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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
[Clostridium-difficile-associated infections]
Catherine Eckert1, Frédéric Barbut
1Université Pierre et Marie Curie, Paris VI, Faculté de médecine Saint-Antoine, 75571 Paris Cedex 12, France. catherine.eckert@sat.aphp.fr
Abstract:
C. difficile is a spore-forming anaerobic enteropathogen. This bacillus is responsible for virtually all cases of pseudomembranous colitis and for 15 to 25% of cases of antibiotic-associated diarrhoea. Clostridium difficile associated-infections (CDI) have a wide range of clinical features which vary from mild uncomplicated diarrhoea to severe debilitating disease, paralytic ileus, toxic megacolon, or even perforation and sometimes death. Risk factors for CDI include age > 65 years, previous hospitalization and recent antibiotic therapy. Main virulence factors for this pathogen are toxins A and B. A third toxin, the binary toxin, has been found in up to 10% of strains from infected patients. For some years, a new hypervirulent strain has emerged. This epidemic strain belongs to PCR-ribotype 027 and is responsible for outbreaks with increased mortality and severity in North America and Europe. The most effective antibiotics for treatment are oral metronidazole and vancomycin. Control of CDI needs to prevent the emergence of CDI by minimizing the number of patients exposed to antimicrobials and to limit cross transmission.
Insights
Clostridium difficile infections (CDI) cause mild to severe symptoms, with risk factors including age and hospitalization. Prevention involves minimizing antimicrobial exposure and limiting transmission.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Clostridium difficile is an anaerobic, spore-forming enteropathogen causing antibiotic-associated diarrhea and pseudomembranous colitis.
- Clostridium difficile associated-infections (CDI) present with a spectrum of illness, from mild diarrhea to life-threatening conditions like toxic megacolon and perforation.
Purpose of the Study:
- To review the clinical features, risk factors, and management of Clostridium difficile associated-infections (CDI).
- To highlight the emergence of a hypervirulent Clostridium difficile strain (PCR-ribotype 027) and its impact.
Main Methods:
- Literature review of Clostridium difficile associated-infections (CDI).
- Analysis of virulence factors, including toxins A, B, and binary toxin.
- Identification of risk factors such as advanced age, hospitalization, and antibiotic use.
Main Results:
- Clostridium difficile associated-infections (CDI) range from mild diarrhea to severe, fatal outcomes.
- Key risk factors include age over 65, hospitalization, and recent antibiotic therapy.
- A hypervirulent Clostridium difficile strain (PCR-ribotype 027) has emerged, causing severe outbreaks.
Conclusions:
- Oral metronidazole and vancomycin are effective treatments for Clostridium difficile associated-infections (CDI).
- Controlling CDI requires preventing its emergence by judicious antimicrobial use and implementing strict infection control measures to limit cross-transmission.
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