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Clostridium difficile infection

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https://www.readbyqxmd.com/read/28087657/european-consensus-conference-on-faecal-microbiota-transplantation-in-clinical-practice
#1
Giovanni Cammarota, Gianluca Ianiro, Herbert Tilg, Mirjana Rajilić-Stojanović, Patrizia Kump, Reetta Satokari, Harry Sokol, Perttu Arkkila, Cristina Pintus, Ailsa Hart, Jonathan Segal, Marina Aloi, Luca Masucci, Antonio Molinaro, Franco Scaldaferri, Giovanni Gasbarrini, Antonio Lopez-Sanroman, Alexander Link, Pieter de Groot, Willem M de Vos, Christoph Högenauer, Peter Malfertheiner, Eero Mattila, Tomica Milosavljević, Max Nieuwdorp, Maurizio Sanguinetti, Magnus Simren, Antonio Gasbarrini
Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance...
January 13, 2017: Gut
https://www.readbyqxmd.com/read/28087170/clostridium-difficile-rates-in-asymptomatic-and-symptomatic-hospitalized-patients-using-nucleic-acid-testing
#2
Cynthia Truong, Lee F Schroeder, Rajiv Gaur, Victoria Emma Anikst, Ikuko Komo, Colleen Watters, Erin McCalley, Carole Kulik, David Pickham, Nancy J Lee, Niaz Banaei
BACKGROUND: The Clostridium difficile rate in symptomatic patients represents both those with C. difficile infection (CDI) and those with colonization. To predict the extent of CDI overdiagnosis, we compared the asymptomatic colonization rate to the symptomatic positivity rate in hospitalized patients using nucleic acid testing. METHODS: Between July 2014 and April 2015, formed stool samples were collected from asymptomatic patients after admission to 3 hospital wards at the Stanford Hospital...
January 3, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28079620/clostridium-difficile-infection-and-risk-of-colectomy-in-patients-with-inflammatory-bowel-disease-a-bias-adjusted-meta-analysis
#3
Yingxi Chen, Luis Furuya-Kanamori, Suhail A Doi, Ashwin N Ananthakrishnan, Martyn Kirk
BACKGROUND: Clostridium difficile infection (CDI) is a common complication of inflammatory bowel diseases (IBDs) and is associated with worse outcome. Variable rates of colectomy have been reported among IBD complicated by CDI. We conducted a systematic review and meta-analysis of studies to assess the association between CDI and colectomy among patients with IBD. METHODS: The literature was systematically searched using PubMed from inception through April 2016...
January 10, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28078087/clostridium-difficile-infection-in-cystic-fibrosis-an-uncommon-but-life-threatening-complication
#4
Francesco Piccolo, Anna Sze Tai, Hooi Ee, Siobhain Mulrennan, Scott Bell, Gerard Ryan
Adults with cystic fibrosis (CF) have significant rates of asymptomatic Clostridium difficile carriage and are frequently exposed to risk factors for C. difficile infection (CDI). Despite this, the rate of reported CDI in CF is low. We describe three cases of near fatal CDI in adults with CF and review the literature regarding presentation, management, and recurrence prevention. Early recognition is important as the clinical presentation may be atypical and the illness can be severe and even life-threatening...
January 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28077697/point-counterpoint-what-is-the-optimal-approach-for-detection-of-clostridium-difficile-infection
#5
Ferric C Fang, Christopher R Polage, Mark H Wilcox
In 2010, we published an initial point-counterpoint on laboratory diagnosis of C. difficile infection (CDI). At that time, nucleic acid amplification tests (NAATs) were just becoming commercially available, and the idea of algorithmic approaches to CDI was being explored. Now there are numerous NAATs in the marketplace and based on recent proficiency test surveys, they have become the predominant method used for CDI diagnosis in the United States. At the same time, there is a body of literature that suggests that NAATs lack clinical specificity and thus inflate CDI rates...
January 11, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28077694/laboratory-testing-of-donors-and-stool-for-fecal-microbiota-transplantation-for-recurrent-c-difficile-infection
#6
Michael H Woodworth, Emma M Neish, Nancy S Miller, Tanvi Dhere, Eileen M Burd, Cynthia Carpentieri, Kaitlin L Sitchenko, Colleen S Kraft
Fecal microbiota transplantation is an efficacious and inexpensive therapy for recurrent Clostridium difficile, yet its safety is thought to depend on appropriate fecal donor screening. FDA guidance for regulation of this procedure is in flux but screening and manufacture of fecal material from asymptomatic donors presents many challenges to clinical laboratories. This minireview summarizes FDA regulatory changes, principles of donor selection and recommended laboratory screening for fecal microbiota transplantation...
January 11, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#7
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28075419/surveillance-of-clostridium-difficile-infections-results-from-a-six-year-retrospective-study-in-nine-hospitals-of-a-north-italian-local-health-authority
#8
Greta Roncarati, Laura Dallolio, Erica Leoni, Manuela Panico, Angela Zanni, Patrizia Farruggia
Clostridium difficile is an emerging cause of healthcare associated infections. In nine hospitals of an Italian Local Health Authority the episodes of C. difficile infection (CDI) were identified using the data registered by the centralized Laboratory Information System, from 2010 to 2015. CDI incidence (positive patients for A and/or B toxins per patients-days) was analysed per year, hospital, and ward. A number of cases approximately equivalent to the mean of identified cases per year were studied retrospectively to highlight the risk factors associated to CDI and their severity...
January 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28070336/noncontiguous-finished-genome-sequence-and-description-of-prevotella-phocaeensis-sp-nov-a-new-anaerobic-species-isolated-from-human-gut-infected-by-clostridium-difficile
#9
P Afouda, S Ndongo, S Khelaifia, N Labas, F Cadoret, F Di Pinto, J Delerce, D Raoult, M Million
Prevotella phocaeensis sp. nov. strain SN19(T) (= DSM 103364) is a new species isolated from the gut microbiota of patient with colitis due to Clostridium difficile. Strain SN19(T) is Gram-negative rod-shaped bacteria, strictly anaerobic, nonmotile and non-endospore forming. The predominance fatty acid is hexadecanoic acid. Its 16S rRNA showed a 97.70% sequence identity with its phylogenetically closest species, Prevotella oralis. The genome is 2 922 117 bp long and contains 2486 predicted genes including 56 RNA genes...
January 2017: New Microbes and New Infections
https://www.readbyqxmd.com/read/28065332/clostridium-difficile-contamination-of-health-care-workers-hands-and-its-potential-contribution-to-the-spread-of-infection-review-of-the-literature
#10
REVIEW
Ingrid Jullian-Desayes, Caroline Landelle, Marie-Reine Mallaret, Christian Brun-Buisson, Frédéric Barbut
BACKGROUND: Clostridium difficile infection (CDI) can be transmitted from patient to patient by the hands of health care workers (HCWs); however, the relative importance of this route in the spread of C difficile in the hospital is currently unknown. Our aim was to review studies examining HCWs' hand carriage and its potential role in CDI transmission. METHODS: First, English-speaking references addressing HCWs' hand sampling obtained from the PubMed database were reviewed...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28063955/asymptomatic-carriers-contribute-to-nosocomial-clostridium-difficile-infection-a-cohort-study-of-4508-patients
#11
Thomas Blixt, Kim Oren Gradel, Christian Homann, Jakob Benedict Seidelin, Kristian Schønning, Anne Lester, Jette Houlind, Marie Stangerup, Magnus Gottlieb, Jenny Dahl Knudsen
BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects of of asymptomatic carriers on nosocomial C difficile infections. METHODS: We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013...
January 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28060888/the-association-between-gaba-modulators-and-clostridium-difficile-infection-a-matched-retrospective-case-control-study
#12
Jonathan Ström, Johan Tham, Fredrik Månsson, Jonas Ahl, Tor C Savidge, Sara M Dann, Fredrik Resman
OBJECTIVE: Recently, metabolomics studies have suggested that the neurotransmitter γ-amino butyric acid (GABA) may modulate C. difficile infection (CDI) pathogenesis. In the present study, we investigated the association between GABA-modulating pharmaceuticals and CDI development. METHODS: In July-December 2013, we performed a matched, retrospective case-control study in Skåne county, Sweden, to assess the association between the use of GABA-modulators (defined as regular use of at least one of the following: zolpidem, zopiclone, benzodiazepines, gabapentin, pregabalin or baclofen) and CDI...
2017: PloS One
https://www.readbyqxmd.com/read/28060753/clostridium-difficile-colonization-in-preoperative-colorectal-cancer-patients
#13
Yi Zheng, Yun Luo, Yinxiang Lv, Chen Huang, Qinsong Sheng, Peng Zhao, Julian Ye, Weiqin Jiang, Lulu Liu, Xiaojun Song, Zhou Tong, Wenbin Chen, Jianjiang Lin, Yi-Wei Tang, Dazhi Jin, Weijia Fang
The entire process of Clostridium difficile colonization to infection develops in large intestine. However, the real colonization pattern of C. difficile in preoperative colorectal cancer patients has not been studied. In this study, 33 C. difficile strains (16.1%) were isolated from stool samples of 205 preoperative colorectal cancer patients. C. difficile colonization rates in lymph node metastasis patients (22.3%) were significantly higher than lymph node negative patients (10.8%) (OR=2.314, 95%CI=1.023-5...
January 2, 2017: Oncotarget
https://www.readbyqxmd.com/read/28060346/cefoperazone-treated-mouse-model-of-clinically-relevant-clostridium-difficile-strain-r20291
#14
Jenessa A Winston, Rajani Thanissery, Stephanie A Montgomery, Casey M Theriot
Clostridium difficile is an anaerobic, gram-positive, spore-forming enteric pathogen that is associated with increasing morbidity and mortality and consequently poses an urgent threat to public health. Recurrence of a C. difficile infection (CDI) after successful treatment with antibiotics is high, occurring in 20-30% of patients, thus necessitating the discovery of novel therapeutics against this pathogen. Current animal models of CDI result in high mortality rates and thus do not approximate the chronic, insidious disease manifestations seen in humans with CDI...
December 10, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28060332/production-crystallization-and-structure-determination-of-c-difficile-ppep-1-via-microseeding-and-zinc-sad
#15
Christian Pichlo, Angelika A Montada, Magdalena Schacherl, Ulrich Baumann
New therapies are needed to treat Clostridium difficile infections that are a major threat to human health. The C. difficile metalloprotease PPEP-1 is a target for future development of inhibitors to decrease the virulence of the pathogen. To perform biophysical and structural characterization as well as inhibitor screening, large amounts of pure and active protein will be needed. We have developed a protocol for efficient production and purification of PPEP-1 by the use of E. coli as the expression host yielding sufficient amounts and purity of protein for crystallization and structure determination...
December 30, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28059612/fecal-microbial-transplantation-as-a-therapeutic-option-in-patients-colonized-with-antibiotic-resistant-organisms
#16
Michael Laffin, Braden Millan, Karen L Madsen
Despite increasing interest in fecal microbiota transplantation (FMT), its full therapeutic potential has yet to be determined. Since its increase in popularity, FMT has been shown to be highly effective in the treatment of both Clostridium difficile infection (CDI) and its recurrent form. Interest in FMT now expands well beyond the treatment of CDI to other processes with known associations to the microbiota such as antibiotic resistant infections, inflammatory bowel disease (IBD), hepatic encephalopathy, neuropsychiatric disorders, and metabolic disease...
January 6, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28058011/fecal-microbial-transplant-for-the-treatment-of-pediatric-inflammatory-bowel-disease
#17
REVIEW
Alice Yuxin Wang, Jelena Popov, Nikhil Pai
The role of fecal microbial transplant (FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrent Clostridium difficile infection (RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease (IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhood-onset disease...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28057949/impact-of-targeted-educational-interventions-on-clostridium-difficile-infection-treatment-in-critically-ill-adults
#18
Drayton A Hammond, Catherine A Hughes, Jacob T Painter, Rose E Pennick, Kshitij Chatterjee, Bradley Boye, Nikhil Meena
Background: Clostridium difficile infection (CDI) is a growing clinical and economic burden throughout the world. Pharmacists often are members of the primary care team in the intensive care unit (ICU) setting; however, the impact of pharmacists educating other health care providers on appropriateness of CDI treatment has not been previously examined. Objective: This study was performed to determine the impact of structured educational interventions on CDI treatment on appropriateness of CDI treatment and clinical outcomes...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28057560/predictors-of-failure-after-single-faecal-microbiota-transplantation-in-patients-with-recurrent-clostridium-difficile-infection-results-from-a-three-year-single-centre-cohort-study
#19
Gianluca Ianiro, Luca Valerio, Luca Masucci, Silvia Pecere, Stefano Bibbò, Gianluca Quaranta, Brunella Posteraro, Diego Currò, Maurizio Sanguinetti, Antonio Gasbarrini, Giovanni Cammarota
OBJECTIVES: Faecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI). Although a single faecal infusion is usually sufficient to eradicate CDI, a considerable rate of patients needs multiple infusions to be cured. The aim of this study was to identify predictors of failure after single faecal infusion in patients with recurrent CDI. METHODS: We included patients with recurrent CDI prospectively treated with FMT by colonoscopy...
January 2, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28054289/procalcitonin-is-a-poor-predictor-of-non-infectious-fever-in-the-neurocritical-care-unit
#20
Karin Halvorson, Sameer Shah, Corey Fehnel, Bradford Thompson, N Stevenson Potter, Mitchell Levy, Linda Wendell
BACKGROUND: Fever is a common occurrence in the Neurocritical Care Unit (NCCU). It is reported that up to 50 % of these fevers are associated with a non-infectious source. As this is a diagnosis of exclusion, a complete fever evaluation must be done to rule out infection. Procalcitonin (PCT) has been identified as a possible biomarker to distinguish infectious from non-infectious etiologies of fever. We hypothesized that PCT could be used as a predictor of infectious fever in febrile patients with intracranial hemorrhage admitted to the NCCU...
January 4, 2017: Neurocritical Care
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