scholarly journals Predictors of First Recurrence of Clostridium difficile Infection: Implications for Initial Management

2012 ◽  
Vol 55 (suppl 2) ◽  
pp. S77-S87 ◽  
Author(s):  
D. W. Eyre ◽  
A. S. Walker ◽  
D. Wyllie ◽  
K. E. Dingle ◽  
D. Griffiths ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Initial Management ◽  
First Recurrence

scholarly journals Treatment of First Recurrence of Clostridium difficile Infection: Fidaxomicin Versus Vancomycin

2012 ◽  
Vol 55 (suppl 2) ◽  
pp. S154-S161 ◽  
Author(s):  
O. A. Cornely ◽  
M. A. Miller ◽  
T. J. Louie ◽  
D. W. Crook ◽  
S. L. Gorbach
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
First Recurrence

scholarly journals Predictors of Mortality Among a National Cohort of Veterans With Recurrent Clostridium difficile Infection

2018 ◽  
Vol 5 (8) ◽  
Author(s):  
Haley J Appaneal ◽  
Aisling R Caffrey ◽  
Maya Beganovic ◽  
Sanja Avramovic ◽  
Kerry L LaPlante
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Control Analysis ◽  
Predictors Of Mortality ◽  
Risk Of Death ◽  
The Third ◽  
Recurrent Clostridium Difficile Infection ◽  
All Cause Mortality ◽  
National Cohort ◽  
First Recurrence

Abstract Background Though recurrent Clostridium difficile infection (CDI) is common and poses a major clinical concern, data are lacking regarding mortality among patients who survive their initial CDI and have subsequent recurrences. Risk factors for mortality in patients with recurrent CDI are largely unknown. Methods Veterans Affairs patients with a first CDI (stool sample with positive C. difficile toxin(s) and ≥2 days CDI treatment) were included (2010–2014). Subsequent recurrences were defined as additional CDI episodes ≥14 days after the stool test date and within 30 days of the end of treatment. A matched (1:4) case–control analysis was conducted using multivariable conditional logistic regression to identify predictors of all-cause mortality within 30 days of the first recurrence. Results Crude 30-day all-cause mortality rates were 10.6% for the initial CDI episode, 8.3% for the first recurrence, 4.2% for the second recurrence, and 5.9% for the third recurrence. Among 110 cases and 440 controls, 6 predictors of mortality were identified: use of proton pump inhibitors (PPIs; odds ratio [OR], 3.86; 95% confidence interval [CI], 2.14–6.96), any antibiotic (OR, 3.33; 95% CI, 1.79–6.17), respiratory failure (OR, 8.26; 95% CI, 1.71–39.92), congitive dysfunction (OR, 2.41; 95% CI, 1.02–5.72), nutrition deficiency (OR, 2.91; 95% CI, 1.37–6.21), and age (OR, 1.04; 95% CI, 1.01–1.07). Conclusions In our national cohort of Veterans, crude mortality decreased by 44% from the initial episode to the third recurrence. Treatment with antibiotics, use of PPIs, and underlying comorbidities were important predictors of mortality in recurrent CDI. Our study assists health care providers in identifying patients at high risk of death after CDI recurrence.

First recurrence of Clostridium difficile infection: clinical relevance, risk factors, and prognosis

2016 ◽  
Vol 35 (3) ◽  
pp. 371-378 ◽  
Author(s):  
T. Larrainzar-Coghen ◽  
D. Rodriguez-Pardo ◽  
M. Puig-Asensio ◽  
V. Rodríguez ◽  
C. Ferrer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Clinical Relevance ◽  
First Recurrence

scholarly journals Management of antibiotic related and clostridium difficile colitis

2014 ◽  
Vol 61 (2) ◽  
pp. 65-70
Author(s):  
Najib Haboubi ◽  
Zoran Krivokapic
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Broad Spectrum ◽  
Bowel Perforation ◽  
Systemic Infection ◽  
The Elderly ◽  
Causative Agents ◽  
Life Threatening ◽  
Clostridium Difficile Colitis ◽  
First Recurrence

Nearly all antibiotics can cause some form of diarrhoea. Clostridium difficile infection has become an important area in our daily clinical practice and is known to cause a broad spectrum of conditions ranging from asymptomatic carriage to the life-threatening pseudomembranous colitis (PMC), with toxic megacolon and ileus. Patients most at risk are those who have been treated with broad spectrum antibiotics, those with serious underlying co-morbidities and the elderly. Over 80% of Clostridium difficile infection reported are in people aged over 65 years. Combination of rapid and accurate diagnosis will result in a better management of Clostridium difficile infection. Discontinuation of causative agents such as antibiotic treatment is often curative. In more serious cases, oral administration of metronidazole or vancomycin is the treatment of choice. Patients should be treated promptly when the diagnosis of Clostridium difficile colitis is made to avoid sepsis or bowel perforation. Relapses of Clostridium difficile infection have been reported in about 20-25% of cases, this may increase to 45-60% after the first recurrence on. In some cases colectomy may improve the outcome of the patient with systemic infection or complicated Clostridium difficile colitis. This article reviews the current literature regarding epidemiological picture, microbiology, histopathology and both medical and surgical managements.

Self-Administered Home Series Fecal “Minitransplants” for Recurrent Clostridium difficile Infection on a Rectal Remnant

2015 ◽  
Vol 24 (4) ◽  
pp. 531-533 ◽  
Author(s):  
Daniel Popa ◽  
Mihaela Laszlo ◽  
Lidia Ciobanu ◽  
Elena Ucenic ◽  
Manuela Mihalache ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Toxic Megacolon ◽  
Fecal Microbiota ◽  
Recurrent Infections ◽  
Resonance Imaging ◽  
Vaginal Infection ◽  
Fecal Microbiota Transplant ◽  
Recurrent Clostridium Difficile Infection

A fecal microbiota transplant has proved to be an extremely effective method for patients with recurrent infections with Clostridium difficile. We present the case of a 65-year-old female patient with multiple Clostridium difficile infection (CDI) relapses on the rectal remnant, post-colectomy for a CDI-related toxic megacolon. The patient also evidenced associated symptomatic Clostridium difficile vaginal infection. She was successfully treated with serial fecal “minitransplants” (self-administered at home) and metronidazole ovules.Abbreviations: GI: gastrointestinal; MRI: magnetic resonance imaging; CDI: Clostridium difficile infection; FMT: fecal microbiota transplant.

Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer

2016 ◽  
Vol 25 (3) ◽  
pp. 385-388 ◽  
Author(s):  
Yvette H. Van Beurden ◽  
Tom Van Gils ◽  
Nienke A. Van Gils ◽  
Zain Kassam ◽  
Chris J.J. Mulder ◽  
...  
Keyword(s):  
Celiac Disease ◽  
T Cell ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Cell Lymphoma ◽  
Fecal Microbiota ◽  
Disease Type ◽  
T Cell Lymphoma ◽  
Type Ii ◽  
Refractory Celiac Disease

Treatment of refractory celiac disease type II (RCD II) and preventing the development of an enteropathy associated T-cell lymphoma in these patients is still difficult. In this case report, we describe a patient with RCD II who received fecal microbiota transfer as treatment for a recurrent Clostridium difficile infection, and remarkably showed a full recovery of duodenal villi and disappearance of celiac symptoms. This case suggests that altering the gut microbiota may hold promise in improving the clinical and histological consequences of celiac disease and/or RCD II. Abbreviations: CDI: Clostridium difficile infection; EATL : enteropathy associated T-cell lymphoma; FMT: fecal microbiota transfer; IEL: intraepithelial lymphocytes; RCD II: refractory celiac disease type II; TPN: total parenteral nutrition.

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