Spread of Clostridium difficile among patients receiving non-absorbable antibiotics for gut decontamination.

Rogers, Thomas R.; Petrou, M.D. Ilya; Lucas, Carol; Chung, Jong-Youn; Barrett, Aaron; Borriello, S. P.; Honour, Pauline

doi:10.1136/bmj.283.6288.408-a

Cited by 40 publications

(6 citation statements)

References 4 publications

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“…Length of stay in hospital was not analysed since the oncological patients involved in this study, particularly the patients with acute leukaemia, had frequent and multiple admissions to hospital with recurrent exposure to the outbreak strain. Rogers et al (1981) have noted the association between prophylactic nonabsorbable antibiotic regimes and colonization of the gastrointestinal tract in children receiving bone marrow transplantation. In this present study, only a few of the 46 patients with acute leukaemia tolerated the non-absorbable antibiotics (framycetin, nystatin, colistin) which were prescribed for the entire treatment period (6 months).…”

Section: Discussionmentioning

confidence: 99%

Clostridium difficileinfection in patients with haematological malignant disease: Risk factors, faecal toxins and pathogenic strains

et al. 1988

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Two hundred and forty-eight patients from shared oncology and general medical wards were prospectively studied over a 6-month period for carriage of Clostridium difficile during an outbreak of clinical disease with an epidemic strain of the organism. Risk factors for infection were assessed. Acute leukaemia and/or its treatment were identified as significantly increasing the risk of infection. The relationship between the type of C. difficile isolated (as defined by a typing system based on the incorporation of [35S]methionine into bacterial proteins followed by gel electrophoresis), the presence of faecal toxins A and B and clinical symptoms were analysed. Carriage of the epidemic strain, type X, had a significant association with symptoms amongst oncology patients, with two thirds of these patients having detectable faecal toxin A and one third detectable faecal toxin B. During an outbreak of C. difficile-associated disease, typing the organism and assaying for both faecal toxins in symptomatic patients may be of benefit in determining which patients require specific, urgent treatment.

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Section: Discussionmentioning

confidence: 99%

Clostridium difficileinfection in patients with haematological malignant disease: Risk factors, faecal toxins and pathogenic strains

et al. 1988

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“…C. difficile has been recognized as an enteric pathogen causing disease almost exclusively in the presence of antibiotic exposure [1-3]. The spectrum of illness caused by C. difficile ranges in severity from asymptomatic carriage to life-threatening pseudomembranous colitis, fulminant colitis, and death [4, 5].…”

Section: Introductionmentioning

confidence: 99%

In vivo lysogenization of a Clostridium difficile bacteriophage ФCD119

2011

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Clostridium difficile is a nosocomial pathogen identified as the cause of antibiotic associated diarrhea and colitis. In this study, we have documented the lysogeny of a C. difficile bacteriophage in hamsters during C. difficile infection. The lysogens isolated from the hamsters were toxin typed and their phage integration site was confirmed by PCR. Through toxin ELISA it was found that the toxin production in the in vivo isolated lysogens was affected due to ΦCD119 lysogenization as in the case of in vitro isolated ΦCD119 lysogens. Together our findings indicate that a baceriophage can lysogenize its C. difficile host even during the infection process and highlights the importance of lysogeny of C. difficile phages as an evolutionary adaptation for survival.

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“…According to several authors, the carriage rate in adults ranges from 0 to 11% (9,26). Clusters of cases or large outbreaks in hospitals have been previously described, and nosocomial spread has been proposed as a mode of transmission (5,6,15,16,25,28,31,32). The role of this microorganism in relapse of inflammatory bowel disease is less evident (10,14,35,41).…”

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confidence: 99%

Serogrouping of Clostridium difficile strains by slide agglutination

Delmée¹,

Homel²,

Wauters³

1985

J Clin Microbiol

129

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Six different agglutinating antisera were obtained by immmunizing rabbits with Formol-treated strains of Clostridium difficile. After appropriate absorption, these antisera were used to define six serogroups designated by the letters A, B, C, D, F, and G. Altogether, 315 strains of C. difficile from various origins were tested for slide agglutination by these antisera; 312 (99%) of them were agglutinated by one of these antisera. A and C were the most common serogroups. An excellent correlation, ranging from 85 to 100%, was found between the serogroup and the toxigenicity of the strains. The correlation between serogroup and sorbitol fermentation was higher, ranging from 89 to 100%. The results of this typing were compared with the clinical origin of the strains. Only strains of serogroups A, C, and D were isolated in 153 cases of antibiotic-associated diarrhea. This series included strains from three outbreaks; all the strains in two of the outbreaks belonged to serogroup C, and in the third, all the strains belonged to serogroup A. Strains of serogroups B, F, and G were only found in the stools of asymptomatic neonates or young children. In the latter samples, strains of serogroups A and D were found in the same ratio as in adults with antibiotic-associated diarrhea, but strains of serogroup C were seldom isolated. In patients treated with antineoplastic drugs and suffering from diarrhea, the distribution of the strains was the same as in cases of antibiotic-associated diarrhea.

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Spread of Clostridium difficile among patients receiving non-absorbable antibiotics for gut decontamination.

Abstract: 1973 ;193 :493-8. 4 Kistner S, Norberg R. Urinary excretion of serum proteins in renal disease. Studies of electrophoretic fractions and IgA, IgG and IgM.

Cited by 40 publications

References 4 publications

Clostridium difficileinfection in patients with haematological malignant disease: Risk factors, faecal toxins and pathogenic strains

Clostridium difficileinfection in patients with haematological malignant disease: Risk factors, faecal toxins and pathogenic strains

In vivo lysogenization of a Clostridium difficile bacteriophage ФCD119

Serogrouping of Clostridium difficile strains by slide agglutination

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