scholarly journals Effect of Restriction of Fluoroquinolone Antibiotics on Clostridioides difficile Infections in the University Hospital Hradec Králové

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 519
Author(s):  
Kristýna Vaverková ◽  
Martin Kracík ◽  
Lenka Ryšková ◽  
Pavla Paterová ◽  
Rudolf Kukla ◽  
...  
Keyword(s):  
University Hospital ◽  
Defined Daily Dose ◽  
Clostridioides Difficile ◽  
Elder Patients ◽  
Positive Stool ◽  
Fluoroquinolone Antibiotics ◽  
Stool Samples ◽  
Polymerase Chain ◽  
The University ◽  
Hospital Acquired

Clostridioides difficile is the most common pathogen responsible for hospital-acquired diarrhea. This complication of antibiotic treatment mainly endangers the health of elder patients. Preventing the development of C. difficile infections (CDI) is still a challenge that needs to be addressed. In our study, the results of 872 C. difficile positive stool samples were used to describe the epidemiological situation affected by a change in the prescription of fluoroquinolone antibiotics. In a total, 93 of strains were typed by polymerase chain reaction (PCR) and capillary gel electrophoresis. Between years 2014 and 2018 the decline in the fluoroquinolones consumption was 69.3 defined daily dose (DDD) per 1000 patient-days (from 103.3 to 34.0), in same period CDI incidence declined by 1.3 cases per 10,000 patient-bed days (from 5.6 to 4.3). Results of epidemiologic and statistical analysis shows that decline in fluoroquinolones consumption has significant influence on CDI incidence and prevalence of hypervirulent strains. In the University Hospital Hradec Králové properly managed antibiotic stewardship policy has reduced CDI incidence by 23.2% and lowered rate of hypervirulent ribotypes 001 and 176.

scholarly journals High incidence of multidrug-resistant fecal E. coli producing ESBLs and carried ST131 in Jordanian adults

10.3823/0810 ◽  
2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Reham Muin Abu Sneineh ◽  
Azmi Mahafzah ◽  
Nayef Abdallat ◽  
Asem A. Shehabi
Keyword(s):  
Multidrug Resistant ◽  
E Coli ◽  
Group I ◽  
High Incidence ◽  
Stool Samples ◽  
Polymerase Chain ◽  
Tract Infections ◽  
The University ◽  
Hospital Acquired ◽  
St131 Clone

Background: Escherichia coli  is part of the human intestine normal flora, although it has the potential of causing variety of invasive and diarrheal diseases. It is also a frequent cause of community- and hospital-acquired urinary tract infections. Intestinal E. coli has the potential to develop rapidly multidrug resistant (MDR) and to emerge as extended-spectrum β-lactamases (ESBLs)-producer.    Methods: Over the period of July through November, 2015; 287 stool samples were collected from Jordanian adults who visited the students’ clinic of the University of Jordan. Fecal samples were collected and cultured for isolation of E. coli. The isolates were investigated for antimicrobial susceptibility, and molecular method of polymerase chain reaction (PCR) was performed for the detection genes of ST131 clone, blaCTX-M group I, blaCTX-M-15, blaNDM-1, blaVIM, blaIMP, blaOXA-48, blaKPC and fluoroquinolones resistance (gyrA and parC). Results: A total of 105/287 E. coli isolates (36.6%) were found to be multi-drug resistant (MDR) to at least 3 classes of antibiotics, of these 45.1% were ESBL-producers. A total of 51 representative MDR isolates indicated the following; 49% were found positive for ST131 clone, 58.8% were resistant for ciprofloxacin, and 41.2% were positive for CTX-M group I and CTX-M-15, respectively. All these MDR isolates were also positive for mutated both gyrA and ParC genes, and only 6 / 51 isolates (11.8%) were positive for each blaNDM-1 and blaKPC.  One out of 51 MDR isolates (2%) was positive for blaVIM, and none of these isolates was positive for blaIMP nor blaOXA-48 genes. Conclusion: This study indicated that a relatively high rates of commensal fecal E. coli isolates from Jordanian adults were MDR, ESBLs-producer and belonging to ST131 clone.  Also, high rates of CTX-M-15 and fluoroquinolones resistance were found among MDR E. coli isolates.    

scholarly journals 247. Validation of the Use of Oral Vancomycin Following Positive Admission Screening Testing for C. difficile

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S123-S123
Author(s):  
Preethi Yeturu ◽  
Jorge P Parada ◽  
Maressa Santarossa ◽  
Laurie Labuszewski ◽  
Jenna Lopez ◽  
...  
Keyword(s):  
Clinical History ◽  
Inclusion Criteria ◽  
Infectious Colitis ◽  
First Line Therapy ◽  
Clostridioides Difficile ◽  
Admission Screening ◽  
Positive Stool ◽  
Number Of Patients ◽  
Polymerase Chain ◽  
Definition Of

Abstract Background Clostridioides difficile can cause a severe infectious colitis and is often associated with significant morbidity and mortality. C. difficile infection (CDI) is defined as the presence of diarrhea plus a positive stool test, whereas C. difficile colonization is defined as a positive stool test in the absence of diarrhea or the presence of diarrhea attributable to causes other than CDI. Widespread use of stool polymerase chain reaction (PCR) testing, especially within the first 3 days of admission, has become common at our institution and has been associated with increased number of positive C. difficile tests results. However, C. difficile colonization rates may be 15% or higher. Oral (PO) vancomycin (vanc) is first line therapy for the treatment of CDI. We sought to evaluate the appropriateness of use of PO vanc in patients who tested positive for C. difficile via stool PCR within 3 days of admission. Methods We reviewed the clinical history, presence of diarrhea, risk factors for diarrhea, treatment and use of an infectious disease (ID) consultation for all patients 18 years of age or older found to test positive for C. difficile by PCR on stool assays during the first 3 days of admission from 07/01/18 to 12/31/18. Results A total of 228 patients met inclusion criteria. 183 (80%) received PO vanc while 45 (20%) did not. 131 (71.6%) of patients who received PO vanc had diarrhea, 39 (21.3%) did not have diarrhea, 13 (7.1%) the presence of diarrhea was unknown. 41 of 143 (28.7%) of patients without ID consults received PO vanc despite not having diarrhea, while 11 of 40 (27.5%) patients seen by ID received PO vanc despite not having diarrhea (p=0.888). Conclusion Most patients who tested positive for C. difficile received PO vanc had documented diarrhea, meeting the definition of CDI. However, over 1 in 5 (21.3%) of patients who received PO vanc did not have diarrhea and may have been colonized rather than have true CDI. ID consultation did not decrease the number of patients without diarrhea who received PO vanc or prevent treatment of colonized patients. This work reveals there may be an opportunity for improvement regarding management of CDI vs. C. difficile colonization which may enhance antibiotic stewardship and the appropriate use of PO vanc. Disclosures All Authors: No reported disclosures

Hospital acquired Clostridioides difficile infection and risk factors for severity in a university hospital: A prospective study

2020 ◽  
Vol 48 (12) ◽  
pp. 1426-1430
Author(s):  
Hüseyin Bilgin ◽  
Elvan Sayın ◽  
Hande Perk Gürün ◽  
Elif Tükenmez-Tigen ◽  
Nurver Ülger Toprak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
University Hospital ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
A Prospective Study ◽  
Hospital Acquired

scholarly journals Distinct yearly change of serotype distribution of human rotavirus in Thailand as determined by ELISA and PCR

1993 ◽  
Vol 111 (2) ◽  
pp. 407-412 ◽  
Author(s):  
Y. Pongsuwanna ◽  
K. Taniguchi ◽  
F. Wakasugi ◽  
Y. Sutivijit ◽  
M. Chiwakul ◽  
...  
Keyword(s):  
Enzyme Linked Immunosorbent Assay ◽  
Serotype Distribution ◽  
Chain Reaction ◽  
Positive Stool ◽  
Human Rotavirus ◽  
Serotype 1 ◽  
Group A ◽  
Yearly Change ◽  
Stool Samples ◽  
Polymerase Chain

SummaryA total of 241 group A rotavirus-positive stool samples collected from diarrhoeic patients in Thailand between July 1988 and June 1991 were characterized for their serotypes by enzyme-linked immunosorbent assay (ELISA) using serotype-specific monoclonal antibodies and by a polymerase chain reaction (PCR). In July 1988–June 1989, serotype 1 was the most prevalent (63·4%), followed by serotype 4 (11·0%) and serotype 2 (8·5%). In July 1989–June 1990, 59·8% were serotype 1, 24·3% were serotype 2, and 6·1 % were serotype 3. In contrast, in July 1990–June 1991, serotype 3 was detected in the highest frequency (40·5%), 29·9% were serotype 1, and 27·3% were serotype 2. Thus, a distinct yearly change of serotype distribution of rotavirus in Thailand was observed in the three consecutive years. In particular, it was of note that the prevalence of serotype 3 greatly increased, in contrast to the previous studies in which almost no serotype 3 rotaviruses were detected in the years 1983–8 in Thailand.

scholarly journals Prevalence of intestinal nematodes in alcoholic patients

2002 ◽  
Vol 35 (6) ◽  
pp. 571-574 ◽  
Author(s):  
Maria P. Zago-Gomes ◽  
Kiyoshi F. Aikawa ◽  
Sandro F. Perazzio ◽  
Carlos S. Gonçalves ◽  
Fausto E.L. Pereira
Keyword(s):  
Immune Modulation ◽  
Control Sample ◽  
Strongyloides Stercoralis ◽  
The Other ◽  
University Hospital ◽  
Ethanol Ingestion ◽  
Stool Examination ◽  
Positive Stool ◽  
Three Samples ◽  
The University

We report the results of a retrospective study on the frequency of intestinal nematodes among 198 alcoholic and 440 nonalcoholic patients at the University Hospital Cassiano Antonio Moraes in Vitória, ES, Brazil. The control sample included 194 nonalcoholic patients matched according to age, sex and neighborhood and a random sample of 296 adults admitted at the same hospital. Stool examination by sedimentation method (three samples) was performed in all patients. There was a significantly higher frequency of intestinal nematodes in alcoholics than in controls (35.3% and 19.2%, respectively), due to a higher frequency of Strongyloides stercoralis (21.7% and 4.1%, respectively). Disregarding this parasite, the frequency of the other nematodes was similar in both groups. The higher frequency of S. stercoralis infection in alcoholics could be explained by immune modulation and/or by some alteration in corticosteroid metabolism induced by chronic ethanol ingestion. Corticosteroid metabolites would mimic the worm ecdisteroids, that would in turn increase the fecundity of females in duodenum and survival of larvae. Consequently, the higher frequency of Strongyloides larvae in stool of alcoholics does not necessarily reflect an increased frequency of infection rate, but only an increased chance to present a positive stool examination using sedimentation methods.

scholarly journals Potential for the current National Healthcare Safety Network (NHSN) >3 days after admission definition of laboratory-identified, healthcare-facility–onset, Clostridioides difficile infection (HO-CDI) to overestimate rates

2020 ◽  
Vol 41 (4) ◽  
pp. 467-468
Author(s):  
Shruti Puri ◽  
Heather Y. Hughes ◽  
Monica D. McCrackin ◽  
Robert Williford ◽  
Mulugeta Gebregziabher ◽  
...  
Keyword(s):  
Healthcare Facility ◽  
National Healthcare ◽  
Clostridioides Difficile ◽  
National Healthcare Safety Network ◽  
Positive Stool ◽  
Clostridioides Difficile Infection ◽  
Stool Samples ◽  
Definition Of

AbstractHealthcare-facility–onset C.difficile LabID events are defined as positive stool samples collected >3 days after hospitalization. Using a definition of >72 hours, we found that 84 of 1013 cases (8.3%) identified as C. difficile LabID events were collected between 48 and 72 hours after admission.

scholarly journals A school outbreak of Norwalk-like virus: evidence for airborne transmission

2003 ◽  
Vol 131 (1) ◽  
pp. 727-736 ◽  
Author(s):  
P. J. MARKS ◽  
I. B. VIPOND ◽  
F. M. REGAN ◽  
K. WEDGWOOD ◽  
R. E. FEY ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Nucleotide Sequence Analysis ◽  
Chain Reaction ◽  
Epidemiological Features ◽  
Positive Stool ◽  
Viral Particles ◽  
Stool Samples ◽  
Polymerase Chain ◽  
The Times

An outbreak of gastroenteritis affected a school attended by children aged 4–11 years. Epidemiological features suggested this was due to Norwalk-like virus (NLV) and this was confirmed by polymerase chain reaction (PCR). Nucleotide sequence analysis of the PCR amplicons revealed identical strains in all five positive stool samples. Pupils were significantly more likely to become ill following an episode of vomiting within their classroom (adjusted odds ratio 4·1, 95% CI 1·8–9·3). The times from exposure to illness were consistent with direct infection from aerosolized viral particles where exposure to vomiting was high.Cleaning with quaternary ammonium preparations made no impact on the course of the outbreak. However, the outbreak stopped after the school closed for 4 days and was cleaned using chlorine-based agents. This study confirms the importance of vomiting in the transmission of NLV and provides evidence that direct infection with aerosolized viral particles occurs.

scholarly journals Genetic Relatedness of 5-Year Isolates of Clostridioides difficile Polymerase Chain Reaction Ribotype 017 Strains in a Hospital

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1229
Author(s):  
Jieun Kim ◽  
Mi-Ran Seo ◽  
Bongyoung Kim ◽  
Jinyeong Kim ◽  
Mi-Hyun Bae ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Antibiotic Resistance ◽  
Genetic Relatedness ◽  
Geometric Mean ◽  
The Other ◽  
Chain Reaction ◽  
Clostridioides Difficile ◽  
Polymerase Chain ◽  
Resistance Rates ◽  
Hospital Acquired

The objective of this study was to analyse the genetic relatedness of Clostridioides difficile polymerase chain reaction ribotype 017 (RT017) strains from patients with hospital-acquired C. difficile infection (HA-CDI) in a hospital with a high RT017 prevalence. From 2009 to 2013, 200 RT017 strains (26.8%) were collected from 745 HA-CDI patient isolates. They comprised 64 MLVA types, and 197 (98.5%) strains were genetically related to 5 clonal complexes (CCs). The largest cluster, CC-A, included 163 isolates of 40 MLVA types. CC-A accounted for 20% of RT017 strains in 2009 and sharply increased to 94.9% in 2010, 94% in 2011, 86.2% in 2012, and 73.5% in 2013. The other 4 CCs included 20 isolates with 7 MLVA types. The resistance rates of antimicrobials were as follows: clindamycin 100%, moxifloxacin 99%, rifaximin 88.5%, and vancomycin 1%. All isolates were susceptible to metronidazole and piperacillin/tazobactam. Comparing antibiotic resistance among CCs, the geometric mean of the minimum inhibitory concentrations of moxifloxacin, vancomycin, and piperacillin/tazobactam were significantly higher for CC-A isolates than for the other CCs. RT017 clones constantly evolved over the 5 years studied with regard to genetic relatedness. The levels of antibiotic resistance may contribute to the persistence of organisms in the institution.

scholarly journals Prevalence of Intestinal Opportunistic Parasites Infections among HIV Positive Children in the University Hospital Center Yalgado Ouédroago of Ouagadougou, Burkina Faso

2021 ◽  
Vol 10 (10) ◽  
pp. 550-557
Author(s):  
Traoré Roukiatou Zongo Cheikna ◽  
Zongo Oumarou Ouédraogo Ganamé Abasse ◽  
Zida Adama Yonaba Caroline ◽  
Traoré Yves Savadogo Aly
Keyword(s):  
Intestinal Parasites ◽  
Cross Sectional Study ◽  
Gastrointestinal Parasites ◽  
Sub Saharan Africa ◽  
University Hospital ◽  
Hiv Positive ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stool Samples ◽  
The University

In sub-Saharan Africa, Gastrointestinal parasites infections are widespread, particularly among immune deficient individuals. Prevalence of these infections varies from locality to other due to many factors. The present cross-sectional study aimed to assess the prevalence of intestinal parasites among HIV-positive children in the paediatric clinic at the University Hospital Yalgado Ouedraogo of Ouagadougou. A cross-sectional study was conducted in the University hospital of Ouagadougou from July to November 2015. Ninety-three (93) freshly issued stool samples were collected in HIV-positive children less than 15 years old. Stool samples were analysed for the presence of various intestinal parasites using direct microscopy, formol-ether concentration method, modified Ziehl Neelsen stain and Weber trichrome stain. The study included 93 HIV positive children. The prevalence of intestinal parasitic infection was 24.73% (23/93). The most detected parasites were Entamoeba coli (52.17% of total detected parasites), Trichomonas intestinalis (21.73%), Giardia intestinalis (8.65%), Entamoeba histolytica (4.34%). Patients with multi-infection (2 or 3 parasites) have been detected. The participants, 97.5% (89/93) were on cotrimoxazole prophylaxis and 81.76% (76/93) were on ARV therapy. Despite the medical care given to the HIV-infected children, the prevalence of opportunistic intestinal is high at the University hospital Yalgado Ouédraogo (CHU-YO)and deserves special attention.

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