Management of Clostridium Difficile: Case study and review of the basic tenets

2011 ◽  
Vol 9 (2) ◽  
Author(s):  
M Roberts ◽  
C Kiire
Keyword(s):  
Clostridium Difficile

scholarly journals Comparing the epidemiology of community- and hospital-associated Clostridium difficile infections in Northern Ireland, 2012–2016: a population data linkage and case–case study

2019 ◽  
Vol 147 ◽  
Author(s):  
A. Maisa ◽  
G. Ross ◽  
N.Q. Verlander ◽  
D. Fairley ◽  
D.T. Bradley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Gastric Acid ◽  
Care Home ◽  
Multivariable Analysis ◽  
Population Data ◽  
Population Based ◽  
Lower Odds ◽  
Community Onset

AbstractThe burden of community-associated Clostridium difficile infection (CA-CDI) has increased. We aimed to describe the epidemiology of CA-CDI to inform future interventions. We used population-based linked surveillance data from 2012 to 2016 to describe socio-demographic factors, ribotype and mortality for all CA (n = 1303) and hospital-associated (HA, n = 1356) CDI. For 483 community-onset (CO) CA-CDI and 287 COHA-CDI cases, a questionnaire on risk factors was completed and we conducted a case–case study using logistic regression models for univariate and multivariable analysis. CA-CDI cases had lower odds of being male (adjusted odds ratio (AOR) 0.71, 95% confidence interval (CI) 0.58–0.87; P < 0.001), and higher odds of living in rural rather than urban settlement (AOR 1.5, 95% CI 1.1–2.1; P = 0.05) compared with HA-CDI cases. The distribution of ribotypes was similar in both groups with RT078 being most prevalent. CDI-specific death was lower in CA-CDI than HA-CDI (7% vs. 11%, P < 0.001). COCA-CDI had lower odds of having had an outpatient appointment in the previous 4 weeks compared with COHA-CDI (AOR 0.61; 95% CI 0.41–0.9, P = 0.01) and lower odds of being in a care home or hospice when compared with their own home, than COHA-CDI (AOR 0.66; 95% CI 0.45–0.98 and AOR 0.35; 95% CI 0.13–0.92, P = 0.02). Exposure to gastric acid suppressants (50% in COCA-CDI and 55% in COHA-CDI) and antimicrobial therapy (18% in COCA-CDI and 20% in COHA-CDI) prior to CDI was similar. Our analysis of community-onset cases suggests that other risk factors for COHA-CDI may be equally important for COCA-CDI. Opportunities to safely reduce antibiotic and gastric acid suppressants use should be investigated in all healthcare settings.

scholarly journals Clinical Severity of Clostridium difficile PCR Ribotype 027: A Case-Case Study

PLoS ONE ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. e1812 ◽  
Author(s):  
Oliver W. Morgan ◽  
Boaventura Rodrigues ◽  
Tony Elston ◽  
Neville Q. Verlander ◽  
Derek F. J. Brown ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clinical Severity ◽  
Ribotype 027 ◽  
Pcr Ribotype 027

Morbidity and mortality associated with Clostridium difficile ribotype 078: a case–case study

2012 ◽  
Vol 82 (2) ◽  
pp. 125-128 ◽  
Author(s):  
L. Patterson ◽  
M.H. Wilcox ◽  
W.N. Fawley ◽  
N.Q. Verlander ◽  
L. Geoghegan ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Morbidity And Mortality ◽  
Ribotype 078

Lyophilised Full Spectrum Microbiota Capsules for Treatment of Severe Clostridium difficile Infection in 2 Patients in ICU: A Case Study

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S838
Author(s):  
Priya Maistry ◽  
Tae Jun Kim ◽  
Dean Yeh ◽  
Anoja W. Gunaratne ◽  
Annabel Clancy ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Full Spectrum ◽  
Severe Clostridium Difficile Infection

scholarly journals Predictive approaches to guide the expression of recombinant vaccine targets in Escherichia coli: a case study presentation utilising Absynth Biologics Ltd. proprietary Clostridium difficile vaccine antigens

2021 ◽  
Author(s):  
Hirra Hussain ◽  
Edward A McKenzie ◽  
Andrew M Robinson ◽  
Neill A Gingles ◽  
Fiona Marston ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Amino Acids ◽  
Clostridium Difficile ◽  
Recombinant Protein ◽  
Recombinant Protein Production ◽  
Protein Production ◽  
Expression Systems ◽  
Predictive Approaches ◽  
Bacterial Expression Systems

AbstractBacterial expression systems remain a widely used host for recombinant protein production. However, overexpression of recombinant target proteins in bacterial systems such as Escherichia coli can result in poor solubility and the formation of insoluble aggregates. As a consequence, numerous strategies or alternative engineering approaches have been employed to increase recombinant protein production. In this case study, we present the strategies used to increase the recombinant production and solubility of ‘difficult-to-express’ bacterial antigens, termed Ant2 and Ant3, from Absynth Biologics Ltd.’s Clostridium difficile vaccine programme. Single recombinant antigens (Ant2 and Ant3) and fusion proteins (Ant2-3 and Ant3-2) formed insoluble aggregates (inclusion bodies) when overexpressed in bacterial cells. Further, proteolytic cleavage of Ant2-3 was observed. Optimisation of culture conditions and changes to the construct design to include N-terminal solubility tags did not improve antigen solubility. However, screening of different buffer/additives showed that the addition of 1–15 mM dithiothreitol alone decreased the formation of insoluble aggregates and improved the stability of both Ant2 and Ant3. Structural models were generated for Ant2 and Ant3, and solubility-based prediction tools were employed to determine the role of hydrophobicity and charge on protein production. The results showed that a large non-polar region (containing hydrophobic amino acids) was detected on the surface of Ant2 structures, whereas positively charged regions (containing lysine and arginine amino acids) were observed for Ant3, both of which were associated with poor protein solubility. We present a guide of strategies and predictive approaches that aim to guide the construct design, prior to expression studies, to define and engineer sequences/structures that could lead to increased expression and stability of single and potentially multi-domain (or fusion) antigens in bacterial expression systems.

scholarly journals Toxic megacolon associated with Clostridium difficile infection: A case study

2016 ◽  
Vol 50 (3) ◽  
pp. 107-109 ◽  
Author(s):  
Ivana Rakovic ◽  
Andriana Bukonjic ◽  
Sara Petrovic ◽  
Sofija Sekulic ◽  
Aleksandra Ilic ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Toxic Megacolon

The Genesis and Internal Dynamics of El Salvador's People's Revolutionary Army, 1970–1976

2014 ◽  
Vol 38 (01) ◽  
pp. 102-129
Author(s):  
ALBERTO MARTÍN ÁLVAREZ ◽  
EUDALD CORTINA ORERO
Keyword(s):  
Latin America ◽  
El Salvador ◽  
Early Years ◽  
Left Wing ◽  
Internal Dynamics ◽  
Internal Coherence ◽  
The 1960S

AbstractUsing interviews with former militants and previously unpublished documents, this article traces the genesis and internal dynamics of the Ejército Revolucionario del Pueblo (People's Revolutionary Army, ERP) in El Salvador during the early years of its existence (1970–6). This period was marked by the inability of the ERP to maintain internal coherence or any consensus on revolutionary strategy, which led to a series of splits and internal fights over control of the organisation. The evidence marshalled in this case study sheds new light on the origins of the armed Salvadorean Left and thus contributes to a wider understanding of the processes of formation and internal dynamics of armed left-wing groups that emerged from the 1960s onwards in Latin America.

Culture and the plasticity of perception

2020 ◽  
Vol 43 ◽  
Author(s):  
Michael Lifshitz ◽  
T. M. Luhrmann
Keyword(s):  
Cultural Context ◽  
Sensory Experience ◽  
Cultural Learning ◽  
The World

Abstract Culture shapes our basic sensory experience of the world. This is particularly striking in the study of religion and psychosis, where we and others have shown that cultural context determines both the structure and content of hallucination-like events. The cultural shaping of hallucinations may provide a rich case-study for linking cultural learning with emerging prediction-based models of perception.

Dual systems for all: Higher-order, role-based relational reasoning as a uniquely derived feature of human cognition

2019 ◽  
Vol 42 ◽  
Author(s):  
Daniel J. Povinelli ◽  
Gabrielle C. Glorioso ◽  
Shannon L. Kuznar ◽  
Mateja Pavlic
Keyword(s):  
Temporal Reasoning ◽  
Higher Order ◽  
Important Case ◽  
Human Cognition ◽  
Relational Reasoning ◽  
Dual Systems ◽  
First Order ◽  
Reasoning System ◽  
Role Based

Abstract Hoerl and McCormack demonstrate that although animals possess a sophisticated temporal updating system, there is no evidence that they also possess a temporal reasoning system. This important case study is directly related to the broader claim that although animals are manifestly capable of first-order (perceptually-based) relational reasoning, they lack the capacity for higher-order, role-based relational reasoning. We argue this distinction applies to all domains of cognition.

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