National Trends (2007-2013) of Clostridium difficile Infection in Patients with Septic Shock: Impact on Outcome

2017 ◽  
Vol 12 (9) ◽  
pp. 717-722 ◽  
Author(s):  
Kshitij Chatterjee ◽  
Abhinav Goyal ◽  
Aditya Chada ◽  
Krishna Kakkera ◽  
Howard Corwin
2017 ◽  
Vol 83 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Allan Mabardy ◽  
Justin Mccarty ◽  
Alan Hackford ◽  
Haisar Dao

The most recent nationwide data show a rising incidence of Clostridium difficile infection in hospitalized patients with ulcerative colitis (UC). We describe recent national trends with regard to incidence, mortality, and the rate of total colectomy. The Nationwide Inpatient Sample database identified patients admitted to hospitals in the United States with diagnoses of C. difficile and inflammatory bowel disease (IBD) during the study years 2007 to 2013. We analyzed incidence of C. difficile, mortality, and colectomy rates. From 2007 to 2013, incidence of patients with IBD admitted with the primary diagnosis of C. difficile rose faster than the non-IBD population (1.24% to 2.14% vs 0.26% to 0.30%, P < 0.0001) and specifically in the UC population rose from 2.36 to 3.48 per cent (P < 0.001). The mortality of non-IBD patients with C. difficile decreased 47 per cent (3.76% to 1.99%, P = 0.003), whereas mortality of IBD patients with C. difficile decreased 54 per cent (6.08% to 2.79%, P = 0.003). For UC patients with primary diagnosis C. difficile, the percentage undergoing total colectomy decreased by 38 per cent (2.47% vs 1.51%, P = 0.049). The incidence of C. difficile continues to rise in the both the IBD and non-IBD population. Our study shows decreasing mortality for IBD and non-IBD patients with C. difficile but a greater decrease in mortality for IBD patients.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Bhagyashri D. Navalkele ◽  
Stephen A. Lerner

Abstract Standard treatment for severe Clostridium difficile infection (CDI) is oral vancomycin with metronidazole. After failure of this standard regimen, treatment becomes challenging. A young woman treated for septic shock developed CDI. Standard treatment failed and she was ineligible for fecal transplant. Addition of tigecycline to her regimen resulted in cure.


2015 ◽  
Vol 24 (4) ◽  
pp. 531-533 ◽  
Author(s):  
Daniel Popa ◽  
Mihaela Laszlo ◽  
Lidia Ciobanu ◽  
Elena Ucenic ◽  
Manuela Mihalache ◽  
...  

A fecal microbiota transplant has proved to be an extremely effective method for patients with recurrent infections with Clostridium difficile. We present the case of a 65-year-old female patient with multiple Clostridium difficile infection (CDI) relapses on the rectal remnant, post-colectomy for a CDI-related toxic megacolon. The patient also evidenced associated symptomatic Clostridium difficile vaginal infection. She was successfully treated with serial fecal “minitransplants” (self-administered at home) and metronidazole ovules.Abbreviations: GI: gastrointestinal; MRI: magnetic resonance imaging; CDI: Clostridium difficile infection; FMT: fecal microbiota transplant.


2016 ◽  
Vol 25 (3) ◽  
pp. 385-388 ◽  
Author(s):  
Yvette H. Van Beurden ◽  
Tom Van Gils ◽  
Nienke A. Van Gils ◽  
Zain Kassam ◽  
Chris J.J. Mulder ◽  
...  

Treatment of refractory celiac disease type II (RCD II) and preventing the development of an enteropathy associated T-cell lymphoma in these patients is still difficult. In this case report, we describe a patient with RCD II who received fecal microbiota transfer as treatment for a recurrent Clostridium difficile infection, and remarkably showed a full recovery of duodenal villi and disappearance of celiac symptoms. This case suggests that altering the gut microbiota may hold promise in improving the clinical and histological consequences of celiac disease and/or RCD II. Abbreviations: CDI: Clostridium difficile infection; EATL : enteropathy associated T-cell lymphoma; FMT: fecal microbiota transfer; IEL: intraepithelial lymphocytes; RCD II: refractory celiac disease type II; TPN: total parenteral nutrition.


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