Burden of<i>Clostridium difficile</i>Infection in the United States

Lessa, Fernanda C.; Mu, Yi; Bamberg, Wendy; Beldavs, Zintars G.; Dumyati, Ghinwa; Dunn, John R.; Farley, Monica M.; Holzbauer, Stacy; Meek, James; Phipps, Erin C; Wilson, Lucy; Winston, Lisa G; Cohen, Jessica; Limbago, Brandi; Fridkin, Scott K.; Gerding, Dale N.; McDonald, L. Clifford

doi:10.1056/nejmoa1408913

Cited by 2,296 publications

(1,788 citation statements)

References 41 publications

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“…mortality rates since 1999 in the US has occurred at all ages > 40. The pronounced proportional hazard pattern ( In summary, in addition to causing significant morbidity (Lessa et al 2015), Clostridium difficile is an emerging cause of death in the United States.…”

Section: Resultsmentioning

confidence: 99%

Clostridium difficileInfection: An Emerging Cause of Death in the Twenty-First Century

Abdullatif

Noymer

2016

Biodemography and Social Biology

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Enterocolitis due to Clostridium difficile is major emerging cause of death in the US. Between 1999 and 2012, C. diff. deaths rose by a staggering almost-10-fold increase, to 7,739 from 793. This paper has three goals. First, we present a demographic description of C. diff. mortality in the US since 1999. Second, we test a hypothesis that the increase in C. diff. deaths is due to population aging. We find that the emergence of this cause of death follows a proportional hazard pattern, above age 40. Thus, population aging is not the only factor responsible for the increase in C. diff. deaths. This, combined with a contributory cause of death analysis, points towards healthcare-based strategies to combat C. diff. Third, we demonstrate a simple weighted least squares technique for estimating Gompertz models that gives parameter estimates that are closer to full maximum likelihood, compared to conventional approaches.Clostridium difficile is a gram-positive spore-forming bacterium, and a clinically-

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Section: Resultsmentioning

confidence: 99%

Clostridium difficileInfection: An Emerging Cause of Death in the Twenty-First Century

Abdullatif

Noymer

2016

Biodemography and Social Biology

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“…UU. y en el mundo en general (49). Según el CDC, en los últimos años, las permanecen dos grupos patógenos.…”

Section: Infección Antibióticos Y Microbiota Intestinalunclassified

Microbiota intestinal y ácidos grasos de cadena corta en pacientes críticos

Ochoa

Giraldo

Barrera-Causil

et al. 2017

Perspect Nutr Humana

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ResumenAntecedentes: diversos estudios han mostrado cambios en la microbiota intestinal (MI) y los áci-dos grasos de cadena corta (AGCC) en pacientes críticos con síndrome de respuesta inflamatoria sistémica (SRIS). Objetivo: revisar la evidencia sobre el papel de la MI y los AGCC en pacientes críticos y su modulación con prebióticos, probióticos y simbióticos. Materiales y métodos: búsque-da de artículos en bases de datos bibliográficas Pubmed, Science Direct, Ovid, Medline y Scopus, utilizando como descriptores microbiota, paciente crítico, unidad de cuidados intensivos, síndrome de respuesta inflamatoria sistémica, ácidos grasos de cadena corta, probióticos, prebióticos y simbióticos. Resultados: la MI en pacientes críticos está disminuida tanto en número de bacterias como en diversidad, lo cual puede resultar en una desregulación de la respuesta inmune sistémica ante la invasión de microorganismos patógenos. Los cambios en los AGCC en pacientes críticos se atribuyen a una disminución de bacterias anaerobias obligadas y sustratos de fermentación necesarios para su producción. La modulación de la MI con probióticos, prebióticos y simbióticos sugiere mejoría en la función intestinal. Conclusiones: la MI y los AGCC en pacientes críticos se encuentran alterados, de ahí que mantener el equilibrio en el entorno intestinal probablemente desempeñe una función clave para disminuir complicaciones y mejorar su pronóstico.Palabras clave: paciente crítico, microbiota, ácidos grasos de cadena corta, síndrome de respuesta inflamatoria sistémica, probióticos, prebióticos, simbióticos. Gut Microbiota and Short-Chain Fatty Acids in Critically Ill Patients AbstractBackground: Different studies have shown changes in gut microbiota and short-chain fatty acids in critically ill patients with Systemic Inflammatory Response Syndrome (SIRS). Aim: To review the evidence about the role of gut microbiota and SCFAs in critically patients and its modulation with prebiotics, probiotics and symbiotic. Materials and Methods: A search of the literature in Pubmed, Science Direct, Ovid, Medline and Scopus databases was conducted. The terms used were microbiota, critically ill, intensive care unit, systemic inflammatory response syndrome, short-chain fatty acids, prebiotics, probiotics and symbiotic. Results: The intestinal microbiota in critically ill patients is reduced in number and diversity, which can lead to dysregulation of the systemic immune response to the pathogenic invasion. Changes in SCFAs in critically ill patients are attributed to a decrease of obligate anaerobic bacteria and the fermentation substrates required for its production. The gut microbiota modulation with prebiotics, probiotics and symbiotic suggest improvement in bowel function. Conclusions: Gut microbiota and SCFAs are altered in critically ill patients; therefore, maintaining the intestinal environment is key for reducing complications and improving prognosis.

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“…It is worth noting that asymptomatic colonization with toxigenic strains is frequent and up to more than 20% of patients with a suspected such infection may have alternative etiologies for persistent diarrhea [5,6]. However, this pathogen, only in the United States, is responsible for half a million infections and it was associated with approximately 29,000 deaths in 2011 [7]. Some sporadic reports obtained from small cohort studies in patients with hospital-acquired infection [8,9] and IBS outpatients [10] yielded conflicting results.…”

Section: Introductionmentioning

confidence: 99%

Clostridium difficile-related postinfectious IBS: a case of enteroglial microbiological stalking and/or the solution of a conundrum?

Bassotti

Macchioni

Corazzi

et al. 2017

Cell. Mol. Life Sci.

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Post-infectious irritable bowel syndrome is a well-defined pathological entity that develops in about one-third of subjects after an acute infection (bacterial, viral) or parasitic infestation. Only recently it has been documented that an high incidence of post-infectious irritable bowel syndrome occurs after Clostridium difficile infection. However, until now it is not known why in some patients recovered from this infection the gastrointestinal disturbances persist for months or years. Based on our in vitro studies on enteric glial cells exposed to the effects of C. difficile toxin B, we hypothesize that persistence of symptoms up to the development of irritable bowel syndrome might be due to a disturbance/impairment of the correct functions of the enteroglial intestinal network.

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Burden ofClostridium difficileInfection in the United States

Abstract: C. difficile was responsible for almost half a million infections and was associated with approximately 29,000 deaths in 2011. (Funded by the Centers for Disease Control and Prevention.).

Cited by 2,296 publications

References 41 publications

Clostridium difficileInfection: An Emerging Cause of Death in the Twenty-First Century

Clostridium difficileInfection: An Emerging Cause of Death in the Twenty-First Century

Microbiota intestinal y ácidos grasos de cadena corta en pacientes críticos

Clostridium difficile-related postinfectious IBS: a case of enteroglial microbiological stalking and/or the solution of a conundrum?

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