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C difficile infections

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https://www.readbyqxmd.com/read/28712548/excess-mortality-between-2007-and-2014-among-patients-with-clostridium-difficile-infection-a-french-health-insurance-database-analysis
#1
F Barbut, S Bouée, L Longepierre, M Goldberg, C Bensoussan, L Levy-Bachelot
BACKGROUND: The impact of CDI (Clostridium difficile infections) on mortality is controversial. AIM: To assess excess mortality due to CDI in France. METHOD: Two cohorts of patients with CDI and a cohort of matched controls were extracted from a 1% representative sample of subjects covered by the general health insurance system in France (EGB database, 660,000 patients). The CDI patients were hospitalized with CDI as a principal diagnosis (PD) or an associated diagnosis (AD) between 2007 and 2014, but not in 2006...
July 13, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28705932/use-of-a-neutralizing-antibody-helps-identify-structural-features-critical-for-binding-of-clostridium-difficile-toxin-tcda-to-the-host-cell-surface
#2
Heather K Kroh, Ramyavardhanee Chandrasekaran, Kim Rosenthal, Rob Woods, Xiaofang Jin, Melanie D Ohi, Andrew C Nyborg, G Jonah Rainey, Paul Warrener, Benjamin W Spiller, D Borden Lacy
Clostridium difficile is a clinically significant pathogen that causes mild-to-severe (and often recurrent) colon infections. Disease symptoms stem from the activities of two large, multi-domain toxins known as TcdA and TcdB. The toxins can bind, enter, and perturb host cell function through a multi-step mechanism of receptor binding, endocytosis, pore formation, autoproteolysis, and glucosyltransferase-mediated modification of host substrates. Monoclonal antibodies that neutralize toxin activity provide a survival benefit in preclinical animal models and prevent recurrent infections in human clinical trials...
July 13, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28705583/prevalence-and-risk-factors-for-colonization-by-clostridium-difficile-and-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-rehabilitation-clinics-in-germany
#3
Mardjan Arvand, Claudia Ruscher, Gudrun Bettge-Weller, Markus Goltz, Yvonne Pfeifer
BACKGROUND: Rehabilitation clinics may vary widely in terms of type of care provided, duration of hospital stay, and case severity. Only few data are available on prevalence of Clostridium difficile or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) colonization in rehabilitation clinics in Germany. AIM: This study investigated the frequency of intestinal colonization by these pathogens among patients in rehabilitation clinics of different specialization...
July 10, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28704538/intestinal-calcium-and-bile-salts-facilitate-germination-of-clostridium-difficile-spores
#4
Travis J Kochan, Madeline J Somers, Alyssa M Kaiser, Michelle S Shoshiev, Ada K Hagan, Jessica L Hastie, Nicole P Giordano, Ashley D Smith, Alyxandria M Schubert, Paul E Carlson, Philip C Hanna
Clostridium difficile (C. difficile) is an anaerobic gram-positive pathogen that is the leading cause of nosocomial bacterial infection globally. C. difficile infection (CDI) typically occurs after ingestion of infectious spores by a patient that has been treated with broad-spectrum antibiotics. While CDI is a toxin-mediated disease, transmission and pathogenesis are dependent on the ability to produce viable spores. These spores must become metabolically active (germinate) in order to cause disease. C. difficile spore germination occurs when spores encounter bile salts and other co-germinants within the small intestine, however, the germination signaling cascade is unclear...
July 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28693926/high-in%C3%A2-vitro-activity-of-fidaxomicin-against-clostridium-difficile-isolates-from-a-university-teaching-hospital-in-china
#5
Jing-Wei Cheng, Qi-Wen Yang, Meng Xiao, Shu-Ying Yu, Meng-Lan Zhou, Timothy Kudinha, Fanrong Kong, Jian-Wei Liao, Ying-Chun Xu
BACKGROUND: Clostridium difficile infection (CDI) is a significant cause of morbidity and mortality in both the acute care setting and the wider healthcare system. The purpose of this study was to evaluate the in vitro activity of fidaxomicin against C.difficile isolates from a university teaching hospital in China. METHODS: One hundred and one C.difficile isolates were collected and analyzed for toxin genes by multiplex PCR. The toxin gene positive strains were also typed by multilocus sequence typing (MLST) and PCR-ribotyping...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28693636/acquisition-of-clostridium-difficile-colonization-and-infection-after-transfer-from-a-veterans-affairs-hospital-to-an-affiliated-long-term-care-facility
#6
Suresh Ponnada, Dubert M Guerrero, Lucy A Jury, Michelle M Nerandzic, Jennifer L Cadnum, M Jahangir Alam, Curtis J Donskey
BACKGROUND Clostridium difficile infection (CDI) and asymptomatic carriage of toxigenic C. difficile are common in long-term care facilities (LTCFs). However, whether C. difficile is frequently acquired in the LTCF versus during acute-care admissions remains unknown. OBJECTIVE To test the hypothesis that LTCF residents often acquire C. difficile colonization and infection in the LTCF DESIGN This 5-month cohort study was conducted to determine the incidence of acquisition of C. difficile colonization and infection in asymptomatic patients transferred from a Veterans Affairs hospital to an affiliated LTCF...
July 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28691996/fecal-microbiota-therapy-with-a-focus-on-c-difficile-infection
#7
Lawrence J Brandt
There has been a paradigm shift in our view of bacteria away from their role as just pathogens. We now have a deepening appreciation of their critical influences in our health maintenance, including energy harvest, metabolism, intestinal development, cell proliferation, nervous system and immune function, as well as their role to protect against intestinal and other infections. A perturbed intestinal microbiome has been associated with an increasing number of gastrointestinal (GI) and non-GI diseases but particularly with C...
July 7, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28689671/detection-of-toxigenic-clostridium-difficile-in-paediatric-patients
#8
Iker Falces-Romero, Paloma Troyano-Hernáez, Silvia García-Bujalance, Fernando Baquero-Artigao, María José Mellado-Peña, Julio García-Rodríguez
INTRODUCTION: Our main objective was a revision of clinical, microbiological and epidemiological results of Clostridium difficile-associated infection in paediatric patients (2010-2015). We compared the diagnoses performed by detection of toxins in feces and those performed by real-time PCR. METHODS: This retrospective study included 82 paediatric patients. Detection of toxigenic C. difficile was performed sequentially, in diarrheal feces and under clinical request...
July 6, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28686001/recreational-sandboxes-for-children-and-dogs-can-be-a-source-of-epidemic-ribotypes-of-clostridium-difficile
#9
Cristina Orden, Carlos Neila, José L Blanco, Sergio Álvarez-Pérez, Celine Harmanus, Ed J Kuijper, Marta E García
Different studies have suggested that the sand of public playgrounds could have a role in the transmission of infections, particularly in children. Furthermore, free access of pets and other animals to the playgrounds might increase such a risk. We studied the presence of Clostridium difficile in 20 pairs of sandboxes for children and dogs located in different playgrounds within the Madrid region (Spain). Clostridium difficile isolation was performed by enrichment and selective culture procedures. The genetic (ribotype and amplified fragment length polymorphism [AFLP]) diversity and antibiotic susceptibility of isolates was also studied...
July 7, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28684034/present-and-past-perspectives-on-clostridium-difficile-infection
#10
D A Álvarez-Hernández, A M González-Chávez, D González-Hermosillo-Cornejo, G A Franyuti-Kelly, A Díaz-Girón-Gidi, R Vázquez-López
Clostridium difficile is a Gram-positive bacillus that has become one of the main hospital-acquired human gastrointestinal infections in recent years. Its incidence is on the rise, involving more virulent strains, affecting new and previously uncontemplated groups of patients, and producing changes in clinical presentation and treatment response that influence disease outcome. Early diagnosis and disease stratification based on the severity of C.difficile infection are essential for therapeutic management and the implementation of containment measures...
July 3, 2017: Revista de Gastroenterología de México
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
#11
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...
July 5, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28680175/outcome-after-discontinuation-of-proton-pump-inhibitors-at-a-residential-care-site-quality-improvement-project
#12
Candy Lee, Anita Lo, Kiran Ubhi, Michael Milewski
BACKGROUND: Increased prescribing of proton pump inhibitors (PPIs) in the past few decades can be attributed mainly to long-term use of this type of therapy. Recent evidence indicates signals of harm associated with long-term use of PPIs, such as increased risk of Clostridium difficile infection, recurrence of C. difficile infection, and fracture. A few studies have assessed the effectiveness of step-down management of patients receiving long-term PPI therapy in ambulatory care settings...
May 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28669864/is-clostridium-difficile-infection-a-risk-factor-for-subsequent-bloodstream-infection
#13
Robert J Ulrich, Kavitha Santhosh, Jill A Mogle, Vincent B Young, Krishna Rao
BACKGROUND: Clostridium difficile infection (CDI) is a common nosocomial diarrheal illness increasingly associated with mortality in United States. The underlying factors and mechanisms behind the recent increases in morbidity from CDI have not been fully elucidated. Murine models suggest a mucosal barrier breakdown leads to bacterial translocation and subsequent bloodstream infection (BSI). This study tests the hypothesis that CDI is associated with subsequent BSI in humans. METHODS: We conducted a retrospective cohort study on 1132 inpatients hospitalized >72 h with available stool test results for toxigenic C...
June 29, 2017: Anaerobe
https://www.readbyqxmd.com/read/28669616/clostridium-difficile-chimeric-toxin-receptor-binding-domain-vaccine-induced-protection-against-different-strains-in-active-and-passive-challenge-models
#14
Jing-Hui Tian, Gregory Glenn, David Flyer, Bin Zhou, Ye Liu, Eddie Sullivan, Hua Wu, James F Cummings, Larry Elllingsworth, Gale Smith
Clostridium difficile is the number one cause of nosocomial antibiotic-associated diarrhea in developed countries. Historically, pathogenesis was attributed two homologous glucosylating toxins, toxin-A (TcdA) and toxin-B (TcdB). Over the past decade, however, highly virulent epidemic strains of C. difficile (B1/NAP1/027) have emerged and are linked to an increase in morbidity and mortality. Increased virulence is attributed to multiple factors including: increased production of A- and B-toxins; production of binary toxin (CDT); and the emergence of more toxic TcdB variants (TcdB(027))...
July 24, 2017: Vaccine
https://www.readbyqxmd.com/read/28666780/impact-of-moving-to-a-new-hospital-build-with-a-high-proportion-of-single-rooms-on-healthcare-associated-infection-and-norovirus-outbreaks
#15
Elizabeth Darley
To determine whether moving to new-build hospital with 75% single-rooms reduced healthcare-associated infection rates, Clostridium difficile infection, meticillin-sensitive Staphylococcus aureus (MSSA) and Escherichia coli bacteraemia rates and bed-days lost during norovirus outbreaks over 5 years at North Bristol NHS Trust were analysed. C. difficile, MSSA bacteraemia and E. coli bacteraemia showed no change in decline rate post-move. Bed-days lost due to norovirus were significantly lower. Increased single room availability had an impact on interruption of highly contagious norovirus infection, dispersed via airborne route, in contrast to bacterial infection, which may originate from patient's own colonising flora and is not widely dispersed through airborne spread...
June 27, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28662012/fatal-course-of-takotsubo-cardiomyopathy-in-a-female-with-recurrent-clostridium-difficile-infection
#16
Waldemar Elikowski, Małgorzata Małek-Elikowska, Monika Lisiecka, Iwona Mozer-Lisewska
Among diverse triggering factors of stress-induced takotsubo cardiomyopathy (TC), a viral or bacterial infection is rarely observed. Sepsis is an exception, regardless of the etiologic pathogen, in which case an excess of catecholamines may result in acute left ventricular dysfunction. TC precipitated by Clostridium difficile infection (CDI) has been reported only in two patients so far. A CASE REPORT: The authors describe another case of TC triggered this time by recurrent C. difficile colitis which occurred in a 72-yearold female...
June 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28660816/the-role-of-antimicrobial-sutures-in-preventing-surgical-site-infection
#17
D Leaper, P Wilson, O Assadian, C Edmiston, M Kiernan, A Miller, G Bond-Smith, J Yap
INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28655581/clinical-and-molecular-characteristics-of-community-acquired-clostridium-difficile-infections-in-comparison-with-those-of-hospital-acquired-c-%C3%A2-difficile
#18
Soon Sung Kwon, Jung Lim Gim, Myung Sook Kim, Heejung Kim, Jun Yong Choi, Dongeun Yong, Kyungwon Lee
Community-acquired Clostridium difficile infection (CA-CDI) is a growing concern. CA-CDI differs from hospital-acquired C. difficile infection (HA-CDI) in its epidemiology, risk factors, severity, and outcomes. In this study, we investigated C. difficile infections in a tertiary care hospital in Seoul, Korea, and compared the CA-CDI and HA-CDI cases diagnosed in the same period. Total 593 cases were confirmed as CDI in 2014, of which CA-CDI accounted for 68 (11.5%) of the total CDI cases. Compared with HA-CDI, the mean age of CA-CDI cases was lower than that of HA-CDI (42...
June 24, 2017: Anaerobe
https://www.readbyqxmd.com/read/28650734/clostridium-difficile-associated-colitis-post-transplant-is-not-associated-with-elevation-of-tacrolimus-concentrations
#19
Hugo J R Bonatti, Karim W Sadik, Elizabeth Krebs, Costi D Sifri, Timothy L Pruett, Robert G Sawyer
BACKGROUND: Diarrhea is a common condition after solid organ transplant (SOT); Clostridium difficile-associated colitis (CDAC) is one of the most common infections after SOT. We documented previously that some types of enteritis are associated with an elevation of tacrolimus (TAC) trough concentrations by interfering with the drug's complex metabolism. PATIENTS AND METHODS: Tacrolimus concentrations of 25 SOT recipients including 12 renal and 13 liver recipients before, during, and after CDAC were analyzed retrospectively...
June 26, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28646951/fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-children
#20
Becky Chen, Vishal Avinashi, Simon Dobson
Fecal microbiota transplantation (FMT) is a relatively simple, promising treatment for recurrent Clostridium difficile infection. While there are a wide variety of approaches including mode of delivery, the results are nonetheless encouraging, even amongst younger children. Experience with FMT in the pediatric population is increasing, showing similar success compared to adults. This article will provide an overview of C. difficile infection along with review of the rationale, methods and complications of FMT including the current experience of FMT in children...
June 2017: Journal of Infection
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