A mouse model of Clostridium difficile-associated disease.

Recurrent Clostridium difficile infection: A review of risk factors, treatments, and outcomes

A new, hypervirulent strain of Clostridium difficile, called NAP1/BI/027, has been implicated in C. difficile outbreaks associated with increased morbidity and mortality since the early 2000s. The epidemic strain is resistant to fluoroquinolones in vitro, which was infrequent prior to 2001. The name of this strain reflects its characteristics, demonstrated by different typing methods: pulsed-field gel electrophoresis (NAP1), restriction endonuclease analysis (BI) and polymerase chain reaction (027). In 2004 and 2005, the US Centers for Disease Control and Prevention (CDC) emphasized that the risk of C. difficile-associated diarrhea (CDAD) is increased, not only by the usual factors, including antibiotic exposure, but also gastrointestinal surgery/manipulation, prolonged length of stay in a healthcare setting, serious underlying illness, immune-compromising conditions, and aging. Patients on proton pump inhibitors (PPIs) have an elevated risk, as do peripartum women and heart transplant recipients. Before 2002, toxic megacolon in C. difficile-associated colitis (CDAC), was rare, but its incidence has increased dramatically. Up to two-thirds of hospitalized patients may be infected with C. difficile. Asymptomatic carriers admitted to healthcare facilities can transmit the organism to other susceptible patients, thereby becoming vectors. Fulminant colitis is reported more frequently during outbreaks of C. difficile infection in patients with inflammatory bowel disease (IBD). C. difficile infection with IBD carries a higher mortality than without underlying IBD. This article reviews the latest information on C. difficile infection, including presentation, vulnerable hosts and choice of antibiotics, alternative therapies, and probiotics and immunotherapy. We review contact precautions for patients with known or suspected C. difficile-associated disease. Healthcare institutions require accurate and rapid diagnosis for early detection of possible outbreaks, to initiate specific therapy and implement effective control measures. A comprehensive C. difficile infection control management rapid response team (RRT) is recommended for each health care facility. A communication network between RRTs is recommended, in coordination with each country’s department of health. Our aim is to convey a comprehensive source of information and to guide healthcare professionals in the difficult decisions that they face when caring for these oftentimes very ill patients.

Clostridium difficile associated infection, diarrhea and colitis.

The toxin-producing bacterium C difficile is the leading cause of antibiotic-associated colitis, with an estimated 500,000 cases C difficile infection (CDI) each year in the US with a cost approaching 3 billion dollars Despite the significance of CDI, the pathogenesis of this infection is still being defined The recent development of tractable murine models of CDI will help define the determinants of C difficile pathogenesis in vivo To determine if cefoperazone-treated mice could be utilized to reveal differential pathogenicity of C difficile strains, 5-8 week old C57BL/6 mice were pretreated with a 10 d course of cefoperazone administered in the drinking water Following a 2-d recovery period without antibiotics, the animals were orally challenged with C difficile strains chosen to represent the potential range of virulence of this organism from rapidly fatal to nonpathogenic Animals were monitored for loss of weight and clinical signs of colitis At the time of harvest, C difficile strains were isolated from cecal contents and the severity of colitis was determined by histopathologic examination of the cecum and colon Cefoperazone treated mice challenged with C difficile strains VPI 10463 and BI1 exhibited signs of severe colitis while infection with 630 and F200 was subclinical This increased clinical severity was correlated with more severe histopathology with significantly more edema, inflammation and epithelial damage encountered in the colons of animals infected with VPI 10463 and BI1 Disease severity also correlated with levels of C difficile cytotoxic activity in intestinal tissues and elevated blood neutrophil counts Cefoperazone treated mice represent a useful model of C difficile infection that will help us better understand the pathogenesis and virulence of this re-emerging pathogen

https://www.tandfonline.com/doi/pdf/10.4161/gmic.19142

Cefoperazone-treated mice as an experimental platform to assess differential virulence of Clostridium difficile strains

https://www.gastrojournal.org/article/S0016-5085(09)00292-3/pdf

Treatment of Clostridium difficile-Associated Disease

1 diarrhea and prevention of disease recurrence in hamsters 2 Rifaximin for Clostridium difficile-associated diarrhea 3 4 Efi Kokkotou, Alan C Moss, Athanasios Michos, Daniel Espinoza, Jeffrey W Cloud, 5 Nasima Mustafa, Michael O’Brien, Charalabos Pothoulakis, Ciarán P. Kelly 6 7 Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA. 8 Mallory Institute and Department of Pathology, Boston University Medical Center, 9 Boston, MA 10 11 12 Corresponding Author: 13 Ciarán P Kelly MD 14 Division of Gastroenterology 15 Dana 601 / East Campus 16 Beth Israel Deaconess Medical Center 17 Boston MA 02215 18 T: (617) 667-1264 19 F: (617) 975-5071 20 ckelly2@bidmc.harvard.edu 21 22 AC CE PT ED Copyright © 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved. Antimicrob. Agents Chemother. doi:10.1128/AAC.01143-07 AAC Accepts, published online ahead of print on 14 January 2008

Efficacy of rifaximin vs. vancomycin for treatment of Clostridium difficile-associated 1 diarrhea and prevention of disease recurrence in hamsters 2 Rifaximin for Clostridium difficile-associated diarrhea 3 4

Clostridium difficile-associated colitis is an increasing cause of morbidity and mortality in hospitalized patients, with high relapse rates following conventional therapy. We sought to determine the efficacy of rifaximin, a novel nonabsorbed antibiotic, in the hamster model of C. difficile-associated diarrhea (CDAD). Hamsters received clindamycin subcutaneously and 24 h later were infected by gavage with one of two C. difficile strains: a reference strain (VPI 10463) and a current epidemic strain (BI17). Vancomycin (50 mg/kg of body weight) or rifaximin (100, 50, and 25 mg/kg) were then administered orally for 5 days beginning either on the same day as infection (prevention) or 24 h later (treatment). Therapeutic effects were assessed by weight gain, histology, and survival. We found that rifaximin was as effective as vancomycin in the prevention and treatment of colitis associated with the two C. difficile strains that we examined. There was no relapse after treatment with vancomycin or rifaximin in hamsters infected with the BI17 strain. Hamsters infected with the VPI 10463 strain and treated with rifaximin did not develop relapsing infection within a month of follow-up, whereas the majority of vancomycin-treated animals relapsed (0% versus 75%, respectively; P < 0.01). In conclusion, rifaximin was found to be an effective prophylactic and therapeutic agent for CDAD in hamsters and was not associated with disease recurrence. These findings, in conjunction with the pharmacokinetic and safety profiles of rifaximin, suggest that it is an attractive candidate for clinical use for CDAD.

Comparative efficacies of rifaximin and vancomycin for treatment of Clostridium difficile-associated diarrhea and prevention of disease recurrence in hamsters.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Jeffrey W. Cloud

Author Tools

Chat about Author

Papers

Efficacy of rifaximin vs. vancomycin for treatment of Clostridium difficile-associated 1 diarrhea and prevention of disease recurrence in hamsters 2 Rifaximin for Clostridium difficile-associated diarrhea 3 4

Comparative efficacies of rifaximin and vancomycin for treatment of Clostridium difficile-associated diarrhea and prevention of disease recurrence in hamsters.