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https://www.readbyqxmd.com/read/28318779/infection-control-implications-of-the-laundering-of-ambulance-staff-uniforms-and-reusable-mops
#1
W G Mackay, S Whitehead, N Purdue, M Smith, N Redhead, C Williams, S Wilson
There is a lack of published studies on laundering in ambulance services. We performed bacterial culture on soiled and unsoiled uniforms and reusable mop heads artificially contaminated with Escherichia coli, Staphylococcus aureus, and Clostridium difficile spores. Current laundering processes used for routine cleans in the ambulances appears, from our simulations, to be effective at reducing vegetative pathogenic bacteria to undetectable levels, <3.398log10 colony-forming units (S. aureus and E. coli)...
February 22, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28314653/assessment-of-risk-factors-for-candidemia-in-non-neutropenic-patients-hospitalized-in-internal-medicine-wards-a-multicenter-study
#2
M Falcone, G Tiseo, C Tascini, A Russo, E Sozio, G Raponi, C Rosin, P Pignatelli, P Carfagna, A Farcomeni, R Luzzati, F Violi, F Menichetti, M Venditti
BACKGROUND: An increasing prevalence of candidemia has been reported in Internal Medicine wards (IMWs). The aim of our study was to identify risk factors for candidemia among non-neutropenic patients hospitalized in IMWs. METHODS: A multicenter case-control study was performed in three hospitals in Italy. Patients developing candidemia (cases) were compared to patients without candidemia (controls) matched by age, time of admission and duration of hospitalization...
March 14, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28302431/a-qualitative-study-to-identify-reasons-for-clostridium-difficile-testing-in-pediatric-inpatients-receiving-laxatives-or-stool-softeners
#3
Joanne Kinlay, Thomas J Sandora
To understand why clinicians send Clostridium difficile tests from hospitalized children receiving laxatives or stool softeners, we performed a mixed-methods study. We prospectively identified tested patients and surveyed their clinicians by e-mail. Reasons for testing included changes in stooling pattern on baseline bowel regimen, other changes in clinical status, and risk factors for C difficile infection. Education targeting discontinuing bowel medications before C difficile testing could improve the specificity of pediatric C difficile infection diagnosis...
March 13, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28301919/clostridium-difficile-toxin-a-induces-reactive-oxygen-species-production-and-p38mapk-activation-to-exert-cellular-toxicity-in-neuronal-cells
#4
Peng Zhang, Ji Hong, I Na Yoon, Jin Ku Kang, Jae Sam Hwang, Ho Kim
Clostridium difficile releases two exotoxins, toxin A and toxin B, which disrupt the epithelial cell barrier in the gut to increase mucosal permeability and trigger inflammation with severe diarrhea. Many studies have suggested that enteric nerves are also directly involved in the progression of this toxin-mediated inflammation and diarrhea. C. difficile toxin A is known to enhance neurotransmitter secretion, increase gut motility, and suppress sympathetic neurotransmission in the guinea pig colitis model. Although previous studies have examined the pathophysiological role of enteric nerves in gut inflammation, the direct effect of toxins on neuronal cells and the molecular mechanisms underlying toxin-induced neuronal stress remained to be unveiled...
March 17, 2017: Journal of Microbiology and Biotechnology
https://www.readbyqxmd.com/read/28296825/frequency-and-risk-factors-of-clostridium-difficile-infection-in-hospitalized-patients-with-pouchitis-a-population-based-study
#5
Gaurav Kistangari, Rocio Lopez, Bo Shen
BACKGROUND: Clostridium difficile infection (CDI) in patients with the ileal pouch after proctocolectomy has been increasingly recognized. We sought to evaluate the frequency and risk factors of CDI in patients with the primary or secondary discharge diagnosis of pouchitis in the United States. METHODS: We reviewed the National Inpatient Sample of the Healthcare Cost and Utilization Project and identified patients admitted for pouchitis with underlying inflammatory bowel disease (IBD) or familial adenomatous polyposis (FAP), between 2010 and 2012...
April 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28295646/the-epidemiology-of-clostridium-difficile-infection-in-a-national-kidney-transplant-centre
#6
C Kennedy, C Waldron, M Skally, L Gaughan, C Magee, K Burns, F Fitzpatrick
BACKGROUND: We aimed to describe the epidemiology and outcomes of CDI in a national kidney transplant centre from 2008-2015. METHODS: Adult kidney and kidney-pancreas transplant recipients were included for analysis if they met the surveillance CDI case definition. Rates of new healthcare-associated CDI (HA-CDI) were expressed per 10,000 KTR/KTPR bed days used (BDU) to facilitate comparisons. RESULTS: Fifty-two cases of CDI were identified in 42 KTRs and KPTRs...
March 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28293151/conventional-and-alternative-treatment-approaches-for-clostridium-difficile-infection
#7
REVIEW
Khalid M Aljarallah
Clostridium difficile-associated disease continues to be one of the leading health concerns worldwide. C. difficile is considered as a causative agent of nosocomial diarrhea that causes serious infection, which may result in death. The incidences of C. difficile infection (CDI) in developed countries have become increasingly high which may be attributed to the emergence of newer epidemic strains, extensive use of antibiotics, and limited alternative therapies. The available treatment options against CDI are expensive and promote resistance...
January 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28288567/determining-clostridium-difficile-intra-taxa-diversity-by-mining-multilocus-sequence-typing-databases
#8
Marina Muñoz, Dora Inés Ríos-Chaparro, Manuel Alfonso Patarroyo, Juan David Ramírez
BACKGROUND: Multilocus sequence typing (MLST) is a highly discriminatory typing strategy; it is reproducible and scalable. There is a MLST scheme for Clostridium difficile (CD), a gram positive bacillus causing different pathologies of the gastrointestinal tract. This work was aimed at describing the frequency of sequence types (STs) and Clades (C) reported and evalute the intra-taxa diversity in the CD MLST database (CD-MLST-db) using an MLSA approach. RESULTS: Analysis of 1778 available isolates showed that clade 1 (C1) was the most frequent worldwide (57...
March 14, 2017: BMC Microbiology
https://www.readbyqxmd.com/read/28286992/cadazolid-for-the-treatment-of-clostridium-difficile
#9
Bradley T Endres, Eugénie Bassères, M Jahangir Alam, Kevin W Garey
Antibiotic development goals for CDI include potent antimicrobial effect against C. difficile, limited killing of host microbiota, potential effect on spores, and ability to interfere with toxin production. Cadazolid, a novel, non-absorbable hybrid antibiotic has many of these criteria. In phase I and II clinical trials, cadazolid was shown to be safe, well tolerated, and efficacious positioning itself as a potential future viable therapeutic option for CDI. Areas covered: This review provides an in-depth evaluation of the chemistry, microbiology, pharmacodynamics, pharmacokinetics, and clinical trial results for cadazolid...
March 13, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28286152/toxin-production-of-clostridium-difficile-in-sub-mic-of-vancomycin-and-clindamycin-alone-and-in-combination-with-ceftazidime
#10
Ebrahim Rezazadeh Zarandi, Shahla Mansouri, Nouzar Nakhaee, Farhad Sarafzadeh, Mohammad Moradi
Toxin production in Clostridium difficile (C. difficile) is a key process for induction of diarrhea. Several factors such as sub-MIC of antibiotics impact on toxin production. The aim of this research is investigation of sub-minimum inhibitory concentration (sub-MIC) of vancomycin (VAN), clindamycin (CLI) separately and in combination with ceftazidime (CAZ) on toxin production in C. difficile. About ∼10(6) colony forming units (CFU) from 18-h culture of C. difficile ATCC 9689 and clinical isolates A(+)/B(+)/CTD(-), were cultured anaerobically in the pre-reduced medium with appropriate concentration of separated and in combination antibiotics...
March 7, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28284851/clostridium-difficile-derived-membrane-vesicles-induce-the-expression-of-pro-inflammatory-cytokine-genes-and-cytotoxicity-in-colonic-epithelial-cells-in%C3%A2-vitro
#11
Asiimwe Nicholas, Hyejin Jeon, Gati Noble Selasi, Seok Hyeon Na, Hyo Il Kwon, Yoo Jeong Kim, Chi Won Choi, Seung Il Kim, Je Chul Lee
Clostridium difficile is the most common etiological agent of antibiotic-associated diarrhea in hospitalized and non-hospitalized patients. This study investigated the secretion of membrane vesicles (MVs) from C. difficile and determined the expression of pro-inflammatory cytokine genes and cytotoxicity of C. difficile MVs in epithelial cells in vitro. C. difficile ATCC 43255 and two clinical isolates secreted spherical MVs during in vitro culture. Proteomic analysis revealed that MVs of C. difficile ATCC 43255 contained a total of 262 proteins...
March 9, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28279860/inhibition-of-spore-germination-growth-and-toxin-activity-of-clinically-relevant-c-%C3%A2-difficile-strains-by-gut-microbiota-derived-secondary-bile-acids
#12
Rajani Thanissery, Jenessa A Winston, Casey M Theriot
The changing epidemiology of Clostridium difficile infection over the past decades presents a significant challenge in the management of C. difficile associated diseases. The gastrointestinal tract microbiota provides colonization resistance against C. difficile, and growing evidence suggests that gut microbial derived secondary bile acids (SBAs) play a role. We hypothesized that the C. difficile life cycle; spore germination and outgrowth, growth, and toxin production, of strains that vary by age and ribotype will differ in their sensitivity to SBAs...
March 6, 2017: Anaerobe
https://www.readbyqxmd.com/read/28279859/factors-associated-with-clostridium-difficile-infection-a-nested-case-control-study-in-a-three-year-prospective-cohort
#13
Nagham Khanafer, Philippe Vanhems, Frédéric Barbut, Christine Luxemburger
BACKGROUND: Clostridium difficile infection (CDI) is a serious medical condition that is associated with substantial morbidity and mortality. Identification of risk factors associated with CDI and prompt recognition of patients at risk is key to successfully preventing CDI. METHODS: A 3-year prospective, observational, cohort study was conducted in a French university hospital and a nested case-control study was performed to identify risk factors for CDI. Inpatients aged 18 years or older, suffering from diarrhea suspected to be related to CDI, were asked to participate...
March 6, 2017: Anaerobe
https://www.readbyqxmd.com/read/28279489/epidemiology-and-risk-factors-for-clostridium-difficile-infection-in-critically-ill-patients-in-spain-the-procrid-study
#14
Antonio Gutiérrez-Pizarraya, Luis Martín-Villén, Luis Alcalá-Hernández, Mercedes Marín Arriaza, Bárbara Balandín-Moreno, César Aragón-González, José Ferreres-Franco, Miguel Ángel Chiveli Monleón, Paloma Anguita-Alonso, Emilio Bouza-Santiago, José Garnacho-Montero
INTRODUCTION: Our objectives were to describe the incidence, clinical characteristics, and risk factors for Clostridium difficile infection (CDI) in critically ill patients and to determine C. difficile PCR-ribotypes. METHODS: Prospective, observational study in 26 Spanish ICUs. Patients with diarrhea meeting ESCMID criteria for CDI were included. Molecular characterization of isolates was performed using PCR ribotyping. RESULTS: Of 4258 patients admitted to the ICUs, 190 (4...
March 6, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28275072/strategies-for-optimizing-the-diagnostic-predictive-value-of-clostridium-difficile-molecular-diagnostics
#15
Larry K Kociolek
Because nucleic acid amplification tests (NAATs) do not distinguish Clostridium difficile infection (CDI) and asymptomatic C. difficile carriage, the diagnostic predictive value of NAATs is limited when used in patients with low probability of CDI. In this issue of the Journal of Clinical Microbiology, Truong et al. report significant reductions in hospital-onset CDI and oral vancomycin utilization at their institution following implementation of a novel intervention that leveraged their clinical bioinformatics resources to prevent C...
March 8, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28274145/emerging-monoclonal-antibodies-against-clostridium-difficile-infection
#16
Séverine Péchiné, Claire Janoir, Anne Collignon
Clostridium difficile infections are characterized by a high recurrence rate despite antibiotic treatments and there is an urgent need to develop new treatments such as fecal transplantation and immonotherapy. Besides active immunotherapy with vaccines, passive immunotherapy has shown promise, especially with monoclonal antibodies. Areas covered: Herein, the authors review the different assays performed with monoclonal antibodies against C. difficile toxins and surface proteins to treat or prevent primary or recurrent episodes of C...
April 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28274126/-selection-of-laboratory-procedures-to-detect-toxigenic-by-the-2-step-method
#17
Yoko Tanino, Mai Kodama, Hiroomi Daicho, Yoshito Miyauchi, Towa Yasumoto, Yukiji Yamada, Noriko Kyotani, Satoko Kurahashi, Masaji Ushiyama, Takeshi Kimura, Toshiaki Komori, Yumiko Fujitomo, Masaki Nakanishi, Naohisa Fujita
The 2-step method is an algorithm to detect toxigenic Clostridium difficile. We herein compared the sensitivities and specificities of an enzyme immunoassay (toxin A/B-EIA), toxigenic culture (TC-EIA), Loop-Mediated Isothermal Amplification assay (LAMP), and Xpert C. difficile (Xpert) with the detection of the toxin B gene by a polymerase chain reaction (PCR). The results obtained showed that the sensitivities and specificities of toxin A/B-EIA, Xpert, TC-EIA, and LAMP were 30 and 100%, 87.2 and 100%, 97.5 and 89...
March 22, 2017: JARMAM: Journal of the Association for Rapid Method and Automation in Microbiology
https://www.readbyqxmd.com/read/28267992/clostridium-difficile-disease-diagnosis-pathogenesis-and-treatment-update
#18
REVIEW
Lena M Napolitano, Charles E Edmiston
Clostridium difficile infections are the leading cause of health care-associated infectious diarrhea, posing a significant risk for both medical and surgical patients. Because of the significant morbidity and mortality associated with C difficile infections, knowledge of the epidemiology of C difficile in combination with a high index of suspicion and susceptible patient populations (including surgical, postcolectomy, and inflammatory bowel disease patients) is warranted. C difficile infections present with a wide spectrum of disease, ranging from mild diarrhea to fulminant colitis or small bowel enteritis and recurrent C difficile infections...
March 3, 2017: Surgery
https://www.readbyqxmd.com/read/28262711/whole-genome-sequences-of-three-clade-3-clostridium-difficile-strains-carrying-binary-toxin-genes-in-china
#19
Rong Chen, Yu Feng, Xiaohui Wang, Jingyu Yang, Xiaoxia Zhang, Xiaoju Lü, Zhiyong Zong
Clostridium difficile consists of six clades but studies on Clade 3 are limited. Here, we report genome sequences of three Clade 3 C. difficile strains carrying genes encoding toxin A and B and the binary toxin. Isolates 103 and 133 (both of ST5) and isolate 106 (ST285) were recovered from three ICU patients. Whole genome sequencing using HiSeq 2500 revealed 4.1-Mb genomes with 28-29% GC content. There were ≥1,104 SNP between the isolates, suggesting they were not of a single clone. The toxin A and B gene-carrying pathogenicity locus (PaLoc) of the three isolates were identical and had the insertion of the transposon Tn6218...
March 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28262046/inhibition-of-mrsa-and-of-clostridium-difficile-by-durancin-61a-synergy-with-bacteriocins-and-antibiotics
#20
Hasna Hanchi, Riadh Hammami, Hélène Gingras, Rim Kourda, Michel G Bergeron, Jeannette Ben Hamida, Marc Ouellette, Ismail Fliss
AIM: The aim of this study was to evaluate the efficacy of durancin 61A alone or in combination with nisin, pediocin PA-1, reuterin, microcin J25, vancomycin or tetracycline as an inhibitor of resistant clinical pathogens and to shed light on its mode of action. RESULTS: Durancin and reuterin were effective inhibitors of Clostridium difficile, vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus. The combination of durancin and reuterin was highly synergistic against C...
March 2017: Future Microbiology
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