Recent trends in diagnosis and treatment of Clostridium difficile in a tertiary care facility

Butterworth, Sonia A.; Koppert, Erik; Clarke, A. M.; Wiggs, Barry; MacFarlane, John K.

doi:10.1016/s0002-9610(98)00058-0

Cited by 16 publications

(13 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Metronidazole resistance among equine C. difficile isolates has been reported (Jang et al 1997;Magdesian et al 1999). Metronidazole resistance was not noted in this study and is thought to be rare overall in human isolates (Dzink and Bartlett 1980;Butterworth et al 1998;Wo n g et al 1999). As a result, metronidazole should be considered the drug of choice for the treatment of equine CDAD.…”

Section: Discussionmentioning

confidence: 57%

“…Clostridium difficile culture and toxin assays provided discrepant results in a number of cases. While discrepancies between C. difficile culture and toxin assays have been reported in man and horses Butterworth et al 1998), the frequency of such discrepant results was surprising. Culture-negative/toxin-positive cases were considered to be true positive cases due to the poor survival of C. difficile i n aerobically stored faecal samples and the stability of toxin under the same conditions (Weese et al 2000).…”

Section: Discussionmentioning

confidence: 94%

“…All C. difficile isolates in this study were susceptible to metronidazole and vancomycin. Metronidazole is the drug of choice in human medicine for the treatment of CDAD (Butterworth et al 1998;Wong et al 1 9 9 9 ) and has been reported to be effective in the treatment of equine idiopathic colitis in a study where testing for C. difficile was not performed (McGorum et al 1998). Metronidazole resistance among equine C. difficile isolates has been reported (Jang et al 1997;Magdesian et al 1999).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A prospective study of the roles ofClostridium difficileand enterotoxigenicClostridium perfringensin equine diarrhoea

Weese

Staempfli

Prescott

2001

Equine Veterinary Journal

152

118

View full text Add to dashboard Cite

Summary Faecal samples from adult horses and from foals with diarrhoea or with normal faeces were evaluated for the presence of Clostridium difficile, C. difficile toxins, C. perfringens enterotoxin (CPE) and C. perfringens spore counts. Clostridium difficile was isolated from 7/55 horses (12.7%) and 11/31 foals (35.5%) with colitis, but from 1/255 normal adults (0.4%) and 0/47 normal foals (P<0.001). Clostridium difficile toxins A and/or B were detected in 12/55 diarrhoeic adults (21.8%) and 5/30 diarrhoeic foals (16.7%) but in only 1/83 adults (1.2%) and 0/21 foals with normal faeces (P<0.001 and P<0.05, respectively). Clostridium perfringens enterotoxin was detected in 9/47 diarrhoeic adults (19%) and 8/28 diarrhoeic foals (28.6%), but was not detected in 47 adult horses (P<0.002) or 4 foals (P = 0.22) with normal faeces. The positive predictive value of isolation of C. perfringens with respect to the presence of CPE was only 60% in adult horses and 64% in foals. There was no association between total C. perfringens spore count and CPE in the faeces. The overall mortality rate from colitis was 22% for adult horses and 18% for foals. Clostridium difficile toxin‐positive adult horses with colitis were less likely to survive than C. difficile‐negative horses with colitis (P = 0.03). This study provides further evidence that C. difficile and enterotoxigenic C. perfringens are associated with equine enterocolitis.

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A prospective study of the roles ofClostridium difficileand enterotoxigenicClostridium perfringensin equine diarrhoea

Weese

Staempfli

Prescott

2001

Equine Veterinary Journal

152

118

View full text Add to dashboard Cite

show abstract

“…Th e majority of the studies were from the United States (38 studies, 84% ( 8,), but six other countries were also represented (Canada ( 35,36 ), Australia ( 34 ), Germany ( 4 ), Ireland ( 5 ), Japan ( 6 ), and the United Kingdom ( 7 )). …”

Section: Coi Study Characteristicsmentioning

confidence: 99%

“…Of the studies, 7% (3 studies) conducted sensitivity analyses ( 37,42,48 ) and 16% (7 studies) provided a justifi ed study perspective (who would have incurred the cost of the disease, e.g., patient or third-party payer) ( 34,47,48,57,61,66,72 ). In addition, 22% (10 studies) indicated the year and currency that costs were evaluated in ( 40,43,45,46,48,52,57,65,67,68 ), 49% (22 studies) presented costs in aggregate and disaggregate form (4)(5)(6)(7)36,(39)(40)(41)44,46,48,52,54,57,59,62,64,66,67,69,72,73 ), 62% (28 studies) calculated descriptive statistics for the cost estimates, along with providing confi dence intervals around the estimates and/or P values ( 4,6,8,34,(3...…”

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%