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https://www.readbyqxmd.com/read/29149279/impact-of-isolating-clostridium-difficile-carriers-on-the-burden-of-isolation-precautions-a-time-series-analysis
#1
Yasi Xiao, Bianka Paquet-Bolduc, Christophe Garenc, Philippe Gervais, Sylvie Trottier, Jean-François Roussy, Jean Longtin, Vivian G Loo, Yves Longtin
Background: The isolation of asymptomatic Clostridium difficile (CD) carriers may decrease the incidence of hospital-associated C. difficile infections (CDI), but its impact on isolation precaution needs is unknown. Methods: Time series analysis to investigate the impact of isolating CD carriers on the burden of isolation precautions from 2008 to 2016 in a Canadian hospital. To account for the changes in C. difficile infection control policies, the series was divided into three intervention periods...
November 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29146947/the-semiquinone-swing-in-the-bifurcating-electron-transferring-flavoprotein-butyryl-coa-dehydrogenase-complex-from-clostridium-difficile
#2
Julius K Demmer, Nilanjan Pal Chowdhury, Thorsten Selmer, Ulrich Ermler, Wolfgang Buckel
The electron transferring flavoprotein/butyryl-CoA dehydrogenase (EtfAB/Bcd) catalyzes the reduction of one crotonyl-CoA and two ferredoxins by two NADH within a flavin-based electron-bifurcating process. Here we report on the X-ray structure of the Clostridium difficile (EtfAB/Bcd)4 complex in the dehydrogenase-conducting D-state, α-FAD (bound to domain II of EtfA) and δ-FAD (bound to Bcd) being 8 Å apart. Superimposing Acidaminococcus fermentans EtfAB onto C. difficile EtfAB/Bcd reveals a rotation of domain II of nearly 80°...
November 17, 2017: Nature Communications
https://www.readbyqxmd.com/read/29146177/clostridium-difficile-and-clostridium-sordellii-toxins-proinflammatory-versus-anti-inflammatory-response
#3
Michel R Popoff
Clostridium difficile and Clostridium sordellii produce related potent toxins (C. difficile toxin A (TcdA) and toxin B (TcdB), C. sordellii lethal toxin (TcsL) and hemorrhagic toxin (TcsH)) which belong to the large clostridial glucosylating toxin (LCGT) family. TcsL is the main C. sordellii toxin as most of toxigenic C. sordellii strains only synthesize this toxin. Intestinal colonization by C. difficile subsequently to unbalanced microbiota is accompanied by release of toxins which induce local tissue destruction and severe inflammatory response...
November 13, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29144223/no-touch-disinfection-methods-to-decrease-multidrug-resistant-organism-infections-a-systematic-review-and-meta-analysis
#4
Alexandre R Marra, Marin L Schweizer, Michael B Edmond
BACKGROUND Recent studies have shown that using no-touch disinfection technologies (ie, ultraviolet light [UVL] or hydrogen peroxide vapor [HPV] systems) can limit the transmission of nosocomial pathogens and prevent healthcare-associated infections (HAIs). To investigate these findings further, we performed a systematic literature review and meta-analysis on the impact of no-touch disinfection methods to decrease HAIs. METHODS We searched PubMed, CINAHL, CDSR, DARE and EMBASE through April 2017 for studies evaluating no-touch disinfection technology and the nosocomial infection rates for Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and other multidrug-resistant organisms (MDROs)...
November 16, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29143704/identification-of-clostridium-difficile-reservoirs-in-the-patient-environment-and-efficacy-of-aerial-hydrogen-peroxide-decontamination
#5
Samuel Yui, Shanom Ali, Monika Muzslay, Annette Jeanes, A Peter R Wilson
OBJECTIVE To identify, using a novel enhanced method of recovery, environmental sites where spores of Clostridium difficile persist despite cleaning and hydrogen peroxide aerial decontamination. DESIGN Cohort study. SETTING Tertiary referral center teaching hospital. METHODS In total, 16 sites representing high-frequency contact or difficult-to-clean surfaces in a single-isolation room or bed area in patient bed bays were sampled before and after terminal or hydrogen peroxide disinfection using a sponge swab...
November 16, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29140433/il-27-il-27receptor-signaling-provides-protection-in-clostridium-difficile-induced-colitis
#6
Lifang Wang, Ju Cao, Congya Li, Zhang Liping
Background: Clostridium difficile is a leading cause of nosocomial infection. The role of cytokine IL-27 in the immunopathology of Clostridium difficile infection (CDI) remains unknown. Methods: The production of IL-27 was determined in human and murine CDI. Furthermore, wild-type (WT) and IL-27 receptor-deficient (WSX-1 -/-) mice were treated with an antibiotic mixture and infected with C.difficile to investigate the effects of IL-27 on host response to CDI. Results: IL-27 production was elevated during CDI in humans and mice...
November 11, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29139189/clostridium-difficile-infection-in-hospitalized-octogenarian-patients
#7
Anca Trifan, Irina Girleanu, Carol Stanciu, Egidia Miftode, Camelia Cojocariu, Ana-Maria Singeap, Catalin Sfarti, Stefan Chiriac, Tudor Cuciureanu, Oana Stoica
AIM: To evaluate the risk factors and outcome of Clostridium difficile infection in hospitalized octogenarian patients. METHODS: A retrospective analysis of risk factors and outcome of C. difficile infection in hospitalized octogenarians was carried out at two academic centers in Romania from January 2014 to September 2016. Demographic, clinical and laboratory characteristics; antibiotics and proton pump inhibitors use in-hospital and 2 months before admission; comorbidities; length of hospital stay; treatment; and outcome were carefully collected from the patients' medical charts and compared with those from octogenarians hospitalized during the same period...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29138099/effect-of-an-antimicrobial-stewardship-programme-on-antimicrobial-utilisation-and-costs-in-patients-with-leukaemia-a-retrospective-interventional-controlled-study
#8
Miranda So, Muhammad Mamdani, Andrew Morris, Tim Lau, Raewyn Broady, Uday Deotare, Jennifer Grant, Dennis Dong Hwan Kim, Aaron D Schimmer, Andre Schuh, Salomeh Shajari, Marilyn Steinberg, Chaim M Bell, Shahid Husain
OBJECTIVES: To examine the effectiveness of an antimicrobial stewardship programme (ASPs) on utilisation and cost of antimicrobials in leukaemia patients in Canada. METHODS: We conducted a multisite, retrospective, observational time-series study from 2005 to 2013. We implemented academic detailing as the intervention of an ASP in leukaemia units at a hospital, piloted February-July 2010, then fully implemented December 2010-March 2013, with no intervention in August-November 2010...
November 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29136420/assessment-of-environmental-contamination-with-pathogenic-bacteria-at-a-hospital-laundry-facility
#9
Karen E Michael, David No, William E Daniell, Noah S Seixas, Marilyn C Roberts
Little is known about exposure to pathogenic bacteria among industrial laundry workers who work with soiled clinical linen. To study worker exposures, an assessment of surface contamination was performed at an industrial laundry facility serving hospitals in Seattle, WA, USA. Surface swab samples (n = 240) from the environment were collected during four site visits at 3-month intervals. These samples were cultured for Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE)...
November 10, 2017: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/29132405/identifying-predictive-features-of-clostridium-difficile-infection-recurrence-before-during-and-after-primary-antibiotic-treatment
#10
Sepideh Pakpour, Amit Bhanvadia, Roger Zhu, Abhimanyu Amarnani, Sean M Gibbons, Thomas Gurry, Eric J Alm, Laura A Martello
BACKGROUND: Colonization by the pathogen Clostridium difficile often occurs in the background of a disrupted microbial community. Identifying specific organisms conferring resistance to invasion by C. difficile is desirable because diagnostic and therapeutic strategies based on the human microbiota have the potential to provide more precision to the management and treatment of Clostridium difficile infection (CDI) and its recurrence. METHODS: We conducted a longitudinal study of adult patients diagnosed with their first CDI...
November 13, 2017: Microbiome
https://www.readbyqxmd.com/read/29123385/clostridium-difficile-infection-in-the-elderly-an-update-on-management
#11
REVIEW
Tomefa E Asempa, David P Nicolau
The burden of Clostridium difficile infection (CDI) is profound and growing. CDI now represents a common cause of health care-associated diarrhea, and is associated with significant morbidity, mortality, and health care costs. CDI disproportionally affects the elderly, possibly explained by the following risk factors: age-related impairment of the immune system, increasing antibiotic utilization, and frequent health care exposure. In the USA, recent epidemiological studies estimate that two out of every three health care-associated CDIs occur in patients 65 years or older...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29122635/nosocomial-proton-pump-inhibitor-administration-and-the-impact-on-hospital-acquired-clostridium-difficile-infection-development-evidence-and-possible-mechanism
#12
REVIEW
Eric Wombwell, Megan E Chittum, Kayla R Leeser
The incidence of Clostridium difficile infection continues to rise globally. Particularly concerning are hospital-acquired cases which attribute significant morbidity, mortality, and expenditures to the healthcare system. Proton pump inhibitors which are widely prescribed and generally considered to have minimal adverse effects, have recently come under scrutiny for positive associations with C. difficile infection development. This article will specifically review the current state of evidence demonstrating a positive association between nosocomial proton pump inhibitor administration and the incidence of hospital-acquired C...
November 6, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29121673/influence-of-vitamin-d-on-key-bacterial-taxa-in-infant-microbiota-in-the-koala-birth-cohort-study
#13
Chris E Talsness, John Penders, Eugène H J M Jansen, Jan Damoiseaux, Carel Thijs, Monique Mommers
Vitamin D has immunomodulatory properties giving it the potential to affect microbial colonization of the intestinal tract. We investigated whether maternal vitamin D supplemention, maternal plasma 25-hydroxyvitamin D concentration, or direct supplementation of the infant influences key bacterial taxa within microbiota of one month old infants. Infant and maternal vitamin D supplement use was ascertained via questionnaires. Maternal plasma 25-hydroxyvitamin D was determined at approximately the 36th week of pregnancy...
2017: PloS One
https://www.readbyqxmd.com/read/29118940/frequency-of-antibiotic-associated-diarrhea-caused-by-clostridium-difficile-among-hospitalized-patients-in-intensive-care-unit-kerman-iran
#14
Ebrahim Rezazadeh Zarandi, Shahla Mansouri, Nouzar Nakhaee, Farhad Sarafzadeh, Zahra Iranmanesh, Mohammad Moradi
Aim: This study evaluated the frequency of C. difficile and CDAD in the ICU of Shahid Bahonhar Hospital, Kerman, Iran. Background: Clostridium difficile (C. difficile) is the most important antibiotic associated diarrhea agent in intensive care unit (ICU) patients. Based on its toxin producing ability, C .difficile is divided to toxigenic and non-toxigenic strains. Methods: A total of 233 diarrheal samples were collected from ICU patients...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/29118745/biofilm-structures-in-a-mono-associated-mouse-model-of-clostridium-difficile-infection
#15
Anna P Soavelomandroso, Françoise Gaudin, Sandra Hoys, Valérie Nicolas, Gayatri Vedantam, Claire Janoir, Sylvie Bouttier
Clostridium difficile infection (CDI) is a major healthcare-associated disease with high recurrence rates. Host colonization is critical for the infectious process, both in first episodes and in recurrent disease, with biofilm formation playing a key role. The ability of C. difficile to form a biofilm on abiotic surfaces is established, but has not yet been confirmed in the intestinal tract. Here, four different isolates of C. difficile, which are in vitro biofilm producers, were studied for their ability to colonize germ-free mice...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29117204/prevalence-of-binary-toxin-positive-clostridium-difficile-in-diarrhoeal-humans-in-the-absence-of-epidemic-ribotype-027
#16
Alan M McGovern, Grace O Androga, Daniel R Knight, Mark W Watson, Briony Elliott, Niki F Foster, Barbara J Chang, Thomas V Riley
Virulence of Clostridium difficile is primarily attributed to the large clostridial toxins A and B while the role of binary toxin (CDT) remains unclear. The prevalence of human strains of C. difficile possessing only CDT genes (A-B-CDT+) is generally low (< 5%), however, this genotype is commonly found in neonatal livestock both in Australia and elsewhere. Zoonotic transmission of C. difficile has been suggested previously. Most human diagnostic tests will not detect A-B-CDT+ strains of C. difficile because they focus on detection of toxin A and/or B...
2017: PloS One
https://www.readbyqxmd.com/read/29116880/safety-and-immunogenicity-of-clostridium-difficile-toxoid-vaccine-in-japanese-adults
#17
Osamu Matsuoka, Dhaval M Patel, Shin Sasaki, Hayato Oka, Toru Sasaki, Patricia J Pietrobon, Thelma Laot, Alain Bouckenooghe, Josemund Menezes, Guy de Bruyn
This was a randomized, placebo-controlled, Phase I/II study conducted in a Japanese cohort to assess the safety and immunogenicity of Clostridium difficile vaccine (the same formulation as that used in the ongoing global Phase III study). Healthy Japanese adults aged 40-75 years were randomized to receive either C. difficile vaccine (N = 67) or placebo (N = 34) by intramuscular injection on Days 0, 7, and 30. Serum IgG specific for toxins A and B was measured by enzyme-linked immunosorbent assay (ELISA) and in vitro functional activity by toxin neutralizing assay (TNA)...
November 8, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29116155/using-crispr-cas9-mediated-genome-editing-to-generate-c-difficile-mutants-defective-in-selenoproteins-synthesis
#18
Kathleen N McAllister, Laurent Bouillaut, Jennifer N Kahn, William T Self, Joseph A Sorg
Clostridium difficile is a significant concern as a nosocomial pathogen, and genetic tools are important when analyzing the physiology of such organisms so that the underlying physiology/pathogenesis of the organisms can be studied. Here, we used TargeTron to investigate the role of selenoproteins in C. difficile Stickland metabolism and found that a TargeTron insertion into selD, encoding the selenophosphate synthetase that is essential for the specific incorporation of selenium into selenoproteins, results in a significant growth defect and a global loss of selenium incorporation...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29112710/interventions-to-reduce-the-incidence-of-hospital-onset-clostridium-difficile-infection-an-agent-based-modeling-approach-to-evaluate-clinical-effectiveness-in-adult-acute-care-hospitals
#19
Anna K Barker, Oguzhan Alagoz, Nasia Safdar
Background: Despite intensified efforts to reduce hospital-onset Clostridium difficile infection (C. difficile; HO-CDI), its clinical and economic impacts continue to worsen. Many institutions have adopted bundled interventions that vary considerably in composition, strength of evidence, and effectiveness. Considerable gaps remain in our knowledge of intervention effectiveness and disease transmission, which hinders HO-CDI prevention. Methods: We developed an agent-based model of C...
November 3, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29112564/a-surgical-clostridium-associated-risk-of-death-score-predicts-mortality-after-colectomy-for-clostridium-difficile
#20
Audrey S Kulaylat, Zain Kassam, Christopher S Hollenbeak, David B Stewart
BACKGROUND: A Clostridium difficile-associated risk of death score was recently developed and validated by using a national cohort of both nonsurgical and surgical patients admitted with C difficile infection. However, risk scores specifically derived from surgical cohorts and designed for patients with C difficile infection are currently unavailable. OBJECTIVE: The aim of this study was to develop a risk of death score for patients with C difficile infection who are being considered for total abdominal colectomy because of the failure of medical therapy...
December 2017: Diseases of the Colon and Rectum
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