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Clostridium difficile

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https://www.readbyqxmd.com/read/27910000/a-review-of-experimental-and-off-label-therapies-for-clostridium-difficile-infection
#1
REVIEW
Csaba Fehér, Alex Soriano, Josep Mensa
In spite of increased awareness and the efforts taken to optimize Clostridium difficile infection (CDI) management, with the limited number of currently available antibiotics for C. difficile the halt of this increasing epidemic remains out of reach. There are, however, close to 80 alternative treatment methods with controversial anti-clostridial efficacy or in experimental phase today. Indeed, some of these therapies are expected to become acknowledged members of the recommended anti-CDI arsenal within the next few years...
December 1, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27908697/clostridium-difficile-carriage-in-adult-cystic-fibrosis-cf-implications-for-patients-with-cf-and-the-potential-for-transmission-of-nosocomial-infection
#2
D G Burke, M J Harrison, C Fleming, M McCarthy, C Shortt, I Sulaiman, D M Murphy, J A Eustace, F Shanahan, C Hill, C Stanton, M C Rea, R P Ross, B J Plant
Clostridium difficile is an anaerobic Gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal-oral route. Despite increasing carriage rates and the presence of C. difficile toxin in stool, patients with CF rarely appear to develop typical manifestations of C. difficile infection (CDI). In this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of C. difficile in a cohort of 60 adult patients with CF who were pre-lung transplant...
November 29, 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/27908435/antimicrobial-stewardship-programs-that-target-only-high-cost-broad-spectrum-antimicrobials-miss-opportunities-to-reduce-clostridium-difficile-infections
#3
Christine Bui, Elizabeth Zhu, Monica A Donnelley, Machelle D Wilson, Margaret Morita, Stuart H Cohen, Jennifer Brown
Antimicrobial stewardship programs are promoted as a strategy to reduce Clostridium difficile infections. We implemented an antimicrobial stewardship program comprised of formulary restriction plus prospective audit with feedback for high-cost and broad-spectrum antimicrobials. Subsequently, we reviewed all heath care facility-onset, health care facility-associated C difficile infections. We found that most of these infections were associated with the antecedent receipt of nonaudited, and often unnecessary, antimicrobials...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27906466/duodenitis-proximal-jejunitis-in-horses-after-experimental-administration-of-clostridium-difficile-toxins
#4
L G Arroyo, M C Costa, B B Guest, B L Plattner, B N Lillie, J S Weese
BACKGROUND: Duodenitis-proximal jejunitis (DPJ) is an acute sporadic gastrointestinal disorder of horses of unknown cause. HYPOTHESIS/OBJECTIVES: We hypothesize that Clostridium difficile toxins are involved in the pathogenesis of DPJ in horses. The objective of this study was to determine whether experimentally delivered C. difficile toxins cause clinical signs and histologic lesions similar to those of naturally occurring DPJ. ANIMALS: Six healthy mature mixed breed horses...
December 1, 2016: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/27905086/bezlotoxumab-first-global-approval
#5
Anthony Markham
Bezlotoxumab (Zinplava™) is a human monoclonal antibody against Clostridium difficile toxin B developed by Merck & Co. In October 2016 it was approved in the USA for reducing the recurrence of C. difficile infection. This article summarizes the milestones in the development of bezlotoxumab leading to this first approval for use in patients receiving antibacterial drug treatment for C. difficile infection who are at high risk for recurrence of C. difficile infection.
November 30, 2016: Drugs
https://www.readbyqxmd.com/read/27897206/the-incidence-and-drug-resistance-of-clostridium-difficile-infection-in-mainland-china-a-systematic-review-and-meta-analysis
#6
Chenjie Tang, Lunbiao Cui, Yuqiao Xu, Le Xie, Pengfei Sun, Chengcheng Liu, Wenying Xia, Genyan Liu
It has been widely reported that the incidence and severity of Clostridium difficile infection (CDI) have increased dramatically in North America and Europe. However, little is known about CDI in Mainland China. In this study, we aimed to investigate the incidence of CDI and the main epidemic and drug-resistant strains of C. difficile in Mainland China through meta-analysis of related studies published after the year 2010. A total of 51 eligible studies were included. The pooled incidence of toxigenic C. difficile among patients with diarrhoea was 14% (95% CI = 12-16%)...
November 29, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27895859/dysbiosis-of-fecal-microbiota-and-high-frequency-of-citrobacter-klebsiella-spp-and-actinomycetes-in-patients-with-irritable-bowel-syndrome-and-gastroenteritis
#7
Leila Ganji, Masoud Alebouyeh, Mohammad Hassan Shirazi, Seyed Saeed Eshraghi, Abbas Mirshafiey, Naser Ebrahimi Daryani, Mohammad Reza Zali
AIM: This study was aimed to characterize putative differences of fecal microbiota between irritable bowel syndrome (IBS) and gastroenteritis patients and healthy controls. BACKGROUND: New evidence proposed that gut microbiota has a deep effect on the balance between health and disease. PATIENTS AND METHODS: The presence of Clostridium difficile, Campylobacter spp., Enterobacteriacea and Staphylococci were detected in the samples using selective and specific culture media...
2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/27895832/clostridium-difficile-a-healthcare-associated-infection-of-unknown-significance-in-adults-in-sub-saharan-africa
#8
REVIEW
Alexander J Keeley, Nicholas J Beeching, Katharine E Stott, Paul Roberts, Alastair J Watson, Michael Bj Beadsworth
BACKGROUND: Clostridium difficile infection (CDI) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality, and financial implications. CDI is a healthcare-associated infection for which the primary risk factor is antibiotic usage, and it is the leading cause of bacterial diarrhoea in HIV-infected patients in the United States. Little is known about the disease burden of CDI in sub-Saharan Africa, where HIV and healthcare-associated infections are more prevalent and antibiotic usage is less restricted...
June 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27895012/a-multicenter-observational-study-of-ceftaroline-fosamil-for-methicillin-resistant-staphylococcus-aureus-bloodstream-infections
#9
Evan J Zasowski, Trang D Trinh, Kimberly C Claeys, Anthony M Casapao, Noor Sabagha, Abdalhamid M Lagnf, Kenneth P Klinker, Susan L Davis, Michael J Rybak
Novel therapies for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) are needed in the setting of reduced antibiotic susceptibilities and therapeutic failure. Ceftaroline is an advanced generation cephalosporin with MRSA activity. Although not FDA approved for MRSA BSI, ceftaroline has generated much interest as a potential treatment option. However, detailed description of its use in this setting remains limited. To address this, we conducted a retrospective, multicenter, observational study of adult patients with MRSA BSI treated with at least 72 hours of ceftaroline from 2011 to 2015...
November 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27893790/detection-of-a-cfr-b-variant-in-german-enterococcus-faecium-clinical-isolates-and-the-impact-on-linezolid-resistance-in-enterococcus-spp
#10
Jennifer K Bender, Carola Fleige, Ingo Klare, Stefan Fiedler, Alexander Mischnik, Nico T Mutters, Kate E Dingle, Guido Werner
The National Reference Centre for Staphylococci and Enterococci in Germany has received an increasing number of clinical linezolid-resistant E. faecium isolates in recent years. Five isolates harbored a cfr(B) variant gene locus the product of which is capable of conferring linezolid resistance. The cfr(B)-like methyltransferase gene was also detected in Clostridium difficile. Antimicrobial susceptibility was determined for cfr(B)-positive and linezolid-resistant E. faecium isolates and two isogenic C. difficile strains...
2016: PloS One
https://www.readbyqxmd.com/read/27891639/consensus-report-faecal-microbiota-transfer-clinical-applications-and-procedures
#11
REVIEW
J König, A Siebenhaar, C Högenauer, P Arkkila, M Nieuwdorp, T Norén, C Y Ponsioen, U Rosien, N G Rossen, R Satokari, A Stallmach, W de Vos, J Keller, R J Brummer
BACKGROUND: Faecal microbiota transplantation or transfer (FMT) aims at replacing or reinforcing the gut microbiota of a patient with the microbiota from a healthy donor. Not many controlled or randomised studies have been published evaluating the use of FMT for other diseases than Clostridium difficile infection, making it difficult for clinicians to decide on a suitable indication. AIM: To provide an expert consensus on current clinical indications, applications and methodological aspects of FMT...
November 27, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27891552/enteric-glial-cells-are-susceptible-to-clostridium-difficile-toxin-b
#12
Katia Fettucciari, Pamela Ponsini, Davide Gioè, Lara Macchioni, Camilla Palumbo, Elisabetta Antonelli, Stefano Coaccioli, Vincenzo Villanacci, Lanfranco Corazzi, Pierfrancesco Marconi, Gabrio Bassotti
Clostridium difficile causes nosocomial/antibiotic-associated diarrhoea and pseudomembranous colitis. The major virulence factors are toxin A and toxin B (TcdB), which inactivate GTPases by monoglucosylation, leading to cytopathic (cytoskeleton alteration, cell rounding) and cytotoxic effects (cell-cycle arrest, apoptosis). C. difficile toxins breaching the intestinal epithelial barrier can act on underlying cells, enterocytes, colonocytes, and enteric neurons, as described in vitro and in vivo, but until now no data have been available on enteric glial cell (EGC) susceptibility...
November 28, 2016: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/27888332/interaction-of-gut-microbiota-with-bile-acid-metabolism-and-its-influence-on-disease-states
#13
REVIEW
Christopher Staley, Alexa R Weingarden, Alexander Khoruts, Michael J Sadowsky
Primary bile acids serve important roles in cholesterol metabolism, lipid digestion, host-microbe interactions, and regulatory pathways in the human host. While most bile acids are reabsorbed and recycled via enterohepatic cycling, ∼5% serve as substrates for bacterial biotransformation in the colon. Enzymes involved in various transformations have been characterized from cultured gut bacteria and reveal taxa-specific distribution. More recently, bioinformatic approaches have revealed greater diversity in isoforms of these enzymes, and the microbial species in which they are found...
November 25, 2016: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/27888222/asymptomatic-colitis-induced-by-low-dose-methotrexate
#14
Toshikazu Ozeki, Yoshiro Fujita
A woman aged 77 years with a history of rheumatoid arthritis (RA) presented with inflammatory colitis confined to her rectum, which was incidentally found by a screening colonoscopy. Histopathological examination of colonic biopsies showed non-specific inflammatory infiltrates of lymphocytes, the cause of which was unknown. She had been diagnosed with RA 5 years before, and she was receiving methotrexate 6 mg weekly, to which tocilizumab had been added 4 years earlier, which achieved stable control of her disease...
November 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27884118/burden-of-clostridium-difficile-associated-disease-among-patients-residing-in-nursing-homes-a-population-based-cohort-study
#15
Holly Yu, Onur Baser, Li Wang
BACKGROUND: Clostridium difficile (C. difficile) infection (CDI) is the leading cause of nosocomial diarrhea in the United States. This study aimed to examine the incidence of CDI and evaluate mortality and economic burden of CDI in an elderly population who reside in nursing homes (NHs). METHODS: This was a population-based retrospective cohort study focusing on US NHs by linking Medicare 5% sample, Medicaid, Minimum Data Set (MDS) (2008-10). NH residents aged ≥65 years with continuous enrollment in Medicare and/or Medicaid Fee-for-Service plan for ≥12 months and ≥2 quarterly MDS assessments were eligible for the study...
November 25, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27883347/-adalimumab-as-induction-therapy-for-crohn-s-disease-one-center-study
#16
Maciej Gonciarz, Aldona Mularczyk, Dawid Szkudłapski, Iwona Piątek, Marek Kopała
: Adalimumab is a subcutaneously administered recombinant fully human monoclonal antibody targeting tumor necrosis factor alpha. It has been approved for use in Poland to treat patients with Crohn's disease under the program of Polish National Health Found since 2010. AIM: The aim of this study was to evaluate the efficacy of adalimumab monotherapy for inducing clinical remission in patients with active Crohn's disease . The primary outcome assessment was the reduction in score to 150 or below on the Crohn's Disease Activity Index (CDAI) at 12 weeks and the secondary one was the reduction in ΔCDAI of at least 100 points...
November 25, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27880843/highly-divergent-clostridium-difficile-strains-isolated-from-the-environment
#17
Sandra Janezic, Mojca Potocnik, Valerija Zidaric, Maja Rupnik
Clostridium difficile is one of the most important human and animal pathogens. However, the bacterium is ubiquitous and can be isolated from various sources. Here we report the prevalence and characterization of C. difficile in less studied environmental samples, puddle water (n = 104) and soil (n = 79). C. difficile was detected in 14.4% of puddle water and in 36.7% of soil samples. Environmental strains displayed antimicrobial resistance patterns comparable to already published data of human and animal isolates...
2016: PloS One
https://www.readbyqxmd.com/read/27879485/patients-views-on-fecal-microbiota-transplantation-an-acceptable-therapeutic-option-in-inflammatory-bowel-disease
#18
Jonas Zeitz, Marina Bissig, Christiane Barthel, Luc Biedermann, Sylvie Scharl, Daniel Pohl, Pascal Frei, Stephan R Vavricka, Michael Fried, Gerhard Rogler, Michael Scharl
BACKGROUND: Fecal microbiota transplantation (FMT) represents a new therapeutic option that has been studied in two randomized-controlled trials in ulcerative colitis patients. Our study aimed to identify patients' views on the use of this novel therapeutic approach. METHODS: Using an anonymous questionnaire, we obtained data from 574 inflammatory bowel disease (IBD) patients on their knowledge and willingness to undergo FMT. RESULTS: A large proportion of IBD patients (53...
November 22, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27878620/the-role-of-single-shot-metronidazole-in-the-prevention-of-clostridium-difficile-infection-following-ileostomy-reversal-surgery
#19
Roland Fernandes, Paul Robinson, Karan Rangarajan, Sophie Scott, Laura Angco
PURPOSE: Symptomatic infection with Clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. In February 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, in a bid to reduce rates of Clostridium difficile infection. METHODS: A retrospective cohort study was conducted at a single, large hospital trust between February 2014 and February 2016, before and after change in antimicrobial policy...
November 23, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27876339/diagnosis-and-treatment-of-clostridium-difficile-c-diff-colitis-review-of-the-literature-and-a-perspective-in-gynecologic-oncology
#20
REVIEW
Kristin N Taylor, Michael T McHale, Cheryl C Saenz, Steven C Plaxe
Clostridium difficile infection (CDI) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. Colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. Although patients with a gynecologic malignancy may be at a higher risk of developing CDI due to an increased likelihood of having one or more risk factors, data do not consistently support the idea that chemotherapy or cancer itself are independently associated with CDI...
November 19, 2016: Gynecologic Oncology
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