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Clostridium difficile infection (CDI)

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102 papers 0 to 25 followers Clostridium difficile infection
https://www.readbyqxmd.com/read/28939450/prediction-of-recurrent-clostridium-difficile-infection-at-the-bedside-the-geih-cdi-score
#1
Javier Cobo, Esperanza Merino, Cristina Martínez, Alberto Cózar-Llistó, Evelyn Shaw, Teresa Marrodán, Esther Calbo, Elena Bereciartúa, Luis A Sánchez-Muñoz, Miguel Salavert, M Teresa Pérez-Rodríguez, Dácil García-Rosado, J María Bravo-Ferrer, Juan Gálvez-Acebal, César Henríquez-Camacho, Jordi Cuquet, Berta Pino-Calm, Luis Torres, Antonio Sánchez-Porto, Borja M Fernández-Félix
Recurrence of Clostridium difficile infection (CDI) has major consequences for both patients and the health system. The ability to predict which patients are at increased risk of recurrent CDI makes it possible to select candidates for treatment with new drugs and therapies (including fecal microbiota transplantation) that have proven to reduce the incidence of recurrence of CDI. Our objective was to develop a clinical prediction tool, the GEIH-CDI score, to determine the risk of recurrence of CDI. Predictors of recurrence of CDI were investigated using logistic regression in a prospective cohort of 274 patients diagnosed with CDI...
September 20, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29424238/the-rise-and-fall-of-metronidazole-for-clostridium-difficile-infection
#2
Elias B Chahine
Clostridium difficile is posing urgent health threats. Older studies have shown that metronidazole and vancomycin are equally effective in the treatment of Clostridium difficile infection (CDI). Given its inexpensive cost and low propensity to select antimicrobial resistant organisms, metronidazole became rapidly the drug of choice despite its pharmacokinetic limitations in the treatment of CDI. However, newer studies demonstrated that metronidazole is inferior to vancomycin, prompting clinicians to change their long-standing position on using metronidazole for mild to moderate infections and on reserving vancomycin for severe infections...
February 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29349705/stool-cultures-at-the-icu-get-rid-of-it
#3
Carolin F Manthey, Darja Dranova, Martin Christner, Laura Berneking, Stefan Kluge, Ansgar W Lohse, Valentin Fuhrmann
BACKGROUND: Stool cultures for Campylobacter, Salmonella and Shigella and/or Yersinia spp. are frequently ordered in critically ill patients with diarrhea. The aim of this study is to analyze the diagnostic yield in a large cohort of critically ill patients. Therefore, we performed a cohort study at the Department of Intensive Care Medicine of a University Hospital (11 ICUs). RESULTS: From all patients who were admitted to the ICU between 2010 and 2015, stool cultures were taken from 2...
January 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29353504/clostridium-difficile-control-measures-current-and-future-methods-for-prevention
#4
Erik R Dubberke, Carlos Mejia-Chew
Clostridium difficile is the most common cause of healthcare associated infection, and C. difficile infection (CDI) is associated with significant costs, morbidity, and mortality. One obstacle to preventing CDI is lack of high quality data on interventions to prevent CDI. This has led some to focus on areas, such as method of hand hygiene, unlikely to impact CDI incidence as much as others, such as contact precautions. In addition, existing strategies, although effective, do have limitations. Another challenge is the ability to rapidly, and accurately, diagnose CDI...
January 22, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29383662/diagnostic-guidance-for-c-difficile-infections
#5
Monique J T Crobach, Amoe Baktash, Nikolas Duszenko, Ed J Kuijper
Diagnosis of Clostridium difficile infection (CDI) can be challenging. First of all, there has been debate on which of the two reference assays, cell cytotoxicity neutralization assay (CCNA) or toxigenic culture (TC) should be considered the gold standard for CDI detection. Although the CCNA suffers most from suboptimal storage conditions and subsequent toxin degradation, TC is reported to falsely increase CDI detection rates as it cannot differentiate CDI patients from patients asymptomatically colonised by toxigenic C...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29383665/cellular-uptake-and-mode-of-action-of-clostridium-difficile-toxins
#6
Panagiotis Papatheodorou, Holger Barth, Nigel Minton, Klaus Aktories
Research on the human gut pathogen Clostridium difficile and its toxins has gained much attention, particularly as a consequence of the increasing threat to human health presented by emerging hypervirulent strains. Toxin A (TcdA) and B (TcdB) are the two major virulence determinants of C. difficile. Both are single-chain proteins with a similar multidomain architecture. Certain hypervirulent C. difficile strains also produce a third toxin, namely binary toxin CDT (Clostridium difficile transferase). As C. difficile toxins are the causative agents of C...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29383668/antibiotic-resistances-of-clostridium-difficile
#7
Patrizia Spigaglia, Paola Mastrantonio, Fabrizio Barbanti
The rapid evolution of antibiotic resistance in Clostridium difficile and the consequent effects on prevention and treatment of C. difficile infections (CDIs) are matter of concern for public health. Antibiotic resistance plays an important role in driving C. difficile epidemiology. Emergence of new types is often associated with the emergence of new resistances and most of epidemic C. difficile clinical isolates is currently resistant to multiple antibiotics. In particular, it is to worth to note the recent identification of strains with reduced susceptibility to the first-line antibiotics for CDI treatment and/or for relapsing infections...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29383670/faecal-microbiota-transplantation-as-emerging-treatment-in-european-countries
#8
Marcello Maida, James Mcilroy, Gianluca Ianiro, Giovanni Cammarota
Clostridium difficile infection (CDI) is one of the most common healthcare-associated infections in the world and is a leading cause of morbidity and mortality in hospitalized patients.Although several antibiotics effectively treat CDI, some individuals do not respond to these drugs and may be cured by transplanting stool from healthy donors. This procedure, termed Faecal Microbiota Transplantation (FMT), has demonstrated remarkable efficacy as a treatment for recurrent CDI.FMT has also been investigated in other diseases and disorders where perturbations to the gut microbiota have been theorized to play a causative role in pathogenesis and severity, such as inflammatory bowel disease (IBD)...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29383669/probiotics-for-prevention-and-treatment-of-clostridium-difficile-infection
#9
Lorena Valdés-Varela, Miguel Gueimonde, Patricia Ruas-Madiedo
Probiotics have been claimed as a valuable tool to restore the balance in the intestinal microbiota following a dysbiosis caused by, among other factors, antibiotic therapy. This perturbed environment could favor the overgrowth of Clostridium difficile and, in fact, the occurrence of C. difficile-associated infections (CDI) is being increasing in recent years. In spite of the high number of probiotics able to in vitro inhibit the growth and/or toxicity of this pathogen, its application for treatment or prevention of CDI is still scarce since there are not enough well-defined clinical studies supporting efficacy...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29310122/dietary-trehalose-enhances-virulence-of-epidemic-clostridium-difficile
#10
J Collins, C Robinson, H Danhof, C W Knetsch, H C van Leeuwen, T D Lawley, J M Auchtung, R A Britton
Clostridium difficile disease has recently increased to become a dominant nosocomial pathogen in North America and Europe, although little is known about what has driven this emergence. Here we show that two epidemic ribotypes (RT027 and RT078) have acquired unique mechanisms to metabolize low concentrations of the disaccharide trehalose. RT027 strains contain a single point mutation in the trehalose repressor that increases the sensitivity of this ribotype to trehalose by more than 500-fold. Furthermore, dietary trehalose increases the virulence of a RT027 strain in a mouse model of infection...
January 3, 2018: Nature
https://www.readbyqxmd.com/read/29203446/update-on-clostridium-difficile-from-the-european-congress-of-clinical-microbiology-and-infectious-diseases-eccmid-2017-22-25-april-vienna-austria
#11
Kerrie Davies, Jane Freeman, Susan Mayor
No abstract text is available yet for this article.
December 1, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29117204/prevalence-of-binary-toxin-positive-clostridium-difficile-in-diarrhoeal-humans-in-the-absence-of-epidemic-ribotype-027
#12
Alan M McGovern, Grace O Androga, Daniel R Knight, Mark W Watson, Briony Elliott, Niki F Foster, Barbara J Chang, Thomas V Riley
Virulence of Clostridium difficile is primarily attributed to the large clostridial toxins A and B while the role of binary toxin (CDT) remains unclear. The prevalence of human strains of C. difficile possessing only CDT genes (A-B-CDT+) is generally low (< 5%), however, this genotype is commonly found in neonatal livestock both in Australia and elsewhere. Zoonotic transmission of C. difficile has been suggested previously. Most human diagnostic tests will not detect A-B-CDT+ strains of C. difficile because they focus on detection of toxin A and/or B...
2017: PloS One
https://www.readbyqxmd.com/read/29048477/the-role-of-toxins-in-clostridium-difficile-infection
#13
Ramyavardhanee Chandrasekaran, D Borden Lacy
Clostridium difficile is a bacterial pathogen that is the leading cause of nosocomial antibiotic-associated diarrhea and pseudomembranous colitis worldwide. The incidence, severity, mortality and healthcare costs associated with C. difficile infection (CDI) are rising, making C. difficile a major threat to public health. Traditional treatments for CDI involve use of antibiotics such as metronidazole and vancomycin, but disease recurrence occurs in about 30% of patients, highlighting the need for new therapies...
November 1, 2017: FEMS Microbiology Reviews
https://www.readbyqxmd.com/read/29061499/reducing-inappropriate-testing-for-the-evaluation-of-diarrhea-among-hospitalized-patients
#14
Chad E Tewell, Thomas R Talbot, George E Nelson, Bryan D Harris, Whitney A Jones, Narinder Midha, David P Mulherin, Eric B Stephens, Anuj Thirwani, Patty W Wright
BACKGROUND: Diarrhea is one of the most common illnesses in the United States. Evaluation frequently does not follow established guidelines. To evaluate the effectiveness of a computerized physician order entry based test guidance algorithm with regards to the clinical, financial, and operational impacts. METHODS: Our population was patients with diarrheal illness at a tertiary academic medical center. The intervention was a computerized physician order entry (CPOE) based test guidance algorithm that restricted the use of stool cultures and ova and parasites testing of diarrhea in the adult inpatient location versus non-intervention sites which were the emergency department, pediatric inpatient, and outpatient locations...
October 20, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29077920/metronidazole-an-update-on-metabolism-structure-cytotoxicity-and-resistance-mechanisms
#15
Simon A Dingsdag, Neil Hunter
Metronidazole, a nitroimidazole, remains a front-line choice for treatment of infections related to inflammatory disorders of the gastrointestinal tract including colitis linked to Clostridium difficile. Despite >60 years of research, the metabolism of metronidazole and associated cytotoxicity is not definitively characterized. Nitroimidazoles are prodrugs that are reductively activated (the nitro group is reduced) under low oxygen tension, leading to imidazole fragmentation and cytotoxicity. It remains unclear if nitroimidazole reduction (activation) contributes to the cytotoxicity profile, or whether subsequent fragmentation of the imidazole ring and formed metabolites alone mediate cytotoxicity...
October 25, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29079158/clostridium-difficile-in-older-adults
#16
REVIEW
Curtis J Donskey
Recent increases in the incidence of Clostridium difficile infection (CDI) have been observed in all age groups, but the elderly have been disproportionately affected and long-term care facilities (LTCFs) have borne a significant proportion of the increasing burden. Recurrences are common in older adults and may have significant adverse effects on quality of life. Ensuring appropriate diagnostic testing and management is challenging for older adults in the community and in LTCFs. This review focuses on current concepts related to the epidemiology, diagnosis, and management of CDI in older adults...
December 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28923757/clinical-practice-and-infrastructure-review-of-fecal-microbiota-transplantation-for-clostridium-difficile-infection
#17
REVIEW
Brendan J Kelly, Pablo Tebas
A substantial proportion of Clostridium difficile infection (CDI) cases recur after completion of antibiotic therapy, and antibiotic cure rates diminish with each recurrence of CDI. Fecal microbiota transplantation (FMT) is an effective therapy for recurrent FMT, which otherwise requires prolonged or indefinite antibiotic treatment. FMT is performed by introducing the fecal microbial community obtained from a healthy donor or pool of donors into the stomach, small intestine, or colon of a patient with CDI. Multiple clinical trials support the usefulness of FMT in treating recurrent CDI, and CDI treatment guidelines now include consideration of FMT at the third CDI recurrence...
January 2018: Chest
https://www.readbyqxmd.com/read/28766951/therapy-for-clostridium-difficile-infection-any-news-beyond-metronidazole-and-vancomycin
#18
REVIEW
C F Manthey, L Eckmann, V Fuhrmann
Infections with Clostridium difficile (CDI) represent a major burden for the health care system. Treatment is generally by antibiotic therapy with metronidazole and vancomycin, but efficacy remains suboptimal. Areas covered: This review discusses established and emerging treatment options for CDI, and current therapeutic guidelines, taking into account disease severity and risk of relapse. Expert commentary: New therapeutic approaches, including antibodies and new classes of antibiotics, and new measures for preventing infection with vaccines are under development in phase II/III clinical trials...
November 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28780742/is-there-a-relationship-between-the-presence-of-the-binary-toxin-genes-in-clostridium-difficile-strains-and-the-severity-of-c-difficile-infection-cdi
#19
C E Berry, K A Davies, D W Owens, M H Wilcox
Some strains of Clostridium difficile produce a binary toxin, in addition to the main C. difficile virulence factors (toxins A and B). There have been conflicting reports regarding the role of binary toxin and its relationship to the severity of C. difficile infection (CDI). Samples, isolates and clinical data were collected as part of a prospective multicentre diagnostic study. Clostridium difficile isolates (n = 1259) were tested by polymerase chain reaction (PCR) assay to detect binary toxin genes cdtA and cdtB...
December 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28805081/bezlotoxumab-for-the-prevention-of-clostridium-difficile-recurrence
#20
Antoine Couture-Cossette, Alex Carignan, Subburaj Ilangumaran, Louis Valiquette
Clostridium difficile infection is a major economic and clinical burden, due to its high frequency of recurrence. Currently recommended treatments are not efficient for prevention and may contribute to the risk of recurrent infection. In recent years, research has focused on strategies to lessen this risk. Bezlotoxumab is a monoclonal antibody that prevents recurrences of C. difficile infection through the antagonism of toxin B. Areas covered: In this review, the authors discuss the burden of C. difficile infection and its recurrences, the mechanisms underlying the recurrences, and current C...
November 2017: Expert Opinion on Biological Therapy
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