Tag Archives: C. diff. prevention

Clostridium difficile (C.diff.) Infection (CDI) Rates In the United States and Across the Globe Have Increased In the Last Decade, Along With Associated Morbidity and Mortality

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Early Diagnosis, Prevention, and Treatment of Clostridium difficile: Update

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
5600 Fishers Lane
Rockville, MD 20857
March 2016

 

Clostridium difficile is a gram-positive, anaerobic bacterium generally associated through ingestion. Various strains of the bacteria may produce disease generating toxins
and TedA and TedB, as well as the lesser understood binary toxin.

Our use of the term indicates this review’s focus is the presence of clinical disease rather than asymptomatic carriage of C. difficile CDI symptoms can range from mild diarrhea to severe cases including pseudomembranous colitis and toxic megacolon and death.

Estimated U.S. health care associated CDI incidence in 2011 was 95.3 per 100,000, or about
293,000 cases nationally. Incidence is higher among females, whites, and persons 65 years of
age or older. (1)

About one third to one half of health-care onset CDI cases begin in long term care,thus residents in these facilities are at high risk.  Incidence rates may increase by four or five-fold during outbreaks.

Community associated CDI, where CDI occurs outside the institutional setting,
is also on the rise, though still generally lower than institution associated rates and may be in part due to increased surveillance. Estimated community associated CDI was 51.9 per 100,000, or   159,700 cases in 2011.  (1)

Community-associated CDI complicates measuring the effectiveness of  prevention within an institutional setting. 3  Additionally, the pathogenesis of CDI is complex and not
completely understood, and onset may occur as late as several months after hospitalization or antibiotic use

The estimated mortality rate for health -care associated CDI ranged from 2.4 to 8.9 deaths per

100,000 population in 2011.(1) For individuals ≥65 years of age, the mortality rate
was 55.1 deaths per 100,000; (1)

CDI was the 17th leading cause of death in this age group (4)
Hypervirulent C. difficile  strains have emerged since 2000 . These affect a wider population

that includes children, pregnant women, and other healthy
adults, many of whom lack standard risk profiles such as previous hospitalization or antibiotic use.(5)

The hypervirulent strains  account for 51 percent of CDI, compared to only 17 percent
of historical isolates. (6)

Time from symptom development to septic shock may be reduced in the hypervirulent strains, making quick diagnosis and proactive treatment regimens critical for positive outcomes.

To read more on  TREATMENT, PREVENTION, KEY QUESTIONS ——

https://www.effectivehealthcare.ahrq.gov/ehc/products/604/2208/c-difficile-update-report-160329.pdf

Early Diagnosis, Prevention, and Treatment of Clostridium difficile: Update

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
5600 Fishers Lane
Rockville, MD 20857
March 2016

 

Sources:

1Appendix J. References for Appendixes
1.Alcala L, Reigadas E, Marin M, et al.
Comparison of GenomEra C. difficile and Xpert
C. difficile as confirmatory tests in a multistep
algorithm for diagnosis of Clostridium difficile
infection.
J Clin Microbiol 2015 Jan;53(1):332
5. PMID: 25392360.
2.Barkin JA, Nandi N, Miller N, et al.
Super iority
of the DNA amplification assay for the
diagnosis of C. difficile infection: a clinical
comparison of fecal tests.
Dig Dis Sci 2012Oct;57(10):2592-
9. PMID: 22576711.
3.Bruins MJ, Verbeek E, Wallinga JA, et al.
Evaluation of three enzyme immunoassay
s and a loo mediated isothermal amplification test
for the laboratory diagnosis of Clostridium
difficile infection. Eur J Clin Microbiol Infect
Dis 2012 Nov;31(11):3035 9. PMID:
22706512.
4.Buchan BW, Mackey TL, Daly JA, et al.
Multicenter clinical evalu
ation of the portrait
toxigenic C. difficile assay for detection of
toxigenic Clostridium difficile strains in clinical
stool specimens. J Clin Microbiol 2012
Dec;50(12):3932-
6. PMID: 23015667.
5.Calderaro A, Buttrini M, Martinelli M, et al.
Comparative analysis of different methods to
detect Clostridium difficile infection. New
Microbiol 2013 Jan;36(1):57-
63. PMID:
23435816.
6.Carroll KC, Buchan BW, Tan S, et al.
Multicenter evaluation of the Verigene
Clostridium difficile nucleic acid assay.
J ClinMicrobiol 2013 Dec;51(12):4120-
5. PMID:24088862

IDSA and SHEA Release New Antibiotic Stewardship Guidelines

In The News

April 2016

Preauthorization of broad-spectrum antibiotics and prospective review after two or three days of treatment should form the cornerstone of antibiotic stewardship programs to ensure the right drug is prescribed at the right time for the right diagnosis. These are among the numerous recommendations included in new guidelines released by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) and published in the journal Clinical Infectious Diseases.

“Initially, antibiotic stewardship was more focused on cost savings, and physicians responded negatively to that, because they often felt it was best to give patients the newest, most expensive drug,” said Tamar Barlam, MD, lead co-author of the guidelines, director of the antibiotic stewardship program at Boston Medical Center and associate professor of medicine at Boston University Medical School. “While these programs do save hospitals money, their most important benefit is that they improve patient outcomes and reduce the emergence of antibiotic resistance. When we say stewardship, we really mean stewardship, and increasingly, doctors are realizing it’s important and necessary.”

The White House has called for hospitals and healthcare systems to implement antibiotic stewardship programs by 2020 to ensure appropriate use of these vital drugs and reduce resistance, an escalating problem that threatens the ability to effectively treat often life-threatening infections.

The new guidelines replace those originally created to help with the development of programs when antibiotic stewardship was in its infancy, and instead focus on specific strategies that the evidence suggests are most beneficial to ensure the program will be effective and sustainable. They also note it is key that these programs tailor interventions based on local issues, resources and expertise. To ensure that, the guidelines recommend the programs be led by physicians and pharmacists and rely on the expertise of infectious diseases specialists.

“We want hospital administrators to understand the importance of giving antibiotic stewardship their full support to ensure its success,” said Sara Cosgrove, MD, MS, lead co-author of the guidelines, president-elect of SHEA and associate professor of medicine and epidemiology at Johns Hopkins University, and director of the antimicrobial stewardship program and associate hospital epidemiologist at The Johns Hopkins Hospital, Baltimore. “Distributing a few brochures or holding grand rounds won’t do it. It’s vital that antibiotic stewardship be integrated into the hospital’s culture and that infectious disease specialists guide strategies that have been shown to work.”

The guidelines note that more research needs to be done to determine how to ensure antibiotic stewardship is most effective. However, the best evidence to date suggests a number of components, including the following, will help ensure the implementation of an effective antibiotic stewardship program.

  • Preauthorization or prospective audit and feedback – Targeted antibiotics, such as those that treat emerging drug-resistant bacterial infections, should require preauthorization. This means providers need to get approval to use antibiotics before they are prescribed. Prospective audit and feedback can be an alternate strategy or combined with preauthorization. Prospective audit allows antibiotic stewards to engage the prescribing clinician after the antibiotic has been used, typically after two or three days, to optimize antibiotic treatments. Both methods can reduce antibiotic misuse and decrease the development of resistance. Hospitals should choose one or both of these methods as part of their program based on their local resources and expertise.
  • Syndrome-specific interventions – The guidelines recommend focused multifaceted interventions for the treatment of specific syndromes, rather than trying to improve treatment of all infections at once. For example, Dr. Barlam said those leading a hospital’s antibiotic stewardship program might take a close look at management of pneumonia during winter, including making recommendations to shorten the amount of time people are treated and switching to an oral agent more quickly, and then measuring the results of those interventions. In the fall, the program might focus on urinary tract infections and then several months later, switch to skin and soft tissue infections. “This method makes stewardship more manageable and provides a targeted and clear treatment message rather than trying to disseminate 100 different lessons at the same time,” she said.
  • Rapid diagnostic testing – The guidelines note that rapid diagnostic testing of respiratory specimens can help determine if the cause is viral and therefore reduce the inappropriate use of antibiotics. They also note that the rapid testing of blood cultures in addition to conventional culture is helpful, but should be guided by the antibiotic stewardship team for maximum benefit to the patient.

Other recommendations include reducing the use of antibiotics associated with Clostridium difficile infection, implementing antibiotic time-outs and other strategies to encourage prescribers to perform routine reviews of regimens and using computerized clinical decision support if possible.

The guidelines do not recommend relying solely on passive educational materials to implement antibiotic stewardship because any improvement likely will not be sustained. Lectures and brochures should be used to supplement strategies such as antibiotic preauthorization and prospective audit and feedback, the authors note.

AT A GLANCE

  • Preauthorization and prospective review of antibiotics are among the many recommendations to ensure antibiotic stewardship programs are most effective, suggest new guidelines from IDSA/SHEA.
  • Antibiotic stewardship programs should be led by physicians and pharmacists, including ID specialists, who have the expertise and education to ensure the right drug is being prescribed at the right time for the right diagnosis.
  • Antibiotic stewardship programs must be based on the specific problems identified by the healthcare facility and a realistic examination of available resources to ensure interventions are performed with consistency.
  • These programs have been shown to improve patient outcomes, reduce antibiotic resistance and save money.

In addition to Drs. Barlam and Cosgrove, the antibiotic stewardship program guidelines panel includes: Lilian Abbo, Conan MacDougall, Audrey N. Schuetz, Ed Septimus, Arjun Srinivasan, Timothy Dellit, Yngve T. Falck-Ytter, Neil Fishman, Cindy W. Hamilton, Timothy C. Jenkins, Pamela A. Lipsett, Preeti N. Malani, Larissa S. May, Gregory J. Moran, Melinda M. Neuhauser, Jason Newland, Christopher A. Ohl, Matthew Samore, Susan Seo and Kavita K. Trivedi.

IDSA and SHEA individually have published myriad treatment guidelines and together have published several, including the prevention of healthcare-associated infections and antimicrobial prophylaxis in surgery.

As with other IDSA and SHEA guidelines, the antibiotic stewardship guidelines will be available in a smartphone format and a pocket-sized quick-reference edition.

The full guidelines are available free on the

IDSA website at http://www.idsociety.org

 

SHEA website at http://www.shea-online.org.

 

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

http://www.eurekalert.org/pub_releases/2016-04/idso-nas041216.php

 

A World of Thanks To the C Diff Foundation Volunteer Patient Advocates Around the Globe

National Volunteers Week     #NVW2016

 

Did you know that it is  NATIONAL VOLUNTEER WEEK
April 10-16, 2016

President Richard Nixon established National Volunteer Week with an executive order in 1974, as a way to recognize and celebrate the efforts of volunteers. Every sitting U.S. president since Nixon has issued a proclamation during National Volunteer Week (as have many U.S. mayors and governors).  Since then, the original emphasis on celebration has widened; the week has become a nationwide effort to urge people to get out and volunteer in their communities.

To each C Diff Foundation Volunteer Patient Advocate, , on behalf of all the staff and the thousands of members around the globe we want to say THANK YOU!

Your continued support and efforts contribute in a significant way to our mission of educating, and advocating for C. diff. infection prevention, treatments, and environmental safety awareness worldwide.

November marked our third  year in “Raising C. diff. infection Awareness” campaign and we thank the many organizations who supported and contributed by sharing information with others.  We are all working toward a shared goal in witnessing a reduction of newly diagnosed C. diff. cases and “None of us can do this alone…..all of us can do this TOGETHER!”

We celebrate our volunteers and this week stands as a reminder that our daily work sharing information, educating, and advocating for C. diff. infections, remains not only critical but it is urgent.

We do not know when new interventions to prevent, to treat, and protect our environments with products that will  eradicate C. diff. spores will become available to the public.  The good news is that we do know that there are many positive interventions presently in clinical trials, which give us all HOPE.

Visit the website for updates and feel free to inquire if you or a loved one would be considered a candidate to participate in an ongoing clinical trial:

 https://cdifffoundation.org/clinical-trials-2/

This is why acts of sharing the C Diff Foundation literature during every opportunity quickly opens doors of knowledge helping others learn how to prevent acquiring this painful and life-threatening infection, treatments available, and disinfecting products with EPA Registered C. diff. kill for environmental safety–  to  help save lives.

Reminder that there is always information and support  available and  only a phone call away 1-844-FOR-CDIF

The C Diff Foundation Volunteer Patient Advocates build awareness, help build support and provide education of C. difficile infection prevention, treatments, and environmental safety measures  to patients, survivors  their families and community healthcare professional centers/offices.  They also  guide individuals in giving a voice to patients, survivors and their families on healthcare-related infections, informing the public,  health-care providers (hospitals, healthcare professionals, etc.), organizations of health-care professionals, the educational world, with the medical, Governmental agencies, and pharmaceutical research communities.

We provide our Volunteer Patient Advocates with the necessary tools, and updates to generate positive results.

Do you have a few extra minutes to share vital information with others to raise C diff. infection awareness in your community?

By becoming a C Diff Foundation Volunteer Patient Advocate you will make a BIG difference and help spare others the pain, suffering, and tragedy of loosing a loved one that is caused by a C. diff. infection.

Contact our office for additional information and register today by e-mailing the C Diff Foundation your name and a valid mailing address to receive an official  C Diff Foundation Volunteer Patient Advocate Packet

info@cdifffoundation.org

On this day, and throughout the year ahead, we want you to be confident that your Volunteer Membership in the Foundation is bringing important information out into the communities and throughout the world through the educational brochures, cards, letters, and from sharing your own personal experiences with others.  Please be sure to share your journey with others in need of “HOPE” on the C. diff. Survivors Alliance Network website  http://www.cdiffsurvivors.org

Your continued donations received during the year are always appreciated. Your gifts assist the Foundation in promoting C. diff. infection prevention, treatments, and environmental safety education, and advocacy to healthcare professionals, families, patients, and communities world-wide.  We are grateful for your assistance, dedication, and support and we hope the Foundation has also been helpful to you.  If you have any suggestions about how we can serve others better or share the information more effectively, please let us know.  You are welcome to email, telephone, or write to the Foundation at any time.

We certainly look forward to your continued Volunteer Membership in the Foundation.  There is so much more that needs to be accomplished and we continue to move forward together promoting our mission, which is entirely dedicated for the good of others.

May you and your families experience continued HOPE for good health, happiness, and peace throughout the year.

Thank You for helping prevent further pain and suffering worldwide by sharing in the

C Diff Foundation’s mission today.

 

Hospital Collaborative Measures Show Positive Results In Driving Down C difficile Infection (CDI) Rates In New York

NewspaperII

In the news

Each hospital had been trying to combat C. difficile on its own, but they were often outwitted by the hardy spore, which is fueled by overuse of antibiotics, spread by hands  and able to survive on bed rails, call buttons and doorknobs for as long as five months if not longer and cleaned off.

Plus, it was traveling: Patients in one hospital or nursing home were often discharged and then admitted to another. Dealing with the mess was costing the hospitals an estimated $4 million to $5 million a year.

So they did something rare for competing health-care systems. Four hospitals joined forces to beat back the debilitating bug, forming a C. difficile prevention collaborative. Six nursing homes that share patients with the hospitals and had a huge C. difficile problem of their own then formed a separate alliance.

It paid off: In the 12 months ended in September 2015, rates of C. difficile infections fell 36% from 2011 levels across the hospitals, which initially were in three but are now in two health-care systems: the University of Rochester Medical Center and Rochester Regional Health System.

“It’s not very simple—you have to have a multidisciplinary approach to prevent this infection,” says Ghinwa Dumyati, who leads both the hospital and nursing-home collaboratives as an infectious-disease physician with the Center for Community Health at the University of Rochester Medical Center. “We needed to work together.”

A good cleaning

Hospitals compete intensely for patients, doctors and insurance dollars, but when it comes to safety, they are increasingly collaborating to solve common problems, according to Arjun Srinivasan, an expert at the Centers for Disease Control and Prevention in the prevention of health-care-associated infections. The CDC says working together allows hospitals to more effectively fight infections caused by drug-resistant bacteria and C. difficile because the bugs are intractable and the difficulties each facility faces are similar. Plus, Dr. Srinivasan says, “hospitals share those patients.”

New federal requirements to improve health-care quality, such as public reporting of health-care-associated infections and penalties for readmissions, also are prodding hospitals to collaborate more on safety issues, Dr. Srinivasan and hospital executives say.

C. difficile is the most common pathogen causing health-care-associated infections in U.S. hospitals, according to the CDC. It led to approximately 453,000 infections and 29,000 deaths in the U.S. in 2011, according to a study last year in the New England Journal of Medicine.

Infections occur when someone ingests C. difficile and takes antibiotics that wipe out the good bacteria in their gut. That leaves the C. difficile to flourish in the colon, producing diarrhea that can last for weeks or months. The elderly are particularly at risk of infection because their immune systems may be weak, and they are frequent users of hospitals and nursing homes.

Rochester’s C. difficile-prevention collaborative began in 2011, funded by the health-care

systems involved and a large regional insurer, Excellus BlueCross BlueShield. It grew out of an earlier initiative that Dr. Dumyati had led that sharply reduced bloodstream infections from central lines, or catheters, inserted in the body. This time, the collaborative—Dr. Dumyati, along with doctors, infection preventionists and others from the hospitals—

chose to target C. difficile. “We knew we had a lot of cases,” she says.

First, the collaborative focused on cleaning procedures. The hospitals taught staff to scrub long and hard with bleach wipes to get rid of super-resilient C. difficile in hospital rooms. “Just like if you’re washing a plate, you have to apply pressure to get food off,” says Jeanna Hibbert, who cleans rooms at Strong Memorial Hospital, one of the four participating hospitals.

They also introduced inspections of cleaned rooms, using a tool that checks for even small amounts of contamination. “That was new and extraordinarily helpful,” says Robert Panzer, chief quality officer and associate vice president at Strong Memorial.

Each hospital made changes in its own way, and borrowed ideas from the others. Strong Memorial dedicated a crew to clean the rooms of discharged C. difficile patients after determining that it takes an hour and half—twice as long as normal—to properly clean them, adopting a practice from its sister, Highland Hospital.

After the collaborative laid out a policy for treating less severe forms of pneumonia, Strong Memorial pharmacists changed an electronic order form for antibiotics to prevent physicians treating those infections from prescribing a class of drugs linked to C. difficile infection without special approval, says Dr. Dumyati.

Across town at Rochester General Hospital, staff promoted the new pneumonia policy in a newsletter for doctors. Use of the desired antibiotic, doxycycline, for pneumonia more than tripled in a year; use of the one it replaced fell 48%, the hospital says.

The team at Rochester General also created a poster with new guidelines for diagnosing and treating urinary-tract infections after the collaborative determined that five out of six of its hospital patients treated for them don’t actually have them. Dr. Dumyati adopted it for use in the nursing homes she had started to work with, with a grant from the state.

The new policies have helped Rochester General strengthen an antibiotic stewardship program it adopted a few years ago, in which a team of experts reviews antibiotic prescriptions, says Maryrose Laguio-Vila, the program’s director. “We gain insight into whether what we’re doing is along the right track or can be tweaked in a certain way.”

The collaborative has helped all of the hospitals improve their practices and patient care, says Nayef El-Daher, chief of infectious disease at Unity Hospital. “When we started the project, every one of us had [our] own ideas and protocols,” he says.

The next front

Dr. Dumyati feeds data on C. difficile infection rates and other measures every quarter to each of the hospitals, so that they can see how they’re doing. “The data really drive where we go next,” she says.

Next, she hopes to take the new policies to doctors’ and dentists’ offices. About 35% of all C. difficile infections aren’t linked to stays in hospitals or long-term-care facilities, according to the NEJM study.

“It’s fairly clear that you have to work with the nursing homes and you have to work across the community to make progress,” says Mark Shelly, chief of infectious disease at Highland Hospital. “Otherwise we’ll be pointing across the fence for a long time.”

 

To read the article in its entirety click on the link below:

 

http://www.wsj.com/articles/rochester-hospitals-unite-to-defeat-a-common-foe-c-difficile-1455592271

Using Antibiotics Wisely, How Everyone Can Help In the Fight Against Antibiotic Resistance Worldwide

Did you have the opportunity to listen  to the live broadcast on “C. diff. Spores and More Global Broadcasting Network”  on Tuesday, February 9th, 2016 with guests Dr. Lori Hicks and Dr. Arjun Srinivasan from  the Centers of Disease Control and Prevention (CDC) ?

Dr. Hicks and Dr. Srinivasan discussed how to use antibiotics wisely and how everyone can help in the fight against antibiotic-resistance.

This important  information  is now available to you on demand by clicking directly on the logo below

 

cdiffRadioLogoMarch2015

For additional information on Inpatient Antibiotic Stewardship please click on the following link:

http://www.cdc.gov/getsmart/healthcare/inpatient-stewardship.html

 

To access the CDC Get Smart Program, please click on the following link to be redirected:

http://www.cdc.gov/getsmart/index.html

 

 

C. diff. Spores and More” programming is brought to you by VoiceAmerica  and sponsored by Clorox Healthcare

For more information please visit the C. diff. Spores and More program page:

https://cdifffoundation.org/c-diff-radio/

C diff Spores and More Global Broadcasting Network and Guests Dr. Srinivasan and Dr. Hicks of the CDC Discuss Antibiotic Resistance

cdiffRadioLogoMarch2015

C. diff. Spores and More , Global Broadcasting Network – innovative and educational interactive healthcare talk radio show discuss antibiotic resistance and what everyone can do to join in the fight against it with guests Dr. Arjun Srinivasan and
Dr. Lauri Hicks on Tuesday, February 9th at 10 AM Pacific Time on VoiceAmerica Health and Wellness Channel

Bringing guests together, such as Dr. Arjun Srinivasan, MD and Dr. Lauri Hicks, DO from the Center of Disease Control and Prevention (CDC), one of the leading government healthcare organizations in the U.S., and internationally recognized experts on antibiotic resistance has built a loyal listenership and continue to inform and educate listeners’ worldwide.

C.diff. Spores and More” is broadcast live every Tuesday at 10 AM Pacific Time on the VoiceAmerica Health and Wellness channel, officially sponsored by Clorox Healthcare. Archived C. diff. Spores and More shows can be found Here.

“I am so proud to be the Senior Executive Producer of the “C. diff. Spores and More,” program as it continues to raise awareness, on a global level, of the overuse of antibiotics. Having guests; Dr. Arjun Srinivasan, MD and Dr. Lauri Hicks, DO truly affect change in both the leadership and education guiding the public and raising awareness in many areas of health care,” stated Robert Ciolino, Senior Executive Producer VoiceAmerica.

About The C diff Foundation Executive Director
Nancy C Caralla, hosts “C. diff. Spores and More” Global Broadcasting Network with a team focus on educating, and advocating for C. diff. infection prevention, treatments, and environmental safety – and more — worldwide.

For information please visit www.cdifffoundation.org

Listen in on Tuesday, February 9th at 10:00 Pacific Time–

https://cdifffoundation.org/c-diff-radio/

C. difficile, a leading Healthcare-Associated Infection, Brings Together World Topic Experts At the International Raising C. diff. Awareness Conference and Health EXPO in Boston, MA on November 9th

 2015 International Raising C. diff. Awareness Conference & Health EXPO

Boston, MA, USA   ~    November 9th

7:30 a.m – 5:00 p.m

conferencesanjuanprJoin us at our 3rd annual International Raising C. diff. Awareness Conference and Health EXPO on November 9th.  Not just another educational conference but one that pairs
world-renowned topic experts with presentations on state-of-the-art health care topics pertaining to a leading Healthcare-Associated Infection (HAI); C. difficile

*Prevention
*Treatments
*Research
*Prevention and Treatment Clinical trials and studies
*Microbiome research
*Infection Prevention
*Environmental Safety
*Fecal Microbiota Restoration and Transplants
……………………..and much more.

The panel of world-renowned topic experts will also discuss the burden of C. diff. the risk factors pertaining to current and emerging treatment options along with the importance of applying evidence-based clinical approaches to the prevention of  a C. diff. infection (CDI), one of the leading Hospital-Acquired Infections.

Clostridium difficile (also known as C. diff.) is an important cause of infectious disease death in the United States.  Nearly half a million Americans suffered from Clostridium difficile (C. diff.) infections in a single year according to a study released February 25, 2015 by the Centers for Disease Control and Prevention (CDC). • More than 100,000 of these infections developed among residents of U.S. nursing homes alone.*  Approximately 29,000 patients died within 30 days of the initial diagnosis of a C. diff. infection.   Of these 29,000 – 15,000 deaths were estimated to be directly related to a  C. diff. infection. Therefore; C. diff. is an important cause of infectious disease death in the U.S.  (Source: CDC)

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Conference Venue:

Double Tree Suites Hotel – Boston – Cambridge
400 Soldiers Field Road, Boston, MA  02134  USA
1-617-783-0090 For Hotel Accommodations *   * There are hotel accommodations available for Sunday evening offered at a special event rate for guests of the C Diff Foundation.  Please inform the DoubleTree representative at the time of creating a reservation to receive the special event room rate.

Exclusive Admission:   $75.00

Student Admission:     $50.00

Each exclusive and student ticket includes admission to all presentations, formal and informal Q&A sessions, introductions to fellow healthcare professionals, continental breakfast  (7:30 a.m.) , a plated four course luncheon with the choice of Chicken Florentine or Petite Filet Mignon main entree, Access to the Health EXPO, a conference book, a educational DVD, and formal conference program.  

To Register and obtain tickets, please click on the following link

NOTE:  *Presentations should not be recorded audio or video or published without prior written and signed permission from the guest speaker and addressed by each attendee seeking publication of said presentations.

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Guest Speakers

Key Speaker and Conference Chair:  Professor Mark Wilcox;  Professor of Medical Microbiology, Leeds Institute of Biomedical and Clinical Sciences, UK. Professor Mark Wilcox is a Consultant Microbiologist, Head of Microbiology and Academic Lead of Pathology at the Leeds Teaching Hospitals, Professor of Medical Microbiology at the University of Leeds, and is the Lead on Clostridium difficile for the Public Health England. He has formerly been the Director of Infection Prevention, Infection Control Doctor and Clinical Director of Pathology at Leeds Teaching Hospitals.

Dr. John Bartlett, MD; Assistant Professor Medicine, UCLA/Sepulveda Veterans Admin Hospital 1972-5, Associate Professor and Professor of Medicine, Tufts University School of Medicine, Boston, 1975-80, Professor of Medicine and Chair Division of Infectious Diseases Division, Johns Hopkins University School of Medicine 1980 – 2006; Professor of Medicine, 2006 – 13; Professor of Medicine emeritus, Johns Hopkins University School of Medicine, 2013.Dominant research interests: anaerobic infections and pulmonary infections 1968 – 74; community acquired pneumonia and diagnostic methods, 1974-1980; Bowel prep for elective colon surgery; Protected bronchoscopy brush catheter-1977; Clostridium difficile 1977 – 84, HIV 1983 – 2014; bioterrorism 1999 –2004; Clostridium difficile infection, HIV/AIDS and antibiotic resistance 2006-2013 with  Major current interests: Clostridium difficile infection, HIV infection, antibiotic resistance, careers in infectious diseases.
Presentation Topic: “The discovery of Clostridium difficile as the cause of antibiotic-associated colitis.”

Professor Simon M. Cutting, Professor of Molecular Microbiology at Royal Holloway, University of London is a bacterial geneticist with over 25 years of experience with Bacillus since graduating from Oxford University with a D. Phil in 1986. His D.Phil was on understanding the genetic control of spore formation in Bacillus. After spending 7 years in the renowned laboratory of Professor Richard Losick at Harvard University Biological Laboratories (USA) he spent 3 years as an Assistant Professor at the University of Pennsylvania Medical School in Philadelphia. He returned to the UK in 1996 and since then has worked on developing bacterial spores as novel oral vaccines at
Royal Holloway, University of London. The Cutting lab has developed a number of prototype oral vaccines and is now entering a ‘first in man’ phase 1/IIa clinical trial of a prototype oral vaccine to 
Clostridium difficile (see www.cdvax.org). His other expertise is in the use of Bacillus spores as probiotics and has a number of contracts and consultancies with European and US companies in the food and feed sectors 
(see SporeGen.com).
Presentation Topic: “Mucosal Vaccination: Decolonisation is Essential to Full Protection Against C. difficile

Dr. Sadeq A. Quraishi, MD, MHA, MMSc   Anesthesiologist/Intensive Care physician in the Department of Anesthesia, Critical Care and Pain Medicine at the Massachusetts General Hospital in Boston, MA. He is also Assistant Professor of Anaesthesia at Harvard Medical School in Boston, MA. Dr. Quraishi’s overall research goal is to better define how macro- and micro-nutrient status influence outcomes during acute stress and critical illness. In particular, his research group has focused on the immunomodulatory effects of vitamin D in the perioperative setting, during acute care hospitalization, and for patients in the intensive care unit. Recently, Dr. Quraishi’s group has identified vitamin D status as a potentially modifiable risk factor for hospital acquired C. diff infections and that the severity of C. Diff infections may also be related to vitamin D status .
Presentation Topic:  “Vitamin D as nutritional immunomodulation
for Clostridium difficile infections.”

Dr. Mary Beth Dorr , Phd, studied Pharmacy at the University of the Sciences in Philadelphia and received a PhD in pharmacokinetics and drug metabolism from the University of North Carolina. For the last 28 years Dr. Dorr has worked in the pharmaceutical industry in various capacities, with the majority of the time devoted to the design and implementation of Phase 1 to 4 clinical trials, primarily for anti-infective products.  Prior to joining Merck, Dr. Dorr directed several large, international clinical studies of the efficacy and safety of two IV antibiotics, Synercid and dalbavancin.  She also directed clinical research programs for gastrointestinal and women’s health products.  Mary Beth joined Merck in February 2011 and is currently a Clinical Director in the Late Stage Clinical Development Department as the Clinical Monitor directing 2 large pivotal Phase 3 trials investigating the safety and efficacy of the monoclonal antibodies actoxumab and bezlotoxumab as adjunctive therapy for the prevention of C. difficile recurrence.
Presentation Topic: Bezlotoxumab for Prevention of Recurrent C. difficile Infection in Patients on Standard of Care Antibiotics:  Results of Phase 3 Trials (MODIFY I and MODIFY II)

Dr. Hudson Garrett, Jr., PhD, MSN, MPH, FNP, CSRN, VA-BC, CDONA,FACONA,DON-CLTC
Dr. Hudson Garrett is currently employed as the VP, Clinical Affairs for PDI and NIce-Pak, and is responsible for the global Clinical Affairs program and also the Medical Science Liaison program for all divisions within the company. He holds a Bachelor of Science degree in Biology/Chemistry and Nursing, a dual Masters in Nursing and Public Health, Post-Masters Certificate as a Family Nurse Practitioner, a Post-Masters Certificate in Infection Prevention and Infection Control and a PhD in Healthcare Administration and Policy. He has completed the Johns Hopkins Fellows Program in Hospital Epidemiology and Infection Control, and the CDC Fundamentals of Healthcare Epidemiology program, and is board certified in family practice, critical care, vascular assess, moderate sedation, legal nurse consulting, and a director of nursing in long term care.  Dr. Garrett is also a Fellow in the Academy of National Associations of Directors of Nursing Administration in Long Term Care.
Presentation Topic:  Preventing Clostridium difficile thru Antibiotic Stewardship

Dr. David Cook, PhD;  A scientist and entrepreneur who has held senior operating and management positions in the biotechnology industry over his 20-year career. Before joining Seres Therapeutics, he was the chief operating officer for the International AIDS Vaccine Initiative, a global R&D organization whose mission is to develop a safe, globally accessible vaccine for HIV. Prior to IAVI, David was the founding CEO at Anza Therapeutics, a biotechnology start-up developing a novel microbial vaccine platform to induce cellular immune responses to fight or prevent diseases such as cancer, hepatitis C, malaria and tuberculosis. He is also a co-inventor on over twenty-five patents. He received his undergraduate degree from Harvard College and his PhD in chemistry from the University of California, Berkeley. Dr Cook is presently Executive Vice President of R&D, Chief Scientific Officer with Seres Therapeutics, Inc.. Presentation Topic: “The role of the microbiome in resisting
C. difficile infection and the mechanism of Ecobiotic drugs.”

Julie Gubb, PhD, CIC,   has worked in the field of Infection Prevention in varying roles at healthcare facilities in multiple states for more than two decades. After graduating from the University of Detroit Mercy with a degree in Medical Technology, she began her career as Senior Clinical Microbiologist at an acute care hospital in Detroit, Michigan, where she developed an interest in Infection Control while managing the activities of a full-service microbiology laboratory. She was the Director of Infection Control at Mount Clemens Regional Medical Center in Michigan, and has also held positions in Infection Prevention at healthcare facilities in California and Nevada. As a Senior Infection Preventionist for Xenex, Julie works closely with hospitals throughout the United States to understand their infection prevention goals and develop strategies for attaining those goals. As an active member of the national organization Association for Professionals in Infection Control & Epidemiology (APIC), she has maintained Board Certification in Infection Control and Epidemiology since 1993 and speaks frequently at APIC chapter meetings.
Presentation Topic: Stand Up for Cleanliness / Enhanced Room Disinfection

Dr. Patricia J. Freda Pietrobon, PhD: Associate Vice President, R&D,
Sanofi Pasteur, has over 25 years of experience in the Vaccine & Diagnostic industries and more then 20 years in leadership roles focusing on research & development of new vaccines. Patricia began her career in diagnostic assay development with a focus on validation and quality alignment to regulatory requirements and GXPs. Patricia has been with Sanofi Pasteur for over 25 years and has contributed to the development and licensure of new bacterial & viral vaccines for pediatric & adult populations worldwide.

Barley Chironda, Manager of Infection Prevention and Control (IPAC) and Medical Device Reprocessing Device at St. Joseph Health Centre in Toronto, Canada. He is certified in Infection prevention and control (CIC TM) and has worked extensively as an Infection Preventionist. Barely has been an integral to the successful decline in Clostridium difficile infections through implementing innovative technology and quality improvement behavioral changes.   Barley’s presentation will show a behind the scenes account of the C. diff. management from the healthcare facilities perspective while providing a call to action.

Dr. Martha Clokie, PhD, Leicester UK, Professor in Microbiology.  Dr. Cloakie’s research focuses on phages that infect bacterial pathogens of medical relevance and  has published 41 papers in this area. Her major focus has been on Clostridium difficile where she has  isolated a large phage collection. In vitro and in vivo data has shown that the viruses have therapeutic potential. A patent has been filed  on these phages and  working with AmpliPhi to develop a product. Dr. Cloakie  has regular contact with the BBC and other media to talk about her work, and other phage projects, and has consulted with Science museum, London and Eden Project, UK to advise on bacteriophage displays.

Lee Jones, Founder, President and CEO of Rebiotix Inc, has over thirty years of experience in the medical technology industry in large and small companies and academia. Most recently Lee was Chief Administrative Officer of the Schulze Diabetes Institute at the University of Minnesota, Minneapolis, MN and is the former president and chief executive officer of Inlet Medical. Inlet Medical was sold to Cooper Surgical in 2006. Lee will introduce Rebiotix Inc.,  a biotechnology company founded in 2011 in Roseville, MN to revolutionize the treatment of challenging gastrointestinal diseases by harnessing the power of the human microbiome The company is developing an entirely new kind of biological drug designed to reverse pathogenic processes responsible for disease through the transplantation of live human-derived microbes into a sick person’s intestinal tract.
Presentation Topic:  Blazing a Trail with the Gut Microbiome

Professor Nancy Sheridan,   a C. diff. Survivor and  Associate Professor at the Fashion Institute of Technology and a winner of the prestigious SUNY Chancellor’s Award for Excellence in Teaching. Professor Sheridan will share her personal experience being treated for a painful and extended journey with a C. diff. infection (CDI).  Professor Sheridan has been teaching since fall 2000 in the Fashion Merchandising Management Department within the School of Business and Technology. For the past seven years, she has also taught at the University of Pennsylvania, Wharton Business School to undergraduate and MBA students.

Dr Mel Thomson, PhD,  completed her Honors degree in microbiology and immunology at the University of Melbourne . She then immigrated to the UK where she worked on various projects as diverse as allergy and cancer before undertaking further studies. She completed a Masters of Research in functional genomics before reading for a PhD in microbial genetic regulation in Neisseria species, both at University of York, UK. After the award of her PhD, Dr Thomson became interested the host-pathogen interactions at the Leeds Institute of Molecular Medicine, UK.  Dr Thomson returned to Australia in 2011 to start her own research group studying host-pathogen interactions in the GI tract, at Deakin Medical School. A passionate science communicator, and has recently become a national ‘torch bearer’ for the concept of crowd funding academic research, which a track record of three successful ‘Pozible’ crowd funding campaigns, ‘Mighty Maggots’, ‘Hips 4 Hipsters’ and ‘No more Poo Taboo’
Presentation Topic: All that glitters is C.diff awareness gold and Crowdfunding: The ‘No more poo taboo’ animation”

Dr Rahma Wehelie – LifeClean International AB – Sweden; LifeClean International AB is a Swedish company with an international orientation that conducts research, development, and production in the spore, bacteria, and virus eliminating industry. LifeClean was established in 2013 after many years of research and the headquarter lies in Uddevalla, Sweden.
Presentation Topic: Dr Wehelie will be discussing LifeClean’s research, development and production eliminating Clostridium difficile, Norovirus, and other multidrug-resistant bacteria

Dr. Klaus Gottlieb, MD, FACG,Synthetic Biologics, Inc.,Vice President, Clinical;Regulatory Affairs   Dr. Gottlieb is an experienced board-certified internist and gastroenterologist with a strong clinical science, business and drug development background. He joined Synthetic Biologics after serving as Senior Medical Director-Therapeutic Strategy Lead Gastroenterology of Quintiles, a Fortune 500 company and the world’s largest provider of biopharmaceutical development and commercial outsourcing services. At Quintiles, Dr. Gottlieb served as Global Medical Advisor for three separate large Phase 3 inflammatory bowel disease (IBD) trials and provided significant input on the shaping, design and evaluation of numerous IBD and other gastrointestinal (GI) clinical trials throughout all stages of development programs. Prior to joining Quintiles in 2013, he was with the FDA in Silver Spring, MD as a Senior Clinical Reviewer for the Division of Gastroenterology and Inborn Errors Products. Widely published, his academic contributions have been recognized by an appointment as Professor of Medicine (Clinical) at George Washington University and the following elected fellowships: Fellow American College of Physicians, Fellow American College of Gastroenterology, Fellow American Society of Gastrointestinal Endoscopy.  Presentation Topic: Protecting the Gut Microbiome

For additional information contact the C Diff Foundation: (919) 201-1512 or
info@cdifffoundation.org

To Register and obtain tickets, please click on the following link

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