Clostridium difficile infections are the leading cause of health
care-associated infectious diarrhea, posing a significant risk for both medical
and surgical patients. Antibiotics can cause or contribute to diarrhea. A major
cause of broad spectrum antibiotic- associated diarrhea and colitis is
Clostridium difficile infection (CDI) A gram-positive anaerobic spore-forming
bacillus, C. difficile spores have been reported to be present in foods such as
fresh vegetables, meat, and shellfish. CDI has become epidemic and is associated
not only with an increase in incidence and severity, but also an increase in
rates of CDI-related morbidity and a four-fold increase in CDI-related mortality
between 1999 and 2014 This infection is acquired via transmission of C.
difficile spores from individuals with active CDI or those who are
asymptomatically colonized and shed spores, individuals who have had contact
with CDI patients and carry the spores on their hands, and from spore-
contaminated environmental exposure. C. difficile spores are resistant to
stomach acid. In the small intestine spores germinate into the vegetative form
of the organism and produce exotoxins A and B.
Disruption of the normal intestinal flora is caused by exposure to
antimicrobial agents prompting C. difficile growth. Hospital infections
are increasing with associated morbidity and mortality. While hospital acquired
infections are of great concern, increasing evidence points to community
acquired infection. In a study reported in 2014, researchers with Kaiser
Permanentein the USA found that the majority of hospitalized patients
positive for C. difficile outside the hospital or within the first 72
hours of hospitalization.
Stone reported:" In the USAC. difficile caused infections in half a
million patients in a single year. Approximately 29,000 patients died within 30
days of the initial diagnosis. Older Americans are especially vulnerable to this
deadly diarrheal infection. Two out of every three healthcare-associated C diff
infections occur in patients aged 65 years or older. More than 80% of the deaths
associated with C diff infection occurred among Americans aged 65 years or
older. More than 100,000 C diff infections develop among residents of US nursing
homes each year, making C diff infections among the most serious healthcare
complications that affect the nursing home population. Unnecessary antibiotic
use and poor infection control practices may increase the spread of C diff
within a healthcare facility and from facility to facility when infected
patients transfer, such as from a hospital to a nursing home. More than 100,000
C diff infections develop among residents of US nursing homes each year, making
C diff infections among the most serious healthcare complications that affect
the nursing home population."
In 2007, the U.K. issued national policies for controlling C. difficile
infection, which included recommendations to avoid clindamycin and
cephalosporins and minimize use of fluoroquinolone, carbapenem and
aminopenicillin, along with improved infection prevention and control measures.
Fluoroquinolone use was reduced by 50%, while C. difficile infections fell by
80%,The fluoroquinolone antibiotics (Ciprofloxacin,
levofloxacin, moxifloxacin) should not be used in office settings and practices
for mundane and pedestrian upper respiratory tract infections such as bronchitis
or sinusitis, or for urinary tract infections.Oral metronidazole
and oral vancomycin have been the primary treatment options for 30 years.
Fidaxomicin is superior to vancomycin but comes at a steep cost.
Fecal transplants are newer and potentially curative treatment options.
Péchiné et al reported on monoclonal antibody development to treat clostria
infection:” Clostridium difficile infections are characterized by a high
recurrence rate despite antibiotic treatments and there is an urgent need to
develop new treatments such as fecal transplantation and immonotherapy. Besides
active immunotherapy with vaccines, passive immunotherapy has shown promise,
especially with monoclonal antibodies. phase III clinical trial (MODIFY II),
which allowed bezlotoxumab to be approved by the Food and Drug Administration
and the European Medicines Agency.”
Fecal transplant are offered with the hope of rebooting a “normal: microbiome
that controls the growth of C. difficile. Staley et al reported on their attempts to use freeze dried fecal flora.
“Fecal microbiota transplantation (FMT) is increasingly being used for treatment
of recurrent Clostridium difficile infection (R-CDI) that cannot be cured with
antibiotics alone. In addition, FMT is being investigated for a variety of
indications where restoration or restructuring of the gut microbial community is
hypothesized to be beneficial. We sought to develop a stable, freeze-dried
encapsulated preparation of standardized fecal microbiota that can be used for
FMT with ease and convenience in clinical practice and research. A single
administration of encapsulated, freeze-dried fecal microbiota from a healthy
donor was highly successful in treating antibiotic-refractory infection.
Listen to Solving Digestive Disorders
This website features topics from the book, Digestive Disorders by Stephen Gislason MD
Print and eBook versions are available. 178 Pages.
The book discusses food-related digestive tracts diseases and common disorders
such as food allergy, inflammatory bowel disease, irritable bowel syndrome,
chronic diarrhea, liver diseases, foodborne infection and motility disorders.
Nutritional concerns with digestive disease are discussed and case histories
illustrate problems and their solution. The solution is found in the Alpha
Nutrition Program, a standard method of diet revision. There are many conditions
that improve with diet revision. Elemental nutrient formulas are recommended for
serious digestive disease.
The latest edition is available as an eBook for download.
Nutrient Formulas and Printed books are shipped from Alpha Online to all destinations in Canada and USA. Prices are listed in Canadian dollars.
Disorders Rescue Help in understanding and managing the most common digestive tract
disorders: Crohn's Disease, Ulcerative Colitis, Irritable Bowel Syndrome,
Functional Dyspepsia, GERD, constipation, diarrhea and abdominal pain. The
starter pack includes one 500 gram jar of
Alpha ENF, the Alpha Nutrition Program, and the book Food & Digestive Disorders.
Three steps to solving a digestive problem
1 You stop ingesting the problem foods and beverages.
2 You eat safe foods and pure nutrients until you clear symptoms.
3 Reintroduce more of the best, nourishing, low-risk foods
If you are not ready for the starter pack, Order Books Separately.
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