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Clostridium difficile infections

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https://www.readbyqxmd.com/read/28435086/toxigenic-clostridium-difficile-colonization-among-hospitalised-adults-risk-factors-and-impact-on-survival
#1
Laura Behar, David Chadwick, Angela Dunne, Christopher I Jones, Clare Procter, Chakravathi Rajkumar, Paula Sharratt, Philip Stanley, Angela Whiley, Mark Wilks, Martin J Llewelyn
OBJECTIVES: To establish risk factors for Clostridium difficile colonization among hospitalized patients in England. METHODS: Patients admitted to elderly medicine wards at three acute hospitals in England were recruited to a prospective observational study. Participants were asked to provide a stool sample as soon as possible after enrolment and then weekly during their hospital stay. Samples were cultured for C. difficile before ribotyping and toxin detection by PCR...
April 20, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28435010/ribotypes-associated-with-clostridium-difficile-outbreaks-in-brazil-display-distinct-surface-protein-profiles
#2
Thais Gonçalves Ferreira, Hercules Moura, John R Barr, Regina M C Pilotto Domingues, Eliane de Oliveira Ferreira
Clostridium difficile is a spore-forming anaerobic intestinal pathogen that causes Clostridium difficile infection (CDI). C. difficile is the leading cause of toxin-mediated nosocomial antibiotic-associated diarrhea. The pathogenesis of CDI is attributed to two major virulence factors, TcdA and TcdB toxins, that cause the symptomatic infection. C. difficile also expresses a number of key proteins, including cell wall proteins (CWPs). S-layer proteins (SLPs) are CWPs that form a paracrystalline surface array that coats the surface of the bacterium...
April 20, 2017: Anaerobe
https://www.readbyqxmd.com/read/28433406/results-of-the-implementation-of-a-multidisciplinary-programme-of-faecal-microbiota-transplantation-by-colonoscopy-for-the-treatment-of-recurrent-clostridium-difficile-infection
#3
Antonio López-Sanromán, Enrique Rodríguez de Santiago, Javier Cobo Reinoso, Rosa Del Campo Moreno, José Ramón Foruny Olcina, Sergio García Fernández, Ana García García de Paredes, Lara Aguilera Castro, Carlos Ferre Aracil, Agustín Albillos Martínez
INTRODUCTION: Recurrent Clostridium difficile infection (CDI) is common and often difficult to manage. Faecal microbiota transplant (FMT) is an effective therapeutic tool in these cases, although its applicability and effectiveness in Spain is currently unknown. AIM: To analyse the technical aspects, safety and effectiveness of the first consolidated FMT programme in Spain. METHODS: Retrospective descriptive study of all patients with recurrent CDI treated with FMT performed by colonoscopy in a tertiary centre after the implementation of a multidisciplinary protocol between March 2015 and September 2016...
April 19, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28431849/prospective-cluster-controlled-crossover-trial-to-compare-the-impact-of-an-improved-hydrogen-peroxide-disinfectant-and-a-quaternary-ammonium-based-disinfectant-on-surface-contamination-and-health-care-outcomes
#4
John M Boyce, Kerri A Guercia, Linda Sullivan, Nancy L Havill, Renee Fekieta, Janet Kozakiewicz, David Goffman
BACKGROUND: Quaternary ammonium-based (Quat) disinfectants are widely used, but they have disadvantages. METHODS: This was a 12-month prospective cluster controlled crossover trial. On 4 wards, housekeepers performed daily cleaning using a disinfectant containing either 0.5% improved hydrogen peroxide (IHP) or Quat. Each month, 5-8 high-touch surfaces in several patient rooms on each ward were tagged with a fluorescent marker and cultured before and after cleaning...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431238/reducing-recurrence-of-c-difficile-infection
#5
Michael G Dieterle, Vincent B Young
Clostridium difficile infection (CDI) is facilitated by alteration of the microbiome following antibiotic administration. Antimicrobial therapy directed against the pathogen can treat CDI. Unfortunately, ∼20% of successfully treated patients will suffer recurrence. Bezlotoxumab, a human monoclonal antibody, binds to C. difficile toxin B (TcdB), reducing recurrence presumably by limiting epithelial damage and facilitating microbiome recovery.
April 20, 2017: Cell
https://www.readbyqxmd.com/read/28430065/ethical-issues-in-fecal-microbiota-transplantation-in-practice
#6
Yonghui Ma, Jiayu Liu, Catherine Rhodes, Yongzhan Nie, Faming Zhang
Fecal microbiota transplantation (FMT) has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: (1) informed consent and the vulnerability of patients; (2) determining what a "suitable healthy donor" is; (3) safety and risk; (4) commercialization and potential exploitation of vulnerable patients; and (5) public health implications...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28429247/a-review-of-the-novel-application-and-potential-adverse-effects-of-proton-pump-inhibitors
#7
REVIEW
Li-Yuan Yu, Lu-Ning Sun, Xue-Hui Zhang, Yue-Qi Li, Lei Yu, Zi-Qing-Yun Yuan, Ling Meng, Hong-Wen Zhang, Yong-Qing Wang
Proton pump inhibitors (PPIs) are known as a class of pharmaceutical agents that target H(+)/K(+)-ATPase, which is located in gastric parietal cells. PPIs are widely used in the treatment of gastric acid-related diseases including peptic ulcer disease, erosive esophagitis and gastroesophageal reflux disease, and so on. These drugs present an excellent safety profile and have become one of the most commonly prescribed drugs in primary and specialty care. Except for gastric acid-related diseases, PPIs can also be used in the treatment of Helicobacter pylori infection, viral infections, respiratory system diseases, cancer and so on...
April 20, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28426451/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#8
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28421185/changes-in-composition-of-the-gut-bacterial-microbiome-after-fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-a-pediatric-heart-transplant-patient
#9
Kyle L Flannigan, Taylor Rajbar, Andrew Moffat, Leanna S McKenzie, Frank Dicke, Kevin Rioux, Matthew L Workentine, Thomas J Louie, Simon A Hirota, Steven C Greenway
The microbiome is increasingly recognized as an important influence on human health and many of the comorbidities that affect patients after solid organ transplantation (SOT) have been shown to involve changes in gut bacterial populations. Thus, microbiome changes in an individual patient may have important health implications after SOT but this area remains understudied. We describe changes in the composition of the fecal microbiome from a pediatric heart transplant recipient before and >2.5 years after he underwent repeated fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection (CDI)...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28417271/antimicrobial-effects-of-manuka-honey-on-in-vitro-biofilm-formation-by-clostridium-difficile
#10
M Piotrowski, P Karpiński, H Pituch, A van Belkum, P Obuch-Woszczatyński
Clostridium difficile is the cause of the nosocomial C. difficile infection (CDI). The conventional antibiotics used in CDI therapy are often unsuccessful, and recurrent infections may occur. Biofilm formation by C. difficile is associated with chronic or recurrent infections; biofilms may contribute to virulence and impaired antimicrobial efficacy. Manuka honey, derived from the Manuka tree (Leptospermum scoparium), is known to exhibit antimicrobial properties that are associated with its significant content of methylglyoxal, a natural antibiotic...
April 18, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28414622/clostridium-difficile-infection
#11
Jennan A Phillips, Stephanie Hammond
Preventing Clostridium difficile, the most common cause of health care-associated infections in hospitals and infectious disease death in the United States, is a national priority. Increased rates of infection among low-risk individuals in the community call for community-based prevention efforts to halt the increasing spread of this highly contagious opportunistic infection.
April 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28411069/clostridium-difficile-and-cystic-fibrosis-management-strategies-and-the-role-of-faecal-transplantation
#12
REVIEW
Roisin Dunwoody, Alan Steel, J Landy, Nicholas Simmonds
Clostridium difficile is a bacterial infection that colonises the gut in susceptible hosts. It is associated with exposure to healthcare settings and antibiotic use. It could be assumed that cystic fibrosis (CF) patients are a high-risk group for C.difficile. However, despite high carriage rates, CF patients have low rates of active disease. There are guidelines for the treatment of C.difficile, however little is published specific to treating C.difficile in CF. This article provides an overview of the current management strategies for C...
March 14, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28410344/preoperative-clostridium-difficile-infection-does-not-affect-pouch-outcomes-in-patients-with-ulcerative-colitis-who-undergo-ileal-pouch-anal-anastomosis
#13
Amy L Lightner, Chung Sang Tse, Kevin Quinn, John R Bergquist, Felicity Enders, Richard Pendegraft, Sahil Khanna, Laura Raffals
BACKGROUND: The operation of choice for patients with chronic ulcerative colitis (CUC) is restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Pouchitis is the most common complication after IPAA. The incidence of Clostridium difficile infection (CDI) is higher in CUC patients than the general population and can lead to significant disease flares and higher rates of colectomy. We sought to determine the risk of pouchitis in patients with precolectomy CDI and 90-day postoperative IPAA complications...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28405601/risk-for-clostridium-difficile-infection-after-allogeneic-hematopoietic-cell-transplant-remains-elevated-in-the-postengraftment-period
#14
Erik R Dubberke, Kimberly A Reske, Margaret A Olsen, Kerry M Bommarito, Sondra Seiler, Fernanda P Silveira, Tom M Chiller, John DiPersio, Victoria J Fraser
BACKGROUND: Clostridium difficile infection (CDI) is a frequent cause of diarrhea among allogeneic hematopoietic cell transplant (HCT) recipients. It is unknown whether risk factors for CDI vary by time posttransplant. METHODS: We performed a 3-year prospective cohort study of CDI in allogeneic HCT recipients. Participants were enrolled during their transplant hospitalizations. Clinical assessments were performed weekly during hospitalizations and for 12 weeks posttransplant, and monthly for 30 months thereafter...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28404757/trends-in-the-incidence-and-outcomes-of-hospitalized-cancer-patients-with-clostridium-difficile-infection-a-nationwide-analysis
#15
Arjun Gupta, Raseen Tariq, Ryan D Frank, Gary W Jean, Muhammad S Beg, Darrell S Pardi, David H Johnson, Sahil Khanna
Background: Patients with cancer have several risk factors for Clostridium difficile infection (CDI), but the impact of CDI on outcomes in this population needs elucidation. We analyzed the incidence of CDI and its impact on outcomes in patients with cancer using the National Hospital Discharge Survey (NHDS) database from 2001 to 2010. Methods: Diagnosis codes were used to identify patients with cancer and CDI events. Demographics, diagnoses, length of stay (LOS), and discharge information were abstracted. Multivariate linear and logistic regression models with weighted analysis were conducted to study CDI incidence and CDI-associated outcomes...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28402634/synthesis-and-biological-evaluation-of-bile-acid-analogues-inhibitory-to-clostridium-difficile-spore-germination
#16
Kristen L Stoltz, Raymond Erickson, Christopher Staley, Alexa R Weingarden, Erin Romens, Clifford J Steer, Alexander Khoruts, Michael J Sadowsky, Peter I Dosa
Standard antibiotic-based strategies for the treatment of Clostridium difficile infections disrupt indigenous microbiota and commonly fail to eradicate bacterial spores, two key factors that allow recurrence of infection. As an alternative approach to controlling C. difficile infection, a series of bile acid derivatives have been prepared that inhibit taurocholate-induced spore germination. These analogues have been evaluated in a highly virulent NAP1 strain using optical density and phase-contrast microscopy assays...
April 12, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28401147/toxinotyping-and-sequencing-of-clostridium-difficile-isolates-from-patients-in-a-tertiary-care-hospital-of-northern-india
#17
Meenakshi Singh, Chetana Vaishnavi, Safrun Mahmood, Rakesh Kochhar
BACKGROUND: Clostridium difficile is an important cause of infectious colitis among hospitalized patients across the globe. The pathogenic potential of C. difficile in producing significant morbidity and mortality is mainly due to production of toxins A and B. The outbreaks of C. difficile infection (CDI) are due to changes in the genetic sequences of the organism. There is hardly any molecular study reported on the prevalent types of C. difficile strains in India. Toxinotyping and sequencing of locally circulating C...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28401056/effect-of-metronidazole-in-infants-with-bowel-habit-change-irrelative-to-the-clostridium-difficile-colonization
#18
Eun Jin Kim, Sung Hyun Lee, Hann Tchah, Eell Ryoo
PURPOSE: Clinical symptoms associated with Clostridium difficile infection (CDI) can vary widely. Carrier state without apparent symptoms is relatively common during infancy. The objective of this study was to determine the association of C. difficile colonization with bowel habit change and the effect of C. difficile colonization treatment on restoration of normal bowel habit. METHODS: Between 2006 and 2014, infants at 1 to 12 months of age with diarrhea for more than 2 weeks who did not improve with conservative care were recruited from Gachon University Gil Medical Center...
March 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28399946/impact-of-a-multifaceted-antimicrobial-stewardship-program-a-front-line-ownership-driven-quality-improvement-project-in-a-large-urban-emergency-department
#19
Adam Jonathan Kaufman, Janine McCready, Jeff Powis
BACKGROUND: Antibiotic overuse has promoted growing rates of antimicrobial resistance and secondary antibiotic-associated infections such as Clostridium difficile (C. difficile). Antimicrobial stewardship programs (ASPs) are effective in reducing antimicrobial use in the inpatient setting; however, the unique environment of the emergency department (ED) lends itself to challenges for successful implementation. Front-line ownership (FLO) methodology has been shown to be a potentially effective strategy for the implementation of inpatient ASPs through an iterative multi-pronged approach driven by front-line providers...
April 12, 2017: CJEM
https://www.readbyqxmd.com/read/28397624/risk-of-clostridium-difficile-infection-in-hematology-oncology-patients-colonized-with-toxigenic-c-difficile
#20
Cara M Cannon, Jackson S Musuuza, Anna K Barker, Megan Duster, Mark B Juckett, Aurora E Pop-Vicas, Nasia Safdar
The prevalence of colonization with toxigenic Clostridium difficile among patients with hematological malignancies and/or bone marrow transplant at admission to a 566-bed academic medical care center was 9.3%, and 13.3% of colonized patients developed symptomatic disease during hospitalization. This population may benefit from targeted C. difficile infection control interventions. Infect Control Hosp Epidemiol 2017;1-3.
April 11, 2017: Infection Control and Hospital Epidemiology
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