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Clostridium difficile infection (CDI)

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49 papers 0 to 25 followers Clostridium difficile infection
María Jesús Vivancos-Gallego, M Ángeles Jiménez-López, Francesca Gioia, Dione Ibañez-Segura, José Romero-Vivas, Javier Cobo
Recurrences of Clostridium difficile infections lead to hospital readmissions and high costs, in addition to the suffering and frustration for the patients. Fidaxomicin has recently been introduced as a new antibiotic that has been shown to significantly reduce the recurrence of this infection. Despite this superiority, its high cost has led to very restrictive policies in its use, as such that many institutions only use it in patients with multiple recurrences. While waiting for new predictive clinical tools, we propose the development of scoring systems that allow the more high-risk patients to be treated earlier...
September 3, 2016: Enfermedades Infecciosas y Microbiología Clínica
Darrin Majors, Patrick Ellis
BACKGROUND: Currently there are no universally accepted approaches for the prevention of recurrent Clostridium difficile infections (CDI) following the initial infection. Several studies have identified common risk factors for the emergence of recurrent CDI. Identifying patients at high risk for recurrent CDI through the assessment of risk factors at initial diagnosis could enable health care providers to optimize available treatment options. A vancomycin hydrochloride-tapered regimen may be an effective treatment option for the prevention of recurrent CDI following the initial infection...
November 2015: Hospital Pharmacy
M J T Crobach, T Planche, C Eckert, F Barbut, E M Terveer, O M Dekkers, M H Wilcox, E J Kuijper
In 2009 the first European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guideline for diagnosing Clostridium difficile infection (CDI) was launched. Since then newer tests for diagnosing CDI have become available, especially nucleic acid amplification tests. The main objectives of this update of the guidance document are to summarize the currently available evidence concerning laboratory diagnosis of CDI and to formulate and revise recommendations to optimize CDI testing. This update is essential to improve the diagnosis of CDI and to improve uniformity in CDI diagnosis for surveillance purposes among Europe...
August 2016: Clinical Microbiology and Infection
Emilio Bouza, Luis Alcalá, Elena Reigadas
INTRODUCTION: Clostridium difficile infection (CDI) is the leading cause of hospital-acquired diarrhea and is associated with a considerable health and cost burden. However, there is still not a clear consensus on the best laboratory diagnosis approach and a wide variation of testing methods and strategies can be encountered. AREAS COVERED: We aim to review the most practical aspects of CDI diagnosis providing our own view on how to optimize CDI diagnosis. Expert commentary: Laboratory diagnosis in search of C...
September 2016: Expert Review of Anti-infective Therapy
Csaba Fehér, Josep Mensa
Clostridium difficile infection (CDI) is increasingly recognized as an emerging healthcare problem of elevated importance. Prevention and treatment strategies are constantly evolving along with the apperance of new scientific evidence and novel treatment methods, which is well-reflected in the differences among consecutive international guidelines. In this article, we summarize and compare current guidelines of five international medical societies on CDI management, and discuss some of the controversial and currently unresolved aspects which should be addressed by future research...
September 2016: Infectious Diseases and Therapy
Katarina Bielakova, Emmanuela Fernandova, Hana Matejovska-Kubesova, Pavel Weber, Dana Prudius, Josef Bednar
BACKGROUND: Clostridium difficile infection (CDI) is becoming a serious problem predominantly in geriatric patients, who are a significant risk group. The goal of this study was to evaluate the risk factors for mortality in CDI patients and to construct a binary logistic regression model that describes the probability of mortality in geriatric patients suffering from CDI. METHODS: In this retrospective study, we evaluated a group of 235 patients over 65 years of age with confirmed diagnoses of CDI, hospitalized at the Department of Internal Medicine, Geriatrics and General Practice, Brno, from January 2008 to December 2013...
August 2016: Wiener Klinische Wochenschrift
Alberto Cózar-Llistó, Antonio Ramos-Martinez, Javier Cobo
Antibiotic use continues to be the most important risk factor for the development of Clostridium difficile infection (CDI) through disruption of the indigenous microbiota of the colon. This factor, together with environmental contamination, makes hospital and other healthcare facilities the perfect breeding ground for the infection. Several groups of patients are exposed to the hospital environment and, at the same time, affected by conditions that can make CDI more prevalent, more severe or make it present a different clinical picture...
September 2016: Infectious Diseases and Therapy
Giulio Didiodato, Leslie Mcarthur
No abstract text is available yet for this article.
December 2015: Open Forum Infectious Diseases
Oliver A Cornely, Maria J G T Vehreschild
No abstract text is available yet for this article.
September 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
J McCord, M Prewitt, E Dyakova, S Mookerjee, J A Otter
The clinical impact of implementing hydrogen peroxide vapour (HPV) disinfection of rooms vacated by patients with Clostridium difficile infection (CDI) was evaluated. Breakpoint time series analysis indicated a significant reduction (P<0.001) in the CDI rate at the time when HPV disinfection was implemented, resulting in a reduction in the CDI rate from 1.0 to 0.4 cases per 1000 patient-days in the 24 months before HPV usage compared with the first 24 months of HPV usage. HPV should be considered to augment the terminal disinfection of rooms vacated by patients with CDI...
October 2016: Journal of Hospital Infection
L Martin-Villen, A Gutierrez-Pizarraya, L Alcala-Hernandez, M Marin-Arriaza, B Balandin-Moreno, C Aragon-Gonzalez, J Ferreres-Franco, M A Chiveli-Monleon, M P Anguita-Alonso, E Bouza-Santiago, J Garnacho-Montero
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Sirisha Kundrapu, Venkata C K Sunkesula, Lucy A Jury, Jennifer L Cadnum, Michelle M Nerandzic, Jackson S Musuuza, Ajay K Sethi, Curtis J Donskey
BACKGROUND: Systemic antibiotics vary widely in in vitro activity against Clostridium difficile. Some agents with activity against C. difficile (e.g., piperacillin/tazobactam) inhibit establishment of colonization in mice. We tested the hypothesis that piperacillin/tazobactam and other agents with activity against C. difficile achieve sufficient concentrations in the intestinal tract to inhibit colonization in patients. METHODS: Point-prevalence culture surveys were conducted to compare the frequency of asymptomatic rectal carriage of toxigenic C...
2016: BMC Infectious Diseases
Nynke Postma, Dorien Kiers, Peter Pickkers
The most important infectious cause of antibiotic-associated diarrhoea and colitis is Clostridium difficile, which is a Gram-positive, anaerobic, spore-forming, toxin-producing bacillus. In this overview we will discuss the diagnostic and therapeutic management of patients presenting with suspected or proven C. difficile infection (CDI). The clinical spectrum varies from asymptomatic C. difficile carriers to fulminant colitis with multi-organ failure. The onset of symptoms is usually within 2 weeks after initiation of antibiotic treatment...
December 2015: International Journal of Antimicrobial Agents
Claudia Hübner, Nils-Olaf Hübner, Michaela Muhr, Franziska Claus, Henning Leesch, Axel Kramer, Steffen Flessa
AIM: Clostridium difficile-associated diarrhea (CDAD) causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted. METHOD: A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald...
2015: GMS Hygiene and Infection Control
Akio Kikuchi, Hiroko Suzuki, Hiroko Shishido, Satomi Abe, Mikako Nakajima, Junko Maeda, Isao Tamura, Mitsuru Shiroishi, Mariko Usui
We examined how doctors evaluate the results of C. DIFF QUIK CHEK COMPLETE (COMPLETE) in the diagnosis and treatment of Clostridium difficile infection (CDI). A total of 887 stool samples submitted from 2012 to 2013 were examined with COMPLETE. Requested specimens among samples with discrepant results were inoculated onto CCMA plates and incubated under anaerobic conditions for 48 h, then retested by COMPLETE if positive culture results were obtained. Of the 887 specimens, 198 (22.3%) were glutamate dehydrogenase-positive and 73(8...
June 2015: Rinsho Byori. the Japanese Journal of Clinical Pathology
Glenn Magee, Marcie E Strauss, Sheila M Thomas, Harold Brown, Dorothy Baumer, Kelly C Broderick
BACKGROUND: The recent epidemiologic changes of Clostridium difficile-associated diarrhea (CDAD) have resulted in substantial economic burden to U.S. acute care hospitals. Past studies evaluating CDAD-attributable costs have been geographically and demographically limited. Here, we describe CDAD-attributable burden in inpatients, overall, and in vulnerable subpopulations from the Premier hospital database, a large, diverse cohort with a wide range of high-risk subgroups. METHODS: Discharges from the Premier database were retrospectively analyzed to assess length of stay (LOS), total inpatient costs, readmission, and inpatient mortality...
November 2015: American Journal of Infection Control
Larry K Kociolek, Dale N Gerding
Clostridium difficile strain BI/NAP1/027 is associated with increased C. difficile infection (CDI) rates and severity, and the efficacy of some CDI therapies may be strain dependent. Although cultured C. difficile isolates can be reliably subtyped by various methods, the long turnaround times, high cost, and limited availability of strain typing preclude their routine use. Nucleic acid amplification tests identify BI/NAP1/027 rapidly from stool, but the emergence of closely related strains compromises test specificity...
January 2016: Journal of Clinical Microbiology
Luis Alcalá-Hernández, Ana Mena-Ribas, Jordi Niubó-Bosh, Mercedes Marín-Arriaza
Clostridium difficile is the leading cause of nosocomial diarrhoea in developed countries, and is one of the main aetiologic agents of community diarrhea. The eruption of the hypervirulent strain BI/NAP1/027 has given rise to an increase in the morbidity and mortality of C.difficile infection (CDI). This document aims to review the main clinical pictures of CDI and the laboratory diagnosis, including sampling, transport and storage of specimens, specimen processing, diagnostic procedures, antimicrobial susceptibility testing, and molecular characterisation of the isolates...
October 19, 2015: Enfermedades Infecciosas y Microbiología Clínica
Casey M Theriot, Vincent B Young
Antibiotics have significant and long-lasting effects on the intestinal microbiota and consequently reduce colonization resistance against pathogens, including Clostridium difficile. By altering the community structure of the gut microbiome, antibiotics alter the intestinal metabolome, which includes both host- and microbe-derived metabolites. The mechanisms by which antibiotics reduce colonization resistance against C. difficile are unknown yet important for development of preventative and therapeutic approaches against this pathogen...
2015: Annual Review of Microbiology
Christopher R Polage, Clare E Gyorke, Michael A Kennedy, Jhansi L Leslie, David L Chin, Susan Wang, Hien H Nguyen, Bin Huang, Yi-Wei Tang, Lenora W Lee, Kyoungmi Kim, Sandra Taylor, Patrick S Romano, Edward A Panacek, Parker B Goodell, Jay V Solnick, Stuart H Cohen
IMPORTANCE: Clostridium difficile is a major cause of health care-associated infection, but disagreement between diagnostic tests is an ongoing barrier to clinical decision making and public health reporting. Molecular tests are increasingly used to diagnose C difficile infection (CDI), but many molecular test-positive patients lack toxins that historically defined disease, making it unclear if they need treatment. OBJECTIVE: To determine the natural history and need for treatment of patients who are toxin immunoassay negative and polymerase chain reaction (PCR) positive (Tox-/PCR+) for CDI...
November 2015: JAMA Internal Medicine
2016-04-26 05:14:41
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