Vancomycin-resistant Clostridium innocuum bacteremia following oral vancomycin for Clostridium difficile infection

Hung, Yuan‐Pin; Lin, Hsiao Ju; Wu, Chi Jung; Chen, Po‐Lin; Lee, Jen‐Chieh; Liu, Hsiao Chieh; Wu, Yi Hui; Yeh, Fang Hao; Tsai, Pei Jane; Ko, Wen Chien

doi:10.1016/j.anaerobe.2014.07.009

Cited by 16 publications

(7 citation statements)

References 21 publications

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“… 49 Previous studies have demonstrated that EEN interventions in CD patients lead to rapid reductions in microbial diversity, 50 which aligns with what we observed in mice fed EEN. EEN and chow fed mice also experienced a bloom in bacterial taxa known to cause bacteremia 51 and recurrent diarrhea, 52 be in higher abundances in IBD patients, 12 and/or are associated with non-sustained remission once EEN is discontinued. 13 The increase in potentially pathogenic bacteria paralleled a significant reduction in bacteria with known anti-inflammatory properties such as Bifidobacterium spp., 53 as well as butyrate-producing bacteria (ie, Anaerostipes caccae ) 22 in the EEN and chow groups.…”

Section: Discussionmentioning

confidence: 99%

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

Healey

Tsai

Schick

et al. 2021

Cellular and Molecular Gastroenterology and Hepatology

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Background & Aims Exclusive enteral nutrition (EEN) is used to treat pediatric Crohn’s disease (CD), but therapeutic benefits are variable, and EEN can lead to microbial dysbiosis. Because of reported lower efficacy EEN is not routinely used to treat pediatric ulcerative colitis (UC). Inulin-type fructans (IN) beneficially modulate the gut microbiome and promote expansion of anti-inflammatory immune cells. We hypothesized that enriching EEN with IN (EEN IN) would enhance treatment efficacy. To test this, we examined the effects of EEN IN on colitis development, the gut microbiome, and CD4 + T cells using an adoptive T-cell transfer model of colitis. Methods TCR-β deficient ( -/- ) mice were randomized to 1 of 4 groups: (1) Control, (2) Chow, (3) EEN, and (4) EEN IN, and naive CD4 + T cells were adoptively transferred into groups 2–4, after which mice were monitored for 5 weeks before experimental endpoint. Results Mice fed EEN IN showed greater colitis protection, with colonic shortening, goblet cell, and crypt density loss reduced compared with EEN fed mice and reduced disease activity and immune cell infiltration compared with chow fed mice, and less crypt hyperplasia and higher survival compared with both groups. EEN IN mice had less deterioration in the colonic mucus layer and had increased levels of Foxp3 + IL-10 + and Rorγt + IL-22 + and reduced levels of Tbet + IFNγ + and Tbet + TNF + CD4 + T cells. EEN IN also led to higher butyrate concentrations, Bifidobacterium spp. and Anaerostipes caccae relative abundance, and lower [ Clostridium ] innocuum group spp. and Escherichia-Shigella spp. relative abundance. Conclusions The EEN IN group showed reduced colitis development as compared with the chow and EEN groups. This highlights the potential benefits of EEN IN as a novel induction therapy for pediatric CD and UC patients.

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Section: Discussionmentioning

confidence: 99%

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

Healey

Tsai

Schick

et al. 2021

Cellular and Molecular Gastroenterology and Hepatology

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“…Cases of concomitant CDI and CMV colitis in immunocompetent patients have also been reported. Coexisting CMV and C. difficile colitis may be refractory to first-line antibiotics for CDI treatment [27, 28]. In the present study, C. difficile and CMV co-infection had more severe colonoscopic features than CDI alone had.…”

Section: Discussionmentioning

confidence: 46%

Retrospective analysis of Clostridium difficile infection in patients with ulcerative colitis in a tertiary hospital in China

Tang

et al. 2019

BMC Gastroenterol

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BackgroundMany reports have documented the increasing impact of Clostridium difficile infection (CDI) in patients with ulcerative colitis (UC). We conducted a retrospective study to determine the incidence, clinical characteristics, risk factors and prognosis of CDI in patients with UC.MethodsWe studied patients with UC, hospitalized between January 2010 and December 2015 in a tertiary hospital in China. Stool samples were tested for C. difficile toxins A and B (CDAB) by enzyme immunoassays in UC patients with disease flare. CDI in UC patients was diagnosed by clinical symptoms and positive CDAB test, and each case was matched with CDAB-negative patients in a 1:2 ratio. Univariate and binary logistic regression analyses were used to measure the differences between patients with and without CDI.ResultsThirty-four (8.92%) of 381 patients with UC were CDAB positive. Antibiotic exposure within 3 months prior to the study (P = 0.004), hospitalization within 1 month prior to the study (P = 0.025), systemic use of steroids (P = 0.002) and active cytomegalovirus (CMV) infection (P = 0.001) were higher in CDI than non-CDI patients. Binary logistic regression analysis revealed that CMV infection was associated with CDI (odds ratio = 13.502, 95% confidence interval 1.307–139.512, P = 0.029). UC patients with C. difficile and CMV co-infection had more severe colonoscopic features.ConclusionsRecent use of antibiotics, prior hospitalization and systemic use of steroids increased the risk of CDI. CMV infection was an independent risk factor of CDI in patients with UC.

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“…The term “innocuum” is derived from “innocuous” (i.e., meaning innocent) as the organism lacks the ability to produce toxins. A PubMed search of the literature identified 16 previously reported cases of C. innocuum infection (Smith and King 1962 ; Castiglioni et al 2003 ; Crum-Cianflone 2009 ; Hung et al 2014 ; Bodey et al 1991 ; Cutrona et al 1995 ). Details of these cases are summarized in Additional file 1 : Table S1.…”

Section: Discussion and Evaluationmentioning

confidence: 99%

“…Median age of patients was 38.0 years, and 66.7% were male. All but one patient had a comorbid disorder, namely acute leukemia, AIDS, chronic hepatitis, genitourinary malignancy, gastro-intestinal malignancy, or organ transplantation (Crum-Cianflone 2009 ; Hung et al 2014 ; Bodey et al 1991 ; Cutrona et al 1995 ; Shah et al 2009 ). The most common clinical symptom was fever of unknown origin followed by the gastrointestinal tract disorder, such as diarrhea or constipation, and/or respiratory disorder.…”

Section: Discussion and Evaluationmentioning

confidence: 99%

Osteomyelitis due to Clostridium innocuum in a patient with acute lymphoblastic leukemia: case report and literature review

et al. 2015

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IntroductionClostridium innocuum is an anaerobic Gram-positive bacterium, unable to produce toxins and rarely causes infections. We report the first case of C. innocuum osteomyelitis and bacteremia in a patient with acute lymphoblastic leukemia (ALL). Findings were compared with previously reported cases of C. innocuum infections in immunocompromised patients, e.g., patients with acquired immune deficiency syndrome, leukemia, and organ transplantation.Case descriptionA 32-year-old Japanese male was admitted for persistent low-grade fever and purpura lasting for 1 month. Complete blood counts and cytogenetic analysis identified Ph1-positive ALL, which was successfully treated using chemotherapy. However, the patient developed high fever and lumbar pain during complete remission. Fluorodeoxyglucose-positron emission tomography and computed tomography demonstrated osteomyelitis. C. innocuum was identified as the causative agent and the patient was successfully treated using antibiotic therapy.Discussion and evaluationWe performed a literature review revealing a number of common aspects to the clinical presentation of C. innocuum infection and an association with various comorbidities. Further, we highlight the most efficient diagnostic and treatment strategies for C. innocuum osteomyelitis.ConclusionsClostridium innocuum can be a causative pathogen of osteomyelitis and bacteremia in immunocompromised patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-015-1176-3) contains supplementary material, which is available to authorized users.

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Vancomycin-resistant Clostridium innocuum bacteremia following oral vancomycin for Clostridium difficile infection

Cited by 16 publications

References 21 publications

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis

Retrospective analysis of Clostridium difficile infection in patients with ulcerative colitis in a tertiary hospital in China

Osteomyelitis due to Clostridium innocuum in a patient with acute lymphoblastic leukemia: case report and literature review

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