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https://www.readbyqxmd.com/read/28827811/long-term-taxonomic-and-functional-divergence-from-donor-bacterial-strains-following-fecal-microbiota-transplantation-in-immunocompromised-patients
#1
Eli L Moss, Shannon B Falconer, Ekaterina Tkachenko, Mingjie Wang, Hannah Systrom, Jasmin Mahabamunuge, David A Relman, Elizabeth L Hohmann, Ami S Bhatt
Immunocompromised individuals are at high risk of developing Clostridium difficile-associated disease (CDAD). Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory or recurrent CDAD and, despite safety concerns, has recently been offered to immunocompromised patients. We investigated the genomics of bacterial composition following FMT in immunocompromised patients over a 1-year period. Metagenomic, strain and gene-level bacterial dynamics were characterized in two CDAD-affected hematopoietic stem cell (HCT) recipients following FMT...
2017: PloS One
https://www.readbyqxmd.com/read/28814204/faecal-microbiota-transplantation-for-em-clostridium-difficile-em-associated-diarrhoea-a-systematic-review-of-randomised-controlled-trials
#2
REVIEW
Paul Moayyedi, Yuhong Yuan, Harith Baharith, Alexander C Ford
OBJECTIVES: Faecal microbiota transplantation (FMT) has emerged as a useful approach for treating Clostridium difficile-associated diarrhoea (CDAD). Randomised controlled trials (RCTs) have recently evaluated its effectiveness, but systematic reviews have focused on evidence from case series. We therefore conducted a systematic review and meta-analysis of RCTs evaluating the effectiveness of FMT for treating CDAD. STUDY DESIGN: We included RCTs that primarily recruited adults with CDAD and compared the effectiveness of FMT with that of placebo, antibiotic therapy, or autologous stool transplantation, or compared different preparations or modes of delivery of FMT...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28774865/shifts-in-antimicrobial-consumption-and-infection-rates-before-and-during-a-piperacillin-tazobactam-shortage
#3
S Travis King, Katie E Barber, Jason J Parham, Kayla R Stover
BACKGROUND: Anti-infective shortages represent a growing threat to the optimal management of the infected patient and alter the institutional selective pressure against hospital-acquired infections. The objective of this analysis was to assess the impact that a shortage of piperacillin-tazobactam had on the overall antibacterial use and HAI rates at an academic institution. METHODS: Antimicrobial use and infection data were extracted from TheraDoc Clinical Surveillance Software (Premier, Inc...
July 31, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28764868/modeling-new-immunoregulatory-therapeutics-as-antimicrobial-alternatives-for-treating-clostridium-difficile-infection
#4
Andrew Leber, Raquel Hontecillas, Vida Abedi, Nuria Tubau-Juni, Victoria Zoccoli-Rodriguez, Caroline Stewart, Josep Bassaganya-Riera
The current treatment paradigm in Clostridium difficile infection is the administration of antibiotics contributing to the high rates of recurrent infections. Recent alternative strategies, such as fecal microbiome transplantation and anti-toxin antibodies, have shown similar efficacy in the treatment of C. difficile associated disease (CDAD). However, barriers exist for either treatment or other novel treatments to displace antibiotics as the standard of care. To aid in the comparison of these and future treatments in CDAD, we developed an in silico pipeline to predict clinical efficacy with nonclinical results...
May 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28652125/probiotic-containing-lactobacillus-casei-lactobacillus-bulgaricus-and-streptococcus-thermophiles-actimel-for-the-prevention-of-clostridium-difficile-associated-diarrhoea-in-the-elderly-with-proximal-femur-fractures
#5
Ravi Mallina, J Craik, N Briffa, Viren Ahluwalia, J Clarke, A G Cobb
The incidence of Clostridium difficile associated diarrhoea (CDAD) is greater in elderly patients. Probiotics may have a beneficial effect in the prevention of CDAD. However, their effect in elderly orthopaedic patients has not been previously reported. Between April 2013 and April 2014, 105 patients admitted with femoral neck fractures, and who required 3days of antibiotics for infection of any cause, were prescribed the probiotic ACTIMEL until 3days after the last antibiotic dose. The incidence of CDAD was compared with historical controls (April 2011-April 2012)...
June 23, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28582620/observation-of-enhanced-chiral-asymmetries-in-the-inner-shell-photoionization-of-uniaxially-oriented-methyloxirane-enantiomers
#6
Maurice Tia, Martin Pitzer, Gregor Kastirke, Janine Gatzke, Hong-Keun Kim, Florian Trinter, Jonas Rist, Alexander Hartung, Daniel Trabert, Juliane Siebert, Kevin Henrichs, Jasper Becht, Stefan Zeller, Helena Gassert, Florian Wiegandt, Robert Wallauer, Andreas Kuhlins, Carl Schober, Tobias Bauer, Natascha Wechselberger, Phillip Burzynski, Jonathan Neff, Miriam Weller, Daniel Metz, Max Kircher, Markus Waitz, Joshua B Williams, Lothar Ph H Schmidt, Anne D Müller, André Knie, Andreas Hans, Ltaief Ben Ltaief, Arno Ehresmann, Robert Berger, Hironobu Fukuzawa, Kiyoshi Ueda, Horst Schmidt-Böcking, Reinhard Dörner, Till Jahnke, Philipp V Demekhin, Markus Schöffler
Most large molecules are chiral in their structure: they exist as two enantiomers, which are mirror images of each other. Whereas the rovibronic sublevels of two enantiomers are almost identical (neglecting a minuscular effect of the weak interaction), it turns out that the photoelectric effect is sensitive to the absolute configuration of the ionized enantiomer. Indeed, photoionization of randomly oriented enantiomers by left or right circularly polarized light results in a slightly different electron flux parallel or antiparallel with respect to the photon propagation direction-an effect termed photoelectron circular dichroism (PECD)...
June 8, 2017: Journal of Physical Chemistry Letters
https://www.readbyqxmd.com/read/28575523/safety-and-pharmacokinetic-study-of-fidaxomicin-in-children-with-clostridium-difficile-associated-diarrhea-a-phase-2a-multicenter-clinical-trial
#7
Molly A O'Gorman, Marian G Michaels, Sheldon L Kaplan, Anthony Otley, Larry K Kociolek, Edward J Hoffenberg, Kwang Sik Kim, Sharon Nachman, Marian D Pfefferkorn, Timothy Sentongo, Janice E Sullivan, Pamela Sears
Background.: Fidaxomicin is an approved therapy for Clostridium difficile-associated diarrhea (CDAD) in adults. The safety of fidaxomicin in children has not been reported. Methods.: In this study (ClinicalTrials.gov identifier NCT01591863), pediatric patients with CDAD received twice-daily oral fidaxomicin at a dose of 16 mg/kg per day (up to 200 mg) for 10 days in an open-label study. Plasma and fecal samples were collected for pharmacokinetic assessments. The primary outcome measure was safety, which was assessed by adverse-event (AE), laboratory, and physical examination/vital-sign monitoring...
May 31, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28426557/loop-ileostomy-versus-total-colectomy-as-surgical-treatment-for-clostridium-difficile-associated-disease-an-eastern-association-for-the-surgery-of-trauma-multicenter-trial
#8
MULTICENTER STUDY
Paula Ferrada, Rachael Callcut, Martin D Zielinski, Brandon Bruns, Daniel Dante Yeh, Tanya L Zakrison, Jonathan P Meizoso, Babak Sarani, Richard D Catalano, Peter Kim, Valerie Plant, Amelia Pasley, Linda A Dultz, Asad J Choudhry, Elliott R Haut
OBJECTIVES: The mortality of patients with Clostridium difficile-associated disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single-center study. To date, no reproducible results have been published. The objective of this study was to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. METHODS: This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28366569/development-of-a-dose-assay-for-a-clostridium-difficile-vaccine-using-a-tandem-ion-exchange-high-performance-liquid-chromatography-method
#9
Feng Wang, Sha Ha, Richard R Rustandi
Clostridium difficile is a gram-positive intestine bacterium that causes a severe diarrhea and could eventually be lethal. The main virulence factor is related to the release of two major exotoxins, toxin A (TcdA) and toxin B (TcdB). Recent C. difficile-associated disease (CDAD) outbreaks have been caused by hypervirulent strains which secrete an additional binary toxin (CDTa/CDTb). Vaccination against these toxins is considered the best way to combat the CDAD. Recently, a novel tetravalent C. difficile vaccine candidate containing all four toxins produced from a baculovirus expression system has been developed...
May 19, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/28336757/development-of-a-bedside-scoring-system-for-predicting-a-first-recurrence-of-clostridium-difficile-associated-diarrhea
#10
Velliyur Viswesh, Ana L Hincapie, Marie Yu, Linda Khatchatourian, Michael A Nowak
PURPOSE: A scoring system for identifying patients at high or low risk for recurrent Clostridium difficile-associated diarrhea (CDAD) is described. METHODS: A retrospective cohort study was performed using data on adults with CDAD admitted to a 3-hospital system from 2009 to 2014. The primary endpoint was the rate of recurrent CDAD within 60 days of clinical cure of CDAD. Risk factors for CDAD recurrence were identified, and a risk prediction tool was developed using multivariate logistic regression...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28265914/-probiotics-is-there-evidence-for-use-against-antibiotic-induced-diarrhea-cdad-and-travellers-diarrhea
#11
REVIEW
Johannes Bogner
No abstract text is available yet for this article.
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28257555/antibiotic-treatment-for-clostridium-difficile-associated-diarrhoea-in-adults
#12
REVIEW
Richard L Nelson, Katie J Suda, Charlesnika T Evans
BACKGROUND: Clostridium difficile (C. difficile) is recognized as a frequent cause of antibiotic-associated diarrhoea and colitis. This review is an update of a previously published Cochrane review. OBJECTIVES: The aim of this review is to investigate the efficacy and safety of antibiotic therapy for C. difficile-associated diarrhoea (CDAD), or C. difficile infection (CDI), being synonymous terms. SEARCH METHODS: We searched MEDLINE, EMBASE, CENTRAL and the Cochrane IBD Group Specialized Trials Register from inception to 26 January 2017...
March 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28164522/detection-of-clostridium-difficile-in-fecal-specimens-a-comparative-evaluation-of-nucleic-acid-amplification-test-and-toxigenic-culture
#13
Shima Lotfian, Masoumeh Douraghi, Amir Aliramezani, Sedighe Ghourchian, Abdolfatah Sarrafnejad, Hojjat Zeraati
BACKGROUND: The available data regarding Clostridium difficile infections (CDIs) in developing countries are scarce. This may be related in part to the complexity of anaerobic bacterial culture and/or cytotoxicity assays of C. difficile. Here, we evaluated the diagnostic efficacy of PCR in comparison with toxigenic culture for direct detection of conserved genes as well as toxin genes of C. difficile in fecal specimens of patients with clinical symptoms of CDI. METHODS: Loose or soft feces from 171 patients suspected of having C...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28139662/use-of-antibiotic-and-prevalence-of-antibiotic-associated-diarrhoea-in-patients-with-spinal-cord-injuries-a-uk-national-spinal-injury-centre-experience
#14
S Wong, P Santullo, J O'Driscoll, A Jamous, S P Hirani, M Saif
BACKGROUND: This was a retrospective audit, with the aims being to (1) record the use of antibiotics; (2) establish the prevalence of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CDAD); and (3) assess if there was any seasonal variation in antibiotic use and incidence of AAD. METHODS: The study was performed at a single spinal cord injury (SCI) centre in the UK. Data were collected using a standardised questionnaire during October 2014 to June 2015...
June 2017: Spinal Cord
https://www.readbyqxmd.com/read/27999606/traditional-chinese-medicine-qpyf-as-preventive-treatment-for-clostridium-difficile-associated-diarrhea-in-a-mouse-model
#15
Guo Ya-Nan, Wang Jun, Zhang Hao-Jun, Jia Hong-Bing, Li Ping, Liu Xin-Zhu
Traditional Chinese medicine QPYF has a good effect for treating antibiotic-associated diarrhea in clinical practice. The aim of this study is to test its efficacy to prevent Clostridium difficile associated diarrhea (CDAD) in a mouse model. C57BL/6 mice were infected with Clostridium difficile VPI 10463 after exposure to antimicrobial mixture. QPYF was administered from 7 days prior to Clostridium difficile infection to 20 days after infection, and its effect was compared with no treatment and receiving placebo...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/27770789/a-dna-vaccine-targeting-tcda-and-tcdb-induces-protective-immunity-against-clostridium-difficile
#16
Bao-Zhong Zhang, Jianpiao Cai, Bin Yu, Yanhong Hua, Candy Choiyi Lau, Richard Yi-Tsun Tsun Kao, Kong-Hung Sze, Kwok-Yung Yuen, Jian-Dong Huang
BACKGROUND: Clostridium difficile-associated disease (CDAD) constitutes a great majority of hospital diarrhea cases in industrialized countries and is induced by two types of large toxin molecules: toxin A (TcdA) and toxin B (TcdB). Development of immunotherapeutic approaches, either active or passive, has seen a resurgence in recent years. Studies have described vaccine plasmids that express either TcdA and/or TcdB receptor binding domain (RBD). However, the effectiveness of one vector encoding both toxin RBDs against CDAD has not been evaluated...
October 22, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27573235/evaluation-of-gastrointestinal-leakage-using-serum-1%C3%A2-3-%C3%AE-d-glucan-in-a-clostridium-difficile-murine-model
#17
Asada Leelahavanichkul, Wimonrat Panpetch, Navaporn Worasilchai, Poorichaya Somparn, Wiwat Chancharoenthana, Sumanee Nilgate, Malcolm Finkelman, Ariya Chindamporn, Somying Tumwasorn
Gastrointestinal (GI) leakage in Clostridium difficile-associated diarrhea (CDAD) is well known but is not routinely assessed in clinical practice. Serum (1→3)-β-D-glucan (BG), a fungal cell wall component used as a biomarker for invasive fungal disease, was tested in a CDAD mouse model with and without probiotics. Higher serum fluorescein isothiocyanate-dextran (FITC-dextran) and spontaneous gram-negative bacteremia, GI leakage indicators, were frequently found in CDAD mice, which died compared with those which survived...
September 2016: FEMS Microbiology Letters
https://www.readbyqxmd.com/read/27446866/association-between-nsaids-and-clostridium-difficile-associated-diarrhea-a-systematic-review-and-meta-analysis
#18
REVIEW
Nitipong Permpalung, Sikarin Upala, Anawin Sanguankeo, Suthanya Sornprom
Objective. Clostridium difficile infection is a leading cause of nosocomial diarrhea in developed countries. Studies evaluating the associations of increased risk of community-acquired CDAD and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have yielded inconclusive results. We conducted a systematic review and meta-analysis to compare the odds of NSAID exposure in patients with CDAD versus patients without CDAD in both community-based and healthcare-associated settings. Methods. Relevant observational studies indexed in PubMed/MEDLINE and EMBASE up to February 2015 were analyzed and data were extracted from nine studies...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27377992/cost-effectiveness-analysis-of-the-use-of-probiotics-for-the-prevention-of-clostridium-difficile-associated-diarrhea-in-a-provincial-healthcare-system
#19
Jenine R Leal, Steven J Heitman, John M Conly, Elizabeth A Henderson, Braden J Manns
OBJECTIVE To conduct a full economic evaluation assessing the costs and consequences related to probiotic use for the primary prevention of Clostridium difficile-associated diarrhea (CDAD). DESIGN Cost-effectiveness analysis using decision analytic modeling. METHODS A cost-effectiveness analysis was used to evaluate the risk of CDAD and the costs of receiving oral probiotics versus not over a time horizon of 30 days. The target population modeled was all adult inpatients receiving any therapeutic course of antibiotics from a publicly funded healthcare system perspective...
September 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27375724/clinical-characteristics-of-clostridium-difficile-associated-diarrhea-among-patients-in-a-tertiary-care-center-in-china
#20
Yongqiang Li, Yi Huang, Yuyuan Li, Yuqiang Nie
OBJECTIVE: This study investigated the incidence, risk factors, and clinical characteristics of Clostridium difficile-associated diarrhea (CDAD) in Chinese patients. METHODS: Fecal specimens of patients with antibiotic-associated diarrhea (AAD) were collected to test C. difficile toxin A and B using enzyme-linked fluorescent assay to identify CDAD. By adopting a nested case-control design, the matched people (ratio 1:3) without AAD were included as controls. RESULTS: Out of 56,172 inpatients, 39,882 (71...
May 2016: Pakistan Journal of Medical Sciences Quarterly
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