Antibiotic-associated diarrhea: Clinical characteristics and the presence of Clostridium difficile

Rodríguez-Varón, A.; Muñoz, Óscar; Pulido-Arenas, Jorge; Amado, Sandra; Tobón-Trujillo, M.

doi:10.1016/j.rgmxen.2016.10.004

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Comparing with the real time PCR, the sensitivity of direct X/pect test was 60%, specificity was 100%, PPV was 100%, and NPV was 89.8% (table 1 , fig 1) and there was 91.2% agreement between both assays (kappa = 0.7, P < 0.001) as shown in table (2). While, the validity values for the indirect X/pect test was 66.7%, 100%, 100% & 91.4% for sensitivity, specificity, PP and NP values respectively, and there was 92.6% agreement between both assays (kappa = 0.757, P<0.001) for detection of CDI as shown in table (3).…”

Section: Resultsmentioning

confidence: 93%

“…Two major toxins produced by C. difficile, toxin A and toxin B, the level of toxins produced relates to the severity of the disease 1 . Toxin A is an enterotoxin that causes tissue damage while toxin B is a more potent cytotoxin and has a direct cytopathic effect by depolymerizing actin filaments causing destruction of the cytoskeleton, this leads to damage for the colonic mucosa 2 .…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Value of Simple Immune-chromatographic Test for Rapid Detection of Clostridium difficile Infection

Fayed

Feky

2019

Egyptian Journal of Medical Microbiology

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Background: Clostridium difficile is a very important cause fo antibiotic-associated diarrhea and pseudomembranous colitis. Diagnosis of C. difficile mainly relies on toxin detection in stool specimens from individuals with suspected disease. Objective: is to introduce to our microbiology laboratory of a simple test that may be rapid, cheap and easily manipulated than conventional methods for effective diagnosis of C. difficile infection. Methodology: Stool samples from sixty eight hospitalized patients developing CDI like symptoms were subjected to culture on CCFA, detection of toxins A and/or B by X/pect test (directly from stool samples and from culture isolates) and Real time PCR for detection of tcdA/ tcdB toxin genes. Results: Toxigenic C. difficile was detected in (22.1%) of suspected cases using tcdA/ tcdB real time PCR which was the gold standard method in our study. The positive rate for the direct X/pect test was 13.2% and for the indirect test was 14.7%. The sensitivity of direct X/pect test was 60%, specificity was 100%, PPV was 100%, and NPV was 89.8% with 91.2% agreement between the direct assay and real time PCR. While, the validity values for the indirect test was 66.7%, 100%, 100% & 91.4% for sensitivity, specificity, PP and NP values respectively, with 92.6% agreement between both assays. Antibiotic intake and recent hospitalization were the most commonly encountered risk factors, followed by number of hospitalization days. Penicillins and cephalosporins were the most frequently associated antibiotics, followed by clindamycin Conclusions: Using X/pect test can combine accurate results with simple procedure that offers results within 20 minutes. Although it is accompanied with low sensitivity and high rate of false-negative results, X/pect test may be of great benefit to practitioners particularly when you need STAT testing or 24 hour/ 7 days coverage. Further, it can be used as a preliminary screening approach allowing patients to be treated early and correctly in order to shorten the duration of symptoms and avoid complications. Fayed and El-Feky / A new method for rapid diagnosis of Clostridium difficile infection, Volume 28 / No.

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Section: Resultsmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Simple Immune-chromatographic Test for Rapid Detection of Clostridium difficile Infection

Fayed

Feky

2019

Egyptian Journal of Medical Microbiology

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“…In a study done by Ingle et al the mean age of patients with C. difficile associated diarrhea was 45.2 years which represents a relatively younger population group ( 13 ). Several other studies have reported a higher rate of C. difficile positive cases in elderly population of the age group 51–60 years ( 14 , 15 ). The rate of isolation of C. difficile is different in adult and pediatric population.…”

Section: Discussionmentioning

confidence: 94%

Antibiotic associated diarrhea due to Clostridioides difficile in a tertiary care teaching hospital, central India

Kapoor¹,

Nema²,

Biswas³

et al. 2023

IJM

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Background and Objectives: The misuse of antibiotics in recent years has led to an increase in antibiotic associated diar- rheas (AAD). Out of several implicated pathogens, Clostridioides difficile is responsible for causing 15-25% of all cases of AAD. However, it has remained under diagnosed for a long time. The current study is planned to explore prevalence of C. difficile amongst AAD patients and to study clinical presentation and associated risk factors. Materials and Methods: Hospital based cross sectional study conducted in patients above 2 years of age. Diagnosis of C. difficile was done by two modalities i.e. glutamate dehydrogenase test followed by toxin detection using enzyme immunoas- say and stool culture followed by toxin gene detection. Results: Twelve of 65 patients (18.4%) were positive for C. difficile. Maximum cases were found in younger age group. Abdominal pain and fever were most common complaints. 12 (18.4%) out of 65 study subjects were found to be positive by ELISA. 2/65 (3%) patients were positive for culture with presence of only tcdB gene. Ceftriaxone was the most commonly used antibiotic (25%). Conclusion: C. difficile is significant pathogen implicated in AAD with a prevalence rate of 18.4%. GDH antigen detection followed by Toxin A/B ELISA for C. difficile yielded better detection rate as compared to stool culture.

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“…Studies have indicated that, after antibiotic treatment, the diversity of the gut microbiota tends to recover best among people living in the community, but less well in those in longstay residential care [4,14]. The occurrence of AAD may also be associated with a prolonged hospital stay [15]. Whether such changes are also the case for hospitalized elderly patients warrants further study.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Fecal Microbiota Diversity in Hospitalized Elderly Patients with Antibiotic- associated Diarrhea

Rong

Wang

et al. 2022

Preprint

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Background: Although a lot of research has confirmed that antibiotics caused microbiota disturbance, the correlation between microbiota and antibiotic treatments in hospitalized elderly patients has not been well studied. Antibiotic-associated diarrhea (AAD) is a common and important ailment in elderly patients, and therefore there is a need for clues to guide antibiotic usage in hospitalized elderly patients. Methods: Thirty-eight elderly patients who were admitted to a medium-sized ward in Huashan hospital affiliated to Fudan University, were divided into various subgroups according to the length of hospitalization and occurrence of AAD. For the identification of microbes, microbial genomic DNA was extracted from fecal samples and subjected to 16S rDNA amplicon pyrosequencing followed by microbial analysis. Results: The antibiotic regimen significantly altered the composition of fecal microbiota, irrespective of the length of hospitalization. In general, lower microbial alpha-diversity, involving decreased abundance of Bifidobacteriumand increased abundance of Enterococcus, was found in all antibiotic-treated patients. Interestingly, the composition of microbiota was significantly different between patients with or without AAD even under similar antibiotic regimens. The supplementation of probiotics benefited AAD patients by protecting against Enterococcus colonization. Conclusions: The fecal microbiota of hospitalized elderly patients was significantly affected by antibiotic usage. Under similar antibiotic regimens, altered microbiota composition was closely related to the occurrence of AAD. The results revealed the importance of microbiota analysis and appropriate interventions during intensive antibiotic usage among hospitalized elderly patients.

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Antibiotic-associated diarrhea: Clinical characteristics and the presence of Clostridium difficile

Cited by 7 publications

References 13 publications

Diagnostic Value of Simple Immune-chromatographic Test for Rapid Detection of Clostridium difficile Infection

Diagnostic Value of Simple Immune-chromatographic Test for Rapid Detection of Clostridium difficile Infection

Antibiotic associated diarrhea due to Clostridioides difficile in a tertiary care teaching hospital, central India

Analysis of Fecal Microbiota Diversity in Hospitalized Elderly Patients with Antibiotic- associated Diarrhea

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