Tag Archives: C. difficile and Sepsis

Centers for Disease Control and Prevention (CDC) Provides Updates On C. difficile Infection Management and Treatment

cdc logo

According to the Centers for Disease Control and Prevention (CDC), Clostridium difficile infection (C. difficile) “has become the most common microbial cause of healthcare-associated infections in U.S. hospitals and costs up to $4.8 billion each year in excess health care costs for acute care facilities alone.”

Statistics provided by the CDC suggest that C. difficile cause nearly 500,000 infections in patients in the US annually.

In one study noted by the CDC, among infected patients, nearly 29,000 died within 30 days of being diagnosed, and more than half of those deaths (15,000) were directly attributable to C. difficile infection.

With C. difficile infection prevention being declared a national priority by the CDC, researchers, public health officials, infectious disease specialists, and others continue to research more effective ways to combat this microbe. Below, we’ve collected links and information on several recent developments.

THE GOOD NEWS
The Center for Infectious Disease Research and Policy (CIDRAP) recently -hospital-stewardship-lowers-antibiotic-use-infections”>reported some good news about the effectiveness of antibiotic stewardship programs (ASPs) in reducing antibiotic usage, especially among patients in the intensive care unit.

Citing the results of a meta-analysis published in Antimicrobial Agents and Chemotherapy, the CIDRAP report noted that, following the implementation of an ASP, “hospital antimicrobial consumption across all studies declined by 19.1%, and antibiotic costs fell by 33.9%. Though a modest decrease of 12.1% in antimicrobial use occurred in general medical wards, antimicrobial use in ICUs fell by 39.5% across the four studies that looked at that parameter.”

The meta-analysis also found that ASPs were effective in curbing the use of non-antibiotic therapies. In the six studies that also monitored antifungal prescription rates, the authors reported a 39.1% decline after ASP initiation.

The use of third- and fourth generation antibiotics (such as cephalosporins, vancomycin, tigecycline, linezolid, imipenem, meropenem, and fluoroquinolones) declined by 26.6% in facilities that implemented an ASP.

The meta-analysis found that bacteria infection rates declined 4.5% in the studies that measured clinical outcomes, and length of hospital stay fell by nearly 9% in studies that measured that metric.

However, the CIDRAP report noted that ASP implementation was not “associated with declining risks for Clostridium difficile (C diff) infections.” The authors of the meta-analysis did note that, in three studies that evaluated C difficile rates, “significant publication bias favored studies that reported ASPs’ negative effects.”

Let’s just get right to the heart of this report from Reuters:

“Fifteen years after the U.S. government declared antibiotic-resistant infections to be a grave threat to public health, a Reuters investigation has found that infection-related deaths are going uncounted, hindering the nation’s ability to fight a scourge that exacts a significant human and financial toll. Even when recorded, tens of thousands of deaths from drug-resistant infections – as well as many more infections that sicken but don’t kill people – go uncounted because federal and state agencies are doing a poor job of tracking them.

The Centers for Disease Control and Prevention (CDC), the go-to national public health monitor, and state health departments lack the political, legal and financial wherewithal to impose rigorous surveillance.”

The report goes on to outline how incomplete, “patchwork” infection reporting requirements for hospitals, and lax requirements in many states regarding physicians’ responsibilities when filling out death certificates, have led to deaths caused by (or at the very least associated with) MRSA and other drug-resistant pathogens to be “grossly under-reported.”

For example, according to Reuters, only 17 states require notification of C. difficile infections. Only two of the so-called “superbug” infections (MRSA bacteremia and C. difficile) are required to be reported to the CDC’s National Healthcare Safety Network surveillance program.

As they say, read the whole thing.

The authors of an article published in Clinical Microbiology and Infection  reported on a study that compared treatment with tigecycline to standard therapy in adult patients with severe C. difficile infection (sCDI).

The retrospective cohort study compared outcomes in patients with sCDI who received tigecycline alone to outcomes in patients who received standard oral vancomycin combined with intravenous metronidazole.

The primary study outcome was clinical recovery (as determined by European Society of Clinical Microbiology and Infectious Diseases guidelines); secondary outcomes were “in-hospital and 90-day all-cause mortality and relapse, colectomy and complication rates.”

A total of 90 patients with sCDI were treated (45 in each group). Patients treated with tigecycline monotherapy tended to do better in terms of cure rate, complicated disease, and CDI sepsis.

The authors reported that, compared to the group that received standard therapy, the tigecycline group had “significantly better outcomes of clinical cure (34/45, 75.6% vs. 24/45, 53.3%; p=0.02), less complicated disease course (13/45, 28.9% vs. 24/45, 53.3%; p=0.02) and less CDI sepsis (7/45, 15.6% vs. 18/45, 40.0%; p=0.009).”

Rates of mortality, disease relapse, and other measures were similar between the groups.

These results led the researchers to conclude that “tigecycline might be considered as a potential candidate for therapeutic usage in cases of sCDI refractory to standard treatment.”

Our good friends at Contagion Live recently reported on a study that has uncovered how the C. difficile bacteria produces toxins, which could aid the development of nonantibiotic drugs to fight C. difficile infection.

According to Contagion Live, C. difficile produces two toxins, toxin A and toxin B, that “cause life-threatening diarrhea as well as pseudomembranous colitis, toxic megacolon, perforations in the colon, sepsis and rarely death.”

Researchers at the University of Texas found that strains of C. difficile with a mutation in a particular Agr locus in their genome could not produce the toxins.

“Identifying a pathway responsible for activating the production of the toxins… opens up a unique therapeutic target for the development of a novel nonantibiotic therapy for C. difficile infections,” said the study authors.

The Contagion Live article includes a quote from author Charles Darkoh, PhD, on the potential implications of these findings.

“By crippling their toxin-making machinery, C. diff cannot make toxins and thus cannot cause disease. My laboratory is already working on this and was awarded a 5-year National Institutes of Health grant to investigate and develop an oral compound we have identified that inactivate the toxins and block the toxin-making machinery of C. diff by targeting this pathway,” he said.

 

 

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

 http://www.hcplive.com/medical-news/latest-news-and-updates-on-c-difficile-infection-management-and-treatment/P-4#sthash.iDm6FgAP.dpuf

 

September Is SEPSIS Awareness Month; Learn More With the CDC and Worldwide Organizations Raising Awareness; It’s A Race Against Time

Sepsis With The CDC; It’s A Race Against Time

Sepsis Awareness Month is in September. SEP for Sepsis.
SEP for September – making September the perfect month for Sepsis Awareness Month 

30 Days to Highlight Sepsis

September is Sepsis Awareness Month and for 30 days, Sepsis Alliance www.sepsis.org and sepsis advocates pull out all the stops to spread the word about what sepsis is, what it does, and how we can make a difference and save lives.

Faces of Sepsis:

PoppaManihat

 

 

 

 

http://www.sepsis.org/faces/michael-j-caralla-sr/

Sepsis hits home and is no stranger to the Foundress of the C diff Foundation or to the millions of families who have lost loved ones from Sepsis.  Loosing a loved one from Septic Shock with C.diff. involvement is devastating for any family.  The C Diff Foundation supports and joins the organizations raising Sepsis awareness worldwide and we encourage everyone to join in the global efforts being made to help save lives.

Click on the Logo below to listen to the Podcast from a live broadcast on “C. diff. Spores and More” Global Broadcasting Network  “Sepsis; Number One Preventable Cause of Death Worldwide”  with guests  Dr. Tex Kissoon, MD,a well-known doctor from Canada, will provide us with the insight into the global phenomenon of Sepsis. Sepsis affects more than 30 million lives per year yet it is almost unknown to the general public and is quite often misdiagnosed by medical professionals worldwide. The reasons of why that is with the “why” Sepsis is so deadly, and what you can do to increase Sepsis awareness– will be discussed in the next 60 minutes. Dr. Kissoon is joined by Ray Schachter, a Sepsis survivor who has dedicated all of his available time to combating and raising awareness of Sepsis worldwide. Both are members of the Global Sepsis Alliance, which has established World Sepsis Day on September 13th every year to raise awareness for Sepsis worldwide.

cdiffRadioLogoMarch2015

 

World Sepsis Day is September 13th

worldSepsisDay

Free online congress on September 8- 9, 2016
Register now!

http://www.world-sepsis-day.org/?MET=HOME&vLANGUAGE=EN

worldsepsisbanner

SepsisCDC710

 

Saving patients from sepsis is a race against time

CDC calls sepsis a medical emergency; encourages prompt action for prevention, early recognition

Sepsis is caused by the body’s overwhelming and life-threatening response to an infection and requires rapid intervention. It begins outside of the hospital for nearly 80 percent of patients. According to a new Vital Signs report released by CDC, about 7 in 10 patients with sepsis had used health care services recently or had chronic diseases that required frequent medical care. These represent opportunities for healthcare providers to prevent, recognize, and treat sepsis long before it can cause life-threatening illness or death.

SepsisCDCThinkSepsis

“When sepsis occurs, it should be treated as a medical emergency,” said CDC Director Tom Frieden, M.D., M.P.H. “Doctors and nurses can prevent sepsis and also the devastating effects of sepsis, and patients and families can watch for sepsis and ask, ‘could this be sepsis?’”   

Certain people with an infection are more likely to get sepsis, including people age 65 years or older, infants less than 1 year old, people who have weakened immune systems, and people who have chronic medical conditions (such as diabetes). While much less common, even healthy children and adults can develop sepsis from an infection, especially when not recognized early. The signs and symptoms of sepsis include: shivering, fever, or feeling very cold; extreme pain or discomfort; clammy or sweaty skin; confusion or disorientation; shortness of breath and a high heart rate.

SepsisCDCBannerHealthcareMatters

According to the Vital Signs report, infections of the lung, urinary tract, skin, and gut most often led to sepsis. In most cases, the germ that caused the infection leading to sepsis was not identified. When identified, the most common germs leading to sepsis were Staphylococcus aureus, Escherichia coli (E. coli), and some types of Streptococcus.

 

Health care providers, patients and their family members can work as a team to prevent sepsis.

Health care providers play a critical role in protecting patients from infections that can lead to sepsis and recognizing sepsis early. Health care providers can:

·         Prevent infections. Follow infection control requirements (such as handwashing) and ensure patients to get recommended vaccines (e.g., flu and pneumococcal).

·         Educate patients and their families. Stress the need to prevent infections, manage chronic conditions, and, if an infection is not improving, promptly seek care. Don’t delay.

·         Think sepsis. Know the signs and symptoms to identify and treat patients earlier.

·         Act fast. If sepsis is suspected, order tests to help determine if an infection is present, where it is, and what caused it. Start antibiotics and other recommended medical care immediately.

·         Reassess patient management. Check patient progress frequently. Reassess antibiotic therapy 24-48 hours or sooner to change therapy as needed. Determine whether the type of antibiotics, dose, and duration are correct.

CDC is working on five key areas related to sepsis:

·         Increasing sepsis awareness by engaging clinical professional organizations and patient advocates.

·         Aligning infection prevention, chronic disease management, and appropriate antibiotic use to promote early recognition of sepsis.

·         Studying risk factors for sepsis that can guide focused prevention and early recognition.

·         Developing tracking for sepsis to measure impact of successful interventions.

·         Preventing infections that may lead to sepsis by promoting vaccination programs, chronic disease management, infection prevention, and appropriate antibiotic use.

To read the entire Vital Signs report visit: www.cdc.gov/vitalsigns/sepsis.

For more information on sepsis and CDC’s work visit: www.cdc.gov/sepsis.

U.S. Department of Health and Human Services

###

CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, stem from human error or deliberate attack, CDC is committed to respond to America’s most pressing health challenges.