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Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole
BACKGROUND: Clostridium difficile is an anaerobic, spore-forming bacterium that is the most common cause of healthcare-associated diarrhea in developed countries. A significant proportion of patients receiving oral vancomycin or metronidazole for treatment of Clostridium difficile infection (CDI) de...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788714/ https://www.ncbi.nlm.nih.gov/pubmed/24098459 http://dx.doi.org/10.1371/journal.pone.0076269 |
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author | Abujamel, Turki Cadnum, Jennifer L. Jury, Lucy A. Sunkesula, Venkata C. K. Kundrapu, Sirisha Jump, Robin L. Stintzi, Alain C. Donskey, Curtis J. |
author_facet | Abujamel, Turki Cadnum, Jennifer L. Jury, Lucy A. Sunkesula, Venkata C. K. Kundrapu, Sirisha Jump, Robin L. Stintzi, Alain C. Donskey, Curtis J. |
author_sort | Abujamel, Turki |
collection | PubMed |
description | BACKGROUND: Clostridium difficile is an anaerobic, spore-forming bacterium that is the most common cause of healthcare-associated diarrhea in developed countries. A significant proportion of patients receiving oral vancomycin or metronidazole for treatment of Clostridium difficile infection (CDI) develop recurrences. However, the period of vulnerability to re-establishment of colonization by C. difficile after therapy is not well defined. PRINCIPAL FINDINGS: In a prospective study of CDI patients, we demonstrated that most vancomycin-treated patients maintained inhibitory concentrations of vancomycin in stool for 4 to 5 days after therapy, whereas metronidazole was only detectable during therapy. From the time of elimination of the antibiotics to 14 to 21 days after therapy, a majority of stool suspensions supported growth of C. difficile and deep 16S rRNA sequencing demonstrated persistent marked alteration of the indigenous microbiota. By 21 to 28 days after completion of CDI treatment, a majority of stool suspensions inhibited growth of C. difficile and there was evidence of some recovery of the microbiota. CONCLUSIONS: These data demonstrate that there is a vulnerable period for re-establishment of C. difficile colonization after CDI treatment that begins within a few days after discontinuation of treatment and extends for about 3 weeks in most patients. |
format | Online Article Text |
id | pubmed-3788714 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-37887142013-10-04 Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole Abujamel, Turki Cadnum, Jennifer L. Jury, Lucy A. Sunkesula, Venkata C. K. Kundrapu, Sirisha Jump, Robin L. Stintzi, Alain C. Donskey, Curtis J. PLoS One Research Article BACKGROUND: Clostridium difficile is an anaerobic, spore-forming bacterium that is the most common cause of healthcare-associated diarrhea in developed countries. A significant proportion of patients receiving oral vancomycin or metronidazole for treatment of Clostridium difficile infection (CDI) develop recurrences. However, the period of vulnerability to re-establishment of colonization by C. difficile after therapy is not well defined. PRINCIPAL FINDINGS: In a prospective study of CDI patients, we demonstrated that most vancomycin-treated patients maintained inhibitory concentrations of vancomycin in stool for 4 to 5 days after therapy, whereas metronidazole was only detectable during therapy. From the time of elimination of the antibiotics to 14 to 21 days after therapy, a majority of stool suspensions supported growth of C. difficile and deep 16S rRNA sequencing demonstrated persistent marked alteration of the indigenous microbiota. By 21 to 28 days after completion of CDI treatment, a majority of stool suspensions inhibited growth of C. difficile and there was evidence of some recovery of the microbiota. CONCLUSIONS: These data demonstrate that there is a vulnerable period for re-establishment of C. difficile colonization after CDI treatment that begins within a few days after discontinuation of treatment and extends for about 3 weeks in most patients. Public Library of Science 2013-10-02 /pmc/articles/PMC3788714/ /pubmed/24098459 http://dx.doi.org/10.1371/journal.pone.0076269 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. |
spellingShingle | Research Article Abujamel, Turki Cadnum, Jennifer L. Jury, Lucy A. Sunkesula, Venkata C. K. Kundrapu, Sirisha Jump, Robin L. Stintzi, Alain C. Donskey, Curtis J. Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole |
title | Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole |
title_full | Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole |
title_fullStr | Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole |
title_full_unstemmed | Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole |
title_short | Defining the Vulnerable Period for Re-Establishment of Clostridium difficile Colonization after Treatment of C. difficile Infection with Oral Vancomycin or Metronidazole |
title_sort | defining the vulnerable period for re-establishment of clostridium difficile colonization after treatment of c. difficile infection with oral vancomycin or metronidazole |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788714/ https://www.ncbi.nlm.nih.gov/pubmed/24098459 http://dx.doi.org/10.1371/journal.pone.0076269 |
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