MONDAY, April 27th – 6:00 p.m. EST
Hosts and Co-Directors
Doctors Caterina Oneto, MD &
Paul Feuerstadt, MD
Topic: Doctors Oneto and Feuerstadt will discuss C. difficile Infections; The What, Where and How. There will be opportunities to ask a brief question to the physicians. We appreciate Dr.’s Oneto and Dr. Feuerstadt for donating their time to discuss C. difficile Infections and to provide information regarding prevention, treatments available, and environmental safety products available. Join Dr. Oneto and Dr. Feuerstadt’s session hosted on the fourth Monday of each month.
Via: Teleconference Call: 1 – 646 -927 – 0297 Conference ID: 123560#
3:00 p.m. PT 4:00 p.m. MT 5:00 p.m. CT 6:00 p.m ET
NOTE: The Physicians will not prescribe, diagnose, or provide medical assessment answers to any individuals participating in their support session. Please contact the Physician providing care for a C. diff. Infection or other diagnoses that are being treated. Thank you.
SUPPORT IS JUST A PHONE CALL AWAY ♥
Support and information sessions are for everyone especially for —
C. diff. survivors continuing their recovery from a prolonged illness.
Patients working their way through any long-term wellness draining diagnosis.
All Sessions are FREE and accessible from the USA and 57 countries *
Support is available to anyone seeking additional information with the desire to speak with others that understand the journey.
PLEASE NOTE * If you, or anyone you know, are experiencing mental or physical symptoms causing pain, fever, discomfort, C. difficile symptoms or changes in a diagnosed infection, or a change in emotional behavior or having suicidal thoughts, DO NOT wait for a scheduled support session. Contact a physician or seek medical attention at a local clinic or hospital immediately. Thank you.
The C. diff. Global TeleSupport Network program is the first-ever FREE GLOBAL patient and family educational support program developed by a U.S. non-profit 501(c)(3) — The C Diff Foundation is dedicated to educating and advocating for C. difficile infection prevention, treatments, clinical trials, support, and environmental safety worldwide.
The decline in C difficile infections may be another sign of improved infection prevention and antibiotic stewardship in US hospitals
C difficile, a bacterium that causes severe diarrhea, is the primary cause of hospital-associated diarrhea and is linked primarily to broad-spectrum antibiotic use, which can disrupt the balance of bacteria in the gut. Reduction of C difficile prevalence has been among the goals of efforts to improve infection prevention and antibiotic use in US hospitals over the past decade.
To assess progress in reducing C difficile infections, CDC researchers used data from the Emerging Infections Program (EIP), which conducts C difficile surveillance in 35 counties in 10 states.
As with the other study, they classified infections as either healthcare-associated or community-associated. Although primarily considered an infection that affects hospital patients, C difficile infections in people with no recent hospital or nursing home stays have been on the rise.
The researchers also adjusted their findings to account for increased use of nucleic acid amplification testing (NAAT) over the study period. NAAT is more sensitive than other types of C difficile testing but cannot distinguish between colonization and infection, which has raised concerns about overdiagnosis.
The percentage of cases diagnosed using NAAT at the EIP hospitals increased from 55% in 2011 to 83% in 2017.
The initial estimate showed a small decline in the total national burden of C difficile infection—from 476,000 cases (154.9 cases per 100,000 population) in 2011
to 462,100 cases (143.6 cases per 100,000 population) in 2017.
But after adjusting NAAT use to the 2011 rate of 55%, total C. difficile infections fell by 24% from 2011 through 2017, driven by a 36% decrease in healthcare-associated infections.
Total hospitalizations for C difficile infection fell by 24%.
The adjusted estimate for community-associated C difficile infections—which accounted for 50% of all infections in 2017—saw no change.
The authors of the study say the reductions in healthcare-associated C difficile could be linked to better adherence to recommended infection-prevention practices, as well as to reduced use of fluoroquinolone antibiotics in hospitals.
In the midst of the COVID-19 pandemic, new data published today in the New England Journal of Medicine (NEJM) provides a glimmer of good news on the infectious disease front.
A study conducted by researchers from the Centers for Disease Control and Prevention (CDC) found that the incidence of infections caused by four multidrug-resistant (MDR) organisms (MDROs) decreased in US hospitals from 2012 through 2017, with the declines ranging from 20% to 39%. While the burden of MDR infections in US hospitals remains substantial, and more work is need to sustain the progress that’s been made, the authors of the study say the findings, which formed the basis for the CDC’s 2019 report on antibiotic resistance, are encouraging.
“For some resistant pathogens, encouraging reductions have been observed in recent years, suggesting that current prevention efforts, particularly infection control interventions focused on healthcare settings, are yielding important benefits,” lead author John Jernigan, MD, of the CDC’s Division of Healthcare Quality Promotion, told CIDRAP News.
In another study today in NEJM, a different team of CDC researchers reported that the national burden of Clostridioides difficile infection and associated hospitalization decreased by nearly a quarter from 2011 through 2017, largely owing to a decline in healthcare-associated C difficile infections.
Declines in 4 MDR pathogens
For the study on MDR infections, Jernigan and his colleagues used electronic health record data from 890 US short-term acute care hospitals to generate a national case count and examine temporal trends for infections caused by the primary MDR pathogens associated with healthcare: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Acinetobacter species, MDR Pseudomonas aeruginosa, and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae.
In 2017, these pathogens, which are considered urgent or serious threats by the CDC because they can cause severe, hard-to-treat invasive infections and spread easily in healthcare settings, caused an estimated 622,390 infections among hospitalized patients. Of these cases, 83% (517,818) were community-onset (either obtained in the community or within the first 3 days of hospitalization) and 17% (104,572) were hospital-onset.
From 2012 through 2017, the researchers found that the incidence decreased for infections caused by MRSA (from 114.18 to 93.68 cases per 10,000 hospitalizations), VRE (24.15 to 15.76 cases per 10,000 hospitalizations), carbapenem-resistant Acinetobacter species (3.33 to 2.47 cases per 10,000 hospitalizations), and MDR P aeruginosa (13.10 to 9.43 cases per 10,000 hospitalizations). There was no significant change on the incidence of CRE infections (3.36 to 3.79 cases per 10,000 hospitalizations).
Although the study did not determines the reasons for these declines, Jernigan says it’s likely that improved infection prevention and control efforts in hospitals have contributed to reducing the spread of these pathogens, particularly MRSA and VRE, which tend to be prevalent in patients who’ve had a lot of healthcare exposure. The incidence of hospital-onset MRSA and VRE declined nearly twice as fast as in community-onset cases.
“During the past decade, healthcare decision makers have placed increased emphasis on infection control in healthcare, including efforts to improve implementation of strategies for preventing device- and procedure-related infections and general infection control measures such as hand hygiene,” he said. “In addition, there has been widespread implementation of MDRO-specific measures designed to prevent healthcare transmission of the pathogens we studied, and many healthcare systems have increased emphasis on antimicrobial stewardship as well.”
Neil Clancy, MD, an associate professor of medicine and infectious disease specialist at the University of Pittsburgh who was not involved in the study, says the data are a welcome bright spot as the nation grapples with the COVID-19 pandemic.
“Taken together, these data suggest that national efforts over the past decade in antimicrobial stewardship and infection prevention, many led by CDC, are making a positive impact on AMR [antimicrobial resistance] in this country,” Clancy said. He’s particularly encouraged by the declines in two of the most worrisome MDR gram-negative (GN) pathogens—carbapenem-resistant Acinetobacter and MDR Pseudomonas.
“Although infections by these pathogens are less common than those caused by MRSA, there are fewer antibiotics active against MDR-GNs,” he said. “Moreover, these bacteria are often acquired by very sick patients in the hospital, so their impact on death and poor outcomes in general is high.”
Notes of caution
But there’s some bad new with the good news. The study also found a 53% rise in incidence of infections caused by ESBL-producing Enterobacteriaceae, largely driven by an increase in community-onset infections. The authors hypothesize that this increase could be linked to Escherichia coli sequence type (ST)131—an epidemic MDR E coli strain that has become a primary cause of antibiotic-resistant infections worldwide and is the most common cause of urinary tract infections.
“More widespread emergence of ESBL bacteria, particularly among otherwise healthy people who are not in the hospital or nursing homes, but rather living in the community, is a potential public health nightmare,” said Clancy, noting that infections caused by ESBL bacteria are also problematic because there are currently no active oral antibiotics for treating them.
Clancy also pointed out that, with 83% of the MDR infections found to be originating in the community, it’s not only the sick people in hospitals who need to worry about those infections.
“The study serves as a reminder that antimicrobial resistance, over the long-term, is as big a public health threat as emerging viral pandemics,” he said.
In an editorial that accompanies the study, infectious disease experts from the University of Washington and the University of California, San Diego, say the results of the study suggest that when it comes to antibiotic resistance, the glass is half full. While the observed reductions indicate that progress is being made, the rise in community-onset MDR infections, and the dwindling pipeline of new antibiotics, underscore the challenges that remain and the need for innovative approaches.
“We cannot afford to be complacent about recent progress in the health care setting, because resistant pathogens are still too common in most institutions, and favorable trends can be readily reversed,” they write. “Moreover, the continued presence of MDR organisms and the rapid emergence of antimicrobial resistance to recently introduced agents mean that new strategies for the treatment of infections by MDR organisms must continue to be a high priority.”
“Innovative interventions and strategies, tailored for the spectrum of healthcare and community settings, will be needed to sustain progress in combating antibiotic resistance,” he said.
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;25:1683-1689).
“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:
C Diff Foundation ( https://cdifffoundation.org/) is a one hundred percent volunteer, world-renowned 501(c)(3) not-for-profit organization and has announced that the Foundation will offer a November clinic sponsored by the C Diff Foundation and dedicated to patients diagnosed and recovering from a C. difficile infection (CDI).
The November 19th C Diff Foundation Clinic will be hosted by Concorde Gastroenterology at their 233 Broadway Suite 840, New York, NY 10279 office. The clinic will hold office hours from 10:00 a.m. until 4:00 p.m. ET
With Doctor’s Caterina Oneto, MD and Paul Feuerstadt, MD Please call +1 212 889 5544 Ext 199 To schedule an appointment.
The August clinic received an overwhelming response from patients in various stages of recovery, including 15 individuals already scheduled with multiple spots planned for patients with recently diagnosed infection or those who have had multiple episodes and need further guidance and management.
Dr. Oneto said, “Through this clinic, we will provide access to high-level care to a number of new consults, as well as existing patients, who are recovering from the infection. It is my pleasure to partner with the C Diff Foundation and lend my expertise to the management and hopefully, eradication of this debilitating disease.”
“We are delighted with the immediate and overwhelming response from the patient community. It is a testament to the needs of those suffering from this infection. With this clinic, we hope to bring awareness, education and more importantly, cutting edge treatment to the general public,” stated Dr. Feuerstadt.
There are plans for additional clinic dates in 2020 in Florida, New York, Connecticut, Illinois, and Minnesota.
“The clinics demonstrate Doctor Oneto and Feuerstadt’s commitment over the years raising C. diff. awareness while providing management of those suffering with
a C. diff. infection. Patients who might not otherwise be able to gain access to providers sub-specializing and caring for those with this infection will have this opportunity available. Doctor’s Oneto and Feuerstadt’s dedication resonates within the C. diff. community and we are grateful for their participation and support.” stated Nancy Caralla, Founding President and Executive Director of the C Diff Foundation.
About C Diff Foundation
C Diff Foundation’s mission is dedicated to reaching out to communities from villages to cities, to medical practitioners, medical students, C. diff. survivors, caregivers, and the patients combating a C. difficile infection (CDI) while providing the general public important information on prevention, treatments available, clinical trials in progress, nutrition, diagnostics, and EPA registered products available for environmental safety worldwide.
About Caterina Oneto, MD
Dr. Caterina Oneto, MD is a Gastroenterologist in private practice in New York and is affiliated with NYU Langone. She completed her Fellowship in Gastroenterology at Montefiore Medical Center, Albert Einstein College of Medicine. Dr. Oneto is the Co-Director of Clinical trials at Concorde Medical Group. Her main focus is Irritable Bowel Disease (IBD),
About Paul Feuerstadt, MD
His areas of interest Clostridioides difficile infection (CDI) and ischemic diseases of the gut and in these areas he has presented his research extensively, authored and co-authored many manuscripts, textbook chapters, and online modules. Another passion of Dr. Feuerstadt is teaching, frequently giving lectures locally, regionally and nationally. He holds a clinical appointment as an Assistant Clinical Professor of Medicine at the Yale University School of Medicine and is a full-time attending physician at the Gastroenterology Center of Connecticut seeing patients with a broad spectrum of clinical gastroenterological diseases.
Dr. Feuerstadt attended the Weill Medical College of Cornell University in Manhattan for medical school and completed his residency in internal medicine at New York-Presbyterian Hospital/Weill Cornell. His clinical fellowship training was completed at Montefiore Medical Center in the Bronx, New York.
Clostridioides difficile infections (AKA C. diff., C.difficile, CDI) and Microbiome modification.
Dr Oneto is also Co-Director of the C.diff. Community Global Support program offered by the
C Diff Foundation. Dr. Oneto appears regularly on Doctor Radio on Sirius Xm
and C. diff. Spores and More Radio (cdiffradio.com).
It is the most common Healthcare-associated infection affecting an estimated 450,000 people annually in the United States alone with ~28,000 deaths from complications of this infection. This infection accounts for ~16% of all healthcare-associated infections.
In the USA: Nearly half a million Americans suffer from Clostridioides difficile (C. diff.) infections in a single year according to a study released on February 25, 2015, by the Centers for Disease Control and Prevention (CDC).
**Approximately 29,000 patients 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 (CDI), making C. difficile a very important cause of infectious disease death in the United States alone. More than 80 percent of the deaths associated with C. difficile occurred among Americans aged 65 years or older. C. difficile causes an inflammation of the colon and deadly diarrhea.
Researchers at The Wellcome Sanger Institute and the London School of Hygiene & Tropical Medicine say they found that C. diff bacteria appears to have broken off into another species, reports StudyFinds.
While the researchers just uncovered the strain, it’s likely been around for tens of thousands of years and is probably the cause of the majority of C.diff infections at hospitals today.
The strain, which is being called C. difficile clade A, was built to withstand modern diet and healthcare facilities way before they existed.
Scientists say that Clostridium difficile (C. diff) is evolving, which could make things more difficult for hospitals that have for years struggled with the bacteria.
The newly discovered strain are problematic because they prefer the sugar-rich diet enjoyed in western countries and can tolerate the cleaning procedures typically carried out at the healthcare facilities in these countries. (*?)
Those involved in the study say it has provided scientists with a better understanding of how bacteria evolves over time. They say the discovery further proves the importance of genomic studies of bacteria.
Another study conducted by the American Society for Microbiology recently found that C. diff is doing a good job of sticking to hospital gowns even after they’ve been treated.