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Clostridium difficile infections

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https://www.readbyqxmd.com/read/28927251/fecal-microbiota-transplantation-past-present-and-future-perspectives
#1
Stefano Bibbò, Gianluca Ianiro, Antonio Gasbarrini, Giovanni Cammarota
Gut microbiota is known to play a main role in regulating both health and disease in humans. Strategies for the therapeutic modulation of gut microbiota are therefore expected to give a relevant contribution in the management of disorders associated with its impairment. Among these options, one of the most renowned is fecal microbiota transplantation (FMT). A growing body of evidence showed clearly that FMT is an effective treatment against recurrent Clostridium difficile infection. Moreover, it was shown to be a promising therapy for the management of several noncommunicable disorders, including inflammatory bowel diseases and metabolic disorders...
December 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28927227/enteric-microbiome-profiles-during-a-randomized-phase-2-clinical-trial-of-surotomycin-versus-vancomycin-for-the-treatment-of-clostridium-difficile-infection
#2
Kristine Cannon, Brendan Byrne, Jennifer Happe, Kaiyu Wu, Linda Ward, Laurent Chesnel, Thomas Louie
Objectives: The effects of surotomycin (CB-183,315, MK-4261), a bactericidal cyclic lipopeptide, and vancomycin, the current standard-of-care for Clostridium difficile infection (CDI), on intestinal pathogens and microbiota were evaluated parallel to a Phase 2 randomized, double-blind clinical trial. Methods: The single-centre cohort included 26 patients receiving surotomycin [125 or 250 mg twice daily ( n  =   9 each)] or oral vancomycin [125 mg four times daily ( n  =   8)] for 10 days...
September 12, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28923757/clinical-practice-and-infrastructure-review-of-fecal-microbiota-transplantation-for-clostridium-difficile-infection
#3
REVIEW
Brendan J Kelly, Pablo Tebas
A significant proportion of C. difficile infection (CDI) cases recur after completion of antibiotic therapy, and antibiotic cure rates diminish with each recurrence of CDI. Fecal microbiota transplantation (FMT) is an effective therapy for recurrent FMT, which otherwise requires prolonged or indefinite antibiotic treatment. FMT is performed by introducing the fecal microbial community obtained from a healthy donor or pool of donors into the stomach, small intestine, or colon of a patient with CDI. Multiple clinical trials support the utility of FMT in treating recurrent CDI, and CDI treatment guidelines now include consideration of FMT at the third CDI recurrence...
September 15, 2017: Chest
https://www.readbyqxmd.com/read/28914275/national-trends-2007-2013-of-clostridium-difficile-infection-in-patients-with-septic-shock-impact-on-outcome
#4
Kshitij Chatterjee, Abhinav Goyal, Aditya Chada, Krishna Siva Kakkera, Howard L Corwin
BACKGROUND: Clostridium difficile is the most common infectious cause of healthcare-associated diarrhea and is associated with worse outcomes and higher cost. Patients with septic shock (SS) are at increased risk of acquiring C. difficile infections (CDIs) during hospitalization, but little data are available on CDI complicating SS. OBJECTIVE: Prevalence of CDI in SS between 2007-2013 and impact of CDI on outcomes in SS. METHODS: Outcomes were prevalence of CDI in SS, effect on mortality, length of stay (LOS), and 30-day readmission...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28903802/can-national-healthcare-associated-infections-hais-data-differentiate-hospitals-in-the-united-states
#5
Max Masnick, Daniel J Morgan, John D Sorkin, Mark D Macek, Jessica P Brown, Penny Rheingans, Anthony D Harris
OBJECTIVE To determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. DESIGN Secondary analysis of publicly available HAI data for calendar year 2013. METHODS We assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals...
October 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28902923/molecular-microbiological-and-clinical-characterization-of-clostridium-difficile-isolates-from-tertiary-care-hospitals-in-colombia
#6
Clara Lina Salazar, Catalina Reyes, Santiago Atehortua, Patricia Sierra, Margarita María Correa, Daniel Paredes-Sabja, Emma Best, Warren N Fawley, Mark Wilcox, Ángel González
In Colombia, the epidemiology and circulating genotypes of Clostridium difficile have not yet been described. Therefore, we molecularly characterized clinical isolates of C.difficile from patients with suspicion of C.difficile infection (CDI) in three tertiary care hospitals. C.difficile was isolated from stool samples by culture, the presence of A/B toxins were detected by enzyme immunoassay, cytotoxicity was tested by cell culture and the antimicrobial susceptibility determined. After DNA extraction, tcdA, tcdB and binary toxin (CDTa/CDTb) genes were detected by PCR, and PCR-ribotyping performed...
2017: PloS One
https://www.readbyqxmd.com/read/28899610/nosocomial-acquired-and-community-onset-clostridium-difficile-infection-at-an-academic-hospital-in-italy-epidemiology-recurrences-and-toxin-genes-distribution
#7
Valeria Visconti, Grazia Brunetti, Maria Rosaria Cuomo, Alessandra Giordano, Giammarco Raponi
Toxinogenic Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea. In this retrospective cohort study the molecular epidemiology of hospital-acquired and community-associated CDI was investigated in patients admitted to a tertiary care hospital. CD in stools samples was revealed by a two steps diagnostic algorithm, firstly screening for positivity to GDH antigen and thereafter RT-PCR analysis. Increased CDI incidence was observed ranging from 1.70episodes/10000patient-days in the 1st year, to 2...
September 9, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28899372/the-combination-of-recombinant-and-non-recombinant-bacillus-subtilis-spore-display-technology-for-presentation-of-antigen-and-adjuvant-on-single-spore
#8
Wojciech Potocki, Alessandro Negri, Grażyna Peszyńska-Sularz, Krzysztof Hinc, Michał Obuchowski, Adam Iwanicki
BACKGROUND: Bacillus subtilis spores can be used for presentation of heterologous proteins. Two main approaches have been developed, the recombinant one, requiring modification of bacterial genome to express a protein of interest as a fusion with spore-coat protein, and non-recombinant, based on the adsorption of a heterologous protein onto the spore. So far only single proteins have been displayed on the spore surface. RESULTS: We have used a combined approach to adsorb and display FliD protein of Clostridium difficile on the surface of recombinant IL-2-presenting spores...
September 12, 2017: Microbial Cell Factories
https://www.readbyqxmd.com/read/28894766/potentially-preventable-hospitalizations-and-the-burden-of-healthcare-associated-infections
#9
Andrea L Lorden, Luohua Jiang, Tiffany A Radcliff, Kathleen A Kelly, Robert L Ohsfeldt
BACKGROUND: An estimated 4% of hospital admissions acquired healthcare-associated infections (HAIs) and accounted for $9.8 (USD) billion in direct cost during 2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable hospitalizations (PPHs) may have acquired an HAI. There is a knowledge gap regarding the co-occurrence of these events. AIMS: To estimate the period occurrences and likelihood of acquiring an HAI for the PPH population. METHODS: Retrospective, cross-sectional study using logistic regression analysis of 2011 Texas Inpatient Discharge Public Use Data File including 2...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28893366/fidaxomicin-reduces-early-toxin-a-and-b-production-and-sporulation-in-clostridium-difficilein-vitro
#10
Michael J Aldape, Aaron E Packham, Dustin D Heeney, Savannah N Rice, Amy E Bryant, Dennis L Stevens
PURPOSE: Fidaxomicin, a macrocyclic antibiotic, has been approved for the treatment of Clostridium difficile infection (CDI). Previous work by our group has demonstrated that some antibiotics at sub-inhibitory concentrations stimulate early toxin production and sporulation by C. difficile. Prior studies revealed that fidaxomicin, when added to late stationary-phase organisms, reduced exotoxin production and spore formation by C. difficile. However, the ability of fidaxomicin to trigger early virulence factor production and spore formation has never been investigated...
September 12, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28891459/prevalence-of-clostridium-difficile-infection-and-colonization-in-a-tertiary-hospital-and-elderly-community-of-north-eastern-peninsular-malaysia
#11
N H Zainul, Z F Ma, A Besari, H Siti Asma, R A Rahman, D A Collins, N Hamid, T V Riley, Y Y Lee
Little is known about Clostridium difficile infection (CDI) in Asia. The aims of our study were to explore (i) the prevalence, risk factors and molecular epidemiology of CDI and colonization in a tertiary academic hospital in North-Eastern Peninsular Malaysia; (ii) the rate of carriage of C. difficile among the elderly in the region; (iii) the awareness level of this infection among the hospital staffs and students. For stool samples collected from hospital inpatients with diarrhea (n = 76) and healthy community members (n = 138), C...
September 11, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28890287/assessing-the-burden-of-clostridium-difficile-infections-for-hospitals
#12
Elise Hebbinckuys, Jean-Pierre Marissal, Cristian Preda, Valérie Leclercq
BACKGROUND: Nosocomial infections place a heavy burden on the healthcare system. However, quantifying the burden raises many questions, ranging from the way to accurately estimate the extra length of stay at hospital to defining and costing the preventative methods among the different care providers. METHOD: We used multi state modeling based on Markov processes and bootstraping to derive individual estimates of the prolongation of stay at hospital associated with Clostridium difficile infection (CDI)...
September 7, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28885907/antibiotic-stewardship-why-we-must-how-we-can
#13
REVIEW
Arjun Srinivasan
Improving our antibiotic use is critical to the safety of our patients and the future of medicine. This can improve patient outcomes, save money, reduce resistance, and help prevent negative consequences such as Clostridium difficile infection. The US Centers for Disease Control and Prevention (CDC) is undertaking a nationwide effort to appropriately improve antibiotic use in inpatient and outpatient settings.
September 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28882627/selection-and-characterization-of-dna-aptamers-for-detection-of-glutamate-dehydrogenase-from-clostridium-difficile
#14
Meng Liu, Qingxin Yin, John D Brennan, Yingfu Li
Rapid and accurate diagnosis of Clostridium difficile infections (CDI) is crucial for patient treatment, infection control and epidemiological monitoring. As an important antigen, glutamate dehydrogenase (GDH) has been proposed as a preliminary screening test target for CDI. However, current assays based on GDH activity or GDH immunoassays have suboptimal sensitivity and specificity. Herein, we described the selection and characterization of single-stranded DNA aptamers that specifically targeted GDH. After 10 rounds of selection, high-throughput sequencing was used to identify enriched aptamer candidates...
September 4, 2017: Biochimie
https://www.readbyqxmd.com/read/28882583/clinical-and-epidemiological-characteristics-in-hospitalized-young-children-with-acute-gastroenteritis-in-southern-taiwan-according-to-major-pathogens
#15
Ning Chung, Shih-Min Wang, Ching-Fen Shen, Fu-Chun Kuo, Tzong-Shiann Ho, Chao Agnes Hsiung, Jung-Jung Mu, Fang-Tzy Wu, Li-Min Huang, Yi-Chuan Huang, Yhu-Chering Huang, Hsin Chi, Hsiao-Chuan Lin, Ching-Chuan Liu
BACKGROUND: Acute gastroenteritis (AGE) can be caused by a wide array of pathogens, including bacteria, viruses, and parasites. A prospective study to investigate the epidemiology and clinical presentation in young children hospitalized with AGE was conducted in a medical center in southern Taiwan. METHODS: Patients aged less than 5 years who was hospitalized due to AGE in National Cheng Kung University Hospital were enrolled from July 2014 to June 2016. The demographic information, clinical features and laboratory data were collected by chart reviews, and stool samples were sent to Centers of Disease Control, Taiwan (Taiwan CDC) for a panel of pathogen identification consisting of two viruses, nine bacteria, and five parasites...
August 31, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28882017/utility-of-rapid-microbiological-techniques-for-the-diagnosis-of-severe-infections
#16
REVIEW
E Cercenado
Rapid diagnostic microbiological techniques and antimicrobial susceptibility testing are necessary for early and adequate treatment. The utility of old (Gram stain, antigen detection, direct antimicrobial susceptibility testing, chromogenic media) and new techniques (molecular assays, MALDI-TOF) is summarized for the rapid diagnosis of bacteraemia and fungaemia, catheter-related bloodstream infections, pneumonia, meningitis, skin and soft-tissue infections, urinary tract infection, Clostridium difficile infection, viral infections, and tuberculosis...
September 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28878013/new-class-of-precision-antimicrobials-redefines-role-of-clostridium-difficile-s-layer-in-virulence-and-viability
#17
Joseph A Kirk, Dana Gebhart, Anthony M Buckley, Stephen Lok, Dean Scholl, Gillian R Douce, Gregory R Govoni, Robert P Fagan
There is a medical need for antibacterial agents that do not damage the resident gut microbiota or promote the spread of antibiotic resistance. We recently described a prototypic precision bactericidal agent, Av-CD291.2, which selectively kills specific Clostridium difficile strains and prevents them from colonizing mice. We have since selected two Av-CD291.2-resistant mutants that have a surface (S)-layer-null phenotype due to distinct point mutations in the slpA gene. Using newly identified bacteriophage receptor binding proteins for targeting, we constructed a panel of Avidocin-CDs that kills diverse C...
September 6, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28875314/a-systematic-literature-review-of-economic-evaluations-of-antibiotic-treatments-for-clostridium-difficile-infection
#18
REVIEW
Hannah E Burton, Stephen A Mitchell, Maureen Watt
BACKGROUND AND OBJECTIVE: Clostridium difficile infection (CDI) is associated with high management costs, particularly in recurrent cases. Fidaxomicin treatment results in lower recurrence rates than vancomycin and metronidazole, but has higher acquisition costs in Europe and the USA. This systematic literature review summarises economic evaluations (EEs) of fidaxomicin, vancomycin and metronidazole for treatment of CDI. METHODS: Electronic databases (MEDLINE(®), Embase, Cochrane Library) and conference proceedings (ISPOR, ECCMID, ICAAC and IDWeek) were searched for publications reporting EEs of fidaxomicin, vancomycin and/or metronidazole in the treatment of CDI...
September 5, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28874882/glucosyltransferase-activity-of-clostridium-difficile-toxin-b-triggers-autophagy-mediated-cell-growth-arrest
#19
Ruina He, Jingyu Peng, Pengfei Yuan, Junjiao Yang, Xiaoji Wu, Yinan Wang, Wensheng Wei
Autophagy is a bulk cell-degradation process that occurs through the lysosomal machinery, and many reports have shown that it participates in microbial pathogenicity. However, the role of autophagy in Clostridium difficile infection (CDI), the leading cause of antibiotics-associated diarrhea, pseudomembranous colitis and even death in severe cases, is not clear. Here we report that the major virulent factor toxin B (TcdB) of Clostridium difficile elicits a strong autophagy response in host cells through its glucosyltransferase activity...
September 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28874406/revisiting-the-role-of-csp-family-proteins-in-regulating-clostridium-difficile-spore-germination
#20
Yuzo Kevorkian, Aimee Shen
Clostridium difficile causes considerable healthcare-associated gastrointestinal disease that is transmitted by its metabolically dormant spore form. Upon entering the gut, C. difficile spores germinate and outgrow to produce vegetative cells that release disease-causing toxins. C. difficile spore germination depends on the Csp family of (pseudo)proteases and the cortex hydrolase, SleC. The CspC pseudoprotease functions as a bile salt germinant receptor that activates the protease CspB, which in turn proteolytically activates SleC zymogen...
September 5, 2017: Journal of Bacteriology
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