20 latest findings on C. diff

Here are 20 recent findings with regard to Clostridium difficile infection. C. diff caused an estimated half a million infections in the country in 2011, according to the CDC.

The findings are listed below, beginning with the most recent:

1. The hospital-acquired infection C. diff may spread outside the hospital setting via food, according to a study presented during the 27th European Congress of Clinical Microbiology and Infectious Diseases held in Vienna from April 22-25. The study included lab results from stool samples taken from patients at 482 hospitals across Europe.

2. New study results show that C. diff infection recurrence may increase the risk of death in patients. The results, presented at the 27th European Congress of Clinical Microbiology and Infectious Diseases, held April 22-25 in Vienna, included the outcomes of 6,874 patients who had acquired the C. diff infection in a hospital between 2002 and 2013. Of these, 16.6 percent experienced C. diff recurrence.

3. Asymptomatic carriers of toxigenic C. diff in hospitals increase the risk of infection for other patients, according to a study published in Gastroenterology. Researchers performed the population-based prospective cohort study at two university hospitals in Denmark. They screened all patients for toxigenic C. diff in the intestine upon admission, from Oct. 1, 2012, to Jan. 31, 2013.

4. A study, published in JAMA Internal Medicine, found gastric suppression medication use increases risk of recurrent C. diff infection. Researchers included proton pump inhibitors and histamine 2 blockers in the study.

5. A study published in Alimentary Pharmacology & Therapeutics shows that a pill form of treatment, involving frozen or freeze-dried fecal microbiota, could be effective for C. diff. Study participants underwent dried fecal microbiota transplants via colonoscopy using fresh, frozen or freeze-dried products.

6. Antibiotic stewardship programs may be key element of managing C. diff infections among patients suffering from osteoarticular infections. Researchers examined a cluster of hospital-acquired C. diff infections among 26 osteoarticular infection patients for the study, which was published in Antimicrobial Resistance & Infection Control.

7. A study, published in JAMA Internal Medicine, shows that switching from using metronidazole to vancomycin as the initial treatment for severe C. diff infections could lower the risk of death among patients. Researchers examined data from more than 10,000 patients treated for C. diff infections through the Department of Veterans Affairs healthcare system between 2005 and 2012 for the study.

8. Researchers found adding the drug bezlotoxumab to standard antibiotic treatment can significantly reduce the risk of recurrent C. diff infections, according to a study published in the New England Journal of Medicine. The double-blind, randomized, placebo-controlled trial involved 2,655 adults in 30 countries around the world.

9. A study in Infection Control & Hospital Epidemiology details the Veterans Health Administration's Antimicrobial Stewardship Initiative that led to a 12 percent decrease in overall antibiotic use and reduced readmissions, mortality and C. diff infections. The initiative involved holding in-person educational conferences, supporting champions, creating online resources and requiring all facilities to maintain an antimicrobial stewardship program.

10. The primary driver in surging rates of C. diff across the U.K.'s publicly funded healthcare system is antibiotic misuse, a study published in The Lancet Infectious Diseases shows. Researchers examined national data on the rates of C. diff from 2006, when high C. diff rates across U.K. hospitals first received public attention, to 2014. The researchers also studied antibiotic prescribing data from the same time period and genome sequences from 4,045 national and international C. diff isolates.

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11. A study published in the British Journal of Pharmacology shows that the use of commonly prescribed heartburn medications is associated with an increased risk of infection for C. diff and Campylobacter. Researchers examined health data on more than 500,000 people collected in a database in Tayside, Scotland. Those who took the acid suppression medications displayed a 1.7-times higher risk for C. diff.

12. A single fecal transplantation is not more effective than the existing standard of care — administration of oral vancomycin taper — for treating patients with recurrent C. diff infection, according to a study published in Clinical Infectious Diseases. Canadian researchers examined patients experiencing an acute episode of recurrent C. diff.

13. Fecal microbiota transfer is an effective long-term treatment for recurrent C. diff infection, a study in United European Gastroenterology shows. Study researchers examined 39 patients treated with FMT for recurrent C. diff infection at an academic medical center between July 2010 and January 2016. 

14. Preventative oral vancomycin reduces the incidence of C. diff during allogeneic hematopoietic stem cell transplantation, a Pittsburgh-based University of Pennsylvania study shows. The study was presented at the 58th Annual American Society of Hematology Meeting and Exposition in San Diego in December. For the study, researchers conducted a retrospective cohort study including 105 adults undergoing allogeneic hematopoietic stem cell transplantation at the University of Pennsylvania between April 2015 and July 2016.

15. A study, published in Alimentary Pharmacology and Therapeutics, found patients with a body mass index of greater than 35 kg/m2 were 1.7-fold more likely to be associated with severe C. diff compared to those with a BMI of 20 to 35 kg/m2. Researchers examined patients admitted with C. diff at a tertiary care center from January 2013 to June 2015.

16. A study in The American Journal of Gastroenterology shows that proton pump inhibitor use does not increase the risk of developing C. diff infection in intensive care units. The investigators analyzed data from all adult ICU patients at three affiliated hospitals between 2010 and 2013.

17. C. diff infections among Medicare enrollees were associated with a significant increase in mortality rates when compared to uninfected Medicare patients (23.4 percent to 42.6 percent), according to a study published in Infection Control & Hospital Epidemiology. Researchers examined Medicare data from 2008 to 2010 on 1,165,165 patients aged 65 years and older. Among these, 6,838 experienced C. diff infections.

18. Dirty linens from healthcare facilities may be a source of environmental C. diff contamination, according to a paper published in FEMS Microbiology Letters. In 2015, researchers examined linens at a laundry facility that services six hospitals, 30 local outpatient clinics and the Washington National Primate Research Center, all located in the Seattle area.

19. A study, published in JAMA Internal Medicine, shows that when patients receive antibiotics in a hospital bed, the next occupant of the bed is at a heightened risk for developing C. diff infection. Researchers looked at patients in four New York City-area hospitals who were admitted from 2010 to 2015. They examined patients who spent 48 hours in a hospital bed whose previous occupant spent 24 hours in the bed, with no more than a week separating the two.

20. Treating empty patient rooms with ultraviolet C light disinfection robots can substantially reduce the rate of C. diff infections in high-risk patients who will later occupy the rooms, according to a new study published in Infection Control & Hospital Epidemiology. Researchers monitored the impact of the technique from February 2014 to January 2015 across three hematology-oncology units at the Hospital of the University of Pennsylvania in Philadelphia.

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