Proton pump inhibitors and risk for Clostridium difficile associated diarrhea

Biswal, Sasmita

doi:10.4103/2319-4170.128002

Cited by 27 publications

(18 citation statements)

References 37 publications

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“…PPI use is also indicated as predisposing to CDI according to some authors. [5,33] 17(34%) patients were found to use PPIs in our study. Prolonged hospital stay and presence of underlying diseases/conditions which have been regarded as the main host risk factors for CDI were exhibited by 24(48%) and 39(78%) of our patients respectively.…”

Section: Resultssupporting

confidence: 47%

Polymerase Chain Reaction for the Detection of Toxin a ( TCD a ) and Toxin B ( TCD B ) Genes of Clostridium Difficile Isolated From Diarrhoeal Cases and Analysis of the Clinical Spectrum

Justin¹,

Antony²

2015

jemds

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BACKGROUND: Molecular methods for detection of toxigenic Clostridium difficile have been established in the developed countries though not very common in our country. AIMS: The study was intended to determine the presence of toxin A and toxin B genes of Clostridium difficile isolates by means of polymerase chain reaction (PCR) and analysis of clinical picture of the patients. MATERIALS AND METHODS:The prospective study was conducted in a tertiary care teaching hospital, South India from January 2012 to December 2014. Stool samples were collected consecutively from 563 in patients with diarrhoea from various wards. Clostridium difficile was isolated and identified by semi quantitative culture, latex agglutination and biochemical reactions. These isolates were then subjected to PCR for the detection of toxin A and toxin B genes. In addition, enzyme immunoassay was performed on stool samples for the detection of toxins A and B. The clinical spectrum of PCR positive patients was also analyzed. RESULTS: From 563 stool specimens, 113 (20.07%) Clostridium difficile isolates were grown by culture and identified by latex agglutination and biochemical reactions. Out of 113 isolates, 94 were subjected to PCR. 50 (53.19%) isolates out of 94 were found to be positive. Three toxigenic types obtained were A + B + , A -B + and A + Bwhich accounted for 6.38%, 42.55% and 4.26% respectively. A -B -isolates were 46.81%. 30 (26.55%) out of 113 stool samples (which were culture positive) was also enzyme immunoassay positive. 32 (64%) out of 50 PCR positive patients exhibited antibiotic usage (p<0.05) and 39(78%) revealed the presence of underlying illnesses/conditions (p<0.01). CONCLUSION: The study highlights the usefulness of PCR for detection of toxigenic Clostridium difficile and for determination of its molecular epidemiology.

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Section: Resultssupporting

confidence: 47%

Polymerase Chain Reaction for the Detection of Toxin a ( TCD a ) and Toxin B ( TCD B ) Genes of Clostridium Difficile Isolated From Diarrhoeal Cases and Analysis of the Clinical Spectrum

Justin¹,

Antony²

2015

jemds

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“…The high incidence of CDI in our cohort could be explained by the frequent antibiotic and PPI usage among our patients. Antibiotic and PPI exposure are predisposing risk factors for CDI (4,5). Even though 40% of the cases were severe, our patients had good outcomes as none required colectomy or died from CDI.…”

mentioning

confidence: 72%

Clostridium difficile infection in intestinal transplant recipients

Goldenberg¹,

Berbel

Camargo³

et al. 2017

Transpl Int

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“…Disruption of the gut microbiome following the use of antibiotics is a major risk factor for C. difficile -associated disease (CDAD) in humans 2 . Other risk factors include age, acid suppression, immunosuppression, gastrointestinal surgery and inflammatory bowel disease 3–5 . Primary treatment for acute infections is antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Amelioration of Clostridium difficile Infection in Mice by Dietary Supplementation With Indole-3-carbinol

et al. 2017

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Objective To determine the therapeutic effects of dietary supplementation on C. difficile infection (CDI). Background With limited treatment options, the rise of Clostridium difficile-associated disease has spurred on the search for novel therapies. Recent data define a role for the aryl hydrocarbon receptor (AHR) and diet-derived AHR ligands in mucosal immunity. We investigated the efficacy of indole-3-carbinol (I3C), a dietary supplement and AHR precursor ligand, in a murine model of CDI. Methods C57BL/6 (B6), AHR−/− and AHR+/− mice were placed on either grain-based or semi-purified diets with or without I3C prior to and during CDI. Mice were followed clinically for a minimum of 6 days, or euthanized between days 0 and 4 of inoculation for analysis of the inflammatory response and microbiota. Results B6 mice fed an AHR ligand-deficient, semi-purified diet have significantly increased disease severity (p < 0.001) and mortality (p<0.001) compared to mice fed diet containing I3C. The addition of I3C to the diet of AHR null mice had less of an impact than in AHR heterozygous littermates, although some protection was seen. Mice on semi-purified I3C-diet had increased cecal Tregs, ILC3s, and γδ T cells as well as an increased neutrophilic response without increased inflammation or bacterial translocation compared to controls. Conclusions I3C is a powerful treatment to reduce impact of CDI in mice. The findings indicate I3C may be acting through both AHR-dependent and -independent mechanisms in this model. Dietary supplementation with I3C is a potential new therapy for prevention and amelioration of C. difficile disease.

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Proton pump inhibitors and risk for Clostridium difficile associated diarrhea

Cited by 27 publications

References 37 publications

Polymerase Chain Reaction for the Detection of Toxin a ( TCD a ) and Toxin B ( TCD B ) Genes of Clostridium Difficile Isolated From Diarrhoeal Cases and Analysis of the Clinical Spectrum

Polymerase Chain Reaction for the Detection of Toxin a ( TCD a ) and Toxin B ( TCD B ) Genes of Clostridium Difficile Isolated From Diarrhoeal Cases and Analysis of the Clinical Spectrum

Clostridium difficile infection in intestinal transplant recipients

Amelioration of Clostridium difficile Infection in Mice by Dietary Supplementation With Indole-3-carbinol

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