Search

Background: This study was performed to determine the magnitude of Clostridioides difficile infection (CDI) in a tertiary care hospital in patients with antibiotic associated diarrhea (AAD) and to study the risk factors associated with this disease. Methods: A descriptive study was conducted in the department of Microbiology in a tertiary care hospital during December 2019 to May 2021. Stool samples were collected from patients with signs and symptoms of AAD who had been consuming antibiotic or anticancer drugs durng six weeks before the sampling. The samples were subjected to C. difficile glutamate dehydrogenase (GDH) enzyme and CD toxin A & B detection by Enzyme Linked Fluorescent Assay (ELFA). Patient’s demographic features and clinical details were noted and statistically correlated with the test results. Results: Among the total 70 samples tested 20 (28%) were positive for GDH alone and 12 (17%) were positive for both GDH and CD toxin A and B. Fluoroquinolones was a significant risk factor in the study. Sepsis and colitis was found to have significant association with C.difficile infection in our study. The crude mortality rate was 17%. Conclusion: Prompt and precise diagnosis and knowledge about the risk factors of CDI helps in effective management and prevention of CDI. [ABSTRACT FROM AUTHOR]

This article provides an overview of the field of probiotics and their potential benefits for human health. Probiotics are live microorganisms that can improve digestive disorders, infectious diarrhea, and antibiotic-associated diarrhea. They have also shown positive effects on immune function, brain function, weight loss, respiratory tract infections, and the prevention of allergic diseases. However, there are limitations and challenges in the prescription and consumption of probiotics, such as strain-specificity and lack of standard regulations. Further research and clinical trials are needed to establish optimal strains, dosages, and treatment durations, as well as to explore potential interactions with other medications or treatments. The article also includes a compilation of various research articles on probiotics, covering a wide range of topics related to their effects on human health. [Extracted from the article]

A recent article in the Journal of Infectious Diseases explores the potential use of loratadine, an over-the-counter antihistamine, as a treatment for Clostridioides difficile infection (CDI). The authors conducted preclinical studies using murine and hamster models, as well as human cell lines and colonic explants, to demonstrate the anti-inflammatory effects of loratadine in CDI. The findings suggest that loratadine may attenuate toxin B-mediated colonic inflammation, independent of histamine receptors but dependent on SRC and NFкB. However, the authors note that the optimal dosage of loratadine for CDI treatment is unclear, and further research is needed to assess its safety and efficacy in humans. [Extracted from the article]

Clostridium difficile infection (CDI) is a common and serious nosocomial infection worldwide. It is also problem in our hospital, a medical school in Khon Kaen University. Rationale use of antimicrobial in the treatment of CDI is still being questionable. This study aimed to explore the characteristic and evaluate the treatment of CDI in our setting. This retrospective cohort study was performed in 168 CDI patients admitted at Srinagarind Hospital between October 2013 and September 2016. Patient medical records were reviewed for demographics, comorbidities, antimicrobial exposures, treatments and clinical outcomes. Antimicrobial therapy for CDI was then evaluated in accordance with the current CDI guideline. Most CDI patients aged over 50 years (72.6%) and 42.8% aged over 65 years. Common comorbidities in the patients were cardiovascular disease (47.6%), diabetes mellitus (27.4%), chronic kidney disease (20.8%), malignancy (16.7%), cerebrovascular disease (11.3%), chronic hepatitis (3.6%) and chronic obstructive pulmonary disease (2.4%). Patients who had taken antimicrobial during hospitalization prior to CDI diagnosis constituted 83.9% of total study population. Metronidazole, vancomycin and both were initial therapy in 83.9, 4.8 and 11.3% of CDI, respectively. Appropriateness of CDI treatment in all terms was 44% and recovery rate was 62% of assessable cases. Nine patients (5.4%) died during hospitalization. In conclusion, most patients had CDI risk factors including elderly, comorbidity, antimicrobial exposure, and prolonged hospital stay. Inappropriate CDI treatment was found in asymptomatic carriers or inappropriate treatment duration. Initial therapy with metronidazole should change to oral vancomycin which was the first-line therapy in the current guidelines. [ABSTRACT FROM AUTHOR]

Background and Objectives: Clostridium difficile is responsible for 15-25% of nosocomial antibiotic associated diarrhea (AAD) cases and all cases of pseudomembranous colitis. C. difficile has two major virulence factors, toxin A (enterotoxin) and toxin B (cytotoxin). The aim of this study was to determine the frequency of C. difficile strains in patients with diarrhea in Babol' hospitals with toxigenic culture and PCR assay. Materials and Methods: One hundred stool specimens were taken from diarrheal patients in hospitals of the city of Babol. All patients had a history of antibiotic use. The samples were cultured on CCFA medium. In the next stage, toxigenic culture was performed for isolated C. difficile strains. Then, PCR assay was used to identify gdh, tcdA and tcdB genes among isolated C. difficile strains. Results: From the 100 stool samples, eight (8%) samples were positive in C. difficile culture. In toxigenic culture, two (2%) of these strains had cytopathic effects on Vero cells. All eight strains had the gdh gene. This gene is specific for C. difficile. Two strains that had cytopathic effects on toxigenic culture were positive for toxin genes. Conclusion: The frequency of toxigenic strains in different parts of the world is variable, and needs to be continually investigated. In the present study, the PCR method had a good correlation with toxigenic culture. Thus, it can replace the laborious and costly cell culture method. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction:Clostridium difficileinfection (CDI) is the most common nosocomial infection in the U.S. 25% of CDI patients go on to develop recurrent CDI (rCDI) following current standard of care (SOC) therapy, leading to morbidity, mortality and economic loss. The first passive immunotherapy drug targetingC.difficiletoxin B (bezlotoxumab) has been approved recently by the FDA and EMA for prevention of rCDI. Areas covered: A body of key studies was selected and reviewed by the authors. The unmet needs in CDI care were ascertained with emphasis in rCDI, including the epidemiology, pathophysiology and current management. The current knowledge about the immune response toC. difficiletoxins and how this knowledge led to the development and the clinical use of bezlotoxumab is described. Current and potential future competitors to the drug were examined. Expert commentary: A single 10 mg/kg intravenous infusion of bezlotoxumab has been shown to decrease rCDI by ~40% (absolute reduction ~10%) in patients being treated for primary CDI or rCDI with SOC antibiotics. TargetingC.difficiletoxins by passive immunotherapy is a novel mechanism for prevention ofC.difficileinfection. Bezlotoxumab will be a valuable adjunctive therapy to reduce the burden of CDI. [ABSTRACT FROM PUBLISHER]

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clostridium difficile infection (CDI) is the leading cause of death due to gastrointestinal infections in the US and is the most common cause of nosocomial diarrhea. The emergence of a hypervirulent strain in the early 2000s has been associated with a dramatic increase in the number and severity of cases in the US, Canada, and several other countries. Most cases are related to antibiotic use, but sporadic cases occur in otherwise healthy individuals with no risk factors. Morbidity and mortality are highest in the elderly. Diagnosis is confirmed by detection of C. difficile toxin in the stools. Treatment should be stratified by severity of disease, with metronidazole use for mild disease cases and vancomycin for severe disease. Recurrent CDI occurs in 10-20 % of cases. A first recurrence can be treated with a ten-day regimen of metronidazole or vancomycin; a second recurrence is best treated by a pulsed regimen of vancomycin. In patients with multiple (three or more) recurrences, fecal microbiota transplant has a high rate of success. The most important methods of prevention are wise antibiotic policies, hand hygiene, isolation, and barrier methods in hospital and long-term care facilities (LCTF) settings. [ABSTRACT FROM AUTHOR]

Copyright of Forum Zakażeń is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Evaluation & Analysis of Drug-Use in Hospitals of China is the property of Evaluation & Analysis of Drug-Use in Hospitals of China Editorial Board and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: Keeping in view the recent flooding of the Indian market with antibiotic and probiotic combinations, we decided to look at the prevalence of antibiotic associated diarrhea (AAD) and Clostridium difficile infection (CDI) in children and reviewed evidence available for use of probiotics in the prevention of AAD. Evidence acquisition: We did a PubMed, Medline and Cochrane library search for literature available in last 25 years. Results: Prevalence of antibiotic associated diarrhea (AAD) is around 11%. Children younger than 2 years and type of antibiotics are the two risk factors identified for AAD. For the pediatric population, CDI reportedly decreased in a tertiary care hospital in India, though number of suspected samples tested increased. The incidence of community acquired CDI is increasing in the pediatric population also. Detection of toxin A and B by enzyme linked immunosorbent assay (ELISA) and detection of toxin B by tissue culture form the mainstay in the diagnosis of C. difficile. Most of the AAD would respond to only discontinuation or change of the antibiotic. Oral metronidazole or oral vancomycin are drugs of choice for CDI. Probiotics reduce the risk of AAD in children and for every 7-10 patients one less would develop AAD. Conclusion: Prevalence of AAD is low and majority will respond to discontinuation of antibiotic. CDI is uncommon in children. Probiotics will prevent AAD in only 1 in 7 children on antibiotics. We need cost effectiveness studies to decide the issue of needing a probiotic antibiotic combination to prevent AAD. [ABSTRACT FROM AUTHOR]

Copyright of Der Gastroenterologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Helicobacter pylori (Hp) eradication therapy alters gut microbiota, provoking gastrointestinal (GI) symptoms that could be improved by probiotics. The study aim was to assess the effect in Hp patients of a Test fermented milk containing yogurt and Lacticaseibacillus (L. paracasei CNCM I-1518 and I-3689, L. rhamnosus CNCM I-3690) strains on antibiotic associated diarrhea (AAD) (primary aim), GI-symptoms, gut microbiota, and metabolites. A randomised, double-blind, controlled trial was performed on 136 adults under 14-day Hp treatment, receiving the Test or Control product for 28 days. AAD and GI-symptoms were reported and feces analysed for relative and quantitative gut microbiome composition, short chain fatty acids (SCFA), and calprotectin concentrations, and viability of ingested strains. No effect of Test product was observed on AAD or GI-symptoms. Hp treatment induced a significant alteration in bacterial and fungal composition, a decrease of bacterial count and alpha-diversity, an increase of Candida and calprotectin, and a decrease of SCFA concentrations. Following Hp treatment, in the Test as compared to Control group, intra-subject beta-diversity distance from baseline was lower (padj = 0.02), some Enterobacteriaceae, including Escherichia-Shigella (padj = 0.0082) and Klebsiella (padj = 0.013), were less abundant, and concentrations of major SCFA (p = 0.035) and valerate (p = 0.045) were higher. Viable Lacticaseibacillus strains were detected during product consumption in feces. Results suggest that, in patients under Hp treatment, the consumption of a multi-strain fermented milk can induce a modest but significant faster recovery of the microbiota composition (beta-diversity) and of SCFA production and limit the increase of potentially pathogenic bacteria. [ABSTRACT FROM AUTHOR]

In recent decade the prevalence of antibiotic associated diarrhea was increased because of more antibiotic usage. Colstridum difficile is a microorganism which can cause mild to severe colitis. But the only cause of colitis related to Antibiotics is not colstridum difficle. In this case report we explain a child whit antibiotic associated colitis due to klebsiella oxtyoca. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate whether probiotic recovery is affected when consumed together with antibiotics. Fecal samples were collected from an earlier antibiotic associated diarrhea, randomized, placebo-controlled study with a product consisting of a combination of Lactobacillus acidophilus NCFM, Lactobacillus paracasei Lpc-37, and Bifidobacterium lactis Bi-07, B. lactis Bl-04 at equal numbers and at a total dose of 1010 CFU. Fecal samples were collected during the screening visit (T0), i.e., at the time of antibiotic prescription, and then on the last day of the antibiotic treatment (T1) as well as seven days after the subject had stopped taking the antibiotic treatment (T2) and at two weeks after completing antibiotic treatment and one week after probiotic/placebo consumption stopped (T3). Samples were analyzed for the presence of the four administered strains. The study was registered at clinicaltrials.gov as NCT01596829. Detection levels of all four strains were significantly increased from T0 to T1 and returned to baseline level from T2 to T3. There were also significantly more subjects with detectable levels of L. paracasei Lpc-37, B. lactis Bi-07, and B. lactis Bl-04 at T1 and T2 compared to T0 and T3, and compared to placebo. Each of the four strains could be detected in the feces of patients apparently unaffected by the simultaneous consumption of antibiotics. [ABSTRACT FROM AUTHOR]