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Clostridium difficile infections

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https://www.readbyqxmd.com/read/28636484/bezlotoxumab-anti-toxin-b-monoclonal-antibody-to-prevent-recurrence-of-clostridium-difficile-infection
#1
Javier A Villafuerte Gálvez, Ciarán P Kelly
Clostridium difficile infection (CDI) is the most common nosocomial infection in the U.S. 25% of CDI patients go on to develop recurrent CDI (rCDI) following current standard of care (SOC) therapy, leading to morbidity, mortality and economic loss. The first passive immunotherapy drug targeting C.difficile toxin B (bezlotoxumab) has been approved recently by the FDA and EMA for prevention of rCDI. Areas covered: A body of key studies was selected and reviewed by the authors. The unmet needs in CDI care were ascertained with emphasis in rCDI, including the epidemiology, pathophysiology and current management...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28633368/impact-of-recurrent-clostridium-difficile-infection-hospitalization-and-patient-quality-of-life
#2
Mark H Wilcox, Harblas Ahir, John E Coia, Andrew Dodgson, Susan Hopkins, Martin J Llewelyn, Chris Settle, Susan Mclain-Smith, Stephen W Marcella
Objectives: Data quantifying outcomes of recurrent Clostridium difficile infection (rCDI) are lacking. We sought to determine the UK hospital resource use and health-related quality of life (HRQoL) associated with rCDI hospitalizations. Patients and methods: A non-interventional study in six UK acute hospitals collected retrospective clinical and resource use data from medical records of 64 adults hospitalized for rCDI and 64 matched inpatient controls with a first episode only (f)CDI...
June 13, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#3
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28630239/an-unusual-case-of-escherichia-coli-o157-h7-infection-with-pseudomembranous-colitis-like-lesions-associated-with-haemolytic-uraemic-syndrome-and-neurological-sequelae
#4
James Kennedy, Lauren Simmonds, Robert Orme, Warren Doherty
A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629876/effect-of-antibiotic-stewardship-on-the-incidence-of-infection-and-colonisation-with-antibiotic-resistant-bacteria-and-clostridium-difficile-infection-a-systematic-review-and-meta-analysis
#5
David Baur, Beryl Primrose Gladstone, Francesco Burkert, Elena Carrara, Federico Foschi, Stefanie Döbele, Evelina Tacconelli
BACKGROUND: Antibiotic stewardship programmes have been shown to reduce antibiotic use and hospital costs. We aimed to evaluate evidence of the effect of antibiotic stewardship on the incidence of infections and colonisation with antibiotic-resistant bacteria. METHODS: For this systematic review and meta-analysis, we searched PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published from Jan 1, 1960, to May 31, 2016, that analysed the effect of antibiotic stewardship programmes on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infections in hospital inpatients...
June 16, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28624753/treatment-of-asymptomatic-uti-in-older-delirious-medical-in-patients-a-prospective-cohort-study
#6
Monidipa Dasgupta, Chris Brymer, Sameer Elsayed
BACKGROUND: Despite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status. OBJECTIVE: To determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery. METHODS: Consecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms...
May 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28623367/bovine-antibodies-targeting-primary-and-recurrent-clostridium-difficile-disease-are-a-potent-antibiotic-alternative
#7
Melanie L Hutton, Bliss A Cunningham, Kate E Mackin, Shelley A Lyon, Meagan L James, Julian I Rood, Dena Lyras
The increased incidence of antibiotic resistant 'superbugs' has amplified the use of broad spectrum antibiotics worldwide. An unintended consequence of antimicrobial treatment is disruption of the gastrointestinal microbiota, resulting in susceptibility to opportunistic pathogens, such as Clostridium difficile. Paradoxically, treatment of C. difficile infections (CDI) also involves antibiotic use, leaving patients susceptible to re-infection. This serious health threat has led to an urgent call for the development of new therapeutics to reduce or replace the use of antibiotics to treat bacterial infections...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28622739/impact-of-a-collaborative-strategy-to-reduce-the-inappropriate-use-of-acid-suppressive-therapy-in-non-intensive-care-unit-patients
#8
Kristen D Belfield, Arpi G Kuyumjian, Rafael Teran, Mariette Amadi, Melissa Blatt, Keri Bicking
BACKGROUND: Stress ulcer prophylaxis (SUP) is inappropriately prescribed in more than 30% of non-intensive care unit (ICU) patients, leading to unnecessary adverse events as well as increases in economic burden. OBJECTIVE: There was an increasing trend in the prophylactic use of acid suppressive therapy (AST) in non-critically ill patients at our institution, which prompted this initiative aimed at reducing the inappropriate use of AST in non-ICU patients. METHODS: This was a retrospective interventional study that consisted of formulation of a guideline, education to the hospitalist service, and intervention by clinical pharmacists...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28622340/antibiotic-prophylaxis-for-surgical-site-infections-as-a-risk-factor-for-infection-with-clostridium-difficile
#9
Aubrey Balch, Aaron M Wendelboe, Sara K Vesely, Dale W Bratzler
OBJECTIVE: We aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior to surgery and infection with Clostridium difficile. DESIGN: We conducted a retrospective case-control study by selecting patients who underwent a surgical procedure between January 1, 2012 and December 31, 2013. SETTING: Large urban community hospital. PATIENTS: Cases and controls were patients age 18+ years who underwent an eligible surgery (i...
2017: PloS One
https://www.readbyqxmd.com/read/28619474/high-metabolic-versatility-of-different-toxigenic-and-non-toxigenic-clostridioides-difficile-isolates
#10
Thomas Riedel, Daniela Wetzel, Julia Danielle Hofmann, Simon Paul Erich Otto Plorin, Henning Dannheim, Mareike Berges, Ortrud Zimmermann, Boyke Bunk, Isabel Schober, Cathrin Spröer, Heiko Liesegang, Dieter Jahn, Jörg Overmann, Uwe Groß, Meina Neumann-Schaal
Clostridioides difficile (formerly Clostridium difficile) is a major nosocomial pathogen with an increasing number of community-acquired infections causing symptoms from mild diarrhea to life-threatening colitis. The pathogenicity of C. difficile is considered to be mainly associated with the production of genome-encoded toxins A and B. In addition, some strains also encode and express the binary toxin CDT. However; a large number of non-toxigenic C. difficile strains have been isolated from the human gut and the environment...
June 1, 2017: International Journal of Medical Microbiology: IJMM
https://www.readbyqxmd.com/read/28617768/serious-bacterial-infections-acquired-during-treatment-of-patients-given-a-diagnosis-of-chronic-lyme-disease-united-states
#11
Natalie S Marzec, Christina Nelson, Paul Ravi Waldron, Brian G Blackburn, Syed Hosain, Tara Greenhow, Gary M Green, Catherine Lomen-Hoerth, Marjorie Golden, Paul S Mead
The term "chronic Lyme disease" is used by some health care providers as a diagnosis for various constitutional, musculoskeletal, and neuropsychiatric symptoms (1,2). Patients with a diagnosis of chronic Lyme disease have been provided a wide range of medications as treatment, including long courses of intravenous (IV) antibiotics (3,4). Studies have not shown that such treatments lead to substantial long-term improvement for patients, and they can be harmful (1,5). This report describes cases of septic shock, osteomyelitis, Clostridium difficile colitis, and paraspinal abscess resulting from treatments for chronic Lyme disease...
June 16, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28617651/microbiota-therapy-for-clostridium-difficile-and-antibiotic-resistant-enteric-infections
#12
Brittany B Lewis, Eric G Pamer
Bacterial pathogens are increasingly antibiotic resistant, and development of clinically effective antibiotics is lagging. Curing infections increasingly requires antimicrobials that are broader spectrum, more toxic, and more expensive, and mortality attributable to antibiotic-resistant pathogens is rising. The commensal microbiota, comprising microbes that colonize the mammalian gastrointestinal tract, can provide high levels of resistance to infection, and the contributions of specific bacterial species to resistance are being discovered and characterized...
June 15, 2017: Annual Review of Microbiology
https://www.readbyqxmd.com/read/28610932/automatic-environmental-disinfection-with-hydrogen-peroxide-and-ion-silver-versus-manual-environmental-disinfection-with-sodium-hypochlorite-a-multicenter-randomized-before-and-after-trial
#13
D Mosci, G W Marmo, L Sciolino, C Zaccaro, R Antonellini, L Accogli, T Lazzarotto, M Mongardi, M P Landini
AIMS: 1. Compare the effectiveness of an automated disinfection system with hydrogen peroxide <8% and silver ion versus a manual method with 0.5% sodium hypochlorite solution to evaluate the reduction of microbial mesophilic contamination and Clostridium difficile (CD) presence; 2. Evaluate the organizational impact of these two technologies in terms of time required for the process. METHODS: A randomized multicenter trial performed in four public and private health facilities in the Emilia-Romagna Region, in different wards including medicine, orthopaedics, long-term care, recovery and functional rehabilitation, which were previously occupied by patients with Clostridium difficile Infection (CDI)...
June 10, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28609252/fecal-microbiota-transplantation-in-metabolic-syndrome-history-present-and-future
#14
P F de Groot, M N Frissen, N C de Clercq, M Nieuwdorp
The history of fecal microbiota transplantation (FMT) dates back even to ancient China. Recently, scientific studies have been looking into FMT as a promising treatment of various diseases, while in the process teaching us about the interaction between the human host and its resident microbial communities. Current research focuses mainly on Clostridium difficile infections, however interest is rising in other areas such as inflammatory bowel disease (IBD) and the metabolic syndrome. With regard to the latter, the intestinal microbiota might be causally related to the progression of insulin resistance and diabetes...
May 4, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28609251/intestinal-microbiota-fecal-microbiota-transplantation-and-inflammatory-bowel-disease
#15
Alexa R Weingarden, Byron P Vaughn
Inflammatory bowel disease (IBD) is a complex set of diseases that lead to chronic inflammation in the gastrointestinal tract. Although the etiology of IBD is not fully understood, it is well-known that the intestinal microbiota is associated with the development and maintenance of IBD. Manipulation of the gut microbiota, therefore, may represent a target for IBD therapy. Fecal microbiota transplantation (FMT), where fecal microbiota from a healthy donor is transplanted into a patient's GI tract, is already a successful therapy for Clostridium difficile infection...
May 4, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28608496/stress-ulcer-prophylaxis-in-the-intensive-care-unit-trial-detailed-statistical-analysis-plan
#16
M Krag, A Perner, J Wetterslev, T Lange, M P Wise, M Borthwick, S Bendel, P Pelosi, F Keus, A B Guttormsen, J C Schefold, T S Meyhoff, S Marker, M H Møller
BACKGROUND: In this statistical analysis plan, we aim to provide details of the pre-defined statistical analyses of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. The aim of the SUP-ICU trial is to assess benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in adult patients in the intensive care unit (ICU). METHODS: The SUP-ICU trial is an investigator-initiated, international, multicentre, randomised, blinded, parallel-group trial of intravenously pantoprazole 40 mg once daily vs...
June 12, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28607673/risk-factors-for-clostridium-difficile-infections-an-overview-of-the-evidence-base-and-challenges-in-data-synthesis
#17
Paul Eze, Evelyn Balsells, Moe H Kyaw, Harish Nair
BACKGROUND: Recognition of a broad spectrum of disease and development of Clostridium difficile infection (CDI) and recurrent CDI (rCDI) in populations previously considered to be at low risk has renewed attention on differences in the risk profile of patients. In the absence of primary prevention for CDI and limited treatment options, it is important to achieve a deep understanding of the multiple factors that influence the risk of developing CDI and rCDI. METHODS: We conducted a review of systematic reviews and meta-analyses on risk factors for CDI and rCDI published between 1990 and October 2016...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28607468/clostridium-difficile-flagella-induce-a-pro-inflammatory-response-in-intestinal-epithelium-of-mice-in-cooperation-with-toxins
#18
Jameel Batah, Hussein Kobeissy, Phuong Trang Bui Pham, Cécile Denève-Larrazet, Sarah Kuehne, Anne Collignon, Claire Janoir-Jouveshomme, Jean-Christophe Marvaud, Imad Kansau
Clostridium difficile is the most important enteropathogen involved in gut nosocomial post-antibiotic infections. The emergence of hypervirulent strains has contributed to increased mortality and morbidity of CDI. The C. difficile toxins contribute directly to CDI-associated lesions of the gut, but other bacterial factors are needed for the bacteria to adhere and colonize the intestinal epithelium. The C. difficile flagella, which confer motility and chemotaxis for successful intestinal colonization, could play an additional role in bacterial pathogenesis by contributing to the inflammatory response of the host and mucosal injury...
June 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28604925/association-of-adverse-events-with-antibiotic-use-in-hospitalized-patients
#19
Pranita D Tamma, Edina Avdic, David X Li, Kathryn Dzintars, Sara E Cosgrove
Importance: Estimates of the incidence of overall antibiotic-associated adverse drug events (ADEs) in hospitalized patients are generally unavailable. Objective: To describe the incidence of antibiotic-associated ADEs for adult inpatients receiving systemic antibiotic therapy. Design, Setting, and Participants: Retrospective cohort of adult inpatients admitted to general medicine wards at an academic medical center. Exposures: At least 24 hours of any parenteral or oral antibiotic therapy...
June 12, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28603640/prevalence-and-molecular-epidemiology-of-clostridium-difficile-infection-in-indonesia
#20
D A Collins, M H Gasem, T H Habibie, I G Arinton, P Hendriyanto, A P Hartana, T V Riley
Clostridium difficile has not been studied in detail in Asia, particularly Southeast Asia. We thus performed a prevalence study across four hospitals in Central Java province, Indonesia. Stool samples were collected from patients with diarrhoea and tested by enzyme immunoassay for glutamate dehydrogenase (GDH) and toxin A/B (C DIFF QUIK CHEK COMPLETE, TechLab). Specimens were cultured and molecular typing was performed. In total, 340 samples were tested, of which 70 (20.6%) were GDH positive, with toxin detected in 19 (5...
July 2017: New Microbes and New Infections
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