Persistent and Recurrent Clostridium difficile Colitis

Abstract

Clostridium difficile infection (CDI) is the most frequent cause of nosocomial diarrhea. It has become a significant dilemma in the treatment of patients, and causes increasing morbidity that, in extreme cases, may result in death. Persistent and recurrent disease hamper attempts at eradication of this infection. Escalating levels of treatment and novel therapeutics are being utilized and developed to treat CDI. Further trials are warranted to definitively determine what protocols can be used to treat persistent and recurrent disease.

Keywords

recurrent Clostridium difficile - BI/NAP1/027 - fecal microbiota therapy

• References

• 1 Lamont JT. Up to Date: Clostridium difficile in adults: Epidemiology, microbiology, and pathophysiology. Available at: http://www.uptodate.com/contents/clostridium-difficile-in-adults-epidemiology-microbiology-and-pathophysiology . Last updated June 24, 2014. Accessed on June 28, 2014.
• 2 Stanley JD(1), Bartlett JG, Dart 4th BW, Ashcraft JH. Clostridium difficile infection. Curr Probl Surg 2013; 50 (7) 302-337
• 3 Surawicz CM, Brandt LJ, Binion DG , et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol 2013; 108 (4) 478-498 , quiz 499
• 4 Cohen SH, Gerding DN, Johnson S , et al; Society for Healthcare Epidemiology of America; Infectious Diseases Society of America. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol 2010; 31 (5) 431-455
• 5 Kelly CP, LaMont JT. Clostridium difficile—more difficult than ever. N Engl J Med 2008; 359 (18) 1932-1940
• 6 LaMont JT. Up to Date: Clostridium difficile in adults: Clinical manifestations and diagnosis. Available at: http://www.uptodate.com/contents/clostridium-difficile-in-adults-clinical-manifestations-and-diagnosis . Last updated Feb 24, 2014. Accessed on May 8, 2014.
• 7 Wang WJ, Gray S, Sison C , et al. Low vitamin D level is an independent predictor of poor outcomes in Clostridium difficile-associated diarrhea. Therap Adv Gastroenterol 2014; 7 (1) 14-19
• 8 Mullane KM, Miller MA, Weiss K , et al. Efficacy of fidaxomicin versus vancomycin as therapy for Clostridium difficile infection in individuals taking concomitant antibiotics for other concurrent infections. Clin Infect Dis 2011; 53 (5) 440-447
• 9 Stephenson KR, Rodriguez-Bigas MA. Decompression of the large intestine in Ogilvie's syndrome by a colonoscopically placed long intestinal tube. Surg Endosc 1994; 8 (2) 116-117
• 10 Groff W. Colonoscopic decompression and intubation of the cecum for Ogilvie's syndrome. Dis Colon Rectum 1983; 26 (8) 503-506
• 11 Golan Y, Epstein L. Safety and efficacy of fidaxomicin in the treatment of Clostridium difficile-associated diarrhea. Therap Adv Gastroenterol 2012; 5 (6) 395-402
• 12 Louie TJ, Miller MA, Mullane KM , et al; OPT-80-003 Clinical Study Group. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med 2011; 364 (5) 422-431
• 13 Figueroa I, Johnson S, Sambol SP, Goldstein EJ, Citron DM, Gerding DN. Relapse versus reinfection: recurrent Clostridium difficile infection following treatment with fidaxomicin or vancomycin. Clin Infect Dis 2012; 55 (Suppl. 02) S104-S109
• 14 Fidaxomicin. Available at: https://online.epocrates.com/noFrame/showPage.do?method=drugs&MonographId=6128&ActiveSectionId=10 . Accessed on June 7, 2014.
• 15 Cocanour CS. Best strategies in recurrent or persistent Clostridium difficile infection. Surg Infect (Larchmt) 2011; 12 (3) 235-239
• 16 O'Horo J, Safdar N. The role of immunoglobulin for the treatment of Clostridium difficile infection: a systematic review. Int J Infect Dis 2009; 13 (6) 663-667
• 17 Borody TJ, Leis S, Pang G, Wettstein AR. Up to Date: Fecal microbiota transplantation in the treatment of recurrent Clostridium difficile infection. Available at: http://www.uptodate.com/contents/fecal-microbiota-transplantation-in-the-treatment-of-recurrent-clostridium-difficile-infection Last updated Aug 29, 2013. Accessed on May 8, 2014.
• 18 Gough E, Shaikh H, Manges AR. Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection. Clin Infect Dis 2011; 53 (10) 994-1002
• 19 Neal MD, Alverdy JC, Hall DE, Simmons RL, Zuckerbraun BS. Diverting loop ileostomy and colonic lavage: an alternative to total abdominal colectomy for the treatment of severe, complicated Clostridium difficile associated disease. Ann Surg 2011; 254 (3) 423-427 , discussion 427–429