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https://www.readbyqxmd.com/read/29769275/-point-counterpoint-active-surveillance-for-carriers-of-toxigenic-clostridium-difficile-should-be-performed-to-guide-prevention-efforts
#1
L Clifford McDonald, Daniel J Diekema
In 2017, we published a point-counterpoint on laboratory diagnosis of C. difficile infection (CDI). At that time, Drs Ferric Fang, Christopher Polage, and Mark Wilcox discussed the strategies for diagnosing Clostridium difficile colitis in symptomatic patients. Since that manuscript new guidelines from the Infectious Diseases Society of American and the Society for Health Care Epidemiology have been published (1) and healthcare systems have begun to explore screening asymptomatic patients for C. difficile colonization...
May 16, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29760164/%C3%A2-bezlotoxumab-for-prevention-of-recurrence-of-clostridium-difficile-infection
#2
(no author information available yet)
Clostridium difficile infection is a significant cause of infectious diarrhoea and is associated with considerable morbidity and mortality.1,2 Management of Clostridium difficile infection often requires treatment with antibiotics (metronidazole, vancomycin or fidaxomicin) alongside supportive care to manage hydration, electrolytes and nutrition. However, the risk of recurrence is approximately 20%.2 Here, we review the evidence for bezlotoxumab (▼ Zinplava - Merck Sharp & Dohme Limited), a monoclonal antibody licensed for the prevention of recurrence of Clostridium difficile in adults who are at high risk of recurrence...
May 2018: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/29759925/metronidazole-in-the-prevention-of-antibiotic-associated-diarrhoea-and-clostridium-difficile-infection-in-high-risk-hospitalised-patients
#3
Marco Tobar-Marcillo, Maria Guerrero-Duran, Ariana Avecillas-Segovia, Lillana Pacchiano-Aleman, Roberto Basante-Díaz, Hiram Vela-Vizcaino, Eduardo Espinosa-Aznar, Pedro Castorena García, Ricardo Santiago-Ramírez, Ixel Rivas-Bucio
BACKGROUND: In-hospital diarrhoea has a high impact on morbidity and mortality rates among hospitalised patients. Chemoprophylaxis with antibiotics in selected patients could be a cost-effective tool for prevention. METHODS: A prospective randomised, open-label study was conducted in a tertiary hospital in Mexico City, selecting patients at high risk of acquiring in-hospital diarrhoea and assigning them to a group taking metronidazole 500mg orally every eight hours for seven days or an observation group...
May 11, 2018: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/29748286/structural-basis-for-recognition-of-frizzled-proteins-by-clostridium-difficile-toxin-b
#4
Peng Chen, Liang Tao, Tianyu Wang, Jie Zhang, Aina He, Kwok-Ho Lam, Zheng Liu, Xi He, Kay Perry, Min Dong, Rongsheng Jin
Clostridium difficile infection is the most common cause of antibiotic-associated diarrhea in developed countries. The major virulence factor, C. difficile toxin B (TcdB), targets colonic epithelia by binding to the frizzled (FZD) family of Wnt receptors, but how TcdB recognizes FZDs is unclear. Here, we present the crystal structure of a TcdB fragment in complex with the cysteine-rich domain of human FZD2 at 2.5-angstrom resolution, which reveals an endogenous FZD-bound fatty acid acting as a co-receptor for TcdB binding...
May 11, 2018: Science
https://www.readbyqxmd.com/read/29725956/use-of-prophylactic-saccharomyces-boulardii-to-prevent-clostridium-difficile-infection-in-hospitalized-patients-a-controlled-prospective-intervention-study
#5
Jeppe West Carstensen, Mahtab Chehri, Kristian Schønning, Steen Christian Rasmussen, Jacob Anhøj, Nina Skavlan Godtfredsen, Christian Østergaard Andersen, Andreas Munk Petersen
Clostridium difficile infection (CDI) is a common complication to antibiotic use. Saccharomyces boulardii has shown effect as a prophylactic agent. We aimed to evaluate the efficacy of S. boulardii in preventing CDI in unselected hospitalized patients treated with antibiotics. We conducted a 1 year controlled prospective intervention study aiming to prescribe Sacchaflor (S. boulardii 5 × 109 , Pharmaforce ApS) twice daily to hospitalized patients treated with antibiotics. Comparable departments from three other hospitals in our region were included as controls...
May 3, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29722832/rising-incidence-of-intestinal-infections-in-inflammatory-bowel-disease-a-nationwide-analysis
#6
Grant E Barber, Steven Hendler, Philip Okafor, David Limsui, Berkeley N Limketkai
Background: Intestinal infections are common in patients with inflammatory bowel disease (IBD) and may mimic IBD flares. In this study, we estimate the changing incidence of intestinal infections among IBD hospitalizations and assess the impact of intestinal infections on key hospitalization metrics. Methods: The National Inpatient Sample (NIS) was analyzed for hospitalizations from IBD between 1998 and 2014. Intestinal infections were identified using ICD-9-CM codes, and incidence for each infection was calculated for Crohn's disease (CD) and ulcerative colitis (UC)...
May 2, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29702133/primary-prevention-of-clostridium-difficile-infections-with-a-specific-probiotic-combining-lactobacillus-acidophilus-cl1285-l-casei-lbc80r-and-l-rhamnosus-clr2-a-critical-appraisal-of-the-evidence
#7
REVIEW
Lynne V McFarland, Noam Ship, Julie Auclair, Mathieu Millette
Clostridium difficile infections (CDI) have become the leading cause of healthcare-associated infections and causes outbreaks around the world. Although various new innovative treatments have been developed, preventive strategies using multi-faceted infection control programmes have not been as successful in reducing CDI rates. The major risk factor for CDI is the disruption of the normally protective gastrointestinal microbiota, typically by antibiotic use. Supplementation with specific probiotics has been found to be effective in preventing various negative outcomes, including antibiotic-associated diarrhoea and CDI...
April 24, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29701662/feasibility-of-a-lactobacillus-casei-drink-in-the-intensive-care-unit-for-prevention-of-antibiotic-associated-diarrhea-and-clostridium-difficile
#8
Cathy Alberda, Sam Marcushamer, Tayne Hewer, Nicole Journault, Demetrios Kutsogiannis
Background: Over 70% of patients are prescribed antibiotics during their intensive care (ICU) admission. The gut microbiome is dramatically altered early in an ICU stay, increasing the risk for antibiotic associated diarrhea (AAD) and Clostridium difficile infections (CDI). Evidence suggests that some probiotics are effective in the primary prevention of AAD and CDI. Aim: To demonstrate safety and feasibility of a probiotic drink in ICU patients. Methods: ICU patients initiated on antibiotics were recruited, and matched with contemporary controls...
April 26, 2018: Nutrients
https://www.readbyqxmd.com/read/29701568/results-of-a-quality-improvement-initiative-reassessing-an-institutional-lumbar-drain-infection-prevention-protocol
#9
Ariane Lewis, Aaron Rothstein, Donato Pacione
OBJECTIVE The objective of this study was to determine the effects of a quality improvement initiative in which daily antibiotics and daily sampling of cerebrospinal fluid (CSF) were discontinued for patients with lumbar drains. METHODS The frequency of surgical site infections (SSIs), antibiotic-related complications (development of Clostridium difficile infection [CDI] and growth of resistant bacteria), and cost for patients with lumbar drains were compared during 3 periods: 1) prolonged prophylactic systemic antibiotics (PPSA) until the time of drain removal and daily CSF sampling (September 2013-2014), 2) PPSA and CSF sampling once after placement then as needed (January 2015-2016), and 3) antibiotics only during placement of the lumbar drain and CSF sampling once after placement then as needed (April 2016-2017)...
April 27, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29695312/microbial-preparations-probiotics-for-the-prevention-of-clostridium-difficile-infection-in-adults-and-children-an-individual-patient-data-meta-analysis-of-6-851-participants
#10
Bradley C Johnston, Lyubov Lytvyn, Calvin Ka-Fung Lo, Stephen J Allen, Duolao Wang, Hania Szajewska, Mark Miller, Stephan Ehrhardt, John Sampalis, Deniz G Duman, Pietro Pozzoni, Agostino Colli, Elisabet Lönnermark, Christian P Selinger, Samford Wong, Susan Plummer, Mary Hickson, Ruzha Pancheva, Sandra Hirsch, Bengt Klarin, Joshua Z Goldenberg, Li Wang, Lawrence Mbuagbauw, Gary Foster, Anna Maw, Behnam Sadeghirad, Lehana Thabane, Dominik Mertz
OBJECTIVETo determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children.DESIGNIndividual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors.METHODSWe searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality...
April 26, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29695310/effectiveness-of-probiotic-for-primary-prevention-of-clostridium-difficile-infection-a-single-center-before-and-after-quality-improvement-intervention-at-a-tertiary-care-medical-center
#11
William E Trick, Stephen J Sokalski, Stuart Johnson, Kristen L Bunnell, Joseph Levato, Michael J Ray, Robert A Weinstein
OBJECTIVETo evaluate probiotics for the primary prevention of Clostridium difficile infection (CDI) among hospital inpatients.DESIGNA before-and-after quality improvement intervention comparing 12-month baseline and intervention periods.SETTINGA 694-bed teaching hospital.INTERVENTIONWe administered a multispecies probiotic comprising L. acidophilus (CL1285), L. casei (LBC80R), and L. rhamnosus (CLR2) to eligible antibiotic recipients within 12 hours of initial antibiotic receipt through 5 days after final dose...
April 26, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29692762/-clostridium-difficile-from-colonization-to-infection
#12
REVIEW
Holger Schäffler, Anne Breitrück
Clostridium difficile is the most frequent cause of nosocomial antibiotic-associated diarrhea. The incidence of C. difficile infection (CDI) has been rising worldwide with subsequent increases in morbidity, mortality, and health care costs. Asymptomatic colonization with C. difficile is common and a high prevalence has been found in specific cohorts, e.g., hospitalized patients, adults in nursing homes and in infants. However, the risk of infection with C. difficile differs significantly between these cohorts...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29689301/distinct-consequences-of-amoxicillin-and-ertapenem-exposure-in-the-porcine-gut-microbiome
#13
Sheila Connelly, Poorani Subramanian, Nur A Hasan, Rita R Colwell, Michael Kaleko
The gut microbiome influences many, if not all, aspects of human health. Antibiotics, while lifesaving, have the unintended consequence of killing commensal microbiota inhabiting the gastrointestinal (GI) tract, which can lead to overgrowth of opportunistic pathogens such as Clostridium difficile and emergence of antibiotic-resistant organisms. Here, porcine models were developed to evaluate changes to the gut microbiome caused by two distinct types of beta-lactam antibiotics delivered via common administration routes, oral amoxicillin and intravenous ertapenem...
April 21, 2018: Anaerobe
https://www.readbyqxmd.com/read/29688901/safety-and-efficacy-of-encapsulated-fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-a-systematic-review
#14
Umair Iqbal, Hafsa Anwar, Muhammad A Karim
BACKGROUND AND AIMS: Fecal microbial transplantation (FMT) has been shown to be effective for the treatment of recurrent clostridium difficile infection (CDI). The efficacy and safety of freeze-dried encapsulated FMT for the treatment of recurrent CDI is unclear. We performed a systematic review to evaluate and analyze the current evidence in this respect. MATERIALS AND METHODS: A systematic literature search was performed using the PubMed, Embase, and Medline databases until December 2017 to identify all original studies that investigated the role of administration of encapsulated FMT in recurrent CDI...
April 23, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29685855/molecular-epidemiologic-study-of-clostridium-difficile-infections-in-university-hospitals-results-of-a-nationwide-study-in-japan
#15
Issei Tokimatsu, Katsumi Shigemura, Kayo Osawa, Shinya Kinugawa, Koichi Kitagawa, Noriko Nakanishi, Hiroyuki Yoshida, Soichi Arakawa, Masato Fujisawa
We conducted a nationwide molecular epidemiological study of Clostridium difficile infection (CDI) in Japan investigated the correlation between the presence of binary toxin genes and CDI severity. This is the first report on molecular epidemiological analyses for CDI in multiple university hospitals in Japan, to our knowledge. We examined 124,484 hospitalized patients in 25 national and public university hospitals in Japan between December 2013 and March 2014, investigating antimicrobial susceptibilities and toxin-related genes for C...
April 20, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29682562/-clostridium-difficile-infections-a-global-overview-of-drug-sensitivity-and-resistance-mechanisms
#16
REVIEW
Saeed S Banawas
Clostridium difficile (C. difficile) is the most prevalent causative pathogen of healthcare-associated diarrhea. Notably, over the past 10 years, the number of Clostridium difficile outbreaks has increased with the rate of morbidity and mortality. The occurrence and spread of C. difficile strains that are resistant to multiple antimicrobial drugs complicate prevention as well as potential treatment options. Most C. difficile isolates are still susceptible to metronidazole and vancomycin. Incidences of C. difficile resistance to other antimicrobial drugs have also been reported...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29678466/cost-effectiveness-analysis-of-oral-probiotics-for-the-prevention-of-clostridium-difficile-associated-diarrhoea-in-children-and-adolescents
#17
Na Li, Bin Zheng, Hong-Fu Cai, Yan-Hui Chen, Ming-Qi Qiu, Mao-Bai Liu
BACKGROUND: The incidence of Clostridium difficile-associated diarrhoea (CDAD) in hospitalized children and adolescents has been increasing year-on-year. Paediatric CDAD represents a significant economic burden on healthcare systems. Probiotics are live organisms thought to improve the microbial balance of the host, counteract disturbances in intestinal flora, and reduce the risk of colonization by pathogenic bacteria. AIM: We conducted a cost-effectiveness analysis to assess the economy of probiotics for the prevention of CDAD in children and adolescents receiving antibiotics...
April 17, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29667186/infectious-diseases-in-older-adults-of-long-term-care-facilities-update-on-approach-to-diagnosis-and-management
#18
REVIEW
Robin L P Jump, Christopher J Crnich, Lona Mody, Suzanne F Bradley, Lindsay E Nicolle, Thomas T Yoshikawa
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review. Following this discussion, salient points on clinical relevance, clinical presentation, diagnostic approach, therapy, and prevention are discussed for skin and soft tissue infections, infectious diarrhea (Clostridium difficile and norovirus infections), bacterial pneumonia, and urinary tract infection, as well as some of the newer approaches to preventive interventions in the LTCF setting...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29661624/long-term-care-facility-national-healthcare-safety-network-enrollment-challenges-2016
#19
Sarah Sutherland, Rebecca Meyer
The Centers for Medicare & Medicaid Services has a national goal to increase the number of long-term care facilities reporting Clostridium difficile infection data to the Centers for Disease Control and Prevention. A partnership between the Tennessee Department of Health and the quality improvement organization, Qsource, helped facilitate successful enrollment into the National Healthcare Safety Network for nursing homes in the state of Tennessee.
April 13, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29659753/patient-and-strain-characteristics-associated-with-clostridium-difficile-transmission-and-adverse-outcomes
#20
Jessica S H Martin, David W Eyre, Warren N Fawley, David Griffiths, Kerrie Davies, Damian P C Mawer, Timothy E A Peto, Derrick W Crook, A Sarah Walker, Mark H Wilcox
Background: No previous study has used whole-genome sequencing (WGS) to investigate risk factors for C. difficile(CD) transmission between symptomatic cases, or assessed the impact of recent acquisition on patient outcome. Methods: This retrospective cohort study included consecutive diarrhoeal samples positive by cytotoxin assay in Leeds, UK(Aug10-Apr12). All samples underwent culture, ribotyping and WGS(Illumina). Sequenced isolates were compared using single nucleotide variants(SNVs)...
April 12, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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