PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Attack on C. difficile: How can we combat this serious health issue

2010-10-19
(Press-News.org) In five different studies presented at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio, researchers explored the impact of various factors on increasing rates of Clostridium difficile infection (C. difficile), such as the use of proton pump inhibitors (PPIs) and the substantial increase in antibiotic use due to new National Hospital Quality Measures; strategies to combat high rates of C. difficile infections; and cutting‐edge treatments for this potentially deadly—and quite common—infection. Five studies were featured during an ACG press briefing on Tuesday, October 18, 2010 entitled: "Attack on C. difficile: A GI Perspective ‐ How We Can Combat this Serious Health Issue." C. difficile associated diarrhea (CDAD) is a major cause of morbidity and increasing health care costs among hospitalized patients, as C. difficile infections have dramatically increased in recent years, with 500,000 cases in the United States annually and approximately 15,000 deaths each year, according to the U.S. Centers for Disease Control & Prevention. Proton Pump Inhibitors Linked to Incidence of C. difficile Associated Diarrhea While antibiotic use is the most documented risk factor for CDAD, attention has been directed towards a plausible‐‐but controversial‐‐link with proton pump inhibitors (PPIs). Researchers today unveiled results of a meta‐analysis of 16 observational studies, which explored the association between CDAD and PPIs. The study, "A Meta‐analysis of 16 Observational Studies on Proton‐Pump Inhibitor Use and Risk of Clostridium difficile Associated Diarrhea" investigated the association between PPIs and CDAD from 1980‐2010 and involved more than 1.2 million hospitalized patients. The investigators extracted adjusted risk estimates from the studies and used a random effects meta‐analysis. The summary risk estimate showed a 65 percent increase in the incidence of CDAD among PPI users, according to Sailajah Janarthanan, M.D., who co‐authored the study. Researchers also conducted a stratified analysis by study design and when looking at both prospective and retrospective studies, found that there was still a significant increase in C. difficile among PPI users. The Introduction of National Hospital Quality Measures Linked to Rising C. difficile Rates In 2004, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) and the Centers for Medicare and Medicaid Services (CMS) introduced National Hospital Quality Measures (NHQM) to improve pneumonia and surgical infection outcomes. However, these new quality measures have resulted in a substantial increase of antibiotic usage, which researchers hypothesized has led to an increase in C. difficile associated diarrhea and colitis in an inner city hospital in New York. As a result, researchers reviewed charts of all patients with confirmed C. difficile infection admitted to the Bronx Lebanon Hospital Center from January 1, 2003 to December 31, 2008. Antibiotic usage for all inpatients during the same time was also reviewed. The study, "National Quality Measures and Clostridium difficile Infection in an Inner City Hospital," found a total of 439 patients with confirmed C. difficile infection from January 1. 2003 to December 31, 2008. "We observed significant increase in Clostridium difficile infection rate between 2003 and 2006," said Ariyo Ihimoyan, M.D. The number of cases per 10,000 admissions was 16 in 2003; 20 in 2004; 50 in 2005; 36 in 2006; 40 in 2007; and 58 in 2008. The total number of antibiotic doses uses per 1000 admissions was 3268 in 2003; 3536 in 2004; 4585 in 2005; 5150 in 2006; 5848 in 2007; and 5867 in 2008. "From these findings, we conclude that the introduction of National Hospital Quality Measures have led to a substantial increase in antibiotic usage," said Dr. Ihimoyan. "We believe this resulted in an increase in Clostridium difficile infections in our patient population. Antibiotic usage‐related quality measures may have resulted in unintended complications and should be re‐evaluated." How Can We Combat C. difficile? Another study unveiled during the October 18 press briefing addressed the ways hospitals, gastroenterologists and other health care practitioners could combat C. difficile entitled, "Aggressive Attack on C. difficile Results in Significant Decrease in Hospital Infection Rate: the INTEGRIS Baptist Medical Center Experience." Waging "an all out war on C. difficile," researchers implemented a number of measures over a three‐month period at INTEGRIS Baptist Medical Center, a tertiary care facility in Oklahoma City which admits approximately 26,000 patients per year and experienced an increase in C. difficile cases. "Aimed at reducing the incidences of C. difficile infections, these measures consisted of a multi‐faceted attack on C. difficile, including improved prevention, early detection, review and full implementation of national infection control guidelines, and aggressive treatment measures," explained Mark H. Mellow, M.D., FACG, Center for Digestive Health, Oklahoma City, OK. "In addition to standard isolation procedures, we also elicited suggestions from physicians and nurses to best ensure compliance, such as placing a trashcan near the door to avoid traversing the room after de‐gowning; keeping an uncluttered sink area; using appropriate size gloves; and making stethoscopes easily accessible," said Dr. Mellow. Dr. Mellow and his team also initiated a campaign to limit proton pump inhibitor use outside of critical care units and encouraged nursing staff to send stool for C. difficile toxin (CDT) testing if C. difficile was suspected, without waiting for physician order. "In the 12 months prior to our interventions, the incidence of CDT positive hospitalized patients was 11.3 per 100 admissions," said Dr. Mellow. "After a 3‐month implementation period, the ensuing 12‐month positive CDT incidence fell to 6.9 per 1000 patients, a decrease in C. difficile infection incidence of 40 percent. As a result, a 'war on C. difficile' can have a significant positive impact on a hospital's rate of infection," said Dr. Mellow. Cutting Edge Treatments Help Patients with C. difficile Up to 25 percent of patients will have a recurrence of C. difficile infection, and a proportion will be refractory to antibiotics. Additional therapies for this difficult‐to‐treat subpopulation include antibiotics, probiotics, toxin‐binding medications, active vaccination, intravenous immunoglobon, and fecal bacteriotherapy (FB). "Fecal bacteriotherapy, more commonly known as fecal transplant, has been slowly gaining ground as a rescue for recurrent and refractory cases of C. difficile associated diarrhea," said C. Brock Miller, M.D., University of North Carolina at Chapel. Dr. Miller and his research team today reported findings from their initial experience using FB via colonoscopy, "Fecal Bacteriotherapy via Colonscopy for Refractory and Recurrent Clostridium difficile Associated Diarrhea," which showcased two patients. The first patient, a healthy 34‐year old woman who developed CDAD after eight courses of antibiotics over six months, and had ongoing recurrences of CDAD, had an immediate improvement in symptoms and has been infection‐free for nine months after fresh stool donated from her healthy 40‐year old sister was liquefied and delivered throughout the terminal ileum and entire colon via colonoscopy. A second patient, a healthy 50‐year old female, who also developed recurrent C. difficile toxin positive diarrhea, elected to undergo FB via colonoscopy after testing and donation by her husband. She has been cured of C. difficile associated diarrhea to date, according to Dr. Miller. "While further clinical studies and long‐term follow‐up of patients are required, fecal bacteriotherapy appears to be a viable, safe, and inexpensive option for cases of recurrent and refractory disease," said Dr. Miller. The goal of another study unveiled today was to explore novel and inexpensive antimicrobial agents commonly found in nature in an effort to combat C. difficile in hospitals. "For more than 2000 years in the Indian subcontinent, indigenous people have been using turmeric in their daily food," explained Rattan Patel, M.D. "Traditional Indian medicine, Ayurveda, has been using this spice to help decrease the rate of gastrointestinal infection." In the study, "Inhibiting Hospital Associated Infection of Toxigenic Clostridium difficile Using Natural Spice – Turmeric (Curcumin)," Dr. Patel and his research team found that all strains of of C. difficile were inhibited by turmeric extract (curcumin). "Turmeric has been shown to be relatively safe in clinical studies, with more than 40 clinical trials already performed in the United States using curcumin as an intervention as per the Clinical Trail database," said Dr. Patel. "It's likely that daily use of turmeric in hospital settings, in food products like curry or soup, can potentially decrease the incidence of Clostridium difficile associated diarrhea. But more studies are needed to determine the mechanism of action of turmeric and the physiological effects of turmeric in animal models of pseudomembranous colitis," said Dr. Patel. INFORMATION:

About the American College of Gastroenterology

Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 11,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost‐effective health care to gastroenterology patients. www.acg.gi.org

View releases on other research breaking at the ACG meeting at www.acg.gi.org/media/press.asp



ELSE PRESS RELEASES FROM THIS DATE:

Watching violent TV or video games desensitizes teenagers and may promote more aggressive behavior

2010-10-19
Watching violent films, TV programmes or video games desensitises teenagers, blunts their emotional responses to aggression and potentially promotes aggressive attitudes and behaviour, according to new research published online today in the Oxford Journal Social Cognitive and Affective Neuroscience (Tuesday 19 October). Although previous research has suggested that people can become more aggressive and desensitised to real-life violence after repeatedly viewing violent media programmes, little is known about how the extent of watching such programmes and the severity ...

Fructose intolerance common in children with functional abdominal pain

2010-10-19
San Antonio, Texas (October 18, 2010) – Fructose intolerance, or fructose malabsorption, is common in children with recurrent or functional abdominal pain, but the condition can be effectively managed with a low‐fructose diet, according to the results of a new study unveiled today at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio, Texas. The study, "Fructose Intolerance/Malabsorption and Recurrent Abdominal Pain in Children," investigated a total of 245 patients with unexplained chronic abdominal pain alone or associated ...

New undertsanding of gut hormones and gut function sheds light on obesity

2010-10-19
Research on obesity examining the role of hormones and the autonomic functions of the digestive system was presented at the 75th Annual Scientific Meeting of the American CoIlege of Gastroenterology. Gastric function, as well the activities of the autonomic nervous system that regulates digestion, are impaired in obese individuals in both fasting and fed states, according to a study from the University of Texas Medical Branch in Galveston, "Altered Postprandial Gastric and Autonomic Functions in Obese Subjects." Measures of gastric myoelectrical activity (GMA) by electrogastrography ...

Vitamin D deficiency puts IBD patients at greater risk of osteoporosis

2010-10-19
San Antonio, Texas (October 18, 2010) – Vitamin D deficiency puts patients with Inflammatory Bowel Disease (IBD) at greater risk of osteoporosis, osteopenia and an overall higher rate of abnormal bone density, according to the results of a new study unveiled today at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio, Texas. The study, "Vitamin D Deficiency and Abnormal DEXA Scans in Inflammatory Bowel Disease Patients," found that of the 161 IBD patients in the cohort, reduction in bone density with a diagnosis of osteoporosis ...

Acid reflux, functional dyspepsia have significant impact on disordered sleep

2010-10-19
San Antonio, Texas (October 18, 2010) – The impact of upper GI conditions, like gastroesophageal reflux disease (GERD) and functional dyspepsia, on sleep—and treatments aimed at providing relief to heartburn/acid reflux patients who suffer from disordered sleep—were explored in three new studies related to sleep dysfunction presented today at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio, Texas. Functional dyspepsia is a common, but poorly understood, upper GI condition affecting approximately 10 percent of U.S. adults. ...

Notable racial disparities in diagnosis, treatment and outcomes of colorectal cancer

2010-10-19
San Antonio, Texas (October 18, 2010) – The latest colorectal cancer research presented at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio this week strengthens the growing body of evidence that suggests significant disparity in colorectal cancer (CRC) demographics and outcomes between various races. In the first in a series of studies investigating colorectal cancer disparities that exist between various races, researchers conducted a retrospective analysis of colonoscopies performed in young patients from July 2003 to December ...

Encouraging findings suggest new avenues for treating liver disease in overweight Americans

2010-10-19
San Antonio, Texas, October 18, 2010 – Estimates of the prevalence of liver disease suggest that one‐third of the United States population has non‐alcoholic fatty liver disease (NAFLD). NAFLD is now the most common cause for elevated liver function tests in the United States, a trend related to the obesity epidemic in this country. Non‐alcoholic steatohepatitis (NASH), the progressive form of NAFLD, can lead to cirrhosis and all its complications. Two studies presented at the 75th Annual Scientific Meeting of the American College of Gastroenterology investigated ...

New studies highlight obesity's impact on gastrointestinal health

2010-10-19
San Antonio, Texas (October 18, 2010) – The association between obesity and gastrointestinal-related cancers and coronary artery disease; the link between an overweight or obese body mass index and the severity of Crohn's disease; and whether inflammatory bowel disease is an independent risk factor for coronary artery disease, were among the highlights of new research that was presented this week at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio. Obesity Linked to Increased Liver Cancer Risk, Adenoma Recurrence Although ...

Investment in CRC screening targeting pre-medicare population could cut medicare treatment costs

2010-10-19
San Antonio, Texas (October 18, 2010) – Investment in screening programs that target the pre-Medicare population, individuals aged between 50 and 64, is needed to reduce the costs of colorectal cancer in the Medicare program, according to the results of a new study, "Cost-Savings to Medicare from Increased Colorectal Cancer Screening in the Pre-Medicare Population," unveiled today at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio, Texas. "With rising chemotherapy costs and aging of the population, the Medicare program will ...

National Stroke Association survey reveals more than half of stroke survivors suffer added burden of little known neurologic condition

2010-10-19
CENTENNIAL, CO – October 18, 2010 – A survey released today by National Stroke Association shows that 53 percent of stroke survivor respondents suffer from symptoms of another neurologic condition called pseudobulbar affect (PBA), a condition thought to be caused by structural damage in the brain due to injury or disease. PBA causes involuntary and unpredictable outbursts of laughing or crying, often in socially inappropriate situations. Even though a significant proportion of stroke survivors suffer from PBA, fewer than one in five are familiar with the condition. Survey ...

LAST 30 PRESS RELEASES:

How can we reduce adolescent pregnancies in low- and middle-income countries?

When sun protection begets malnutrition: vitamin D deficiency in Japanese women

Cannabis use can cause chromosomal damage, increasing cancer risk and harming offspring

Survey finds many Americans apply misguided and counterproductive advice to combat holiday weight gain

New study reveals half a century of change on Britain’s iconic limestone pavements

Green flight paths could unlock sustainable aviation, new research suggests

Community partners key to success of vaccine clinic focused on neurodevelopmental conditions

Low-carbon collaborative dual-layer optimization for energy station considering joint electricity and heat demand response

McMaster University researchers uncover potential treatment for rare genetic disorders

The return of protectionism: The impact of the Sino-US trade war

UTokyo and NARO develop new vertical seed distribution trait for soybean breeding

Research into UK’s use of plastic packaging finds households ‘wishcycle’ rather than recycle – risking vast contamination

Vaccine shows promise against aggressive breast cancer

Adverse events affect over 1 in 3 surgery patients, US study finds

Outsourcing adult social care has contributed to England’s care crisis, argue experts

The Lancet: Over 800 million adults living with diabetes, more than half not receiving treatment, global study suggests

New therapeutic approach for severe COVID-19: faster recovery and reduction in mortality

Plugged wells and reduced injection lower induced earthquake rates in Oklahoma

Yin selected as a 2024 American Society of Agronomy Fellow

Long Covid could cost the economy billions every year

Bluetooth technology unlocks urban animal secrets

This nifty AI tool helps neurosurgeons find sneaky cancer cells

Treatment advances, predictive biomarkers stand to improve bladder cancer care

NYC's ride-hailing fee failed to ease Manhattan traffic, new NYU Tandon study reveals

Meteorite contains evidence of liquid water on Mars 742 million years ago

Self-reported screening helped reduce distressing symptoms for pediatric patients with cancer

Which risk factors are linked to having a severe stroke?

Opening borders for workers: Abe’s profound influence on Japan’s immigration regime

How skills from hospitality and tourism can propel careers beyond the industry

Research shows managers of firms handling recalls should review media scrutiny before deciding whether to lobby

[Press-News.org] Attack on C. difficile: How can we combat this serious health issue