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Clostridium Diff

Kristin N Taylor, Michael T McHale, Cheryl C Saenz, Steven C Plaxe
Clostridium difficile infection (CDI) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. Colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. Although patients with a gynecologic malignancy may be at a higher risk of developing CDI due to an increased likelihood of having one or more risk factors, data do not consistently support the idea that chemotherapy or cancer itself are independently associated with CDI...
November 19, 2016: Gynecologic Oncology
Somwail Rasla, Amr El Meligy, Dragos F Cucu
We report a rare case of Hydralazine-induced ANCA associated glomerulonephritis with alveolar hemorrhage in the setting of acute Clostridium Difficile Infection. A 71-year-old Caucasian woman with hypertension, who was being treated with hydralazine 25 mg twice a day for six years, presented to the hospital with diarrhea, nausea, vomiting and anemia. She had acute kidney injury and urinalysis showed proteinuria, dysmorphic RBCs, and rare RBC cast. She was found to have Clostridium difficile colitis which was successfully treated...
November 1, 2016: Rhode Island Medical Journal
Karin Johansson, Hanna Karlsson, Torbjörn Norén
Diagnostic testing for Clostridium difficile infection (CDI) has, in recent years, seen the introduction of rapid dual-EIA (enzyme immunoassay) tests combining species-specific glutamate dehydrogenase (GDH) with toxin A/B. In a prospective study, we compared the C. DIFF Quik Chek Complete test to a combination of selective culture (SC) and loop-mediated isothermal amplification (LAMP) of the toxin A gene. Of 419 specimens, 68 were positive in SC including 62 positive in LAMP (14.7%). The combined EIA yielded 82 GDH positives of which 47 were confirmed toxin A/B positive (11%) corresponding to a sensitivity and specificity of 94% for GDH EIA compared to SC and for toxin A/B EIA a sensitivity of 71% and a specificity of 99% compared to LAMP...
November 2016: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Hae-Sun Chung, Miae Lee
Rapid and accurate diagnosis of Clostridium difficile infection (CDI) is crucial for patient care, infection control, and efficient surveillance. We evaluated C. DIFF QUIK CHEK COMPLETE (QCC; TechLab), which detects glutamate dehydrogenase (GDH) antigen (QCC-Ag) and toxin A/B (QCC-Tox) simultaneously, and compared it to the laboratory diagnostics for CDI currently in use in a tertiary hospital setting with a high prevalence of CDI. QCC, RIDASCREEN C. difficile toxin A/B assay (Toxin EIA; R-Biopharm AG), chromID C...
January 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
B Kullin, T Brock, N Rajabally, F Anwar, G Vedantam, S Reid, V Abratt
The C. difficile infection rate in South Africa is concerning. Many strains previously isolated from diarrhetic patients at Groote Schuur Hospital were ribotype 017. This study further characterised these strains with respect to their clonal relationships, antibiotic susceptibility, toxin production and various attributes impacting on pathogen colonisation. Multilocus variable-number tandem-repeat analysis (MLVA) was used to characterise all C. difficile isolates. Antibiotic susceptibility was determined by E-test and PCR-based analysis of the ermB, gyrA and gyrB genes...
October 2016: European Journal of Clinical Microbiology & Infectious Diseases
Viytta N Abdullatif, Andrew Noymer
Enterocolitis due to Clostridium difficile is major emerging cause of death in the U.S. Between 1999 and 2012, C. diff. deaths rose by a staggering almost ten-fold amount, to 7,739 from 793. This article has three goals. First, we present a demographic description of C. diff. mortality in the U.S. since 1999. Second, we test a hypothesis that the increase in C. diff. deaths is due to population aging. We find that the emergence of this cause of death follows a proportional hazard pattern above age 40. Thus, population aging is not the only factor responsible for the increase in C...
2016: Biodemography and Social Biology
Richard E Nelson, Makoto Jones, Molly Leecaster, Matthew H Samore, William Ray, Angela Huttner, Benedikt Huttner, Karim Khader, Vanessa W Stevens, Dale Gerding, Marin L Schweizer, Michael A Rubin
BACKGROUND: A number of strategies exist to reduce Clostridium difficile (C. difficile) transmission. We conducted an economic evaluation of "bundling" these strategies together. METHODS: We constructed an agent-based computer simulation of nosocomial C. difficile transmission and infection in a hospital setting. This model included the following components: interactions between patients and health care workers; room contamination via C. difficile shedding; C. difficile hand carriage and removal via hand hygiene; patient acquisition of C...
2016: PloS One
Yuka Yamagishi, Hiroshige Mikamo
Clostridium difficile (C. difficile) is a major pathogen for diarrhea in hospitalized patients and because of outbreak of highly virulent strain in EU and US, increased length of hospital stay and increased numbers of severe patients and deaths have become major challenges. In recent years, transmissions through community-acquired or food-borne infections are reported. National surveillance has been already performed overseas. Guidelines for preventing C. difficile infection (CDI) is available, and education activities are promoted for preventing the infection spread...
December 2015: Japanese Journal of Antibiotics
Özlem Yoldaş, Mustafa Altındiş, Davut Cufalı, Gülşah Aşık, Recep Keşli
BACKGROUND: Clostridium difficile is a common cause of hospital-acquired diarrhea, which is usually associated with previous antibiotic use. The clinical manifestations of C. difficile infection (CDI) may range from mild diarrhea to fulminant colitis. Clostridium difficile should be considered in diarrhea cases with a history of antibiotic use within the last 8 weeks (community-associated CDI) or with a hospital stay of at least 3 days, regardless of the duration of antibiotic use (hospital-acquired CDI)...
January 2016: Balkan Medical Journal
Guoping Cheng, Zihua Li, Xin Dai, Zaihua Wang, Ping Cai, Li Chen, Zhen Zhang
OBJECTIVE: To analyze the incidence and treatment of Clostridium difficile infection (CDI) in pediatric patients with antibiotic-associated diarrhea (AAD). METHOD: Clinical data of totally 577 pediatric patients with AAD seen from January 2012 to January 2014 were collected; those children were divided according to age into 4 groups, 0.25 -1 year, >1 -4 years, >4 -12 years and >12 -18 years old groups, and 220 healthy children were enrolled as controls...
March 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
M Krůtová, O Nyč
OBJECTIVE: To assess the availability of the laboratory diagnosis of infections caused by C. difficile in the Czech Republic (CR), including the range of tests used, possible combinations, and adequate interpretation of model results. MATERIAL AND METHODS: Data were collected through a web questionnaire survey with the participation of representatives of 61 public and private microbiological laboratories. The questionnaire addressed the use of diagnostic test kits and culture media in the diagnosis of C...
June 2015: Epidemiologie, Mikrobiologie, Imunologie
Sudha P Jayaraman, Reza Askari, Molli Bascom, Xiaoxia Liu, Selwyn O Rogers, Michael Klompas
BACKGROUND: There were two major outbreaks of multi-drug resistant Acinetobacter baumannii (MDRA) in our general surgery and trauma intensive care units (ICUs) in 2004 and 2011. Both required aggressive multi-faceted interventions to control. We hypothesized that the infection control response may have had a secondary benefit of reducing rates of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile (C. diff). METHODS: We analyzed data retrospectively from a prospective infection control database at a major university hospital and calculated the incidence rates of nosocomial MRSA, VRE, and C...
December 2014: Surgical Infections
Wafaa Jamal, Eunice M Pauline, Vincent O Rotimi
OBJECTIVES: To evaluate the performance of the GeneXpert C. difficile assay and C. diff Quik Chek Complete (QCC) kit for the detection of toxins from fecal specimens and cooked meat broth (CMB) culture using toxigenic stool culture as reference method, for the diagnosis of C. difficile infection (CDI) in a community setting. METHODS: Non-repeat stool samples were tested simultaneously by GeneXpert and QCC. Toxin detection was done on neat stool samples, inoculated CMB, and isolated colonies...
December 2014: International Journal of Infectious Diseases: IJID
Luis Alcalá, Elena Reigadas, Mercedes Marín, Antonia Fernández-Chico, Pilar Catalán, Emilio Bouza
We compared two multistep diagnostic algorithms based on C. Diff Quik Chek Complete and, as confirmatory tests, GenomEra C. difficile and Xpert C. difficile. The sensitivity, specificity, positive predictive value, and negative predictive value were 87.2%, 99.7%, 97.1%, and 98.3%, respectively, for the GenomEra-based algorithm and 89.7%, 99.4%, 95.5%, and 98.6%, respectively, for the Xpert-based algorithm. GenomEra represents an alternative to Xpert as a confirmatory test of a multistep algorithm for Clostridium difficile infection (CDI) diagnosis...
January 2015: Journal of Clinical Microbiology
Daniel R Knight, Michele M Squire, Thomas V Riley
Clostridium difficile is a well-known enteric pathogen of humans and the causative agent of high-morbidity enteritis in piglets aged 1 to 7 days. C. difficile prevalence in Australian piglets is as high as 70%. The current diagnostic assays have been validated only for human infections, and there are no published studies assessing their performance in Australian piglets. We evaluated the suitability of five assays for detecting C. difficile in 157 specimens of piglet feces. The assays included a loop-mediated isothermal amplification (LMIA)-PCR for tcdA (illumigene C...
November 2014: Journal of Clinical Microbiology
Shipeng Yu, Ahmed Abdelkarim, Ali Nawras, Bryan Thomas Hinch, Chimaka Mbaso, Shahul Valavoor, Fadi Safi, Jeffrey Hammersley, Jianlin Tang, Ragheb Assaly
Clostridium difficile (C diff) colitis infection is the most common cause of nosocomial infectious diarrhea and the prevalence is increasing worldwide. Toxic megacolon is a severe complication of C diff colitis associated with high mortality. Gastrointestinal (GI) comorbidity and impaired smooth muscle contraction are risk factors for the development of C diff-associated toxic megacolon. We present a case of fulminant C diff colitis with toxic megacolon in a patient with Duchenne muscular dystrophy (DMD) in the intensive care unit...
March 2016: American Journal of Therapeutics
Heejung Kim, Wan Hee Kim, Myungsook Kim, Seok Hoon Jeong, Kyungwon Lee
We evaluated the new C. DIFF QUIK CHEK COMPLETE (CD COMPLETE; TechLab, USA), which is a rapid membrane enzyme immunoassay that uses a combination of glutamate dehydrogenase (GDH) antigen and toxin A and B detection. A total of 608 consecutive loose stool specimens collected from the patients with suspected Clostridium difficile infection (CDI) from August to December 2012 were subjected to the CD COMPLETE and VIDAS Clostridium difficile A & B (VIDAS CDAB; bioMérieux, France). Their performances were compared with a toxigenic culture as a reference...
May 2014: Annals of Laboratory Medicine
J Hart, P Putsathit, D R Knight, L Sammels, T V Riley, A Keil
The increasing incidence of Clostridium difficile infection (CDI) in paediatric hospitalised populations, combined with the emergence of hypervirulent strains, community-acquired CDI and the need for prompt treatment and infection control, makes the rapid, accurate diagnosis of CDI crucial. We validated commonly used C. difficile diagnostic tests in a paediatric hospital population. From October 2011 to January 2012, 150 consecutive stools were collected from 75 patients at a tertiary paediatric hospital in Perth, Western Australia...
September 2014: European Journal of Clinical Microbiology & Infectious Diseases
L Bareková, E Zálabská, I Hanovcová
BACKGROUND: Clostridium difficile is currently a significant cause of nosocomial diarrhea. For several years, the number of infectious cases in the community has also been increasing. Since the beginning of 2010, quite a large increase in the number of Clostridium difficile infections (CDIs) has been noted in Pardubice Regional Hospital (PRH). The objectives of this study were to describe and evaluate the methods used in the laboratory diagnosis of CDIs in PRH, and to describe the laboratory diagnostic algorithm used here...
September 2013: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
Noah A Brown, William D Lebar, Carol L Young, Rosemary E Hankerd, Duane W Newton
Clostridium difficile infection (CDI) caused by toxigenic strains of C. difficile is primarily a nosocomial infection with increasing prevalence. Stool specimens are typically collected in Cary-Blair transport medium to maximize culture-based detection of common stool pathogens. The goal of this study was to establish an analytically accurate and efficient algorithm for the detection of CDI in our patient population using samples collected in Cary-Blair transport medium. In addition, we wished to determine whether the sensitivity and specificity of PCR was affected by freezing samples before testing...
March 8, 2011: Infectious Disease Reports
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