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Clostridium difficile infection

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https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#1
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538249/norovirus-and-clostridium-difficile-outbreaks-squelching-the-wildfire
#2
Ann Fisher, Louise M Dembry
PURPOSE OF REVIEW: Gastrointestinal outbreaks in the healthcare setting cause increased morbidity and mortality in an already vulnerable population. Optimization of infection prevention measures can be a challenge in healthcare settings. This review describes new literature that may change the traditional infection prevention approach to such outbreaks. RECENT FINDINGS: Asymptomatic carriers of both norovirus and Clostridium difficile can pose risk of transmission to others and the environment...
May 22, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28533000/clinical-immunological-and-microbiological-predictors-of-poor-outcome-in-clostridium-difficile-infection
#3
E Reigadas, L Alcalá, M Marín, A Martín, E Bouza
BACKGROUND: Clostridium difficile infection (CDI) causes increased morbidity and mortality. Clinical data cannot clearly predict poor CDI outcome. Data on the value of microbiological predictors is scarce. OBJECTIVE: To identify early predictors of poor outcome of CDI. METHODS: We prospectively included patients with CDI aged >2years. Clinical, immunological (Toxin B IgG/Ig A and Toxin A IgG/Ig A), microbiological factors (bacterial load, toxin quantification, sporulation, germination, and metronidazole susceptibility) were evaluated to identify early independent predictors of poor outcome...
May 11, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28531908/methods-and-reporting-studies-assessing-fecal-microbiota-transplantation-a-systematic-review
#4
Aïda Bafeta, Amelie Yavchitz, Carolina Riveros, Rui Batista, Philippe Ravaud
Background: Fecal microbiota transplantation (FMT) could be a novel treatment option for several chronic diseases associated with altered gut microbiota. Purpose: To examine the conduct and reporting of studies assessing FMT. Data Sources: Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and Web of Science from inception to 31 January 2017. Study Selection: Two reviewers independently examined titles and abstracts to identify all English-language reports of human clinical studies assessing the safety or efficacy of FMT...
May 23, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28531289/management-of-bacteriuria-in-veterans-affairs-hospitals
#5
Emily S Spivak, Muriel Burk, Rongping Zhang, Makoto M Jones, Melinda M Neuhauser, Matthew Bidwell Goetz, Francesca E Cunningham
Background: Bacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (ASB) and long durations of therapy for symptomatic urinary tract infections (UTIs), yet large-scale evaluations of bacteriuria management among inpatients are lacking. Methods: Inpatients with bacteriuria were classified as asymptomatic or symptomatic based on established criteria applied to data collected by manual chart review. We examined frequency of treatment of ASB, factors associated with treatment of ASB, durations of therapy, and frequency of complications including Clostridium difficile infection, readmission and all-cause mortality within 28 days of discharge...
May 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28529025/how-to-establish-and-run-a-stool-bank
#6
REVIEW
Elisabeth M Terveer, Yvette H van Beurden, Abraham Goorhuis, Jos F M L Seegers, Martijn P Bauer, E van Nood, Marcel G W Dijkgraaf, Chris J J Mulder, Christina M J E Vandenbroucke-Grauls, Hein W Verspaget, Josbert J Keller, Ed J Kuijper
Since 2013, several stool banks have been developed following publications reporting on clinical success of "Fecal Microbiota Transplantation" (FMT) for recurrent Clostridium difficile infections (CDI). However, protocols for donor screening, fecal suspension preparation and transfer of the fecal suspension differ between various countries and institutions. Moreover, no European consensus exists regarding the legislative aspects of the fecal suspension product. Internationally standardized recommendations about the above mentioned aspects have not yet been established...
May 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28527248/-clinical-and-demographic-profile-and-risk-factors-for-clostridium-difficile-infection
#7
Carlos Carvajal, Carlos Pacheco, Fabián Jaimes
INTRODUCTION: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. OBJECTIVE: To determine the clinical characteristics of hospitalized patients with C. difficile infection. MATERIALS AND METHODS: We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#8
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#9
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28522725/draft-genome-sequences-of-five-enterococcus-species-isolated-from-the-gut-of-patients-with-suspected-clostridium-difficile-infection
#10
Eduardo Castro-Nallar, Sandro L Valenzuela, Sebastián Baquedano, Carolina Sánchez, Fabiola Fernández, Annette N Trombert
We present draft genome sequences of five Enterococcus species from patients suspected of Clostridium difficile infection. Genome completeness was confirmed by presence of bacterial orthologs (97%). Gene searches using Hidden-Markov models revealed that the isolates harbor between seven and 11 genes involved in antibiotic resistance to tetracyclines, beta-lactams, and vancomycin.
May 18, 2017: Genome Announcements
https://www.readbyqxmd.com/read/28520994/gut-microbiota-mediated-protection-against-diarrheal-infections
#11
Stefanie L Vogt, B Brett Finlay
Background: The mammalian gut microbiota is a highly abundant and diverse microbial community that resides in the gastrointestinal tract. One major benefit that the gut microbiota provides to its host is colonization resistance-the ability to prevent colonization by foreign microbes, including diarrheal pathogens such as Clostridium difficile , Salmonella enterica serovar Typhimurium and diarrheagenic Escherichia coli . Methods: We conducted a literature review of the effects of the gut microbiota on infection by diarrheal pathogens...
April 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28520993/effects-of-short-and-long-course-antibiotics-on-the-lower-intestinal-microbiome-as-they-relate-to-traveller-s-diarrhea
#12
Lawrence Clifford McDonald
BACKGROUND: Antibiotics have profound and lasting effects on the lower intestinal (gut) microbiome that can both promote resistance and increase susceptibility to colonization and infection; knowledge of these changes is important to the prevention and treatment of traveler's diarrhea. METHODS: Recent data from epidemiologic and modern metagenomics studies were reviewed in regard to how such findings could inform the prevention and treatment of traveler's diarrhea...
April 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28520953/evolving-insights-into-the-epidemiology-and-control-of-clostridium-difficile-in-hospitals
#13
Daniel A Caroff, Deborah S Yokoe, Michael Klompas
Typing studies suggest most cases of hospital-onset Clostridium difficile infection are unrelated to other cases of active disease in the hospital. New cases may instead be due to transmissions from asymptomatic carriers or progression of latent C.difficile present-on-admission to active infection. Direct exposure to antibiotics remains the primary risk factor for C.difficile infection but ward-level antibiotic use, antibiotic exposure of the prior room occupant, and C.difficile status of the prior room occupant increase risk for C...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28516109/serum-derived-bovine-immunoglobulin-as-novel-adjunct-in-complicated-clostridium-difficile-colitis-treatment
#14
Samson Ferm, Nims Varadi, Constantine Fisher, Ellen Gutkin
Clostridium difficile infection (CDI) is a well-known complication of antibiotic therapy. It is associated with significant morbidity, mortality, and cost in the hospital setting. The main symptoms include watery diarrhea, abdominal pain, and distension, but CDI can also present as toxic megacolon, bowel perforation with peritonitis, sepsis and renal failure. Therapy includes metronidazole and oral vancomycin, with rectal vancomycin and fecal transplant reserved for more complicated cases. Adjunctive treatments such as probiotics have been tried with mixed results...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28513974/fecal-microbiota-transplantation-outcomes-in-immunocompetent-and-immunocompromised-patients-a-single-center-experience
#15
Sally Alrabaa, Ripal Jariwala, Kristen Zeitler, Jose Montero
BACKGROUND: Clostridium difficile infection (CDI) is a major infectious disease focus for which fecal microbiota transplantation (FMT) has been used with success in various patient populations. METHODS: We conducted a retrospective study of FMT in immunocompetent and immunocompromised patients to review outcomes at our center, with a focus on identifying risk factors for FMT failure in solid organ transplant (SOT) patients. FMT was conducted using universal banked frozen stool via naso-duodenal tube in patients with recurrent CDI of 3 or more episodes per our institutional protocol...
May 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28512094/intrinsic-toxin-derived-peptides-destabilize-and-inactivate-clostridium-difficile-tcdb
#16
Jason L Larabee, Sarah J Bland, Jonathan J Hunt, Jimmy D Ballard
Clostridium difficile infection (CDI) is a major cause of hospital-associated, antibiotic-induced diarrhea, which is largely mediated by the production of two large multidomain clostridial toxins, TcdA and TcdB. Both toxins coordinate the action of specific domains to bind receptors, enter cells, and deliver a catalytic fragment into the cytosol. This results in GTPase inactivation, actin disassembly, and cytotoxicity. TcdB in particular has been shown to encode a region covering amino acids 1753 to 1851 that affects epitope exposure and cytotoxicity...
May 16, 2017: MBio
https://www.readbyqxmd.com/read/28511200/enteric-infection-in-relapse-of-inflammatory-bowel-disease-the-utility-of-stool-microbial-pcr-testing
#17
Jordan E Axelrad, Andrew Joelson, Yael R Nobel, Garrett Lawlor, Peter H R Green, Simon Lichtiger, Benjamin Lebwohl
BACKGROUND: The similar presentations in relapse of inflammatory bowel disease (IBD) and enteric infection pose substantial barriers to diagnosis and treatment. The objective of this study was to investigate the incidence, etiology, predictors, and treatment of enteric infection in patients with IBD. METHODS: We reviewed the records of 214 patients with IBD who underwent 295 gastrointestinal pathogen panel and Clostridium difficile infection (CDI) polymerase chain reaction (PCR) stool tests during an exacerbation of symptoms...
June 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28510584/identification-of-novel-risk-factors-for-community-acquired-clostridium-difficile-infection-using-spatial-statistics-and-geographic-information-system-analyses
#18
Deverick J Anderson, Leoncio Flavio Rojas, Shera Watson, Lauren P Knelson, Sohayla Pruitt, Sarah S Lewis, Rebekah W Moehring, Emily E Sickbert Bennett, David J Weber, Luke F Chen, Daniel J Sexton
BACKGROUND: The rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. As a result, risk factors for exposure to C. difficile in community settings have been inadequately studied. MAIN OBJECTIVE: To identify novel environmental risk factors for CA-CDI. METHODS: We performed a population-based retrospective cohort study of patients with CA-CDI from 1/1/2007 through 12/31/2014 in a 10-county area in central North Carolina...
2017: PloS One
https://www.readbyqxmd.com/read/28506317/changes-in-microbial-ecology-after-fecal-microbiota-transplantation-for-recurrent-c-difficile-infection-affected-by-underlying-inflammatory-bowel-disease
#19
Sahil Khanna, Yoshiki Vazquez-Baeza, Antonio González, Sophie Weiss, Bradley Schmidt, David A Muñiz-Pedrogo, John F Rainey, Patricia Kammer, Heidi Nelson, Michael Sadowsky, Alexander Khoruts, Stefan L Farrugia, Rob Knight, Darrell S Pardi, Purna C Kashyap
BACKGROUND: Gut microbiota play a key role in maintaining homeostasis in the human gut. Alterations in the gut microbial ecosystem predispose to Clostridium difficile infection (CDI) and gut inflammatory disorders such as inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) from a healthy donor can restore gut microbial diversity and pathogen colonization resistance; consequently, it is now being investigated for its ability to improve inflammatory gut conditions such as IBD...
May 15, 2017: Microbiome
https://www.readbyqxmd.com/read/28506071/fecal-microbiota-transplantation-in-recurrent-clostridium-difficile-infection-in-a-patient-with-concomitant-inflammatory-bowel-disease
#20
Marta Gravito-Soares, Elisa Gravito-Soares, Francisco Portela, Manuela Ferreira, Carlos Sofia
The use of fecal microbiota transplantation in recurrent Clostridium difficile infection and coexistent inflammatory bowel disease remains unclear. A 61-year-old man with ulcerative pancolitis was diagnosed with a third recurrence of Clostridium difficile infection, previously treated with metronidazole, vancomycin and fidaxomicin. Fecal microbiota transplantation of an unrelated healthy donor was performed by the lower route. After a twelve month follow-up, the patient remains asymptomatic without Clostridium difficile infection relapses or inflammatory bowel disease flare-ups...
May 16, 2017: Revista Española de Enfermedades Digestivas
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