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Acute Responses to Infectious and Inflammatory Disorders of the Gastrointestinal System.

Infectious and inflammatory disorders of the gastrointestinal system are life-threatening and occur frequently in hospitalized adults. Inflammatory and inflammation-related diseases of the gastrointestinal tract seen in the acutely and critically ill have numerous causes. In acute pancreatitis and toxic infections caused by the bacterium Clostridium difficile, where severe infections can develop, inflammation plays a causative and crucial role. Severe acute pancreatitis puts a patient at risk for infected necrosis, which can result in septicemia and shock. Similarly, patients treated with anti

Role of doxycycline in Clostridium difficile infection acquisition.

OBJECTIVE: To evaluate and review the literature surrounding the potential protective benefit of tetracyclines, particularly doxycycline, in reducing Clostridium difficile infection (CDI) acquisition. DATA SOURCES: MEDLINE/PubMed, Google Scholar, and International Pharmaceutical Abstracts were searched through January 2014 using the search terms doxycycline, tetracycline, and Clostridium difficile. STUDY SELECTION AND DATA EXTRACTION: Relevant studies, case reports, and review articles were screened for inclusion. Bibliographies of articles were extensively reviewed for additional sources.

Biological Therapies for the Management of Enteric Disease: Considerations for the Clinician.

Several biologic therapies have been approved for enteric diseases. We evaluate each biologic's role based on their mechanism of action in treating these conditions. This review examines data on efficacy and safety, as well as considerations for using these therapies in clinical practice in inflammatory bowel diseases, enteric infections-specifically Clostridioides difficile colitis-and potentially in the increasingly prevalent disorder of eosinophilic esophagitis. When choosing an appropriate therapy, it is important to assess patient severity, as most biologics are approved for those with mo…

Роль трансплантации фекалий микробиота в отдельных нейродегенеративных заболеваниях и нейродегенерационных расстройствах.

Пересадка кишечной микробиоты (FMT) — это медицинская процедура, позволяющая установить стабильную и здоровую кишечную микробиоту при различных заболеваниях, которые, как считается, связаны с дисбиозом кишечника. В настоящее время ДРМ успешно используется для лечения повторяющейся диффицилии Clostridioide. Однако в последние годы появились свидетельства того, что изменения в составе кишечного микробиота могут также иметь отношение к патогенезу нескольких нейропсихиатрических и нейроразвитых заболеваний, включая болезнь Альцгеймера, множественный склероз, болезнь Паркинсона, расстройства аутизм

Совпадение в аннотации оригинала
Fecal microbiota transplantation (FMT) is a medical procedure that allows to establish a stable and healthy intestinal microbiota in various diseases believed to be related to a gut dysbiosis. Currently, FMT is successfully used to treat recurrent Clostridioides difficile infection. However, in recent years there has been evidence that changes in composition…

Impact of a 4-year antimicrobial stewardship program implemented in a Greek tertiary hospital.

This study aimed to investigate the effects of a 4-year antibiotic stewardship program (ASP) in a tertiary hospital. We monitored data for 2015 (pre-intervention) and 2016-2019 (post-intervention) about antibiotic consumption (DDD/100 bed days), Clostridioides difficile infections (CDIs), resistance rates, length of stay (LOS), and annual antibiotic costs. Significant reductions were observed for total antibiotics/colistin/carbapenems/quinolones/tigecycline consumption and resistance rates of Pseudomonas aeruginosa, Klebsiella pneumoniae, and vancomycin-resistant enterococci. Considerable redu…

Unchecked Immunity to Unleashed Anarchy: A Case of Hemophagocytic Lymphohistiocytosis Following Combination Immune Checkpoint Inhibitor Therapy.

Immune checkpoint inhibitors (ICIs) can cause rare but fatal immune-related adverse events such as hemophagocytic lymphohistiocytosis (HLH). We describe a 42-year-old female with metastatic clear cell renal cell carcinoma who developed HLH following treatment with first-line ipilimumab and nivolumab. Initial symptoms mimicked sepsis and recurrent Clostridioides difficile infection, delaying diagnosis. Eventually, laboratory findings met HLH-2004 criteria, and initiation of high-dose corticosteroids led to improvement. This case illustrates the diagnostic complexity of HLH in ICI-treated patien…

Long-Term Infectious Complications of Kidney Transplantation.

Infections remain a common complication of solid-organ transplantation. Most infections in the first month after transplant are typically he … virus, cytomegalovirus, Epstein-Barr virus, and norovirus), bacterial (urinary tract infections and Clostridioides difficile colitis), and fungal infections. Current guidelines for safe living post-transplant are also summarized. Literature supporting prophylaxis and vaccination is also provided.

Bacteria That Cause Enteric Diseases Stimulate Distinct Humoral Immune Responses.

Bacterial enteric pathogens individually and collectively represent a serious global health burden. Humoral immune responses following natural or experimentally-induced infections are broadly appreciated to contribute to pathogen clearance and prevention of disease recurrence. Herein, we have compared observations on humoral immune mechanisms following infection with Citrobacter rodentium, the model for enteropathogenic Escherichia coli, Vibrio cholerae, Shigella species, Salmonella enterica species, and Clostridioides difficile. A comparison of what is known about the humoral immune responses…

Ceftazidime-Avibactam as Osteomyelitis Therapy: A Miniseries and Review of the Literature.

Bone and joint infections (BJIs) caused by multidrug-resistant gram-negative bacteria are becoming a concern due to limited therapeutic opti … g every 8 h for 42 days in all cases. One potential drug-related adverse effect was observed, i.e., Clostridioides difficile infection, which occurred after fourteen days of treatment with ceftazidime-avibactam.

The grim reaper evading modern medicine: aspergillosis, adenovirus, and Hodgkin lymphoma.

Illustrative cases of diseases that are difficult to suspect and diagnose can serve as useful reminders. Invasive pulmonary aspergillosis and adenovirus hepatitis are two such diseases, both revealed by autopsy in this case of Hodgkin lymphoma refractory to chemotherapy treated with allogeneic hematopoietic stem cell transplantation complicated by these two fatal infections. This patient was cured of Hodgkin lymphoma, Clostridioides difficile colitis and thrombotic thrombocytopenic purpura using the marvels of modern medicine. This case illustrates many features of aspergillosis and adenovirus…

Working with C. difficile in a Hypoxic Chamber.

Clostridioides difficile is an enteropathogen responsible for diarrhea under conditions leading to a dysbiosis of the gut microbiota, in particular after an antibiotic treatment. It is a spore-forming obligate anaerobe, which is, as such, usually cultivated in anaerobiosis in laboratories. Yet the gastrointestinal tract (GIT), its natural niche, is not completely deprived of oxygen (O2) and the O2 tension in the gut even rises under conditions of dysbiosis. C. difficile is able to tolerate the low O2 tensions it encounters in the GIT. C. difficile spores germinate in the small intestine at 4% …

Gut Microbiota and Clostridium difficile: What We Know and the New Frontiers.

Our digestive system, particularly our intestines, harbors a vast amount of microorganisms, whose genetic makeup is referred to as the microbiome. Clostridium difficile is a spore-forming Gram-positive bacterium, which can cause an infection whose symptoms range from asymptomatic colonization to fearsome complications such as the onset of toxic megacolon. The relationship between gut microbiota and Clostridium difficile infection has been studied from different perspectives. One of the proposed strategies is to be able to specifically identify which types of microbiota alterations are most at

Exotoxin-Targeted Drug Modalities as Antibiotic Alternatives.

The paradigm of antivirulence therapy dictates that bacterial pathogens are specifically disarmed but not killed by neutralizing their virul … urrently used exotoxin-targeted drugs, namely the monoclonal antibodies bezlotoxumab (toxin B/TcdB, Clostridioides difficile), raxibacumab (anthrax toxin, Bacillus anthracis), and obiltoxaximab (anthrax toxin, Bacillus anthracis), but also to challenges with some of the promising leads. We also highlight the recent developments in pre-clinical research sector to …

Learning from Nature: Bacterial Spores as a Target for Current Technologies in Medicine (Review).

The capability of some representatives of Clostridium spp. and Bacillus spp. genera to form spores in extreme external conditions long ago became a subject of medico-biological investigations. Bacterial spores represent dormant cellular forms of gram-positive bacteria possessing a high potential of stability and the capability to endure extreme conditions of their habitat. Owing to these properties, bacterial spores are recognized as the most stable systems on the planet, and spore-forming microorganisms became widely spread in various ecosystems. Spore-forming bacteria have been attracted inc

Clinical Management of Infectious Diarrhea.

BACKGROUND: Infectious diarrhea is the most common cause of diarrhea worldwide and is responsible for more deaths than other gastrointestinal tract diseases such as gastrointestinal cancers, peptic ulcer disease or inflammatory bowel disease. Diarrheal disease still represents the 8th leading cause of death worldwide, with more than 1,6 million attributed fatalities in 2016 alone. The majority of cases can be divided into three principal clinical presentations: acute watery diarrhea lasting 5-10 days and normally self-limiting, bloody diarrhea (dysentery), and persistent diarrhea with or witho

Use of probiotics in prevention and treatment of patients with Clostridium difficile infection.

Clostridium difficile is an anaerobic, gram positive, sporulating, toxin-producing bacillus which causes a spectrum of clinical disease ranging from an asymptomatic carrier state to toxic megacolon and fulminant disease. Infection with C. difficile is an expensive and pervasive health care burden. The current theory regarding the development of C. difficile infection (CDI) suggests that disruption of the structure and/or function of an individual's normal intestinal microbiota enables colonization by C. difficile, and in the absence of an effective immune response, the bacteria causes illness.