Clostridioides difficile Infections

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

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 8159

Special Issue Editor


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Guest Editor
National Reference Laboratory for Clostridium difficile, AP-HP Assistance Publique - Hopitaux de Paris, 75004 Paris, France
Interests: Clostridiodes difficile infection; infection control; epidemiology; gut microbiota

Special Issue Information

Dear Colleagues,

Clostridioides difficile has emerged as a key pathogen over the last 20 years. It is recognized as the major agent responsible for antibiotic-associated diarrhea, especially among hospitalized patients. Community-acquired C. difficile infections (CDI) have also been increasingly reported but still remain underdiagnosed. CDI represent a considerable economic and societal burden. Despite advances in clinical research and in basic science on this anaerobic spore-forming bacterium, there are still grey areas in our knowledge on CDI epidemiology, physiopathology, and management.

We are currently seeking manuscripts for a Special Issue of Microorganisms covering all aspects of C. difficile research with a focus on:

  • Epidemiological data with a specific focus on the One Health aspects of CDI;
  • New advances in C. difficile diagnosis;
  • New microbiota-targeting therapies based on probiotics, prebiotics, synbiotics, non-toxigenic bacteria or fecal microbiota transplantation;
  • C. difficile virulome and resistome;
  • Interactions between microbiota and C. difficile.

Submitted manuscripts will be peer-reviewed to ensure that the issue contains high-quality contributions. This Special Issue will provide the readership with the most up-to-date information on Clostridium difficile infection diagnosis, treatment, and prevention.

Prof. Dr. Frédéric Barbut
Guest Editor

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Keywords

  • Clostridiodes difficile infection
  • infection control
  • epidemiology
  • C. difficile diagnosis
  • Community-acquired C. difficile infections (CDI)

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Published Papers (2 papers)

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Research

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11 pages, 441 KiB  
Article
Comparative Evaluation of Three Immunoassays for the Simultaneous Detection of Clostridioides difficile Glutamate Dehydrogenase and Toxin A/B
by Namsu Kim, Seung Yeob Lee, Joonhong Park and Jaehyeon Lee
Microorganisms 2022, 10(5), 947; https://doi.org/10.3390/microorganisms10050947 - 30 Apr 2022
Cited by 2 | Viewed by 2803
Abstract
Background: In the medical laboratory, a step-by-step workflow for Clostridioides difficile infection (CDI) detection using glutamate dehydrogenase (GDH) and toxin A/B assays for initial screening, along with a nucleic acid amplification test (NAAT), has been recommended recently. In this study, we evaluated these [...] Read more.
Background: In the medical laboratory, a step-by-step workflow for Clostridioides difficile infection (CDI) detection using glutamate dehydrogenase (GDH) and toxin A/B assays for initial screening, along with a nucleic acid amplification test (NAAT), has been recommended recently. In this study, we evaluated these three immunoassays for the simultaneous detection of GDH and Clostridioides difficile (CD) toxin A/B. Methods: A total of 304 stool samples were tested for the presence of GDH antigen and CD toxin A/B using VIDAS C. difficile GDH and toxin A/B (CDAB), RIDASCREEN C. difficile GDH and toxin A/B (RIDA), and C. DIFF QUIK CHEK COMPLETE according to the manufacturers’ recommendations. As complementary reference methods for GDH and toxin A/B detection in the three immunoassays, CD cultures using ChromID C. difficile agar and the Xpert C. difficile assay, respectively, were tested. Results: All three GDH assays showed overall substantial agreement with the CD culture. All three toxin A/B assays showed overall moderate agreement with the Xpert C. difficile assay. In comparison with consensus results, VIDAS GDH and QCC GDH showed almost perfect agreement, whereas RIDA GDH showed inferior but substantial agreement. All three toxin A/B assays showed almost perfect agreement. Conclusions: Since the QCC GDH and toxin A/B assay is relatively more sensitive and specific than the other two immunoassays for discriminating toxigenic or non-toxigenic CDI, QCC is very helpful for the simultaneous identification of GDH and CD toxin A/B in the initial step of the two-round workflow for diagnosing CDI. Full article
(This article belongs to the Special Issue Clostridioides difficile Infections)
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Review

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22 pages, 354 KiB  
Review
Controversies in the Prevention and Treatment of Clostridioides difficile Infection in Adults: A Narrative Review
by Taryn B. Bainum, Kelly R. Reveles, Ronald G. Hall II, Kelli Cornell and Carlos A. Alvarez
Microorganisms 2023, 11(2), 387; https://doi.org/10.3390/microorganisms11020387 - 3 Feb 2023
Cited by 18 | Viewed by 4801
Abstract
Clostridioides difficile remains a problematic pathogen resulting in significant morbidity and mortality, especially for high-risk groups that include immunocompromised patients. Both the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America (IDSA/SHEA), as well as the American College of [...] Read more.
Clostridioides difficile remains a problematic pathogen resulting in significant morbidity and mortality, especially for high-risk groups that include immunocompromised patients. Both the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America (IDSA/SHEA), as well as the American College of Gastroenterology (ACG) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) recently provided guideline updates for C. difficile infection (CDI). In this narrative review, the authors reviewed available literature regarding the prevention or treatment of CDI in adults and focused on disagreements between the IDSA/SHEA and ACG guidelines, as well as articles that have been published since the updates. Several options for primary prophylaxis are available, including probiotics and antibiotics (vancomycin, fidaxomicin). The literature supporting fidaxomicin is currently quite limited. While there are more studies evaluating probiotics and vancomycin, the optimal patient populations and regimens for their use have yet to be defined. While the IDSA/SHEA guidelines discourage metronidazole use for mild CDI episodes, evidence exists that it may remain a reasonable option for these patients. Fidaxomicin has an advantage over vancomycin in reducing recurrences, but its use is limited by cost. Despite this, recent studies suggest fidaxomicin’s cost-effectiveness as a first-line therapy, though this is highly dependent on institutional contracts and payment structures. Secondary prophylaxis should focus on non-antimicrobial options to lessen the impact on the microbiome. The oral option of fecal microbiota transplantation (FMT), SER109, and the now FDA-approved RBX2660 represent exciting new options to correct dysbiosis. Bezlotoxumab is another attractive option to prevent recurrences. Further head-to-head studies of newer agents will be needed to guide selection of the optimal therapies for CDI primary and secondary prophylaxis. Full article
(This article belongs to the Special Issue Clostridioides difficile Infections)
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