Severe Clostridium difficile colitis

Rubin, Marc; Bodenstein, Lawrence; Kent, K. Craig

doi:10.1007/bf02054220

Cited by 211 publications

(135 citation statements)

References 4 publications

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“…Previously published CDAD severity grading systems were developed on the basis of outcomes and characteristics seen in patients with CDAD throughout their clinical course. 14,15 The grading system presented herein was developed on the basis of clinical presentation (symptoms present within 48 hours before or after CDAD diagnosis). Application of this system identified patients at increased risk for adverse events associated with CDAD.…”

Section: Resultsmentioning

confidence: 99%

Severity of Clostridium difficile–Associated Disease (CDAD) in Allogeneic Stem Cell Transplant Recipients: Evaluation of a CDAD Severity Grading System

Dubberke

Sadhu

Gatti

et al. 2007

Infect. Control Hosp. Epidemiol.

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Section: Resultsmentioning

confidence: 99%

Severity of Clostridium difficile–Associated Disease (CDAD) in Allogeneic Stem Cell Transplant Recipients: Evaluation of a CDAD Severity Grading System

Dubberke

Sadhu

Gatti

et al. 2007

Infect. Control Hosp. Epidemiol.

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“…Patients with hypoalbuminemia (a serum albumin level of 2.5 g/ dL-3.0 g/dL) [25,26] have been shown to be at an increased risk of contracting severe CDI, as well as those with a serum creatinine of 2.26 g/dL or greater. [27] Looking at patient demographics, there was no significant difference between groups, thereby rejecting the null hypothesis that there were inherent differences in risk to develop CDI between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of Probiotics among Patients Receiving Antibiotics with a High Risk of Acquiring Clostridium difficile Infection

Dickson¹,

Hung²,

Chen³

2016

Int J Dig Dis

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Importance: Despite recommendations not to routinely use probiotics for primary prevention of Clostridium difficile infection (CDI) from Updated Practice Guidelines for CDI in 2010 by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America, the use of probiotics remains common among prescribers and patients. To our knowledge, there has been no analysis conducted to evaluate the impact of probiotics on the primary prevention of CDI among patients receiving antibiotics known to be associated with an increased risk of CDI. Objective:To determine whether patients who receive "high-risk" antibiotics along with probiotics are at a decreased risk of developing CDI. Design, setting, and participants:This was a retrospective cohort study including adult patients admitted to Yale New Haven Hospital, Saint Raphael Campus, between July 1, 2010 and December 31, 2010. Patients were excluded if they did not receive high-risk antibiotic(s) for more than 5 days nor had a history of CDI. Interventions:Eligible patients were then analyzed based on whether they had received concomitant use of probiotics or antibiotics alone. Main outcome(s) and measure(s):The primary outcome of the study was the development of CDI within 90 days of high-risk antibiotic use.Results: A total of 389 patients were included in the study. CDI occurred in 8.4% (12/143) of patients who received concomitant probiotics as opposed to 3.3% (8/246) that had CDI and received antibiotics alone with relative risk (RR) of 2.58 (95% CI: 1.08, 6.16; p=0.033). A chi-square analysis identified statistically significant differences in age (p<0.0001) and proton-pump inhibitor (PPI) utilization (p=0.0088), but the imbalance between patients with and without probiotics was removed after adjusting for the propensity score (p=0.1141). Conclusion and relevance:We found that use of antibiotics along with probiotics had a significantly higher incidence of CDI than those who did not receive probiotics. Our findings based on adjusted odds ratio do not support the recommendation of the routine use of probiotics for the prevention of CDI. Other strategies such as eliminating the unnecessary use of PPI should be applied to prevent CDI.

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“…In spite of this, it is necessary to consider neutropenic patients given long-term broad-spectrum antibiotics to be at risk for C. difficile infection. 7,[12][13][14] The source of infection can either be endogenous or exogenous. It is difficult to ascertain the source of infection in our patient.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 Vancomycin and metronidazole are considered to be the first choices. 2,5,7,[12][13][14]18,19 Because of the low concentration of these drugs in intestinal lumen when administered parenterally, they must be given orally. Administration by a nasogastric tube is sometimes necessary.…”

Section: Discussionmentioning

confidence: 99%

Pseudomembraneous clostridium after autologous bone marrow transplantation

Kavan

Sochor

Nyč

et al. 1998

Bone Marrow Transplant

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Summary:Clostridium difficile (C. difficile) pseudomembraneous colitis was diagnosed in a 13-year-old boy with Hodgkin's disease 3 months after autologous bone marrow transplantation. Hematopoiesis was fully reconstituted at the time. C. difficile infection occurred after gall bladder empyema had been treated conservatively with i.v. antibiotics and prophylactic 4-week administration of oral amoxicillin. C. difficile colitis was diagnosed early and intensive supportive therapy combined with administration of i.v. and subsequently oral vancomycin therapy failed. It is a phenomenon rarely seen and successful eradication of the clostridium infection was only achieved by a combination of higher dose vancomycin with metronidazole. During the post-colitis recovery the patient experienced a relapse of Hodgkin's disease and died following further surgical intervention 137 days post-transplantation.

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Severe Clostridium difficile colitis

Abstract: Patients with severe C. difficile colitis can be readily identified. Often they have coexisting illness that precludes operation. In this series, only 1 of 21 patients with severe C. difficile might have benefited from an aggressive surgical approach.

Cited by 211 publications

References 4 publications

Severity of Clostridium difficile–Associated Disease (CDAD) in Allogeneic Stem Cell Transplant Recipients: Evaluation of a CDAD Severity Grading System

Severity of Clostridium difficile–Associated Disease (CDAD) in Allogeneic Stem Cell Transplant Recipients: Evaluation of a CDAD Severity Grading System

Clinical Impact of Probiotics among Patients Receiving Antibiotics with a High Risk of Acquiring Clostridium difficile Infection

Pseudomembraneous clostridium after autologous bone marrow transplantation

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