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Clostridium difficile infections

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https://www.readbyqxmd.com/read/28102756/treatment-of-recurrent-clostridium-difficile-infection-using-fecal-microbiota-transplantation-in-patients-with-inflammatory-bowel-disease
#1
Krista M Newman, Kevin M Rank, Byron P Vaughn, Alexander Khoruts
We recently compared results of fecal microbiota transplantation (FMT) in patients with refractory, recurrent Clostridium difficile infection (rCDI), with and without underlying inflammatory bowel disease (IBD). Here we extend this cohort and analyze outcomes in greater detail by subtype of IBD. We find that FMT is generally effective in breaking the cycle of CDI recurrence, but its effects on overall IBD progression are much less predictable. We discuss a number of challenges intrinsic to this complex clinical situation and outline the next steps that can address these challenges going forward...
January 19, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28096487/a-clostridium-difficile-specific-gel-forming-protein-required-for-optimal-spore-germination
#2
M Lauren Donnelly, William Li, Yong-Qing Li, Lauren Hinkel, Peter Setlow, Aimee Shen
: Clostridium difficile is a Gram-positive spore-forming obligate anaerobe that is a leading cause of antibiotic-associated diarrhea worldwide. In order for C. difficile to initiate infection, its aerotolerant spore form must germinate in the gut of mammalian hosts. While almost all spore-forming organisms use transmembrane germinant receptors to trigger germination, C. difficile uses the pseudoprotease CspC to sense bile salt germinants. CspC activates the related subtilisin-like protease CspB, which then proteolytically activates the cortex hydrolase SleC...
January 17, 2017: MBio
https://www.readbyqxmd.com/read/28096320/streptococcus-gordonii-a-rare-cause-of-prosthetic-joint-infection-in-a-total-hip-replacement
#3
Christopher Fenelon, John G Galbraith, David M Dalton, Eric Masterson
A 69-year-old female with a history of bilateral total hip replacements presented with rigors, fever and sudden onset left groin pain. A pelvic X-ray showed well-fixed implants. Blood results revealed a leucocytosis (white cell count 22.3 × 10(9) l(-1)) and elevated C-reactive protein (211 mg/l). Ultrasound-guided aspiration of her left hip grew Streptococcus gordonii No source infection could be identified apart from a new chronic sinus infection in a left upper incisor. Following a discussion with the patient a 6-week course of intravenous ceftriaxone was started and was successful in normalizing her inflammatory markers...
January 16, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28093134/management-of-clostridium-difficile-infection-in-inflammatory-bowel-disease-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#4
REVIEW
Sahil Khanna, Andrea Shin, Ciarán P Kelly
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection...
February 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28091625/mplex-a-method-for-simultaneous-pathogen-inactivation-and-extraction-of-samples-for-multi-omics-profiling
#5
Kristin E Burnum-Johnson, Jennifer E Kyle, Amie J Eisfeld, Cameron P Casey, Kelly G Stratton, Juan F Gonzalez, Fabien Habyarimana, Nicholas M Negretti, Amy C Sims, Sadhana Chauhan, Larissa B Thackray, Peter J Halfmann, Kevin B Walters, Young-Mo Kim, Erika M Zink, Carrie D Nicora, Karl K Weitz, Bobbie-Jo M Webb-Robertson, Ernesto S Nakayasu, Brian Ahmer, Michael E Konkel, Vladimir Motin, Ralph S Baric, Michael S Diamond, Yoshihiro Kawaoka, Katrina M Waters, Richard D Smith, Thomas O Metz
The continued emergence and spread of infectious agents is of great concern, and systems biology approaches to infectious disease research can advance our understanding of host-pathogen relationships and facilitate the development of new therapies and vaccines. Molecular characterization of infectious samples outside of appropriate biosafety containment can take place only subsequent to pathogen inactivation. Herein, we describe a modified Folch extraction using chloroform/methanol that facilitates the molecular characterization of infectious samples by enabling simultaneous pathogen inactivation and extraction of proteins, metabolites, and lipids for subsequent mass spectrometry-based multi-omics measurements...
January 16, 2017: Analyst
https://www.readbyqxmd.com/read/28089675/burden-of-clostridium-difficile-infection-associated-hospitalization-in-a-cohort-of-middle-aged-and-older-adults
#6
Yingxi Chen, Kathryn Glass, Bette Liu, Rosemary J Korda, Thomas V Riley, Martyn D Kirk
BACKGROUND: Clostridium difficile is the principal cause of infectious diarrhea in hospitalized patients. The aim of this study was to describe and compare length of stay (LOS), costs, and in-hospital deaths for C difficile infection (CDI) and non-CDI hospitalizations, in a cohort of middle-aged and older Australians. METHODS: We used survey data from the 45 and Up Study, linked to hospitalization and death data. We calculated the average LOS and costs per hospitalization, and the proportion of in-hospital deaths for CDI and non-CDI hospitalizations...
January 13, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28089100/community-onset-clostridium-difficile-infection-at-a-tertiary-medical-center-in-southern-taiwan-2007-2015
#7
Chin-Shiang Tsai, Yuan-Pin Hung, Jen-Chieh Lee, Nan-Yao Lee, Po-Lin Chen, Ling-Shan Syue, Ming-Chi Li, Chia-Wen Li, Wen-Chien Ko
BACKGROUND: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. METHODS: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI)...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28087657/european-consensus-conference-on-faecal-microbiota-transplantation-in-clinical-practice
#8
Giovanni Cammarota, Gianluca Ianiro, Herbert Tilg, Mirjana Rajilić-Stojanović, Patrizia Kump, Reetta Satokari, Harry Sokol, Perttu Arkkila, Cristina Pintus, Ailsa Hart, Jonathan Segal, Marina Aloi, Luca Masucci, Antonio Molinaro, Franco Scaldaferri, Giovanni Gasbarrini, Antonio Lopez-Sanroman, Alexander Link, Pieter de Groot, Willem M de Vos, Christoph Högenauer, Peter Malfertheiner, Eero Mattila, Tomica Milosavljević, Max Nieuwdorp, Maurizio Sanguinetti, Magnus Simren, Antonio Gasbarrini
Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance...
January 13, 2017: Gut
https://www.readbyqxmd.com/read/28087170/clostridium-difficile-rates-in-asymptomatic-and-symptomatic-hospitalized-patients-using-nucleic-acid-testing
#9
Cynthia Truong, Lee F Schroeder, Rajiv Gaur, Victoria Emma Anikst, Ikuko Komo, Colleen Watters, Erin McCalley, Carole Kulik, David Pickham, Nancy J Lee, Niaz Banaei
BACKGROUND: The Clostridium difficile rate in symptomatic patients represents both those with C. difficile infection (CDI) and those with colonization. To predict the extent of CDI overdiagnosis, we compared the asymptomatic colonization rate to the symptomatic positivity rate in hospitalized patients using nucleic acid testing. METHODS: Between July 2014 and April 2015, formed stool samples were collected from asymptomatic patients after admission to 3 hospital wards at the Stanford Hospital...
January 3, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28079620/clostridium-difficile-infection-and-risk-of-colectomy-in-patients-with-inflammatory-bowel-disease-a-bias-adjusted-meta-analysis
#10
Yingxi Chen, Luis Furuya-Kanamori, Suhail A Doi, Ashwin N Ananthakrishnan, Martyn Kirk
BACKGROUND: Clostridium difficile infection (CDI) is a common complication of inflammatory bowel diseases (IBDs) and is associated with worse outcome. Variable rates of colectomy have been reported among IBD complicated by CDI. We conducted a systematic review and meta-analysis of studies to assess the association between CDI and colectomy among patients with IBD. METHODS: The literature was systematically searched using PubMed from inception through April 2016...
January 10, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28078087/clostridium-difficile-infection-in-cystic-fibrosis-an-uncommon-but-life-threatening-complication
#11
Francesco Piccolo, Anna Sze Tai, Hooi Ee, Siobhain Mulrennan, Scott Bell, Gerard Ryan
Adults with cystic fibrosis (CF) have significant rates of asymptomatic Clostridium difficile carriage and are frequently exposed to risk factors for C. difficile infection (CDI). Despite this, the rate of reported CDI in CF is low. We describe three cases of near fatal CDI in adults with CF and review the literature regarding presentation, management, and recurrence prevention. Early recognition is important as the clinical presentation may be atypical and the illness can be severe and even life-threatening...
January 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28077697/point-counterpoint-what-is-the-optimal-approach-for-detection-of-clostridium-difficile-infection
#12
Ferric C Fang, Christopher R Polage, Mark H Wilcox
In 2010, we published an initial point-counterpoint on laboratory diagnosis of C. difficile infection (CDI). At that time, nucleic acid amplification tests (NAATs) were just becoming commercially available, and the idea of algorithmic approaches to CDI was being explored. Now there are numerous NAATs in the marketplace and based on recent proficiency test surveys, they have become the predominant method used for CDI diagnosis in the United States. At the same time, there is a body of literature that suggests that NAATs lack clinical specificity and thus inflate CDI rates...
January 11, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28077694/laboratory-testing-of-donors-and-stool-for-fecal-microbiota-transplantation-for-recurrent-c-difficile-infection
#13
Michael H Woodworth, Emma M Neish, Nancy S Miller, Tanvi Dhere, Eileen M Burd, Cynthia Carpentieri, Kaitlin L Sitchenko, Colleen S Kraft
Fecal microbiota transplantation is an efficacious and inexpensive therapy for recurrent Clostridium difficile, yet its safety is thought to depend on appropriate fecal donor screening. FDA guidance for regulation of this procedure is in flux but screening and manufacture of fecal material from asymptomatic donors presents many challenges to clinical laboratories. This minireview summarizes FDA regulatory changes, principles of donor selection and recommended laboratory screening for fecal microbiota transplantation...
January 11, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#14
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28075419/surveillance-of-clostridium-difficile-infections-results-from-a-six-year-retrospective-study-in-nine-hospitals-of-a-north-italian-local-health-authority
#15
Greta Roncarati, Laura Dallolio, Erica Leoni, Manuela Panico, Angela Zanni, Patrizia Farruggia
Clostridium difficile is an emerging cause of healthcare associated infections. In nine hospitals of an Italian Local Health Authority the episodes of C. difficile infection (CDI) were identified using the data registered by the centralized Laboratory Information System, from 2010 to 2015. CDI incidence (positive patients for A and/or B toxins per patients-days) was analysed per year, hospital, and ward. A number of cases approximately equivalent to the mean of identified cases per year were studied retrospectively to highlight the risk factors associated to CDI and their severity...
January 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28070336/noncontiguous-finished-genome-sequence-and-description-of-prevotella-phocaeensis-sp-nov-a-new-anaerobic-species-isolated-from-human-gut-infected-by-clostridium-difficile
#16
P Afouda, S Ndongo, S Khelaifia, N Labas, F Cadoret, F Di Pinto, J Delerce, D Raoult, M Million
Prevotella phocaeensis sp. nov. strain SN19(T) (= DSM 103364) is a new species isolated from the gut microbiota of patient with colitis due to Clostridium difficile. Strain SN19(T) is Gram-negative rod-shaped bacteria, strictly anaerobic, nonmotile and non-endospore forming. The predominance fatty acid is hexadecanoic acid. Its 16S rRNA showed a 97.70% sequence identity with its phylogenetically closest species, Prevotella oralis. The genome is 2 922 117 bp long and contains 2486 predicted genes including 56 RNA genes...
January 2017: New Microbes and New Infections
https://www.readbyqxmd.com/read/28065332/clostridium-difficile-contamination-of-health-care-workers-hands-and-its-potential-contribution-to-the-spread-of-infection-review-of-the-literature
#17
REVIEW
Ingrid Jullian-Desayes, Caroline Landelle, Marie-Reine Mallaret, Christian Brun-Buisson, Frédéric Barbut
BACKGROUND: Clostridium difficile infection (CDI) can be transmitted from patient to patient by the hands of health care workers (HCWs); however, the relative importance of this route in the spread of C difficile in the hospital is currently unknown. Our aim was to review studies examining HCWs' hand carriage and its potential role in CDI transmission. METHODS: First, English-speaking references addressing HCWs' hand sampling obtained from the PubMed database were reviewed...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28063955/asymptomatic-carriers-contribute-to-nosocomial-clostridium-difficile-infection-a-cohort-study-of-4508-patients
#18
Thomas Blixt, Kim Oren Gradel, Christian Homann, Jakob Benedict Seidelin, Kristian Schønning, Anne Lester, Jette Houlind, Marie Stangerup, Magnus Gottlieb, Jenny Dahl Knudsen
BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects of of asymptomatic carriers on nosocomial C difficile infections. METHODS: We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013...
January 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28060888/the-association-between-gaba-modulators-and-clostridium-difficile-infection-a-matched-retrospective-case-control-study
#19
Jonathan Ström, Johan Tham, Fredrik Månsson, Jonas Ahl, Tor C Savidge, Sara M Dann, Fredrik Resman
OBJECTIVE: Recently, metabolomics studies have suggested that the neurotransmitter γ-amino butyric acid (GABA) may modulate C. difficile infection (CDI) pathogenesis. In the present study, we investigated the association between GABA-modulating pharmaceuticals and CDI development. METHODS: In July-December 2013, we performed a matched, retrospective case-control study in Skåne county, Sweden, to assess the association between the use of GABA-modulators (defined as regular use of at least one of the following: zolpidem, zopiclone, benzodiazepines, gabapentin, pregabalin or baclofen) and CDI...
2017: PloS One
https://www.readbyqxmd.com/read/28060753/clostridium-difficile-colonization-in-preoperative-colorectal-cancer-patients
#20
Yi Zheng, Yun Luo, Yinxiang Lv, Chen Huang, Qinsong Sheng, Peng Zhao, Julian Ye, Weiqin Jiang, Lulu Liu, Xiaojun Song, Zhou Tong, Wenbin Chen, Jianjiang Lin, Yi-Wei Tang, Dazhi Jin, Weijia Fang
The entire process of Clostridium difficile colonization to infection develops in large intestine. However, the real colonization pattern of C. difficile in preoperative colorectal cancer patients has not been studied. In this study, 33 C. difficile strains (16.1%) were isolated from stool samples of 205 preoperative colorectal cancer patients. C. difficile colonization rates in lymph node metastasis patients (22.3%) were significantly higher than lymph node negative patients (10.8%) (OR=2.314, 95%CI=1.023-5...
January 2, 2017: Oncotarget
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