Guidelines for Clostridium difficile infection in adults

Kukla, Michał; Adrych, Krystian; Dobrowolska, Agnieszka; Mach, Tomasz; Reguła, Jarosław; Rydzewska, Grażyna

doi:10.5114/pg.2020.93629

Cited by 27 publications

(60 citation statements)

References 65 publications

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“…The use of PTZ was profoundly associated with OS. PTZ has a significant effect on the gut microbiota, and some studies indicate a substantial decrease in anaerobic commensals four to eight days after using it [ 26 , 27 , 28 ]. Specifically, PTZ reduces the population profile of Bifidobacterium , Eubacterium and Lactobacillus in human gut microbiota [ 26 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

et al. 2021

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Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) (p = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77–6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30–5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC.

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Section: Discussionmentioning

confidence: 99%

Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

et al. 2021

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“…The treatment of COVID-19 is mainly symptomatic and is based on international research and guidelines [7,8]. Drugs recommended include chloroquine, hydroxychloroquine, azithromycin and lopinavir/ritonavir [9].…”

Section: Introductionmentioning

confidence: 99%

<i>Clostridioides difficile</i> infection in coronavirus disease 2019: an underestimated problem?

Lewandowski¹,

Rosołowski²,

Kaniewska³

et al. 2020

Polish Archives of Internal Medicine

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“…In addition, Castagliuolo et al reported that the 54-kDa protease of Saccharomyces bourardii degrades both CD toxin and its brush border membrane receptor, thus protecting rats from CD enteritis [ 42 ]. However, the clinical effect of probiotics on CDAD is controversial [ 43 , 44 ]. Further efforts to explore the detailed mechanisms by which human gut microbes antagonize CD are necessary to establish strategies to control refractory CDAD.…”

Section: Discussionmentioning

confidence: 99%

The Human Gut Microbe Bacteroides thetaiotaomicron Suppresses Toxin Release from Clostridium difficile by Inhibiting Autolysis

et al. 2021

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Disruption of the human gut microbiota by antibiotics can lead to Clostridium difficile (CD)-associated diarrhea. CD overgrowth and elevated CD toxins result in gut inflammation. Herein, we report that a gut symbiont, Bacteroides thetaiotaomicron (BT), suppressed CD toxin production. The suppressive components are present in BT culture supernatant and are both heat- and proteinase K-resistant. Transposon-based mutagenesis indicated that the polysaccharide metabolism of BT is involved in the inhibitory effect. Among the genes identified, we focus on the methylerythritol 4-phosphate pathway gene gcpE, which supplies the isoprenoid backbone to produce the undecaprenyl phosphate lipid carrier that transports oligosaccharides across the membrane. Polysaccharide fractions prepared from the BT culture suppressed CD toxin production in vitro; the inhibitory effect of polysaccharide fractions was reduced in the gcpE mutant (ΔgcpE). The inhibitory effect of BT-derived polysaccharide fraction was abrogated by lysozyme treatment, indicating that cellwall-associated glycans are attributable to the inhibitory effect. BT-derived polysaccharide fraction did not affect CD toxin gene expression or intracellular toxin levels. An autolysis assay showed that CD cell autolysis was suppressed by BT-derived polysaccharide fraction, but the effect was reduced with that of ΔgcpE. These results indicate that cell wall-associated glycans of BT suppress CD toxin release by inhibiting cell autolysis.

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Guidelines for Clostridium difficile infection in adults

Cited by 27 publications

References 65 publications

Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

<i>Clostridioides difficile</i> infection in coronavirus disease 2019: an underestimated problem?

The Human Gut Microbe Bacteroides thetaiotaomicron Suppresses Toxin Release from Clostridium difficile by Inhibiting Autolysis

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