Vaginal carriage and neonatal acquisition of Clostridium difficile

Tabaqchali, Soad; O'Farrell, S; Nash, James; Wilks, Mark

doi:10.1099/00222615-18-1-47

Cited by 27 publications

(10 citation statements)

References 12 publications

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“…38°C) in 26 to 66% of patients (102,196,262). Leukocytosis is a common clinical feature in the severely ill patient, with leukocyte counts exceeding 15,000 cells per mm3 in 40 to 50% of patients (196,262 (34,35,73,118,153,178,228,252,258); however, other studies have reported acquisition rates of 0 to 6% (127,153,246,257). These differences in the acquisition rates of C. difficile in neonates and young children most likely represent varied degrees of environmental exposure in nurseries or transfer from the hands of hospital staff rather than disparities in the rate of maternal exposure (12).…”

Section: Introductionmentioning

confidence: 99%

Clostridium difficile: clinical disease and diagnosis

1993

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Clostridium difficile is an opportunistic pathogen that causes a spectrum of disease ranging from antibiotic-associated diarrhea to pseudomembranous colitis. Although the disease was first described in 1893, the etiologic agent was not isolated and identified until 1978. Since clinical and pathological features of C. difficile-associated disease are not easily distinguished from those of other gastrointestinal diseases, including ulcerative colitis, chronic inflammatory bowel disease, and Crohn's disease, diagnostic methods have relied on either isolation and identification of the microorganism or direct detection of bacterial antigens or toxins in stool specimens. The current review focuses on the sensitivity, specificity, and practical use of several diagnostic tests, including methods for culture of the etiologic agent, cellular cytotoxicity assays, latex agglutination tests, enzyme immunoassay systems, counterimmunoelectrophoresis, fluorescent-antibody assays, and polymerase chain reactions.

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Section: Introductionmentioning

confidence: 99%

Clostridium difficile: clinical disease and diagnosis

1993

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“…32 The source of C. difficile in neonates is believed to be either the mother's vaginal flora or the health care environment. 33,34 In older children, day-care reservoirs for acquisition of C. difficile have been described. 35 …”

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confidence: 99%

Clostridium difficile-associated diarrhea in adults

Poutanen

Simor²

2004

Canadian Medical Association Journal

360

280

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CLOSTRIDIUM DIFFICILE is the most important cause of nosocomial diarrhea in adults. Illness may range from mild watery diarrhea to life-threatening colitis. An antecedent disruption of the normal colonic flora followed by exposure to a toxigenic strain of C. difficile are necessary first steps in the pathogenesis of disease. Diagnosis is based primarily on the detection of C. difficile toxin A or toxin B. First-line treatment is with oral metronidazole therapy. Treatment with oral vancomycin therapy should be reserved for patients who have contraindications or intolerance to metronidazole or who fail to respond to first-line therapy

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“…20 In addition, 6 (21%) of 29 women initially presenting to a second sexually transmitted diseases clinic in the United Kingdom were also found to be colonized with C. difficile in their vaginal tracts. 21 Nevertheless, other studies have failed to confirm these findings. 22 Our patient had recently been hospitalized at an outside hospital; however, he denied receiving antibiotics or a proton pump inhibitor.…”

Section: Discussionmentioning

confidence: 85%

Lymphogranuloma Venereum Proctitis and Clostridium difficile Colitis in an HIV-Infected Patient

Muzny¹,

Kapil²,

Ayensu³

et al. 2014

Infectious Diseases in Clinical Practice

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A human immunodeficiency virus-infected man who has sex with men presented with several months of abdominal pain, diarrhea, rectal pain, and rectal discharge of bright red blood and pus. He reported receptive anal intercourse with multiple casual male partners. He was subsequently diagnosed with lymphogranuloma venereum proctitis and Clostridium difficile colitis. It is possible that C. difficile was sexually transmitted in this case because the patient did not have any of the traditional risk factors for C. difficile. Clinicians should be cognizant of the diagnosis of lymphogranuloma venereum, particularly among high risk men who have sex with men, and its potential association with other gastrointestinal pathogens such as C. difficile that may be sexually transmitted. Failure to identify and treat these pathogens can lead to significant complications and the potential for transmission to others. Key Words: lymphogranuloma venereum, HIV/AIDS, men who have sex with men (Infect Dis Clin Pract 2014;22: e116-e118)A norectal and intestinal infections due to a variety of pathogens are common among men who have sex with men (MSM), 1 particularly those with human immunodeficiency virus (HIV). 2 We present a case of an HIV-infected MSM with lymphogranuloma venereum (LGV) proctitis and Clostridium difficile colitis. Lymphogranuloma venereum is a sexually transmitted infection (STI) caused by the LGV serovars (L1, L2, L3) of Chlamydia trachomatis. 3 C. difficile, the most common cause of health care-associated diarrhea, 4-6 may also be a sexually transmitted pathogen. 7 CASE REPORTA 23-year-old HIV-infected African American MSM presented to an HIV clinic with 2 months history of abdominal pain, diarrhea, and rectal pain and discharge of bright red blood and pus. He also reported a diffuse body rash including his palms and soles. He was nonadherent with his HIV therapy. He had recently been admitted to an outside hospital for the diarrhea and rectal complaints and was told that external hemorrhoids were the cause. His most recent sexual encounter was 2 months earlier (before the onset of his symptoms) at which time he had unprotected receptive anal intercourse (RAI) with several casual male partners that he met through the internet. He denied any recent travel.On examination, the patient was afebrile, tachycardic, and had orthostatic hypotension. He was cachectic with temporal wasting. Abdominal examination was benign. He had a diffuse hyperpigmented macular rash involving the palms and soles. Genitourinary examination revealed tender bilateral inguinal lymph nodes and a superficial ulcerative lesion near the opening of the urethral meatus. No penile discharge was noted. He refused a digital rectal examination; however, visual examination showed a nonthrombosed external hemorrhoid, yellow rectal discharge, and 2 small superficial perianal ulcerative lesions.The patient was admitted. White blood cell count and serum creatinine level were normal. Serum rapid plasma reagin showed a titer reactive to 1:1024 dilutions. Absolute ...

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Vaginal carriage and neonatal acquisition of Clostridium difficile

Cited by 27 publications

References 12 publications

Clostridium difficile: clinical disease and diagnosis

Clostridium difficile: clinical disease and diagnosis

Clostridium difficile-associated diarrhea in adults

Lymphogranuloma Venereum Proctitis and Clostridium difficile Colitis in an HIV-Infected Patient

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