Prevention of Clostridioides difficile in hospitals: A position paper of the International Society for Infectious Diseases

Doll, Michelle; Marra, Alexandre R.; Apisarnthanarak, Anucha; Al-Maani, Amal; Abbas, Salma; Rosenthal, Víctor D.

doi:10.1016/j.ijid.2020.10.039

Cited by 21 publications

(16 citation statements)

References 74 publications

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“…In recent years, the anaerobic gastrointestinal pathogen Clostridioides difficile has established itself as one of the major causative agents of pseudomembranous colitis and toxic megacolon ( Wiegand et al, 2012 ; Nasiri et al, 2018 ; Martínez-Meléndez et al, 2020 ; Doll et al, 2021 ). C. difficile does not only produce enterotoxins that damage the gastrointestinal epithelium ( Fletcher et al, 2021 ) but also forms easily transmittable spores that significantly contribute to C. difficile’s efficient spreading in the environment, hospitals and elderly homes ( McLure et al, 2019 ; Hernandez et al, 2020 ; Werner et al, 2020 ; Khader et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

What’s a Biofilm?—How the Choice of the Biofilm Model Impacts the Protein Inventory of Clostridioides difficile

et al. 2021

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The anaerobic pathogen Clostridioides difficile is perfectly equipped to survive and persist inside the mammalian intestine. When facing unfavorable conditions C. difficile is able to form highly resistant endospores. Likewise, biofilms are currently discussed as form of persistence. Here a comprehensive proteomics approach was applied to investigate the molecular processes of C. difficile strain 630Δerm underlying biofilm formation. The comparison of the proteome from two different forms of biofilm-like growth, namely aggregate biofilms and colonies on agar plates, revealed major differences in the formation of cell surface proteins, as well as enzymes of its energy and stress metabolism. For instance, while the obtained data suggest that aggregate biofilm cells express both flagella, type IV pili and enzymes required for biosynthesis of cell-surface polysaccharides, the S-layer protein SlpA and most cell wall proteins (CWPs) encoded adjacent to SlpA were detected in significantly lower amounts in aggregate biofilm cells than in colony biofilms. Moreover, the obtained data suggested that aggregate biofilm cells are rather actively growing cells while colony biofilm cells most likely severely suffer from a lack of reductive equivalents what requires induction of the Wood-Ljungdahl pathway and C. difficile’s V-type ATPase to maintain cell homeostasis. In agreement with this, aggregate biofilm cells, in contrast to colony biofilm cells, neither induced toxin nor spore production. Finally, the data revealed that the sigma factor SigL/RpoN and its dependent regulators are noticeably induced in aggregate biofilms suggesting an important role of SigL/RpoN in aggregate biofilm formation.

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Section: Introductionmentioning

confidence: 99%

What’s a Biofilm?—How the Choice of the Biofilm Model Impacts the Protein Inventory of Clostridioides difficile

et al. 2021

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“…Se recomienda una vez diagnostica la infección establecer medidas de precaución de contacto, como colocar al paciente en una habitación privada, colocar guantes y batas en la entrada de la habitación las cuales se deben descartar cada vez que se entra en la misma, realizar lavado de manos después de tener contacto con el paciente y entre pacientes. Se recomienda que la duración del aislamiento sea hasta 48 después de la resolución de la diarrea (15,16). Está demostrado que el uso de soluciones con alcohol no elimina las esporas de Clostridium difficile, por lo que se recomienda el lavado de manos con agua y jabón en su lugar (4).…”

Section: Prevención De La Infección Por Clostridium Difficileunclassified

Infección por Clostridium difficile y el papel del trasplante de microbiota fecal

2021

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El Clostridium difficile es una bacteria anaeróbica, gram positiva capaz de colonizar el colon y producir diarrea aguda. Es una de las infecciones nosocomiales más importantes causante de una alta morbilidad a nivel hospitalario. La clínica de la infección es amplia variando desde portadores asintomáticos hasta colitis fulminante, siendo la diarrea aguda la principal manifestación. El diagnóstico siempre se sospecha en cualquier paciente con diarrea aguda y factores de riesgo; y se confirma con una prueba en heces capaz de detectar las toxinas o el gen del Clostridium difficile. El tratamiento dependerá de la severidad de la infección, por lo general utilizando antibióticos de amplio espectro con sensibilidad por la bacteria como metronidazol, vancomicina o fidaxomicina. En algunas ocasiones la cirugía está indicada aunque no es lo más común. En el caso de aquellos pacientes con múltiples recurrencias el tratamiento con mayor evidencia de tasa de curación es el trasplante de microbiota fecal. La prevención con medidas de aislamiento y lavado de manos es de suma importancia para prevenir la transmisión entre pacientes a nivel hospitalario.

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“…Nosocomial infection of the Clostridioides difficile ( C. difficile ) etiology contributes, in most cases, to the prolonged hospitalization of a patient, whose underlying disease is not associated with the pathogen mentioned. Other important determinants increasing the risk of C. difficile infection (CDI) are the patient’s old age, the implementation of antibiotic therapy, invasive medical procedures, multi-patient rooms and direct contact with medical personnel, which may be the carrier of C. difficile spores, especially in a situation where hospital hygiene standards do not exist in practice [ 1 , 2 , 3 , 4 ]. It should be emphasized that hospitalization of the patient is nothing other than placing him or her in a potentially contaminated environment.…”

Section: Introductionmentioning

confidence: 99%

Level of Knowledge of Medical Staff on the Basis of the Survey in Terms of Risk Management, Associated with Clostridioides difficile Infections

Kiersnowska

Lemiech-Mirowska

Semczuk

et al. 2021

IJERPH

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Infections caused by the toxigenic strains of Clostridioides difficile in the hospital environment pose a serious public health problem. The progressive increase in hospital infections in Poland indicates that risk management is a tool that is not used in an effective way and significantly differs from the goals set by the Leading Authorities, the Ministry of Health and its subordinate units. Systematic education of medical personnel constitutes the basic element of rational risk management aimed at reducing the number of infections as it allows for the transfer of knowledge, development of appropriate organizational procedures, and improves internal communication. This paper presents the results of a survey conducted in hospital facilities throughout Poland. The study dealt with what medical personnel know about channels of transmission and prevention of Clostridioides difficile infections in the hospital setting, professional training and risk management in terms of reducing the number of infections. The survey reveals that Clostridioides difficile continues to be a serious problem in the inpatient care system. Procedures and management strategies implemented by hospitals in order to limit the spread of the pathogen are predominantly focused on short-term action, which does not lead to a real improvement in terms of hospitalized patients’ safety. The infection risk management system was assessed at a fairly low level. The obtained research results confirmed the research hypotheses that had been formulated.

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Prevention of Clostridioides difficile in hospitals: A position paper of the International Society for Infectious Diseases

Cited by 21 publications

References 74 publications

What’s a Biofilm?—How the Choice of the Biofilm Model Impacts the Protein Inventory of Clostridioides difficile

What’s a Biofilm?—How the Choice of the Biofilm Model Impacts the Protein Inventory of Clostridioides difficile

Infección por Clostridium difficile y el papel del trasplante de microbiota fecal

Level of Knowledge of Medical Staff on the Basis of the Survey in Terms of Risk Management, Associated with Clostridioides difficile Infections

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