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clostridium difficile and hiv

David B Gootenberg, Jeffrey M Paer, Jesus-Mario Luevano, Douglas S Kwon
PURPOSE OF REVIEW: Despite HIV therapy advances, average life expectancy in HIV-infected individuals on effective treatment is significantly decreased relative to uninfected persons, largely because of increased incidence of inflammation-related diseases, such as cardiovascular disease and renal dysfunction. The enteric microbial community could potentially cause this inflammation, as HIV-driven destruction of gastrointestinal CD4 T cells may disturb the microbiota-mucosal immune system balance, disrupting the stable gut microbiome and leading to further deleterious host outcomes...
February 2017: Current Opinion in Infectious Diseases
Alexander J Keeley, Nicholas J Beeching, Katharine E Stott, Paul Roberts, Alastair J Watson, Michael Bj Beadsworth
BACKGROUND: Clostridium difficile infection (CDI) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality, and financial implications. CDI is a healthcare-associated infection for which the primary risk factor is antibiotic usage, and it is the leading cause of bacterial diarrhoea in HIV-infected patients in the United States. Little is known about the disease burden of CDI in sub-Saharan Africa, where HIV and healthcare-associated infections are more prevalent and antibiotic usage is less restricted...
June 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
Ankita Tirath, Sandra Tadros, Samuel L Coffin, Kristina W Kintziger, Jennifer L Waller, Stephanie L Baer, Rhonda E Colombo, Lu Y Huber, Mufaddal F Kheda, N Stanley Nahman
Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea. Patients with end-stage renal disease (ESRD) may be at increased risk for CDI. Patients with ESRD with CDI have increased mortality, longer length of stay, and higher costs. The present studies extend these observations and address associated comorbidities, incidence of recurrence, and risk factors for mortality. We queried the United States Renal Data System (USRDS) for patients with ESRD diagnosed with CDI, and assessed for the incidence of infection, comorbidities, and mortality...
February 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
David J Weber, William A Rutala
Health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, Clostridium difficile). An effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and isolation of potentially infectious patients, and hand hygiene; (2) assuring immunity to vaccine-preventable diseases; and, (3) immediate availability of a medical evaluation after a nonprotected exposure to an infectious disease...
September 2016: Infectious Disease Clinics of North America
Sergio Serrano-Villar, David Rojo, Mónica Martínez-Martínez, Simon Deusch, Jorge F Vázquez-Castellanos, Talía Sainz, Mar Vera, Santiago Moreno, Vicente Estrada, María José Gosalbes, Amparo Latorre, Abelardo Margolles, Jana Seifert, Coral Barbas, Andrés Moya, Manuel Ferrer
Imbalances in gut bacteria have been associated with multiple diseases. However, whether there are disease-specific changes in gut microbial metabolism remains unknown. Here, we demonstrate that human immunodeficiency virus (HIV) infection (n = 33) changes, at quantifiable levels, the metabolism of gut bacteria. These changes are different than those observed in patients with the auto-immune disease systemic lupus erythaematosus (n = 18), and Clostridium difficile-associated diarrhoea (n = 6). Using healthy controls as a baseline (n = 16), we demonstrate that a trend in the nature and directionality of the metabolic changes exists according to the type of the disease...
2016: Scientific Reports
John V Gahagan, Wissam J Halabi, Vinh Q Nguyen, Joseph C Carmichael, Alessio Pigazzi, Michael J Stamos, Steven D Mills
BACKGROUND: HIV has become a chronic disease, which may render this population more prone to developing the colorectal pathologies that typically affect older Americans. METHODS: A retrospective review of the Nationwide Inpatient Sample was performed to identify patients who underwent colon and rectal surgery from 2001 to 2010. Multivariate analysis was used to evaluate outcomes among the general population, patients with HIV, and patients with AIDS. RESULTS: Hospital admissions for colon and rectal procedures of patients with HIV/AIDS grew at a faster rate than all-cause admissions of patients with HIV/AIDS, with mean yearly increases of 17...
June 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Khee-Siang Chan, Wen-Ying Lee, Wen-Liang Yu
Cytomegalovirus (CMV) colitis usually occurs in immunocompromised patients with human immunodeficiency virus infection, organ transplantation, and malignancy receiving chemotherapy or ulcerative colitis receiving immunosuppressive agents. However, CMV colitis is increasingly recognized in immunocompetent hosts. Notably, CMV colitis coexisting with Clostridium difficile infection (CDI) in apparently healthy individuals has been published in recent years, which could result in high morbidity and mortality. CMV colitis is a rare but possible differential diagnosis in immunocompetent patients with abdominal pain, watery, or especially bloody diarrhea, which could be refractory to standard treatment for CDI...
December 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Joseph C Gathe, Efemena M Diejomaoh, Carl C Mayberry, John B Clemmons
Clostridium difficile is a gram-positive bacterium that is recognized as a causative organism of pseudomembranous enterocolitis. This infection has become a major public health challenge and is a source of considerable morbidity and mortality in those infected. We present a 62-year-old African American female with a long history of HIV infection, who presented with abdominal pain and continuous diarrhea due to pseudomembranous colitis. After failing multiple episodes of conventional therapy, it was decided to treat her with fecal microbiota transplantation...
March 2016: Journal of the International Association of Providers of AIDS Care
Fadel S Alyaqoub, Yasser A Aldhamen, Benjamin J Koestler, Eric L Bruger, Sergey S Seregin, Cristiane Pereira-Hicks, Sarah Godbehere, Christopher M Waters, Andrea Amalfitano
There is a compelling need for more effective vaccine adjuvants to augment induction of Ag-specific adaptive immune responses. Recent reports suggested the bacterial second messenger bis-(3'-5')-cyclic-dimeric-guanosine monophosphate (c-di-GMP) acts as an innate immune system modulator. We recently incorporated a Vibrio cholerae diguanylate cyclase into an adenovirus vaccine, fostering production of c-di-GMP as well as proinflammatory responses in mice. In this study, we recombined a more potent diguanylate cyclase gene, VCA0848, into a nonreplicating adenovirus serotype 5 (AdVCA0848) that produces elevated amounts of c-di-GMP when expressed in mammalian cells in vivo...
February 15, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Enrico D'Amelio, Simonetta Salemi, Raffaele D'Amelio
A brief history of vaccination is presented since the Jenner's observation, through the first golden age of vaccinology (from Pasteur's era to 1938), the second golden age (from 1940 to 1970), until the current period. In the first golden age, live, such as Bacille Calmette Guérin (BCG), and yellow fever, inactivated, such as typhoid, cholera, plague, and influenza, and subunit vaccines, such as tetanus and diphtheria toxoids, have been developed. In the second golden age, the cell culture technology enabled polio, measles, mumps, and rubella vaccines be developed...
May 3, 2016: International Reviews of Immunology
Fernando González-Romo, Juan J Picazo
Recent and important advances in the fields of immunology, genomics, functional genomics, immunogenetics, immunogenomics, bioinformatics, microbiology, genetic engineering, systems biology, synthetic biochemistry, proteomics, metabolomics and nanotechnology, among others, have led to new approaches in the development of vaccines. The better identification of ideal epitopes, the strengthening of the immune response due to new adjuvants, and the search of new routes of vaccine administration, are good examples of advances that are already a reality and that will favour the development of more vaccines, their use in indicated population groups, or its production at a lower cost...
October 2015: Enfermedades Infecciosas y Microbiología Clínica
Stefano Di Bella, Alexander W Friedrich, Esther García-Almodóvar, Maria Serena Gallone, Fabrizio Taglietti, Simone Topino, Vincenzo Galati, Emma Johnson, Silvia D'Arezzo, Nicola Petrosillo
BACKGROUND: HIV infection is a risk factor for Clostridium difficile infection (CDI) yet the immune deficiency predisposing to CDI is not well understood, despite an increasing incidence of CDI among such individuals. We aimed to estimate the incidence and to evaluate the risk factors of CDI among an HIV cohort in Italy. METHODS: We conducted a retrospective case-control (1:2) study. Clinical records of HIV inpatients admitted to the National Institute for Infectious Disease "L...
2015: BMC Infectious Diseases
Stefano Di Bella, Theodore Gouliouris, Nicola Petrosillo
Clostridium difficile infection (CDI) is an emerging problem worldwide associated with significant morbidity, mortality, recurrence rates and healthcare costs. Immunosuppressed patients, including HIV-seropositive individuals, solid organ transplant recipients, patients with malignancies, hematopoietic stem cell transplant recipients, and patients with inflammatory bowel disease are increasingly recognized as being at higher risk of developing CDI where it may be associated with significant complications, recurrence, and mortality...
April 2015: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
N Kumar, M Ekka, Raghunandan P, S Ranjan, S Sinha, S K Sharma, R Chaudhry, N Sharma, H Ahmad, J C Samantaray, V Sreenivas
BACKGROUND: Patients with HIV/AIDS are at a high risk of being infected with toxin-producing strains of Clostridium difficile (C. difficile) because of frequent hospitalization, exposure to antibiotics and antibiotic prophylaxis for opportunistic infections. There are little data from India on the prevalence of C. difficile infection in such patients. METHODS: We assessed the occurrence of C. difficile infections in HIV-positive patients with diarrhoea by looking for the presence of its toxin as well as by culturing...
May 2014: National Medical Journal of India
Andrew S Hunter, David J Guervil, Katherine K Perez, Amy N Schilling, Collin N Verheyden, Nancy N Vuong, Ran Xu
PURPOSE: The most important articles on infectious diseases (ID) pharmacotherapy published in the peer-reviewed literature in 2013, as nominated and selected by panels of pharmacists and others with ID expertise, are summarized. SUMMARY: Members of the Houston Infectious Diseases Network were asked to nominate articles published last year in prominent biomedical journals that had a major impact in the field of ID pharmacotherapy. A list of 27 nominated articles on ID-related topics in general and 26 articles specifically focused on human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) was compiled...
November 15, 2014: American Journal of Health-system Pharmacy: AJHP
Cecília L Costa, Carlos Quesada-Gómez, Cibele B Mano de Carvalho, Rafael H González, Markus A Gifoni, Ronaldo A Ribeiro, Gerly Anne de Castro Brito
Clostridium difficile is the most important cause of nosocomial diarrhea, mainly associated with antibiotic use and immunodeficiency. Although, an increased incidence of community-acquired C. difficile infection (CA-CDI) has been reported worldwide, this infection has been under-diagnosed in Latin America. This is the first report of a CA-CDI case in Latin America, in an HIV-positive patient with cancer.
September 2014: International Journal of Infectious Diseases: IJID
Colleen R Kelly, Chioma Ihunnah, Monika Fischer, Alexander Khoruts, Christina Surawicz, Anita Afzali, Olga Aroniadis, Amy Barto, Thomas Borody, Andrea Giovanelli, Shelley Gordon, Michael Gluck, Elizabeth L Hohmann, Dina Kao, John Y Kao, Daniel P McQuillen, Mark Mellow, Kevin M Rank, Krishna Rao, Arnab Ray, Margot A Schwartz, Namita Singh, Neil Stollman, David L Suskind, Stephen M Vindigni, Ilan Youngster, Lawrence Brandt
OBJECTIVES: Patients who are immunocompromised (IC) are at increased risk of Clostridium difficile infection (CDI), which has increased to epidemic proportions over the past decade. Fecal microbiota transplantation (FMT) appears effective for the treatment of CDI, although there is concern that IC patients may be at increased risk of having adverse events (AEs) related to FMT. This study describes the multicenter experience of FMT in IC patients. METHODS: A multicenter retrospective series was performed on the use of FMT in IC patients with CDI that was recurrent, refractory, or severe...
July 2014: American Journal of Gastroenterology
L Brassinne, H Rodriguez-Villalobos, S Jonckheere, J E Dubuc, J C Yombi
Anaerobes are less frequently described as causative pathogen of prosthetic joint infection (PJI). We report the first case of early PJI after hip arthroplasty due to Clostridium difficile in a diabetic and HIV-1 infected patient with bacteremia. Our patient was successfully treated through surgical debridement and prosthesis retention combined with targeted antibiotic therapy.
June 2014: Anaerobe
V Sumana Kumarappa, Hiren Patel, Anish Shah, Walid Baddoura, Vincent A DeBari
Studies have demonstrated low serum levels of total protein (TP) and albumin (ALB) in patients with Clostridium difficile infection (CDI), especially with refractory and recurrent disease. However, it is not known whether low TP and/or ALB levels are a risk factor for CDI or merely a result of diarrheal loss. The aim of this study is to determine if low TP and/or ALB level is an antecedent or sequela of CDI, which would be useful in risk stratification of hospitalized or nursing home patients. A retrospective cohort study was conducted in a 700-bed tertiary care teaching hospital...
2014: Annals of Clinical and Laboratory Science
Javier Marco-Martínez, Raquel Barba-Martín, Susana Plaza-Canteli, Jesús Canora-Lebrato, Manuel Méndez-Baillón, Jose M de Miguel-Yanes, Antonio Zapatero-Gaviria
INTRODUCTION: Clostridium Difficile infection (CDI) is increasing in Spain. A review is presented of this infection in order to evaluate the burden of the disease in this country. MATERIAL: An analytical retrospective and descriptive study was conducted by analyzing the Minimum Basic Data Set of patients admitted to Internal Medicine Departments and with and without CDI between the years 2005-2010. Clinical and demographical variables were compared. RESULTS: Mean age was 75...
January 2015: Enfermedades Infecciosas y Microbiología Clínica
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