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Title: Clostridium Difficile Infection Following Chemotherapy. VOLUME: 5 ISSUE: 1. Author(s):Shahzad Raza, Mahadi A. Baig, Helena Russell, Yanick Gourdet and Barbara J. Berger. Affiliation:Department of Medicine Brookdale University Hospital and Medical Center, New York, USA.. Keywords:Chemotherapy, glutamate dehydrogenase test, real-time polymerase chain reaction, enzyme immunoassays, Clostridium difficile infection. Abstract: Clostridium difficile infection (CDI) is a major concern for health care system and clinicians. Interest in C. difficile infection has increased recently due to an ongoing C. difficile epidemic with a hypervirulent strain and mortality. Disease due to C. difficile is responsible for substantial strain on the hospital system by increasing patients length of stay and increasing costs. Present studies have demonstrated chemotherapeutic agents as an independent risk factor for CDI potentially leading towards serious morbidity and mortality. However, the current strategies ...
New advances in the treatment of Clostridium difficile infection (CDI) Dennis D Hedge, Joe D Strain, Jodi R Heins, Debra K FarverSouth Dakota State University College of Pharmacy, Brookings, SD 57007, USAAbstract: Clostridium difficile infections (CDI) have increased in frequency throughout the world. In addition to an increase in frequency, recent CDI epidemics have been linked to a hypervirulent C. difficile strain resulting in greater severity of disease. Although most mild to moderate cases of CDI continue to respond to metronidazole or vancomycin, refractory and recurrent cases of CDI may require alternative therapies. This review provides a brief overview of CDI and summarizes studies involving alternative antibiotics, toxin binders, probiotics, and immunological therapies that can be considered for treatment of acute and recurrent CDI in severe and refractory situations.Keywords: Clostridium difficile, antibiotics, probiotics, immunological therapy
Clostridium difficile infections cause morbidity and mortality. The authors conducted a retrospective review of Clostridium difficile infection (CDI) in kidney transplant recipients at their center over a 3 year period. The overall rate of CDI was 6.1% and increased over time during the study. A case-control study was subsequently performed to determine the risk factors for infection. Independent predictors of CDI among kidney transplant recipients were VRE colonization, having a CDC-criteria high risk donor, and administration of high-risk antibiotics such as antipseudomonal penicillins and carbapenems. There were no deaths in this series although 10.8% had recurrent infection. The study highlights the need for judicious antibiotic use and good infection control practices in transplant units.. ...
1. Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(9):825-34. doi: 10.1056/NEJMoa1408913 25714160. 2. Chitnis AS, Holzbauer SM, Belflower RM, Winston LG, Bamberg WM, Lyons C, et al. Epidemiology of community-associated Clostridium difficile infection, 2009 through 2011. JAMA internal medicine. 2013;173(14):1359-67. doi: 10.1001/jamainternmed.2013.7056 23780507. 3. Eyre DW, Cule ML, Wilson DJ, Griffiths D, Vaughan A, OConnor L, et al. Diverse sources of C. difficile infection identified on whole-genome sequencing. The New England journal of medicine. 2013;369(13):1195-205. doi: 10.1056/NEJMoa1216064 24066741. 4. Freeman J, Bauer MP, Baines SD, Corver J, Fawley WN, Goorhuis B, et al. The changing epidemiology of Clostridium difficile infections. Clin Microbiol Rev. 2010;23(3):529-49. doi: 10.1128/CMR.00082-09 20610822. 5. He M, Miyajima F, Roberts P, Ellison L, Pickard DJ, Martin MJ, et al. ...
Clostridium difficile infections (CDI) are the most frequent cause of diarrhoea in hospitals. Geriatric patients are more often affected by the condition, by a relapse and complications. Therefore, a crucial question is how often colonization with toxigenic Clostridium difficile strains occurs in elderly patients without diarrhoea and whether there is a
Background Clostridium difficile is a Gram-positive bacteria found in the large bowel or colon that causes mild to severe intestinal conditions and sometimes death. The primary risk factors for development of Clostridium difficile infection (CDI) include healthcare exposure and recent antimicrobial use. The purpose of this study is to compare risk factors associated with CDI occurring in the Community to those associated with Healthcare Facility Associated CDI in the metro Atlanta population from September 1, 2009 - April 30, 2011. Methods Patients were identified through C. difficile surveillance program of the Georgia Emerging Infections Program (EIP). Prospective, population based, laboratory based surveillance for all positive C. difficile cases in the Georgia Health District 3 (HD3). Due to the sampling scheme, for this analysis CO-HCFA and HCFO cases were combined to make a Healthcare Facility Associated (HCFA) classification. Using SAS, a logistic regression analysis was performed to compare the
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. Clostridium difficile remains the most important cause of healthcare-associated diarrhea and has become the most commonly identified cause of healthcare-associated infection in adults in the United States. Moreover, C. difficile has established itself as an important community pathogen.
Glutamate dehydrogenase (GDH), an enzyme present in high copy numbers in many organisms, has proved to be a sensitive screening marker for Clostridium difficile. Since GDH is present in many intestinal bacteria, it is crucial that assay systems for glutamate dehydrogenase be accurate and highly sensitive for the detection of C. difficile-specific GDH. The RIDA®QUICK Clostridium difficile GDH immunochromatographic rapid test meets both of these requirements to a high degree. Although it does not eliminate the need for the detection of C. difficile toxins A and B, which is obligatory for the diagnosis of Clostridium difficile infection, the RIDA®QUICK Clostridium difficile GDH difficile rapid test improves the reliability of detection of this very consequential nosocomial pathogen when performed sequentially, i.e., before or parallel to the RIDA®QUICK Clostridium difficile Toxin A/B rapid test. Both the specific clinical symptoms and signs and the positive detection of C. difficile toxins A and ...
Although mostly associated with antibiotic use in hospitalized patients, C. difficile infections in people in the community have become more common. As of 2014, they accounted for 41 percent of all C. difficile infections, according to the Centers for Disease Control and Prevention (CDC). In this new case-control study, researchers enrolled adult patients from 10 U.S. sites during 2014-2015 who tested positive for C. difficile as an outpatient, or within three days of being hospitalized, and who had not been admitted to a health care facility within the past 12 weeks.. Each patient was matched to a person who did not have a C. difficile infection as a control. All of the study participants-452 total-were interviewed individually by phone to collect information about their health, medication use, recent health care visits, household exposures, and diet. In line with previous studies, larger percentages of patients with community-associated C. difficile infections had prior outpatient health care ...
High-risk patients must be warned about proton pump inhibitors and Clostridium difficile infection, as community-acquired C. difficile infections increase.
Cross-sectional studies suggest an increasing trend in incidence and relatively low recurrence rates of Clostridium difficile infections in Asia than in Europe and North America. The temporal trend of C. difficile infection in Asia is not completely understood. We conducted a territory-wide population-based observational study to investigate the burden and clinical outcomes in Hong Kong, China, over a 9-year period. A total of 15,753 cases were identified, including 14,402 (91.4%) healthcare-associated cases and 817 (5.1%) community-associated cases. After adjustment for diagnostic test, we found that incidence increased from 15.41 cases/100,000 persons in 2006 to 36.31 cases/100,000 persons in 2014, an annual increase of 26%. This increase was associated with elderly patients, for whom incidence increased 3-fold over the period. Recurrence at 60 days increased from 5.7% in 2006 to 9.1% in 2014 (p<0.001). Our data suggest the need for further surveillance, especially in Asia, which contains ≈60
Optimer announced the combined data from its two Phase 3 trials of fidaxomicin for the treatment of patients with Clostridium difficile infection (CDI).
[115 Pages Report] Check for Discount on United States Drugs for Clostridium Difficile Infections Market Report 2017 report by QYResearch Group. In this report, the United States Drugs for Clostridium Difficile...
title: Epidemiology and clinical features of toxigenic culture-confirmed hospital?onset Clostridium difficile infection: A multicentre prospective study in tertiary hospitals of South Korea, doi: 10.1099/jmm.0.070672-0, category: Article
Certain types of anti-depressants have been linked to an increase in the risk of Clostridium difficile infection (CDI) finds a study in BioMed Centrals open access journal BMC Medicine. Awareness of this link should improve ...
Background: Clostridium difficile infection is increasing in incidence, severity, and mortality (1). Surgery is sometimes used to manage complicated infections because it improves short-term survival (2); however, it is associated with high rates of morbidity and poor long-term survival (3). Surgery is most often used when disease recurs and cannot be controlled with antibiotics, because the risk for severe complications and mortality increases greatly during these recurrences (4). An alternative effective treatment for recurrent disease involves delivery of stool from a healthy donor directly into a patients colon. This procedure is known as fecal microbiota transplantation (FMT), and it can be done via enema or colonoscopy or indirectly into the colon through the upper gastrointestinal tract using various methods (5 ...
This episode discussed the difference between probiotics, synbiotics and prebiotics as well as information on probiotics. I also discuss antibiotic induced Clostridium difficile infections also known as C. Diff infections. Remember that the toxin produced by this bacteria is what causes the symptoms and issues with this infection. It can ...
Testing is generally not necessarily for patients with formed stools (no diarrhea). The gold standard for diagnosis of C. difficile infection is cell culture cytotoxic assay, but it is rarely used clinically (difficult technique and time consuming). Among patients with diarrhea,C. difficile infection is diagnosed either by enzyme immunoassay (ELISA) for toxins A and/or B in stools or by DNA-based tests (PCR) that detect bacterial toxin genes in stools. Although both ELISA and DNA-based tests may be performed sequentially, only one positive test is sufficient to diagnose C. difficile infection. Both ELISA and DNA-based tests also have a high negative predictive value , 95% among average-risk patients, and generally negative results warrants the search for alternative diagnoses. The advantage of DNA-based tests over ELISA is that it may detect the presence of BI/NAP1/027 strain, which alters the management plan. However, DNA-based tests may also detect clinically irrelevant findings that may delay ...
BackgroundThe incidence and severity of Clostridium difficile infections are increasing. Acid-suppressive therapy has been suggested as a risk factor for C diff
Tangiisura, B, Davies, J G, Cheek, L, Rajkumar, C and Llewelyn, M (2010) Diagnosis of Clostridium difficile infection is associated with a small increased risk of death in elderly inpatients. Journal of Hospital Infection, 74 (4). pp. 401-3. ISSN 0195-6701 Full text not available from this repository ...
Clostridium difficile infection was more prevalent in patients undergoing allogeneic stem cell transplantation compared with patients undergoing autologous stem cell transplantation, according to findings published in Infection Control & Hospital Epidemiology.
Clostridium Difficile Infections Treatment Market - Industry Value Forecast, Dynamics, growth, potential, segments, market share, Size, online PDF Report, Free Sample Copy, Future projection, Analysis, supply and demand, trends, opportunities, Product types, Regions, current market, worth, overview, Competition Landscape and Dashboard.
Global Clostridium Difficile Infection Treatment Market is set to surpass from US$ 752.3 Mn in 2016 to US$ 1,316.7 Mn by 2025 end, with a healthy CAGR of 6.5% during the forecast period 2017-2025.
A novel approach to prevent C. difficile infection is to use compounds with activity against C. difficile as primary prophylaxis in high risk patients. Chemoprophylaxis theoretically can prevent C. difficile infection by two mechanisms. It may reduce transmission from asymptomatic C. difficile carriers by reducing the number of spores shed in the stool and prevent replication and subsequent toxin production of the organisms in patients at risk for C. difficile infection ...
Clostridium difficile has become the leading cause of nosocomial diarrhea in adults. A substantial increase has occurred in morbidity and mortality associated with disease caused by C difficile and in the identification of new hypervirulent strains, warranting a high clinical index of suspicion for infections due to this organism. Prevention of infection requires a multidisciplinary approach, including early recognition of disease, effective contact isolation precautions, adherence to disinfectant policies, and judicious use of antibiotics. Current treatment approaches are based on the severity of illness. As hypervirulent strains evolve, unsuccessful treatments are more common. Complicated colitis caused by C difficile may benefit from surgical intervention. Subtotal colectomy and end ileostomy have been the procedures of choice, but are associated with a high mortality rate because of late surgical consultation and use of surgery as a salvage therapy. A promising surgical alternative is ...
C. difficile infections occur when someone is taking antibiotics.. The antibiotics destroy the good bacteria that usually protect patients, leaving C. difficile bacteria to take over.. Essentially the symptoms are diarrhea. That may not sound too bad, but for the elderly it can be deadly. The CDC associates C. difficile with 14,000 deaths a year.. The bacteria can be killed relatively easily, ironically enough with antibiotics. But the spores are hardy.. The author of the report, CDC epidemiologist Dr. Clifford McDonald, says the spores arent killed by hand washing - even with antibacterial soap - and they can last months out in the open.. "In the past a lot of C. difficle infections were considered to happen just generally in the community. But this report shows that most of these so called community infections actually occur in people with recent exposure to medical facilities.". Dr. Ileana Arias, the deputy director of the CDC, says the good news is that C. difficile infections are very ...
In 2015, Clostridium difficile testing rates among 30 US community, multispecialty, and cancer hospitals were 14.0, 16.3, and 33.9/1,000 patient-days, respectively. Pooled hospital onset rates were 0.56, 0.84, and 1.57/1,000 patient-days, respectively. Higher testing rates may artificially inflate reported rates of C. difficile infection. C. difficile surveillance should consider testing frequency.
What is C. difficile? C. difficile (Clostridium difficile) is a bacteria that can either live in the bowel as part of normal bowel flora without causing harm, or it can cause an infection (diarrhea, fever, abdominal pain).
Annual counts and rates of C. difficile infections by acute trust and clinical commissioning group (CCG) in patients aged 2 years and over.
Semantic Scholar extracted view of Clostridium difficile infections: analysis of recurrence in an area with low prevalence of 027 strain. by Emmanuel Thomas et al.
Clinical cure is resolution or improvement of symptoms and signs of C. difficile infection such that additional or alternative antimicrobial therapy or other theraperutic intervention is not needed. In addition, patient must have absence of fever for two consecutive days and ,3 non-lliquid stools per day for two consecutive ...
RESULTS: Twenty-two patients were included, most of whom were male (55%) with a mean age of 58 years (range: 20-83 yrs). The most common underlying malignancies were nine patients with lymphoma (41%), seven with leukemia (32%), and six with solid tumors (27%). Indications for FDX included recurrent CDI in 16 patients (72%) and failure of both metronidazole and oral vancomycin in 6 patients (28%). Nineteen patients (86%) were on concomitant antimicrobials during CDI treatment. Clinical response to FDX was 91%, and overall sustained clinical response was 82%. FDX was well tolerated with no major adverse events that were FDX related or discontinuations due to drug-related adverse events ...
Prolongation of length of stay and |i|Clostridium difficile|/i| infection: A review of the methods used to examine length of stay due to healthcare associated infections
Panelists Peter L. Salgo, MD; Yoav Golan, MD, MS; Erik Dubberke, MD; Lawrence J. Brandt, MD; Dale N. Gerding, MD; and Daniel E. Freedberg, MD, MS, provide an overview of |em|Clostridium difficile|/em| and highlight common presenting factors of the disease in hospital settings and community practices.
Am J Gastroenterol 2015 Mar. has an interesting article on Clostridium difficile colonization and interesting finding based on data meta-analysis byDouglas K. Rex, MD reviewing Zacharioudakis IM et al. In a meta-analysis, risk for clinical Clostridium difficile infection was increased six fold in those who were colonized when admitted. Early studies suggested that Clostridium difficile […]. Read More ...
Clostridium difficileis a spore-forming, toxin-producing, gram-positive anaerobic bacterium that causes antibiotic-associated colitis. It colonizes the human intestinal tract after the normal gut flora has been altered by antibiotic therapy.C. diffic
Clostridium difficile infection (CDI) is a potentially fatal bacterial infection that leads to 3,700 deaths a year in Europe, yet almost two-thirds of CDI cases are missed because clinicians fail to request tests for C. difficile toxins. When CDI remains undiagnosed and untreated, it not only endangers patients health, it also poses a serious cost to healthcare systems.
METHODS: Data for this study were obtained from the U.S. National Hospital Discharge Surveys from 2001 to 2010. Eligible patients included those at least 18 years old with a discharge diagnosis of cancer (ICD-9-CM codes 140-165.X, 170-176.X, 179-189.X, 190-209.XX). CDI was identified using ICD-9-CM code 008.45. Data weights were applied to sampled patients to provide national estimates. CDI incidence was calculated as CDI discharges per 1000 total cancer discharges. The in-hospital mortality rate and hospital length of stay (LOS) were compared between cancer patients with and without CDI using bivariable analyses ...
Vienna (ots/PRNewswire) - CDI is one of the top ten hospital-acquired infections (HAIs) in European Hospitals[1] and is estimated to be three times as deadly as MRSA[2],[3] Data...
Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis - Gastroenterology (free). Source: EvidenceAlerts (free resource to find articles of interest). In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by ,50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. "There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses".. ...
Background: Clostridium difficile infection (CDI) is one of the most common nosocomial infections in the United States. The incidence of CDI in children has increased significantly in the last 20 years and up to 35% of pediatric patients develop recurrent infections. Therefore, it is imperative to further analyze the incidence and relapse rates of CDI in the pediatric population and determine the most effective treatment modalities. Methods: This was a retrospective cohort study for patients aged 1-21 years treated for CDI at our institution from January 2010 - December 2014 Results: We identified 201 patients, accounting for 231 separate episodes of CDI. Fourteen percent of those with CDI had known or were found to have IBD. Roughly 36% of patients were immunocompromised, and 49% had recent antibiotic exposure. Ten to 14 days of oral metronidazole was the most common initial treatment (70%) followed by vancomycin monotherapy (15%) and combination therapy (12%). About 28% of cases had at least ...
Purpose of review To provide a review of literature that discusses some of the most successful antimicrobial stewardship interventions reported across institutions worldwide in response to increased ...
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Joyanna M. Wendt, Jessica A. Cohen, Yi Mu, Ghinwa K. Dumyati, John R. Dunn, Stacy M. Holzbauer, Lisa G. Winston, Helen L. Johnston, James I. Meek, Monica M. Farley, Lucy E. Wilson, Erin C. Phipps, Zintars G. Beldavs, Dale N. Gerding, L. Clifford McDonald, Carolyn V. Gould, Fernanda C. Lessa ...
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Too much zinc in the diet may alter gut microbiota, increasing susceptibility to Clostridium difficile infection, especially for those using antibiotics.
Fidaxomicin was highly effective in patients with cancer treated for the first episode of C. difficile infection (CDI) after failure of standard therapy and in patients with recurrent CDI, results of a study presented at IDWeek 2013.
What is Clostridium difficile (C. difficile)? Clostridium difficile (C. difficile) is a bacterium that is related to the bacterium that cause tetanus and botuli
Nicole Le Saux is Associate Professor in the Division of Infectious Diseases at the University of Ottawa *. As physicians we should be concerned about the inappropriate use of antibiotics. Have you ever had a patient with an extended spectrum beta-lactamase (ESBL), E. coli or Klebsiella urinary tract infection, a Clostridium difficile infection (CDI) or a drug-resistant N. gonorrhoeae?. Whereas resistant bacteria and CDI were rare a decade ago, these clinical situations are now commonplace in hospitals, long term care facilities and emergency departments. According to the the rate of CDI in hospitalized patients is 3.4 cases per 1000 patient admissions (approximately one in every 300 patients admitted). As of 2014, 18.2% of isolates of Neisseria gonorrhoeae were resistant to penicillin with worrisome decreased susceptibility to cefixime, ceftriaxone and azithromycin. ...continue reading →. ...