Article
Immunology
Malin Inghammar, Henrik Svanstrom, Marianne Voldstedlund, Mads Melbye, Anders Hviid, Kare Molbak, Bjorn Pasternak
Summary: In a nationwide study among adults in Denmark, it was found that the use of PPIs is associated with a moderately increased risk of community-associated Clostridium difficile infection. The elevated risk remained up to 1 year after the end of PPI treatment.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Microbiology
Jimmy Zhang, Ling Chen, Angela Gomez-Simmonds, Michael T. T. Yin, Daniel E. Freedberg
Summary: This retrospective cohort study explored the association between antibiotic exposure and community-acquired Clostridioides difficile infection (CA-CDI). The study found that the relative risks associated with different antibiotics may vary over time, and the absolute risks have not been clearly established. Clindamycin, cefdinir, cefuroxime, and fluoroquinolones had the highest risks for CA-CDI compared to doxycycline. Nitrofurantoin was also associated with CA-CDI in older patients with elevated baseline risk. These findings can guide antibiotic selection and future stewardship efforts.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Review
Immunology
Ying Luo, Sumei Zhang, Hua Shang, Weitong Cui, Qinglu Wang, Bin Zhu
Summary: Hematopoietic stem cell transplant recipients are susceptible to Clostridium difficile infection. A meta-analysis of relevant studies found an overall CDI prevalence of 13.2% in HSCT patients, with higher rates among allogeneic transplantation recipients compared to autologous HSCT recipients. The incidence rates of CDI varied worldwide, with North America having higher rates than Europe but no significant difference with Asia. PCR-diagnosed CDI had a significantly higher prevalence than enzyme immunoassay-diagnosed CDI. CDI was a common complication among HSCT recipients, with recurrence and severe cases observed.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Immunology
Aaron C. Miller, Alan T. Arakkal, Daniel K. Sewell, Alberto M. Segre, Joseph Tholany, Philip M. Polgreen, CDC MInD Healthcare Grp
Summary: This study evaluated the risk of CDI (Clostridioides difficile infection) associated with different types of antibiotics using a large database. Results showed that clindamycin and later-generation cephalosporins had the highest risk, while minocycline and doxycycline had the lowest risk. These findings are important for informing antibiotic prescribing decisions and stewardship efforts.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Review
Public, Environmental & Occupational Health
Scott Anjewierden, Zheyi Han, Adam M. Brown, Curtis J. Donskey, Abhishek Deshpande
Summary: This meta-analysis identified risk factors for asymptomatic Clostridioides difficile colonization, including previous hospitalization, gastric acid suppression, tube feeding, and corticosteroid use. Recognition of these risk factors may help in early identification of carriers and reducing transmission.
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
(2021)
Article
Surgery
Alexis Hess, Saskya Byerly, Emily Lenart, Cory Evans, Andrew Kerwin, Dina Filiberto
Summary: This study aimed to identify predictors of Clostridium Difficile Infection (CDI) in general surgery patients. Patients who underwent general surgery operations were analyzed, and it was found that older age, emergent operation, increased time to operation, infections at surgical sites, deep organ space infections, steroid use, metastatic cancer, smoking, and decreased body mass index (BMI) were independent predictors of CDI.
AMERICAN JOURNAL OF SURGERY
(2023)
Article
Gastroenterology & Hepatology
Anqi Jin, Tony Chien, Qiwen Huang, Pragati Kenkare, Mai Vu, Sandra Wilson, Edward S. Huang
Summary: The study found that cholecystectomy is associated with a slightly increased risk of incident CDI, but this effect is not influenced by the use of proton pump inhibitors, antibiotics, or hospitalization.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Article
Public, Environmental & Occupational Health
Junji Shiode, Masakuni Fujii, Junichiro Nasu, Mamoru Itoh, Shuhei Ishiyama, Akiko Fujiwara, Masao Yoshioka
Summary: A study investigated the changes in HO-CDI incidence after relocation to a new hospital and found a reduction in CO-CDI incidence associated with the move. Environmental improvements may have decreased the reservoir of C. difficile, leading to a decrease in asymptomatic carriers and CO-CDI patients.
AMERICAN JOURNAL OF INFECTION CONTROL
(2022)
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
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
Biochemistry & Molecular Biology
Tadakuni Monma, Junichi Iwamoto, Akira Honda, Hajime Ueda, Fumio Kakizaki, Shoichiro Yara, Teruo Miyazaki, Tadashi Ikegami
Summary: The ratio of secondary bile acids in serum can serve as a biomarker for predicting susceptibility to Clostridium difficile infection, with levels below a certain threshold indicating a higher risk of CDI.
Article
Medicine, General & Internal
Karen Kong, Sara S. Soliman, Rolando H. Rolandelli, Matthew J. Elander, Joseph Flanagan, Daniel Hakakian, Zoltan H. Nemeth
Summary: Patients who undergo surgical procedures involving the removal of the ileum are at a higher risk of developing CDI. Utilizing preoperative oral antibiotics in part of bowel preparation may help reduce this risk, in addition to maintaining hygienic measures and providing attentive care for these patients.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Microbiology
Vanessa Lang, Katrin Gunka, Jan Rudolf Ortlepp, Ortrud Zimmermann, Uwe Gross
Summary: Nosocomial infections with Clostridioides difficile have emerged as a serious health threat. This study aimed to identify risk factors for C. difficile infection beyond the well-known factors. It found that regular consumption of proton pump inhibitors, low vegetable intake, and the use of the diuretic agent torasemid were additional risk factors for CDI.
FRONTIERS IN MICROBIOLOGY
(2022)
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)
Review
Public, Environmental & Occupational Health
N. Dong, Z. R. Li, P. Qin, C. X. Qiang, J. Yang, Y. N. Niu, X. R. Niu, X. X. Liu, W. G. Wang, B. J. Wen, Z. R. Ouyang, Y. L. Zhang, M. Zhao, J. Y. R. Li, J. H. Zhao
Summary: The study systematically reviewed the risk factors for CDI in children, including prior antibiotic exposure, prolonged hospitalization, history of hospitalization, etc., providing important evidence for the prevention of C. difficile-associated diarrhoea in children.
JOURNAL OF HOSPITAL INFECTION
(2022)
Letter
Geriatrics & Gerontology
Rachel D. Savage, Paula A. Rochon, Yingbo Na, Rachel Strauss, Kevin A. Brown, Andrew P. Costa, Sudeep Gill, Jennie Johnstone, Peter Tanuseputro, Nathan M. Stall, Pat Armstrong
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Public, Environmental & Occupational Health
Herbert Sagbo, Paulin Kpodji, Tchaa Abalo Bakai, Nagham Khanafer
Summary: This study examines the differences in breakfast eating, fruit and vegetable consumption, and physical activity among primary schoolchildren in Benin according to socio-economic determinants. The findings suggest that children of educated parents have a higher probability of regular breakfast and fruit consumption. Higher socio-economic status is associated with higher fruit intake and lower physical activity.
INTERNATIONAL HEALTH
(2023)
Article
Immunology
Nick Daneman, Samantha Lee, Heming Bai, Chaim M. Bell, Susan E. Bronskill, Michael A. Campitelli, Gail Dobell, Longdi Fu, Gary Garber, Noah Ivers, Matthew Kumar, Jonathan M. C. Lam, Bradley Langford, Celia Laur, Andrew M. Morris, Cara L. Mulhall, Ruxandra Pinto, Farah E. Saxena, Kevin L. Schwartz, Kevin A. Brown
Summary: In this randomized controlled trial, enhanced email nudging strategies were found to modestly improve the opening of antibiotic audit and feedback reports among physicians.
OPEN FORUM INFECTIOUS DISEASES
(2022)
Article
Infectious Diseases
Kwadwo Mponponsuo, Kevin A. Brown, Daniel J. Fridman, Jennie Johnstone, Bradley J. Langford, Samantha M. Lee, Derek R. MacFadden, Samir N. Patel, Kevin L. Schwartz, Nick Daneman
Summary: In this study, the clinical outcomes of highly bioavailable oral antibiotics were compared with less-bioavailable options in patients with gram-negative bloodstream infections. The results showed that patients who received highly bioavailable antibiotics had significantly better clinical outcomes compared to those who received less-bioavailable options.
CLINICAL MICROBIOLOGY AND INFECTION
(2023)
Article
Public, Environmental & Occupational Health
Shilo H. McBurney, Jeffrey C. Kwong, Kevin A. Brown, Frank Rudzicz, Branson Chen, Elisa Candido, Natasha S. Crowcroft
Summary: The study aimed to develop a reference standard for pertussis validation studies that provides adequate analytic precision and minimizes bias. A stratified sampling strategy was used to build the reference standard from a primary care electronic medical record cohort. The results showed moderate to substantial abstraction reliability. This approach can be used to conduct validation studies for pertussis and other low prevalence diseases, mitigating bias and incorporating a range of case severities.
ANNALS OF EPIDEMIOLOGY
(2023)
Article
Medicine, General & Internal
Nick Daneman, Daniel Fridman, Jennie Johnstone, Bradley J. Langford, Samantha M. Lee, Derek M. MacFadden, Kwadwo Mponponsuo, Samir N. Patel, Kevin L. Schwartz, Kevin A. Brown
Summary: This study investigated patients with E.coli bloodstream infections in Ontario, Canada from 2017 to 2020, and found that resistance to multiple antibiotics is associated with a significant increase in mortality risk among patients.
Article
Medicine, General & Internal
Kevin L. Schwartz, Jun Wang, Mina Tadrous, Bradley J. Langford, Nick Daneman, Valerie Leung, Tara Gomes, Lindsay Friedman, Peter Daley, Kevin A. Brown
Summary: A randomized controlled trial conducted before the emergence of the Omicron variant found that nirmatrelvir-ritonavir was effective in preventing severe COVID-19. A population-based cohort study conducted in Ontario further confirmed the effectiveness of nirmatrelvir-ritonavir in reducing hospital admission and death from COVID-19, even with the prevalence of the Omicron variant.
CANADIAN MEDICAL ASSOCIATION JOURNAL
(2023)
Article
Immunology
Derek R. MacFadden, Colleen Maxwell, Dawn Bowdish, Susan Bronskill, James Brooks, Kevin Brown, Lori L. Burrows, Anna Clarke, Bradley Langford, Elizabeth Leung, Valerie Leung, Doug Manuel, Allison McGeer, Sharmistha Mishra, Andrew M. Morris, Caroline Nott, Sumit Raybardhan, Mia Sapin, Kevin L. Schwartz, Miranda So, Jean-Paul R. Soucy, Nick Daneman
Summary: Antibiotic use is common among patients diagnosed with SARS-CoV-2. However, those who have completed the primary COVID-19 vaccination series have significantly reduced antibiotic use.
CLINICAL INFECTIOUS DISEASES
(2023)
Letter
Medicine, General & Internal
Jonathan S. Zipursky, Kevin A. Brown, Sara Khan, Eyal Cohen, Jacqueline Burke, Emily Austin, Nathan M. Stall
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Multidisciplinary Sciences
Ramandip Grewal, Lena Nguyen, Sarah A. Buchan, Sarah E. Wilson, Sharifa Nasreen, Peter C. Austin, Kevin A. Brown, Deshayne B. Fell, Jonathan B. Gubbay, Kevin L. Schwartz, Mina Tadrous, Kumanan Wilson, Jeffrey C. Kwong
Summary: This study investigates the protection provided by mRNA COVID-19 vaccine booster doses against Omicron-associated severe disease in adults aged 50 and older. The authors use data from Ontario, Canada, and find that booster doses provide strong protection but that it declined during the period of BA.4/BA.5 predominance.
NATURE COMMUNICATIONS
(2023)
Article
Medicine, General & Internal
Sarah C. J. Jorgensen, Alejandro Hernandez, Deshayne B. Fell, Peter C. Austin, Rohan D'Souza, Astrid Guttmann, Kevin A. Brown, Sarah A. Buchan, Jonathan B. Gubbay, Sharifa Nasreen, Kevin L. Schwartz, Mina Tadrous, Kumanan Wilson, Jeffrey C. Kwong
Summary: This study aimed to assess the effectiveness of maternal mRNA covid-19 vaccination during pregnancy against Delta and Omicron SARS-CoV-2 infection and hospital admission in infants. The results showed that maternal vaccination with two doses during pregnancy provided high protection against Delta and moderate protection against Omicron infection and hospital admission in infants, with the third trimester and third dose being the most effective. The effectiveness of two doses decreased as infants age beyond eight weeks.
BMJ-BRITISH MEDICAL JOURNAL
(2023)
Article
Medicine, General & Internal
Rob Daniels, Juliette Cottin, Nagham Khanafer
Summary: This study evaluates the impact of point-of-care testing (POCT) strategy on maintaining elective surgeries and simplifying appointment processes. The results show that POCT significantly improves flow management and is well-accepted by both patients and providers.
Letter
Medicine, General & Internal
Nisha Thampi, Kevin L. Schwartz, Michelle Science, Kevin A. Brown
Article
Geriatrics & Gerontology
Pamela Leece, Michael Whelan, Andrew P. Costa, Nick Daneman, Jennie Johnstone, Allison McGeer, Paula Rochon, Kevin L. Schwartz, Kevin A. Brown
Summary: Studies conducted before the COVID-19 pandemic have found that crowding in nursing homes is associated with higher incidence of respiratory infections and mortality. This association is consistent across various respiratory pathogens. Decreasing crowding is important for resident wellbeing and reducing the transmission of respiratory pathogens.
LANCET HEALTHY LONGEVITY
(2023)
Article
Microbiology
Matt Driedger, Nick Daneman, Kevin Brown, Wayne L. Gold, Sarah C. J. Jorgensen, Colleen Maxwell, Kevin L. Schwartz, Andrew M. Morris, Deva Thiruchelvam, Bradley Langford, Elizabeth Leung, Derek Macfadden, Ahmed Babiker
Summary: The COVID-19 pandemic has impacted the detection and incidence of bloodstream infections. Blood culture ordering increased in hospitals, while community-acquired and LTC-acquired BSIs decreased. There was an increase in the proportion of blood culture contaminants in the community and LTC settings. The incidence of community-acquired Streptococcus pneumoniae and Staphylococcus aureus bacteremia decreased.
MICROBIOLOGY SPECTRUM
(2023)