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https://www.readbyqxmd.com/read/29383668/antibiotic-resistances-of-clostridium-difficile
#1
Patrizia Spigaglia, Paola Mastrantonio, Fabrizio Barbanti
The rapid evolution of antibiotic resistance in Clostridium difficile and the consequent effects on prevention and treatment of C. difficile infections (CDIs) are matter of concern for public health. Antibiotic resistance plays an important role in driving C. difficile epidemiology. Emergence of new types is often associated with the emergence of new resistances and most of epidemic C. difficile clinical isolates is currently resistant to multiple antibiotics. In particular, it is to worth to note the recent identification of strains with reduced susceptibility to the first-line antibiotics for CDI treatment and/or for relapsing infections...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29370348/clostridium-difficile-whole-genome-sequencing-reveals-limited-transmission-among-symptomatic-children-a-single-center-analysis
#2
Larry K Kociolek, Dale N Gerding, Robyn O Espinosa, Sameer J Patel, Stanford T Shulman, Egon A Ozer
Background: Although pediatric Clostridium difficile infections (CDI) are increasing, C. difficile transmission patterns among children are poorly understood. Methods: We performed whole genome sequencing (WGS) on C. difficile isolates collected from children diagnosed with CDI between Dec. 2012 and Dec. 2013 at a single academic medical center. Genome sequences of isolates from CDIs diagnosed ≥ 8 weeks after study initiation were compared to all study isolate genome sequences...
January 23, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29305285/national-healthcare-safety-network-laboratory-identified-clostridium-difficile-event-reporting-a-need-for-diagnostic-stewardship
#3
Clare Rock, Zoi Pana, Surbhi Leekha, Polly Trexler, Jennifer Andonian, Avinash Gadala, Karen C Carroll, Lisa L Maragakis
We describe the proportion of health care facility-onset Clostridium difficile infection (HO-CDI) National Healthcare Safety Network laboratory-identified events at our facility that were deemed nontrue HO-CDIs. Reasons included testing in a patient without significant diarrhea or with recent laxative use, or delayed testing. Standardized infection ratios using only true HO-CDI in the numerator were improved compared with publically reported standardized infection ratios. A prioritization matrix identifies which clinical services could benefit most from directed diagnostic stewardship interventions...
January 2, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29232392/experimental-and-numerical-study-of-the-failure-process-and-energy-mechanisms-of-rock-like-materials-containing-cross-un-persistent-joints-under-uniaxial-compression
#4
Rihong Cao, Ping Cao, Hang Lin, Xiang Fan
Joints and fissures in natural rocks have a significant influence on the stability of the rock mass, and it is often necessary to evaluate strength failure and crack evolution behavior. In this paper, based on experimental tests and numerical simulation (PFC2D), the macro-mechanical behavior and energy mechanism of jointed rock-like specimens with cross non-persistent joints under uniaxial loading were investigated. The focus was to study the effect of joint dip angle α and intersection angle γ on the characteristic stress, the coalescence modes and the energy release of jointed rock-like specimens...
2017: PloS One
https://www.readbyqxmd.com/read/29132224/incidence-and-costs-of-cardiac-device-infections-retrospective-analysis-using-german-health-claims-data
#5
Saskia Ludwig, Cathrin Theis, Ben Brown, Andreas Witthohn, Wolfram Lux, Andreas Goette
AIM: Estimate incidence and costs of cardiac device infections (CDIs) in Germany. MATERIALS & METHODS: Patients had an implantable cardioverter defibrillator implanted over 2010-2013 and were followed to December 2014 using German health insurance claims data. A case-controlled analysis was performed using propensity score matching methods. RESULTS: Risk of CDI 12 months post-implant was 3.4% overall, either 2.9% for de novo procedures versus 4...
November 14, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29123385/clostridium-difficile-infection-in-the-elderly-an-update-on-management
#6
REVIEW
Tomefa E Asempa, David P Nicolau
The burden of Clostridium difficile infection (CDI) is profound and growing. CDI now represents a common cause of health care-associated diarrhea, and is associated with significant morbidity, mortality, and health care costs. CDI disproportionally affects the elderly, possibly explained by the following risk factors: age-related impairment of the immune system, increasing antibiotic utilization, and frequent health care exposure. In the USA, recent epidemiological studies estimate that two out of every three health care-associated CDIs occur in patients 65 years or older...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29100777/anisometry-of-medial-patellofemoral-ligament-reconstruction-in-the-setting-of-increased-tibial-tubercle-trochlear-groove-distance-and-patella-alta
#7
Lauren H Redler, Kathleen N Meyers, Jacqueline M Brady, Elizabeth R Dennis, Joseph T Nguyen, Beth E Shubin Stein
PURPOSE: To assess the impact elevated tibial tubercle-trochlear groove (TT-TG) distance and patella height, as measured by the Caton-Deschamps Index (CDI), have on the isometry of a reconstructed medial patellofemoral ligament (MPFL). METHODS: Nine fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and a mobile tibia. A suture fixed to the MPFL origin on the patella and free to move at the Schöttle point on the femur represented a reconstructed MPFL...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29066337/clostridium-difficile-causing-pediatric-infections-new-findings-from-a-hospital-based-study-in-italy
#8
Patrizia Spigaglia, Fabrizio Barbanti, Elio Castagnola, Maria Cristina Diana, Luisa Pescetto, Roberto Bandettini
Recent studies support a change of Clostridium difficile infections (CDIs) epidemiology in pediatric patients. Since limited information is available about C. difficile in this population, we investigated the epidemiology of CDI in a large pediatric hospital that acts as reference centre in Italy and analyzed C. difficile isolates to identify the prevalent PCR-ribotypes (RTs), the binary toxin (CDT)-positive strains and the antibiotic susceptibility patterns. The CDI incidence was 6.6 cases/1000 admissions and the majority (92%) of CDI were healthcare-associated (47% occurred in the Hematology-Oncology and in the Gastroenterology units)...
October 21, 2017: Anaerobe
https://www.readbyqxmd.com/read/28956651/getting-clocked-screening-for-tbi-related-cognitive-impairment-with-the-clock-drawing-test
#9
Elias Hazan, Jia Zhang, Megan Brenkel, Kenneth Shulman, Anthony Feinstein
PRIMARY OBJECTIVE: Undetected cognitive impairment resulting from Traumatic Brain Injuries (TBIs), particularly the 75-95% classified as mild (mTBI), poses a significant public health challenge as untreated symptoms, can persist and cause lasting disability. These cognitive deficits are often missed by standard screening tests, creating a need for alternative cognitive screening tools. The Clock Drawing Test (CDT), a popular, brief cognitive screening instrument, was used to evaluate cognition in persons with TBI...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28936948/control-of-clostridium-difficile-infection-by-defined-microbial-communities
#10
James Collins, Jennifer M Auchtung
Each year in the United States, billions of dollars are spent combating almost half a million Clostridium difficile infections (CDIs) and trying to reduce the ∼29,000 patient deaths in which C. difficile has an attributed role. In Europe, disease prevalence varies by country and level of surveillance, though yearly costs are estimated at €3 billion. One factor contributing to the significant health care burden of C. difficile is the relatively high frequency of recurrent CDIs. Recurrent CDI, i.e., a second episode of symptomatic CDI occurring within 8 weeks of successful initial CDI treatment, occurs in ∼25% of patients, with 35 to 65% of these patients experiencing multiple episodes of recurrent disease...
September 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28914275/national-trends-2007-2013-of-clostridium-difficile-infection-in-patients-with-septic-shock-impact-on-outcome
#11
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/28776206/healthcare-associated-clostridium-difficile-infections-are-sustained-by-disease-from-the-community
#12
Angus McLure, Archie C A Clements, Martyn Kirk, Kathryn Glass
Clostridium difficile infections (CDIs) are some of the most common hospital-associated infections worldwide. Approximately 5% of the general population is colonised with the pathogen, but most are protected from disease by normal intestinal flora or immune responses to toxins. We developed a stochastic compartmental model of CDI in hospitals that captures the condition of the host's gut flora and the role of adaptive immune responses. A novel, derivative-based method for sensitivity analysis of individual-level outcomes was developed and applied to the model...
October 2017: Bulletin of Mathematical Biology
https://www.readbyqxmd.com/read/28756805/burden-of-clostridium-difficile-infections-in-french-hospitals-in-2014-from-the-national-health-insurance-perspective
#13
Soline Leblanc, Cécile Blein, Antoine Andremont, Pierre-Alain Bandinelli, Thibaut Galvain
OBJECTIVE To describe the hospital stays of patients with Clostridium difficile infection (CDI) and to measure the hospitalization costs of CDI (as primary and secondary diagnoses) from the French national health insurance perspective DESIGN Burden of illness study SETTING All acute-care hospitals in France METHODS Data were extracted from the French national hospitalization database (PMSI) for patients covered by the national health insurance scheme in 2014. Hospitalizations were selected using the International Classification of Diseases, 10 th revision (ICD-10) code for CDI...
August 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28681203/increasing-incidence-of-clostridium-difficile-ribotype-001-associated-with-severe-course-of-the-infection-and-previous-fluoroquinolone-use-in-the-czech-republic-2015
#14
M Krutova, J Matejkova, P Drevinek, E J Kuijper, O Nyc
The aim of the study was to provide an update on the epidemiology of C. difficile infection (CDI) in a representative number of hospitals within the Czech Republic in 2015. In 2015, twenty-eight Czech hospitals were invited to participate in a CDI study. Laboratories sent the first 20 consecutive C. difficile isolates for characterization by capillary-electrophoresis (CE) ribotyping and the presence of toxin genes and collected patient data on previous hospitalization, antibiotic treatment, the number of CDI episodes and the course of CDI...
November 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28659674/blunt-diaphragmatic-injuries-pericardial-ruptures
#15
Tevrat Özalp, Mustafa Küpeli, Yaşar Sönmezoğlu, Abdülkadir Çakmak, Siraç Akgül, Mithat Fazlioğlu, Cevdet Tokat
Blunt traumatic diaphragmatic injuries (BTDIs) can be misdiagnosed. Careful evaluation of associated injuries in BTDI is important. In this study, we evaluated treatment options and difficulties in the diagnosis of patients with BTDI. We evaluated ten patients retrospectively with BTDI admitted to our departments, between January 2004 and 2015. Age, gender, trauma type, symptoms, radiological findings, diagnosis time, location and grade of the diaphragmatic injury, surgical type of repair, associated injuries and pericardial rupture, and morbidity and mortality rates were recorded...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28602274/impact-of-an-electronic-sepsis-initiative-on-antibiotic-use-and-health-care-facility-onset-clostridium-difficile-infection-rates
#16
Robert Hiensch, Jashvant Poeran, Patricia Saunders-Hao, Victoria Adams, Charles A Powell, Allison Glasser, Madhu Mazumdar, Gopi Patel
BACKGROUND: Although integrated, electronic sepsis screening and treatment protocols are thought to improve patient outcomes, less is known about their unintended consequences. We aimed to determine if the introduction of a sepsis initiative coincided with increases in broad-spectrum antibiotic use and health care facility-onset (HCFO) Clostridium difficile infection (CDI) rates. METHODS: We used interrupted time series data from a large, tertiary, urban academic medical center including all adult inpatients on 4 medicine wards (June 2011-July 2014)...
October 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28551713/atomoxetine-effects-on-attentional-bias-to-drug-related-cues-in-cocaine-dependent-individuals
#17
Luca Passamonti, M Luijten, H Ziauddeen, I T S Coyle-Gilchrist, T Rittman, S A E Brain, R Regenthal, I H A Franken, B J Sahakian, E T Bullmore, T W Robbins, K D Ersche
RATIONALE: Biased attention towards drug-related cues and reduced inhibitory control over the regulation of drug-intake characterize drug addiction. The noradrenaline system has been critically implicated in both attentional and response inhibitory processes and is directly affected by drugs such as cocaine. OBJECTIVES: We examined the potentially beneficial effects of the noradrenaline reuptake inhibitor atomoxetine in improving cognitive control during two tasks that used cocaine- and non-cocaine-related stimuli...
August 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28479377/higher-incidence-of-clostridium-difficile-infection-among-individuals-with-inflammatory-bowel-disease
#18
Harminder Singh, Zoann Nugent, B Nancy Yu, Lisa M Lix, Laura E Targownik, Charles N Bernstein
BACKGROUND & AIMS: Studies of Clostridium difficile infections (CDIs) among individuals with inflammatory bowel disease (IBD) have used data from single centers or CDI administrative data codes of limited diagnostic accuracy. We determined the incidence, risk factors, and outcomes after CDI in a population-based cohort of patients with IBD and laboratory confirmation diagnoses of CDI. METHODS: We searched the University of Manitoba IBD Epidemiology Database and Manitoba Health CDI databases to identify individuals with CDI, with or without IBD, from July 1, 2005 through March 31, 2014...
August 2017: Gastroenterology
https://www.readbyqxmd.com/read/28457354/clostridium-difficile
#19
REVIEW
Scott R Curry
Clostridium difficile infections (CDIs) have emerged as one of the principal threats to the health of hospitalized and immunocompromised patients. The importance of C difficile colonization is increasingly recognized not only as a source for false-positive clinical testing but also as a source of new infections within hospitals and other health care environments. In the last five years, several new treatment strategies that capitalize on the increasing understanding of the altered microbiome and host defenses in patients with CDI have completed clinical trials, including fecal microbiota transplantation...
June 2017: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/28452915/leapfrog-hospital-safety-score-magnet-designation-and-healthcare-associated-infections-in-united-states-hospitals
#20
Amy L Pakyz, Hui Wang, Yasar A Ozcan, Michael B Edmond, Timothy J Vogus
OBJECTIVE: Healthcare-associated infections (HAIs) pose a challenge to patient safety. Although studies have explored individual level, few have focused on organizational factors such as a hospital's safety infrastructure (indicated by Leapfrog Hospital Safety Score) or workplace quality (Magnet recognition). The aim of the study was to determine whether Magnet and hospitals with better Leapfrog Hospital Safety Scores have fewer HAIs. METHODS: Ordered probit regression analyses tested associations between Safety Score, Magnet status, and standardized infection ratios, depicting whether a hospital had a Clostridium difficile infection (CDI) and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection standardized infection ratio that was "better," "no different," or "worse" than a National Benchmark as per Centers for Disease Control and Prevention's National Healthcare Safety Network definitions...
April 27, 2017: Journal of Patient Safety
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