Browsing by Subject "Clostridium difficile"

Now showing 1 - 6 of 6
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    Antibiotic-associated diarrhea
    (2008-09-02) Stark, Thomas
    Antibiotic-associated diarrhea (AAD) is a significant cause of morbidity and mortality. The most common pathogen associated with AAD is Clostridium difficile which is among the leading causes of nosocomial infections. Succesfull treatment for this condition involves prolonged use of antibiotics or livestool enimas. Evidence suggests that the use of probiotics has no role in treatment or prevention of this condition.
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    Antibiotic-Associated Diarrhea
    (2009-05-04) Turgasen, Sarah
    Antibiotic-associated diarrhea (AAD) is an important cause of morbidity, mortality and cost in hospitalized patients. Recent RTC’s and meta-analyses have shown that administration of a probioticcontaining drink during and after antibiotic treatment may be a cost-effective way to prevent AAD.
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    The basics every patient needs to know about Clostridium difficile-associated diarrhea
    (2008-09-02) Lieser, Matthew
    The purpose of this article was to provide patients with background information about Clostridium difficile-associated disease. These include signs/symptoms, risk factors, and treatment options.
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    Environmental contamination in households of patients with recurrent clostridium difficile infection
    (2014-09) Shaughnessy, Megan Kosel
    Background: Recurrent Clostridium difficile infection (R-CDI) is common and difficult to treat, potentially necessitating fecal microbiota transplantation (FMT). Although C. difficile spores can persist in the hospital environment and cause infection, little is known about their potential presence in the household environment.Methods: Households of R-CDI subjects in the peri-FMT period, and of geographically and age-matched controls, were analyzed for presence of C. difficile. Household environmental surfaces and fecal samples from humans and pets in the household were examined. Post-FMT subject households were also examined (environmental surfaces only). Participants were surveyed regarding their personal history and household cleaning habits. Environmental and fecal samples were cultured for C. difficile. Species identity and molecular characteristics of presumptive C. difficile isolates were determined using the PRO kit (Remel, USA), Gram staining, PCR, toxinotyping, tcdC gene sequencing, and pulsed-field gel electrophoresis (PFGE).Results: Environmental cultures detected C. difficile on ¡Ý 1 surface in 8/8 (100%) peri-FMT households vs. 3/8 (38%) post-FMT households and 3/8 (38%) control households (P = 0.025). The most common C. difficile-positive surfaces were the vacuum (11/27, 41%), toilet (8/30, 27%), and bathroom sink (5/29, 17%). C. difficile was detected in 3/36 (8%) fecal samples (2 R-CDI subjects, 1 household member). Nine (90%) of 10 households with multiple C. difficile-positive samples had a single genotype present each. Conclusions: C. difficile was found in the household environment of R-CDI patients. Whether this is a cause or consequence of R-CDI is unknown. If household contamination leads to R-CDI, effective decontamination may be protective.
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    Mechanisms of Fecal Microbiota Transplantation and Development of Novel Therapies for Clostridium difficile Infection
    (2015-08) Weingarden, Alexa
    Clostridium difficile infection is the most common nosocomial infection in the US and other developed countries, yet standard antibiotic therapy for this infection fails to cure nearly a quarter of patients. These individuals experience a recurrence of the infection, and a large subset of patients with a single recurrence go on to develop recurrent C. difficile infection syndrome (R-CDI), characterized by vicious cycles of repeated antibiotic use and recurrence of disease. Although fecal microbiota transplantation (FMT) is now widely recognized as an extremely effective therapy for R-CDI, its mechanisms were heretofore unknown. This substantial gap in our knowledge limited both our ability to design novel therapies for R-CDI and our understanding of the role our native intestinal microbes play in our health. The work herein summarizes our efforts to identify and test the mechanisms behind this important treatment. Our findings indicate that fecal bile acid composition, which is significantly altered following FMT, also dramatically impacts C. difficile physiology. Bile acids present after FMT, compared to those present prior to the procedure, prevent germination of C. difficile spores and limit the growth of vegetative cells. With this knowledge, we demonstrated that a bile acid already clinically available, ursodeoxycholic acid (UDCA), can also prevent C. difficile germination and growth. Although unfortunately UDCA is a poor treatment option for many patients due to its absorption in the small intestine, we showed both that a non-absorbed derivative of UDCA, C7-sulfated UDCA, may be a promising novel therapy for R-CDI, and that UDCA may still have clinical utility in patients with altered gastrointestinal anatomy. These findings have paved the way for novel treatments for this widespread infection.
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    Prevalence of Clostridium difficile in retail meats from Minnesota and comparison of growth and survival of human and animal isolates
    (2013-08) Sepulveda Diaz, Rocio Veronica
    Clostridium difficile is a Gram positive, anaerobic, spore-forming, rod-shaped bacterium that causes antibiotic-associated diarrhea in hospitalized and community-dwelling patients. Recent findings have suggested that this organism may be transmitted from animals to humans through the consumption of contaminated foods. Genotypic similarities have been found among C. difficile strains isolated from animals and humans. However, comparisons of the behavior of these two groups of strains at the physiological level have not been conducted in detail. This study sought to determine the prevalence of C. difficile in retail meats from Minnesota and to compare human and animal isolates by measuring the growth rate and their survival in meats during cold storage. Meat samples were obtained from retail stores from Minnesota and consisted mainly of raw beef, pork, and poultry. These samples were analyzed for the presence of C. difficile by initial enrichment in Clostridium difficile moxalactam-norfloxacin (CDMN) broth, followed by ethanol shock, plating onto CDMN agar, and anaerobic incubation for 48 h at 37°C. Suspicious colonies were subjected to confirmation by colony morphology, Gram staining, and production of L-proline aminopeptidase. Growth rate parameters were determined for a total of 35 C. difficile strains isolated from humans and animals. Optical density was measured during exponential growth on brain hearth infusion broth at 37°C anoxically. The average growth rates of the two groups were then compared. A subgroup of 5 human and 5 animal strains was selected to assess the survival of C. difficile in meats during cold storage. C. difficile strains were inoculated onto ground meats to a level of approximately 105 CFU/g. Inoculated meats were stored at 4°C and -15°C for 5 and 20 days, respectively. C. difficile counts were determined at different times during storage by plating onto CDMN agar. A total of 342 raw meat and poultry samples were collected from 5 different counties in central Minnesota from 25 retail stores. Twenty nine samples had CDMN-presumptive colonies, but none of them were confirmed as C. difficile C.I. 0-0.013% of meats positive for C. difficile at a 95% level. The average growth rate of 22 human strains at 37°C was 0.52± 0.25 h-1, which was not significantly different from the value for 13 animal strains (0.62± 0.15 h-1) (p>0.05). Counts of C. difficile strains inoculated on ground beef and chicken diminished during storage at 4°C and -15°C. Overall reduction in bacterial counts was not significantly different between human and animal strains. These findings suggested that C. difficile was not commonly present in retail meats from Minnesota. C. difficile strains isolated from animals had similar growth rates at 37°C as the strains from human origin. C. difficile viable counts diminished over time during refrigeration and freezing of inoculated meats. Additionally, the methodology used in the present study was effective in recovering C. difficile from artificially inoculated meats.