Abstract This clinical practice guideline is a focused update on management of Clostridioides difficile infection (CDI) in adults specifically addressing the use fidaxomicin and bezlotoxumab for treatment CDI. was developed by multidisciplinary panel representing Infectious Diseases Society America (IDSA) Healthcare Epidemiology (SHEA). intended healthcare professionals who care with CDI, including specialists infectious diseases, gastroenterologists, hospitalists, pharmacists, any...

This clinical practice guideline is a focused update on management of Clostridioides difficile infection (CDI) in adults specifically addressing the use fidaxomicin and bezlotoxumab for treatment CDI. was developed by multidisciplinary panel representing Infectious Diseases Society America (IDSA) Healthcare Epidemiology (SHEA). intended healthcare professionals who care with CDI, including specialists infectious diseases, gastroenterologists, hospitalists, pharmacists, any clinicians...

There have been several recent reports of Clostridioides difficile infection (CDI) due to isolates with reduced fidaxomicin susceptibility (minimum inhibitory concentration [MIC] ≥ 2 µg/mL). However, the clinical implications are uncertain because achieves high concentrations in intestinal tract. In an acute care hospital, we conducted a 3-year cohort study patients CDI determine frequency and impact on response treatment. Stool specimens were cultured for C. difficile, testing was performed...

Colonization with nontoxigenic Clostridioides difficile strain M3 (NTCD-M3) has been demonstrated in susceptible hamsters and humans when administered after vancomycin treatment. NTCD-M3 also shown to decrease risk of recurrent C. infection (CDI) patients following treatment for CDI. As there are no data colonization fidaxomicin treatment, we studied the efficacy determined fecal antibiotic levels a well-studied hamster model Ten 10 became colonized 5 days was daily 7 discontinuation. The...

Abstract Background Antibiotic use is a major risk factor for recurrent Clostridioides difficile infection (CDI) due to the associated disruption in gut microbiota. Fecal microbiota, live-jslm (REBYOTA®; RBL, previously RBX2660), first microbiota-based live biotherapeutic approved by US Food and Drug Administration prevent CDI adults following standard-of-care antibiotic treatment. To investigate impact of non-CDI antibiotics on durability subgroup analysis was conducted PUNCH™ Open-Label...

Abstract Background Clostridioides difficile infection (CDI) is a common healthcare-associated leading to significant morbidity and mortality. Antibiotic exposure primary risk factor associated with CDI, but other factors for include advanced age, frequent hospitalization, immunosuppression, previous gastric acid suppression. This study aimed evaluate CDI no documented antibiotic exposure. Methods case-control of 131 patients positive C. (CD) test between 7/2022 - 6/2023 at the Edward Hines...

Abstract Background Antimicrobial resistance in Clostridioides difficile (CD) has been a key contributor for the spread of specific endemic CD strains. Monitoring changes antimicrobial minimum inhibitor concentration (MIC) over time could potentially predict future outbreaks. We determined change MIC 40 years 10 critical antibiotics one epidemic and strain groups. Methods agar dilution was performed on 193 clinical isolates collected from 1984 – 2023 identified as restriction endonuclease...

Abstract Background Clostridioides difficile infections (CDI) are caused by a diverse group of strains with differences in prevalence and differing antimicrobial susceptibilities. Over the past 20 years C. (CD) molecular epidemiology has changed as epidemic strain recognized PCR-Ribotype (RT) 027 decreased. The objective this study was to determine current susceptibility patterns CD at two Veteran Affairs hospitals.Figure 1.PCR-Ribotyping isolates collected from Hines VA Cleveland 7/2022 -...

Abstract Background Active Clostridioides difficile infection (CDI) surveillance is conducted by the U.S. CDC’s Emerging Infections Program (EIP) and includes collection of a convenience sample stool specimens from C. positive cases. Accurate molecular epidemiology relies on recovering clinical specimens. We sought to determine whether CDI diagnostic testing approach was associated with likelihood culturing stool.Table 1.Characteristics collected identified through in Colorado Georgia,...

Assess the efficacy of staged interventions aimed to reduce inappropriate Clostridioides difficile testing and hospital-onset C. infection (HO-CDI) rates. Interrupted time series. Community-based. National Healthcare Safety Network (NHSN) metrics from January 2019 November 2022 were analyzed after three at a community-based healthcare system. Interventions included: (1) an electronic medical record (EMR) based hard stop requiring confirming ≥3 loose or liquid stools over 24 h, (2) infectious...

This feature about a patient recently treated for C. difficile infection who now needs intravenous antibiotics offers case vignette accompanied by two essays, one supporting use of oral vancomycin prophylaxis and the other not it.

We treated 46 patients with multiple recurrent Clostridioides difficile infections (mrCDI) using a tapered-pulsed (T-P) fidaxomicin regimen, the majority of whom failed prior T-P vancomycin treatment. Sustained clinical response rates at 30 and 90 days were 74% (34/46) 61% (28/46). shows promise for management mrCDI.

The COVID-19 pandemic was associated with increases in some healthcare-associated infections. We investigated the impact of on rates and molecular epidemiology Clostridioides difficile infection (CDI) within one VA hospital. anticipated that potential widespread use antibiotics for pneumonia during might increase CDI given are a major risk CDI. Hospital data patients recurrent (rCDI) were reviewed both prior to (2015 2019) (2020-2021). Restriction endonuclease analysis (REA) strain typing...

To assess fecal microbiota, live-jslm (REBYOTA, abbreviated as RBL, formerly RBX2660) efficacy and safety in participants grouped by recurrent Clostridioides difficile infection (rCDI) risk factors treatment-related variables.

Abstract Background Omadacycline is a novel aminomethylcycline tetracycline antimicrobial that was approved for the treatment of community-associated bacterial pneumonia (CABP) and acute skin structure infections (ABSSSI) in 2018. has demonstrated high degree vitro activity towards Clostridioides difficile previous data have hypothesized use omadacycline CABP or ABSSSI may decrease risk C. infections. Objectives To compare versus commonly used antimicrobials indications use. Methods We...

Abstract During a surveillance study of patients in long-term care facility and the affiliated acute hospital United States, we identified Clostridioides difficile strain related to epidemic PCR ribotype (RT) 027 associated with outbreaks severe disease. Fifteen were infected this strain, characterized as restriction endonuclease analysis group DQ RT591. Like RT027, DQ/RT591 contained genes for toxin B binary CDT tcdC gene identical sequence. Whole-genome sequencing multilocus sequence...

Most pathogenic strains of C. difficile possess two large molecular weight single unit toxins with four similar functional domains. The disrupt the actin cytoskeleton intestinal epithelial cells leading to loss tight junctions, which ultimately manifests as diarrhea in host. While initial studies purified animal models pointed toxin A (TcdA) main virulence factor, using isogenic mutants demonstrated that B (TcdB) alone was sufficient cause disease. In addition, natural occurrence TcdA−/TcdB+...

In contrast to the epidemiology 10 years earlier at our hospital when epidemic restriction endonuclease analysis (REA) group strain BI accounted for 72% of

Abstract Background The quantitative relationship between antimicrobial agent consumption and rise or fall of antibiotic resistance has rarely been studied. We began all admission surveillance testing for methicillin-resistant Staphylococcus aureus (MRSA) in August 2005 with subsequent contact isolation decolonization using nasally applied mupirocin ointment those colonized. In October 2012, we discontinued medical (nonsurgical service) patients. Methods conducted a retrospective study from...

The COVID-19 pandemic was associated with increases in some healthcare-associated infections. We investigated the impact of on rates and molecular epidemiology Clostridioides difficile infection (CDI) within one VA Hospital. anticipated that potential widespread use antibiotics for pneumonia during might increase CDI given are a major risk CDI. Hospital data patients recurrent (rCDI) were reviewed pre-COVID-19 (2015 to 2019) (2020 - 2021). Restriction endonuclease analysis (REA) strain...

Fidaxomicin is an oral narrow-spectrum novel 18-membered macrocyclic antibiotic that was initially approved in 2011 by the US FDA for treatment of Clostridioides difficile infections (CDI) adults. In February 2020, fidaxomicin CDI children age >6 months. adults, as efficacious vancomycin treating and reduces risk recurrent CDI. An investigator-blinded, randomized, multicenter, multinational clinical trial comparing efficacy safety with recently published confirming similar findings...