Search Our Scientific Publications & Authors

Cell Mol Gastroenterol Hepatol 2019 Apr 17. Epub 2019 Apr 17.

Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address:

Background & Aims: Gut dysbiosis plays a role in hepatic encephalopathy (HE), while its relationship at the acute episode of overt HE (AHE), the disease progression and clinical outcomes remains unclear. We aimed to identify AHE-specific microbiome and its association to patients' outcomes.

Methods: We profiled fecal microbiome changes for a cohort of 62 patients with cirrhosis and AHE i) before treatment, ii) 2-3 days after medication and iii) 2-3 months after recovery, and three control cohorts i) healthy individuals, patients with ii) compensated or iii) decompensated cirrhosis. Read More

Cell Host Microbe 2019 Apr 13. Epub 2019 Apr 13.

Department of Microbiology, Immunology and Cancer Biology, University of Virginia Health System, Charlottesville, VA 22908, USA; Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA; Department of Pathology, University of Virginia Health System, Charlottesville, VA 22908, USA. Electronic address:

Clostridium difficile infection (CDI) is the number one hospital-acquired infection in the United States. CDI is more common and severe in inflammatory bowel disease patients. Here, we studied the mechanism by which prior colitis exacerbates CDI. Read More

Clin Transplant 2019 Apr 19:e13564. Epub 2019 Apr 19.

Department of Medicine, Washington University School of Medicine, St. Louis, MO.

These updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice address the prevention and management of Clostridium difficile infection in solid organ transplant (SOT) recipients. Clostridioides (formerly Clostridium) difficile infection (CDI) is among the most common hospital acquired infections. In SOT recipients the incidence of CDI varies by type and number or organs transplanted. Read More

Cell Rep 2019 Apr;27(3):750-761.e7

Laboratory of Immunoinflammation, Department of Genetics, Evolution, Microbiology, and Immunology, Institute of Biology, University of Campinas, Campinas, SP 13083-862, Brazil. Electronic address:

Antibiotic-induced dysbiosis is a key factor predisposing intestinal infection by Clostridium difficile. Here, we show that interventions that restore butyrate intestinal levels mitigate clinical and pathological features of C. difficile-induced colitis. Read More

Antimicrob Agents Chemother 2019 Apr 15. Epub 2019 Apr 15.

Department of Medicine, Division of Infectious Disease, University of Wisconsin - Madison School of Medicine and Public Health, Madison, Wisconsin, USA.

Probiotics may represent a promising approach for reducing () infections (CDI). A clinical trial conducted by our group demonstrated CDI patients undergoing adjunctive treatment with probiotics had reduction in diarrhea duration and compositional changes in their stool microbiome. Here we modified a CDI mouse model to represent clinical outcomes observed in patients and employ this model to identify evidence for prevention of primary CDI and relapse with the same probiotic. Read More

Rev Gastroenterol Mex 2019 Apr 12. Epub 2019 Apr 12.

Hospital Ángeles y Hospital Lomas, San Luis Potosí, S.L.P., México. Electronic address:

In recent decades, Clostridium difficile infection (CDI) has become a worldwide health problem. Mexico is no exception, and therefore the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, endoscopists, internists, infectious disease specialists, and microbiologists) to carry out the "Consensus on the prevention, diagnosis, and treatment of Clostridium difficile infection", establishing useful recommendations (in relation to the adult population) for the medical community. Said recommendations are presented herein. Read More

Inflamm Bowel Dis 2019 Apr 13. Epub 2019 Apr 13.

Division of Gastroenterology, University of California, San Francisco, California, USA.

Background: Hospitalization for ulcerative colitis is a high-risk period associated with increased risk of Clostridium difficile infection, thromboembolism, and opiate use. The study aim was to develop and implement a quality-improvement intervention for inpatient ulcerative colitis management that standardizes gastroenterology consultant recommendations and improves delivery of evidence-based care.

Methods: All adult patients hospitalized for ulcerative colitis between July 1, 2014, and December 31, 2017, who received intravenous corticosteroids were included. Read More

Am J Infect Control 2019 Apr 9. Epub 2019 Apr 9.

Columbia University, School of Nursing, New York, NY.

Background: Staff nurse and infection preventionist (IP) workload increases in response to exposures and outbreaks. Understanding the time burden associated with responding to specific pathogens may improve resource allocation. The purpose of this study was to evaluate workload increases reported by nurses and IPs in response to common exposures and outbreaks. Read More

Intensive Crit Care Nurs 2019 Apr 9. Epub 2019 Apr 9.

Department of Critical Care Medicine, "ATTIKON" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address:

Background: Clostridium difficile is one of the major causes of diarrhoea among critically ill patients and its prevalence increases exponentially in relation to the use of antibiotics and medical devices. We sought to investigate the incidence of C. difficile infection in Greek units, and identify potential risk factors related to C. Read More

J Pharm Policy Pract 2019 29;12. Epub 2019 Mar 29.

Institute of clinical sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK.

Background: Proton pump inhibitors (PPIs) are used worldwide for the treatment of gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD). Although considered to be widely safe, PPIs have been associated with the potential risk of adverse effects such as infections including pneumonia and , malabsorption of vitamins and minerals, dementia and more recently with chronic kidney disease (CKD). Evidence including large cohort studies suggests that there is a greater risk of developing CKD in chronic users of PPIs. Read More

Infect Control Hosp Epidemiol 2019 Apr 12:1-6. Epub 2019 Apr 12.

Department of Internal Medicine,University of Iowa,Iowa City,Iowafor the CDC MInD-Healthcare Program.

Objective: To estimate the burden of Clostridium difficile infections (CDIs) due to interfacility patient sharing at regional and hospital levels.

Design: Retrospective observational study.

Methods: We used data from the Healthcare Cost and Utilization Project California State Inpatient Database (2005-2011) to identify 26,878,498 admissions and 532,925 patient transfers. Read More

Eur J Gastroenterol Hepatol 2019 Apr 9. Epub 2019 Apr 9.

Gastroenterology Department.

Background: Inflammatory bowel disease (IBD) is an independent risk factor for Clostridium difficile infection (CDI), which is associated significantly with disease severity. We aimed to determine the rates of CDI among hospitalized IBD patients in major tertiary referral hospitals in Greece.

Patients And Methods: A retrospective analysis was carried out of stool cultures from hospitalized patients investigated for diarrhea, during 2016, tested for CDI with glutamate dehydrogenase (GDH) and toxins A and B. Read More

Vaccine 2019 May 5;37(19):2600-2607. Epub 2019 Apr 5.

Pfizer Inc, Pearl River, NY, USA. Electronic address:

Background: Clostridium difficile infection (CDI) is a major global cause of nosocomial and community-acquired infections. Despite potentially severe or fatal complications and frequent recurrence, no preventive vaccine is currently available. This randomized, observer-blinded, placebo-controlled phase 1 study in older Japanese adults evaluated safety and immunogenicity of an investigational C difficile vaccine containing a mixture of genetically detoxified and chemically inactivated toxoids, A and B. Read More

Pathog Glob Health 2019 Apr 9:1-9. Epub 2019 Apr 9.

b Neurogenic Inflammation Research Center , Mashhad University of Medical Sciences , Mashhad , Iran.

Clostridium species are ubiquitous and associated with various diseases in animals and humans. However, there is little knowledge about the prevalence of their resistance to antibiotics in Iran. Therefore, the aim of this study was to determine the prevalence of antibiotic-resistant Clostridium species in Iran through a meta-analysis of eligible studies published up until December 2018. Read More

Anaerobe 2019 Apr 6;57:107-114. Epub 2019 Apr 6.

Southern Right Whale Health Monitoring Program, Chubut, 9120, Argentina; School of Veterinary Medicine, University of California Davis, California, 95616, United States.

Between 2003 and 2017, at least 706 southern right whale (Eubalaena australis) calves died at the Península Valdés calving ground in Argentina. Pathogenic microbes are often suggested to be the cause of stranding events in cetaceans; however, to date there is no evidence supporting bacterial infections as a leading cause of right whale calf deaths in Argentina. We used high-throughput sequencing and culture methods to characterize the bacterial communities and to detect potential pathogens from the intestine of stranded calves. Read More

Expert Rev Med Devices 2019 Apr 8. Epub 2019 Apr 8.

b Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences , Tehran , Iran .

Objectives: Endogenous and exogenous infection of the biliary tract could occur during endoscopic retrograde cholangiopancreatography.

Methods: Bile samples of patients with hepatobiliary diseases, and swab samples of elevator channel samples of duodenoscope and washing instruments were prepared simultaneously and cultured aerobically and anaerobically. Antimicrobial susceptibility of the most common characterized bacterial species was tested, and their genetic relatedness was analyzed by multiple locus variable number of tandem repeats method. Read More

Sci Rep 2019 Apr 4;9(1):5634. Epub 2019 Apr 4.

Actelion Pharmaceuticals Ltd, Allschwil, Switzerland.

Oxazolidinones are synthetic antibiotics used for treatment of infections caused by Gram-positive bacteria. They target the bacterial protein synthesis machinery by binding to the peptidyl transferase centre (PTC) of the ribosome and interfering with the peptidyl transferase reaction. Cadazolid is the first member of quinoxolidinone antibiotics, which are characterized by combining the pharmacophores of oxazolidinones and fluoroquinolones, and it is evaluated for treatment of Clostridium difficile gastrointestinal infections that frequently occur in hospitalized patients. Read More

Life Sci Alliance 2019 Apr 4;2(2). Epub 2019 Apr 4.

Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, OH, USA

impairs Paneth cells, driving intestinal inflammation that exaggerates colitis. Besides secreting bactericidal products to restrain , Paneth cells act as guardians that constitute a niche for intestinal epithelial stem cell (IESC) regeneration. However, how IESCs are sustained to specify Paneth-like cells as their niche remains unclear. Read More

Vet Immunol Immunopathol 2019 Apr 4;210:28-37. Epub 2019 Mar 4.

Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, SP, Brazil.

Information on the dynamics of the chicken immune system during bacterial or parasite challenge in the presence or absence of stressful situations may provide a better understanding of the complex mechanisms behind these diseases. Necrotic enteritis (NE) had been controlled previously by the proper use of antimicrobial agents; however, more recently, NE has reemerged in many countries. The imposed restrictions on antimicrobial use and/or the intensive productive programs implemented by producers are challenges the birds, leading to large host adaptive responses that in many instances are like those elicited by stressors. Read More

Anaerobe 2019 Apr 1. Epub 2019 Apr 1.

Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, 86011, USA; Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, 86011, USA. Electronic address:

Clostridioides difficile infection (CDI) is an emerging public health threat and C. difficile is the most common cause of antimicrobial-associated diarrhea worldwide and the leading cause of hospital-associated infections in the US, yet the burden of community-acquired infections (CAI) is poorly understood. Characterizing C. Read More

Eur J Clin Microbiol Infect Dis 2019 Apr 3. Epub 2019 Apr 3.

Department of Infectious and Tropical Diseases, Jagiellonian University, Medical College, Śniadeckich 5, 31-501, Krakow, Poland.

Clostridium difficile (C. difficile) is a Gram-positive, spore-forming, anaerobic bacillus, which is widely distributed in the intestinal tract of humans and animals and in the environment. In the last decade, the frequency and severity of C. Read More

Sci Rep 2019 Apr 3;9(1):5554. Epub 2019 Apr 3.

Glaxo Smith Kline Vaccines, Via Fiorentina 1, 53100, Siena, Italy.

Clostridium difficile is a Gram-positive, anaerobic bacterium and the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis. C. difficile modulates its transition from a motile to a sessile lifestyle through a mechanism of riboswitches regulated by cyclic diguanosine monophosphate (c-di-GMP). Read More

PLoS One 2019 3;14(4):e0214880. Epub 2019 Apr 3.

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P., India.

Background: Amebiasis, caused by Entamoeba histolytica (E. histolytica), is a significant cause of morbidity and mortality in developing countries. Mortality due to amebiasis is mostly by extra intestinal infections, amebic liver abscess being the most common one. Read More

Eur J Clin Microbiol Infect Dis 2019 Apr 2. Epub 2019 Apr 2.

Medical Intensive Care Unit, La Source Hospital, CHR Orléans, 14, Hospital Bd, 45100, Orléans, France.

To investigate the predictors and burden of hospital readmission with recurrent Clostridioides difficile infection (rCDI) in a large European healthcare system with a low prevalence of hyper-virulent C. difficile clones. We conducted an inception cohort study based on an exhaustive health insurance database and including all survivors of a first hospital stay with CDI over a one-year period (2015) in France. Read More

Lancet 2019 Mar 29. Epub 2019 Mar 29.

Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK. Electronic address:

Tetanus is a vaccine-preventable disease that still commonly occurs in many low-income and middle-income countries, although it is rare in high-income countries. The disease is caused by the toxin of the bacterium Clostridium tetani and is characterised by muscle spasms and autonomic nervous system dysfunction. Global vaccination initiatives have had considerable success but they continue to face many challenges. Read More

Int J Food Microbiol 2019 Jun 10;298:74-80. Epub 2019 Mar 10.

Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy.

Clostridium difficile is a major cause of infectious diarrhea associated to healthcare settings. Community-acquired infections are increasingly reported in the last decade and exposure other than to symptomatic patients rather to contaminated foods or animals is feasible. Occurrence of C. Read More

Diabetes Ther 2019 Mar 29. Epub 2019 Mar 29.

Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan.

Herein we describe four patients with acquired hemophilia A (AHA) caused by factor VIII (FVIII) inhibitor and histories of dipeptidyl peptidase-4 inhibitor (DPP4-I) treatment for diabetes mellitus (DM). Drug exposure can cause a breakdown of immune tolerance to FVIII associated with CD4 T cells, resulting in the induction of autoantibodies against FVIII. In patient 1 in the present series, FVIII inhibitor disappeared after DPP4-I treatment. Read More

CMAJ Open 2019 Jan-Mar;7(1):E174-E181. Epub 2019 Mar 29.

Public Health Ontario (Brown, Chambers, MacFarlane, Langford, Leung, Quirk, Schwartz, Garber); St. Joseph's Health Centre (Langford, Schwartz); Department of Medicine (Garber) and Dalla Lana School of Public Health (Brown, Schwartz), University of Toronto, Toronto, Ont.

Background: Antibiotic use in long-term care homes is highly variable. High rates of antibiotic use are associated with antibiotic resistance and infection. We asked 2 questions regarding a program designed to improve diagnosis and management of urinary tract infections in long-term care: whether the program decreased urine culturing and antibiotic prescribing rates and whether specific strategies of the program were more or less likely to be adopted. Read More

Anaerobe 2019 Mar 26;57:59-62. Epub 2019 Mar 26.

Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Huddinge, Sweden. Electronic address:

Identification of anaerobic bacteria causing blood stream infections (BSI) is challenging. This study describes the epidemiology of anaerobic BSI at a tertiary care hospital and the performance of a rapid method for identification of anaerobic bacteria from blood cultures over three years, between June 2015 and June 2018. Short-term culturing is a low-cost user-friendly method and may be used for rapid identification of bacteria from positive blood cultures by matrix-associated laser desorption ionization time of flight (MALDI-TOF). Read More

J Hosp Infect 2019 Mar 26. Epub 2019 Mar 26.

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom. Electronic address:

Background: Antibiotic resistance is a growing global problem associated with increased morbidity and mortality, and presents a significant financial and economic burden on healthcare. FMT has been proven effective for curing recurrent Clostridium difficile infections, however no systematic review to date has addressed its effectiveness for decolonisation of antibiotic-resistant bacteria from the gut.

Aim: To answer the following research question: Does faecal microbiota transplantation decolonise antibiotic-resistant bacteria from the gut of colonised adults?

Methods: A systematic review was performed by undertaking a comprehensive search on MEDLINE, Embase, CENTRAL, PubMed and CINAHL databases for evidence up till May 2018. Read More

Presse Med 2019 Mar 26. Epub 2019 Mar 26.

Assistance publique Hôpitaux de Paris (AP-HP), hôpital Cochin, service de gastroentérologie, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Paris-Descartes, 12, rue de l'École de médecine, 75006 Paris, France. Electronic address:

Proton pump inhibitors (PPIs) are among the most prescribed drugs in the world. While their efficacy in acute management is indisputable, it has long been suggested that PPI therapy is safe in the long term. In recent years, there has been growing and justified concern about the long-term risks of PPIs. Read More

Medicine (Baltimore) 2019 Mar;98(13):e15004

Department of Pharmacy.

Rationale: Clostridium difficile-associated diarrhea (CDAD) remains a persistent challenge, with substantially increased incidence and severity. The rising burden of CDAD requires urgent identification of preventable risk factors.

Patients Concerns: A 77-year-old man with the symptoms of abdominal pain and watery diarrhea was readmitted to the hospital, who received cephalosporins and proton pump inhibitors (PPIs) during the initial hospitalization for 12 days until discharge. Read More

Poult Sci 2019 Mar 28. Epub 2019 Mar 28.

Guelph Research and Development Centre, Agriculture and Agri-Food Canada (AAFC), Guelph, ON N1G 5C9, Canada.

There is a need to develop cost-effective approaches to modulate gut microbiota, promote bird health, and prevent infections in pasture-raised broiler chickens. The present study evaluated the efficacy of organic wild blueberry (Vaccinium angustifolium) also called low-bush blueberry pomace (LBBP)-supplemented feed to modulate the chicken gut microbiota, and blood metabolites in order to improve bird health and productivity. Slow-growing broiler chickens were reared on pasture up to 64 D for sampling after 2 wk of treatment during brooding with 0, 1, and 2% LBBP in feed. Read More

Front Vet Sci 2019 13;6:73. Epub 2019 Mar 13.

Department of Animal Science, Michigan State University, East Lansing, MI, United States.

Growth performance and feed efficiency are essential parameters when evaluating profitability of livestock. However, animal performance does not always reflect optimal gut health. Decades of research have supported the theory that improved animal performance such as average daily gain and feed efficiency can be impacted by intestinal health or the ability of the intestinal mucosa to absorb nutrients, but dysfunction may be found when the animal is stressed. Read More

SAGE Open Med Case Rep 2019 19;7:2050313X19838442. Epub 2019 Mar 19.

Clinic of Gastroenterology, Adana City Research and Education Hospital, University of Health Sciences, Adana, Turkey.

The infection-related disease varies from mild diarrhoea to pseudomembranouscolitis. Although infection is commonly considered to be a hospital-acquired infection, a significant number of cases are community acquired. Community-acquired infection can exhibit itself as ileus or toxic megacolon. Read More

Biomarkers 2019 Mar 25:1-5. Epub 2019 Mar 25.

f Faculty of Medicine , University of Medicine and Pharmacy Cluj-Napoca , Sibiu , Romania.

Background: There are only limited data in the literature on the thrombotic risk of patients with Clostridium difficile (CD) colitis, although this disease is widespread throughout the world.

Objective: The aim of this study was to explore thrombin generation in these patients - the best way to evaluate their coagulation.

Methods: A prospective observational study was conducted during 15 months on hospitalized patients with CD colitis. Read More

Therap Adv Gastroenterol 2019 14;12:1756284819836893. Epub 2019 Mar 14.

Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA Harvard Medical School, Boston, MA.

Fecal microbiota transplantation (FMT) has changed the treatment landscape of infection (CDI). Emerging evidence has shown that FMT can also be an effective and safe treatment strategy in CDI with underlying inflammatory bowel disease (IBD). Recently, randomized controlled trials of FMT in ulcerative colitis support its expanding role in restoring gut homeostasis in this disease. Read More

Eur J Med Chem 2019 May 1;170:203-224. Epub 2019 Mar 1.

School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW, 2522, Australia. Electronic address:

Clostridioides (formerly Clostridium) difficile is a Gram-positive anaerobic bacterial pathogen that causes severe gastrointestinal infection in humans. The current chemotherapeutic options are vastly inadequate, expensive and limited; this results in an exorbitant medical and financial burden. New, inexpensive chemotherapeutic treatments for C. Read More

mSphere 2019 03 20;4(2). Epub 2019 Mar 20.

Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA

Between October 2016 and June 2017, a C57BL/6J mouse colony that was undergoing a pre- and perinatal methyl donor supplementation diet intervention to study the impact of parental nutrition on offspring susceptibility to disease was found to suffer from an epizootic of unexpected deaths. Necropsy revealed the presence of severe colitis, and further investigation linked these outbreak deaths to a strain of ribotype 027 that we term 16N203. infection (CDI) is associated with antibiotic use in humans. Read More

J Invest Surg 2019 Mar 20:1-9. Epub 2019 Mar 20.

a Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Department of Pediatric Surgery , Nationwide Children's Hospital , Columbus , OH , USA.

Background: Clostridium difficile infection is the most common cause of antimicrobial-associated diarrhea. Our aim was to introduce a novel and efficient clinical sickness score (CSS), and to define a detailed histologic injury score (HIS) in a murine model of C. difficile colitis. Read More

J Thorac Cardiovasc Surg 2019 Feb 20. Epub 2019 Feb 20.

Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany.

Objectives: The pathology of structural valvular heart disease (sVHD) ranges from basic diseases of rheumatologic origin to chronic degenerative remodeling processes after acute bacterial infections. Molecular genetic methods allow detection of the complete microbial spectrum in heart valve tissues independent of microbiological cultivation. In particular, whole-metagenome analysis is a sensitive and highly specific analytical method that allows a deeper insight into the pathogenicity of the diseases. Read More

Lancet Infect Dis 2019 Mar 15. Epub 2019 Mar 15.

Synthetic Biologics, Rockville, MD, USA.

Background: Infections with Clostridium difficile are a health threat, yet no products are currently licensed for prevention of primary C difficile infections. Intravenous β-lactam antibiotics are considered to confer a high risk of C difficile infection because of their biliary excretion into the gastrointestinal tract and disruption of the gut microbiome. ribaxamase (SYN-004) is an orally administered β-lactamase that was designed to be given with intravenous β-lactam antibiotics to degrade excess antibiotics in the upper gastrointestinal tract before they disrupt the gut microbiome and lead to C difficile infection. Read More

Am J Infect Control 2019 Mar 16. Epub 2019 Mar 16.

Department of Rehabilitation Medicine, University of Washington, Seattle, WA.

Both quaternary ammonium and bleach-based cleaning products are effective in reducing the transmission of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus in hospitals, but bleach-based compounds demonstrate better control of Clostridium difficile infections. Our pilot study demonstrates the potential to reduce C. difficile transmission in an acute care hospital by eliminating the need for providers to choose the appropriate cleaning product from isolation precaution carts. Read More

J Hosp Infect 2019 Mar 15. Epub 2019 Mar 15.

Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.

Background: Clostridium difficile infection (CDI) is the leading cause of antibiotic-associated diarrhoea with peak incidence in late winter or early autumn. Although CDI is commonly associated with hospitals, community transmission is important.

Aim: To explore potential drivers of CDI seasonality and the effect of community-based interventions to reduce transmission. Read More

Diagn Microbiol Infect Dis 2019 Feb 16. Epub 2019 Feb 16.

Department of Medical Microbiology, Medical University of Sofia, 1431 Sofia, Bulgaria.

Two-year Clostridioides (Clostridium) difficile recurrences in a boy with ulcerative colitis are described. Isolates were toxin A/B positive and nonhypervirulent, and resistotypes of 2017 isolates differed from those in 2016, suggesting a reinfection, later confirmed by multilocus sequence typing (ST49 and ST92, respectively). Resistotypes may show the need of genotypic analysis. Read More

Epidemiol Infect 2019 Jan;147:e141

Public Health Agency, Health Protection Service Northern Ireland,Belfast,Northern Ireland.

The burden of community-associated Clostridium difficile infection (CA-CDI) has increased. We aimed to describe the epidemiology of CA-CDI to inform future interventions. We used population-based linked surveillance data from 2012 to 2016 to describe socio-demographic factors, ribotype and mortality for all CA (n = 1303) and hospital-associated (HA, n = 1356) CDI. Read More

J Crohns Colitis 2019 Mar 13. Epub 2019 Mar 13.

Department of Pathology, University of Cologne, Germany.

Background And Aims: In active ulcerative colitis [UC] refractory to mesalazine, escalation to either steroids or immunosuppression is common practice. The efficacy and safety of alternative escalation therapy with a novel leukocyte apheresis device were studied.

Methods: This was a prospective, randomized, controlled multicentre pilot study comparing leukocyte apheresis with prednisolone in refractory UC (disease activity index [DAI] ≥ 4 and ≤8). Read More

Case Rep Crit Care 2019 3;2019:2987682. Epub 2019 Feb 3.

Department of Surgery/Division of Trauma and Critical Care, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA.

Introduction: Isolated small bowel enteritis is a rare condition with significant morbidity and mortality.

Presentation Of Case: An 83-year-old female with refractory ulcerative colitis underwent a total proctocolectomy and end ileostomy. Her postoperative course was complicated with return to the operating room for repair of an incarcerated port site hernia. Read More

MBio 2019 03 12;10(2). Epub 2019 Mar 12.

Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.

The increasing clinical importance of human infections (frequently severe) caused by PCR ribotype 078 (RT078) was first reported in 2008. The severity of symptoms (mortality of ≤30%) and the higher proportion of infections among community and younger patients raised concerns. Farm animals, especially pigs, have been identified as RT078 reservoirs. Read More

Z Gastroenterol 2019 Mar 12;57(3):296-303. Epub 2019 Mar 12.

Klinik für Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, Klinikum Bogenhausen, Städtisches Klinikum München GmbH, Deutschland.

Introduction:  Fecal microbiota transplantation (FMT) represents a treatment option for recurring Clostridium difficile-associated colitis. However, there is also evidence that FMT can be effective in treating ulcerative colitis. This study examined the approval and willingness of affected patients who underwent FMT. Read More