Author Archives: cdifffoundation

Contaminated Bed Linens and Microbes

Federal health officials recently reported that at least two million Americans are infected every year by antibiotic-resistant bacteria, and at least 23,000 die from those infections (1). This harsh reality of hospital infections means that there is no doubting the importance of their control and prevention. Limiting the spread of infection will require novel infection control strategies. A key element of this strategy is to control the dispersal of microbes via contaminated bed linen, mattresses and other points of close contact with infected individuals (2).

As modern-day hospital infection control measures improve, there is an increased focus on bed linen and associated materials as possible sources of infection. Fijan and Turk (3), identify incidences of Staphylococcus aureusEnterococcus faeciumPseudomonas aeruginosa and Enterobacter aerogenes surviving temperatures of 60°C during standard washing processes. A study by Craemer and Humphries, (4) outlined many of the issues posed by inadequate cleaning of hospital beds. It was advocated that decontamination should be performed once a week in cases where patients were at a particular risk of infection. The optimal bed linen described was that which is easily washed and dried and has the lowest potential to harbour microorganisms. In addition, it is reaffirmed that pillows and mattresses warrant the greatest level of attention due to their proximity to patients undergoing care. The correct maintenance of storage presses and trolleys as part of any decontamination process is highlighted as an area that should also be considered as part of such a strategy.

A healthy individual is a reservoir of microbial contaminants that for the most part do not result in any adverse health effects. The innate and adaptive immune system combines with the physical barriers of the body to protect individuals from infection. As humans constantly shed skin, hair, saliva and sebaceous particles from their bodies in bed, the knock-on effect is the accumulation of microorganisms in bed linen. However, the development and persistence of dust mites and dust mite allergen (Der p 1 or Der f 1) in pillows is a major factor for people with immune hypersensitivity. It has been established that Der p 1 levels in house dust exceeding 2 µg/g are sufficient for eliciting an allergic/asthmatic response (5). In instances where an individual is immunocompromised, has an underlying infection, or has other predisposing factors such as asthma that make them susceptible to infectious diseases, the environment in which the person finds themselves may have a strong influence on their health.

The issues surrounding textiles in bedding and their role in reducing the risk of diminishing the health of individuals is not limited to the hospital setting. Recently, a national pillow health check performed in Ireland in conjunction with Gabriel Scientific and airmid healthgroup laboratories gave some indication as to the potential levels of contaminants present as we sleep. The study unveiled extremely high levels of bacteria and fungi in a selection of pillows that were analyzed. In addition, the concentration of dust mite allergen was found in some cases to be above the levels that have been demonstrated to elicit severe allergenic responses. Interestingly, a survey undertaken by those who submitted pillows for testing showed occurrences of contamination were frequently associated with factors such as the pillows being older, lower frequency of cleaning and reporting of poor sleep quality. While further research in this area is warranted to provide meaningful statistical correlations between contamination levels and the development and persistence of clinical manifestations, this work has strengthened the opinion that an improvement of an individual’s health may be enhanced by more frequent laundering of bed linen using better methods.

To view the article in its entirety, please click on the link below to be redirected:

https://www.airmidhealthgroup.com/resources-at-airmidhealthgroup/articles/742-contamination-of-bed-linen-factors-in-microbial-and-allergen-accumulation.html

 

To protect individuals from infection, the development of fabrics and textiles has led towards a more active means of preventing microbial growth. The practice of impregnating textiles with divalent cations such as silver or copper as a means to disrupt microbial membrane stability has been proposed as a solution, with claims of antifouling properties, odor control and prevention of topical infection (6, 7) The principal weakness of this technology is the leaching effect overtime during conventional washing of fabrics, depending on the manufacturing process, which may reduce the efficacy of such treatments (8). In addition, there is a growing body of evidence to suggest that this may pose an environmental risk as bioaccumulation of silver in aquatic life result in toxicity for marine life (9). Nevertheless, the application of such textile design and the development of new antimicrobial technologies could represent an invaluable tactic in controlling the spread of infections. Looking to the future, a combination of bed protection systems that are easily cleaned as well as the application of novel technologies in the construction of antimicrobial textiles could be one way in which the spread of infections is controlled.

About the author
John Fallon PhD is a Senior Microbiologist at airmid healthgroup, which helps clients with products and services related to residential and commercial indoor environments to differentiate their customer offerings through health-relevant marketing claims. Clients include Dyson Inc., LG Electronics, Stanley Steemer, Shaw Industries, Fellowes, Spring Air, Tarkett and Kenmore. airmid creates value for clients through a number of collaborative strategies, including field research projects, environmental test chamber studies and licensing our own intellectual property. airmid specializes in studying the relationship between allergens, viruses, bacteria, molds or other ultra-fine particles in the air and on surfaces to the spread of illness and disease in buildings. As a leading authority on biomedical and aerobiology research, they use this deep domain knowledge to improve products and services to make the indoor environment as healthy as possible. For more information, visit www.airmidhealthgroup.com.

References

  1. http://www.cdc.gov/drugresistance/threat-report-2013/
  2. Thilagavathi, G. and T. Kannaian, (2008). Dual antimicrobial and blood repellent finish for cotton hospital fabrics. Indian Journal of Fibre and Textile Research; 33: 23 – 29.
  3. Fijan, S. and S.S Turk, (2012). Hospital textiles, are they a possible vehicle for healthcare-associated infections? International Journal of Environmental Research and Public Health; 9 (9): 3330 – 3343.
  4. Craemer, E. and H. Humphreys, (2008). The contribution of beds to healthcare-associated infection: the importance of adequate decontamination. Journal of Hospital Infection; 69 (1): 8-23.
  5. Platts-Mills, T.A., Vervloet, D., Thomas, W.R., Aalberse, R.C. and M.D. Chapman, (1997). Indoor allergens and asthma: report of the Third International Workshop. Journal of Allergy and Clinical Immunology; 100 (6): S1 – S24.
  6. Borkow, G. and Gabbay, J. (2004). Putting Copper into Action: Copper-impregnated Products with Potent Biocidal Activities. FASEB Journal; 18(14): 1728-1730.
  7. Haug, S., Roll, A., Schmid-Grendelmeier, P., Johansen, P. Wüthrich, B. Kündig, T. and G. Sent, (2006). Coated Textiles in the Treatment of Atopic Dermatitis. Current problems in dermatology; 33: 144 – 151.
  8. Benn, T.M and P. Westerhoff, (2008). Nanoparticle silver released into water from commercially available sock fabrics. Environmental Science and Technology; 42 (11): 4133 – 4139.
  9. Mathivanan, V., Ananth, S. Ganesh Prabu, P. and Selvisabhanayakam, (2012). Role of silver nanoparticles: behavior and effects in the aquatic environment – a review. International Journal of Research in Biological Sciences; 2 (2): 77 – 82

FDA Approves Merck’s DIFICID® (fidaxomicin) to Treat Clostridioides difficile (C. diff. ) in Children Aged Six Months and Older

Merck (NYSE: MRK), known as MSD outside the United States and Canada, announced on January 27, 2020, that the U.S. Food and Drug Administration (FDA) has approved a New Drug Application (NDA) for DIFICID® (fidaxomicin) for oral suspension, and a supplemental New Drug Application (sNDA) for DIFICID tablets for the treatment of Clostridioides (formerly Clostridium) difficile-associated diarrhea (CDAD) in children aged six months and older.1

 

DIFICID is a macrolide antibacterial medicine indicated in adults and pediatric patients aged 6 months and older for the treatment of CDAD.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of DIFICID and other antibacterial drugs, DIFICID should be used only to treat infections that are proven or strongly suspected to be caused by Clostridioides difficile (C. difficile).

DIFICID is contraindicated in patients who have known hypersensitivity to fidaxomicin or any other ingredient in DIFICID. DIFICID should only be used for the treatment of CDAD. DIFICID is not expected to be effective for the treatment of other types of infections due to minimal systemic absorption of fidaxomicin.

C. difficile is an important cause of health care- and community-associated diarrheal illness in children and sustained cure is difficult to achieve in some patients. The fidaxomicin pediatric trial was the first randomized controlled trial of C. difficile infection treatment in children,” said Dr. Larry K. Kociolek, Associate Medical Director of Infection Prevention and Control at Ann & Robert H. Lurie Children’s Hospital of Chicago. “I am very excited to have a new C. difficile infection treatment option for my pediatric patients.”

“Merck is committed to developing new treatments, as well as expanding indications of existing ones, in order to provide more solutions to treat infectious diseases, particularly among children,” said Dr. Nicholas Kartsonis, senior vice president, clinical research, infectious diseases and vaccines, Merck Research Laboratories. “C. difficile infection is an urgent public health challenge. We are grateful to the health care practitioners, the patients and their families for their invaluable contributions in helping to bring this new pediatric indication and the oral suspension formulation for DIFICID to the U.S. market.”

Both applications received a priority review classification by the FDA. The investigational pediatric indication for DIFICID was granted Orphan Drug Designation in 2010.

Data Supporting the Approval of DIFICID in Pediatric Patients

The FDA’s approval of the new formulation and new indication for DIFICID was based on a Phase 3, multicenter, investigator-blind, randomized, parallel-group study (known as the SUNSHINE study, NCT02218372), in which the safety and efficacy of fidaxomicin was evaluated in pediatric patients from 6 months to less than 18 years of age (one patient was less than six months of age). This study, sponsored by Astellas Pharma Europe B.V. (with Merck & Co., Inc. as collaborator) included 148 randomized patients aged <18 years with confirmed CDI, of whom 142 received either fidaxomicin (suspension or tablets, twice daily) or vancomycin (suspension or tablets, four times daily) in a 2:1 ratio. Patients were randomized by age group, as follows: 30 patients from 6 months to <2 years; 49 patients age 2 to <6 years, 40 patients age 6 to <12 years and 29 patients age 12 to <18 years. Generally, the two treatment groups were balanced regarding demographics and other baseline characteristics. CDAD clinical response in the overall pediatric population, assessed through two days following 10 days of treatment, was similar between the fidaxomicin and vancomycin groups (77.6% vs. 70.5% with a 95% CI for the treatment difference of 7.5 [-7.4%, 23.9%]). Sustained clinical response, defined as the proportion of treated patients with confirmed clinical response and no CDAD recurrence through 30 days after the end of treatment, was higher for fidaxomicin than for vancomycin (68.4% vs. 50.0% with a 95% CI for the treatment difference of 18.4 [1.5%, 35.3%]).

The safety of DIFICID in pediatric patients 6 months to less than 18 years of age was evaluated in a Phase 2 single-arm trial in 38 patients and a Phase 3 randomized, active-controlled trial in 98 patients treated with DIFICID and 44 patients treated with vancomycin. Treatment discontinuation due to adverse reactions occurred in 7.9% (3/38) of patients in the Phase 2 trial, and in 1% (1/98) and 2.3% (1/44) of DIFICID- and vancomycin-treated patients, respectively, in the Phase 3 trial. The most common selected adverse reactions occurring in ≥5% of pediatric patients treated with DIFICID in the Phase 3 trial were pyrexia (13.3%), abdominal pain (8.2%), vomiting (7.1%), diarrhea (7.1%), constipation (5.1%), increased aminotransferases (5.1%) and rash (5.1%). One death occurred in the Phase 2 single-arm trial and three deaths occurred in the Phase 3 trial of DIFICID-treated patients. No deaths occurred in vancomycin-treated patients during the study period (40 days). All deaths occurred in patients less than 2 years of age and appeared to be related to underlying comorbidities.

About Clostridioides difficile

Clostridioides (formerly Clostridium) difficile, also known as C. difficile or C. diff, is one of the most common causes of healthcare-associated infections in U.S. hospitals.2 Recent estimates suggest C. difficile causes almost 500,000 infections annually in the United States and is associated with approximately 29,000 deaths within 30 days of initial diagnosis.3 According to the CDC’s Antibiotic Resistance Threats in the United States, 2019 (2019 AR Threats Report), C. difficile is categorized as an urgent threat and is stated as a public health threat that requires urgent and aggressive action.4

Important Safety Information about DIFICID (fidaxomicin)

DIFICID is contraindicated in patients who have known hypersensitivity to fidaxomicin or any other ingredient in DIFICID.

Acute hypersensitivity reactions, including dyspnea, rash, pruritus, and angioedema of the mouth, throat, and face have been reported with DIFICID. If a severe hypersensitivity reaction occurs, DIFICID should be discontinued and appropriate therapy should be instituted.

DIFICID is not expected to be effective for the treatment of other types of infections due to minimal systematic absorption of fidaxomicin. DIFICID has not been studied for the treatment of infections other than CDAD. DIFICID should only be used for the treatment of CDAD.

Only use DIFICID for infection proven or strongly suspected to be caused by C. difficile. Prescribing DIFICID in the absence of a proven or strongly suspected C. difficile infection is unlikely to provide benefit to the patient and increases the risk of development of drug-resistant bacteria.

The most common adverse reactions reported in adults are nausea (11%), vomiting (7%), abdominal pain (6%), gastrointestinal hemorrhage (4%), anemia (2%) and neutropenia (2%).

The most common adverse reactions in pediatric patients are pyrexia (13.3%), abdominal pain (8.2%), vomiting (7.1%), diarrhea (7.1%), constipation (5.1%), increased aminotransferases (5.1%) and rash (5.1%).

Among patients receiving DIFICID (fidaxomicin), 33 (5.9%) withdrew from trials as a result of adverse reactions. Vomiting was the primary adverse reaction leading to discontinuation of dosing (incidence of 0.5% for both DIFICID and vancomycin patients).

The safety and effectiveness of DIFICID have not been established in pediatric patients younger than 6 months of age.

The recommended dose for adults is one 200 mg DIFICID tablet orally twice daily for 10 days, with or without food.

The recommended dose for pediatric patients weighing at least 12.5 kg and able to swallow tablets is one 200 mg DIFICID tablet administered orally twice daily for 10 days. If unable to swallow tablets, pediatric patients may be dosed with DIFICID oral suspension based on weight. DIFICID oral suspension should be administered orally twice daily for 10 days.

No dose adjustment is recommended for patients 65 years of age or older.

No dose adjustment is recommended for patients with renal impairment.

No dosage adjustments are recommended when co-administering DIFICID with substrates of P-gp or CYP enzymes.

The impact of hepatic impairment on the pharmacokinetics of DIFICID has not been evaluated; however, because DIFICID and its active metabolite (OP-1118) do not appear to undergo significant hepatic metabolism, elimination of DIFICID and OP-1118 is not expected to be significantly affected by hepatic impairment.

About Merck

For more than a century, Merck, a leading global biopharmaceutical company known as MSD outside of the United States and Canada, has been inventing for life, bringing forward medicines and vaccines for many of the world’s most challenging diseases. Through our prescription medicines, vaccines, biologic therapies, and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to health care through far-reaching policies, programs, and partnerships. Today, Merck continues to be at the forefront of research to advance the prevention and treatment of diseases that threaten people and communities around the world – including cancer, cardio-metabolic diseases, emerging animal diseases, Alzheimer’s disease and infectious diseases including HIV and Ebola. For more information, visit www.merck.com and connect with us on Twitter, Facebook, Instagram, YouTube, and LinkedIn.

Forward-Looking Statement of Merck & Co., Inc., Kenilworth, N.J., USA

This news release of Merck & Co., Inc., Kenilworth, N.J., USA (the “Company”) includes “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. These statements are based upon the current beliefs and expectations of the company’s management and are subject to significant risks and uncertainties. There can be no guarantees with respect to pipeline products that the products will receive the necessary regulatory approvals or that they will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements.

Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in the United States and internationally; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; the company’s ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the company’s patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions.

The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in the company’s 2018 Annual Report on Form 10-K and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site (www.sec.gov).

Please see U.S. Prescribing Information for DIFICID (fidaxomicin) at https://www.merck.com/product/usa/pi_circulars/d/dificid/dificid_pi.pdf, and Patient Information for DIFICID (fidaxomicin) at https://www.merck.com/product/usa/pi_circulars/d/dificid/dificid_ppi.pdf.


1 DIFICID in the US and Canada is a trademark of Cubist Pharmaceuticals LLC, an indirect wholly-owned subsidiary of Merck Sharp & Dohme Corp.

2 Lessa, Fernanda. “Burden of Clostridium difficile Infection in the United States.” The New England Journal of Medicine, vol. 372, Feb. 2015, pp.825-834.

3 Ibid.

4 “Antibiotic Resistance Threats in the United States, 2019.” U.S. Centers for Disease Control and Prevention, 2019, p. 65.

 

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

https://www.mrknewsroom.com/news-release/prescription-medicine-news/fda-approves-mercks-dificid-fidaxomicin-treat-clostridioides

Thanksgiving Greeting

Our Thanksgiving Message 🦃

Thanksgiving is that time of year with expressions of gratitude and thankfulness for those in our lives.  For some people, it’s extremely difficult and maybe even a bit complicated and we understand. For others, it’s a time for harvesting the strength to push forward and allow more time for healing and we understand. It’s a day in the journey where we pause to share the attitude of gratitude for the little things in life. 💚 On behalf of all the members, patient advocates, and the C Diff Foundation family worldwide, we send you and your family our warmest wishes, Happy Thanksgiving. 💚

 

Centers for Disease Control and Prevention Publish the 2018 National & State Healthcare Associated Infection Progress Report

The CDC published the 2018 National and State Healthcare-Associated Infection (HAI) Progress Report showing significant progress nationally  in reducing several hospital-acquired infections and highlighting that prevention of these infections is possible. CDC’s HAI Progress Report is a snapshot of how each state and the country are doing in eliminating the infections outlined in the HAI National Action Plan.

 

Using data from CDC’s National Healthcare Safety Network (NHSN), the 2018 HAI Progress Report shows the following reductions have been achieved nationally among acute care hospitals (2017 – 2018):

  • About 9% decrease in central line-associated bloodstream infections (CLABSIs)
  • About 8% decrease in catheter-associated urinary tract infections (CAUTIs)
  • No significant changes in ventilator-associated events (VAEs)
  • No significant changes in surgical site infections (SSIs) related to the 10 procedures tracked in the report
  • No significant changes in hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections
  • About 12% decrease in hospital-onset C. difficile infections

 Each day, approximately one in 31 U.S. patients have at least one infection in association with his or her hospital care, underscoring the need for improvements in patient care practices in U.S. healthcare facilities. While much progress has been made, more needs to be done to prevent healthcare-associated infections in a variety of settings. Ongoing collaboration between public health, healthcare professionals, and other partners is critical to ensuring patient safety.

 Additionally, the HAI Progress Report data are now available in CDC’s new Antibiotic Resistance & Patient Safety Portal (AR&PSP), an interactive web-based application that was created to innovatively display data collected through CDC’s NHSN and other sources.  We hope you’ll use the AR&PSP to view enhanced data visualizations on Antibiotic Resistance, Use, and Stewardship datasets as well as HAI data for the nation and states.

November Is C. diff. Awareness Month: We Can Make a Difference Together Worldwide

In joint efforts with the C Diff Foundation Advocates and organizations dedicated in preventing and treating life-threatening Clostridioides difficile (C. diff., C. difficile) infections,  we express our gratitude and congratulate the State of Arizona, Arkansas, Idaho, Michigan, Minnesota, New Mexico,  Pennsylvania, West Virginia,  Wisconsin, to name a few, to date  for declaring November “Clostridioides difficile (C. diff., C. difficile) Awareness Month.

The Proclamations approved serve to heighten awareness of the impact this disease has on patients across the United States. The infection, which has been labeled an urgent national health threat by the Centers for Disease Control (CDC), results in 500,000 infections each year and is directly responsible for approximately 29,000 patients who died within 30 days of the initial diagnosis of C. difficile.  Of those, about 15,000 deaths were estimated to be directly attributable to C. difficile infections.

 

 

 

 

 

An excerpt from USA Today article published in 2012:    Deaths and illnesses are much higher than reports have shown. In March, the  CDC  said in a report that the C difficile infection kills 14,000 people a year. But that estimate is based on death certificates, which often don’t list the infection when patients die from complications, such as kidney failure.  Hospital billing data collected by the federal Agency for Healthcare Research and Quality shows that more than 9% of C. diff-related hospitalizations end in death — nearly five times the rate for other hospital stays. That adds up to more than 30,000 fatalities among the 347,000 C. diff hospitalizations in 2010. Thousands of patients are treated in nursing homes, clinics and doctors’ offices.

“We’re talking in the range of close to 500,000 total cases a year,” says Cliff McDonald, a C. diff expert, and senior science adviser in the CDC’s Division of Healthcare Quality Promotion. And annual fatalities “may well be … as high as 30,000.”

* AHRQ News and Numbers provides statistical highlights on the use and cost of health services and health insurance in the United States.

http://archive.ahrq.gov/news/newsroom/news-and-numbers/012512.html

In the USA:  Nearly half a million Americans suffer from Clostridium difficile (C. diff.) infections in a single year according to a study released February 25, 2015, by the Centers for

Not only in November, but every day of the year it is our time to make a difference!  Most patients and their families, until their diagnosis, are not familiar with this infectious disease.  When they tell their friends and family, their friends and family have never heard of a C. difficile (Clostridium difficile, C. diff., CDI)  infection before.

Sometimes, even when they are told by their doctors of this diagnosis, the doctors can be largely unfamiliar with the impact of this infection and the treatments readily available. This is astonishing. Why? Because a C. diff. infection impacts individuals differently than it did decades ago.  The re-occurrence rate is greater today than it was in previous years.   C.difficile infections are not only acquired by a hospital stay but can be community-acquired.  It is a global diagnosis and this infection is not isolated in the senior population, however; seniors remain in the higher risk category of acquiring this infection.

FACT:  About a C. diff. infection  — Over 41 individuals lose their life to a Clostridioides difficile infection in the United States of America alone each day — C. difficile has no boundaries — It can be acquired by anyone –  at any location and at any age.

Every year we work together to change the level of C. difficile awareness worldwide. Every year we make a difference. Every day of every year we share information through education and advocacy for patients and continue to raise awareness of Clostridioides difficile infection (C. diff., C. difficile, CDI) prevention, treatments, clinical trials, and environmental safety  — further than the day before.

“None of us can do this alone – All of us can do this together.”

Clostridioides difficile (C. diff. C. difficile, CDI) has had an immeasurable impact on our families, in our communities, in our countries.  It is a leading Healthcare-associated infection (HAI) yet awareness of Clostridioides difficile remains quite low among the general public worldwide.

Help us change this.  Contact us and join us TODAY!

Take Action

  • Draft a letter to your State Governor requesting a Proclamation for November dedicated for promoting Clostridium difficile Infection Awareness.
  • Create Your Own Fundraiser!
  • Contact kathy@cdifffoundation.org to get started on the fundraiser of your choice.

Awareness Tools

  • Share the C Diff Foundation brochure  (request your copies by e-mail)  A great guide to explain details about a C. diff. infection and data on C. diff. prevention, treatments, and environmental safety available.
  • The Clinical Trials Page showcases Clostridium difficile prevention and treatment clinical trials available and research-driven results.
  • Personal Stories on C. diff. Survivors Alliance  allow you to share your story, to help raise awareness about C. difficile infections, and to help raise funds for C Diff Foundation www.cdifffoundation.org
  • Share  C.diff. Global Community Support session information which is FREE and available across the USA and accessible from 57 countries to learn more about a C. diff. infection, Nutrition, and to speak with health care providers and fellow-C.diff. survivors to gain knowledge and have questions answered.

Social Media Involvement

Please join us and share YOUR story. Use these November Awareness campaign hashtags to spread awareness for November Is Clostridioides difficile (Clostridium difficile, C.diff., C.difficile, CDI) Infection Awareness Month.

To obtain printed literature to share with your family, friends, colleagues, in your community and with your health care providers  — along with  a “November Is C. diff. Awareness Month”  Magnet, please contact the C Diff Foundation’s Main Office (727) 205-3922 or email your request:  info@cdifffoundation.org

#CdiffInfectionAwareness

(Facebook)  (Twitter)

#CdiffNovemberAwareness

(Facebook)  (Twitter)

# # # # # # # # # # # # # # # # # # # # # # #

NOVEMBER IS ALSO U.S. Antibiotics Awareness Week

November 18 – 24, 2019

 

 

 

CDC’s educational effort, Be Antibiotics Aware: Smart Use, Best Care, is the year-round effort to improve antibiotic prescribing and use and combat antibiotic resistance.

In November the  annual campaign  developed by the Centers for Disease Control and Prevention (CDC) :

Share the resources of countries Raising Antibiotic Awareness Worldwide

https://www.cdc.gov/antibiotic-use/week/get-involved.html

Antibiotic Awareness Week

https://www.england.nhs.uk/2019/10/world-antibiotic-awareness-week-18-22-november/

 

How do Antibiotics cause C. diff.?  The antibiotics cause a disruption in the normal intestinal flora which leads to an overgrowth of C. difficile bacteria in the colon. Leading antibiotics are known to disrupt the normal intestinal flora.

As far back as November 2012, the CDC started sharing a public announcement regarding antibiotic use: Colds and many ear and sinus infections are caused by viruses, not bacteria. Taking antibiotics to treat a “virus” can make those drugs less effective when you and your family really need them. Limiting the usage of antibiotics will also help limit new cases of CDI.
*Always discuss the symptoms and medications with the treating Physician/Healthcare Provider.

 

Your participation makes a BIG difference around the globe.

Study Shows Older Adults Diagnosed With Cancer Have a Higher Risk Of Acquiring a C. diff. Infection

Older adults with cancer have a higher risk of developing Clostridioides difficile infection (CDI) than those without a cancer diagnosis, according to a new study.

The risk is particularly high for those with hematologic malignancies and those with recently diagnosed solid tumors

and distant metastasis (Emerg Infect Dis 2019;25[9]:1683-1689).

“CDI is the leading cause of healthcare-associated infection,” said Mini Kamboj, MD, the chief medical epidemiologist of infection control at Memorial Sloan Kettering Cancer Center in New York City. “Older adults over the age of 65 are at a higher risk for developing CDI and related complications. Our study demonstrates that this risk in advanced age is further amplified by a cancer diagnosis.”

Dr. Kamboj and her colleagues conducted a retrospective cohort study using population-based Surveillance, Epidemiology, and End Results/Medicare–linked data to assess CDI occurrence during 2011. Medicare beneficiaries with and without cancer were included. For those with cancer, patients with solid (breast, colon, lung, prostate, and head and neck) and hematologic (lymphoma, myeloma, and leukemia) tumors diagnosed from 2006 to 2010 were included. All included participants were at least 66 years of age at the time of diagnosis. They also included patients at least 66 years of age at the start of 2011 with no history of cancer.

Of the 93,566 beneficiaries in the study, 2.6% were diagnosed with CDI during the study period. Of these, 2.8% of the patients with cancer had CDI, compared with 2.4% of the noncancer patients. The incidence of CDI also increased with age: from 1.9% among patients 66 to 69 years of age to 2.9% among patients at least 85 years of age.

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

https://www.clinicaloncology.com/Current-Practice/Article/08-19/Older-Adults-With-Cancer-at-High-Risk-for-C.-diff-Infection/55862?utm_source=dlvr.it&utm_medium=twitter

Researchers Find C. diff. a Major Cause of Nosocomial Diarrheal Disease Exhibits Phenotypic Heterogeneity Within a Clonal Population As a Result of Phase Variation

Recent work has revealed that Clostridioides difficile, a major cause of nosocomial diarrheal disease, exhibits phenotypic heterogeneity within a clonal population as a result of phase variation.

Many C. difficile strains representing multiple ribotypes develop two colony morphotypes, termed rough and smooth, but the biological implications of this phenomenon have not been explored. Here, we examine the molecular basis and physiological relevance of the distinct colony morphotypes produced by this bacterium. We show that C. difficile reversibly differentiates into rough and smooth colony morphologies and that bacteria derived from the isolates display discrete motility behaviors. We identified an atypical phase-variable signal transduction system consisting of a histidine kinase and two response regulators, named herein colony morphology regulators RST (CmrRST), which mediates the switch in colony morphology and motility behaviors. The CmrRST-regulated surface motility is independent of flagella and type IV pili, suggesting a novel mechanism of cell migration in C. difficile. Microscopic analysis of cell and colony structure indicates that CmrRST promotes the formation of elongated bacteria arranged in bundled chains, which may contribute to bacterial migration on surfaces. In a hamster model of acute C. difficile disease, the CmrRST system is required for disease development. Furthermore, we provide evidence that CmrRST phase varies during infection, suggesting that the intestinal environment impacts the proportion of CmrRST-expressing C. difficile. Our findings indicate that C. difficile employs phase variation of the CmrRST signal transduction system to generate phenotypic heterogeneity during infection, with concomitant effects on bacterial physiology and pathogenesis.

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

https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000379