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Christoph Lübbert, Lisa Zimmermann, Julia Borchert, Bernd Hörner, Reinier Mutters, Arne C Rodloff
INTRODUCTION: Clostridium difficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20-30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30-65%. Accurate data for Germany are not yet available. METHODS: Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed...
October 21, 2016: Infectious Diseases and Therapy
Vivian G Loo, Paul Brassard, Mark A Miller
OBJECTIVE To determine the risk of Clostridium difficile transmission from index cases with C. difficile infection (CDI) to their household contacts and domestic pets. DESIGN A prospective study from April 2011 to June 2013. SETTING Patients with CDI from Canadian tertiary care centers. PARTICIPANTS Patients with CDI, their household human contacts, and pets. METHODS Epidemiologic information and stool or rectal swabs were collected from participants at enrollment and monthly for up to 4 months. Pulsed-field gel electrophoresis (PFGE) was performed on C...
November 2016: Infection Control and Hospital Epidemiology
Worawan B Limpitikul, Ivy E Dick, David Tester, Nicole J Boczek, Pattraranee Limphong, Wanjun Yang, Myoung Hyun Choi, Jennifer Babich, Deborah DiSilvestre, Ronald J Kanter, Gordon F Tomaselli, Michael J Ackerman, David Yue
RATIONALE: Calmodulinopathies comprise a new category of potentially life-threatening genetic arrhythmia syndromes capable of producing severe long QT syndrome (LQTS) with mutations involving either CALM1, CALM2, or CALM3 The underlying basis of this form of LQTS is a disruption of Ca(2+)/CaM-dependent inactivation (CDI) of L-type Ca(2+) channels (LTCCs). OBJECTIVE: To gain insight into the mechanistic underpinnings of calmodulinopathies and devise new therapeutic strategies for the treatment of this form of LQTS...
October 20, 2016: Circulation Research
Jennifer L Kuntz, Jennifer M Baker, Patricia Kipnis, Sherian Xu Li, Vincent Liu, Yang Xie, Stephen Marcella, Gabriel J Escobar
BACKGROUND Considerable efforts have been dedicated to developing strategies to prevent and treat recurrent Clostridium difficile infection (rCDI); however, evidence of the impact of rCDI on patient healthcare utilization and outcomes is limited. OBJECTIVE To compare healthcare utilization and 1-year mortality among adults who had rCDI, nonrecurrent CDI, or no CDI. METHODS We performed a nested case-control study among adult Kaiser Foundation Health Plan members from September 1, 2001, through December 31, 2013...
October 20, 2016: Infection Control and Hospital Epidemiology
Zhen Huo, Tao Lu, Zhiyong Liang, Fan Ping, Jie Shen, Jingjing Lu, Wenbing Ma, Dachun Zhao, Dingrong Zhong
BACKGROUND: Isolated hypothalamic-pituitary Langerhans cell histiocytosis (HPLCH) is very rare. We investigated the clinicopathological characteristics, endocrine function changes, BRAF(V600E) mutations and treatments of isolated HPLCH. METHODS: We identified seven patients with isolated HPLCH by reviewing the clinical and pathological files in our hospital from 2007 to 2015. The clinical characteristics of the seven patients were retrospectively reviewed, especially the endocrine function changes...
October 19, 2016: Diagnostic Pathology
Mária Džunková, Giuseppe D'Auria, Hua Xu, Jun Huang, Yinghua Duan, Andrés Moya, Ciarán P Kelly, Xinhua Chen
Antibiotics have significant and long-lasting impacts on the intestinal microbiota and consequently reduce colonization resistance against Clostridium difficile infection (CDI). Standard therapy using antibiotics is associated with a high rate of disease recurrence, highlighting the need for novel treatment strategies that target toxins, the major virulence factors, rather than the organism itself. Human monoclonal antibodies MK-3415A (actoxumab-bezlotoxumab) to C. difficile toxin A and toxin B, as an emerging non-antibiotic approach, significantly reduced the recurrence of CDI in animal models and human clinical trials...
2016: Frontiers in Cellular and Infection Microbiology
Alessandro Cassini, Diamantis Plachouras, Tim Eckmanns, Muna Abu Sin, Hans-Peter Blank, Tanja Ducomble, Sebastian Haller, Thomas Harder, Anja Klingeberg, Madlen Sixtensson, Edward Velasco, Bettina Weiß, Piotr Kramarz, Dominique L Monnet, Mirjam E Kretzschmar, Carl Suetens
BACKGROUND: Estimating the burden of healthcare-associated infections (HAIs) compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. Based on the methodology of the Burden of Communicable Diseases in Europe (BCoDE) project and 2011-2012 data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals, we estimated the burden of six common HAIs...
October 2016: PLoS Medicine
Jeffrey D McCurdy, Felicity T Enders, Sahil Khanna, David H Bruining, Andrea Jones, Jill M Killian, Raseen Tariq, Thomas C Smyrk, Edward V Loftus
BACKGROUND: Clostridium difficile infection (CDI) and Cytomegalovirus (CMV) reactivation are associated with disease exacerbations and poor outcomes in inflammatory bowel disease (IBD). Therefore, we assessed the association between these organisms in patients with IBD and the impact on colectomy. METHODS: A retrospective case-control study was conducted to assess CDI prevalence in patients with IBD with a tissue diagnosis of CMV compared with matched IBD controls without CMV from 2005 to 2011...
November 2016: Inflammatory Bowel Diseases
Do Young Noh, Chan Kim, Yoonhee Kim, Changyong Song
Achieving a resolution near 1 nm is a critical issue in coherent x-ray diffraction imaging (CDI) for applications in materials and biology. Albeit with various advantages of CDI based on synchrotrons and newly developed x-ray free electron lasers, its applications would be limited without improving resolution well below 10 nm. Here, we review the issues and efforts in improving CDI resolution including various methods for resolution determination. Enhancing diffraction signal at large diffraction angles, with the aid of interference between neighboring strong scatterers or templates, is reviewed and discussed in terms of increasing signal-to-noise ratio...
October 18, 2016: Journal of Physics. Condensed Matter: An Institute of Physics Journal
Jessica Martin, Mark Wilcox
PURPOSE OF REVIEW: Clostridium difficile infection has attained high prominence given its prevalence and impacts on patients and healthcare institutions. Multiple new approaches to the prevention and treatment of C. difficile infection (CDI) are undergoing clinical trials. RECENT FINDINGS: Bezlotoxumab is a monoclonal antibody against toxin B that has successfully completed phase III studies, demonstrating a significant reduction in recurrent CDI when given with standard of care antibiotics...
October 7, 2016: Current Opinion in Infectious Diseases
Emily S Starn, Holly Hampe, Thomas Cline
Health care facility-acquired Clostridium difficile infections (HCFA-CDI) have increased over the last several decades despite facilities developing protocols for prescribing probiotics with antibiotics to prevent HCFA-CDI. The literature does not consistently support this. A retrospective medical record review evaluated the care effectiveness of this practice. Care effectiveness was not found; patients receiving probiotics with antibiotics were twice as likely to develop HCFA-CDI (P = .004). Except with glycopeptides, patients were 1...
October 2016: Quality Management in Health Care
Sara Tedeschi, Filippo Trapani, Maddalena Giannella, Francesco Cristini, Fabio Tumietto, Michele Bartoletti, Annalisa Liverani, Salvatore Pignanelli, Luisa Toni, Roberto Pederzini, Augusto Cavina, Pierluigi Viale
OBJECTIVE To assess the impact of an antimicrobial stewardship program (ASP) on antibiotic consumption, Clostridium difficile infections (CDI), and antimicrobial resistance patterns in a rehabilitation hospital. DESIGN Quasi-experimental study of the periods before (from January 2011 to June 2012) and after (from July 2012 to December 2014) ASP implementation. SETTING 150-bed rehabilitation hospital dedicated to patients with spinal-cord injuries. INTERVENTION Beginning in July 2012, an ASP was implemented based on systematic bedside infectious disease (ID) consultation and structural interventions (ie, revision of protocols for antibiotic prophylaxis and education focused on the appropriateness of antibiotic prescriptions)...
October 17, 2016: Infection Control and Hospital Epidemiology
Alexandre R Marra, Michael B Edmond, Bradley A Ford, Loreen A Herwaldt, Abdullah R Algwizani, Daniel J Diekema
Using an algorithm including both enzyme immunoassay (EIA) and nucleic acid amplification (NAAT) for Clostridium difficile infection (CDI) diagnosis, we found that the use of NAAT versus EIA almost doubled our hospital-onset CDI laboratory-identified (LabID) event standardized infection ratio (SIR). We recommend that the current risk adjustment approach be modified. Infect Control Hosp Epidemiol 2016:1-3.
October 17, 2016: Infection Control and Hospital Epidemiology
S D Stites, C A Cooblall, J Aronovitz, S B Singletary, K Micklow, M Sjeime
BACKGROUND: The incidence and severity of Clostridium difficile infection (CDI) have increased in recent years. Predictive models may help to identify at-risk patients before the onset of infection. Early identification of high-risk patients could help antimicrobial stewardship (AMS) programmes and other initiatives to better prevent C. difficile in these patients. AIM: To develop a predictive model that identifies patients at high risk for CDI at the time of hospitalization...
August 24, 2016: Journal of Hospital Infection
Lifei Wang, Zhengzhi Feng, Guoyu Yang, Yaling Yang, Kaifa Wang, Qin Dai, Mengxue Zhao, Chaobing Hu, Rui Zhang, Keyu Liu, Yu Guang, Fan Xia
The aim of this study is to determine the prevalence and correlates of depressive symptoms in a school-based sample of 7-17-year-old children and adolescents in west-central China. A large cross-sectional sample survey of 10657 children and adolescents was conducted in Chongqing, a municipality in west-central China. Data were collected from the Children's Depression Inventory (CDI), Adolescent Self-Rating Life Events Checklist (ASLEC) and social-demographic variables which were evaluated with a structured scale...
September 28, 2016: Psychiatry Research
Ankita Tirath, Sandra Tadros, Samuel L Coffin, Kristina W Kintziger, Jennifer L Waller, Stephanie L Baer, Rhonda E Colombo, Lu Y Huber, Mufaddal F Kheda, N Stanley Nahman
Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea. Patients with end-stage renal disease (ESRD) may be at increased risk for CDI. Patients with ESRD with CDI have increased mortality, longer length of stay, and higher costs. The present studies extend these observations and address associated comorbidities, incidence of recurrence, and risk factors for mortality. We queried the United States Renal Data System (USRDS) for patients with ESRD diagnosed with CDI, and assessed for the incidence of infection, comorbidities, and mortality...
October 13, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Esther van Kleef, Sarah R Deeny, Mark Jit, Barry Cookson, Simon D Goldenberg, W John Edmunds, Julie V Robotham
BACKGROUND: Early clinical trials of a Clostridium difficile toxoid vaccine show efficacy in preventing C. difficile infection (CDI). The optimal patient group to target for vaccination programmes remains unexplored. This study performed a model-based evaluation of the effectiveness of different CDI vaccination strategies, within the context of existing infection prevention and control strategies such as antimicrobial stewardship. METHODS: An individual-based transmission model of CDI in a high-risk hospital setting was developed...
October 7, 2016: Vaccine
Jonna Jalanka, Eero Mattila, Hanne Jouhten, Jorn Hartman, Willem M de Vos, Perttu Arkkila, Reetta Satokari
BACKGROUND: Faecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection (rCDI). It restores the disrupted intestinal microbiota and subsequently suppresses C. difficile. The long-term stability of the intestinal microbiota and the recovery of mucosal microbiota, both of which have not been previously studied, are assessed herein. Further, the specific bacteria behind the treatment efficacy are also investigated. METHODS: We performed a high-throughput microbiota profiling using a phylogenetic microarray analysis of 131 faecal and mucosal samples from 14 rCDI patients pre- and post-FMT during a 1-year follow-up and 23 samples from the three universal donors over the same period...
October 11, 2016: BMC Medicine
Daniel E Freedberg, Hojjat Salmasian, Bevin Cohen, Julian A Abrams, Elaine L Larson
Objective: To assess whether receipt of antibiotics by prior hospital bed occupants is associated with increased risk for CDI in subsequent patients who occupy the same bed. Design, Setting, and Participants: This is a retrospective cohort study of adult patients hospitalized in any 1 of 4 facilities between 2010 and 2015. Patients were excluded if they had recent CDI, developed CDI within 48 hours of admission, had inadequate follow-up time, or if their prior bed occupant was in the bed for less than 24 hours...
October 10, 2016: JAMA Internal Medicine
Christina M Beck, Julia L E Willett, David A Cunningham, Jeff J Kim, David A Low, Christopher S Hayes
Many Gram-negative bacterial pathogens express contact-dependent growth inhibition (CDI) systems that promote cell-cell interaction. CDI+ bacteria express surface CdiA effector proteins, which transfer their C-terminal toxin domains into susceptible target cells upon binding to specific receptors. CDI+ cells also produce immunity proteins that neutralize the toxin domains delivered from neighboring siblings. Here, we show that CdiAEC536 from uropathogenic Escherichia coli 536 (EC536) uses OmpC and OmpF as receptors to recognize target bacteria...
October 2016: PLoS Pathogens
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