Antibiotic-Associated Colitis

Thielman, Nathan M.; Wilson, Kenneth H.

doi:10.1016/b978-0-443-06839-3.00096-5

Cited by 11 publications

(15 citation statements)

References 241 publications

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“…Clinical manifestations of C. diffi cile-associated colitis (CDAC) range from abdominal pain, diarrhea, and fever to severe complications, including toxic megacolon and colonic perforation. 1 Two major toxins, toxin A and toxin B, are the main virulence factors associated with CDAC. Until recently, all pathogenic C. diffi cile strains were thought to produce both toxin A and toxin B.…”

Section: Introductionmentioning

confidence: 99%

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

Kikkawa

Miyamoto

Takiguchi

et al. 2008

Journal of Infection and Chemotherapy

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Section: Introductionmentioning

confidence: 99%

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

Kikkawa

Miyamoto

Takiguchi

et al. 2008

Journal of Infection and Chemotherapy

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“…CDT belongs to a family of binary ADP-ribosylating toxins consisting of two separate toxin components: CDTa, an ADPribosyltransferase that modifies actin, and CDTb, which binds to host cells and translocates CDTa into the cytosol. The prevalence of the binary toxin in CDI is 1.6-20.8% (1). While the C. difficile carriage rate in healthy adults is 1-3%, hospitalization is an important risk factor that increases the risk of colonization.…”

mentioning

confidence: 99%

A Diagnostic Algorithm for the Detection of Clostridium difficile-Associated Diarrhea

Yoldaş¹,

Altındiş²,

Çufali³

et al. 2016

Balkan Med J

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Background: Clostridium difficile is a common cause of hospital-acquired diarrhea, which is usually associated with previous antibiotic use. The clinical manifestations of C. difficile infection (CDI) may range from mild diarrhea to fulminant colitis. Clostridium difficile should be considered in diarrhea cases with a history of antibiotic use within the last 8 weeks (community-associated CDI) or with a hospital stay of at least 3 days, regardless of the duration of antibiotic use (hospital-acquired CDI). Aims: This study investigated the frequency of CDI in diarrheic patients and evaluated the efficacy of the triple diagnostic algorithm that is proposed here for C. difficile detection. Study Design: Cross-sectional study. Methods: In this study, we compared three methods currently employed for C. difficile detection using 95 patient stool samples: an enzyme immunoassay (EIA) for toxin A/B (C. diff Toxin A+B; Diagnostic Automation Inc.; Calabasas, CA, USA), an EIA for glutamate dehydrogenase (GDH) (C. DIFF CHEK-60TM, TechLab Inc.; Blacksburg, VA, USA), and a polymerase chain reaction (PCR)-based assay (GeneXpert ® C. difficile; Cepheid, Sunnyvale, CA, USA) that detects C. difficile toxin genes and conventional methods as well. In this study, 50.5% of the patients were male, 50 patients were outpatients, 32 were from inpatient clinics and 13 patients were from the intensive care unit. Results:Of the 95 stool samples tested for GDH, 28 were positive. Six samples were positive by PCR, while nine samples were positive for toxin A/B. The hypervirulent strain NAP-1 and binary toxin was not detected. The rate of occurrence of toxigenic C. difficile was 5.1% in the samples. Cefaclor, ampicillin-sulbactam, ertapenem, and piperacillin-tazobactam were the most commonly used antibiotics by patients preceding the onset of diarrhea. Among the patients who were hospitalized in an intensive care unit for more than 7 days, 83.3% were positive for CDI by PCR screening. If the PCR test is accepted as the reference: C. difficile Toxin A/B ELISA sensitivity and specificity were 67% and 94%, respectively, and GDH sensitivity and specificity were 100% and 75%, respectively. Conclusion: Tests targeting C. difficile toxins are frequently applied for the purpose of diagnosing CDI in a clinical setting. However, changes in the temperature and reductant composition of the feces may affect toxin stability, potentially yielding false-negative test results. Therefore, employment of a GDH EIA, which has high sensitivity, as a screening test for the detection of toxigenic strains, may prevent false-negative results, and its adoption as part of a multistep diagnostic algorithm may increase accuracy in the diagnosis of CDIs.

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“…Several recommendations are given regarding adjunctive ICV treatment of C. difficile colitis [59,[74][75][76][77][78][79]. Orally administered vancomycin can result in significant.…”

Section: Discussionmentioning

confidence: 99%

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Ahmadi¹,

Rezaee²,

Tanha³

et al. 2016

J Gynecol Res Obstet

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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...

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Antibiotic-Associated Colitis

Cited by 11 publications

References 241 publications

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

A Diagnostic Algorithm for the Detection of Clostridium difficile-Associated Diarrhea

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

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