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Clostridium difficile infections

L Clifford McDonald, Dale N Gerding, Stuart Johnson, Johan S Bakken, Karen C Carroll, Susan E Coffin, Erik R Dubberke, Kevin W Garey, Carolyn V Gould, Ciaran Kelly, Vivian Loo, Julia Shaklee Sammons, Thomas J Sandora, Mark H Wilcox
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis...
March 19, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Raseen Tariq, Dhruvika Mukhija, Arjun Gupta, Siddharth Singh, Darrell S Pardi, Sahil Khanna
Purpose: Statins have pleiotropic effects beyond cholesterol lowering by immune modulation. The association of statins with primary Clostridium difficile infection (CDI) is unclear as studies have reported conflicting findings. We performed a systematic review and meta-analysis to evaluate the association between statin use and CDI. Patients and methods: We searched MEDLINE, Embase, and Web of Science from January 1978 to December 2016 for studies assessing the association between statin use and CDI...
2018: Infection and Drug Resistance
Hajime Kanamori, David J Weber, Maria F Gergen, Lauren M DiBiase, Emily E Sickbert-Bennett, William A Rutala
BACKGROUND: Single outbreaks have often been reported in health care settings, but the frequency of outbreaks at a hospital over time has not been described. We examined epidemiologic features of all health care-associated outbreak investigations at an academic hospital during a 5-year period. METHODS: Health care-associated outbreak investigations at an academic hospital (2012-2016) were retrospectively reviewed through data on comprehensive hospital-wide surveillance and pulsed-field gel electrophoresis (PFGE) analysis...
March 16, 2018: American Journal of Infection Control
Ruihong Luo, Janice M Weinberg, Tamar F Barlam
OBJECTIVE Clostridium difficile infection (CDI) is common in solid organ transplant (SOT) recipients, but few studies have examined long-term outcomes. We studied the impact of CDI after SOT on mortality and transplant organ complication-related hospitalizations (TOH). METHODS SOT recipients ≥18 years of age with at least 1 year of posttransplant data were analyzed using the MarketScan database for 2007-2014. Patients who died within one year of transplant were followed until death. Patients were grouped as early CDI (ie, first occurrence ≤90 days posttransplant), late CDI (ie, first occurrence >90 days posttransplant) and controls (ie, no CDI occurrence during follow-up)...
March 19, 2018: Infection Control and Hospital Epidemiology
Sara L Revolinski, L Silvia Munoz-Price
New studies have been published regarding the epidemiology of Clostridium difficile in topics such as asymptomatic C. difficile colonization, community-associated C. difficile infection, environmental contamination outside healthcare settings, animal colonization, and the interactions between C. difficile and the gut microbiome. In addition to summarizing these findings, this review offers a perspective on the potential impact of high-throughput sequencing and other potential techniques on the prevention of C...
March 19, 2018: Infection Control and Hospital Epidemiology
Kathleen A Quan, Jennifer Yim, Doug Merrill, Usme Khusbu, Keith Madey, Linda Dickey, Amish A Dangodara, Scott E Rudkin, Margaret O'Brien, Daniel Thompson, Nimisha Parekh, C Gregory Albers, William C Wilson, Lauri Thrupp, Cassiana E Bittencourt, Susan S Huang, Shruti K Gohil
No abstract text is available yet for this article.
March 19, 2018: Infection Control and Hospital Epidemiology
Kordo Saeed, Christina Petridou, Hazel Gray, Matthew Dryden, Karen Davis-Blues, Sheryl Lucero, Natalie Parker, Taryn Keyser, Tanya Matthews, Nick Cortes, Stephen Kidd, Claire Thomas, Heather Peacock, Joanna Hornzee, Bruce Wake
Background: In Hampshire Hospitals NHS Foundation Trust, in addition to an on-the-spot investigation into hospital-onset Clostridium difficile infection (CDI) by the infection prevention team, a multidisciplinary team root cause analysis (MDT-RCA) forum has been developed. The MDT-RCA aims to deliver a more thorough investigation into individual cases and the recommendation of cases to the clinical commissioning groups (CCG) appeals panel against potential financial penalties (£10,000 per breached case)...
March 2018: Journal of Infection Prevention
Jennie Wilson
No abstract text is available yet for this article.
March 2018: Journal of Infection Prevention
Marc Philip Pimentel, Michael Klompas, Allen Kachalia
No abstract text is available yet for this article.
March 16, 2018: BMJ Quality & Safety
Grzegorz Ziółkowski, Iwona Pawłowska, Lech Krawczyk, Jadwiga Wojkowska-Mach
BACKGROUND: Acinetobacter baumannii strains are currently the most commonly isolated non-fermenting rods at Polish intensive care units (ICUs), and they are the dominant aetiological agents of pneumonia. This study aimed to evaluate the prevalence of A. baumannii isolated from patients who were hospitalised at Sosnowiec Hospital's ICU. We also investigated the drug sensitivity of A. baumannii in relation to antibiotic consumption expressed as the defined daily dose (DDD) and Clostridium difficile infection (CDI)...
March 13, 2018: Journal of Infection and Public Health
Francesca Micoli, Paolo Costantino, Roberto Adamo
Cell surface carbohydrates have been proven optimal targets for vaccine development. Conjugation of polysaccharides to a carrier protein triggers a T-cell dependent immune response to the glycan moiety. Licensed glycoconjugate vaccines are produced by chemical conjugation of capsular polysaccharides to prevent meningitis caused by meningococcus, pneumococcus and Haemophilus influenzae type b. However, other classes of carbohydrates (O-antigens, exopolysaccharides, wall/teichoic acids) represent attractive targets for developing vaccines...
March 14, 2018: FEMS Microbiology Reviews
Monique J T Crobach, Jonathan J Vernon, Vivian G Loo, Ling Yuan Kong, Séverine Péchiné, Mark H Wilcox, Ed J Kuijper
Clostridium difficile is the main causative agent of antibiotic-associated and health care-associated infective diarrhea. Recently, there has been growing interest in alternative sources of C. difficile other than patients with Clostridium difficile infection (CDI) and the hospital environment. Notably, the role of C. difficile -colonized patients as a possible source of transmission has received attention. In this review, we present a comprehensive overview of the current understanding of C. difficile colonization...
April 2018: Clinical Microbiology Reviews
A von Braun, C Lübbert
The incidence of clostridium difficile infections (CDI) remains on a high level globally. In Germany, the number of severe or even lethal cases continues to increase. The main risk factor for the development of CDI is exposure to broad spectrum antibiotics, which disturb the physiological microbiome and therefore enable colonization with C. difficile. According to the updated US and European guidelines, orally administered vancomycin is the treatment of choice. Fidaxomicin is as effective as vancomycin but has the advantage of a lower rate of recurrence...
March 13, 2018: Der Internist
Isobel Ramsay, Nicholas M Brown, David A Enoch
Recurrence occurs in approximately 25% of all cases of Clostridium difficile infection (CDI) and poses a unique clinical challenge. Traditionally, treatment options of CDI have been limited to regimes of established antibiotics (eg, pulsed/tapered vancomycin) but faecal transplantation is emerging as a useful alternative. In recent years, promising new strategies have emerged for effective prevention of recurrent CDI (rCDI) including new antimicrobials (eg, fidaxomicin) and monoclonal antibodies (eg, bezlotoxumab)...
2018: Infectious Diseases
C Diamond, T McNeilly
Clostridium Difficile represents one of the major challenges of the antimicrobial era with associated significant morbidity. Treatment options are limited to a number of specific antibiotics with significant failure rates. Faecal Microbiota Transplantation has been recognised as a possible treatment option when standard therapy fails. We report a local case of Clostridium Difficile Infection ultimately requiring Faecal Microbiota Transplantation with good success. While no formal service providing the treatment is available within Northern Ireland it is a feasible treatment option for Clostridium Difficile Infection...
May 2017: Ulster Medical Journal
Brunella Posteraro, Federico Pea, Luca Masucci, Patrizia Posteraro, Maurizio Sanguinetti
Clostridium difficile infection (CDI) is the most common healthcare-associated infection worldwide. As standard CDI antibiotic therapies can result in unacceptably high recurrence rates, novel therapeutic strategies for CDI are necessary. A recently emerged immunological therapy is a monoclonal antibody against C. difficile toxin B. Areas covered: In this review, the authors summarize the available pharmacological, preclinical, and clinical data for the CDI treatment based on anti-toxin A (actoxumab) and anti-toxin B (bezlotoxumab) human monoclonal antibodies (HuMabs), and discuss about the potentiality of a therapy that includes HuMab combined administration for CDI...
March 15, 2018: Expert Opinion on Biological Therapy
Natalia Blanco, Seth Walk, Anurag N Malani, Alexander Rickard, Michele Benn, Marisa Eisenberg, Min Zhang, Betsy Foxman
PURPOSE: This study aimed to describe the correlation between Clostridium difficile spore and toxin levels within the human host. In addition, we assessed whether overgrowth of Candida albicans modified this association. METHODOLOGY: We measured toxin, spore and Candida albicans levels among 200 successively collected stool samples that tested positive for C. difficile, and PCR ribotyped these C. difficile isolates. Analysis of variance and linear regression were used to test the association between spore and toxin levels...
March 13, 2018: Journal of Medical Microbiology
Joseph P Zackular, Eric P Skaar
Clostridium difficile in one of the most commonly reported nosocomial pathogens worldwide. Beyond antibiotic use, little is known about the host, microbiota, and environmental factors that contribute to susceptibility to and severity of C. difficile infection (CDI). We recently observed that in a mouse model of CDI, excess dietary zinc (Zn) alters the gut microbiota and decreases resistance to CDI. Moreover, we determined that high levels of Zn exacerbate C. difficile-associated disease and calprotectin-mediated Zn limitation is an essential host response to infection...
March 13, 2018: Gut Microbes
Ryan M Carnahan, Jennifer L Kuntz, Shirley V Wang, Candace Fuller, Joshua J Gagne, Charles E Leonard, Sean Hennessy, Tamra Meyer, Patrick Archdeacon, Chih-Ying Chen, Catherine A Panozzo, Sengwee Toh, Hannah Katcoff, Tiffany Woodworth, Aarthi Iyer, Sophia Axtman, Elizabeth A Chrischilles
PURPOSE: The Food and Drug Administration's Sentinel System developed parameterized, reusable analytic programs for evaluation of medical product safety. Research on outpatient antibiotic exposures, and Clostridium difficile infection (CDI) with non-user reference groups led us to expect a higher rate of CDI among outpatient clindamycin users vs penicillin users. We evaluated the ability of the Cohort Identification and Descriptive Analysis and Propensity Score Matching tools to identify a higher rate of CDI among clindamycin users...
March 13, 2018: Pharmacoepidemiology and Drug Safety
Reuban Toby D'cruz, Cheryl Chien-Li Lau, Thomas Paulraj Thamboo
Cytomegalovirus (CMV) typically causes gastrointestinal infections in immunocompetent patients. Colonic perforations secondary to CMV are exceeding rare. We describe a 88-year-old male presenting with a week-long history of intractable abdominal discomfort, bloating, nausea and diarrhea. Flexible sigmoidoscopy revealed significant ulceration with yellowish slough. Emergency surgery was performed subsequently in view of multiple perforations in the rectosigmoid junction. CMV gastrointestinal infections demonstrated an ischemic process secondary to vasculitis, which accelerated the pathway to colonic perforation...
March 12, 2018: Archives of Virology
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