Background: Antibiotics targeted against C. difficile bacteria are necessary, but insufficient, to achieve a durable clinical response because they have no effect on C. difficile spores that germinate within a disrupted microbiome. ECOSPOR-III evaluated SER-109, an investigational, biologically-derived microbiome therapeutic of purified Firmicute spores for treatment of recurrent CDI. Methods: Adults ≥18 years with recurrent [...]

Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing [...]

Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) reporting and included with other hospital-acquired infections as publically reported data. CDI contribute to prolonged hospital stays, inappropriate antimicrobial use, [...]

Background: In the United States, 32 million people have a documented penicillin allergy and up to 20% of hospitalized patients’ records describe a penicillin allergy (PcnA). Less than 10% of patients with reported penicillin allergy have true clinically relevant PcnA when objectively tested through rigorous skin testing (1-3). Clinicians subsequently avoid appropriate penicillin or penicillin [...]

Background: The overall incidence of Clostridium difficile infection (CDI) is higher among patients with inflammatory bowel disease (IBD). The nature of this disease association is unknown but likely involves an altered gut microbiome and impaired host immune responses. Studies on CDI in IBD patients have yielded variable and conflicting results on outcome measures such as [...]

Background: Patients hospitalized with hematologic malignancy are particularly vulnerable to infection. Clostridium difficile infection (CDI) has become the most common cause of healthcare-associated infections in U. S. hospitals, and the excess healthcare costs related to CDI are estimated to be as much as 4. 8 billion dollars for acute care facilities alone. We sought to [...]

Background: Data is emerging on the efficacy of fecal microbial transplantation (FMT) for recurrent clostridium difficile infection (CDI) management with success rates of 80-90% in general population. Immunocompromised patients continue to be excluded from randomized trials involving FMT due to concerns related to its safety and efficacy. Current guidelines recommend caution with FMT in immunocompromised [...]

Background: Guidelines on the treatment of Clostridioides (Clostridium) difficile infection (CDI) have historically recommended avoiding antimotility agents (AAs) in patients with active CDI based on theoretical concerns that administration of AAs may precipitate serious adverse events such as toxic megacolon in these patients. These recommendations, however, are based on limited and conflicting data. We previously [...]

Background: There are 400,000 cases and 30,000 deaths from Clostridium difficile (C. diff) infections in the United States annually. Efforts to reduce the transmission of C. diff have focused on patients with diarrhea, however, many patients with C. diff are carriers who do not have symptoms. Because they are not isolated, carriers serve as a [...]

Background: Timely Clostridium difficile Infection (CDI) testing is challenging but is important for faster and appropriate isolation and treatment of patients. Few studies have specifically addressed effective methods to hasten CDI testing without relying on PCR. We sought to use Quality Improvement methodologies including the Plan-Do-Study-Act (PDSA) Cycle and Control Charts to reduce CDI testing [...]