Costs Associated with the Treatment of Clostridioides Difficile Infections

Sierocka, Aleksandra; Kiersnowska, Zofia; Lemiech-Mirowska, Ewelina; Marczak, Michał

doi:10.3390/ijerph18147647

Cited by 5 publications

(5 citation statements)

References 22 publications

(23 reference statements)

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“…CDI not only is associated with substantial morbidity and mortality worldwide but also significantly prolongs the length of hospital stay; as a result, the average cost of hospitalization greatly increases (99). Moreover, the resistance rate of C. difficile to its first-line treatment antibiotics is increasing, and the recurrence rate after antibiotic treatment remains at a high level (100,101).…”

Section: Discussionmentioning

confidence: 99%

Immunoinformatics Approach Toward the Introduction of a Novel Multi-Epitope Vaccine Against Clostridium difficile

et al. 2022

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Clostridium difficile (C.difficile) is an exclusively anaerobic, spore-forming, and Gram-positive pathogen that is the most common cause of nosocomial diarrhea and is becoming increasingly prevalent in the community. Because C. difficile is strictly anaerobic, spores that can survive for months in the external environment contribute to the persistence and diffusion of C. difficile within the healthcare environment and community. Antimicrobial therapy disrupts the natural intestinal flora, allowing spores to develop into propagules that colonize the colon and produce toxins, thus leading to antibiotic-associated diarrhea and pseudomembranous enteritis. However, there is no licensed vaccine to prevent Clostridium difficile infection (CDI). In this study, a multi-epitope vaccine was designed using modern computer methods. Two target proteins, CdeC, affecting spore germination, and fliD, affecting propagule colonization, were chosen to construct the vaccine so that it could simultaneously induce the immune response against two different forms (spore and propagule) of C. difficile. We obtained the protein sequences from the National Center for Biotechnology Information (NCBI) database. After the layers of filtration, 5 cytotoxic T-cell lymphocyte (CTL) epitopes, 5 helper T lymphocyte (HTL) epitopes, and 7 B-cell linear epitopes were finally selected for vaccine construction. Then, to enhance the immunogenicity of the designed vaccine, an adjuvant was added to construct the vaccine. The Prabi and RaptorX servers were used to predict the vaccine’s two- and three-dimensional (3D) structures, respectively. Additionally, we refined and validated the structures of the vaccine construct. Molecular docking and molecular dynamics (MD) simulation were performed to check the interaction model of the vaccine–Toll-like receptor (TLR) complexes, vaccine–major histocompatibility complex (MHC) complexes, and vaccine–B-cell receptor (BCR) complex. Furthermore, immune stimulation, population coverage, and in silico molecular cloning were also conducted. The foregoing findings suggest that the final formulated vaccine is promising against the pathogen, but more researchers are needed to verify it.

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Section: Discussionmentioning

confidence: 99%

Immunoinformatics Approach Toward the Introduction of a Novel Multi-Epitope Vaccine Against Clostridium difficile

et al. 2022

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“…The literature data are very similar and confirm that the duration of hospitalisation of patients infected with C. difficile was, in most cases, longer than the average stay of the entire studied population of patients. The extended duration of stay due to CDI, among other things, increases of the costs of treatment for patients [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the many years of our studies, we have concentrated on the hospital environment surrounding the patient, the hygiene of medical personnel and general hospital hygiene, which are only some of the causes of HAIs. In our studies we would like to demonstrate that these causes have a significant impact on patient safety, and also that incorrect organisation of infection risk management can be encountered in medical facilities in Poland [ 1 , 15 , 26 , 27 , 30 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Detection and Analysis of Clostridioides difficile Spores in a Hospital Environment

Kiersnowska

Lemiech-Mirowska

Michałkiewicz

et al. 2022

IJERPH

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Clostridioides difficile, due to its long survival time in a hospital environment, is considered to be one of the most frequent factors in healthcare-associated infections. Patient care requires not only rapid and accurate diagnosis, but also knowledge of individual risk factors for infections, e.g., with C. difficile, in various clinical conditions. The goal of this study was to analyse the degree of contamination of a hospital environment with C. difficile spores. Culturing was performed using C diff Banana BrothTM medium, which enables germination of the spores of these bacteria. Samples were collected from inanimate objects within a hospital environment in a specialist hospital in Poland. The results of the study demonstrated the presence of 18 positive samples of Clostridioides spp. (15.4%). Of these, C. difficile spores were detected in six samples, Clostridioides perfringens in eight samples, Clostridioides sporogenes in two samples and Clostridioides innocuum and Clostridioides baratii in one sample each. Among the six samples of C. difficile, a total of four strains which produce the B toxin were cultured. The binary toxin related to ribotype 027 was not detected in our study. Nosocomial infection risk management is a significant problem, mainly concerning the issues of hygiene maintenance, cleaning policy and quality control, and awareness of infection risk.

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“…The patient was fed through an intestinal probe. (2) -result of the Mann-Whitney U test; (1) -result of chi-square ML. Cole index [%]: 90-110%-overweight; 85-90%-mild impairment of nutrition state; 75-85%moderate impairment of nutrition state; 75% and lower-severe malnutrition.…”

Section: Nutrition Indicatorsmentioning

confidence: 99%

“…Infections caused by toxigenic strains of Clostridioides difficile (CD) constitute a growing public health challenge, both clinically and economically [ 1 ]. Pediatric patients treated at oncology units are a group of patients at an especially high risk of a Clostridioides difficile infection (CDI) [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Clostridioides difficile Infections among Pediatric Patients Hospitalized at an Oncology Department of a Tertiary Hospital in Poland

et al. 2023

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Background and Objectives: Gastrointestinal tract infections caused by Clostridioides difficile bacteria are diagnosed in pediatric patients with increasing frequency. Children treated at pediatric units are a group of patients at high risk of this infection; therefore, appropriate differential diagnostics and an individual approach to every case are of particular importance. The goal of the study was to assess the clinical parameters of patients with a confirmed CD infection and colonization. Materials and Methods: Every positive case was subjected to a retrospective analysis based on medical history and an infection notification note. Results: Positive results were obtained for 30 patients, among whom the results of 18 patients were considered to justify the diagnosis of an infection. In the remaining patients, treatment was not initiated in only three cases. Cases were detected where treatment was initiated despite the lack of sufficient clinical evidence. Conclusions: This study demonstrates that there are many factors that result in a high risk of the occurrence of CDI in oncology patients, such as antibiotic therapy, multiple hospitalizations, and myelosuppression.

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Costs Associated with the Treatment of Clostridioides Difficile Infections

Cited by 5 publications

References 22 publications

Immunoinformatics Approach Toward the Introduction of a Novel Multi-Epitope Vaccine Against Clostridium difficile

Immunoinformatics Approach Toward the Introduction of a Novel Multi-Epitope Vaccine Against Clostridium difficile

Detection and Analysis of Clostridioides difficile Spores in a Hospital Environment

Clostridioides difficile Infections among Pediatric Patients Hospitalized at an Oncology Department of a Tertiary Hospital in Poland

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