The Prognostic Value of Inflammatory Markers in Clostridium difficile-associated Diarrhea.

The Prognostic Value of Inflammatory Markers in Clostridium difficile-associated Diarrhea. Isr Med Assoc J. 2019 Oct;21(10):658-661 Authors: Nseir W, Khamisy-Farah R, Amara A, Farah R Abstract BACKGROUND: The incidence of Clostridium difficile-associated diarrhea (CDAD) is increasing and is associated with significant morbidity and mortality. Therefore, there is a need to find new tools to determine the severity of the disease. OBJECTIVES: To investigate the prognostic values of inflammatory markers such as mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), and C-reactive protein (CRP) in patients with CDAD. METHODS: The study comprised of 100 patients diagnosed with CDAD. The study included an additional control group of 69 patients with diarrhea who were negative for C. difficile toxin. The control group was age- and sex-matched and hospitalized at the same time period. NLR and MPV were obtained from complete blood count results. Serum CRP levels were measured by the latex particle enhanced immunoturbidimetric assay. Blood samples for all inflammatory markers were collected at time of diagnosis and prior to initiating the antibiotic therapy. Demographic, clinical, laboratory, and prognostic data were collected from medical records for a period of 90 days from the initial diagnosis of CDAD. RESULTS: The mean age of the CDAD group was 68.6 ± 21.5 years compared to 65.6 ± 24.5 in the control group (P = 0.29). Our findi...
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research

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Purpose of review Antimicrobial resistance (AMR) is a global threat worldwide, with deaths associated with AMR infections projected to exceed 10 million per year by the year 2050. The overuse and misuse of antibiotics is the primary driver of this resistance, with up to 50% of antibiotics prescribed in the hospital setting being either unnecessary or inappropriate. Antimicrobial stewardship (AMS) programs (ASPs) can mitigate some of this resistance, with the benefits well recognized; however, if we are to truly advance the state of AMS, the principles and practices should align with patient safety. Recent findings In ...
Source: Current Opinion in Infectious Diseases - Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research
Oral vancomycin prophylaxis can prevent healthcare-facility-onset C. difficile infection (HCFO-CDI) in high-risk patients receiving systemic antibiotic therapy, according to results from an open-label randomized study.Reuters Health Information
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Infectious Diseases News Source Type: news
AbstractPurposeTo investigate changes in the incidence of postoperative infections in the surgical department of a teaching hospital.MethodsDuring the 30-year period from September 1987 to August 2017, 11,568 gastroenterological surgical procedures were performed in our surgical department. This 30-year period was divided into seven periods (A –G), ranging from 2 to 7 years each and based on the infection control methods used in each period. We then compared the rates of incisional surgical site infection (SSI) and organ/space SSI; remote infection (RI) including respiratory tract infection (RTI), intravascular ...
Source: Surgery Today - Category: Surgery Source Type: research
ve; S Abstract The burden of Clostridium difficile associated diarrhea is a worrying clinical issue worldwide, mainly as regarding the high incidence of recurrences after standard antibiotic therapy and the risk for more severe clinical manifestations. For this reason, new and more effective therapies are needed for the treatment of recurrent episodes. Fecal microbiota transplantation seems to be a valid tool considering the mechanism of action and the growing number of studies that demonstrate its clinical efficacy. PMID: 31644957 [PubMed - as supplied by publisher]
Source: Anaerobe - Category: Microbiology Authors: Tags: Anaerobe Source Type: research
Retrospective analysis of data from 43 US hospitals suggest 67.8% of patients received excess antibiotic therapy which was not associated with lower rates of any adverse outcomes, including death, readmission, emergency department visit, or Clostridium difficile infection.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
This study demonstrated a high rate of toxigenic C. difficile colonization in domestic dogs and zoo animals with ribotypes similar to those causing human disease. These results demonstrate the relationship between humans, animals, and the environment in the dissemination of spores. PMID: 31207298 [PubMed - as supplied by publisher]
Source: Anaerobe - Category: Microbiology Authors: Tags: Anaerobe Source Type: research
This study aimed to evaluate whether ASP interventions have contributed to reducing CDI rates.MethodsA retrospective review of ASP interventions issued from January 2013 to April 2014 was performed using data from the ASP database of Singapore General Hospital, a 1600-bed tertiary-care hospital in Singapore. A total of 283 interventions satisfied the inclusion criteria, of which commonly audited antibiotics were piperacillin/tazobactam (41.3%) and carbapenems (54.8%). Comparisons were made at 30 days post-intervention between those with accepted or rejected interventions. The primary outcome was CDI incidence; seconda...
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
Procalcitonin is a biomarker that supports clinical decision-making on when to initiate and discontinue antibiotic therapy. Several cost (-effectiveness) analyses have been conducted on Procalcitonin-guided antibiotic stewardship, but none mainly based on US originated data. Using a Procalcitonin-algorithm to guide antibiotic use in sepsis and hospitalised lower respiratory tract infection patients is expected to generate cost-savings to the hospital and lower rates of antibiotic resistance and C.difficile infections.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
ConclusionCosts and clinical burdens associated with false-positive cultures are substantial and can be reduced by available interventions, including phlebotomists and use of ISDD.
Source: Journal of Hospital Infection - Category: Infectious Diseases Source Type: research
Conclusions As the intestinal mucosa surface constitutes the major surface of the body which is in direct contact with the outer environment, intestinal immune homeostasis must be accurately regulated. The interplay between commensal microbiota, intestinal stromal cells, and the mucosal immune system components should guarantee the intestinal homeostasis to avoid a sustained inflammation that could induce tissue damage. However, several factors can lead to inflammation through homeostasis breakdown. Figure 1 summarizes the main points that have been reviewed here. We have described what it is known so far about the role o...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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