Tag Archives: Cdiff research

Clostridium difficile Infection Incidence In Mainland China – A Systematic Review

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 Abstract

It has been widely reported that the incidence and severity of Clostridium difficile infection (CDI) have increased dramatically in North America and Europe. However, little is known about CDI in Mainland China. In this study, we aimed to investigate the incidence of CDI and the main epidemic and drug-resistant strains of C. difficile in Mainland China through meta-analysis of related studies published after the year 2010. A total of 51 eligible studies were included. The pooled incidence of toxigenic C. difficile among patients with diarrhoea was 14% (95% CI = 12-16%). In Mainland China, ST-37 and ST-3 were the most prevalent strains; fortunately, hypervirulent strains, such as ST-1 (BI/NAP1/027) and ST-11 (RT 078), have only occurred sporadically to date.

The rates of C. difficile resistance to ciprofloxacin (98.3%; 95% CI = 96.9-99.7%), clindamycin (81.7%; 95% CI = 76.1-87.3%) and erythromycin (80.2%; 95% CI = 73.5-86.9%) are higher than in other counties; however, none of the C. difficile isolates reported in Mainland China were resistant to metronidazole (n/N = 0/960), vancomycin (n/N = 0/960), tigecycline (n/N = 0/41) or piperacillin/tazobactam(n/N = 0/288).

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https://www.ncbi.nlm.nih.gov/pubmed/27897206?dopt=Abstract&utm_source=dlvr.it&utm_medium=twitter

C. difficile Researcher Kirk Hevener Of ISU And Research Group At Texas A&M University and University of Hawaii Work On A New Way To Treat Clostridium difficile

Kirk Hevener of the ISU Department of Biomedical and Pharmaceutical Sciences is part of a group that is working on a new way to treat Clostridium difficile, commonly called
C. difficile or C. diff. Working with researchers from Texas A&M University and the University of Hawaii
, Hevener is researching a new target that could change the way C. diff is treated through a $415,000 grant from the National Institute of Health.

C. diff  is a bacteria that commonly causes infection of the colon and can lead to severe damage, and in some cases can even be fatal. It is also highly drug-resistant and extremely transmittable.

Hevener identified C. diff as a possible candidate for research while working with a completely different bacteria during his postdoctoral fellowship in Chicago.

Porphyromonas gingivalis is a bacteria that causes disease in the mouth.

While these two bacteria are unrelated, they have two common traits. Both are pathogenic, meaning they cause disease, and contain an enzyme called FabK.

FabK is not found in many other bacteria, so Hevener decided that C. diff would be a good candidate to extend his work in Chicago to, with FabK being the focus of his current work.

This enzyme is part of the fatty acid synthesis pathway. This creates lipids that are used to create the cell membrane, among other functions of the cell. Within C. diff, it is also is part of the mechanism that creates the bacteria’s spores. These spores are inactive forms of the bacteria and are extremely difficult to kill.  They are the reason that recurrence and transmission rates are so high inside of hospitals.

Hevener is studying ways this enzyme can be targeted specifically, with molecules known as inhibitors.

If he and his team can prove that FabK is targetable, it could lead to the development of new medications specific to the treatment of C. diff.

Hevener wanted to make clear that he is currently working on target validation, and not drug development. He and his team are validating that by inhibiting this enzyme, the bacteria would not be able to able to reproduce and create spores, which would then allow others to develop a medication to leverage this mechanism.

By targeting FabK specifically, Hevener’s team would create a narrow spectrum method of treatment, as opposed to the more common broad spectrum approach.

Broad spectrum antibiotics affect all bacteria, regardless if they are pathogenic or beneficial.

There are many bacteria found inside of the human body that aid in different ways from digestion to preventing harmful organisms causing infection.

This narrow spectrum approach has two benefits for a medication developed using it: it does not kill helpful organisms and it helps slow the development of resistance.

Hevener explained that it is impossible to create an antibiotic that is immune to the development of resistance, but because a medication of this type would affect only C. diff, other bacteria would not develop resistance and transfer that genetic mutation to other bacteria. This would slow the progress of a medication becoming less effective or possibly obsolete over time.

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

http://isubengal.com/narrowing-c-difficile/

Clostridium difficile Infection Research and Development Community – Update On Antibody-based Immunotherapies

An update on antibody-based immunotherapies for Clostridium difficile infection

Authors Hussack G, Tanha J

Greg Hussack,1 Jamshid Tanha1–3

1Human Health Therapeutics Portfolio, National Research Council Canada, Ottawa, 2School of Environmental Sciences, University of Guelph, Guelph, 3Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada

Abstract: Clostridium difficile continues to be one of the most prevalent hospital-acquired bacterial infections in the developed world, despite the recent introduction of a novel and effective antibiotic agent (fidaxomicin). Alternative approaches under investigation to combat the anaerobic Gram-positive bacteria include fecal transplantation therapy, vaccines, and antibody-based immunotherapies. In this review, we catalog the recent advances in antibody-based approaches under development and in the clinic for the treatment of C. difficile infection. By and large, inhibitory antibodies that recognize the primary C. difficile virulence factors, toxin A and toxin B, are the most popular passive immunotherapies under investigation. We provide a detailed summary of the toxin epitopes recognized by various antitoxin antibodies and discuss general trends on toxin inhibition efficacy. In addition, antibodies to other C. difficile targets, such as surface-layer proteins, binary toxin, motility factors, and adherence and colonization factors, are introduced in this review.

Click on the following link to access article in its entirety:

https://www.dovepress.com/an-update-on-antibody-based-immunotherapies-for-clostridium-difficile–peer-reviewed-article-CEG

U.Va.’s Division of Infectious Diseases and International Health Could Lead To a New Treatment For C. diff. Infection (CDI)

 

Every year, about half a million patients are infected by Clostridium difficile, an otherwise harmless bacterium that can multiply out of control when the use of antibiotics upsets the balance of microorganisms in the gut. In 2011, about 15,000 deaths were directly attributable to the infection, according to a recent study by the federal Centers for Disease Control and Prevention (CDC).

Current probiotic treatments, which promote the growth of helpful bacteria, have been ineffective against the infection, also known as C. diff.

But work being done at U.Va.’s Division of Infectious Diseases and International Health could lead to a new treatment by the end of the calendar year, according to Dr. Bill Petri, chief of the division. That’s an unusually optimistic estimate in medical research, where scientific breakthroughs predate new treatments by several years.

“Some of these advanced probiotics are actually being tested today in the clinic for their role,” Petri said. “We’re actually participating in advanced clinical trials at U.Va.”

Immunologist Erica L. Buonomo was the driving force behind the new discovery, Petri said, which has to do with the role of white blood cells in protecting against C. diff.

Buonomo found that a particular type of white blood cells, called eosinophils, act as a barrier against the infection, which breaks down the lining of the gut. These eosinophils are recruited by a protein called IL-25. A serious C. diff infection kills eosinophils, allowing the bacteria to enter the gut.

The researchers found that gut bacteria stimulate the production of IL-25, so the right probiotic could help with the production of protective eosinophils.

“We identified a pathway in the immune response that reduces the severity of an infection,” Buonomo said. “When we activate this pathway, we find mice are a lot less sick.”

The discovery would be especially helpful for elderly patients, who are most at risk. It also could have larger implications in the world of microbiology.

Eosinophils are best known for their role in allergic reactions and asthma attacks, when a high number of eosinophils cause inflammation.

The function of these cells was not entirely clear before Buonomo’s discovery. She believes this knowledge could help doctors fight other types of gastrointestinal disorders, such as irritable bowel syndrome.

U.Va. is now working on a probiotic with a Boston-based firm called Seres Therapeutics 

The finished product will be tested in Charlottesville, Petri said.

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Stop the Spread of Antibiotic Resistance and C. difficile Infections

Antibiotic-resistant germs cause more than 2 million illnesses and at least 23,000 deaths each year in the US.

Up to 70% fewer patients will get CRE over 5 years if facilities coordinate to protect patients.

Preventing infections and improving antibiotic prescribing could save 37,000 lives from drug-resistant infections over 5 years.

Problem:  Germs spread between patients and across health care facilities.

Antibiotic resistance is a threat.

 

  • Nightmare germs called CRE (carbapenem-resistant Enterobacteriaceae) can cause deadly infections and have become resistant to all or nearly all antibiotics we have today. CRE spread between health care facilities like hospitals and nursing homes when appropriate actions are not taken.
  • MRSA (methicillin-resistant Staphylococcus aureus) infections commonly cause pneumonia and sepsis that can be deadly.
  • The germ Pseudomonas aeruginosa can cause HAIs, including bloodstream infections. Strains resistant to almost all antibiotics have been found in hospitalized patients.
  • These germs are some of the most deadly resistant germs identified as “urgent” and “serious” threats.
C. difficile infections are at historically high rates.
  • C. difficile (Clostridium difficile), a germ commonly found in health care facilities, can be picked up from contaminated surfaces or spread from a healthcare provider’s hands.
  • Most C. difficile is not resistant to antibiotics, but when a person takes antibiotics, some good germs are destroyed. Antibiotic use allows C. difficile to take over, putting patients at high risk for deadly diarrhea.
Working together is vital.
  • Infections and antibiotic use in one facility affect other facilities because of patient transfers.
  • Public health leadership is critical so that facilities are alerted to data about resistant infections, C. difficile, or outbreaks in the area, and can target effective prevention strategies.
  • When facilities are alerted to increased threat levels, they can improve antibiotic use and infection control actions so that patients are better protected.
  • National efforts to prevent infections and improve antibiotic prescribing could prevent 619,000 antibiotic-resistant and C. difficile infections over 5 years.

 

  • “Patients and their families may wonder how they can help stop the spread of infections,” says Michael Bell, M.D., deputy director of CDC’s Division of Healthcare Quality Promotion. “When receiving health care, tell your doctor if you have been hospitalized in another facility or country, wash your hands often, and always insist that everyone have clean hands before touching you.”

 

 

 

 

 

Antibiotic-resistant germs, those that no longer respond to the drugs designed to kill them, cause more than 2 million illnesses and at least 23,000 deaths each year in the United States. C. difficile caused close to half a million illnesses in 2011, and an estimated 15,000 deaths a year are directly attributable to C. difficile infections.

 The report recommends the following coordinated, two-part approach to turn this data into action that prevents illness and saves lives:

  1. Public health departments track and alert health care facilities to drug-resistant germ outbreaks in their area and the threat of germs coming from other facilities, and
  2. Health care facilities work together and with public health authorities to implement shared infection control actions to stop the spread of antibiotic-resistant germs and C. difficile between facilities.

“Antibiotic resistant infections in health care settings are a growing threat in the United States, killing thousands and thousands of people each year,” said CDC Director Tom Frieden, M.D., M.P.H. “We can dramatically reduce these infections if health care facilities, nursing homes, and public health departments work together to improve antibiotic use and infection control so patients are protected.”

The promising news is that CDC modeling projects that a coordinated approach—that is, health care facilities and health departments in an area working together—could prevent up to 70 percent of life-threatening carbapenem-resistant Enterobacteriaceae (CRE) infections over five years. Additional estimates show that national infection control and antibiotic stewardship efforts led by federal agencies, health care facilities, and public health departments could prevent 619,000 antibiotic-resistant and C. difficile infections and save 37,000 lives over five years.

During the next five years, with investments, CDC’s efforts to combat C. difficile infections and antibiotic resistance under the National Strategy to Combat Antibiotic Resistant Bacteria, in collaboration with other federal partners, will enhance national capabilities for antibiotic stewardship, outbreak surveillance, and antibiotic resistance prevention. These efforts hold the potential to cut the incidence of C. difficile, health care CRE, and MRSA bloodstream infections by at least half.

The proposed State Antibiotic Resistance Prevention Programs (Protect Programs) would implement this coordinated approach. These Protect Programs would be made possible by the funding proposed in the President’s FY 2016 budget request, supporting work with health care facilities in all 50 states to detect and prevent both antibiotic-resistant germs and C. difficile infections. The FY 2016 budget would also accelerate efforts to improve antibiotic stewardship in health care facilities.