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"Clostridium difficile" "prevention"

Francesca Micoli, Paolo Costantino, Roberto Adamo
Cell surface carbohydrates have been proven optimal targets for vaccine development. Conjugation of polysaccharides to a carrier protein triggers a T-cell dependent immune response to the glycan moiety. Licensed glycoconjugate vaccines are produced by chemical conjugation of capsular polysaccharides to prevent meningitis caused by meningococcus, pneumococcus and Haemophilus influenzae type b. However, other classes of carbohydrates (O-antigens, exopolysaccharides, wall/teichoic acids) represent attractive targets for developing vaccines...
March 14, 2018: FEMS Microbiology Reviews
Monique J T Crobach, Jonathan J Vernon, Vivian G Loo, Ling Yuan Kong, Séverine Péchiné, Mark H Wilcox, Ed J Kuijper
Clostridium difficile is the main causative agent of antibiotic-associated and health care-associated infective diarrhea. Recently, there has been growing interest in alternative sources of C. difficile other than patients with Clostridium difficile infection (CDI) and the hospital environment. Notably, the role of C. difficile -colonized patients as a possible source of transmission has received attention. In this review, we present a comprehensive overview of the current understanding of C. difficile colonization...
April 2018: Clinical Microbiology Reviews
A von Braun, C Lübbert
The incidence of clostridium difficile infections (CDI) remains on a high level globally. In Germany, the number of severe or even lethal cases continues to increase. The main risk factor for the development of CDI is exposure to broad spectrum antibiotics, which disturb the physiological microbiome and therefore enable colonization with C. difficile. According to the updated US and European guidelines, orally administered vancomycin is the treatment of choice. Fidaxomicin is as effective as vancomycin but has the advantage of a lower rate of recurrence...
March 13, 2018: Der Internist
Isobel Ramsay, Nicholas M Brown, David A Enoch
Recurrence occurs in approximately 25% of all cases of Clostridium difficile infection (CDI) and poses a unique clinical challenge. Traditionally, treatment options of CDI have been limited to regimes of established antibiotics (eg, pulsed/tapered vancomycin) but faecal transplantation is emerging as a useful alternative. In recent years, promising new strategies have emerged for effective prevention of recurrent CDI (rCDI) including new antimicrobials (eg, fidaxomicin) and monoclonal antibodies (eg, bezlotoxumab)...
2018: Infectious Diseases
Brunella Posteraro, Federico Pea, Luca Masucci, Patrizia Posteraro, Maurizio Sanguinetti
Clostridium difficile infection (CDI) is the most common healthcare-associated infection worldwide. As standard CDI antibiotic therapies can result in unacceptably high recurrence rates, novel therapeutic strategies for CDI are necessary. A recently emerged immunological therapy is a monoclonal antibody against C. difficile toxin B. Areas covered: In this review, the authors summarize the available pharmacological, preclinical, and clinical data for the CDI treatment based on anti-toxin A (actoxumab) and anti-toxin B (bezlotoxumab) human monoclonal antibodies (HuMabs), and discuss about the potentiality of a therapy that includes HuMab combined administration for CDI...
March 15, 2018: Expert Opinion on Biological Therapy
Natalia Blanco, Seth Walk, Anurag N Malani, Alexander Rickard, Michele Benn, Marisa Eisenberg, Min Zhang, Betsy Foxman
PURPOSE: This study aimed to describe the correlation between Clostridium difficile spore and toxin levels within the human host. In addition, we assessed whether overgrowth of Candida albicans modified this association. METHODOLOGY: We measured toxin, spore and Candida albicans levels among 200 successively collected stool samples that tested positive for C. difficile, and PCR ribotyped these C. difficile isolates. Analysis of variance and linear regression were used to test the association between spore and toxin levels...
March 13, 2018: Journal of Medical Microbiology
Anna Maikova, Johann Peltier, Pierre Boudry, Eliane Hajnsdorf, Nicolas Kint, Marc Monot, Isabelle Poquet, Isabelle Martin-Verstraete, Bruno Dupuy, Olga Soutourina
Clostridium difficile, a major human enteropathogen, must cope with foreign DNA invaders and multiple stress factors inside the host. We have recently provided an experimental evidence of defensive function of the C. difficile CRISPR (clustered regularly interspaced short palindromic repeats)-Cas (CRISPR-associated) system important for its survival within phage-rich gut communities. Here, we describe the identification of type I toxin-antitoxin (TA) systems with the first functional antisense RNAs in this pathogen...
February 26, 2018: Nucleic Acids Research
Kinga Podlaszewska, Ewa Małecka-Panas, Anita Gąsiorowska
INTRODUCTION: Clostridium difficile associated colitis became over last years a worldwide medical issue. It involves patients of the Polish hospitals too. The aim of the study was the analysis of CDAD incidence and the course of infection in Gastroenterology Ward of Regional Specialist Hospital of Zgierz, 2012-2015. MATERIAL AND METHODS: Retrospective analysis of the medical documentation of 79 patients with CDAD was performed. Demographic and epidemiological data and the clinical course of infection were analyzed...
February 28, 2018: Polski Przeglad Chirurgiczny
Jiayi Cai, Chunyang Zhao, Yajie Du, Yaqiong Zhang, Mingyi Zhao, Qingchun Zhao
Background: Probiotics are commonly used for the prevention of antibiotic-associated diarrhea (AAD). However, the optimum regimen remains controversial. Objective: The objective of this article is to compare and rank the relative efficacy and tolerability among all available probiotic agents for AAD through a network meta-analysis. Methods: Eligible studies were identified by searching PubMed, Embase, Medline, Cochrane library and Web of Science for randomized controlled trials (RCTs) that examined the efficacy of probiotic therapy for AAD...
March 2018: United European Gastroenterology Journal
Sarah Tschudin-Sutter, Ed J Kuijper, Ana Durovic, Maria J G T Vehreschild, Frédéric Barbut, Catherine Eckert, Fidelma Fitzpatrick, Markus Hell, Torbjörn Norén, Jean O'Driscoll, John Coia, Petra Gastmeier, Lutz von Müller, Mark H Wilcox, Andreas F Widmer
SCOPE: Clostridium difficile infection (CDI) is the most important infective cause of healthcare-associated diarrhoea in high income countries and one of the most important healthcare-associated pathogens in both Europe and the United States. It is associated with high morbidity and mortality resulting in both societal and financial burden. A significant proportion of this burden is potentially preventable by a combination of targeted infection prevention and control measures and antimicrobial stewardship...
March 2, 2018: Clinical Microbiology and Infection
A J Rensing, B M Whittam, K H Chan, M P Cain, A E Carroll, W E Bennett
INTRODUCTION: Surgeons frequently use surgical antibiotic prophylaxis (SAP), despite limited evidence to support its efficacy. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), Clostridium difficile infection, and selecting for resistant bacteria. Surgical site infections (SSI) are very rare in patients undergoing clean pediatric urologic procedures. Current guidelines are unclear about the efficacy of surgical antibiotic prophylaxis for prevention of SSI in the pediatric population...
February 21, 2018: Journal of Pediatric Urology
(no author information available yet)
Background: Hospital-acquired infections (HAIs) are infections that patients contract while in the hospital that were neither present nor developing at the time of admission. In Canada an estimated 10% of adults with short-term hospitalization have HAIs. According to 2003 Canadian data, between 4% and 6% of these patients die from these infections. The most common HAIs in Ontario are caused by Clostridium difficile . The standard method of reducing and preventing these infections is decontamination of patient rooms through manual cleaning and disinfection...
2018: Ontario Health Technology Assessment Series
Ilana L Stroke, Jeffrey J Letourneau, Teresa E Miller, Yan Xu, Igor Pechik, Diana R Savoly, Linh Ma, Laurie J Sturzenbecker, Joan Sabalski, Philip D Stein, Maria L Webb, David W Hilbert
Clostridium difficile infection (CDI) is the leading cause of hospital-acquired infectious diarrhea, with significant morbidity, mortality and associated healthcare costs. The major risk factor for CDI is antimicrobial therapy, which disrupts the normal gut microbiota and allows C. difficile to flourish. Treatment of CDI with antimicrobials is generally effective in the short-term, but recurrent infections are frequent and problematic, indicating that improved treatment options are necessary. Symptoms of disease are largely due to two homologous toxins, TcdA and TcdB, which are glucosyltransferases that inhibit host Rho GTPases...
February 26, 2018: Antimicrobial Agents and Chemotherapy
Hande Boyaci, James Chen, Mirjana Lilic, Margaret Palka, Rachel Anne Mooney, Robert Landick, Seth A Darst, Elizabeth A Campbell
Fidaxomicin (Fdx) is an antimicrobial RNA polymerase (RNAP) inhibitor highly effective against Mycobacterium tuberculosis RNAP in vitro , but clinical use of Fdx is limited to treating Clostridium difficile intestinal infections due to poor absorption. To identify the structural determinants of Fdx binding to RNAP, we determined the 3.4 Å cryo-electron microscopy structure of a complete M. tuberculosis RNAP holoenzyme in complex with Fdx. We find that the actinobacteria general transcription factor RbpA contacts fidaxomycin, explaining its strong effect on M...
February 26, 2018: ELife
Danielle L Palms, Elisabeth Mungai, Taniece Eure, Angela Anttila, Nicola D Thompson, Margaret A Dudeck, Jonathan R Edwards, Jeneita M Bell, Nimalie D Stone
BACKGROUND: In 2012, the Centers for Disease Control and Prevention launched the Long-term Care Facility (LTCF) Component of the National Healthcare Safety Network (NHSN) designed for LTCFs to monitor Clostridium difficile infections (CDIs), urinary tract infections (UTIs), infections due to multidrug-resistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA), and infection prevention process measures. METHODS: We describe characteristics and reporting patterns of facilities enrolled in the first 3 years of the surveillance system and rate estimates for CDI, UTI, and MRSA data submitted between 2013 and 2015...
February 22, 2018: American Journal of Infection Control
L Clifford McDonald, Dale N Gerding, Stuart Johnson, Johan S Bakken, Karen C Carroll, Susan E Coffin, Erik R Dubberke, Kevin W Garey, Carolyn V Gould, Ciaran Kelly, Vivian Loo, Julia Shaklee Sammons, Thomas J Sandora, Mark H Wilcox
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis...
February 15, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Marie Christine Uwamahoro, Richard Massicotte, Yves Hurtubise, François Gagné-Bourque, Akier Assanta Mafu, L'Hocine Yahia
Spore-forming pathogenic bacteria, such as Clostridium difficile , are associated with nosocomial infection, leading to the increased use of sporicidal disinfectants, which impacts socioeconomic costs. However, C. difficile can be prevented using microorganisms such as Bacillus amyloliquefaciens , a prophylactic agent that has been proven to be effective against it in recent tests or it can be controlled by sporicidal disinfectants. These disinfectants against spores should be evaluated according to a known and recommended standard...
2018: Frontiers in Public Health
Meghann L Davis, Harlan G Sparrow, Judy O Ikwuagwu, William L Musick, Kevin W Garey, Katherine K Perez
OBJECTIVES: Clostridium difficile infection (CDI) is the most common cause of healthcare-associated infections in the United States. Despite well-established risk factors, very little research has focused on use of these variables to identify a patient population at high-risk for CDI to target with primary prevention strategies. A predictive index for healthcare-associated CDI could improve clinical care and guide research for primary prevention trials. Our objective was to develop a predictive index to identify patients at high-risk for healthcare-associated CDI...
February 15, 2018: Clinical Microbiology and Infection
Oana Bulat, Cristian Bulat, Mihaela Blaj, Ioana Lupusoru, Viorel Scripcariu
BACKGROUND: Schewanella spp. is Gram-negative bacteria, saprophytes and rarely pathogenic. Initially isolated in 193, these belong to the marine environment; Schewanella (Pseudomonas) putrefaciens was found in water, soil and animal sources and produces hydrogen sulphide. Saccharomyces cerevisiae is the well-known yeast used for fermentation in industry and in molecular biology for research. In humans, it is a very rare pathogen which colonises the digestive tract and its utility has been linked to the treatment and prevention of diarrhoea associated with Clostridium difficile...
February 15, 2018: Balkan Medical Journal
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
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