9/18/2018. Clostridium Difficile: Updates on Diagnosis and Treatment. Clostridium difficile Infection (CDI) Clostridium difficile Infection (CDI)
|
|
- Audrey Francis
- 5 years ago
- Views:
Transcription
1 Clostridium Difficile: Updates on Diagnosis and Treatment Elizabeth Hudson, DO, MPH 9/25/18 Antibiotic-associated diarrhea and colitis were well established soon after widespread use of antibiotics In 1978, C. difficile was identified as the causative pathogen in the majority of cases of antibiotic-associated colitis many early cases were attributed to clindamycin Between 1989 and 1992, a strain of C. difficile highly resistant to clindamycin was implicated in large outbreaks of diarrhea in four hospitals in the United States From 2003 to 2006, CDI was observed to be more frequent, severe, refractory to standard therapy, and more likely to relapse than previously described These observations have been attributed to the emergence of a new strain designated BI, NAP1, or ribotype 027 This strain appears to be more virulent than other strains: attributable to increased toxin production compared with previous strains Fluoroquinolone use has strongly correlated with the emergence of this strain 1
2 In 2011, an estimated 453,000 initial cases of CDI occurred in the United States An estimated 159,700 cases were community associated and 293,000 were health care associated, with 107,600 of them hospital acquired The BI/NAP1/027 strain was identified more often in health care-associated cases than in community-associated cases Seeing more colonization with C diff C. difficile carriage occurs in 8 to 10 % of adults residing in hospitals or long-term care facilities (the carrier rate among healthy adults is about 3 percent) Asymptomatic C. difficile carriers are capable of shedding C. difficile spores and serve as a reservoir for environmental contamination to other hospitalized patients New exposure and colonization by C. difficile are more likely to lead to CDI, while patients previously colonized with C. difficile are more likely to remain asymptomatic during their hospitalization Antibiotic exposure Age > 65 Risk Factors for First Episode of CDI Immunocompromised patients (CA, Chemo, IBD) PPI use: risk of CDI ranges from 1.4 to 2.75 times higher among patients with PPI exposure compared with those without PPI exposure causal association has not been established and the relationship between the risk of CDI and PPI dose and duration of use is uncertain d/c unnecessary PPIs is reasonable although there is insufficient evidence for discontinuation of PPIs as a measure for preventing CDI Hospitalization (exposure to colonized patients) 2
3 Risk Factors for Recurrent Episode of CDI The same as for initial infection AND Need for ongoing therapy with concomitant antibiotics during treatment for CDI Patient with a UTI or PNA and C diff Serum creatinine 1.2 mg/dl Clinical Manifestations of CDI For most with CDI, symptoms occur in the setting of recent (within the past 8 weeks) or current antibiotic use Most often see 2 weeks after receipt of antibiotics Fluoroquinolones, Clinda, Cephalosporins and Penicillins are most likely to predispose to CDI Any antibiotic can predispose to CDI 5-10 % have not been exposed to antibiotics? Exposed to a shedding asymptomatic carrier Carrier state : reservoir Clinical Manifestations of CDI Nonsevere CDI: Watery diarrhea (>or= 3 stools in 24 hours) with lower abdominal pain and cramping, Low grade fever, and Leukocytosis of >or= 15K and Creatinine of <1.5 Severe CDI: Diarrhea, diffuse abdominal pain, lactic acidosis, elevated creatinine and marked leukocytosis (up to 40K) Occasionally, severe CDI presents as ileus with little to no diarrhea: colon atonic Fulminant colitis: CDI with severe sepsis Patient should have CT A/P done and Surgical evaluation 3
4 Copyrights apply Diagnosis of CDI Clinical diagnosis: don t wait for lab confirmation to treat in right clinical scenario! Kaiser So Cal changed testing algorithm for C diff ~ 3 years ago Two step test Initial test for C diff Ag and toxin A and B test and reflex to NAAT PCR if these results are indeterminate Checks for NAP1 toxin, too Treatment of Nonsevere CDI Please note that Flagyl is no longer the initial treatment of choice for nonsevere CDI Many Flagyl failures in nonsevere CDI 4
5 Treatment of C diff: Severe Disease There is no consensus definition for severe CDI, nor is there agreement as to the most important clinical indicators that should be used to differentiate severity Patients with acute CDI may develop signs of systemic toxicity with or without profuse diarrhea warranting admission to an intensive care unit or emergency surgery Treatment of CDI: Severe Disease Severe CDI can quickly progress to fulminant CDI Some cases of severe CDI require surgical intervention Treatment of CDI: Fulminant Disease Surgery is sometimes required, especially with megacolon Many of these patients are on other antibiotics for other infections If so, treatment for CDI should be extended to one additional week after other s completion 5
6 Treatment of Recurrent CDI Recurrent C. difficile infection is defined by resolution of CDI symptoms while on appropriate therapy, followed by reappearance of symptoms within two to eight weeks after treatment has been stopped Fecal Microbiota Transplantation (FMT) For patients with multiple recurrences who have received appropriate antibiotic treatment for at least three CDI episodes (initial episode plus two recurrences), recommendation is for fecal microbiota transplantation (FMT) Instillation of processed stool collected from a healthy donor into the intestinal tract of a patient with recurrent CDI Efficacy of FMT has been evaluated in randomized trials; cure rates 70-90% Alteration of the colonic microbiota appears to be FMT appears to be safe; mild to moderate adverse events (such as abdominal discomfort) are generally self-limited Questions? 6
Clostridium Difficile Infection in Adults Treatment and Prevention
Clostridium Difficile Infection in Adults Treatment and Prevention Definition: Clostridium Difficile colonizes the human intestinal tract after the normal gut flora has been altered by antibiotic therapy
More informationCLOSTRIDIUM DIFICILE. Negin N Blattman Infectious Diseases Phoenix VA Healthcare System
CLOSTRIDIUM DIFICILE Negin N Blattman Infectious Diseases Phoenix VA Healthcare System ANTIBIOTIC ASSOCIATED DIARRHEA 1978: C diff first identified 1989-1992: Four large outbreaks in the US caused by J
More informationENGLISH FOR PROFESSIONAL PURPOSES UNIT 3 HOW TO DEAL WITH CLOSTRIDIUM DIFFICILE
ENGLISH FOR PROFESSIONAL PURPOSES UNIT 3 HOW TO DEAL WITH CLOSTRIDIUM DIFFICILE The diagnosis of CDI should be based on a combination of clinical and laboratory findings. A case definition for the usual
More informationStony Brook Adult Clostridium difficile Management Guidelines. Discontinue all unnecessary antibiotics
Stony Brook Adult Clostridium difficile Management Guidelines Summary: Use of the C Diff Infection (CDI) PowerPlan (Adult) Required Patient with clinical findings suggestive of Clostridium difficile infection
More informationThe Epidemiology of Clostridium difficile DANIEL SAMAN, DRPH, MPH RESEARCH SCIENTIST ESSENTIA INSTITUTE OF RURAL HEALTH
The Epidemiology of Clostridium difficile DANIEL SAMAN, DRPH, MPH RESEARCH SCIENTIST ESSENTIA INSTITUTE OF RURAL HEALTH Some history first Clostridium difficile, a spore-forming gram-positive (i.e., thick
More informationClostridium difficile CRISTINA BAKER, MD, MPH INFECTIOUS DISEASE PARK NICOLLET/HEALTH PARTNERS 11/9/2018
Clostridium difficile CRISTINA BAKER, MD, MPH INFECTIOUS DISEASE PARK NICOLLET/HEALTH PARTNERS 11/9/2018 Disclosures None Objectives Highlight important changes in the management of Clostridium difficile
More informationDiagnosis, Management, and Prevention of Clostridium difficile infection in Long-Term Care Facilities: A Review
Diagnosis, Management, and Prevention of Clostridium difficile infection in Long-Term Care Facilities: A Review October 18, 2010 James Kahn and Carolyn Kenney, MSIV Overview Burden of disease associated
More informationClostridium difficile Infection: Diagnosis and Management
Clostridium difficile Infection: Diagnosis and Management Brian Viviano D.O. Case study 42 year old female with history of essential hypertension and COPD presents to ED complaining of 24 hours of intractable,
More informationClostridium difficile Infection (CDI) Management Guideline
Clostridium difficile Infection (CDI) Management Guideline Do not test all patients with loose or watery stools for CDI o CDI is responsible for
More informationCase 1. Which of the following would be next appropriate investigation/s regarding the pts diarrhoea?
Case 1 21 yr old HIV +ve, Cd4-100 HAART naïve Profuse diarrhoea for 3/52. Stool MC&S ve Which of the following would be next appropriate investigation/s regarding the pts diarrhoea? Repeat stool MC&S Stool
More informationDISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.
DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this
More informationABSTRACT PURPOSE METHODS
ABSTRACT PURPOSE The purpose of this study was to characterize the CDI population at this institution according to known risk factors and to examine the effect of appropriate evidence-based treatment selection
More informationClostridium difficile Infection (CDI)
18.09.10 월요집담회 Clostridium difficile Infection (CDI) R4 송주혜 Clostridium difficile infection (CDI) Anaerobic gram (+), spore-forming, toxin(tcda&tcdb)-producing bacillus Transmitted among humans through
More informationDivision of GIM Lecture Series Case Presentation David A. Erickson, M.D October 9th, 2013
Division of GIM Lecture Series Case Presentation David A. Erickson, M.D October 9th, 2013 Financial Disclosures No financial disclosures Objectives Review a case of recurrent Clostridium difficile infection
More informationClostridium difficile
Clostridium difficile Alex Aspinall MD, PhD, FRCPC Clinical Assistant Professor, University of Calgary Division of Gastroenterology and Hepatology, South Health Campus www.seacourses.com 1 Learning Points
More informationEDUCATIONAL COMMENTARY CLOSTRIDIUM DIFFICILE UPDATE
EDUCATIONAL COMMENTARY CLOSTRIDIUM DIFFICILE UPDATE Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE credits click
More informationJourney to Decreasing Clostridium Difficile and the Unexpected Twist. Jackie Morton, Infection Prevention Cortney Swiggart, Medication Safety Officer
Journey to Decreasing Clostridium Difficile and the Unexpected Twist Jackie Morton, Infection Prevention Cortney Swiggart, Medication Safety Officer 4/13/2018 Objectives Discuss the organism and clinical
More informationClostridium difficile infection (CDI) Week 52 (Ending 30/12/2017)
Clostridium difficile infection (CDI) Week 52 (Ending 30/12/2017) What is Clostridium difficile? Clostridium difficile is a Gram-positive anaerobic spore forming bacillus. It is ubiquitous in nature and
More informationClostridium difficile Essential information
Clostridium difficile Essential information Clostridium difficile Origins Clostridium difficile (C. diff) is a Gram positive, spore forming, anaerobic bacterium with a rod structure. It was first identified
More informationClostridium difficile: Can you smell the new updates?
Clostridium difficile: Can you smell the new updates? Sunish Shah, Pharm.D. PGY-2 Infectious Disease Pharmacy Resident Yale-New Haven Hospital sshah1741@mail.usciences.edu Learning objectives Recognize
More informationAnnex C: - CDI What s the diff? 4 th Annual Outbreak Management Workshop September 19, 2013 Naideen Bailey & Grace Volkening
Annex C: - CDI What s the diff? 4 th Annual Outbreak Management Workshop September 19, 2013 Naideen Bailey & Grace Volkening There s an updated Annex C Annex C is an extension to the PIDAC Infection Prevention
More informationPatient Safety Summit 2014
Patient Safety Summit 2014 The War on C Diff Mark Mellow, MD + C Diff The Organism Gram + bacillus Anaerobic Spore forming Intestinal flora (up to 35% hospitalized patients, 3% of healthy adults) Leading
More informationClostridium Difficile colitismore
Clostridium Difficile colitismore virulent than ever ECHO- February 18, 2016 Charles Krasner, M.D. UNR School of Medicine Sierra NV Veterans Affairs Hospital Growing problem of pseudomembranous colitis
More informationClostridium Difficile Infection: Applying New Treatment Guidelines and Strategies to Reduce Recurrence Rate
Clostridium Difficile Infection: Applying New Treatment Guidelines and Strategies to Reduce Recurrence Rate Objectives Summarize the changing epidemiology and demographics of patients at risk for Clostridium
More informationClostridium Difficile Associated Disease. Edmund Krasinski, Jr., D.O., F.A.C.G. Southwest Conference on Medicine 2011
Clostridium Difficile Associated Disease Edmund Krasinski, Jr., D.O., F.A.C.G. Southwest Conference on Medicine 2011 Introduction Which of the following is more common in community hospitals in the Southeast
More informationUpdated Clostridium difficile Treatment Guidelines
Updated Clostridium difficile Treatment Guidelines Arielle Arnold, PharmD, BCPS Clinical Pharmacist Saint Alphonsus Regional Medical Center September 29 th, 2018 Disclosures Nothing to disclose Learning
More informationA Pharmacist Perspective
Leveraging Technology to Reduce CDI A Pharmacist Perspective Ed Eiland, Pharm.D., MBA, BCPS (AQ-ID) Clinical Practice and Business Supervisor Huntsville Hospital System Huntsville Hospital 881 licensed
More informationMarch 3, To: Hospitals, Long Term Care Facilities, and Local Health Departments
March 3, 2010 To: Hospitals, Long Term Care Facilities, and Local Health Departments From: NYSDOH Bureau of Healthcare Associated Infections HEALTH ADVISORY: GUIDANCE FOR PREVENTION AND CONTROL OF HEALTHCARE
More informationLiterature Scan: Antibiotics for Clostridium difficile Infection. Month/Year of Review: May 2015 Date of Last Review: April 2012
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationmore intense treatments are needed to get rid of the infection.
What Is Clostridium Difficile (C. Diff)? Clostridium difficile, or C. diff for short, is an infection from a bacterium that can grow in your intestines and cause bad GI symptoms. The main risk of getting
More informationClostridium DifficileInfection & Readmissions: An ounce of prevention is worth a pound of cure
Clostridium DifficileInfection & Readmissions: An ounce of prevention is worth a pound of cure Brian S. Zuckerbraun, MD, FACS Henry T. Bahnson Professor of Surgery University of Pittsburgh Chief, Trauma
More informationC. difficile: The Changing Epidemiology Evaluations Clostridium difficile Thank You to our Sponsors
C. difficile: The Changing Epidemiology Ghinwa Dumyati, MD University of Rochester Monroe County Department of Public Health Thank You to our Sponsors Evaluations School of Public Health, University at
More informationWhat s New for Clostridium difficile John Lynch MD MPH Harborview Medical Center University of Washington
What s New for Clostridium difficile 2013 John Lynch MD MPH Harborview Medical Center University of Washington Pathogenic Mechanisms of Diarrhea Toxins: Preformed: S aureus, C perfringens, B cereus Formed
More informationClostridium difficile infection surveillance: Applying the case definition
Clostridium difficile infection surveillance: Applying the case definition PICNet Conference March 3 rd 2016 Presented by: Tara Leigh Donovan, MSc Managing Consultant (Former Epidemiologist) 1 Disclaimer
More informationCorporate Medical Policy Fecal Microbiota Transplantation
Corporate Medical Policy Fecal Microbiota Transplantation File Name: Origination: Last CAP Review: Next CAP Review: Last Review: Fecal_microbiota_transplantation 7/2014 11/2017 11/2018 11/2017 Description
More informationIncidence of and risk factors for communityassociated Clostridium difficile infection
University of Iowa Iowa Research Online Theses and Dissertations 2010 Incidence of and risk factors for communityassociated Clostridium difficile infection Jennifer Lee Kuntz University of Iowa Copyright
More informationThe epidemiology of Clostridium difficile infection (CDI) in hospitals, longterm care and the community. J Scott Weese DVM DVSc DipACVIM
The epidemiology of Clostridium difficile infection (CDI) in hospitals, longterm care and the community J Scott Weese DVM DVSc DipACVIM C. difficile Gram positive anaerobic sporeforming bacterium first
More informationStar Articles in Review
Star Articles in Review CDDW/CASL Meeting Toronto, February 10, 2014 Christina M. Surawicz, MD MACG Professor of Medicine Division of Gastroenterology Department of Medicine University of Washington Disclosure
More informationClostridium difficile: An Overview
Clostridium difficile: An Overview CDI Webinar July 11, 2017 PUBLIC HEALTH DIVISION Acute and Communicable Disease Prevention Section Outline Background Microbiology Burden Pathogenesis Diagnostic testing
More informationUpdate on Clostridium difficile infection.
Update on Clostridium difficile infection. K. Honein Gastroenterologist, HDF Associate Professor Head of Medicine Department St Joseph University-Beirut. Introduction Gram+anaerobic bacillus responsible
More informationECHO-Antibiotic Stewardship Program
ECHO-Antibiotic Stewardship Program More Interesting Recent Literature Updates April 20, 2017 Charles Krasner, M.D. University of NV, Reno School of Medicine Sierra NV Veterans Affairs Medical Center Antibiotic
More informationACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Clostridium difficile Infections
ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Clostridium difficile Infections Christina M. Surawicz, MD 1, Lawrence J. Brandt, MD 2, David G. Binion, MD 3, Ashwin N. Ananthakrishnan,
More informationSherwood L. Gorbach, MD Professor of Public Health, Medicine, and Microbiology Tufts University School of Medicine
Sherwood L. Gorbach, MD Professor of Public Health, Medicine, and Microbiology Tufts University School of Medicine Chief Scientific Officer, Optimer Pharmaceuticals, Inc. Conflicts: Chief Scientific Officer,
More informationDISCLOSURE Relevant relationships with commercial entities Wyeth (received advisory board & speaker honoraria) Potential for conflicts of interest wit
GASTROENTERITIS DISCLOSURE Relevant relationships with commercial entities Wyeth (received advisory board & speaker honoraria) Potential for conflicts of interest within this presentation fidaxomicin (which
More informationClostridium difficile infections Crappy Options
Clostridium difficile infections Crappy Options Alexandru Petre David MD Infectious Diseases April 21, 2015 Objectives Microbiology Epidemiology Who is at risk? Pathogenesis Diagnosis Treatment Historical
More informationLoyola s C diff Journey
Loyola s C diff Journey Kevin Smith, MD Associate Chief Medical Officer, Quality & Safety Aziz Ansari, DO Associate Chief Medical Officer, Clinical Optimization/Revenue Integrity Background Loyola Medicine
More information! MQ is a 44 year old woman that I first saw in Sept ! In MVA in Jan 2003 requiring spinal surgery
Case MQ is a 44 year old woman that I first saw in Sept 2006 UPDATE ON CLOSTRIDIUM DIFFICILE DISEASE Richard A. Jacobs, M.D.,PhD In MVA in Jan 2003 requiring spinal surgery Subsequently developed fecal
More informationClostridium difficile Infection (CDI) Guideline Update:
Clostridium difficile Infection (CDI) Guideline Update: Understanding the Data Behind the Recommendations Erik R. Dubberke, MD, MSPH A Webinar for HealthTrust Members Professor of Medicine September 24,
More informationLos Angeles County Department of Public Health: Your Partner in CDI Prevention
Los Angeles County Department of Public Health: Your Partner in CDI Prevention Dawn Terashita, MD, MPH Acute Communicable Disease Control Los Angeles County Department of Public Health dterashita@ph.lacounty.gov
More informationFecal microbiota transplantation: Breaking the chain of recurrent C. difficile infection
Fecal microbiota transplantation: Breaking the chain of recurrent C. difficile infection Issue Date: June 2013 Vol. 8 No. 6 Author: Amy Marinski, MSN, RN, CCRN, CNL More than 3 million new cases of Clostridium
More informationFecal Microbiota Transplantation in C. diff. colitis Benefits and Limitations
January 27th 2017, 8th Gastro Foundation Weekend for Fellows; Spier Hotel & Conference Centre, Stellenbosch Fecal Microbiota Transplantation in C. diff. colitis Benefits and Limitations Gerhard Rogler,
More informationDETECTION OF TOXIGENIC CLOSTRIDIUM DIFFICILE
CLINICAL GUIDELINES For use with the UnitedHealthcare Laboratory Benefit Management Program, administered by BeaconLBS DETECTION OF TOXIGENIC CLOSTRIDIUM DIFFICILE Policy Number: PDS 021 Effective Date:
More informationCLOSTRIDIUM DIFFICILE: IMPROVING DIAGNOSIS AND TREATMENT. Joshua T. Watson, M.D. Lowcountry Gastroenterology Associates
CLOSTRIDIUM DIFFICILE: IMPROVING DIAGNOSIS AND TREATMENT Joshua T. Watson, M.D. Lowcountry Gastroenterology Associates Learning Objectives Recognize patients who are highest risk for C. diff infections
More informationDisclosure. Objectives. Assessment Questions. History. Clinical Case 2/27/2015. Clostridium difficile update and new therapies
Disclosure Clostridium difficile update and new therapies Corey Frederick, PharmD PGY-2 Pharmacy Resident, Infectious Diseases Jackson Memorial Hospital Miami, Florida I do not have a vested interest in
More informationTreatment Update on Fecal Microbiota Transplantation. Arnab Ray, MD Ochsner Clinic Foundation Gastroenterology Department
Treatment Update on Fecal Microbiota Transplantation Arnab Ray, MD Ochsner Clinic Foundation Gastroenterology Department Disclosure I serve as a paid medical monitor for Rebiotix Objectives The scope of
More informationC. difficile: When to Do Fecal Microbiota Transplant (FMT)
C. difficile: When to Do Fecal Microbiota Transplant (FMT) Lawrence J. Brandt, MD, MACG Emeritus Chief, Gastroenterology Montefiore Medical Center Professor of Medicine and Surgery Albert Einstein College
More informationPatient presentation
Update: Clostridium difficile Colitis David H. Kerman, MD Assistant Professor of Clinical Medicine Director, Fellowship Program Division of Gastroenterology University of Miami Miller School of Medicine
More informationBezlotoxumab (Zinplava) as Adjunct Treatment for Clostridium difficile. Janel Liane Cala, RPh Medical Center Hospital
Bezlotoxumab (Zinplava) as Adjunct Treatment for Clostridium difficile Janel Liane Cala, RPh Medical Center Hospital Objectives Review pathophysiology, risk factors, prevention, and treatment options of
More informationDuodenal infusion of donor feces for recurrent Clostridium difficile infection A French experience
Duodenal infusion of donor feces for recurrent Clostridium difficile infection A French experience Benoit Guery Unité des Maladies Infectieuses CHRU - Faculté de Médecine Lille Conflicts of interest Conferences,
More informationManaging Clostridium Difficile: An Old Bug With
932 The Red Section see related editorial on page x Managing Clostridium Difficile: An Old Bug With New Tricks Stephen M. Vindigni, MD, MPH 1,2 and Christina M. Surawicz, MD 1 Am J Gastroenterol (2018)
More informationFecal Microbiota Transplantation (FMT): Current Concepts in Clostridium difficile and beyond
Fecal Microbiota Transplantation (FMT): Current Concepts in Clostridium difficile and beyond Amir Patel, MD Assistant Professor of Medicine Froedtert Hospital and the Medical College of Wisconsin I have
More informationHEALTHCARE- ASSOCIATED INFECTIONS: A FOCUS ON Clostridium difficile
OBJECTIVES HEALTHCARE- ASSOCIATED INFECTIONS: A FOCUS ON Clostridium difficile Identify and describe the pathophysiology of C. diff. Identify and describe current therapies in treatment of C. diff Identify
More informationClostridium difficile Infection (CDI) What is it? Modes of transmission? Environmental Sources? Control Measures?
Clostridium difficile Infection (CDI) What is it? Modes of transmission? Environmental Sources? Control Measures? Clostridium difficile Clostridium difficile - first described in 1935 when it was isolated
More informationTreatment of Clostridium Difficile Infection in Community Teaching Hospital: A Retrospective Study
International Journal of Infectious Diseases and Therapy 2018; 3(3): 52-61 http://www.sciencepublishinggroup.com/j/ijidt doi: 10.11648/j.ijidt.20180303.12 ISSN: 2578-9651 (Print); ISSN: 2578-966X (Online)
More informationClinical Review Criteria Fecal Microbial Transplant for Treatment of C. Difficile Infection Fecal GI Infusion Fecal Capsule (G3 OpenBiome)
Clinical Review Criteria Fecal Microbial Transplant for Treatment of C. Difficile Infection Fecal GI Infusion Fecal Capsule (G3 OpenBiome) Criteria Codes Revision History Kaiser Foundation Health Plan
More informationThe incubation period is unknown. However; the onset of clinical disease is typically 5-10 days after initiation of antimicrobial treatment.
C. DIFFICILE Case definition CONFIRMED CASE A patient is defined as a case if they are one year of age or older AND have one of the following requirements: A laboratory confirmation of a positive toxin
More informationInter-hospital Geriatrics Meeting August 2014 The Watery Curse
Inter-hospital Geriatrics Meeting August 2014 The Watery Curse Speaker: Dr. KK Yam (QMH) Supervisor: Dr. Patrick Chiu Patient s history F/95 Lives with daughter & maid ADL partially dependent. Walks with
More informationAn Oral Fecal Transplant for Lunch?- Frankly Speaking EP 53
An Oral Fecal Transplant for Lunch?- Frankly Speaking EP 53 Transcript Details This is a transcript of an episode from the podcast series Frankly Speaking accessible at Pri- Med.com. Additional media formats
More informationJMSCR Vol 05 Issue 07 Page July 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i7.15 Rapid Diagnosis of Toxigenic Clostridium
More informationManagement of the Hospitalized IBD Patient. Drew DuPont MD
Management of the Hospitalized IBD Patient Drew DuPont MD Ulcerative Colitis: Indications for Admission Severe ulcerative colitis Frequent loose bloody stools ( 6 per day) Severe cramps Systemic toxicity:
More informationHistorical Perspective
The Diagnosis of C. difficile Infections: Does Molecular Make it More or Less difficile? Stephen M. Brecher Ph.D. VA Boston Health Care System BU School of Medicine The opinions expressed in this presentation
More informationClostridium difficile Infection in the Department of Defense (DOD):
1 1 Clostridium difficile Infection in the Department of Defense (DOD): 2007-2013 NMCPHC-EDC- TR-271-2015 By Charlotte Neumann and Uzo Chukwuma February 2015 Approved for public release. Distribution is
More informationPros and Cons of Alternative Diagnostic Testing Strategies for C. difficile Infection
Pros and Cons of Alternative Diagnostic Testing Strategies for C. difficile Infection Christopher R. Polage, MD, MAS Associate Professor of Pathology and Infectious Diseases UC Davis Disclosures Test materials
More informationLe infezioni da Clostridium difficile, gravi, ricorrenti e complicate Nicola Petrosillo
Le infezioni da Clostridium difficile, gravi, ricorrenti e complicate Nicola Petrosillo Istituto Nazionale per le Malattie Infettive «lazzaro Spallanzani», IRCCS-Roma The infectious cycle of transmission
More informationLearning Goals. Clostridium difficile. Historical Context. Historical Context 6/27/2012
Learning Goals Clostridium difficile Justin L. Sewell, MD, MPH Assistant Clinical Professor of Medicine University of California San Francisco San Francisco General Hospital Understand the epidemiology,
More informationTreating and Preventing. C. difficile Infections A Review of the Research for Adults
Treating and Preventing C. difficile Infections A Review of the Research for Adults e Is This Information Right for Me? This information is right for you if: Your health care professional has said that
More informationUpdates to pharmacological management in the prevention of recurrent Clostridium difficile
Updates to pharmacological management in the prevention of recurrent Clostridium difficile Julia Shlensky, PharmD PGY2 Internal Medicine Resident September 12, 2017 2017 MFMER slide-1 Clinical Impact Increasing
More informationResponders as percent of overall members in each category: Region: New England 50 (57% of 87 members) 46 (57% of 81 members) 21 (55% of 38 members)
Infectious Diseases Society of America Emerging Infections Network Report for Query: Recurrent C. difficile Infections (CDI) Overall response rate: 621/1212 (51.2%) physicians responded from 09/26/12 to
More informationClinical. Clostridium Difficile: Standard Operating Procedure. Document Control Summary. Contents
Clinical Clostridium Difficile: Standard Operating Procedure Document Control Summary Status: Version: Author/Title: Owner/Title: Approved by: Ratified: Related Trust Strategy and/or Strategic Aims Implementation
More informationClostridiodes Difficile Colitis: Update on Guidelines. Jade Le, MD Texas Health Physicians Group No disclosures April 6, 2018
Clostridiodes Difficile Colitis: Update on Guidelines Jade Le, MD Texas Health Physicians Group No disclosures April 6, 2018 Outline Overview of CDI Diagnosis of C Difficile- updates Infection Prevention
More informationGUIDELINE FOR THE MANAGEMENT OF ANTIBIOTIC- ASSOCIATED DIARRHOEA IN ADULTS
GUIDELINE FOR THE MANAGEMENT OF ANTIBIOTIC- ASSOCIATED DIARRHOEA IN ADULTS Version 3.0 Date ratified May 2008 Review date May 2010 Ratified by NUH Antibiotic Guidelines Committee NUH Drugs and Therapeutics
More informationIs FMT the answer? Challenging Cases in CDI. Ted Steiner, M.D. April 1, 2016
Is FMT the answer? Challenging Cases in CDI Ted Steiner, M.D. April 1, 2016 CONFLICT OF INTEREST DISCLOSURE SLIDE In the past 2 years I have been an employee of: In the past 2 years I have been a consultant
More informationC. DIFFICILE UPDATE. Heather Bell, DO Infectious Diseases Physician
C. DIFFICILE UPDATE Heather Bell, DO Infectious Diseases Physician None to report DISCLOSURE Case review Review IDSA CDI guidelines discuss changes Questions Testing recommendations Treatment recommendations
More informationAll POOPed out: fecal microbiota transplant in C. difficile
All POOPed out: fecal microbiota transplant in C. difficile SUSAN M. KELLIE, MD, MPH PROFESSOR OF INTERNAL MEDICINE DIVISION OF INFECTIOUS DISEASES UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE HOSPITAL
More informationDisarming C. diff bacteria without destroying healthy gut flora
Disarming C. diff bacteria without destroying healthy gut flora Stanford University School of Medicine scientists successfully defeated a dangerous intestinal pathogen, Clostridium difficile, with a drug
More information7/30/2018 C. DIFFICILE UPDATE DISCLOSURE OUTLINE. Heather Bell, DO Infectious Diseases Physician. None to report
C. DIFFICILE UPDATE Heather Bell, DO Infectious Diseases Physician None to report DISCLOSURE Case review Review IDSA CDI guidelines discuss changes Testing recommendations Treatment recommendations Isolation
More informationModern approach to Clostridium Difficile Infection
Modern approach to Clostridium Difficile Infection Pseudomembranous Colitis: Principles for diagnosis and treatment Aggelos Stefos Internist, Infectious diseases Specialist Department of Medicine and Research
More information... Inflammatory disorder of the colon that occurs as a complication of antibiotic treatment.
Definition Inflammatory disorder of the colon that occurs as a complication of antibiotic treatment. " Epidemiology Humans represent the main reservoir of Clostridium difficile, which is not part of the
More informationNursing Infectious Diseases Topics. David H. Spach, MD Professor of Medicine Division of Infectious Diseases University of Washington, Seattle
Nursing Infectious Diseases Topics David H. Spach, MD Professor of Medicine Division of Infectious Diseases University of Washington, Seattle Clostridium difficile Free Access Via Web Source: Cohen SH,
More informationCDI The Impact. Disclosures. Acknowledgments. Objectives and Agenda. What s in the Name? 11/14/2012. Lets Talk Numbers
Disclosures No conflict of interest to declare Acknowledgments Objectives and Agenda Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) Guidelines
More informationL. Clifford McDonald, MD. Senior Advisor for Science and Integrity September 16, 2015
Controversies and Current Issues in Diagnosis, Surveillance, and Treatment of Clostridium difficile infeciton L. Clifford McDonald, MD Senior Advisor for Science and Integrity September 16, 2015 Division
More informationRapid-VIDITEST C. difficile Ag (GDH) Card/Blister
Li StarFish S.r.l. Via Cavour, 35-20063 Cernusco S/N (MI), Italy Tel. +39-02-92150794 - Fax. +39-02-92157285 info@listarfish.it -www.listarfish.it Rapid-VIDITEST C. difficile Ag (GDH) Card/Blister One
More informationFecal Microbiota Transplantation. Description
Section: Medicine Effective Date: April 15, 2017 Original Policy Date: September 12, 2014 Subject: Fecal Microbiota Transplantation Page: 1 of 10 Last Review Status/Date: March 2017 Fecal Microbiota Transplantation
More informationFecal Microbiota Transplantation
Protocol Fecal Microbiota Transplantation (20192) Medical Benefit Effective Date: 10/01/14 Next Review Date: 07/18 Preauthorization Yes Review Dates: 07/14, 07/15, 07/16, 07/17 Preauthorization is required.
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Juul FE, Garborg K, Bretthauer M, et al. Fecal microbiota transplantation
More informationClostridium difficile
Clostridium difficile Care Homes IPC Study Day Sue Barber Infection Prevention & Control Lead AV & Chiltern CCG s Clostridium difficile A spore forming Bacterium. Difficult to grow in the laboratory hence
More informationC. Difficile Testing Protocol
C. Difficile Testing Protocol Caroline Donovan, RN, BSN, ONC- Infection Control Practitioner Abegail Pangan, RN, MSN, CIC- Infection Control Practitioner U.S. NEWS & WORLD REPORT 2017 2018 RANKINGS Acute
More informationTitle: Fecal microbiota transplantation in recurrent Clostridium difficile infection in a patient with concomitant inflammatory bowel disease
Title: Fecal microbiota transplantation in recurrent Clostridium difficile infection in a patient with concomitant inflammatory bowel disease Authors: Marta Gravito-Soares, Elisa Gravito-Soares, Francisco
More information500,000 29,000. New 2015 Data. Lessa et al, N Eng J Med 2015: 34.2% of CDI cases were considered community-acquired
Cost-effective Treatment of Clostridium difficile Infection in the ICU Kevin W. Garey, PharmD, MS. Professor and Chair University of Houston College of Pharmacy New 2015 Data 500,000 29,000 Lessa et al,
More informationPresenter Disclosure Information
10:45 11:45am New Approaches to Treating C. Difficile Infection SPEAKER Kalpana Gupta, MD, MPH Presenter Disclosure Information The following relationships exist related to this presentation: Kalpana Gupta,
More information