scholarly journals Fecal Transplantation using a Nasoenteric Tube during an Initial Episode of Severe Clostridium difficile Infection

2016 ◽  
Vol 48 (1) ◽  
pp. 31 ◽  
Author(s):  
Yong Duk Jeon ◽  
Namki Hong ◽  
Jung Ho Kim ◽  
Se Hee Park ◽  
Sung Bae Kim ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Fecal Transplantation ◽  
Initial Episode ◽  
Severe Clostridium Difficile Infection

Comparison of Oral Vancomycin Capsule and Solution for Treatment of Initial Episode of Severe Clostridium difficile Infection

2013 ◽  
Vol 28 (2) ◽  
pp. 183-188 ◽  
Author(s):  
Stephanie N. Bass ◽  
Simon W. Lam ◽  
Seth R. Bauer ◽  
Elizabeth A. Neuner
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Clinical Cure ◽  
Primary Objective ◽  
Oral Solution ◽  
Oral Vancomycin ◽  
First Line Therapy ◽  
Initial Episode ◽  
Outcome Differences ◽  
Severe Clostridium Difficile Infection

Objective: Vancomycin is recommended as a first-line therapy for severe Clostridium difficile infection (CDI). Due to the high cost of commercially available vancomycin capsules, hospitals frequently compound oral solution despite a lack of data comparing outcomes. This study was conducted to determine treatment outcome differences based on oral vancomycin formulation. Methods: Medical charts of 76 patients with an initial episode of severe CDI receiving oral vancomycin as a commercially available capsule or a compounded oral solution for at least 72 hours were retrospectively reviewed. The primary objective was to compare the time to clinical cure of CDI. Results: Baseline characteristics between groups were similar except for the median lactate, which was higher in compounded oral solution group (1.5 vs 0.6 mmol/L, P < .001). There was no difference in clinical cure at day 10 (64% solution vs 59% capsules, P = .664). Median time to clinical cure was 8 days for solution and 7 for capsules ( P = .597). After adjustment, the hazard ratio of time to clinical cure for solution compared to capsules was 1.15 ( P = .69). No significant differences in mortality, recurrence, or complications were noted. Conclusion: Formulation of oral vancomycin did not impact treatment outcomes in this retrospective study.

Risk Factors and Outcomes Associated With Severe Clostridium difficile Infection in Children

2012 ◽  
Vol 31 (2) ◽  
pp. 134-138 ◽  
Author(s):  
Jason Kim ◽  
Julia F. Shaklee ◽  
Sarah Smathers ◽  
Priya Prasad ◽  
Lindsey Asti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Severe Clostridium Difficile Infection

scholarly journals Genetic determinants of trehalose utilization are not associated with severe Clostridium difficile infection

2019 ◽  
Author(s):  
Katie Saund ◽  
Krishna Rao ◽  
Vincent B. Young ◽  
Evan S. Snitkin
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Case Control Study ◽  
Severe Infection ◽  
Case Control ◽  
Genetic Determinants ◽  
Severe Clostridium Difficile Infection ◽  
Control Study

ABSTRACTIn a case-control study of patients with C. difficile infection we found no statistically significant association between the presence of trehalose utilization variants in infecting C. difficile strains and development of severe infection. These results do not support trehalose utilization conferring enhanced virulence in the context of human C. difficile infections.

scholarly journals Derivation and Validation of a Clinical Prediction Tool for Severe Clostridium difficile Infection

2011 ◽  
Vol 140 (5) ◽  
pp. S-326-S-327 ◽  
Author(s):  
Xi Na ◽  
Alan J. Martin ◽  
Daniel A. Leffler ◽  
Sarah L. Flores ◽  
Kyne Lorraine ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Prediction Tool ◽  
Clinical Prediction ◽  
Severe Clostridium Difficile Infection ◽  
Clinical Prediction Tool

scholarly journals Routine Treatment-Resistant Clostridium difficile Infection during Recovery from Myxedema

2017 ◽  
Vol 11 (3) ◽  
pp. 748-754 ◽  
Author(s):  
Jan K. Adamski ◽  
Björn B. Jäschke ◽  
Raija S. Uusitalo-Seppälä ◽  
Kalle V.J. Moilanen ◽  
Antti V. Pehkonen ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Laboratory Tests ◽  
Fecal Microbiota Transplantation ◽  
Recovery Phase ◽  
Fecal Microbiota ◽  
Treatment Resistant ◽  
Clinical Recovery ◽  
Resistant Form ◽  
Severe Clostridium Difficile Infection

Development of the extreme form of hypothyroidism defined as myxedema is very rare. Acute symptoms and their management have been described in detail previously. However, not much attention has been devoted to therapeutic challenges that are faced in the recovery phase of the treatment, especially pertaining to the gastrointestinal system. The link between myxedema and the appearance of severe Clostridium difficile infection (CDI) has not been established so far. A 61-year-old woman with no significant medical record was admitted to hospital because of infected heel pressure and thyroid dysfunction. A week later, due to hypothermia, hypotension, and unconsciousness, she was transferred to the intensive care unit. The clinical picture and the results of laboratory tests confirmed diagnosis of myxedema. After the introduction of resuscitative measures and hormonal substitution, patient’s condition stabilized within 10 days. Due to concomitant sepsis, initially piperacillin/tazobactam and later cefuroxime were administered. After 20 days of antibiotic therapy, the patient developed CDI that was resistant to the routine mode of treatment. The clinical recovery was achieved only after a fecal microbiota transplantation procedure. The function of the digestive tract in myxedema is disturbed by gastric achlorydia and reduced peristalsis, which in turn can predispose the small intestine to overgrowth of bacteria. The use of antibiotics can additionally decrease the intestinal bacterial diversity, favoring the overgrowth of Clostridium difficile. The authors conclude that myxedema may increase the likelihood of a treatment-resistant form of CDI that requires the implementation of fecal microbiota transplantation.

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