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Clostridium Difficile Toxin

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https://www.readbyqxmd.com/read/28642147/the-role-of-tigecycline-in-the-management-of-clostridium-difficile-infection-a-retrospective-cohort-study
#1
Eliza Manea, Jesús Sojo-Dorado, Raluca E Jipa, Serban N Benea, Jesús Rodríguez-Baño, Adriana Hristea
OBJECTIVE: We aimed to compare the outcomes of patients with C.difficile infection (CDI) treated either with tigecycline associated with vancomycin, or with vancomycin alone. METHODS: This single-centre retrospective cohort study included all adults hospitalized from September 2014 through August 2015 for symptomatic, incident CDI confirmed by polymerase chain reaction for C.difficile toxin in stools. The primary outcome was the rate of favourable outcome, defined as a composite of clinical response (resolution of symptoms without need for additional CDI therapy) and achieving discharge without CDI-related surgery or intensive care; a secondary outcome was CDI recurrence...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28641091/increasing-rates-of-clostridium-difficile-infection-in-mexican-hospitals
#2
Laura Palau Dávila, Elvira Garza-González, Patricia Rodríguez-Zulueta, Rayo Morfín-Otero, Eduardo Rodríguez-Noriega, Diana Villar-Compte, Juan C Rodríguez-Aldama, Adrián Camacho-Ortiz
INTRODUCTION: The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world. METHODS: This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis...
June 19, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28636484/bezlotoxumab-anti-toxin-b-monoclonal-antibody-to-prevent-recurrence-of-clostridium-difficile-infection
#3
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/28636257/covalent-attachment-and-pro-pro-endopeptidase-ppep-1-mediated-release-of-clostridium-difficile-cell-surface-proteins-involved-in-adhesion
#4
REVIEW
Jeroen Corver, Valentina Cordo', Hans C van Leeuwen, Oleg I Klychnikov, Paul J Hensbergen
In the past decade, Clostridium difficile has emerged as an important gut pathogen. This anaerobic, Gram-positive bacterium is the main cause of infectious nosocomial diarrhea. Whereas much is known about the mechanism through which the C. difficile toxins cause diarrhea, relatively little is known about the dynamics of adhesion and motility, which is mediated by cell surface proteins. This review will discuss the recent advances in our understanding of the sortase-mediated covalent attachment of cell surface (adhesion) proteins to the peptidoglycan layer of C...
June 21, 2017: Molecular Microbiology
https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#5
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
#6
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/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/28619474/high-metabolic-versatility-of-different-toxigenic-and-non-toxigenic-clostridioides-difficile-isolates
#8
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/28615471/clostridium-difficile-pcr-cycle-threshold-predicts-free-toxin
#9
Fiona Senchyna, Rajiv L Gaur, Saurabh Gombar, Cynthia Y Truong, Lee F Schroeder, Niaz Banaei
Background. There is no stand-alone Clostridium difficile diagnostic that can sensitively and rapidly detect fecal free toxins. We investigated the performance of C. difficile PCR cycle threshold (CT) for predicting free toxin status.Method. Consecutive stool samples (n=312) positive for toxigenic C. difficile with the GeneXpert C.diff Epi tcdB PCR assay were tested with the rapid membrane C. DIFF QUIK CHEK COMPLETE immunoassay (RMEIA). RMEIA toxin-negative samples were tested with the cell cytotoxicity neutralization assay (CCNA) and tgcBIOMICS ELISA...
June 14, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28607468/clostridium-difficile-flagella-induce-a-pro-inflammatory-response-in-intestinal-epithelium-of-mice-in-cooperation-with-toxins
#10
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/28603640/prevalence-and-molecular-epidemiology-of-clostridium-difficile-infection-in-indonesia
#11
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
https://www.readbyqxmd.com/read/28596022/dipping-into-the-clostridium-difficile-pool-are-alcohol-based-dispensers-fomites-for-c-difficile
#12
James A Hall, Ryan R Keul, Justin D Shanks, Robert Fader, Jon D Herrington
The purpose of this study was to evaluate alcohol-based dispensers as potential fomites for Clostridium difficile. A convenience sample of 120 alcohol-based dispensers was evaluated for the presence of C difficile either by culture or polymerase chain reaction for C difficile toxin. The results demonstrated that C difficile was not cultured, and C difficile toxin was not detected using polymerase chain reaction; however, gram-positive rods, Clostridium perfringens, Pantoea agglomerans, coagulase-negative Staphylococcus, Peptostreptococcus, Bacillus spp, and microaerophilic Streptococcus were present within the overflow basins of the alcohol-based dispensers...
June 5, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28592627/cytokines-are-markers-of-the-clostridium-difficile-induced-inflammatory-response-and-predict-disease-severity
#13
Hua Yu, Kevin Chen, Ying Sun, Mihaela Carter, Kevin W Garey, Tor C Savidge, Sridevi Devaraj, Mary Elizabeth Tessier, Erik C von Rosenvinge, Ciaran P Kelly, Marcela F Pasetti, Hanping Feng
The host immune response affects pathogen virulence in Clostridium difficile infection (CDI). Thus, cytokine responses to CDI are likely associated with disease initiation and progression. Understanding the molecular drivers of inflammation and biochemical markers of disease severity are important for developing novel therapies and predicting the disease prognosis. In this study, we investigated cytokine production in patients with CDI and evaluated the potential of cytokines to serve as biomarkers for CDI and predictors of disease severity...
June 7, 2017: Clinical and Vaccine Immunology: CVI
https://www.readbyqxmd.com/read/28589214/-individualized-treatment-strategies-for-clostridium-difficile-infections
#14
REVIEW
P Solbach, P Dersch, O Bachmann
Upon hospitalization, up to 15.5% of patients are already colonized with a toxigenic Clostridium difficile strain (TCD). The rate of asymptomatic colonization is 0-3% in healthy adults and up to 20-40% in hospitalized patients. The incidence and mortality of C. difficile infection (CDI) has significantly increased during recent years. Mortality lies between 3 and 14%. CDI is generally caused by intestinal dysbiosis, which can be triggered by various factors, including antibiotics or immune suppressants. If CDI occurs, ongoing antibiotic therapy should be discontinued...
June 6, 2017: Der Internist
https://www.readbyqxmd.com/read/28583353/the-recognition-and-characterisation-of-finnish-clostridium-difficile-isolates-resembling-pcr-ribotype-027
#15
Marcela Krutova, Otakar Nyc, Jana Matejkova, Ed J Kuijper, Jari Jalava, Silja Mentula
PURPOSE: To characterise and compare twenty-eight Finnish Clostridiumdifficile RT027-like isolates, selected based on the presence of 18 bp deletion in the tcdC gene and toxin gene profile (A, B, binary), with eleven RT027 isolates from different Finnish geographical areas and time periods. METHODS: Twenty-eight C. difficile RT027-like isolates and 11 RT027 comparative strains were characterised by capillary-electrophoresis (CE) ribotyping, multi-locus variable tandem-repeats analysis (MLVA), multi-locus sequence typing (MLST), and sequencing of tcdC and gyrA gene fragments...
May 24, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28580925/crystal-structure-of-the-multiple-antibiotic-resistance-regulator-marr-from-clostridium-difficile
#16
J W Peng, H Yuan, X S Tan
Regulators of multiple antibiotic resistance (MarRs) are key players against toxins in prokaryotes. MarR homologues have been identified in many bacterial and archaeal species which pose daunting antibiotic resistance issues that threaten public health. The continuous prevalence of Clostridium difficile infection (CDI) throughout the world is associated with the abuse of antibiotics, and antibiotic treatments of CDI have limited effect. In the genome of C. difficile strain 630, the marR gene (ID 4913953) encodes a MarR protein...
June 1, 2017: Acta Crystallographica. Section F, Structural Biology Communications
https://www.readbyqxmd.com/read/28578412/hsp70-facilitates-trans-membrane-transport-of-bacterial-adp-ribosylating-toxins-into-the-cytosol-of-mammalian-cells
#17
Katharina Ernst, Johannes Schmid, Matthias Beck, Marlen Hägele, Meike Hohwieler, Patricia Hauff, Anna Katharina Ückert, Anna Anastasia, Michael Fauler, Thomas Jank, Klaus Aktories, Michel R Popoff, Cordelia Schiene-Fischer, Alexander Kleger, Martin Müller, Manfred Frick, Holger Barth
Binary enterotoxins Clostridium (C.) botulinum C2 toxin, C. perfringens iota toxin and C. difficile toxin CDT are composed of a transport (B) and a separate non-linked enzyme (A) component. Their B-components mediate endocytic uptake into mammalian cells and subsequently transport of the A-components from acidic endosomes into the cytosol, where the latter ADP-ribosylate G-actin resulting in cell rounding and cell death causing clinical symptoms. Protein folding enzymes, including Hsp90 and peptidyl-prolyl cis/trans isomerases facilitate transport of the A-components across endosomal membranes...
June 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28577357/assessing-the-effect-of-patient-screening-and-isolation-on-curtailing-clostridium-difficile-infection-in-hospital-settings
#18
Sara Maghdoori, Seyed M Moghadas
BACKGROUND: Patient screening at the time of hospital admission is not recommended as a routine practice, but may be an important strategy for containment of Clostridium difficile infection (CDI) in hospital settings. We sought to investigate the effect of patient screening in the presence of asymptomatic carriers and in the context of imperfect patient isolation. METHODS: We developed and parameterized a stochastic simulation model for the transmission dynamics of CDI in a hospital ward...
June 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28577158/adherence-to-clinical-practice-guidelines-for-the-management-of-clostridium-difficile-infection-in-japan-a-multicenter-retrospective-study
#19
K Kobayashi, N Sekiya, Y Ainoda, H Kurai, A Imamura
This study was conducted to investigate the adherence to clinical practice guidelines (CPGs) for Clostridium difficile infection (CDI). A retrospective multicenter observational study was conducted via chart review at four teaching hospitals in Japan from April 2012 through September 2013. CDI was diagnosed based on positive identification of CD toxin by enzyme immunoassay testing. CDI patients were divided into non-severe and severe groups according to the severity criteria of four published guidelines (SHEA/IDSA 2010, ACG 2013, ESCMID 2009, HPA/DH 2008)...
June 2, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28575285/comparison-of-control-of-clostridium-difficile-infection-in-six-english-hospitals-using-whole-genome-sequencing
#20
David W Eyre, Warren N Fawley, Anu Rajgopal, Christopher Settle, Kalani Mortimer, Simon D Goldenberg, Susan Dawson, Derrick W Crook, Tim E A Peto, A Sarah Walker, Mark H Wilcox
Background.: Variation in Clostridium difficile infection (CDI) rates between healthcare institutions suggests overall incidence could be reduced if the lowest rates could be achieved more widely. Methods.: We used whole-genome sequencing (WGS) of consecutive C. difficile isolates from 6 English hospitals over 1 year (2013-14) to compare infection control performance. Fecal samples with a positive initial screen for C. difficile were sequenced. Within each hospital, we estimated the proportion of cases plausibly acquired from previous cases...
May 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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