Antimicrobial Drugs and Community–acquired<i>Clostridium difficile–</i>associated Disease, UK

Delaney, Joseph A.; Dial, Sandra; Barkun, Alan N.; Suissa, Samy

doi:10.3201/eid1305.061124

Cited by 45 publications

(29 citation statements)

References 16 publications

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“…8 Likewise, in numerous recent publications quinolone usage has also been implicated in Clostridium difficile infection, particularly with reference to the newly described O27 hypervirulent strain. [9][10][11] Quinolone antibiotics are not recommended for first-line management of uncomplicated UTI partly for the reasons already expressed: to attempt to limit resistance occurring to this potent group of antibiotics, because they are more expensive than some of the alternatives already mentioned, and because of some of the issues concerning MRSA and C. difficile.…”

Section: Quinolonesmentioning

confidence: 99%

Antibiotics for uncomplicated urinary tract infection in women

Thompson¹,

Yacomeni²,

Townsend³

2010

Prescriber

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Most well women with uncomplicated urinary tract infection should respond to three days'treatment with a first-line antibiotic. Our Drug review describes the properties and side-effects of the recommended antibiotics, followed by sources of further information.E very year, around 5 per cent of women present to their GP with symptoms of dysuria and frequency, and approximately half of this number have confirmed urinary tract infection (UTI) upon laboratory investigation. This makes UTI one of the most common reasons for both presentation to primary care (especially in otherwise well women) and for anti biotic prescription. 1 Acute uncomplicated UTI is defined as UTI in a person with a structurally and functionally normal urinary tract. In contrast, a UTI can be considered complicated if there are functional or anatomical abnormalities within the urinary tract or underlying diseases that predispose to UTI, eg diabetes mellitus. 2 Acute uncomplicated UTI is predominantly obser ved in women, and recurrent cystitis is seen mostly in young, healthy women with normal urinary tracts (though the shorter female urethra is a predisposing factor to UTI).Complicated UTI may occur in anyone with predisposing illness or underlying abnormalities and Drug review UTI

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Section: Quinolonesmentioning

confidence: 99%

Antibiotics for uncomplicated urinary tract infection in women

Thompson¹,

Yacomeni²,

Townsend³

2010

Prescriber

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“…Two components are essential for CDAD to occur: first, exposure to antimicrobials and, second, exposure to toxigenic C. difficile (23). While exposure to C. difficile occurs most frequently in the hospital, exposure to antimicrobials as long as 6 months before the start of a CDAD episode has been associated with an increased risk of developing symptomatic CDAD (12). Indeed, almost half of elderly patients admitted to hospitals with community-acquired CDAD in Québec received antibiotics 3 months prior to their admission (14).…”

mentioning

confidence: 99%

Seasonal Variations in Clostridium difficile Infections Are Associated with Influenza and Respiratory Syncytial Virus Activity Independently of Antibiotic Prescriptions: a Time Series Analysis in Québec, Canada

Gilca

Fortin

Frenette

et al. 2012

Antimicrob Agents Chemother

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Seasonal variations in Clostridium difficile-associated diarrhea (CDAD), with a higher incidence occurring during winter months, have been reported. Although winter epidemics of respiratory viruses may be temporally associated with an increase in CDAD morbidity, we hypothesized that this association is mainly due to increased antibiotic use for respiratory infections. The objective of this study was to evaluate the effect of the two most frequent respiratory viruses (influenza virus and respiratory syncytial virus [RSV]) and antibiotics prescribed for respiratory infections (fluoroquinolones and macrolides) on the CDAD incidence in hospitals in the province of Québec, Canada. A multivariable Box-Jenkins transfer function model was built to relate monthly CDAD incidence to the monthly percentage of positive tests for influenza virus and RSV and monthly fluoroquinolone and macrolide prescriptions over a 4-year period (January 2005 to December 2008). Analysis showed that temporal variations in CDAD incidence followed temporal variations for influenza virus (P ‫؍‬ 0.043), RSV (P ‫؍‬ 0.004), and macrolide prescription (P ‫؍‬ 0.05) time series with an average delay of 1 month and fluoroquinolone prescription time series with an average delay of 2 months (P ‫؍‬ 0.01). We conclude that influenza virus and RSV circulation is independently associated with CDAD incidence after controlling for fluoroquinolone and macrolide use. This association was observed at an aggregated level and may be indicative of other phenomena occurring during wintertime.

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“…Toxin-producing Clostridium difficile strains are important pathogens among patients who are treated with antibiotics or chemotherapeutic agents not only in the hospital environment but also in the community (3,6,10). Since the recognition of outbreaks of C. difficile infection (CDI) caused by C. difficile PCR ribotype 027 in Canada, the United States, and several European countries, rapid and accurate diagnosis of CDI is very important to stop the spread of these strains (7,8,19).…”

mentioning

confidence: 99%

Comparison of a Rapid Molecular Method, the BD GeneOhm Cdiff Assay, to the Most Frequently Used Laboratory Tests for Detection of Toxin-Producing Clostridium difficile in Diarrheal Feces

et al. 2009

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Six hundred diarrheal stool specimens were collected from inpatients and outpatients at local university hospitals for the detection of toxigenic Clostridium difficile using three parallel methods, the BD GeneOhm Cdiff assay, the tissue culture cytotoxicity assay, and a commercially available enzyme-linked fluorescence immunoassay (ELFA) (Vidas C. difficile toxin A and B assay; bioMérieux). Toxigenic C. difficile culture was also performed to further clarify discordant results. During a 3-month study period, 58 (9.7%) of the 600 diarrheal samples examined were positive by the BD GeneOhm Cdiff assay, while the Vidas C. difficile toxin A and B assay and the cytotoxicity assay performed directly on stool samples gave 4.7% and 6.3% positivity rates, respectively. In the case of four samples, BD GeneOhm Cdiff assay results were not evaluable at first because of the presence of PCR inhibitors, but upon repeat testing from the frozen lysates, all of these samples proved to be negative. After resolution with toxigenic culture, the cytotoxicity assay proved to be positive in 55 samples (9.2%), while the ELFA was positive in 37 samples (6.2%). Results of culture and repeated cytotoxicity assays emphasized the importance of the culture method, because the use of ELFA or enzyme immunoassay without a culture method may lead to a substantial portion of toxigenic C. difficile strains being missed.Toxin-producing Clostridium difficile strains are important pathogens among patients who are treated with antibiotics or chemotherapeutic agents not only in the hospital environment but also in the community (3, 6, 10). Since the recognition of outbreaks of C. difficile infection (CDI) caused by C. difficile PCR ribotype 027 in Canada, the United States, and several European countries, rapid and accurate diagnosis of CDI is very important to stop the spread of these strains (7,8,19). In addition, the increasing morbidity and mortality rates associated with CDI and the increasing number of recurrences and therapeutic failures also highlight the need for the development of a rapid and reliable detection method for toxigenic C. difficile in diarrheal feces (12).Only a few laboratories routinely use the tissue culture cytotoxicity and toxin neutralization assays for the detection of toxigenic C. difficile in feces, because they are labor-intensive and time-consuming and standardization is very difficult. Due to their rapid turnaround time, enzyme immunoassays (EIAs) that detect toxin A and/or toxin B in stool are used in most laboratories (11,16). To increase the sensitivity of these tests and in some instances to facilitate epidemiological investigations, culture of C. difficile has become essential. In spite of this, most laboratories use a single toxin detection test on feces for detection of toxigenic C. difficile (4). In the last 10 years, in-house PCR and real-time PCR assays have been developed to detect C. difficile toxin genes. These assays have shown very good sensitivity and specificity and short turnaround times (1, 17). Howev...

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Antimicrobial Drugs and Community–acquiredClostridium difficile–associated Disease, UK

Cited by 45 publications

References 16 publications

Antibiotics for uncomplicated urinary tract infection in women

Antibiotics for uncomplicated urinary tract infection in women

Seasonal Variations in Clostridium difficile Infections Are Associated with Influenza and Respiratory Syncytial Virus Activity Independently of Antibiotic Prescriptions: a Time Series Analysis in Québec, Canada

Comparison of a Rapid Molecular Method, the BD GeneOhm Cdiff Assay, to the Most Frequently Used Laboratory Tests for Detection of Toxin-Producing Clostridium difficile in Diarrheal Feces

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