ill-adults
#20
Drayton A Hammond, Catherine A Hughes, Jacob T Painter, Rose E Pennick, Kshitij Chatterjee, Bradley Boye, Nikhil Meena
Background: Clostridium difficile infection (CDI) is a growing clinical and economic burden throughout the world. Pharmacists often are members of the primary care team in the intensive care unit (ICU) setting; however, the impact of pharmacists educating other health care providers on appropriateness of CDI treatment has not been previously examined. Objective: This study was performed to determine the impact of structured educational interventions on CDI treatment on appropriateness of CDI treatment and clinical outcomes...
December 2016: Hospital Pharmacy
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