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C difficile infections

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https://www.readbyqxmd.com/read/28223256/role-of-the-leukocyte-response-in-normal-and-immunocompromised-host-after-clostridium-difficile-infection
#1
Edwin Vargas, Senu Apewokin, Rajat Madan
Clostridium difficile is the leading cause of healthcare-associated infections in the United States. Clinically, C. difficile-associated disease can present as asymptomatic colonization, self-limited diarrheal illness or severe colitis (that may result in death). This variability in disease course and outcomes suggests that host factors play an important role as key determinants of disease severity. Currently, there are several scoring indices to estimate severity of C. difficile-associated disease. Leukocytosis and renal failure are considered to be the most important predictors of C...
February 18, 2017: Anaerobe
https://www.readbyqxmd.com/read/28220514/randomised-clinical-trial-faecal-microbiota-transplantation-for-recurrent-clostridum-difficile-infection-fresh-or-frozen-or-lyophilised-microbiota-from-a-small-pool-of-healthy-donors-delivered-by-colonoscopy
#2
Z D Jiang, N J Ajami, J F Petrosino, G Jun, C L Hanis, M Shah, L Hochman, V Ankoma-Sey, A W DuPont, M C Wong, A Alexander, S Ke, H L DuPont
BACKGROUND: Faecal microbiota transplantation (FMT) has become routine in managing recurrent C. difficile infection (CDI) refractory to antibiotics. AIM: To compare clinical response and improvements in colonic microbiota diversity in subjects with recurrent CDI using different donor product. METHODS: Seventy-two subjects with ≥3 bouts of CDI were randomised in a double-blind study to receive fresh, frozen or lyophilised FMT product via colonoscopy from 50 g of stool per treatment from eight healthy donors...
February 21, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28219893/toxin-positive-clostridium-difficile-latently-infect-mouse-colonies-and-protect-against-highly-pathogenic-c-difficile
#3
Lucie Etienne-Mesmin, Benoit Chassaing, Oluwaseyi Adekunle, Lisa M Mattei, Frederic D Bushman, Andrew T Gewirtz
OBJECTIVE: Clostridium difficile is a toxin-producing bacterium and a leading cause of antibiotic-associated disease. The ability of C. difficile to form spores and infect antibiotic-treated persons at low multiplicity of infection (MOI) underlies its large disease burden. However, C. difficile-induced disease might also result from long-harboured C. difficile that blooms in individuals administered antibiotics. DESIGN: Mice purchased from multiple vendors and repeatedly testing negative for this pathogen by quantitative PCR bloomed C...
February 20, 2017: Gut
https://www.readbyqxmd.com/read/28219462/the-use-of-a-computerized-provider-order-entry-alert-to-decrease-rates-of-clostridium-difficile-testing-in-young-pediatric-patients
#4
Maribeth R Nicholson, Peter N Freswick, M Cecilia Di Pentima, Li Wang, Kathryn M Edwards, Gregory J Wilson, Thomas R Talbot
BACKGROUND Infants and young children are frequently colonized with C. difficile but rarely have symptomatic disease. However, C. difficile testing remains prevalent in this age group. OBJECTIVE To design a computerized provider order entry (CPOE) alert to decrease testing for C. difficile in young children and infants. DESIGN An interventional age-targeted before-after trial with comparison group SETTING Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, Tennessee. PATIENTS All children seen in the inpatient or emergency room settings from July 2012 through July 2013 (pre-CPOE alert) and September 2013 through September 2014 (post-CPOE alert) INTERVENTION In August of 2013, we implemented a CPOE alert advising against testing in infants and young children based on the American Academy of Pediatrics recommendations with an optional override...
February 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28217763/impact-of-tigecycline-versus-other-antibiotics-on-the-fecal-metabolome-and-on-colonization-resistance-to-clostridium-difficile-in-mice
#5
Robin L P Jump, David Kraft, Kelly Hurless, Alex Polinkovsky, Curtis J Donskey
BACKGROUND: The glycylcycline antibiotic tigecycline may have a relatively low propensity to promote Clostridium difficile infection in part because it causes less disruption of the indigenous intestinal microbiota than other broad-spectrum antibiotics. We used a mouse model to compare the effects of tigecycline versus other commonly used antibiotics on colonization resistance to C. difficile and on the metabolic functions of the intestinal microbiota. METHODS: To assess in vivo colonization resistance to C...
January 18, 2017: Pathogens & Immunity
https://www.readbyqxmd.com/read/28217744/effect-of-tcdr-mutation-on-sporulation-in-the-epidemic-clostridium-difficile-strain-r20291
#6
Brintha P Girinathan, Marc Monot, Daniel Boyle, Kathleen N McAllister, Joseph A Sorg, Bruno Dupuy, Revathi Govind
Clostridium difficile is an important nosocomial pathogen and the leading cause of hospital-acquired diarrhea. Antibiotic use is the primary risk factor for the development of C. difficile-associated disease because it disrupts normally protective gut flora and enables C. difficile to colonize the colon. C. difficile damages host tissue by secreting toxins and disseminates by forming spores. The toxin-encoding genes, tcdA and tcdB, are part of a pathogenicity locus, which also includes the tcdR gene that codes for TcdR, an alternate sigma factor that initiates transcription of tcdA and tcdB genes...
January 2017: MSphere
https://www.readbyqxmd.com/read/28216085/occurrence-of-clostridium-difficile-ribotype-027-in-hospitals-of-silesia-poland
#7
Małgorzata Aptekorz, Anna Szczegielniak, Barbara Wiechuła, Celine Harmanus, Ed Kuijper, Gayane Martirosian
Clostridium difficile is an important healthcare-associated pathogen, responsible for a broad spectrum of diarrheal diseases. The aim of this prospective study was to determine the occurrence of C. difficile infection (CDI), to characterize cultured C. difficile strains and to investigate the association of fecal lactoferrin with CDI. Between January 2013 and June 2014, 148 stool samples were obtained from adult diarrheal patients (C. difficile as a suspected pathogen) hospitalized in different healthcare facilities of 15 Silesian hospitals...
February 12, 2017: Anaerobe
https://www.readbyqxmd.com/read/28215602/clostridium-difficile-infection-in-acute-flares-of-inflammatory-bowel-disease-a-prospective-study
#8
Harry Sokol, Valérie Lalande, Cecilia Landman, Anne Bourrier, Isabelle Nion-Larmurier, Sylvie Rajca, Julien Kirchgesner, Philippe Seksik, Jacques Cosnes, Frédéric Barbut, Laurent Beaugerie
OBJECTIVES: Clostridium difficile infection (CDI) is a common complication in inflammatory bowel disease (IBD) and has been associated with poor IBD outcome. The aims of our study were to look for predictive factors of CDI in patients hospitalized for IBD flare and to evaluate a rapid testing strategy in this population. METHODS: Consecutive patients hospitalized for IBD flare in Saint-Antoine Hospital (Paris, France) were prospectively tested for CDI with a defined strategy involving rapid testing and reference methods...
January 30, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28215073/identification-of-highly-specific-diversity-oriented-synthesis-derived-inhibitors-of-clostridium-difficile
#9
Jeremy R Duvall, Leanne Bedard, Adel M Naylor-Olsen, Abigail L Manson, Joshua A Bittker, Wenye Sun, Mark E Fitzgerald, Zhenmin He, Maurice Dupont Lee, Jean-Charles Marie, Giovanni Muncipinto, Diane Rush, Deming Xu, Huisheng Xu, Mingliang Zhang, Ashlee M Earl, Michelle A Palmer, Michael A Foley, Joseph P Vacca, Christina A Scherer
In 2013, the Centers for Disease Control highlighted Clostridium difficile as an urgent threat for antibiotic resistant infections, in part due to the emergence of highly virulent fluoroquinolone resistant strains. Limited therapeutic options currently exist, many of which result in disease relapse. We sought to identify molecules specifically targeting C. difficile in high throughput screens of our diversity-oriented synthesis compound collection. We identified two scaffolds with apparently novel mechanisms of action that selectively target C...
February 19, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/28214735/rna-based-control-mechanisms-of-clostridium-difficile
#10
REVIEW
Olga Soutourina
Clostridium difficile (CD)-associated diarrhoea is currently the most prevalent nosocomial diarrhoea worldwide. Many characteristics of CD pathogenicity remain poorly understood. Recent data strongly indicate the importance of an RNA network for the control of gene expression in CD. More than 200 regulatory RNAs have been identified by deep sequencing and targeted approaches, including Hfq-dependent trans riboregulators, cis-antisense RNAs, CRISPR RNAs, and c-di-GMP-responsive riboswitches. These regulatory RNAs are involved in the control of major processes in the CD infection cycle, for example motility, biofilm formation, adhesion, sporulation, stress response, and defence against bacteriophages...
February 16, 2017: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/28213939/protective-antibodies-against-clostridium-difficile-are-present-in-intravenous-immunoglobulin-and-are-retained-in-humans-following-its-administration
#11
Ola H Negm, Brendon MacKenzie, Mohamed R Hamed, Omar Aj Ahmad, Clifford C Shone, David P Humphreys, K Ravi Acharya, Christine E Loscher, Izabela Marszalowska, Mark Lynch, Mark H Wilcox, Tanya M Monaghan
The prevalence of serum antibodies against C. difficile (CD) toxins A and B in healthy populations have prompted interest in evaluating the therapeutic activity of intravenous immunoglobulin (IVIg) in individuals experiencing severe or recurrent C. difficile infection (CDI). Despite some promising case reports, a definitive clinical role for IVIg in CDI remains unclear. Contradictory results may be attributed to a lack of consensus regarding optimal dose, timing of administration and patient selection as well as variability in specific antibody content between commercial preparations...
February 18, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28209199/making-life-difficult-for-clostridium-difficile-augmenting-the-pathogen-s-metabolic-model-with-transcriptomic-and-codon-usage-data-for-better-therapeutic-target-characterization
#12
Sara Saheb Kashaf, Claudio Angione, Pietro Lió
BACKGROUND: Clostridium difficile is a bacterium which can infect various animal species, including humans. Infection with this bacterium is a leading healthcare-associated illness. A better understanding of this organism and the relationship between its genotype and phenotype is essential to the search for an effective treatment. Genome-scale metabolic models contain all known biochemical reactions of a microorganism and can be used to investigate this relationship. RESULTS: We present icdf834, an updated metabolic network of C...
February 16, 2017: BMC Systems Biology
https://www.readbyqxmd.com/read/28206678/systematic-review-with-meta-analysis-the-impact-of-clostridium-difficile-infection-on-the-short-and-long-term-risks-of-colectomy-in-inflammatory-bowel-disease
#13
REVIEW
C C Y Law, R Tariq, S Khanna, S Murthy, J D McCurdy
BACKGROUND: Clostridium difficile infection (CDI) is associated with increased mortality in inflammatory bowel disease (IBD), but the risk of colectomy is variable and has not been adequately studied. AIM: To perform a systematic review and meta-analysis to assess the impact of CDI on colectomy risk in IBD. METHODS: Multiple databases were searched systematically for observational studies reporting colectomy risk in IBD, stratified by the presence of CDI, and the duration of follow-up (short term 3 months, and long term at least 1 year)...
February 16, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28198085/the-alternative-sigma-factor-%C3%AF-b-plays-a-crucial-role-in-adaptive-strategies-of-clostridium-difficile-during-gut-infection
#14
Nicolas Kint, Claire Janoir, Marc Monot, Sandra Hoys, Olga Soutourina, Bruno Dupuy, Isabelle Martin-Verstraete
Clostridium difficile is a major cause of diarrhoea associated with antibiotherapy. Exposed to stresses in the gut, C. difficile can survive by inducing protection, detoxification, and repair systems. In several firmicutes, most of these systems are controlled by the general stress response involving σ(B) . In this work, we studied the role of σ(B) in the physiopathology of C. difficile. We showed that the survival of the sigB mutant during the stationary phase was reduced. Using a transcriptome analysis, we showed that σ(B) controls the expression of ∼25% of genes including genes involved in sporulation, metabolism, cell surface biogenesis, and the management of stresses...
February 15, 2017: Environmental Microbiology
https://www.readbyqxmd.com/read/28195066/successful-therapy-of-clostridium-difficile-infection-with-fecal-microbiota-transplantation
#15
P C Konturek, J Koziel, W Dieterich, D Haziri, S Wirtz, I Glowczyk, K Konturek, M F Neurath, Y Zopf
Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea and represents an important burden for healthcare worldwide. Symptoms of severe CDI include watery, foul-smelling diarrhea, peripheral leucocytosis, increased C-reactive protein (CRP), acute renal failure, hypotension and pseudomembranous colitis. Recent studies indicate that the main cause of CDI is dysbiosis, an imbalance in the normal gut microbiota. The restoration of a healthy gut microbiota composition via fecal microbiota transplantation (FMT) recently became more popular...
December 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28182338/evaluation-of-nested-polymerase-chain-reaction-and-immunoassay-for-rapid-diagnosis-of-clostridium-difficile-in-children-with-community-acquired-diarrhea
#16
Ahmed Elewa, Maysaa El Sayed-Zaki
BACKGROUND: Clostridium difficile (C. difficile) is a known pathogen associated with diarrhea especially in hospital acquired diarrhea. Yet, it is being recognized as a probable etiology for community acquired diarrhea. The aim of the present study was to detect the presence of C. difficile as a pathogen causing community acquired diarrhea in children and to verify the value of different laboratory methods for diagnosis, namely specific culture, immunoassay for toxin detection, and nested polymerase chain reaction (nested-PCR)...
February 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28181098/effect-of-aging-on-the-composition-of-fecal-microbiota-in-donors-for-fmt-and-its-impact-on-clinical-outcomes
#17
Rohit Anand, Yang Song, Shashank Garg, Mohit Girotra, Amitasha Sinha, Anita Sivaraman, Laila Phillips, Sudhir K Dutta
BACKGROUND: Fecal microbiota transplantation (FMT) is emerging as an effective therapy for the treatment of recurrent Clostridium difficile infection (RCDI). Selecting an appropriate donor is vital to the success of FMT. However, the relationship between age of donors and the efficacy of FMT has not been examined to date. The aim of this study was to examine the effect of age of healthy donors on their fecal microbiota and assess the impact of these changes on the clinical efficacy of FMT...
February 8, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28181032/comprehensive-evaluation-of-chemiluminescent-immunoassays-for-the-laboratory-diagnosis-of-clostridium-difficile-infection
#18
A Makristathis, I Zeller, D Mitteregger, M Kundi, A M Hirschl
For the microbiological diagnosis of a Clostridium (C.) difficile infection (CDI), a two-test algorithm consisting of a C. difficile glutamate dehydrogenase (GDH)-immunoassay followed by a toxin-immunoassay in positive cases is widely used. In this study, two chemiluminescent immunoassays (CLIAs), one for GDH and the other for the toxins A and B, have been evaluated systematically using appropriate reference methods. Three-hundred diarrhoeal stool specimens submitted for CDI diagnosis were analysed by the LIAISON CLIAs (DiaSorin)...
February 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28178876/designing-fecal-microbiota-transplant-trials-that-account-for-differences-in-donor-stool-efficacy
#19
Scott W Olesen, Thomas Gurry, Eric J Alm
Fecal microbiota transplantation is a highly effective intervention for patients suffering from recurrent Clostridium difficile, a common hospital-acquired infection. Fecal microbiota transplantation's success as a therapy for C. difficile has inspired interest in performing clinical trials that experiment with fecal microbiota transplantation as a therapy for other conditions like inflammatory bowel disease, obesity, diabetes, and Parkinson's disease. Results from clinical trials that use fecal microbiota transplantation to treat inflammatory bowel disease suggest that, for at least one condition beyond C...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28178052/fecal-microbiota-transplant-for-clostridium-difficile-infection-in-a-pregnant-patient
#20
Bejan J Saeedi, Doree Gardner Morison, Colleen S Kraft, Tanvi Dhere
BACKGROUND: Clostridium difficile infection has been associated with negative outcomes in the general population and in pregnant patients. Fecal microbiota transplant has become the standard for treatment of recurrent as well as refractory C difficile infection. CASE: We present a case of a 28-year-old pregnant woman who presented with recurrent C difficile infection despite treatment with vancomycin and fidaxomicin and underwent a successful fecal microbiota transplant through colonoscopy at 18 weeks of gestation...
March 2017: Obstetrics and Gynecology
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