Antibiotic-Associated Pseudomembranous Colitis Due to Toxin-Producing Clostridia

Bartlett, John G.; Chang, Te‐Wen; Gurwith, Marc; Gorbach, Sherwood L.; Onderdonk, Andrew B.

doi:10.1056/nejm197803092981003

Cited by 1,229 publications

(496 citation statements)

References 7 publications

Supporting

Mentioning

468

Contrasting

Unclassified

Order By: Relevance

“…The role of Clostridium difficile in antibiotic-associated diarrhoea and pseudomembranous colitis is well established (Bartlett et al 1978;Larson et al 1978). Both these conditions have been related to the use of antimicrobial agents (Bartlett et al 1979), however this is not always the case (Wald, Mendelow & Bartlett, 1980;Howard, Sullivan & Troster, 1980) and the significance of C. difficile in other forms of diarrhoea is still being debated (Falsen et al 1980;Bolton, Sheriff & Read, 1980;Brettle et al 1982).…”

Section: Introductionmentioning

confidence: 99%

Clostridium difficilein general practice and community health

Riley

Wymer

Bamford

et al. 1986

J. Hyg.

View full text Add to dashboard Cite

SUMMARYThe isolation rate for Clostridium difficile in diarrhceal stools was investigated in patients from general practice and community health centres over a 14-month period. C. difficile or its cytotoxin was detected in specimens from 89 (4 7 00) of 1882 patients studied and accounted for 30 3 Qo of all enteropathogenic micro-organisms isolated. Overall C. difficile was second only to Giandia lamblia in frequency.

show abstract

Section: Introductionmentioning

confidence: 99%

Clostridium difficilein general practice and community health

Riley

Wymer

Bamford

et al. 1986

J. Hyg.

View full text Add to dashboard Cite

show abstract

“…1,[6][7][8][9][10][11][12][13][14][15]9). A pesar de los datos encontrados por estos investigadores, la muestra solo incluía 22 casos y 44 controles, y se plantearon reparos sobre la sensibilidad de la prueba diagnóstica utilizada para la detección de la toxina.…”

Section: Discussionunclassified

“…El diagnóstico de la enfermedad se hace con base en la presencia de síntomas como diarrea, fiebre, dolor y distensión abdominal (1,25). Si bien la (17) 1 (3) 2 (7) 22 (73) 12 (14) 4 (5) 1 (1) (53) 12 (40) 18 (21) 21 (25) 45 (54) * Para nueve pacientes no se solicitó hacer examen coprológico.…”

Section: Discussionunclassified

See 1 more Smart Citation

Clinical and demographic profile and risk factors for Clostridium difficile infection

Carvajal¹,

Pacheco²,

Jaimes³

2017

biomedica

View full text Add to dashboard Cite

Contribución de los autores:Todos los autores participaron en igual medida en todos los aspectos del estudio y la redacción del manuscrito. Introducción. La enfermedad asociada a Clostridium difficile es la principal causa de diarrea infecciosa adquirida en el hospital; su creciente incidencia, las menores tasas de respuesta al tratamiento inicial y la mayor tasa de recaídas han incrementado la carga de la enfermedad. Objetivo. Determinar las características clínicas de los pacientes hospitalizados con enfermedad asociada a C. difficile. Materiales y métodos. Se hizo un estudio de casos anidado en una cohorte. Se revisaron las historias clínicas de pacientes con diarrea iniciada durante su hospitalización a quienes se les había practicado la prueba de detección de la toxina A-B de C. difficile, entre febrero de 2010 y febrero de 2012. Se definió como caso al paciente hospitalizado con diarrea y prueba de Enzyme Linked Fluorescent Assay (ELFA) positiva para la toxina y, como control, a aquel con resultado negativo para la toxina. Se recolectaron los datos demográficos y clínicos, así como la información sobre los factores asociados, la estancia hospitalaria, el tratamiento y las complicaciones. Perfil clínico y demográfico y factores de riesgo frente a la infección por Clostridium difficileResultados. Durante el periodo de seguimiento se recolectaron datos de 123 pacientes, de los cuales 30 fueron positivos para la toxina. La edad media en la población de estudio fue de 49 años y el 60 % correspondía a hombres. Los síntomas predominantes fueron el dolor abdominal (35 %) y la fiebre (34 %). Las principales complicaciones fueron la alteración electrolítica y la sepsis grave asociada con disfunción renal. La mortalidad total fue de 13 % y los factores independientes asociados con la aparición de la infección fueron el uso de inhibidores de la bomba de protones y la cirugía gastrointestinal previa. Conclusiones. El uso de inhibidores de la bomba de protonesy la cirugía gastrointestinal previa fueron factores asociados con la infección por C. difficile. Clinical and demographic profile and risk factors for Clostridium difficile infectionIntroduction: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. Objective: To determine the clinical characteristics of hospitalized patients with C. difficile infection. Materials and methods:We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C. difficile had been requested from February, 2010, to February, 2012. We defined case as a patient with diarrhea and a positive assay for the toxin, and control as those patients with a negative assay for the toxin. We collected data on demographic and clinical characteristics, risk factors, hospital length of stay, treatment, and complications. Results: We collec...

show abstract

“…The organism now known as C. difficile was described by Hall and O'Toole in 1935, 11 but it was not until 1978 that Bartlett and colleagues 12 identified C. difficile as the causative agent of antibiotic-associated pseudomembranous colitis. C. difficile is a Gram-positive, anaerobic, sporeforming rod.…”

Section: Organism Descriptionmentioning

confidence: 99%

Laboratory Diagnosis of Clostridium difficile Infection

Tenover¹,

Baron²,

Peterson

et al. 2011

The Journal of Molecular Diagnostics

View full text Add to dashboard Cite

The laboratory diagnosis of Clostridium difficile infection (CDI) continues to be challenging. Recent guidelines from professional societies in the United States note that enzyme immunoassays for toxins A and B do not have adequate sensitivity to be used alone for detecting CDI, yet the optimal method for diagnosing this infection remains unclear. Nucleic acid amplification tests (NAATs) that target chromosomal toxin genes (usually the toxin B gene, tcdB) show high sensitivity and specificity, provide rapid results, and are amenable to both batch and on-demand testing, but these tests were not universally recommended for routine use in the recent guidelines. Rather, two-step algorithms that use glutamate dehydrogenase (GDH) assays to screen for C. difficile in stool specimens, followed by either direct cytotoxin testing or culture to identify toxin-producing C. difficile isolates, were recommended in one guideline and either GDH algorithms or NAATs were recommended in another guideline. Unfortunately, neither culture nor direct cytotoxin testing is widely available. In addition, this two-step approach requires 48 to 92 hours to complete, which may delay the initiation of therapy and critical infection control measures. Recent studies also show the sensitivity of several GDH assays to be <90%. This review considers the role of NAATs for diagnosing CDI and explores their potential advantages over two-step algorithms, including shorter time to results, while providing comparable, if not superior, accuracy.

show abstract

Antibiotic-Associated Pseudomembranous Colitis Due to Toxin-Producing Clostridia

Cited by 1,229 publications

References 7 publications

Clostridium difficilein general practice and community health

Clostridium difficilein general practice and community health

Clinical and demographic profile and risk factors for Clostridium difficile infection

Laboratory Diagnosis of Clostridium difficile Infection

Contact Info

Product

Resources

About