• Quality Improvement in Health Care
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• v.22 no.2
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• pp.15-25
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• 2016

Objectives: In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results. Methods: We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed. Result: The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients. Conclusion: In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.

• The Journal of the Korea Contents Association
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• v.10 no.5
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• pp.259-266
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• 2010

Clostridium difficile-associated disease (CDAD) is an important nosocomial infectious diarrhea and is associated with antibiotic use. Recently, incidence of C. difficile has been increasing in hospitals. A total of 1,329 stool specimens were examined from January, 2005 to December, 2008. This study analyzed the incidence and clinical characteristics of C. difficile infections on them. Out of 1,329 stool specimens, 283 specimens showed toxin A/B positive, using EIA. The positive rate was 21.2%; with the highest incidence among and above the 70years old. On endoscopy, psedo membranous colitis was found in 57.7%, and 19.5% of patients were normal. Pathologic finding showed PMC in 26.8% of patients, AAC in 52.2%. C. difficile was associated with PMC, however, endoscopic and pathologic findings tests showed normal to PMC.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.6
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• pp.517-522
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• 2015

The objective of this study is to report the clinical application of Korean and Western medicine on chronic diarrhea and Clostridium difficile associated diarrhea. Clostridium difficile associated diarrhea is usually triggered by using antibiotics. This patient also took some antibiotics and she started to suffer diarrhea diagnosed as chronic and Clostridium difficile associated diarrhea. She had suffered from diarrhea over 10 times per day. We checked changes of numbers, total volume of defecations and stool form. We treated the patient with acupuncture, moxibustion, herbal medicine and metronidazole. After treatment, diarrhea was stopped and the patient defecated normal form stool. According to this study, acupuncture, moxibustion, herbal medicine and metronidazole was effective for 1 case of stroke patient with chronic and Clostridium difficile associated diarrhea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.80-84
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• 2014

Clostridium difficile infection has been increasing since 2000 in children and in adults. Frequent antibiotics use, comorbidity, and the development of hypervirulent strains have increased the risk of infection. Despite the high carriage rates of C. difficile, infants rarely develop clinical infection. Discontinuing antibiotics and supportive management usually leads to resolution of disease. Antibiotics use should be stratified depending on the patient's age and severity of the disease.

• Korean Journal of Clinical Pharmacy
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• v.20 no.1
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• pp.78-84
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• 2010

Background: Clostridium difficile is the primary reason of the nosocomial diarrhea. The antimicrobial therapy plays a central role in the pathogenesis of Clostridium difficile associated diarrhea (CDAD). Although nearly all classes of antimicrobial agents have been associated with CDAD, clindamycin and the third-generation cephalosporins have traditionally been considered to the greatest risk factor. Recent studies have also implicated fluoroquinolones as high-risk agents due to increasing use of the agents. This study was to determine the incidence and the risk factors of CDAD related to the administered antibiotics and to assess the therapeutic regimen of metronidazole or vancomycin based on the C. difficile toxin assay Methods: A retrospective study was performed in patients with Clostridium difficile toxin assay at I Hospital (Incheon, South Korea) during the period from January 2007 through December 2007. Administrative, laboratory, and pharmacy data were collected from Electronic Medical Databases. Results: The analysis included 129 reported C.difficile toxin assay results, with 42 positive cases and 87 negative cases. Significant antibiotic risk factors for CDAD included the use of the fourth-generation cephalosporinse (OR=5.97, 95% CI 1.37-25.98, P=0.017). Administration of metronidazole was protective against CDAD (OR=0.30, 95% CI 0.12-0.74, P=0.009). Prolonged antimicrobial therapy has been associated with an increased risk of CDAD. The third-generation cephalosporins (OR=3.81, 95% CI 1.08-13.41, P=0.037) and aminoglycoside (OR=5.50, 95% CI 1.43-21.10, P=0.013) demonstrated greater risk for CDAD over 15 days than 8days or less days of treatment duration. Conclusions: The fourth and third generation cephalosporin, aminglycoside were the significant risk factors compared with other antibiotics, whereas metronidazole appears to be protective. The longer duration of antiobiotic use increased CDAD.

• Food Science of Animal Resources
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• v.38 no.4
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• pp.759-767
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• 2018

The concern about the possibility of food can be a vehicle for the transmission of Clostridium difficile to humans has been raised recently due to the similarities among the strains isolated from patients, foods and food animals. In this study, therefore, the prevalence of C. difficile was investigated in beef and chicken meat products collected from 57 different butcher shops, markets and fast food restaurants in Sakarya province of Turkey. Two out of 101 samples (1.98%) was positive for C. difficile indicating a very low prevalence. The pathogen was isolated from an uncooked meatball sample and a cooked meat $d{\ddot{o}}ner$ sample, whereas not detected in chicken meat samples. The meatball isolate was resistant to vancomycin and tetracycline, while the cooked meat $d{\ddot{o}}ner$ isolate was resistant to vancomycin and metronidazole. Both isolates were sensitive to moxifloxacin and clindamycin. Toxins A and B were not detected. This study reveals the presence of C. difficile in further processed beef products in Turkey.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.9
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• pp.1326-1330
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• 2012

This study was conducted to develop a loop-mediated isothermal amplification (LAMP) method for the detection of Clostridium difficile. The tested target gene was 16S ribosomal RNA. Five different LAMP primer sets were designed, and LAMP was performed. All primer sets targeting the 16S rRNA gene (BIP, FIP, B3, F3, LF, PF) were determined as positive in tcdA-positive, tcdB-postive ($A^+B^+$) and tcdA-negative, tcdB-negative ($A^-B^-$) Clostridium difficile strains. As the LAMP reaction took less than 80 min and did not require expensive machine such as thermocycler, it can be used as a rapid and simple detection method for foodborne pathogens.

• Bulletin of Food Technology
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• v.24 no.4
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• pp.622-630
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• 2011

• Safe Food
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• v.8 no.3
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• pp.30-35
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• 2013

• Intestinal research
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• v.13 no.1
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• pp.80-84
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• 2015

The rates and severity of Clostridium difficile infections, including pseudomembranous colitis, have increased markedly. However, there are few effective treatments for refractory or recurrent C. difficile infections and the outcomes are poor. Fecal microbiota transplantation is becoming increasingly accepted as an effective and safe intervention in patients with recurrent disease, likely due to the restoration of a disrupted microbiome. Cure rates of >90% are being consistently reported from multiple centers. We cured a case of severe refractory C. difficile infection with fecal microbiota transplantation in a patient colonized by vancomycin-resistant enterococcus.