Review
Medicine, General & Internal
Ibrahim A. Al-Zahrani
Summary: Clostridioides difficile (C. difficile) infection is a global threat to many healthcare settings. Excessive use of antimicrobials, lack of optimal antibiotic policies, and suboptimal infection control practices have fueled the development of this health issue. Prudent use of antimicrobials and simple infection control measures can significantly reduce infection rates.
SAUDI MEDICAL JOURNAL
(2023)
Article
Cell Biology
Qiwen Dong, Huaiying Lin, Marie-Maude Allen, Julian R. Garneau, Jonathan K. Sia, Rita C. Smith, Fidel Haro, Tracy McMillen, Rosemary L. Pope, Carolyn Metcalfe, Victoria Burgo, Che Woodson, Nicholas Dylla, Claire Kohout, Anitha Sundararajan, Evan S. Snitkin, Vincent B. Young, Louis-Charles Fortier, Mini Kamboj, Eric G. Pamer
Summary: Clostridioides difficile strains of different virulence levels contribute to varying severity of colitis. This study found that a natural deletion in the cdtR gene attenuates virulence in epidemic ST1 C. difficile isolates without affecting colonization. Distinguishing strains based on the presence of cdtR may improve the specificity of diagnostic tests for C. difficile colitis.
Article
Microbiology
Katarina Curova, Martin Novotny, Lubos Ambro, Anna Kamlarova, Viera Lovayova, Vladimir Hrabovsky, Leonard Siegfried, Pavol Jarcuska, Peter Jarcuska, Annamaria Toporova
Summary: Dysbiosis of gut microbiota caused by antibiotics is crucial in the formation of Clostridioides difficile (CD). Toxin-producing strains play a role in the pathogenesis of Clostridioides difficile infection (CDI), a common hospital-acquired infection. Through molecular methods, 84 C. difficile isolates from stool samples of suspected CDI patients in a Slovakian hospital were characterized. The majority of CD isolates carried genes encoding toxins A and B and a significant proportion were positive for the binary toxin. Specific ribotypes were identified, indicating local CDI outbreaks. Previous antibiotic use was found to be a significant risk factor for CDI development in patients over 65.
Article
Multidisciplinary Sciences
Jieun Kim, Bongyoung Kim, Hyunjoo Pai
Summary: The objective of this study was to determine the trend and diversity of binary toxin-positive Clostridioides difficile over 10 years in Korea. Among the 3278 isolates in 2009-2018, 58 possessed binary toxin genes, with the proportion of CDT-positive isolates increasing over the 10-year period. Thirteen sequence types were identified, with ST1 strains showing resistance to several antibiotics.
SCIENTIFIC REPORTS
(2023)
Review
Multidisciplinary Sciences
Tebelay Dilnessa, Alem Getaneh, Workagegnehu Hailu, Feleke Moges, Baye Gelaw
Summary: A high prevalence of C. difficile was observed among hospitalized patients, emphasizing the need for attention and prevention. The resistance of C. difficile to metronidazole and vancomycin was lower compared to other antibiotics.
Article
Infectious Diseases
Elena Novakova, Zuzana Stofkova, Vladimira Sadlonova, Lukas Hleba
Summary: This study analyzed the phenotypic and genotypic characteristics of C. difficile isolates from patients with CDI in Slovakia, revealing a high prevalence of RT176 and 001.
Article
Immunology
Jen-Chieh Lee, Yuan -Pin Hung, Bo -Yang Tsai, Pei -Jane Tsai, Wen -Chien Ko
Summary: Severe CDIs in the ICU were not rare in this study. The ileus group tended to have more severe presentation, with severe and fulminant CDIs accounting for 65.2% and an ICU mortality rate of 39.1%. Clinicians should be aware of abdominal symptoms and signs other than diarrhea, such as ileus, for timely diagnosis and management of CDI.
JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION
(2021)
Article
Infectious Diseases
Jieun Kim, Mi-Ran Seo, Bongyoung Kim, Jinyeong Kim, Mi-Hyun Bae, Hyunjoo Pai
Summary: This study aimed to analyze the genetic relatedness of Clostridioides difficile RT017 strains in a hospital with high prevalence. The majority of the strains were genetically related to CC-A, indicating the transmission and evolution of RT017 strains within the hospital. Variations in antibiotic resistance rates were observed among different CCs, suggesting significant differences in resistance profiles.
Article
Infectious Diseases
Papanin Putsathit, Stacey Hong, Narelle George, Christine Hemphill, Peter G. Huntington, Tony M. Korman, Despina Kotsanas, Monica Lahra, Rodney McDougall, Andrew McGlinchey, Casey Moore, Graeme R. Nimmo, Louise Prendergast, Jennifer Robson, Lynette Waring, Michael C. Wehrhahn, Gerhard F. Weldhagen, Richard M. Wilson, Thomas Riley, Daniel R. Knight
Summary: The study found that the majority of C. difficile isolated in Australia showed susceptibility to the recommended antimicrobials for treating CDI, with low resistance to carbapenems and fluoroquinolones, and rare multidrug resistance. However, resistance to clindamycin was common, with one fluoroquinolone-resistant ribotype 027 strain detected.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2021)
Review
Infectious Diseases
Ishani Wickramage, Patrizia Spigaglia, Xingmin Sun
Summary: Clostridioides difficile (CD) is a major concern as one of the top five antibiotic resistance threats in the USA, with a global increase in multidrug resistance and emergence of more virulent strains. Understanding the evolving antibiotic resistance mechanisms of CD is crucial for guiding antibiotic stewardship policies and developing new therapeutic targets. Epidemiological surveillance and strain-specific characteristics are key in combating the spread of resistance genes among different CD strains.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2021)
Article
Infectious Diseases
Monika Kabala, Zygmunt Gofron, Malgorzata Aptekorz, Krzysztof Sacha, Celine Harmanus, Ed Kuijper, Gayane Martirosian
Summary: The study aimed to investigate an outbreak of Clostridioides difficile with rifampicin resistance in a Polish tertiary care hospital. Analysis revealed widespread resistance to imipenem and rifampicin among isolates, likely due to neglect of hygienic procedures. MLVA analysis confirmed transmission and outbreak of multidrug-resistant C. difficile strains in Southern Poland, highlighting the need for further research.
INFECTION AND DRUG RESISTANCE
(2021)
Article
Microbiology
Malgorzata Aptekorz, Krzysztof Sacha, Zygmunt Gofron, Monika Kabala, Celine Harmanus, Ed Kuijper, Gayane Martirosian
Summary: This study aimed to analyze the antibiotic susceptibility of C. difficile isolates from patients in Silesia, Poland. The results showed a high prevalence of multidrug-resistant MRT 027/176 C. difficile strains in the region, emphasizing the importance of enhancing regional infection control and antibiotic stewardship.
Article
Multidisciplinary Sciences
Amanda Nadia Diniz, Loren Nery Fontoura Moura, Diogo Soares Goncalves Cruz, Carlos Augusto Oliveira Junior, Henrique Cesar Pereira Figueiredo, Joao Luis Reis Cunha, Eduardo Garcia Vilela, Edward J. Kuijper, Mark H. Wilcox, Francisco Carlos Faria Lobato, Rodrigo Otavio Silveira Silva
Summary: Clostridioides difficile infection (CDI) is a global healthcare problem, and new strains continue to emerge. This study characterized three novel Brazilian clade 2 strains of C. difficile and conducted a two-year survey in animals and humans. The results suggest that these new clade 2 strains have virulence potential and continue to emerge in Brazil.
Article
Pediatrics
Ryan M. Hanson, Amy J. Wagner
Summary: Severe, complicated Clostridium difficile colitis is rare in pediatric patients and little is known about its medical and surgical management in this population. A case report of a 15-year-old female patient with severe, complicated C difficile colitis successfully treated with diverting loop ileostomy and colonic lavage is presented. This approach, instead of subtotal colectomy and end ileostomy, should be considered as an alternative for pediatric patients with severe, complicated C difficile colitis.
Review
Public, Environmental & Occupational Health
Peng An Khun, Thomas V. Riley
Summary: This review provides an overview of Clostridium difficile infection (CDI) in southeast Asia, including its prevalence, detection methods, antimicrobial susceptibility profiles, and the potential significance of a One Health approach. CDI is a common cause of hospital-acquired gastroenteritis worldwide, with higher rates observed in high-income countries. Lack of knowledge and awareness about CDI, along with antimicrobial abuse and inadequate education on appropriate usage, contribute to its evolution. Underreporting of CDI rates and misuse of antimicrobial agents pose a significant threat in regions like Indochina, while C. difficile RT 017 strain is endemic in southeast Asia.
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
(2022)
Review
Infectious Diseases
Sajad Yaghoubi, Angelina Olegovna Zekiy, Marcela Krutova, Mehrdad Gholami, Ebrahim Kouhsari, Mohammad Sholeh, Zahra Ghafouri, Farajolah Maleki
Summary: Tigecycline is a unique semisynthetic antimicrobial agent developed to treat polymicrobial infections caused by multidrug-resistant pathogens. By adding a glycyclamide moiety to the structure of minocycline, tigecycline is able to bypass tetracycline resistance mechanisms. It is currently approved for complicated skin infections, intra-abdominal infections, and community-acquired bacterial pneumonia in adults.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2022)
Review
Infectious Diseases
Eva Smelikova, Jan Tkadlec, Marcela Krutova
Summary: This article discusses the methods for screening mcr-mediated resistance to colistin, emphasizing the importance of rapid tests and broth microdilution for confirmation of resistance. Active targeted screening is necessary for monitoring mcr-mediated colistin resistance.
CLINICAL MICROBIOLOGY AND INFECTION
(2022)
Article
Microbiology
Pawel Karpinski, Dorota Wultanska, Michal Piotrowski, Marie Brajerova, Agnieszka Mikucka, Hanna Pituch, Marcela Krutova
Summary: The motility and genotype of flagellin fliC and fliD genes were investigated in 82 C. difficile isolates, with RT023 showing the highest motility similar to hypervirulent RT027 and its genetic relative RT176.
Review
Gastroenterology & Hepatology
Manu P. Bilsen, Merel M. C. Lambregts, Joffrey van Prehn, Ed J. Kuijper
Summary: Recent studies have shown some effectiveness of fecal microbiota transplantation (FMT) for decolonization of multidrug-resistant organisms (MDRO), but questions remain regarding its true efficacy, optimal route of administration, role of antibiotics pre and post-FMT, and efficacy in different patient populations. Further research is needed to explore the observed decrease in MDRO infections post-FMT.
CURRENT OPINION IN GASTROENTEROLOGY
(2022)
Review
Public, Environmental & Occupational Health
Cornelis Adrianus De Pijper, Jenny Lea Schnyder, Cornelis Stijnis, Abraham Goorhuis, Martin Peter Grobusch
Summary: Severe thrombocytopenia is a rare but life-threatening complication of ZVI, with immune-induced thrombocytopenia as the main pathophysiological mechanism. Further research is needed to determine the optimal treatment strategy for this complication due to a lack of cases.
TRAVEL MEDICINE AND INFECTIOUS DISEASE
(2022)
Review
Microbiology
Ebrahim Kouhsari, Nourkhoda Sadeghifard, Arezoo Khadiv, Hojjat Sayadi, Taghi Amiriani, Sobhan Ghafourian, Hassan Valadbeigi, Marcela Krutova
Summary: This meta-analysis provides comprehensive data on the prevalence of metronidazole and clarithromycin heteroresistance in H. pylori positive samples. The study finds that approximately 7% of samples show heteroresistance to clarithromycin, and approximately 14% show heteroresistance to metronidazole.
ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS
(2022)
Article
Microbiology
Alois Cizek, Martina Masarikova, Jan Mares, Marie Brajerova, Marcela Krutova
Summary: A diverse spectrum of C. difficile strains was found in wastewater and surface water. Interestingly, a recently discovered plasmid-mediated resistance to metronidazole was detected in C. difficile from river water.
MICROBIOLOGY SPECTRUM
(2022)
Article
Infectious Diseases
Marcela Krutova, Marie Brajerova, Zdenek Kepka, Ales Briksi, Petr Hubacek, Pavel Drevinek
Summary: This study evaluated the analytical performance of an automated antigen assay in a population of community-dwelling subjects with mild respiratory symptoms or being asymptomatic, and compared its sensitivity in Delta- and Omicron-variant positive samples. The results showed that the antigen test had an overall sensitivity of 77.9% in prospective samples, with higher sensitivity observed in Omicron-variant samples.
INFLUENZA AND OTHER RESPIRATORY VIRUSES
(2022)
Review
Infectious Diseases
Marcela Krutova, Mark Wilcox, Ed Kuijper
Summary: The recommendations for the treatment of Clostridioides difficile infection (CDI) have been updated recently. The drug of choice for CDI treatment should not only possess clinical efficacy, but also exhibit optimal antimicrobial stewardship by restoring the gut microbiota quickly to minimize the risk of infection relapses. Metronidazole, the current treatment option, has low concentration in stool and reduced antimicrobial bioactivity due to interactions with fecal microbiota. Elevated minimum inhibitory concentrations of metronidazole in epidemic C. difficile ribotypes and the emergence of resistance pose potential risks for treatment failure. Oral vancomycin and fidaxomicin, on the other hand, reach high concentrations in the stool and can effectively reduce C. difficile shedding. Facilities with higher CDI incidence and/or occurrence of epidemic ribotypes should avoid using metronidazole to prevent prolonged shedding and further transmission. Fidaxomicin, with its narrow spectrum of antimicrobial activity and persistence on spores, is the preferred option to reduce recurrent CDI rates.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Microbiology
Jan Tkadlec, Anh Vu Le, Marie Brajerova, Anna Soltesova, Jozef Marcisin, Pavel Drevinek, Marcela Krutova
Summary: The epidemiology of MRSA is characterized by the rise and fall of epidemic clones. This study aimed to gain data on the current epidemiology of MRSA in Slovakia, and it identified the presence of epidemic HA-MRSA clones and the emergence of the global epidemic USA300 CA-MRSA clone. The extensive spread of the USA300 clone in Slovakia is a significant finding.
MICROBIOLOGY SPECTRUM
(2023)
Article
Microbiology
Ishani Wickramage, Zhong Peng, Soumyadeep Chakraborty, Celine Harmanus, Ed J. Kuijper, Sally Alrabaa, Wiep Klaas Smits, Xingmin Sun
Summary: Clostridioides difficile has a complex relationship with antibiotics, as they can both increase the risk of infection and be the primary treatment for C. difficile infection (CDI). This study identified two clinical isolates of C. difficile with elevated resistance to vancomycin and rifaximin, as well as mutations related to resistance. The findings highlight the importance of surveillance in understanding antibiotic resistance and developing effective treatment strategies.
MICROBIOLOGY SPECTRUM
(2023)
Article
Infectious Diseases
Adriana Plankaova, Marie Brajerova, Vaclav Capek, Gabriela Balikova Novotna, Pete Kinross, Jana Skalova, Anna Soltesova, Pavel Drevinek, Marcela Krutova
Summary: This study investigated the epidemiology of Clostridioides difficile infection (CDI) in Slovakian hospitals after the emergence of ribotype 176 (027-like) in 2016. The results showed that the newly-predominant RT176 and endemic RT001 are driving the epidemiology of CDI in Slovakia. The use of fluoroquinolones and macrolide-lincosamide-streptogramin B antibiotics contributes to the spread of these epidemic lineages.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2023)
Letter
Microbiology
Jan Tkadlec, Jana Prasilova, Pavel Drevinek
MICROBIOLOGY SPECTRUM
(2023)
Article
Microbiology
P. M. C. Klein Klouwenberg, W. van der Kuil, A. J. van Griethuysen, M. Hendriks, E. J. Kuijper, D. W. Notermans, A. F. Schoffelen, ISIS AR Study Grp
Summary: Using data from the Dutch national surveillance system for antimicrobial resistance, this study found discrepancies in minimum inhibitory concentrations of aminoglycosides measured by the automated testing systems VITEK2 and Phoenix. The Phoenix system showed higher MICs and an annual increase in resistance for certain species. These findings have implications for the clinical treatment of sepsis patients.
MICROBIOLOGY SPECTRUM
(2023)
Article
Health Care Sciences & Services
Karuna E. W. Vendrik, Amoe Baktash, Jelle J. Goeman, Celine Harmanus, Daan W. Notermans, Sabine C. de Greeff, Ed J. Kuijper
Summary: This study found a higher proportion of severe CDI cases during the second wave of COVID-19, which was partially caused by delayed diagnostics possibly due to decreased patient visits or restricted hospital referral.
LANCET REGIONAL HEALTH-EUROPE
(2022)
