Asymptomatic neonatal colonisation by Clostridium difficile.

Bolton, R P; Tait, Steven; Dear, P. R. F.; Losowsky, M.S.

doi:10.1136/adc.59.5.466

Cited by 103 publications

(78 citation statements)

References 23 publications

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“…Considering the relatively small number of participants in this study, this finding should be confirmed by additional large-scale studies; however, this finding was comparable with those of previous studies in which no significant association was observed between antibiotic usage and CDC in both term and preterm infants [2,13,17]. In our study, we also compared two different NICUs to examine the influence of environmental factors.…”

Section: Discussionsupporting

confidence: 38%

“…In a recent study, colonization of hospitalized preterm infants by Clostridium species was only associated with the NICU in multiple regression analysis. Although C. difficile was not separately analyzed and the type of feeding was not investigated in that study, the association of the NICU itself with Clostridium species colonization may support the importance of environmental factors in the colonization process of C. difficile in preterm infants [2,16].…”

Section: Discussionmentioning

confidence: 99%

“…Clostridium difficile (C. difficile), which is one of the important etiologic agents of pseudomembranous colitis in older children and adults, causes an asymptomatic infection in most neonates and Pediatr Gastroenterol Hepatol Nutr young infants [1][2][3]. Likewise, in most cases, colonization of hospitalized preterm infants in the neonatal intensive care unit (NICU) is not apparently harmful; however, the association of C. difficile colonization (CDC) with necrotizing enterocolitis or nonspecific gastrointestinal symptoms such as diarrhea has been infrequently reported [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Chang

Shim

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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Section: Discussionsupporting

confidence: 38%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Chang

Shim

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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“…In addition to the majority of patients with community-associated CDI having had antibiotic exposure within 12 weeks, the authors found that 82 % of this cohort had outpatient or inpatient health care exposure, and there was a trend toward proton pump inhibitor (PPI) use, compared to those without antibiotic exposure [14]. Contact with children younger than 2 years, who are known to be frequent asymptomatic carriers of C. difficile, has also been associated with increased risk of community-acquired CDI [14,17,18]. The pathophysiology underlying the association of CDI with these lesserknown yet emerging cohorts remains unclear.…”

Section: Clostridium Difficile Infection (Cdi)mentioning

confidence: 99%

Recurrent Clostridium difficile infection and the microbiome

2015

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The diverse and densely populated gastrointestinal microbiota is essential for the regulation of host physiology and immune function. As our knowledge of the composition and function of the intestinal microbiota continues to expand, there is new interest in using these developments to tailor fecal microbiota transplantation (FMT) and microbial ecosystem therapeutics (MET) for a variety of diseases. The potential role of FMT and MET in the treatment of Clostridium difficile infection (CDI)-currently the leading nosocomial gastrointestinal infection-has proven highly effective for recurrent CDI, and has emerged as a paradigm shift in the treatment of this disease. The current review will serve as a summary of the key aspects of CDI, and will introduce the essential framework and challenges of FMT, as is currently practiced. MET represents the progression of conventional bacteriotherapy that fundamentally capitalizes on the restorative properties of intestinal bacterial communities and may be viewed as the culmination of a rationally designed therapeutic modality. As our understanding of the composition and function of the intestinal microbiota evolves, it will likely drive next-generation microbiota therapies for a range of medical conditions, such as inflammatory bowel disease, obesity, and metabolic syndrome.

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“…Up to 50% of human infants are culture positive, though disease is almost unheard of in this group. 13 Infants may be refractory to disease because they lack toxin receptors. 18 The next highest prevalence of asymptomatic individuals is among hospital patients, of whom approximately 20% are culture positive.…”

Section: Epidemiology and Prevalencementioning

confidence: 99%

The Comparative Pathology ofClostridium difficile-associated Disease

2006

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Abstract. Clostridium difficile is a confirmed pathogen in a wide variety of mammals, but the incidence of disease varies greatly in relation to host species, age, environmental density of spores, administration of antibiotics, and possibly, other factors. Lesions vary as well, in severity and distribution within individuals, and in some instances, age groups, of a given species. The cecum and colon are principally affected in most species, but foals and rabbits develop severe jejunal lesions. Explanations for variable susceptibility of species, and age groups within a species, are largely speculative. Differences in colonization rates and toxin-receptor densities have been proposed. Clostridium difficile-associated disease is most commonly diagnosed in Syrian hamsters, horses, and neonatal pigs, but it is reported sporadically in many other species. The essential virulence factors of C. difficile are large exotoxins, toxin A (TcdA) and toxin B (TcdB). Receptor-mediated endocytosis of the toxins is followed by endosomal acidification, a necessary step for conversion of the toxin to its active form in the cytosol. Cell-surface receptors have been characterized for TcdA, but remain to be identified for TcdB. Both TcdA and TcdB disrupt the actin cytoskeleton by disrupting Rho-subtype, intracellular signaling molecules. Disruption of the actin cytoskeleton is catastrophic for cellular function, but inflammation and neurogenic stimuli are also involved in the pathogenesis of the disease.

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Asymptomatic neonatal colonisation by Clostridium difficile.

Cited by 103 publications

References 23 publications

Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Recurrent Clostridium difficile infection and the microbiome

The Comparative Pathology ofClostridium difficile-associated Disease

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