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"Clostridium difficile" "prevention"

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https://www.readbyqxmd.com/read/28210836/clostridium-difficile-infection-in-inflammatory-bowel-disease-challenges-in-diagnosis-and-treatment
#1
REVIEW
Ying M Tang, Christian D Stone
The problem of Clostridium difficile infection (CDI) has reached epidemic proportions, particularly in industrialized nations. The pathophysiology, disease course and the potential complications are well appreciated in the general hospitalized patient. However, when CDI occurs in the setting of inflammatory bowel disease (IBD), a number of distinct differences in the diagnosis and clinical management of the infection in this population should be appreciated by gastroenterologists, hospitalists and other care providers...
February 16, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28210531/the-daniel-k-inouye-college-of-pharmacy-scripts-updates-on-clostridium-difficile-infection-advances-in-laboratory-testing-to-aid-diagnosis-and-treatment
#2
Louis Lteif
Clostridium difficile remains a major source of nosocomial infections and associated diarrhea. More recently, community-acquired cases are on the rise creating a concern for a serious public health threat. Appropriate infection control precautions as well as prevention and optimal management may help to avoid detrimental outbreaks. A key step is utilizing laboratory testing for quick and accurate diagnosis of potential cases. This overview article describes Clostridium difficile infection control and prevention methods and updates the most recent management strategies including a focus on the utilization and interpretation of laboratory diagnostic testing and appropriate treatment...
February 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28192108/timely-use-of-probiotics-in-hospitalized-adults-prevents-clostridium-difficile-infection-a-systematic-review-with-meta-regression-analysis
#3
Nicole T Shen, Anna Maw, Lyubov L Tmanova, Alejandro Pino, Kayley Ancy, Carl V Crawford, Matthew S Simon, Arthur T Evans
BACKGROUND & AIMS: Systematic reviews have provided evidence for the efficacy of probiotics in preventing Clostridium difficile infection (CDI), but guidelines do not recommend probiotic use for prevention of CDI. We performed an updated systematic review to help guide clinical practice. METHODS: We searched MEDLINE, EMBASE, International Journal of Probiotics and Prebiotics, and The Cochrane Library databases for randomized controlled trials evaluating use of probiotics and CDI in hospitalized adults taking antibiotics...
February 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28187144/a-mathematical-model-of-clostridium-difficile-transmission-in-medical-wards-and-a-cost-effectiveness-analysis-comparing-different-strategies-for-laboratory-diagnosis-and-patient-isolation
#4
Vered Schechner, Yehuda Carmeli, Moshe Leshno
BACKGROUND: Clostridium difficile infection (CDI) is a common and potentially fatal healthcare-associated infection. Improving diagnostic tests and infection control measures may prevent transmission. We aimed to determine, in resource-limited settings, whether it is more effective and cost-effective to allocate resources to isolation or to diagnostics. METHODS: We constructed a mathematical model of CDI transmission based on hospital data (9 medical wards, 350 beds) between March 2010 and February 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28169013/cost-analysis-of-an-outbreak-of-clostridium-difficile-infection-ribotype-027-in-a-dutch-tertiary-care-centre
#5
Y H van Beurden, M K Bomers, S D van der Werff, E A P M Pompe, S Spiering, C M J E Vandenbroucke-Grauls, C J J Mulder
BACKGROUND: The economic impact of Clostridium difficile infection (CDI) on the healthcare system is significant. From May 2013 to May 2014, an outbreak of C. difficile ribotype 027 occurred in a Dutch tertiary care hospital, involving 72 patients. The primary aim of this study was to provide insight into the financial burden that this CDI outbreak brought upon this hospital. METHODS: A retrospective analysis was performed to estimate the costs of a one-year-long C...
December 30, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28167669/mucosal-antibodies-to-the-c-terminus-of-toxin-a-prevent-colonization-of-clostridium-difficile
#6
Huynh A Hong, Krisztina Hitri, Siamand Hosseini, Natalia Kotowicz, Donna Bryan, Fatme Mawas, Anthony J Wilkinson, Annie van Broekhoven, Jonathan Kearsey, Simon M Cutting
Mucosal immunity is considered important for protection to Clostridium difficile infection (CDI). We show that in hamsters immunized with Bacillus subtilis spores expressing a carboxy-terminal segment (TcdA26-39) of C. difficile toxin A no colonization occurs in protected animals when challenged with C. difficile strain 630. By contrast, animals immunized with toxoids showed no protection and remained fully colonized. As well as neutralizing toxins, antibodies to TcdA26-39 (but not to toxoids), whether raised to the recombinant protein, or to TcdA26-39 expressed on the B...
February 6, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28166328/comparative-effectiveness-of-vancomycin-and-metronidazole-for-the-prevention-of-recurrence-and-death-in-patients-with-clostridium-difficile-infection
#7
Vanessa W Stevens, Richard E Nelson, Elyse M Schwab-Daugherty, Karim Khader, Makoto M Jones, Kevin A Brown, Tom Greene, Lindsay D Croft, Melinda Neuhauser, Peter Glassman, Matthew Bidwell Goetz, Matthew H Samore, Michael A Rubin
Importance: Metronidazole hydrochloride has historically been considered first-line therapy for patients with mild to moderate Clostridium difficile infection (CDI) but is inferior to vancomycin hydrochloride for clinical cure. The choice of therapy may likewise have substantial consequences on other downstream outcomes, such as recurrence and mortality, although these secondary outcomes have been less studied. Objective: To evaluate the risk of recurrence and all-cause 30-day mortality among patients receiving metronidazole or vancomycin for the treatment of mild to moderate and severe CDI...
February 6, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28145453/high-prevalence-of-toxigenic-clostridium-difficile-in-public-space-lawns-in-western-australia
#8
Peter Moono, Su Chen Lim, Thomas V Riley
Clostridium difficile is a well-established hospital pathogen. Recently, it has been detected increasingly in patients without hospital contact. Given this rise in community associated infections with C. difficile, we hypothesized that the environment could play an important role in transmission of spores outside the hospital. Lawn samples (311) collected in public spaces in the metropolitan area of Perth, Western Australia, from February to June 2016 were cultured for C. difficile. C. difficile was isolated from the samples by direct and enrichment culture, and characterized by standard molecular methods using toxin gene PCR and ribotyping...
February 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28134674/clostridium-difficile-infection-an-orthopaedic-surgeon-s-guide-to-epidemiology-management-and-prevention
#9
Paul A Anderson, James Bernatz, Nasia Safdar
Clostridium difficile infection is a growing concern in health care and is a worrisome complication in orthopaedics. The incidence and severity of this infection are increasing, although the incidence following orthopaedic surgery is comparatively lower than that seen in patients in most other surgical specialties. The typical geriatric orthopaedic patient may have many risk factors that increase the likelihood of C difficile infection, including advanced age, residence in a long-term care facility, multiple comorbidities, the use of perioperative antibiotics, and a long length of stay...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28133313/-a-case-of-advanced-rectal-cancer-resulting-in-a-pathologically-complete-response-after-neoadjuvant-chemotherapy
#10
Takayuki Minoji, Kohei Murata, Tomohiro Kitahara, Shu Okamura, Yoichiro Nushijima, Rie Hamano, Tetsu Yanagisawa, Nariaki Fukuchi, Chikara Ebisui, Hideoki Yokouchi, Masakatsu Kinuta, Kazuhito Ohishi
A 61-years-old man was admitted to our hospital because of abdominal pain. Colonoscopy revealed a type 2 tumor in the rectum, which was diagnosed as low differentiated adenocarcinoma. At least 8 abdominal lymph adenopathies were enhanced on contrast-enhanced CT. We diagnosed stage cT3N2H0M0P0, cStage III b. Because of the risk of a poor prognosis, we tried neoadjuvant chemotherapy for the purpose of down staging. A CRT was prevented by Clostridium difficile enteritis, but we completed 80% of the regimen. Laparoscopic abdominoperineal resection was performed after 4 months of chemotherapy...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28125650/development-of-a-novel-vaccine-containing-binary-toxin-for-the-prevention-of-clostridium-difficile-disease-with-enhanced-efficacy-against-nap1-strains
#11
Susan Secore, Su Wang, Julie Doughtry, Jinfu Xie, Matt Miezeiewski, Richard R Rustandi, Melanie Horton, Rachel Xoconostle, Bei Wang, Catherine Lancaster, Adam Kristopeit, Sheng-Ching Wang, Sianny Christanti, Salvatore Vitelli, Marie-Pierre Gentile, Aaron Goerke, Julie Skinner, Erica Strable, David S Thiriot, Jean-Luc Bodmer, Jon H Heinrichs
Clostridium difficile infections (CDI) are a leading cause of nosocomial diarrhea in the developed world. The main virulence factors of the bacterium are the large clostridial toxins (LCTs), TcdA and TcdB, which are largely responsible for the symptoms of the disease. Recent outbreaks of CDI have been associated with the emergence of hypervirulent strains, such as NAP1/BI/027, many strains of which also produce a third toxin, binary toxin (CDTa and CDTb). These hypervirulent strains have been associated with increased morbidity and higher mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28122873/rising-stakes-for-healthcare-associated-infection-prevention-implications-for-the-clinical-microbiology-laboratory-revised
#12
Daniel J Diekema
Healthcare associated infection (HAI) rates are subject to public reporting, and are linked to hospital reimbursement from the Centers for Medicare and Medicaid Services (CMS). The increasing pressure to lower HAI rates comes at a time when advances in the clinical microbiology laboratory (CML) provide more precise and sensitive tests, altering HAI detection in ways that may increase reported HAI rates. I review how changing CML practices can impact HAI rates, and how the financial implications of HAI metrics may produce pressure to change diagnostic testing practices...
January 25, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28121498/bezlotoxumab-for-prevention-of-recurrent-clostridium-difficile-infection
#13
RANDOMIZED CONTROLLED TRIAL
Mark H Wilcox, Dale N Gerding, Ian R Poxton, Ciaran Kelly, Richard Nathan, Thomas Birch, Oliver A Cornely, Galia Rahav, Emilio Bouza, Christine Lee, Grant Jenkin, Werner Jensen, You-Sun Kim, Junichi Yoshida, Lori Gabryelski, Alison Pedley, Karen Eves, Robert Tipping, Dalya Guris, Nicholas Kartsonis, Mary-Beth Dorr
Background Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy. Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively. Methods We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis...
26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28104319/the-mexican-consensus-on-probiotics-in-gastroenterology
#14
M A Valdovinos, E Montijo, A T Abreu, S Heller, A González-Garay, D Bacarreza, M Bielsa-Fernández, M C Bojórquez-Ramos, F Bosques-Padilla, A I Burguete-García, R Carmona-Sánchez, A Consuelo-Sánchez, E Coss-Adame, J A Chávez-Barrera, M de Ariño, J Flores-Calderón, O Gómez-Escudero, M S González-Huezo, M E Icaza-Chávez, A Larrosa-Haro, M Morales-Arámbula, C Murata, J A Ramírez-Mayans, J M Remes-Troche, T Rizo-Robles, M Peláez-Luna, E M Toro-Monjaraz, A Torre, M E Urquidi-Rivera, R Vázquez, J K Yamamoto-Furusho, F Guarner
INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology...
January 16, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28104287/enhanced-terminal-room-disinfection-and-acquisition-and-infection-caused-by-multidrug-resistant-organisms-and-clostridium-difficile-the-benefits-of-enhanced-terminal-room-disinfection-study-a-cluster-randomised-multicentre-crossover-study
#15
Deverick J Anderson, Luke F Chen, David J Weber, Rebekah W Moehring, Sarah S Lewis, Patricia F Triplett, Michael Blocker, Paul Becherer, J Conrad Schwab, Lauren P Knelson, Yuliya Lokhnygina, William A Rutala, Hajime Kanamori, Maria F Gergen, Daniel J Sexton
BACKGROUND: Patients admitted to hospital can acquire multidrug-resistant organisms and Clostridium difficile from inadequately disinfected environmental surfaces. We determined the effect of three enhanced strategies for terminal room disinfection (disinfection of a room between occupying patients) on acquisition and infection due to meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, C difficile, and multidrug-resistant Acinetobacter. METHODS: We did a pragmatic, cluster-randomised, crossover trial at nine hospitals in the southeastern USA...
January 16, 2017: Lancet
https://www.readbyqxmd.com/read/28096487/a-clostridium-difficile-specific-gel-forming-protein-required-for-optimal-spore-germination
#16
M Lauren Donnelly, William Li, Yong-Qing Li, Lauren Hinkel, Peter Setlow, Aimee Shen
: Clostridium difficile is a Gram-positive spore-forming obligate anaerobe that is a leading cause of antibiotic-associated diarrhea worldwide. In order for C. difficile to initiate infection, its aerotolerant spore form must germinate in the gut of mammalian hosts. While almost all spore-forming organisms use transmembrane germinant receptors to trigger germination, C. difficile uses the pseudoprotease CspC to sense bile salt germinants. CspC activates the related subtilisin-like protease CspB, which then proteolytically activates the cortex hydrolase SleC...
January 17, 2017: MBio
https://www.readbyqxmd.com/read/28078087/clostridium-difficile-infection-in-cystic-fibrosis-an-uncommon-but-life-threatening-complication
#17
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/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#18
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/28057659/lactobacillus-reuteri-dsm-17938-in-the-prevention-of-antibiotic-associated-diarrhoea-in-children-protocol-of-a-randomised-controlled-trial
#19
Maciej Kołodziej, Hania Szajewska
INTRODUCTION: Administration of some probiotics appears to reduce the risk of antibiotic-associated diarrhoea (AAD). The effects of probiotics are strain-specific, thus, the efficacy and safety of each probiotic strain should be established separately. We aim to assess the effects of Lactobacillus reuteri DSM 17938 administration for the prevention of diarrhoea and AAD in children. METHODS AND ANALYSIS: A total of 250 children younger than 18 years treated with antibiotics will be enrolled in a double-blind, randomised, placebo-controlled trial in which they will additionally receive L...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28052855/syn-004-ribaxamase-an-oral-%C3%AE-lactamase-designed-to-protect-the-gut-microbiome-from-the-deleterious-effects-of-certain-intravenously-administered-%C3%AE-lactam-antibiotics-degrades-ceftriaxone-excreted-into-the-intestine-in-phase-2a-clinical-studies
#20
John F Kokai-Kun, Tracey Roberts, Olivia Coughlin, Eric Sicard, Marianne Rufiange, Richard Fedorak, Christian Carter, Marijke H Adams, James Longstreth, Heidi Whalen, Joseph Sliman
SYN-004 (ribaxamase) is a β-lactamase designed to be orally administered concurrently with intravenous β-lactam antibiotics including most penicillins and cephalosporins. Ribaxamase's anticipated mechanism of action is to degrade excess β-lactam antibiotic that is excreted into the small intestine. This enzymatic inactivation of excreted antibiotic is expected to protect the gut microbiome from disruption and thus prevent undesirable side effects including secondary infections like Clostridium difficile as well as other antibiotic-associated diarrheas...
January 4, 2017: Antimicrobial Agents and Chemotherapy
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