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https://www.readbyqxmd.com/read/27910000/a-review-of-experimental-and-off-label-therapies-for-clostridium-difficile-infection
#1
REVIEW
Csaba Fehér, Alex Soriano, Josep Mensa
In spite of increased awareness and the efforts taken to optimize Clostridium difficile infection (CDI) management, with the limited number of currently available antibiotics for C. difficile the halt of this increasing epidemic remains out of reach. There are, however, close to 80 alternative treatment methods with controversial anti-clostridial efficacy or in experimental phase today. Indeed, some of these therapies are expected to become acknowledged members of the recommended anti-CDI arsenal within the next few years...
December 1, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27908697/clostridium-difficile-carriage-in-adult-cystic-fibrosis-cf-implications-for-patients-with-cf-and-the-potential-for-transmission-of-nosocomial-infection
#2
D G Burke, M J Harrison, C Fleming, M McCarthy, C Shortt, I Sulaiman, D M Murphy, J A Eustace, F Shanahan, C Hill, C Stanton, M C Rea, R P Ross, B J Plant
Clostridium difficile is an anaerobic Gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal-oral route. Despite increasing carriage rates and the presence of C. difficile toxin in stool, patients with CF rarely appear to develop typical manifestations of C. difficile infection (CDI). In this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of C. difficile in a cohort of 60 adult patients with CF who were pre-lung transplant...
November 29, 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/27908435/antimicrobial-stewardship-programs-that-target-only-high-cost-broad-spectrum-antimicrobials-miss-opportunities-to-reduce-clostridium-difficile-infections
#3
Christine Bui, Elizabeth Zhu, Monica A Donnelley, Machelle D Wilson, Margaret Morita, Stuart H Cohen, Jennifer Brown
Antimicrobial stewardship programs are promoted as a strategy to reduce Clostridium difficile infections. We implemented an antimicrobial stewardship program comprised of formulary restriction plus prospective audit with feedback for high-cost and broad-spectrum antimicrobials. Subsequently, we reviewed all heath care facility-onset, health care facility-associated C difficile infections. We found that most of these infections were associated with the antecedent receipt of nonaudited, and often unnecessary, antimicrobials...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27906466/duodenitis-proximal-jejunitis-in-horses-after-experimental-administration-of-clostridium-difficile-toxins
#4
L G Arroyo, M C Costa, B B Guest, B L Plattner, B N Lillie, J S Weese
BACKGROUND: Duodenitis-proximal jejunitis (DPJ) is an acute sporadic gastrointestinal disorder of horses of unknown cause. HYPOTHESIS/OBJECTIVES: We hypothesize that Clostridium difficile toxins are involved in the pathogenesis of DPJ in horses. The objective of this study was to determine whether experimentally delivered C. difficile toxins cause clinical signs and histologic lesions similar to those of naturally occurring DPJ. ANIMALS: Six healthy mature mixed breed horses...
December 1, 2016: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/27905086/bezlotoxumab-first-global-approval
#5
Anthony Markham
Bezlotoxumab (Zinplava™) is a human monoclonal antibody against Clostridium difficile toxin B developed by Merck & Co. In October 2016 it was approved in the USA for reducing the recurrence of C. difficile infection. This article summarizes the milestones in the development of bezlotoxumab leading to this first approval for use in patients receiving antibacterial drug treatment for C. difficile infection who are at high risk for recurrence of C. difficile infection.
November 30, 2016: Drugs
https://www.readbyqxmd.com/read/27897206/the-incidence-and-drug-resistance-of-clostridium-difficile-infection-in-mainland-china-a-systematic-review-and-meta-analysis
#6
Chenjie Tang, Lunbiao Cui, Yuqiao Xu, Le Xie, Pengfei Sun, Chengcheng Liu, Wenying Xia, Genyan Liu
It has been widely reported that the incidence and severity of Clostridium difficile infection (CDI) have increased dramatically in North America and Europe. However, little is known about CDI in Mainland China. In this study, we aimed to investigate the incidence of CDI and the main epidemic and drug-resistant strains of C. difficile in Mainland China through meta-analysis of related studies published after the year 2010. A total of 51 eligible studies were included. The pooled incidence of toxigenic C. difficile among patients with diarrhoea was 14% (95% CI = 12-16%)...
November 29, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27895832/clostridium-difficile-a-healthcare-associated-infection-of-unknown-significance-in-adults-in-sub-saharan-africa
#7
REVIEW
Alexander J Keeley, Nicholas J Beeching, Katharine E Stott, Paul Roberts, Alastair J Watson, Michael Bj Beadsworth
BACKGROUND: Clostridium difficile infection (CDI) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality, and financial implications. CDI is a healthcare-associated infection for which the primary risk factor is antibiotic usage, and it is the leading cause of bacterial diarrhoea in HIV-infected patients in the United States. Little is known about the disease burden of CDI in sub-Saharan Africa, where HIV and healthcare-associated infections are more prevalent and antibiotic usage is less restricted...
June 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27895012/a-multicenter-observational-study-of-ceftaroline-fosamil-for-methicillin-resistant-staphylococcus-aureus-bloodstream-infections
#8
Evan J Zasowski, Trang D Trinh, Kimberly C Claeys, Anthony M Casapao, Noor Sabagha, Abdalhamid M Lagnf, Kenneth P Klinker, Susan L Davis, Michael J Rybak
Novel therapies for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) are needed in the setting of reduced antibiotic susceptibilities and therapeutic failure. Ceftaroline is an advanced generation cephalosporin with MRSA activity. Although not FDA approved for MRSA BSI, ceftaroline has generated much interest as a potential treatment option. However, detailed description of its use in this setting remains limited. To address this, we conducted a retrospective, multicenter, observational study of adult patients with MRSA BSI treated with at least 72 hours of ceftaroline from 2011 to 2015...
November 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27893790/detection-of-a-cfr-b-variant-in-german-enterococcus-faecium-clinical-isolates-and-the-impact-on-linezolid-resistance-in-enterococcus-spp
#9
Jennifer K Bender, Carola Fleige, Ingo Klare, Stefan Fiedler, Alexander Mischnik, Nico T Mutters, Kate E Dingle, Guido Werner
The National Reference Centre for Staphylococci and Enterococci in Germany has received an increasing number of clinical linezolid-resistant E. faecium isolates in recent years. Five isolates harbored a cfr(B) variant gene locus the product of which is capable of conferring linezolid resistance. The cfr(B)-like methyltransferase gene was also detected in Clostridium difficile. Antimicrobial susceptibility was determined for cfr(B)-positive and linezolid-resistant E. faecium isolates and two isogenic C. difficile strains...
2016: PloS One
https://www.readbyqxmd.com/read/27891639/consensus-report-faecal-microbiota-transfer-clinical-applications-and-procedures
#10
REVIEW
J König, A Siebenhaar, C Högenauer, P Arkkila, M Nieuwdorp, T Norén, C Y Ponsioen, U Rosien, N G Rossen, R Satokari, A Stallmach, W de Vos, J Keller, R J Brummer
BACKGROUND: Faecal microbiota transplantation or transfer (FMT) aims at replacing or reinforcing the gut microbiota of a patient with the microbiota from a healthy donor. Not many controlled or randomised studies have been published evaluating the use of FMT for other diseases than Clostridium difficile infection, making it difficult for clinicians to decide on a suitable indication. AIM: To provide an expert consensus on current clinical indications, applications and methodological aspects of FMT...
November 27, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27891552/enteric-glial-cells-are-susceptible-to-clostridium-difficile-toxin-b
#11
Katia Fettucciari, Pamela Ponsini, Davide Gioè, Lara Macchioni, Camilla Palumbo, Elisabetta Antonelli, Stefano Coaccioli, Vincenzo Villanacci, Lanfranco Corazzi, Pierfrancesco Marconi, Gabrio Bassotti
Clostridium difficile causes nosocomial/antibiotic-associated diarrhoea and pseudomembranous colitis. The major virulence factors are toxin A and toxin B (TcdB), which inactivate GTPases by monoglucosylation, leading to cytopathic (cytoskeleton alteration, cell rounding) and cytotoxic effects (cell-cycle arrest, apoptosis). C. difficile toxins breaching the intestinal epithelial barrier can act on underlying cells, enterocytes, colonocytes, and enteric neurons, as described in vitro and in vivo, but until now no data have been available on enteric glial cell (EGC) susceptibility...
November 28, 2016: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/27884118/burden-of-clostridium-difficile-associated-disease-among-patients-residing-in-nursing-homes-a-population-based-cohort-study
#12
Holly Yu, Onur Baser, Li Wang
BACKGROUND: Clostridium difficile (C. difficile) infection (CDI) is the leading cause of nosocomial diarrhea in the United States. This study aimed to examine the incidence of CDI and evaluate mortality and economic burden of CDI in an elderly population who reside in nursing homes (NHs). METHODS: This was a population-based retrospective cohort study focusing on US NHs by linking Medicare 5% sample, Medicaid, Minimum Data Set (MDS) (2008-10). NH residents aged ≥65 years with continuous enrollment in Medicare and/or Medicaid Fee-for-Service plan for ≥12 months and ≥2 quarterly MDS assessments were eligible for the study...
November 25, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27880843/highly-divergent-clostridium-difficile-strains-isolated-from-the-environment
#13
Sandra Janezic, Mojca Potocnik, Valerija Zidaric, Maja Rupnik
Clostridium difficile is one of the most important human and animal pathogens. However, the bacterium is ubiquitous and can be isolated from various sources. Here we report the prevalence and characterization of C. difficile in less studied environmental samples, puddle water (n = 104) and soil (n = 79). C. difficile was detected in 14.4% of puddle water and in 36.7% of soil samples. Environmental strains displayed antimicrobial resistance patterns comparable to already published data of human and animal isolates...
2016: PloS One
https://www.readbyqxmd.com/read/27876339/diagnosis-and-treatment-of-clostridium-difficile-c-diff-colitis-review-of-the-literature-and-a-perspective-in-gynecologic-oncology
#14
REVIEW
Kristin N Taylor, Michael T McHale, Cheryl C Saenz, Steven C Plaxe
Clostridium difficile infection (CDI) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. Colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. Although patients with a gynecologic malignancy may be at a higher risk of developing CDI due to an increased likelihood of having one or more risk factors, data do not consistently support the idea that chemotherapy or cancer itself are independently associated with CDI...
November 19, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27871997/survival-and-prevalence-of-clostridium-difficile-in-manure-compost-derived-from-pigs
#15
Masaru Usui, Mayuko Kawakura, Nobuki Yoshizawa, Lai Lai San, Chie Nakajima, Yasuhiko Suzuki, Yutaka Tamura
Pigs, particularly piglets, have been identified as reservoir hosts of Clostridium difficile. To examine the survival ability of this pathogen in pig feces-based manure compost, C. difficile spores, which were prepared to contain as few vegetative cells as possible, were artificially inoculated into pig feces and incubated at different temperatures. While C. difficile survived in the feces incubated at temperatures below 37 °C for over 30 days, cell numbers gradually decreased at thermophilic temperatures (over 55 °C; p < 0...
November 18, 2016: Anaerobe
https://www.readbyqxmd.com/read/27870984/prevalence-and-molecular-characterization-of-clostridium-difficile-isolates-from-a-pig-slaughterhouse-pork-and-humans-in-taiwan
#16
Ying-Chen Wu, Chih-Ming Chen, Chih-Jung Kuo, Jen-Jie Lee, Pin-Chun Chen, Yi-Chih Chang, Ter-Hsin Chen
Clostridium difficile causes antibiotic-associated diarrhea in both humans and animals. The ribotype 078, predominant in food animals, is associated with community-acquired C. difficile infection, and C. difficile is suggested to be a foodborne pathogen. Recently, the C. difficile ribotype 078 lineage emerged in patients and pigs in Taiwan. This study aimed to investigate the prevalence and molecular characterization of C. difficile isolated from a pig slaughterhouse, retail meat, ready-to-eat meals, and humans in Taiwan...
November 12, 2016: International Journal of Food Microbiology
https://www.readbyqxmd.com/read/27866755/evaluation-of-an-automated-room-decontamination-device-using-aerosolized-peracetic-acid
#17
Thriveen S C Mana, Brett Sitzlar, Jennifer L Cadnum, Annette L Jencson, Sreelatha Koganti, Curtis J Donskey
Because manual cleaning is often suboptimal, there is increasing interest in use of automated devices for room decontamination. We demonstrated that an ultrasonic room fogging system that generates submicron droplets of peracetic acid and hydrogen peroxide eliminated Clostridium difficile spores and vegetative pathogens from exposed carriers in hospital rooms and adjacent bathrooms.
November 18, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27866475/an-increase-in-healthcare-associated-clostridium-difficile-infection-associated-with-use-of-a-defective-peracetic-acid-based-surface-disinfectant
#18
Jennifer L Cadnum, Annette L Jencson, Marguerite C O'Donnell, Elizabeth R Flannery, Michelle M Nerandzic, Curtis J Donskey
BACKGROUND We investigated an increase in the incidence of healthcare-associated Clostridium difficile infection (CDI) that occurred following a change from a bleach disinfectant to a peracetic acid-based disinfectant. OBJECTIVE To evaluate the efficacy of the peracetic acid-based disinfectant. DESIGN Laboratory-based product evaluation. METHODS The commercial peracetic acid-based product is activated on site by mixing a small volume of concentrated hydrogen peroxide and peracetic acid present in a "SmartCap" reservoir with the remaining contents of the container...
November 21, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27865545/anti-cgrp-antibodies-block-cgrp-induced-diarrhea-in-mice
#19
Eric A Kaiser, Brandon J Rea, Adisa Kuburas, Brian R Kovacevich, Leon F Garcia-Martinez, Ana Recober, Andrew F Russo
The multifunctional neuropeptide calcitonin gene-related peptide (CGRP) and its receptor are expressed throughout the gastrointestinal tract. Previous studies have shown that CGRP has roles in intestinal motility, water secretion, and inflammation. Furthermore, animal studies have demonstrated CGRP involvement in diarrhea secondary to C. difficile and food allergies. Diarrhea thus provides a convenient bioassay of CGRP activity in the GI system. In this proof of principle study, we report that prophylactic administration of an anti-CGRP antibody is able to block CGRP-induced diarrhea in mice...
November 14, 2016: Neuropeptides
https://www.readbyqxmd.com/read/27862113/rethinking-strategies-to-select-antibiotic-therapy-in-cdi
#20
Teena Chopra, Ellie J C Goldstein, Sherwood L Gorbach
In recent years, Clostridium difficile infection (CDI) has become a global public health threat associated with increased morbidity, mortality, and economic burden, all of which are exacerbated with disease recurrence. Current guidelines informing treatment decisions are largely based on definitions of disease severity at diagnosis, with subjective components not well delineated across treatment algorithms and clinical trials. Furthermore, there is little evidence linking severity at onset to outcome. However, reducing the risk of recurrence may offer both a better outcome for the individual and decreased downstream economic impact...
November 9, 2016: Pharmacotherapy
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