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Clostridium difficile and probiotics

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17 papers 100 to 500 followers
By Joe Weatherly FM/Hospitalist-CoFounder of QuestioningMedicine and PCRAP contributor.
Fernanda C Lessa, Yi Mu, Wendy M Bamberg, Zintars G Beldavs, Ghinwa K Dumyati, John R Dunn, Monica M Farley, Stacy M Holzbauer, James I Meek, Erin C Phipps, Lucy E Wilson, Lisa G Winston, Jessica A Cohen, Brandi M Limbago, Scott K Fridkin, Dale N Gerding, L Clifford McDonald
BACKGROUND: The magnitude and scope of Clostridium difficile infection in the United States continue to evolve. METHODS: In 2011, we performed active population- and laboratory-based surveillance across 10 geographic areas in the United States to identify cases of C. difficile infection (stool specimens positive for C. difficile on either toxin or molecular assay in residents ≥ 1 year of age). Cases were classified as community-associated or health care-associated...
February 26, 2015: New England Journal of Medicine
Carolyn V Gould, Jonathan R Edwards, Jessica Cohen, Wendy M Bamberg, Leigh Ann Clark, Monica M Farley, Helen Johnston, Joelle Nadle, Lisa Winston, Dale N Gerding, L Clifford McDonald, Fernanda C Lessa
Nucleic acid amplification testing (NAAT) is increasingly being adopted for diagnosis of Clostridium difficile infection (CDI). Data from 3 states conducting population-based CDI surveillance showed increases ranging from 43% to 67% in CDI incidence attributable to changing from toxin enzyme immunoassays to NAAT. CDI surveillance requires adjustment for testing methods.
November 2013: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Judith Maria Wenisch, Susanne Equiluz-Bruck, Marta Fudel, Ingun Reiter, Andrea Schmid, Erna Singer, Andreas Chott
Clostridium difficile infections (CDI) in hospitalized patients are known to be closely related to antibiotic exposure. Although several substances can cause CDI, the risk differs between individual agents. In Vienna and other eastern parts of Austria, CDI ribotype 027 is currently highly prevalent. This ribotype has the characteristic of intrinsic moxifloxacin resistance. Therefore, we hypothesized that moxifloxacin restriction can decrease the number of CDI cases in hospitalized patients. Our antibiotic stewardship (ABS) group applied an information campaign on CDI and formal restriction of moxifloxacin in Wilhelminenspital (Vienna, Austria), a 1,000- bed tertiary care hospital...
September 2014: Antimicrobial Agents and Chemotherapy
Marije K Bomers, Michiel A van Agtmael, Hotsche Luik, Christina M J E Vandenbroucke-Grauls, Yvo M Smulders
OBJECTIVES: Early and rapid identification of Clostridium difficile infections (CDI) is important to prevent transmission. In this study we assessed the diagnostic accuracy of a trained detection dog for detecting CDI cases on hospital wards in an outbreak setting. METHODS: During a CDI outbreak in a large Dutch university hospital, we screened affected hospital wards repeatedly with a trained detection dog. The dog's response was compared to the clinical diagnosis, supported by laboratory results...
November 2014: Journal of Infection
Lindsay M Urben, Jennifer Wiedmar, Erica Boettcher, Rodrigo Cavallazzi, Robert G Martindale, Stephen A McClave
Probiotics are living microorganisms which have demonstrated many benefits in prevention, mitigation, and treatment of various disease states in critically ill populations. These diseases include antibiotic-associated diarrhea, Clostridium difficile diarrhea, ventilator-associated pneumonia, clearance of vancomycin-resistant enterococci from the GI tract, pancreatitis, liver transplant, major abdominal surgery, and trauma. However, their use has been severely limited due to a variety of factors including a general naïveté within the physician community, lack of regulation, and safety concerns...
2014: Current Gastroenterology Reports
Marya D Zilberberg, Kimberly Reske, Margaret Olsen, Yan Yan, Erik R Dubberke
BACKGROUND: Recurrent Clostridium difficile infection (rCDI) affects 10% to 25% of patients with initial CDI (iCDI). Initiation of new therapies that reduce recurrences rests on identifying patients at high risk for rCDI at iCDI onset. OBJECTIVE: To develop a predictive model for rCDI based on factors present at iCDI onset. DESIGN: Retrospective cohort study. SETTING: Large urban academic medical center. PATIENTS: All adult patients with an inpatient iCDI from January 1, 2003 to December 31, 2009...
July 2014: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Eric T Lofgren, Stephen R Cole, David J Weber, Deverick J Anderson, Rebekah W Moehring
BACKGROUND: Clostridium difficile is a health care-associated infection of increasing importance. The purpose of this study was to estimate the time until death from any cause and time until release among patients with C. difficile, comparing the burden of those in the intensive care unit (ICU) with those in the general hospital population. METHODS: A parametric mixture model was used to estimate event times, as well as the case-fatality ratio in ICU and non-ICU patients within a cohort of 609 adult incident cases of C...
July 2014: Epidemiology
Michael R Kolber, Ben Vandermeer, G Michael Allan
No abstract text is available yet for this article.
July 2014: American Journal of Gastroenterology
Faisal Alasmari, Sondra M Seiler, Tiffany Hink, Carey-Ann D Burnham, Erik R Dubberke
BACKGROUND: Clostridium difficile infection (CDI) incidence has increased dramatically over the last decade. Recent studies suggest that asymptomatic carriers may be an important reservoir of C. difficile in healthcare settings. We sought to identify the prevalence and risk factors for asymptomatic C. difficile carriage on admission to the hospital. METHODS: Patients admitted to Barnes-Jewish Hospital without diarrhea were enrolled from June 2010 through October 2011...
July 15, 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Lukas Buendgens, Jan Bruensing, Michael Matthes, Hanna Dückers, Tom Luedde, Christian Trautwein, Frank Tacke, Alexander Koch
PURPOSE: Proton pump inhibitors (PPIs) effectively prevent gastrointestinal bleedings in critically ill patients at the intensive care unit (ICU). In non-ICU hospitalized patients, PPI administration increases the risk of infectious complications, especially Clostridium difficile-associated diarrhea (CDAD); but no such data are available for the ICU setting. MATERIALS AND METHODS: This is a retrospective, observational, single-center analysis (1999-2010) including 3286 critically ill patients...
August 2014: Journal of Critical Care
Susan E Sharp, Lila O Ruden, Julie C Pohl, Patricia A Hatcher, Linda M Jayne, W Michael Ivie
The diagnosis of Clostridium difficile infection continues to be a challenge for many clinical microbiology laboratories. A new lateral flow assay, the C.Diff Quik Chek Complete assay, which tests for the presence of both glutamate dehydrogenase (GDH) and C. difficile toxins A and B, was evaluated for its ability to diagnose C. difficile disease. The results of this assay were compared to those of both PCR and toxigenic culture. The results showed that this assay allows 88% of specimens to be accurately screened as either positive (both tests positive) or negative (both tests negative) for the presence of toxigenic C...
June 2010: Journal of Clinical Microbiology
Stephen J Allen, Kathie Wareham, Duolao Wang, Caroline Bradley, Hayley Hutchings, Wyn Harris, Anjan Dhar, Helga Brown, Alwyn Foden, Michael B Gravenor, Dietrich Mack
BACKGROUND: Antibiotic-associated diarrhoea (AAD) occurs most frequently in older (≥65 years) inpatients exposed to broad-spectrum antibiotics. When caused by Clostridium difficile, AAD can result in life-threatening illness. Although underlying disease mechanisms are not well understood, microbial preparations have been assessed in the prevention of AAD. However, studies have been mostly small single-centre trials with varying quality, providing insufficient data to reliably assess effectiveness...
October 12, 2013: Lancet
Thomas Fekete
No abstract text is available yet for this article.
May 21, 2013: Annals of Internal Medicine
Bradley C Johnston, Stephanie S Y Ma, Joshua Z Goldenberg, Kristian Thorlund, Per O Vandvik, Mark Loeb, Gordon H Guyatt
BACKGROUND: Antibiotic treatment may disturb the resistance of gastrointestinal flora to colonization. This may result in complications, the most serious of which is Clostridium difficile–associated diarrhea (CDAD). PURPOSE: To assess the efficacy and safety of probiotics for the prevention of CDAD in adults and children receiving antibiotics. DATA SOURCES: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Allied and Complementary Medicine Database, Web of Science, and 12 gray-literature sources...
December 18, 2012: Annals of Internal Medicine
Xing Wang Gao, Mohamed Mubasher, Chong Yu Fang, Cheryl Reifer, Larry E Miller
OBJECTIVES: Standard therapies for antibiotic-associated diarrhea (AAD) and Clostridium difficile-associated diarrhea (CDAD) have limited efficacy. Probiotic prophylaxis is a promising alternative for reduction of AAD and CDAD incidence. METHODS: In this single-center, randomized, double-blind, placebo-controlled dose-ranging study, we randomized 255 adult inpatients to one of three groups: two probiotic capsules per day (Pro-2, n=86), one probiotic capsule and one placebo capsule per day (Pro-1, n=85), or two placebo capsules per day (n=84)...
July 2010: American Journal of Gastroenterology
Elizabeth A Sailhamer, Katherine Carson, Yuchiao Chang, Nikolaos Zacharias, Konstantinos Spaniolas, Malek Tabbara, Hasan B Alam, Marc A DeMoya, George C Velmahos
HYPOTHESIS: There exist predictors of mortality and the need for colectomy among patients with fulminant Clostridium difficile colitis. DESIGN: Retrospective study. SETTING: Academic tertiary referral center. PATIENTS: We reviewed the records of 4796 inpatients diagnosed as having C difficile colitis from January 1, 1996, to December 31, 2007, and identified 199 (4.1%) with fulminant C difficile colitis, as defined by the need for colectomy or admission to the intensive care unit for C difficile colitis...
May 2009: Archives of Surgery
Sasha D Adams, David W Mercer
PURPOSE OF REVIEW: Clostridium difficile is the most common cause of nosocomial infectious diarrhea in adults. The purpose of this review is to increase awareness that infection from C. difficile is not always indolent, but with fulminant colitis, it can be lethal. The epidemiology, pathogenesis and treatment of C. difficile infection are discussed, with special emphasis on management of fulminant colitis. RECENT FINDINGS: Clostridium difficile causes fulminant colitis in 3-8% of patients...
August 2007: Current Opinion in Critical Care
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