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C difficile infections

Garth A James, Laurent Chesnel, Laura Boegli, Elinor deLancey Pulcini, Steve Fisher, Philip S Stewart
Background: Clostridium difficile, a spore-forming Gram-positive anaerobic bacillus, is the most common causative agent of healthcare-associated diarrhoea. Formation of biofilms may protect C. difficile against antibiotics, potentially leading to treatment failure. Furthermore, bacterial spores or vegetative cells may linger in biofilms in the gut causing C. difficile infection recurrence. Objectives: In this study, we evaluated and compared the efficacy of four antibiotics (fidaxomicin, surotomycin, vancomycin and metronidazole) in penetrating C...
October 6, 2017: Journal of Antimicrobial Chemotherapy
Mamidipudi Thirumala Krishna, Aarnoud P Huissoon, Mark Li, Alex Richter, Devadas Ganesh Pillay, Dhinakaran Sambanthan, Sumanth C Raman, Shuaib Nasser, Siraj A Misbah
Approximately 90-99% of patients with a label of penicillin allergy (PenA) are not allergic when comprehensively investigated. An inaccurate label of PenA has major public health implications - longer hospital stay, more frequent hospital admissions, greater use of fluoroquinolones, glycopeptides, cephalosporins and other expensive antibiotics resulting in significantly higher costs to the health service and predisposing to Clostridium difficile, meticillin-resistant Staphylococcus aureus infections and vancomycin resistant enterococcus...
October 13, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Katharina Stein, Sarah Egan, Helen Lynch, Céline Harmanus, Lorraine Kyne, Celine Herra, Sinead McDermott, Ed Kuijper, Fidelma Fitzpatrick, Susan FitzGerald, Lynda Fenelon, Denise Drudy
Clostridium difficile is an important enteric pathogen in humans causing infections in the healthcare environment and the community. Carriage of C. difficile and C. difficile-related enterocolitis has been reported in piglets worldwide. The aim of this study was to investigate the rates of C. difficile isolation from pigs in Ireland. Faecal samples from piglet litters and sows were collected from six farms in 2015. The sows were non-diarrhoeal at the time of sampling. The diarrhoeal status of the piglets was unknown...
October 9, 2017: Anaerobe
Gurinder K Vinner, Goran T Vladisavljević, Martha R J Clokie, Danish J Malik
The prevalence of pathogenic bacteria acquiring multidrug antibiotic resistance is a global health threat to mankind. This has motivated a renewed interest in developing alternatives to conventional antibiotics including bacteriophages (viruses) as therapeutic agents. The bacterium Clostridium difficile causes colon infection and is particularly difficult to treat with existing antibiotics; phage therapy may offer a viable alternative. The punitive environment within the gastrointestinal tract can inactivate orally delivered phages...
2017: PloS One
Joshua Wolf, Li Tang, Patricia M Flynn, Ching-Hon Pui, Aditya H Gaur, Yilun Sun, Hiroto Inaba, Tracy Stewart, Randall T Hayden, Hana Hakim, Sima Jeha
Background: Infection is the most important cause of treatment-related morbidity and mortality in pediatric patients treated for acute lymphoblastic leukemia (ALL). Although routine in adults with leukemia, antibacterial prophylaxis is controversial in pediatrics because of insufficient evidence for its efficacy or antibiotic choice and concerns about promoting antibiotic resistance and Clostridium difficile infection. Methods: This was a single-center, observational cohort study of patients with newly diagnosed ALL, comparing prospectively collected infection-related outcomes in patients who received no prophylaxis, levofloxacin prophylaxis, or other prophylaxis during induction therapy on the total XVI study...
September 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Raseen Tariq, Darrell S Pardi, Pritish K Tosh, Randall C Walker, Raymund R Razonable, Sahil Khanna
Broad-spectrum antibiotics for recurrent multidrug-resistant urinary tract infections (UTIs) disrupt the gut microbiome and promote antibiotic resistance. Fecal microbiota transplantation led to resolution of recurrent Clostridium difficile, significantly decreased recurrent UTI frequency, and improved antibiotic susceptibility profile of UTI-causing organisms.
July 18, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Raffaele Del Prete, Luigi Ronga, Grazia Addati, Raffaella Magrone, Giuseppe Miragliotta
Clostridium difficile is an emerging cause of healthcare-associated infections. The increasing frequency and severity is attributed to highly virulent ribotypes such as 027. The aim of this study was to retrospectively analyze the prevalence of CDI and ribotype 027 in 481 clinical samples collected from hospitalized patients and sent to the laboratory of molecular biology, UOC Microbiology and Virology, Azienda Ospedaliera-Universitaria, Policlinico of Bari, Italy. Toxins A+B and DNA C. difficile detections were performed using immunochromatographic test and a multiplex real-time PCR assay, respectively...
October 10, 2017: New Microbiologica
Rebecca Rabi, Lynne Turnbull, Cynthia B Whitchurch, Milena Awad, Dena Lyras
Clostridium sordellii is an often-lethal bacterium causing human and animal disease. Crucial to the infectious cycle of C. sordellii is its ability to produce spores, which can germinate into toxin-producing vegetative bacteria under favorable conditions. However, structural details of the C. sordellii spore are lacking. Here, we used a range of electron microscopy techniques together with superresolution optical microscopy to characterize the C. sordellii spore morphology with an emphasis on the exosporium...
September 2017: MSphere
Irene Thompson, Colin Lavelle, Laurence Leonard
BACKGROUND: Clostridium difficile (C. difficile) is a leading cause of infectious diarrhoea in hospitals. Sending faecal samples for testing expedites diagnosis and appropriate treatment. Clinical suspicion of C. difficile based on patient history, signs and symptoms is the basis for sampling. Sending faecal samples from patients with diarrhoea 'just in case' the patient has C. difficile may be an indication of poor clinical management. AIM: To evaluate the effectiveness of an intervention by an Infection Prevention and Control Team (IPCT) in reducing inappropriate faecal samples sent for C...
November 2016: Journal of Infection Prevention
María C Legaria, Raquel Rollet, Ana Di Martino, Liliana Castello, Claudia Barberis, María A Rossetti, María C Guardati, Liliana Fernández Canigia, Graciela Carloni, Mirta Litterio, Marta Rocchi, Eduardo G Anchart, Fernando M Trejo, Jessica Minnaard, Diana Klajn, Silvia C Predari
The best laboratory diagnostic approach to detect Clostridioides [Clostridium] difficile infection (CDI) is a subject of ongoing debate. With the aim of evaluating four laboratory diagnostic methods, 250 unformed stools from patients with suspected CDI submitted to nine medical center laboratories from November 2010 to December 2011, were studied using: (1) an immunochromatographic rapid assay test that combines the qualitative determination of glutamate dehydrogenase (GDH) plus toxins A and B (QAB), the CDIFF QUIK CHEK COMPLETE assay; (2) an enzyme immunoassay for qualitative determination of toxins A and B, the RIDASCREEN™ C...
October 5, 2017: Revista Argentina de Microbiología
E Reigadas, P Muñoz-Pacheco, L Alcalá, M Marín, A Martin, E Bouza
BACKGROUND: Rifaximin has been proposed as an alternative treatment for specific cases of Clostridium difficile infection (CDI) and intestinal decontamination. Rifaximin-resistant C. difficile has occasionally been reported. Antibiotic susceptibility testing relies on anaerobic agar dilution (reference method), which is cumbersome and not routinely used. There is no commercial test for detection of resistance to rifaximin. OBJECTIVES: To assess resistance to rifaximin by C...
October 6, 2017: Anaerobe
Marcin Dembek, Stephanie E Willing, Huynh A Hong, Siamand Hosseini, Paula S Salgado, Simon M Cutting
Clostridium difficile remains a leading nosocomial pathogen, putting considerable strain on the healthcare system. The ability to form endospores, highly resistant to environmental insults, is key to its persistence and transmission. However, important differences exist between the sporulation pathways of C. difficile and the model Gram-positive organism Bacillus subtilis. Amongst the challenges in studying sporulation in C. difficile is the relatively poor levels of sporulation and high heterogeneity in the sporulation process...
2017: Frontiers in Microbiology
Yoshitomo Morinaga, Norihiko Akamatsu, Junichi Matsuda, Hiroko Tateno, Takeshi Tomaru, Ai Tanaka, Sayuri Morita, Makoto Nakamura, Hideaki Kato, Megumi Annaka, Yoshishige Masuda, Yasutomo Itakura, Takashi Inamatsu, Katsunori Yanagihara
Laboratory underdiagnosis of toxigenic Clostridium difficile can lead to inappropriate management of C. difficile infection (CDI). A fully automated molecular test (FAMT), BD MAX, and enzyme immunoassays for C. difficile glutamate dehydrogenase (GDH) and for toxin A/B antigen test were evaluated using clinical specimens. Laboratory analysis of 231 fecal specimens from patients suspected with CDI, indicated that the sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of FAMT was 98...
September 30, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Melina Kachrimanidou, Zoi Tegou, Maria Chasampalioti, Kostoula Arvaniti, Efthymia Protonotariou, Lemonia Skoura
Clostridium difficile infection (CDI) is a major cause of health care-associated diarrhea. The aim of the present study was to evaluate a two-step approach for the diagnosis of CDI. The two-step procedure consisted of GDH-toxin A/B EIA (Enzyme immunoassay targeting enterotoxin A and Cytotoxin B), followed by PCR detecting toxigenic C. difficile. Results indicate that EIAs provide a rapid screening assay for the laboratory diagnosis of CDI but, in GDH-positive and toxins-negative samples, EIA should be always followed by PCR to distinguish toxigenic vs nontoxigenic strains...
September 29, 2017: Journal of Microbiological Methods
Huynh A Hong, William T Ferreira, Siamand Hosseini, Saba Anwar, Krisztina Hitri, Anthony J Wilkinson, Wilfried Vahjen, Jürgen Zentek, Mikhail Soloviev, Simon M Cutting
Clostridium difficile infection (CDI) is an important hospital-acquired infection resulting from the germination of spores in the intestine as a consequence of antibiotic-mediated dysbiosis of the gut microbiota. Key to this is CotE, a protein displayed on the spore surface and carrying two functional elements, an N-terminal peroxiredoxin and a C-terminal chitinase domain. Using isogenic mutants we show in vitro and ex vivo that CotE enables binding of spores to mucus by direct interaction with mucin and contributes to its degradation...
September 15, 2017: Journal of Infectious Diseases
Jae Hyun Shin, Yingnan Gao, John H Moore, David T Bolick, Glynis L Kolling, Martin Wu, Cirle A Warren
Clostridium difficile infection (CDI) is a serious threat for an aging population. Using an aged mouse model, we evaluated the effect of age and the roles of innate immunity and intestinal microbiota.Aged (18 months) and young (8 weeks) mice were infected with C. difficile and disease severity, immune response, and intestinal microbiome were compared. The same experiment was repeated with intestinal microbiota exchange between aged and young mice before infection. Higher mortality was observed in aged mice with weaker neutrophilic mobilization in blood and intestinal tissue and depressed pro-inflammatory cytokines in early infection...
August 22, 2017: Journal of Infectious Diseases
Sujata Lall, Gita Nataraj, Preeti Mehta
INTRODUCTION: Clostridium difficile is a Gram-positive spore-bearing anaerobic bacillus increasingly associated with both community- and hospital-acquired colitis and diarrhea. It is the most common identifiable bacterial cause of healthcare-associated diarrhea associated with antibiotic use and one of the most common anaerobic infections. The diagnosis of C. difficile infection includes detection of toxin A/B in stool specimens by direct enzyme immunoassay, culture of pathogen from the stool specimens using a selective agar Cycloserine-Cefoxitin fructose agar (CCFA), tissue culture assay, and detection of glutamate dehydrogenase an enzyme produced by C...
October 2017: Journal of Laboratory Physicians
Anna K Barker, Caroline Zellmer, Jessica Tischendorf, Megan Duster, Susan Valentine, Marc Oliver Wright, Nasia Safdar
The prevalence of Clostridium difficile spores was assessed in 48 observations of infected inpatients. Participants were randomized to hand hygiene with either alcohol-based handrub or soap and water. C difficile was recovered in 14.6% of pre-hand hygiene observations. It was still present on 5 of these 7 participants after hand hygiene (3/3 using alcohol-based handrub; 2/4 using soap and water).
October 1, 2017: American Journal of Infection Control
Anna K Barker, Megan Duster, Susan Valentine, Timothy Hess, Laurie Archbald-Pannone, Richard Guerrant, Nasia Safdar
Background: Clostridium difficile is the most common cause of hospital-acquired infections, responsible for >450 000 infections annually in the USA. Probiotics provide a promising, well-tolerated adjunct therapy to standard C. difficile infection (CDI) treatment regimens, but there is a paucity of data regarding their effectiveness for the treatment of an initial CDI. Objectives: We conducted a pilot randomized controlled trial of 33 participants from February 2013 to February 2015 to determine the feasibility and health outcomes of adjunct probiotic use in patients with an initial mild to moderate CDI...
August 23, 2017: Journal of Antimicrobial Chemotherapy
Pavel Cermak, Jana Olsovska, Alexandr Mikyska, Martin Dusek, Zuzana Kadleckova, Jiri Vanicek, Otakar Nyc, Karel Sigler, Vanda Bostikova, Pavel Bostik
Anaerobic bacteria, such as Bacteroides fragilis or Clostridium perfringens, are part of indigenous human flora. However, Clostridium difficile represents also an important causative agent of nosocomial infectious antibiotic-associated diarrhoea. Treatment of C. difficile infection is problematic, making it imperative to search for new compounds with antimicrobial properties. Hops (Humulus lupulus L.) contain substances with antibacterial properties. We tested antimicrobial activity of purified hop constituents humulone, lupulone and xanthohumol against anaerobic bacteria...
September 28, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
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