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Microorganisms
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Clostridium difficile Infection in Clinical Practice: From Bench to Bedside
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Clostridium difficile Infection in Clinical Practice: From Bench to Bedside

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 7531

Special Issue Editors

Dr. Antonina Giammanco

E-Mail Website
Guest Editor
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
Interests: lipidology; metabolic diseases; cardiovascular diseases; lysosomal storage diseases (LSDs); biomedical research; biotechnology
Prof. Dr. Maurizio Averna

E-Mail Website
Guest Editor
Department of Internal Medicine and Medical Specialties, Universita degli Studi di Palermo, Palermo, Italy
Interests: internal medicine; biomedical research; metabolic diseases; lipidology; cardiovascular diseases
Dr. Rossella Spina

E-Mail Website
Guest Editor
Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, Palermo, Italy
Interests: biomedical research; biotechnology; next-generation sequencing

Special Issue Information

Dear Colleagues, 

Clostridium difficile is a bacterium that infects the colon. Symptoms may range from diarrhea to life-threatening damage. Illness from C. difficile typically occurs after the use of antibiotic medications. It most commonly affects older adults in hospitals and long-term care facilities.

The aim of this Special Issue is to evaluate the incidence of C. difficile infection (CDI) and risk factors in hospitalized patients, considering the length of hospital stays and all-cause in-hospital mortality in the groups of patients with CDI as well as the rate of re-hospitalization and all-cause mortality during follow-up, thus making improvements in the surveillance systems advisable.

In addition, microbiological data may be an important supplement to epidemiological surveillance data and allow deeper insights into epidemiological changes, and new diagnostic methods will be considered for rapid identification and the containment of C. difficile spread.

Dr. Antonina Giammanco
Prof. Dr. Maurizio Averna
Dr. Rossella Spina
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • C. difficile
  • infection
  • epidemiology
  • management
  • surveillance

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Published Papers (3 papers)

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Research

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9 pages, 678 KiB  
Article
Molecular Epidemiology, Clinical Course, and Implementation of Specific Hygiene Measures in Hospitalised Patients with Clostridioides difficile Infection in Brandenburg, Germany
by Esther E. Dirks, Jasminka A. Luković, Heidrun Peltroche-Llacsahuanga, Anke Herrmann, Alexander Mellmann and Mardjan Arvand
Microorganisms 2023, 11(1), 44; https://doi.org/10.3390/microorganisms11010044 - 22 Dec 2022
Cited by 3 | Viewed by 2156
Abstract
(1) Background: Clostridioides difficile infections (CDI) have increased worldwide, and the disease is one of the most common healthcare-associated infections (HAI). This study aimed to evaluate the molecular epidemiology of C. difficile, the clinical outcome, and the time of initiation of specific [...] Read more.
(1) Background: Clostridioides difficile infections (CDI) have increased worldwide, and the disease is one of the most common healthcare-associated infections (HAI). This study aimed to evaluate the molecular epidemiology of C. difficile, the clinical outcome, and the time of initiation of specific hygiene measures in patients with CDI in a large tertiary-care hospital in Brandenburg. (2) Methods: Faecal samples and data from hospitalised patients diagnosed with CDI were analysed from October 2016 to October 2017. The pathogens were isolated, identified as toxigenic C. difficile, and subsequently subtyped using PCR ribotyping and whole genome sequencing (WGS). Data regarding specific hygiene measures for handling CDI patients were collected. (3) Results: 92.1% of cases could be classified as healthcare-associated (HA)-CDI. The recurrence rate within 30 and 90 days after CDI diagnosis was 15.7% and 18.6%, and the mortality rate was 21.4% and 41.4%, respectively. The most frequent ribotypes (RT) were RT027 (31.3%), RT014 (18.2%), and RT005 (14.1%). Analysis of WGS data using cgMLST showed that all RT027 isolates were closely related; they were assigned to two subclusters. Single-room isolation or barrier measures were implemented in 95.7% patients. (4) Conclusions: These data show that RT027 is regionally predominant, thus highlighting the importance of specific hygiene measures to prevent and control CDI and the need to improve molecular surveillance of C. difficile at the local and national level. Full article
(This article belongs to the Special Issue Clostridium difficile Infection in Clinical Practice: From Bench to Bedside)
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15 pages, 306 KiB  
Article
Clostridioides Difficile Infection before and during Coronavirus Disease 2019 Pandemic—Similarities and Differences
by Nadica Kovačević, Vedrana Petrić, Maria Pete, Milica Popović, Aleksandra Plećaš-Đurić, Slađana Pejaković, Slavica Tomić, Dimitrije Damjanov, Dijana Kosijer and Milica Lekin
Microorganisms 2022, 10(11), 2284; https://doi.org/10.3390/microorganisms10112284 - 17 Nov 2022
Cited by 4 | Viewed by 1365
Abstract
The aim of this study was to investigate the differences of Clostridioides difficile infection (CDI) during the COVID-19 pandemic compared to the pre-COVID-19 era. CDI patients treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Serbia during 2017–2019 (n = [...] Read more.
The aim of this study was to investigate the differences of Clostridioides difficile infection (CDI) during the COVID-19 pandemic compared to the pre-COVID-19 era. CDI patients treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Serbia during 2017–2019 (n = 304) were compared with COVID-19/CDI patients treated in period September 2021–September 2022 (n = 387). Groups were compared by age, gender, comorbidities, previous medications, laboratory findings, and outcome within 30 days. In the CDI/COVID-19 group, we found: greater percentage of males 59.8% vs. 42.6% (p ≤ 0.001), older age 72.8 ± 9.4 vs. 65.6 ± 11.7 (p ≤ 0.001), higher Charlson comorbidity score (CCS) (3.06 ± 1.54 vs. 2.33 ± 1.34 (p ≤ 0.001), greater percentage of chronic renal failure (33.9% vs. 23.4% (p = 0.003), malignances (24.3% vs. 13.5% (p ≤ 0.001), chronic obstructive pulmonary disease (22.7% vs. 15.5% (p = 0.017), higher usage of macrolide (38.5% vs. 8.6% (p ≤ 0.001), greater percentage of patients with hypoalbuminemia ≤25 g/L (19.6% vs. 12.2% (p ≤ 0.001), lower percentage of patients with elevated creatinine (≥200 mmol/L) (31.5% vs. 43.8%) (p = 0.002), and greater percentage of lethal outcome 29.5% vs. 6.6% (p ≤ 0.001). In the prediction of lethal outcome multivariate regression analysis extracted as an independent predictor, only higher CRP values in the non-COVID-19 group and in the COVID-19 group: older age (p ≤ 0.001), CCS (p = 0.019) and CRP (p = 0.015). COVID-19 changes the disease course of CDI and should be taken into consideration when managing those patients. Full article
(This article belongs to the Special Issue Clostridium difficile Infection in Clinical Practice: From Bench to Bedside)

Review

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19 pages, 1955 KiB  
Review
Clostridium difficile Induced Inflammasome Activation and Coagulation Derangements
by Marta Mattana, Riccardo Tomasello, Claudia Cammarata, Paola Di Carlo, Teresa Fasciana, Giulio Giordano, Alessandro Lucchesi, Sergio Siragusa and Mariasanta Napolitano
Microorganisms 2022, 10(8), 1624; https://doi.org/10.3390/microorganisms10081624 - 10 Aug 2022
Cited by 4 | Viewed by 2664
Abstract
C. difficile enterocolitis (CDAC) is the most common hospital infection, burdened by an increased incidence of coagulation-related complications such as deep vein thrombosis (DVT) and disseminated intravascular coagulation (DIC) as well as a significant sepsis-related mortality. In this review, we analyzed the available [...] Read more.
C. difficile enterocolitis (CDAC) is the most common hospital infection, burdened by an increased incidence of coagulation-related complications such as deep vein thrombosis (DVT) and disseminated intravascular coagulation (DIC) as well as a significant sepsis-related mortality. In this review, we analyzed the available data concerning the correlation between coagulation complications related to C. difficile infection (CDI) and inflammasome activation, in particular the pyrin-dependent one. The little but solid available preclinical and clinical evidence shows that inflammasome activation increases the risk of venous thromboembolism (VTE). As proof of this, it has been observed that in vitro inhibition of the molecules (e.g., tissue factor) mainly involved in coagulation activation could block the process. In vivo studies show that it could be possible to reduce the incidence of complications associated with C. difficile infection (CDI) and mortality due to a state of hypercoagulability. A personalized therapeutic approach to reduce the inflammatory activity and prevent thromboembolic complications could be preliminarily defined to reduce mortality. Full article
(This article belongs to the Special Issue Clostridium difficile Infection in Clinical Practice: From Bench to Bedside)
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