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Jacqueline Färber, Sebastian Illiger, Fabian Berger, Barbara Gärtner, Lutz von Müller, Christoph H Lohmann, Katja Bauer, Christina Grabau, Stefanie Zibolka, Dirk Schlüter, Gernot Geginat
BACKGROUND: Here we describe a cluster of hospital-acquired Clostridium difficile infections (CDI) among 26 patients with osteoarticular infections. The aim of the study was to define the source of C. difficile and to evaluate the impact of general infection control measures and antibiotic stewardship on the incidence of CDI. METHODS: Epidemiological analysis included typing of C. difficile strains and analysis of possible patient to patient transmission. Infection control measures comprised strict isolation of CDI patients, additional hand washings, and intensified environmental cleaning with sporicidal disinfection...
2017: Antimicrobial Resistance and Infection Control
Luz Balsalobre-Arenas, Teresa Alarcón-Cavero
Rapid diagnostic techniques are valuable tools in the diagnosis of gastrointestinal infections, especially for the detection of some microorganisms and in certain groups of patients. While antigen detection techniques are widely used in Clinical Microbiology laboratories, for the diagnosis of viruses, some parasites and some bacteria, molecular techniques are routinely used only for some pathogens (such as Clostridium difficile). However, molecular techniques are constantly evolving, and they allow a rapid diagnosis for an increasing number of pathogens, with high sensitivity and specificity...
February 23, 2017: Enfermedades Infecciosas y Microbiología Clínica
John W Loughney, Catherine Lancaster, Colleen E Price, Van M Hoang, Sha Ha, Richard R Rustandi
Clostridium difficile infection (CDI) is the leading cause of gastroenteritis-associated death in the United States. The major virulent factors of C. difficile are toxin A (TcdA) and toxin B (TcdB). Toxicity is mediated by the glucosyltransferase domains on TcdA and TcdB wherein a glucose is transferred from UDP-glucose to Ras homolog family member A (RhoA) receptor. This modification results in disruption of critical cell signaling events. Vaccination against these toxins is considered the best way to combat the CDI...
January 31, 2017: Journal of Chromatography. A
Deirdre A Collins, Papanin Putsathit, Briony Elliott, Thomas V Riley
Clostridium difficile infection (CDI) has risen in prominence in Australia recently. We conducted laboratory-based surveillance of CDI to examine C. difficile circulating in Australia in October/November 2012. We collected 542 isolates from all States and Territories of Australia except the Northern Territory. The most common ribotypes (RTs) were RTs 014/020 (25.5%), 002 (10.5%), 056 (5.9%) and 070 (4.2%). The survey results were compared with results from a similar Australian survey conducted in 2010. Proportions of RTs 014/020 and 002 remained similar, while RTs 056 (5...
February 23, 2017: Pathology
C Lübbert, B Salzberger, J Mössner
The human intestinal microbiome has important metabolic and immunological functions for the host and is part of the defense against pathogens in the gastrointestinal tract. Antibiotics, probiotics, dietary measures, such as prebiotics, and the relatively newly established method of fecal microbiota transplantation (FMT, also known as fecal microbiome transfer) all influence the intestinal microbiome. The FMT procedure comprises the transmission of fecal microorganisms from a healthy donor into the gastrointestinal tract of a patient...
February 24, 2017: Der Internist
Mohtashim Lohani, Anupam Dhasmana, Shafiul Haque, Mohd Wahid, Arshad Jawed, Sajad A Dar, Raju K Mandal, Mohammed Y Areeshi, Saif Khan
Clostridium difficile is an enteric pathogen that causes approximately 20% to 30% of antibiotic-associated diarrhea. In recent years, there has been a substantial rise in the rate of C. difficile infections as well as the emergence of virulent and antibiotic resistant C. difficile strains. So, there is an urgent need for the identification of therapeutic potential targets and development of new drugs for the treatment and prevention of C. difficile infections. In the current study, we used a hybrid approach by combining sequence similarity-based approach and protein-protein interaction network topology-based approach to identify and characterize the potential drug targets of C...
February 21, 2017: Journal of Microbiological Methods
Daniel M Autenrieth, Daniel C Baumgart
In the past decade the gut microbiome has received scientific attention like few other topics. It has become increasingly apparent that the commensal microbiota plays an important role in maintaining the health of the host. Changes of the microbiota composition or function coincide with different disorders such as infectious (i. e. Clostridium difficile infection) or inflammatory bowel diseases like Crohn's disease or ulcerative colitis. Although the significance of this observation has not yet been fully elucidated and understood, several of attempts aimed at modulating the microbiota composition have been made...
February 2017: Deutsche Medizinische Wochenschrift
Jorge Silva-Velazco, Tracy L Hull, Craig Messick, James M Church
Severity of Clostridium difficile infection (CDI) varies from one patient to another. We aimed to test the hypothesis that surgical patients would suffer more severe CDIs than medical patients. Patients receiving in-hospital medical or surgical treatment for any underlying disease from 2007 to 2012, who developed CDI, were divided into two groups: "Medical group" and "Surgical group." Demographics, disease characteristics, and outcomes including mortality and recurrence were compared. Of 3231 patients with CDI evaluated, 1984 (61...
December 1, 2016: American Surgeon
M P Davies, M Anderson, A C Hilton
BACKGROUND: Transfer of Clostridium difficile by Musca domestica has been demonstrated, revealing their potential for disseminating infection in the hospital environment. AIM: To determine the ability of M. domestica larvae to acquire and retain C. difficile throughout their metamorphosis into adult flies. METHODS: Larvae were exposed to spores of C. difficile in a faecal emulsion, and examined externally and internally to determine carriage and internalization of spores through their development to adults...
January 27, 2017: Journal of Hospital Infection
David A Johnson, Philip O Katz, David Armstrong, Henry Cohen, Brendan C Delaney, Colin W Howden, Peter Katelaris, Radu I Tutuian, Donald O Castell
The availability of over-the-counter (OTC) proton pump inhibitors (PPIs) for the short-term (2 weeks) management of frequent heartburn (≥2 days/week) has increased markedly, yet evidence-based recommendations have not been developed. A panel of nine international experts in gastroesophageal reflux disease developed consensus statements regarding the risks and benefits of OTC PPIs using a modified Delphi process. Consensus (based on ≥80% approval) was reached through multiple rounds of remote voting and a final round of live voting...
February 23, 2017: Drugs
Lorraine D Hernandez, Heather K Kroh, Edward Hsieh, Xiaoyu Yang, Maribel Beaumont, Payal R Sheth, Edward DiNunzio, Stacey A Rutherford, Melanie D Ohi, Grigori Ermakov, Li Xiao, Susan Secore, Jerzy Karczewski, Fred Racine, Todd Mayhood, Paul Fischer, Xinwei Sher, Pulkit Gupta, D Borden Lacy, Alex G Therien
The exotoxins TcdA and TcdB are produced by the bacterial pathogen Clostridium difficile and are responsible for the pathology associated with C. difficile infection (CDI). The antitoxin antibodies actoxumab and bezlotoxumab bind to and neutralize TcdA and TcdB, respectively. Bezlotoxumab was recently approved by the FDA for reducing the recurrence of CDI. We have previously shown that a single molecule of bezlotoxumab binds to two distinct epitopes within the TcdB CROP domain preventing toxin binding to host cells...
February 20, 2017: Journal of Molecular Biology
D Debray, E Mas, A Munck, M Gérardin, H Clouzeau
In cystic fibrosis (CF), approximately 5-8% of the patients develop multilobular cirrhosis during the first decade of life. Annual screening (clinical examination, liver biochemistry, ultrasonography) is recommended in order to identify early signs of liver involvement, initiate ursodeoxycholic acid therapy and detect complications (portal hypertension and liver failure). Management should focus on nutrition and prevention of variceal bleeding. The gut may also be involved in children with CF. Gastroesophageal reflux is frequent, although often neglected and should be investigated by pH monitoring and impedancemetry, if available...
December 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Tonya L Scardina, Elena Kang Martinez, Neelam Balasubramanian, Mary Fox-Geiman, Scott E Smith, Jorge P Parada
STUDY OBJECTIVES: The primary objective was to determine the impact of hematologic malignancies and/or conditioning regimens on the risk of developing Clostridium difficile infection (CDI) in patients undergoing hematopoietic stem cell transplantation (HSCT). Secondary objectives were to determine if traditional CDI risk factors applied to patients undergoing HSCT and to determine the presence of CDI markers of severity of illness among this patient population. DESIGN: Single-center, retrospective, case-control study...
February 22, 2017: Pharmacotherapy
Alexander Swidsinski, Yvonne Dörffel, Vera Loening-Baucke, Christoph Gille, Anne Reißhauer, Onder Göktas, Monika Krüger, Jürgen Neuhaus, Wieland Schrödl
AIM: To test the effects of humic acids on innate microbial communities of the colon. METHODS: We followed the effects of oral supplementation with humic acids (Activomin(®)) on concentrations and composition of colonic microbiome in 14 healthy volunteers for 45 d. 3 × 800 mg Activomin(®) were taken orally for 10 d followed by 3 × 400 mg for 35 d. Colonic microbiota were investigated using multicolor fluorescence in situ hybridization (FISH) of Carnoy fixated and paraffin embedded stool cylinders...
February 7, 2017: World Journal of Gastroenterology: WJG
Edwin Vargas, Senu Apewokin, Rajat Madan
Clostridium difficile is the leading cause of healthcare-associated infections in the United States. Clinically, C. difficile-associated disease can present as asymptomatic colonization, self-limited diarrheal illness or severe colitis (that may result in death). This variability in disease course and outcomes suggests that host factors play an important role as key determinants of disease severity. Currently, there are several scoring indices to estimate severity of C. difficile-associated disease. Leukocytosis and renal failure are considered to be the most important predictors of C...
February 18, 2017: Anaerobe
Yossi Paitan, Tamar Miller Roll, Amos Adler
OBJECTIVES: Rapid and accurate detection of C. difficile in stool impacts patient treatment and containment efforts. Detection of C. difficile toxin genes using nucleic acid amplification techniques (NAAT) is part of a multistep algorithm. Our objective was to directly compare the diagnostic accuracy and applicability of 6 commercial C. difficile NAAT assays. METHODS: In this study, 210 specimens were analysed in parallel by 6 commercial NAAT. Toxigenic culture was used as a reference method...
February 18, 2017: Clinical Microbiology and Infection
Mauricio Redondo-Solano, Dennis E Burson, Harshavardhan Thippareddi
The thermal resistance of four strains of Clostridium difficile spores (three hypervirulent and one nonhypervirulent) in peptone water (PW) and pork meat was evaluated individually at 70, 75, 80, 85, and 90°C using two recovery methods (taurocholate and lysozyme). PW or meat was inoculated with C. difficile spores and mixed to obtain ca. 5.0 log CFU/ml or 4.0 log CFU/g, respectively. The D-values of C. difficile spores in PW ranged from 7.07 to 22.14 h, 1.42 to 3.82 h, 0.35 to 0.59 h, 4.93 to 5.95 min, and 1...
September 2016: Journal of Food Protection
Priti Poojary, Aparna Saha, Kinsuk Chauhan, Priya Simoes, Bruce E Sands, Judy Cho, Thomas Ullman, Girish Nadkarni, Ryan Ungaro
BACKGROUND: Early readmissions are important indicators of quality of care. Limited data exist describing hospital readmissions in ulcerative colitis (UC). The aim of this study was to describe unplanned, 30-day readmissions among adult UC patients and to assess readmission predictors. METHODS: We analyzed the 2013 United States National Readmission Database and identified UC admissions using administrative codes in patients from 18 to 80 years of age. Our primary outcome was a 30-day, unplanned readmission rate...
March 2017: Inflammatory Bowel Diseases
Z D Jiang, N J Ajami, J F Petrosino, G Jun, C L Hanis, M Shah, L Hochman, V Ankoma-Sey, A W DuPont, M C Wong, A Alexander, S Ke, H L DuPont
BACKGROUND: Faecal microbiota transplantation (FMT) has become routine in managing recurrent C. difficile infection (CDI) refractory to antibiotics. AIM: To compare clinical response and improvements in colonic microbiota diversity in subjects with recurrent CDI using different donor product. METHODS: Seventy-two subjects with ≥3 bouts of CDI were randomised in a double-blind study to receive fresh, frozen or lyophilised FMT product via colonoscopy from 50 g of stool per treatment from eight healthy donors...
February 21, 2017: Alimentary Pharmacology & Therapeutics
Lucie Etienne-Mesmin, Benoit Chassaing, Oluwaseyi Adekunle, Lisa M Mattei, Frederic D Bushman, Andrew T Gewirtz
OBJECTIVE: Clostridium difficile is a toxin-producing bacterium and a leading cause of antibiotic-associated disease. The ability of C. difficile to form spores and infect antibiotic-treated persons at low multiplicity of infection (MOI) underlies its large disease burden. However, C. difficile-induced disease might also result from long-harboured C. difficile that blooms in individuals administered antibiotics. DESIGN: Mice purchased from multiple vendors and repeatedly testing negative for this pathogen by quantitative PCR bloomed C...
February 20, 2017: Gut
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