Thrombin generation is increased in patients with <i>Clostridium difficile</i> colitis – a pilot study

Mihăilă, Romeo-Gabriel; Cătană, Crina; Olteanu, Ariela; Bîrluțiu, Victoria; Sălcudean, Cosmin; Mihăilă, Marius D.

doi:10.1080/1354750x.2019.1600021

Cited by 5 publications

(7 citation statements)

References 19 publications

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“…There have been reports of increased incidence of venous thromboembolic episodes (VTE) in patients with Clostridium difficile infections [9][10][11]. According to one study, it was found that patients with a positive Clostridium difficile testing were more likely to have associated VTE (OR of 3.23 (95% CI 1.00, 10.45).…”

Section: Discussionmentioning

confidence: 99%

“…A surgical cohort study that included 1728 surgical patients over a course of 30 months showed an independent association of VTE with Clostridium difficile (OR: 1.87 [1.00 to 3.47], P = .049) [ 10 ]. A pilot study described increased thrombin generation seen in patients admitted with Clostridium difficile infections and highlighted this as one of many underlying mechanisms [ 11 ]. Based on these reports, a simplified version of Virchow’s triad for VTE in Clostridium difficile is depicted in Figure 8 .…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

Kumar¹,

Ghazanfar²,

Davidson³

2021

Cureus

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Most cases of Clostridium difficile infection are hospital acquired; but in recent times, the incidence of community-acquired infections has increased. Patients with Clostridium difficile infections are at an increased risk for thrombosis. We report a case of an 82-year-old female who was admitted to the intensive care unit for acute hypoxic respiratory failure and septic shock. She was found to have Clostridium difficile infection at presentation. During the hospitalization, we discovered bilateral lower extremity venous thromboembolism, bilateral pulmonary embolism, multifocal thromboembolic brain infarctions, and acute arterial thromboembolic occlusion of right upper and lower extremities. This patient adds to the list of cases of venous thromboembolism associated with Clostridium difficile infections and is the first case of associated arterial embolic phenomenon. There is a need to further investigate the association of Clostridium difficile infections and thromboembolism.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

Kumar¹,

Ghazanfar²,

Davidson³

2021

Cureus

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“…In this regard, we agree with Vargas et al 75 in that the total leukocyte count alone is not a specific indicator for CDI. Previous work evaluating platelet count in CDI episodes reported controversial results, assigning them both a beneficial and detrimental role in relation to clinical symptoms [76][77][78][79][80][81][82][83][84][85] . We have recently shown that platelets bind to C. difficile and promote its uptake by human macrophages using macropinocytic pathways 86 .…”

Section: Blood and Serum Parametersmentioning

confidence: 99%

Unveiling the threat: Characterization ofClostridioides difficileInfection in the Northwest Region of Buenos Aires between 2019-2023 and Associated Risk Factors redefined through a Meta-Analysis

Barbero,

Moriconi,

Palma

et al. 2024

Preprint

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Clostridioides difficile stands as the leading cause of hospital acquired enteric infection in developed countries. In Argentina, the epidemiology of Clostridioides difficile infection (CDI) is currently poorly characterized. Therefore, we conducted a retrospective case-control study evaluating the prevalence of CDI in 249 stool samples collected between 2019 and 2023 in the Northwest region of Buenos Aires. The presence of C. difficile was detected by combining three techniques (EIA, PCR and toxigenic culture) in a diagnostic algorithm. Clinical and demographic data from patients was also analyzed to identify CDI-associated risk factors. 1 in 5 patients presented C. difficile as the etiological agent of diarrhea and the 80% of CDI+ cases carried toxigenic strains, most of which had been acquired in the community. Age ≥69 years, previous use of antibiotics, previous hospitalization and previous episodes of CDI emerged as predisposing factors for CDI in our study cohort. Blood parameters such as an elevated number of leukocytes and platelets, a decreased basophil count, and an increased urea concentration were identified as indicators of CDI. We also carried out a systematic review and a meta-analysis where we contrasted our results with 39 studies selected from different countries around the world. At the global level, the meta-analysis highlighted advanced age, previous consumption of antibiotics and previous hospitalization as CDI risk factors and the leukocyte count as an indicator of CDI. These results emphasize the importance of epidemiological studies and reveal crucial information for healthcare decision-making regarding CDI.

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“…Thrombin generation assay was performed on a population of 84 individuals composed of patients with CDI (n = 33) and healthy volunteers (n = 51). Indeed, C. difficile was independently associated with venous thromboembolism [67]. TG assay is a novel diagnostic test capable of globally evaluating hemostasis.…”

Section: Thrombin Generation Assaymentioning

confidence: 99%

Clostridium difficile Induced Inflammasome Activation and Coagulation Derangements

et al. 2022

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C. difficile enterocolitis (CDAC) is the most common hospital infection, burdened by an increased incidence of coagulation-related complications such as deep vein thrombosis (DVT) and disseminated intravascular coagulation (DIC) as well as a significant sepsis-related mortality. In this review, we analyzed the available data concerning the correlation between coagulation complications related to C. difficile infection (CDI) and inflammasome activation, in particular the pyrin-dependent one. The little but solid available preclinical and clinical evidence shows that inflammasome activation increases the risk of venous thromboembolism (VTE). As proof of this, it has been observed that in vitro inhibition of the molecules (e.g., tissue factor) mainly involved in coagulation activation could block the process. In vivo studies show that it could be possible to reduce the incidence of complications associated with C. difficile infection (CDI) and mortality due to a state of hypercoagulability. A personalized therapeutic approach to reduce the inflammatory activity and prevent thromboembolic complications could be preliminarily defined to reduce mortality.

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Thrombin generation is increased in patients with Clostridium difficile colitis – a pilot study

Cited by 5 publications

References 19 publications

A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

A Rare Case of Arterial and Venous Thromboembolism in a Patient With Severe Clostridium difficile Infection

Unveiling the threat: Characterization ofClostridioides difficileInfection in the Northwest Region of Buenos Aires between 2019-2023 and Associated Risk Factors redefined through a Meta-Analysis

Clostridium difficile Induced Inflammasome Activation and Coagulation Derangements

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