Author Archives: cdifffoundation

A White Blood Cell In Motion Chasing Bacteria

What do White Blood Cells do?

 

White blood cells (also called leukocytes or immune cells) are cells which form a component of the blood.

They help to defend the body against infectious disease and foreign materials as part of the immune system.

There are normally between 4×109 and 11×109 white blood cells in a litre of healthy adult blood about 7,000 to 25,000 white blood cells per drop.

In conditions such as leukaemia this may rise to as many as 50,000 white blood cells in a single drop of blood.

As well as in the blood, white cells are also found in large numbers in the lymphatic system, the spleen, and in other body tissues.

……………………………

Detecting White Blood Cell (Stool)

Does this test have other names?

Stool white blood cell test, fecal leukocyte (LOO-koh-site) test

What is this test?

This test looks for white blood cells in your stool, which can help your health care provider diagnose the cause of inflammatory diarrhea.

White blood cells, also called leukocytes, are immune system cells that can show up in the stool if you have inflammatory diarrhea. This type of diarrhea may be a symptom of an infection caused by bacteria such as Shigella, Clostridium difficile, Campylobacter, or Salmonella. It may also occur in inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis.

Why do I need this test?

You might have this test if you have inflammatory diarrhea. Symptoms may include:

  • Numerous small loose stools
  • Blood or mucus in the stool
  • Severe cramping in your abdomen
  • Fever

What other tests might I have along with this test?

Your doctor may order other tests that look at the stool for:

  • Lactoferrin or calprotectin, which are substances made by certain white blood cells
  • Parasites

Your doctor may also order a stool culture. For this test, bacteria in a stool sample are encouraged to grow in the lab so they can be seen.

What do my test results mean?

A result for a lab test may be affected by many things, including the method the laboratory uses to do the test.  If your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your health care provider.

White blood cells in the stool may mean that you have inflammation in your gastrointestinal tract. But a negative result doesn’t rule out a problem. Some people with these illnesses don’t have white blood cells in their stool.

How is this test done?

Your health care provider will give you a special container with a tightly fitting lid to place the stool sample in. If you aren’t able to produce a stool sample, your doctor may collect a sample by inserting a swab into your rectum.

What might affect my test results?

Urine or toilet paper may contamínate the sample, affecting the results. Drinking milk can affect the results.

How do I get ready for this test?

You don’t need to prepare for this test, but it’s a good idea to tell the health care provider about other health problems you may have. Be sure your doctor knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don’t need a prescription and any illicit drugs you may use.

 

* Discuss stool specimens and lab testing with your health care provider for additional information.

 

Sources:

https://www.sciencedaily.com/terms/white_blood_cell.htm

https://baycare.org/health-library/health-encyclopedia/2015/02/04/06/52/white-blood-cell-stool

4 Year Sepsis Study of New York’s Sepsis Regulations Being Launched By University of Pittsburgh Researcher

A University of Pittsburgh researcher is launching a four-year study of New York’s sepsis regulations to see what worked and what didn’t in the state’s fight against one of health care’s biggest killers.

Research has shown that speeding up sepsis treatment, which New York’s law accomplished, reduces deaths from the condition . The new study will examine the law more broadly, probing whether it might have had unintended negative consequences.

“Just because the protocol is good doesn’t mean that a regulatory-based effort to force hospitals to adopt these protocols led to better outcomes,” said Dr. Jeremy Kahn, a Pitt professor of critical care medicine and health policy and management who is heading the $1.5 million study.

New York required hospitals to adopt time-based sepsis protocols in 2013 after a 12-year-old boy, Rory Staunton, died from the condition after cutting his arm in a gym class a year earlier. The condition, in which the body’s immune system overreacts to infection, contributes to as many as half of all hospital deaths, according to the National Institutes of Health.

Sepsis has been likened to heart attacks and strokes, which killed many more patients before evidence-based treatment protocols were adopted. Hospitals in most states aren’t required to do anything specific to treat the condition, although many have voluntarily adopted protocols. Pennsylvania Health Department officials have said they plan to launch a two-year process this fall to incorporate sepsis protocols in the state’s hospital regulations.

New York’s protocols include taking blood cultures to guide diagnosis and treatment, analyzing lactate levels that can signify septic shock and administering fluids and antibiotics.

Kahn said the protocols raise concerns over two primary dangers: overuse of antibiotics and overuse of fluids.

The study of New York’s three-hour protocols found that administering fluids didn’t appear to improve outcomes, and too much fluid can lead to harm, Kahn said. Antibiotics, while a critical part of sepsis treatment, can also harm patients by killing good bacteria in the gut and creating a more welcoming environment for a deadly infection known as C-diff.

The new study, funded by the federal Agency for Healthcare Research and Quality, will examine complications, length of hospital stays, costs and other elements of the protocols, Kahn said. The study will compare sepsis treatment outcomes in New York to outcomes in Pennsylvania, Massachusetts, Washington and Florida, he said — states with similar numbers and types of hospitals.

“The hope would be to help policymakers in other states, specifically in Pennsylvania, as they design these regulations,” he said.

He expects bigger hospitals with more resources will have better sepsis outcomes than smaller rural hospitals. Another factor that might influence outcomes is whether hospitals have a designated sepsis specialist who influences how hospitals approach the condition.

Researchers plan to study the effects of sepsis policies for the first two years — delivering early results to Harrisburg before the planned update to hospital regulations — and to spend another two years interviewing doctors and health care specialists to gather more detail about how the protocols work.

“We can’t stand by as hundreds of thousands of Americans are dying each year of sepsis,” Kahn said. “But the question is, can we craft those policies; can the policy response to sepsis be evidence-based?”

Researchers From Loyola Medicine Retrospectively Studied 100 Vancomycin Taper and Pulse Treatment Patients Treated For Recurrent C. difficile Infection

A tapered and pulsed regimen with vancomycin — with diligent follow-up — can achieve significant cure rates in recurrent Clostridium difficile (C. difficile) infected patients, according to a new study.

Researchers from Loyola Medicine retrospectively studied 100 vancomycin taper and pulse treatment patients treated for recurrent C. difficile infection between January 1, 2009 and December 31, 2014. Their clinic, the study authors wrote, has been a referral center for the infection for the past decade.

To read the article in its entirety please click on the following link:

http://www.mdmag.com/medical-news/pulsed-and-tapered-vancomycin-likely-route-to-recurrent-clostridium-difficile-cure

However, despite the guidelines for treatment of recurrent C. difficile infection being not too different than recurrent episodes – except for the use of vancomycin when the case is severe – there have not been many studies on this vancomycin taper and pulsed dosing. 

The researchers observed that after a referral, the confirmed recurrent C. difficile patients were treated with a vancomycin taper and pulse regimen: a taper of vancomycin to once-daily, followed by alternate day dosing; or once-daily followed by alternate day dosing; followed by every third day, for at least 2 weeks. After this regimen, all patients had 90-day follow-up documentation.

On average, the patients in the clinic were on their third C. difficile diarrhea episode. Half of the patients had also received a standard course of vancomycin, while another third had received some type of vancomycin taper regimen, the researchers said.

Despite the fact that many of these patients were a “treatment experienced” population, 75% of the patients who received a supervised vancomycin taper and pulsed regimen achieved a cure,  study author Stuart Johnson  MD, . He added that the results were further improved for patients who received the expended pulse phase: 81% achieved a cure.

“The findings were not unexpected to us, but I think that many clinicians will be surprised how well a deliberate, prolonged vancomycin taper and pulse regimen – with careful follow up – works,” Johnson said.

There were no significant differences among the patients in terms of gender, age, concomitant antibiotics, proton pump inhibitor use, histamine receptor-2 blocker use, or patients with a regimen greater than 10 weeks in length, the researchers continued.

The researchers added that their finding of improved cure rates with alternate-day dosing plus every third day dosing over strictly alternate-day dosing is consistent with the hypothesis that pulsed dosing can promote a cyclical decrease in spore burden, they wrote. This can also permit the resetting of normal microbiota in the gut.

Johnson concluded that the clinical implications of the study show most recurrent C. difficile patients do not need fecal microbiota transplant (FMT).

“FMT has received an enormous amount of press and this procedure is now widely available throughout the US,” Johnson said. “FMT is attractive because it addresses one of the primary mechanisms involved with recurrent C. difficile infection, a marked disruption of the resident bacteria that populate the intestine and provide an important host defense against C. difficile.

Although physicians screen donor feces for “known pathogens,” not all is known of the potential complications to come from FMT, Johnson said.

“In addition, it appears that efficacy with a carefully supervised vancomycin taper and pulse regimen compare to that achieved with FMT,” Johnson said.

The study, “Vancomycin Taper and Pulsed Regimen with careful Follow up for Patients with Recurrent Clostridium difficile Infection,” was published in the journal Clinical Infectious Diseases.

Summit Announces Positive Data From Phase 2 C. difficile Clinical Trial Supporting Ridinilazole To Treat C. diffiicle Infection

SUMMIT ANNOUNCES POSITIVE TOP-LINE DATA FROM AN EXPLORATORY PHASE 2 CLINICAL TRIAL SUPPORTING RIDINILAZOLE AS A HIGHLY SELECTIVE ANTIBIOTIC FOR THE TREATMENT OF CDI

  • Ridinilazole treatment more preserving of gut microbiome than fidaxomicin

 * Listen In on September 26th 10aPT/1pET www.cdiffradio.com   live broadcast with our guests from Summit Therapeutics.

 

 

Oxford, UK, 5 September 2017Summit Therapeutics plc (NASDAQ: SMMT, AIM: SUMM), the drug discovery and development company advancing therapies for Duchenne muscular dystrophy and Clostridium difficile infection (‘CDI’), today announces positive top-line data from an exploratory Phase 2 clinical trial that support ridinilazole as a highly selective and potent antibiotic product candidate for the treatment of CDI. In the Phase 2 clinical trial, ridinilazole preserved the gut microbiome of CDI patients to a greater extent than the marketed narrow-spectrum antibiotic, fidaxomicin. During the trial’s ten-day treatment period, ridinilazole treatment had markedly less impact on the gut microbiome of trial patients by measures of overall diversity and changes in key bacterial families, when compared to those trial patients dosed with fidaxomicin.

 

In the trial, ridinilazole and fidaxomicin both reduced the abundance of C. difficile. However, fidaxomicin-treated patients had reduced abundancy of other bacterial families associated with microbiome health. For a number of these bacterial families, the difference between the two treatments was statistically significant. Another measure of microbiome health is alpha diversity as measured by the Simpson’s Diversity Index. There was a greater reduction in alpha-diversity during fidaxomicin treatment compared with ridinilazole-treated patients. These measures were a key secondary endpoint of the clinical trial and provide additional evidence of ridinilazole’s precision in killing C. difficile while preserving the gut microbiome. The primary endpoint of the trial was safety, as measured by the number of treatment emergent adverse events and serious adverse events. During the trial, no new or unexpected safety signals were identified and ridinilazole was well-tolerated.

 

“We increasingly recognise the importance of a healthy and diverse gut microbiome for protection against recurrent CDI, which is a major challenge in the management of the disease. These latest clinical findings show ridinilazole better preserved the microbiome of CDI patients than fidaxomicin, the narrowest spectrum antibiotic currently available for CDI,” commented Professor Mark Wilcox, Consultant Microbiologist & Head of Microbiology Research & Development at the Leeds Teaching Hospitals NHS Trust, Professor of Medical Microbiology at the University of Leeds, and Public Health England’s Lead on C. difficile in England. “Further, these microbiome data are very supportive of ridinilazole’s profile as a highly selective antibiotic with the potential to achieve a meaningful improvement in clinical outcomes for CDI patients.”

 

The exploratory open-label Phase 2 clinical trial enrolled 27 patients aged between 18 and 90 years at trial sites in the US, the UK and the Czech Republic. Patients were randomly assigned to receive either ridinilazole (200mg, twice a day) or fidaxomicin (200mg, twice a day) for ten days. The trial population was unbalanced with more patients randomised to ridinilazole at higher risk of poorer clinical outcomes as measured by ATLAS score, and also with predisposing factors for recurrent CDI.

 

A secondary endpoint of sustained clinical response (‘SCR’), defined as clinical cure at the end of treatment and no recurrence of CDI within the next 30 days, was achieved in seven of 14 ridinilazole treated patients and six of 13 fidaxomicin treated patients. The trial was not designed for efficacy comparisons due to the small number of patients.

 

Dr David Roblin, Chief Medical and Operating Officer of Summit added, “Ridinilazole is a precision antibiotic that is designed to selectively target C. difficile while being highly preserving of the gut microbiome that plays a crucial role in naturally protecting against recurrent CDI. Ridinilazole has now provided evidence of its high selectivity in two complementary clinical trials. The data from our earlier Phase 2 trial showed a greater microbiome preservation of ridinilazole-treated patients compared with the current standard of care, vancomycin, which led to achieving statistical superiority in sustained clinical response. We believe ridinilazole has the potential to become a front-line therapy for CDI and look forward to initiating Phase 3 clinical trials in the first half of 2018.”

 

More detailed findings from this trial are expected to be presented at an upcoming international infectious disease conference. The results build on positive data from a Phase 2 proof of concept trial of ridinilazole that were published in The Lancet Infectious Diseases in April 2017. Ridinilazole is currently being prepared for Phase 3 clinical trials that are planned to commence in the first half of 2018.

 

SOURCE:  www.summitplc.com

Norman B. Javitt, M.D. Is Welcomed As a Member Of the C Diff Foundation, R & D Committee

We are pleased to welcome
Norman B. Javitt, M.D. to the
C Diff Foundation.

Dr. Javitt has an extensive professional career in health care.  New York University Medical Center: Instructor, then Assistant Professor Medicine where his career was devoted mostly to research in liver disease, specifically in inborn errors of cholesterol metabolism affecting newborns, and to teaching medical students.

Cornell University Medical School-New York Hospital:  Associate Professor of Medicine, then Professor of medicine and Chief, Division of Gastroenterology the research program continued to grow, attracting many fellows from all over the world.  Also provided care for private patients, both children and adults, with difficult liver problems.

New York University Medical Center:  Professor of Medicine and of Pediatrics, Division chairman Hepatic Diseases April, Research professor 2015-presnt.  At NYUMC Dr. Javitt has been focusing on C. difficile research  and teaching medical students and house staff.  His research interest has also expand to many areas of cholesterol synthesis and metabolism other than just liver disease.

Dr. Javitt has published research papers in age-related macular degeneration, in vitro fertilization, and Alzheimer’s disease.  He has also published more than 150 research papers, in addition to several books and review articles, and presented work at numerous professional meetings and symposia throughout the world.  His work has been supported by the National Institutes of Health, by private foundations and Pharmaceutical companies.  Dr. Javitt is welcomed by fellow researchers in the Research and Development Committee Chaired by Professor Simon M. Cutting, Ph.D…

Study Show 9% Fewer Antibiotics Prescribed

The use of antibiotics among Americans with commercial health insurance has decreased during the past several years, according to a new analysis that nevertheless
shows lingering variations for different ages and in different parts of the country.

The study released provides the latest evidence of how doctors and patients have begun to heed warnings that excessive antibiotic use breeds dangerous drug resistance and “superbug” bacteria.

The analysis is based on 173 million insurance claims from people under age 65 with Blue Cross Blue Shield coverage
who filled prescriptions
between 2010 and 2016.

 

It is a sequel of sorts to research by the federal Centers for Disease Control and Prevention, which found a smaller decline and comparable age and geographic variations.

The CDC reported a 5 percent decrease overall between 2011 and 2014 in antibiotic prescriptions written in outpatient settings such as doctors’ offices, clinics and hospital emergency rooms.

The study by the Blue Cross Blue Shield Association found that 9 percent fewer antibiotics prescribed in outpatient settings were filled in 2016, compared with 2010.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Blue Cross Blue Shield Study:

https://www.bcbs.com/the-health-of-america/reports/antibiotic-prescription-rates-declining-in-the-US?utm_source=social&utm_medium=linkedin&utm_content=&utm_campaign=hoa-antibiotics

 

To read more of this article please click on the link provided below:

https://www.washingtonpost.com/news/to-your-health/wp/2017/08/24/fewer-antibiotic-prescriptions-are-being-filled-a-new-analysis-finds/?utm_term=.d30b61b8fae7

C. diff. Spores and More, Join Us and Celebrate

www.cdiffradio.com

C. diff. Spores and More

Sponsored by Clorox Healthcare

Join us and Celebrate

with our 81,453 listeners – so far –  in Season III.

We thank our listeners joining us every

Tuesday at 10:00 a.m. PT / 1:00 p.m. ET

across the U.S. A. and to our listeners in

  • Australia
  • Brazil
  • Canada
  • China
  • France
  • Germany
  • India
  • Ireland
  • Israel
  • Japan
  • Malaysia
  • Peru
  • Russia
  • Spain
  • Switzerland
  • Taiwan
  • Trinidad
  • Ukraine
  • UK    and Across the Globe

We also extend our sincere gratitude to the guests who take time out of their busy

schedules to join us on each live broadcast.  Though their words of wisdom and

by sharing the most up-to-date information with us raises awareness in so

many important areas of healthcare.

 

Season III concludes on October 31, 2017

and we will be gearing up for

the 5th Annual International C. diff. Awareness Conference & Health EXPO taking

place on November 9th and 10th at the University of Nevada – Las Vegas.

For conference information please click on the link below.

https://cdifffoundation.org/2017cdiffconference/about-nov-2017-annual-conference/

 

Join us in Season IV when we return on January 9th, 2018

as we continue bringing you updates that are focused on, but not limited to,

C. difficile infection prevention, treatments, clinical trials, environmental safety

and much more.

Thank you again for listening and we wish you and your families improved health,

continued healing, and the best day — which you all deserve!