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Clostridium difficile infections

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https://www.readbyqxmd.com/read/28527248/-clinical-and-demographic-profile-and-risk-factors-for-clostridium-difficile-infection
#1
Carlos Carvajal, Carlos Pacheco, Fabián Jaimes
INTRODUCTION: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. OBJECTIVE: To determine the clinical characteristics of hospitalized patients with C. difficile infection. MATERIALS AND METHODS: We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#2
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#3
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28522725/draft-genome-sequences-of-five-enterococcus-species-isolated-from-the-gut-of-patients-with-suspected-clostridium-difficile-infection
#4
Eduardo Castro-Nallar, Sandro L Valenzuela, Sebastián Baquedano, Carolina Sánchez, Fabiola Fernández, Annette N Trombert
We present draft genome sequences of five Enterococcus species from patients suspected of Clostridium difficile infection. Genome completeness was confirmed by presence of bacterial orthologs (97%). Gene searches using Hidden-Markov models revealed that the isolates harbor between seven and 11 genes involved in antibiotic resistance to tetracyclines, beta-lactams, and vancomycin.
May 18, 2017: Genome Announcements
https://www.readbyqxmd.com/read/28520994/gut-microbiota-mediated-protection-against-diarrheal-infections
#5
Stefanie L Vogt, B Brett Finlay
Background: The mammalian gut microbiota is a highly abundant and diverse microbial community that resides in the gastrointestinal tract. One major benefit that the gut microbiota provides to its host is colonization resistance-the ability to prevent colonization by foreign microbes, including diarrheal pathogens such as Clostridium difficile , Salmonella enterica serovar Typhimurium and diarrheagenic Escherichia coli . Methods: We conducted a literature review of the effects of the gut microbiota on infection by diarrheal pathogens...
April 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28520993/effects-of-short-and-long-course-antibiotics-on-the-lower-intestinal-microbiome-as-they-relate-to-traveller-s-diarrhea
#6
Lawrence Clifford McDonald
BACKGROUND: Antibiotics have profound and lasting effects on the lower intestinal (gut) microbiome that can both promote resistance and increase susceptibility to colonization and infection; knowledge of these changes is important to the prevention and treatment of traveler's diarrhea. METHODS: Recent data from epidemiologic and modern metagenomics studies were reviewed in regard to how such findings could inform the prevention and treatment of traveler's diarrhea...
April 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28520953/evolving-insights-into-the-epidemiology-and-control-of-clostridium-difficile-in-hospitals
#7
Daniel A Caroff, Deborah S Yokoe, Michael Klompas
Typing studies suggest most cases of hospital-onset Clostridium difficile infection are unrelated to other cases of active disease in the hospital. New cases may instead be due to transmissions from asymptomatic carriers or progression of latent C.difficile present-on-admission to active infection. Direct exposure to antibiotics remains the primary risk factor for C.difficile infection but ward-level antibiotic use, antibiotic exposure of the prior room occupant, and C.difficile status of the prior room occupant increase risk for C...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28516109/serum-derived-bovine-immunoglobulin-as-novel-adjunct-in-complicated-clostridium-difficile-colitis-treatment
#8
Samson Ferm, Nims Varadi, Constantine Fisher, Ellen Gutkin
Clostridium difficile infection (CDI) is a well-known complication of antibiotic therapy. It is associated with significant morbidity, mortality, and cost in the hospital setting. The main symptoms include watery diarrhea, abdominal pain, and distension, but CDI can also present as toxic megacolon, bowel perforation with peritonitis, sepsis and renal failure. Therapy includes metronidazole and oral vancomycin, with rectal vancomycin and fecal transplant reserved for more complicated cases. Adjunctive treatments such as probiotics have been tried with mixed results...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28513974/fecal-microbiota-transplantation-outcomes-in-immunocompetent-and-immunocompromised-patients-a-single-center-experience
#9
Sally Alrabaa, Ripal Jariwala, Kristen Zeitler, Jose Montero
BACKGROUND: Clostridium difficile infection (CDI) is a major infectious disease focus for which fecal microbiota transplantation (FMT) has been used with success in various patient populations. METHODS: We conducted a retrospective study of FMT in immunocompetent and immunocompromised patients to review outcomes at our center, with a focus on identifying risk factors for FMT failure in solid organ transplant (SOT) patients. FMT was conducted using universal banked frozen stool via naso-duodenal tube in patients with recurrent CDI of 3 or more episodes per our institutional protocol...
May 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28512094/intrinsic-toxin-derived-peptides-destabilize-and-inactivate-clostridium-difficile-tcdb
#10
Jason L Larabee, Sarah J Bland, Jonathan J Hunt, Jimmy D Ballard
Clostridium difficile infection (CDI) is a major cause of hospital-associated, antibiotic-induced diarrhea, which is largely mediated by the production of two large multidomain clostridial toxins, TcdA and TcdB. Both toxins coordinate the action of specific domains to bind receptors, enter cells, and deliver a catalytic fragment into the cytosol. This results in GTPase inactivation, actin disassembly, and cytotoxicity. TcdB in particular has been shown to encode a region covering amino acids 1753 to 1851 that affects epitope exposure and cytotoxicity...
May 16, 2017: MBio
https://www.readbyqxmd.com/read/28511200/enteric-infection-in-relapse-of-inflammatory-bowel-disease-the-utility-of-stool-microbial-pcr-testing
#11
Jordan E Axelrad, Andrew Joelson, Yael R Nobel, Garrett Lawlor, Peter H R Green, Simon Lichtiger, Benjamin Lebwohl
BACKGROUND: The similar presentations in relapse of inflammatory bowel disease (IBD) and enteric infection pose substantial barriers to diagnosis and treatment. The objective of this study was to investigate the incidence, etiology, predictors, and treatment of enteric infection in patients with IBD. METHODS: We reviewed the records of 214 patients with IBD who underwent 295 gastrointestinal pathogen panel and Clostridium difficile infection (CDI) polymerase chain reaction (PCR) stool tests during an exacerbation of symptoms...
June 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28510584/identification-of-novel-risk-factors-for-community-acquired-clostridium-difficile-infection-using-spatial-statistics-and-geographic-information-system-analyses
#12
Deverick J Anderson, Leoncio Flavio Rojas, Shera Watson, Lauren P Knelson, Sohayla Pruitt, Sarah S Lewis, Rebekah W Moehring, Emily E Sickbert Bennett, David J Weber, Luke F Chen, Daniel J Sexton
BACKGROUND: The rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. As a result, risk factors for exposure to C. difficile in community settings have been inadequately studied. MAIN OBJECTIVE: To identify novel environmental risk factors for CA-CDI. METHODS: We performed a population-based retrospective cohort study of patients with CA-CDI from 1/1/2007 through 12/31/2014 in a 10-county area in central North Carolina...
2017: PloS One
https://www.readbyqxmd.com/read/28506317/changes-in-microbial-ecology-after-fecal-microbiota-transplantation-for-recurrent-c-difficile-infection-affected-by-underlying-inflammatory-bowel-disease
#13
Sahil Khanna, Yoshiki Vazquez-Baeza, Antonio González, Sophie Weiss, Bradley Schmidt, David A Muñiz-Pedrogo, John F Rainey, Patricia Kammer, Heidi Nelson, Michael Sadowsky, Alexander Khoruts, Stefan L Farrugia, Rob Knight, Darrell S Pardi, Purna C Kashyap
BACKGROUND: Gut microbiota play a key role in maintaining homeostasis in the human gut. Alterations in the gut microbial ecosystem predispose to Clostridium difficile infection (CDI) and gut inflammatory disorders such as inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) from a healthy donor can restore gut microbial diversity and pathogen colonization resistance; consequently, it is now being investigated for its ability to improve inflammatory gut conditions such as IBD...
May 15, 2017: Microbiome
https://www.readbyqxmd.com/read/28506071/fecal-microbiota-transplantation-in-recurrent-clostridium-difficile-infection-in-a-patient-with-concomitant-inflammatory-bowel-disease
#14
Marta Gravito-Soares, Elisa Gravito-Soares, Francisco Portela, Manuela Ferreira, Carlos Sofia
The use of fecal microbiota transplantation in recurrent Clostridium difficile infection and coexistent inflammatory bowel disease remains unclear. A 61-year-old man with ulcerative pancolitis was diagnosed with a third recurrence of Clostridium difficile infection, previously treated with metronidazole, vancomycin and fidaxomicin. Fecal microbiota transplantation of an unrelated healthy donor was performed by the lower route. After a twelve month follow-up, the patient remains asymptomatic without Clostridium difficile infection relapses or inflammatory bowel disease flare-ups...
May 16, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28506028/comparison-of-the-hospital-acquired-clostridium-difficile-infection-risk-of-using-proton-pump-inhibitors-versus-histamine-2-receptor-antagonists-for-prophylaxis-and-treatment-of-stress-ulcers-a-systematic-review-and-meta-analysis
#15
Mohamed Azab, Loomee Doo, Daniel H Doo, Yousif Elmofti, Muazer Ahmed, John Jay Cadavona, Xibei B Liu, Amaan Shafi, Moon Kyung Joo, Ji Won Yoo
Background/Aims: Although proton pump inhibitors (PPIs) have been widely used for the prevention and treatment of stress gastric ulcers in hospital settings, there are concerns that PPIs increase the risk of Clostridium difficile infection (CDI). However, little is known about the risk of CDI following PPI and histamine-2 receptor antagonist (H2RA) use. We evaluated the comparative hospital-acquired CDI occurrence risk associated with the concurrent use of PPIs versus H2RAs. Methods: A systematic search of PubMed, MEDLINE/ Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Google Scholar through August 19, 2016, identified 12 studies that reported the hospital-acquired CDI occurrence following H2RA and PPI use for the prevention and treatment of stress gastric ulcers...
May 17, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28501926/an-outbreak-of-clostridium-difficile-pcr-ribotype-027-in-spain-risk-factors-for-recurrence-and-a-novel-treatment-strategy
#16
E Bouza, L Alcalá, M Marín, M Valerio, E Reigadas, P Muñoz, M González-Del Vecchio, V de Egea
An outbreak of Clostridium difficile infection (CDI) caused by ribotype 027 (B1/NAP1) began in our hospital in November 2014, and produced 141 episodes in the following months. The aim of this study is to describe this outbreak, assess risk factors for recurrence of CDI-027 and to analyze the implementation of a novel treatment strategy. This is a prospective study of all patients with CDI-027, from November 2014 to November 2015. The epidemiological data were collected daily for each patient. We compared clinical characteristics and treatment between patients with and without recurrence of CDI-027...
May 13, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28501554/molecular-typing-of-clostridium-difficile-isolates-cultured-from-patient-stool-samples-and-gastroenterological-medical-devices-in-a-single-iranian-hospital
#17
Masoumeh Azimirad, Marcela Krutova, Otakar Nyc, Zahra Hasani, Leili Afrisham, Masoud Alebouyeh, Mohammad Reza Zali
This study aimed to characterize Clostridium difficile isolates cultured from stool samples of patients with C. difficile infection (CDI) and swabs from a medical environment in a gastroenterology centre in Tehran, Iran. A total of 158 samples (105 stool samples from hospitalized patients and 53 swabs from medical devices and the environment) were collected from January 2011 to August 2011 and investigated for the presence of C. difficile by direct anaerobic culture on a selective media for C. difficile. C...
May 10, 2017: Anaerobe
https://www.readbyqxmd.com/read/28498996/protective-factors-in-the-intestinal-microbiome-against-clostridium-difficile-infection-in-recipients-of-allogeneic-hematopoietic-stem-cell-transplantation
#18
Yeon Joo Lee, Esther S Arguello, Robert R Jenq, Eric Littmann, Grace J Kim, Liza C Miller, Lilan Ling, Cesar Figueroa, Elizabeth Robilotti, Miguel-Angel Perales, Juliet N Barker, Sergio Giralt, Marcel R M van den Brink, Eric G Pamer, Ying Taur
Background: Clostridium difficile infection (CDI) is a frequent complication in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT), who receive intensive treatments that significantly disrupt the intestinal microbiota. In this study, we examined the microbiota composition of allo-HSCT recipients to identify bacterial colonizers that confer protection against CDI after engraftment. Methods: Feces collected from adult recipients allo-HSCT at engraftment were analyzed; 16S ribosomal RNA genes were sequenced and analyzed from each sample...
April 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28497295/assessing-the-risk-and-disease-burden-of-clostridium-difficile-infection-among-patients-with-hospital-acquired-pneumonia-at-a-university-hospital-in-central-china
#19
Chunhui Li, Juping Duan, Sidi Liu, Xiujuan Meng, Chenchao Fu, Cui Zeng, Anhua Wu
PURPOSE: Hospital-acquired pneumonia (HAP) remains one of the major hospital-acquired infections in China. Antibiotic treatment of HAP may lead to subsequent Clostridium difficile infection (CDI). Baseline data on the occurrence of CDI among HAP patients in China are currently unavailable. This study examines the risk and disease burden of CDI among HAP hospitalized patients (HAP-CDI). METHODS: We conducted a prospective study among ICU patients with HAP and hospital-onset diarrhea from January 2014 to December 2014 in a teaching hospital in China...
May 11, 2017: Infection
https://www.readbyqxmd.com/read/28497217/inhibition-of-clostridium-difficile-in-mice-using-a-mixture-of-potential-probiotic-strains-enterococcus-faecalis-nm815-e-faecalis-nm915-and-e-faecium-nm1015-novel-candidates-to-control-c-difficile-infection-cdi
#20
Nahla M Mansour, Walid F Elkhatib, Khaled M Aboshanab, May M A Bahr
This study is aimed at the isolation, identification, and characterization of potential probiotic strains capable of inhibiting Clostridium difficile in vitro and in vivo. Twenty isolates were isolated from infant fecal samples and screened against C. difficile using their cell-free supernatant. Only three isolates showed maximum inhibition from 56.05 to 60.60%, thus they were characterized for probiotic properties and safety. The results obtained approved their tolerance to the gastrointestinal tract conditions and safety profile...
May 11, 2017: Probiotics and Antimicrobial Proteins
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