Clostridium diffcile associated infection, diarrhea andcolitis

Hookman, Perry; Barkin, Jamie S.

doi:10.3748/wjg.15.1554

Cited by 254 publications

(209 citation statements)

References 170 publications

Supporting

Mentioning

179

Contrasting

Unclassified

Order By: Relevance

“…Toxin B induces breakdown of cytoskeleton as it is a powerful cytotoxin. Besides their cytotoxic effects, these two productions induce production of cytokines resulting in a noticeable inflammatory response [11].…”

Section: Discussionmentioning

confidence: 99%

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Ahmadi¹,

Rezaee²,

Tanha³

et al. 2016

J Gynecol Res Obstet

View full text Add to dashboard Cite

Journal of Gynecological Research and Obstetrics 055According to the operation report numerous adhesions were detected during surgery, many of which especially those in the uterine incision site had been released. The patient received one dose of prophylactic cefazolin after clamping of the umbilical cord. Before discharge (discharged with personal consent) she had gas passage and defecation.Three days after C/S the patient was hospitalized with a presumed ileus. At that point she seemed well and had no fever and tachycardia; the abdomen was distended; bowel sounds were normal. On palpation, tenderness in left lower quadrant without rebound was present. In chest auscultation no abnormal finding except dextrocardia was detected (Figures 1,2).Initially the patient was managed conservatively, laboratory tests and surgery consult were ordered.The patient was not allowed to take anything by mouth and it was well emphasised to her to stay mobile. Despite gas passage her abdominal distention fluctuated during the first two days of hospitalization. During this period the laboratory findings were normal, no leucocytosis was present and hemoglobin and electrolytes were normal. Just on abdominal x ray( upright and flat) hyperinflation was to be seen.After the second day, diarrhea and a 38 C fever were added to the patients' signs. The diarrhea contained greenish liquid with white cheese -like parts. The patient was not ill, the abdominal palpation revealed no change and the laboratory findings were still normal.On the third day, abdominal distention was noticeably increased and the abdomen became tenser. Emergent surgery and gastrointestinal consult were ordered and the patient was admitted to the intensive care unit. At that point potassium was as low as 2.4 IntroductionPseudomembranous colitis (PMC) is a type of colitis (and sometimes enteritis), with special pathologic and oftentimes radiologic features, which is usually associated with the overgrowth of a bacterium called Clostridium difficile. Although this condition normally occurs following antibiotic consumption, it may rarely happen in other settings such as bowel ischemia, intestinal obstruction, and intestinal surgery or chemotherapy. Moreover, gastrointestinal infections (e.g. Staphylococcus aureus) can induce a similar condition [1].A recent increase in the incidence rate and severity of clostridium difficile infection has been reported, which is thought to be due to the great use of broad spectrum antibiotics worldwide and the development of a hypervirulant strain of this organism [2][3][4]. The presentation of PMC can vary from a self-limiting diarrhea to toxic megacolon and death [5]. Yet, many cases have confusing clinical features and their condition may not be diagnosed immediately [1]. History of previous antibiotic intake especially cephalosporins and flouroquinolones is the most important risk factor for PMC [6][7][8]. This risk is at its peak within the first month after antibiotic use [9].Immediate diagnosis and treatment of this condition can decre...

show abstract

Section: Discussionmentioning

confidence: 99%

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Ahmadi¹,

Rezaee²,

Tanha³

et al. 2016

J Gynecol Res Obstet

View full text Add to dashboard Cite

show abstract

“…Durante el curso clínico de la IACD se ha observado un importante aumento de la cantidad de esporas excretadas por las deposiciones 2,70,71 , indicando que C. difficile esporula dentro del tracto intestinal, contribuyendo a la persistencia dentro del hospedero (Figura 2). La resistencia de las esporas de C. difficile a los antimicrobianos es tal, que éstas pueden persistir después de un curso terapéutico de metronidazol y vancomicina 72 .…”

Section: Factores De Persistencia De Las Esporas De C Difficile En Eunclassified

Esporas de Clostridium difficile y su relevancia en la persistencia y transmisión de la infección

Barra-Carrasco

Hernández-Rocha

Ibáñez

et al. 2014

Rev. chil. infectol.

View full text Add to dashboard Cite

Clostridium difficile spores and its relevance in the persistence and transmission of the infection C. difficile is an anaerobic spore former pathogen and the most important etiologic agent of nosocomial and community acquired antibiotics associated diarrheas. C. difficile infections (CDI) are responsible for an elevated rate of morbidity in developed and developing countries. Although the major virulence factors responsible for clinical symptoms of CDI are the two toxins TcdA and TcdB, C. difficile spores are the main vehicle of infection, persistence and transmission of CDI. Recent work has unrevealed unique properties of C. difficile spores that make them remarkable morphotypes of persistence and transmission in the host, including their resistance to antibiotics, the host immune response and disinfectants. The present review summarizes relevant aspects of C. difficile spore biology that have major implications from a clinical and medical perspective.

show abstract

“…Treatment regimens included either the combination of metronidazole and vancomycin, or one of the drugs as monotherapy. Patients with severe colitis (abdominal distention, white blood cell [WBC] count > 25 x 10 9 /L, albumin count < 30 g/L) were prescribed a dual regimen, while others were prescribed monotherapy [3,4].…”

Section: Methodsmentioning

confidence: 99%

Clostridium difficile infection: a Serbian single-center experience

Korać¹,

Milošević²,

Marković³

et al. 2015

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Clostridium difficile infection (CDI) is the most common cause of hospital-acquired diarrhea. Severity of CDI is associated with advanced age and co-morbidities. The clinical spectrum varies from mild watery diarrhea to severe fulminant pseudomembranous colitis with complications. Methodology: This study conducted over a six-year period (2008 to 2013) included 510 patients treated at the University Hospital for Infectious and Tropical Diseases in Belgrade, Serbia. In patients with a history of previous hospitalization and/or treatment with antimicrobial agents who developed diarrhea, the diagnosis was established with rapid tests for C. difficile toxin A and B and by stool culture for C. difficile (454 patients) or by endoscopic examination and histological analyses of the biopsy samples taken from the colonic mucosa (56 patients). Results: The mean age of patients was 67.71± 13.34 years. A total of 67.8% patients were older than 65 years. Over half (58.7%) of the patients were female. 93% had been previously hospitalized and/or had surgical interventions, during which they had been treated with antibiotics. In the clinical presentation spectrum, pseudomembranous colitis occurred in 51.0% .The mean duration of illness after the introduction of specific antibiotic therapy was 7.10 ± 4.88 days. Complications developed in 14 patients. The disease relapsed in 43 (8.4%). Thirty-two (6.3%) patients died, mostly due to co-morbidities. Conclusions: CDI is the most important cause of hospital-acquired diarrhea in Serbia. The disease mainly affects elderly patients with comorbidities. The incidence of complications is low and prognosis is age dependent and related to pre-existing diseases.

show abstract

Clostridium diffcile associated infection, diarrhea andcolitis

Cited by 254 publications

References 170 publications

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Esporas de Clostridium difficile y su relevancia en la persistencia y transmisión de la infección

Clostridium difficile infection: a Serbian single-center experience

Contact Info

Product

Resources

About