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healthcarefoundationus · 5 years ago

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Living with recurrent C. diff? 5 tips to enjoying the holidays

Just when we all thought it was still March, the holidays have crept up on us. Let’s face it, we could all use a little joy right now to brighten up our holidays. Although the holidays may look different this year, many of us are hoping to keep a few normal traditions. Whether it’s gathering safely with family or enjoying a special meal, if you’re suffering from a recurrent diarrheal condition like C. difficile infection, those things can be anything but normal. Here are 5 tips Dr. Paul Feuerstadt of the PACT Gastroenterology Center in Connecticut recommends to help people with C. diff enjoy the holiday season.

1) Try your best to decompress

The holidays come with their own set of stressors. Gathering for meals with loved ones shouldn’t be one of them. Feuerstadt explains that those living with recurrent C. diff often show greater signs of stress in general, and frequently when it comes to mealtime.

Many C. diff patients often suffer a range of increased emotions which can be further elevated during the holiday season. Whether it’s grief, anger, fear, depression or anxiety, remember the holidays are a time to be kind to one another, including yourself.1

Take some time for yourself. Each day take 10 minutes to relax. Close your eyes and try your best to clear your mind.

Find outlets to help manage your stress and anxiety, such as through yoga, listening to music, reading a good book or just by getting enough sleep (7-8 hours per night).1

Listen to your body. It will tell you when you may need to take a minute for yourself. If the feelings are more intense than you feel you can consistently handle, follow up with your healthcare provider.

2) Don’t try to do it all yourself

The holidays can be a busy time of year. From picking out gifts for loved ones, to decorating the house, those suffering from C. diff can feel overwhelmed easily.

Rather than trying to do everything this year, why not focus on a couple of fun holiday traditions you enjoy? Maybe your one big activity is family baking and you ask a family member to help you decorate cookies. Whatever it may be, remember you don’t need to do it all. Focus your attention on one or two holiday traditions so you’re able to enjoy them to the fullest.

3) Know what’s on the menu

Whether you’re the chef or guest at a holiday dinner, know what’s on the menu. If there are certain foods or ingredients you must avoid, let your host know.

Although no two people are alike, there are foods that C. diff patients should generally avoid, including dairy products with lactose, greasy foods and any foods that may cause bloating (e.g., broccoli, onions, beans).2

Knowing it’s never good to arrive at a holiday gathering empty-handed, consider bringing a dish that you know will keep your gut calm and that you can eat without repercussions.

Remember to consult your healthcare professional for more information on nutritional advice for foods that are best suited for your body type and C. diff infection.

4) Practice health and safety guidelines

Anyone living with recurrent C. diff knows how contagious it is. That’s why it’s important to ensure you maintain standard health and safety measures, such as frequent handwashing. When using the restroom, be sure to always wash your hands with soap and water before touching surfaces such as doorknobs. Please be aware that alcohol-based hand sanitizer will not kill C. diff spores.3,4

Although already top of mind for most, COVID-19 is still on the rise in many parts of the country. Proper handwashing, social distancing and wearing of face coverings is essential for everyone. Many people living with C. diff have already been practicing many of these universal hygiene measures before COVID-19 so this will be less of an adjustment.

COVID-19 has opened the doors to telehealth, making it even easier and more common for people with C. diff to connect with both their local medical providers but also experts across the country who might be able to help. If you feel that you are not well, you should feel free to utilize these modern tools to communicate with providers to get the proper care you need, when you need it.

5) Try a new tradition

2020 has been a year unlike any other. We’ve all had to reimagine the expectation of being “together” and perhaps this year is the time to try a new tradition — like a virtual meal with family and friends who are far away. If you’re a big football fan, you may consider a Zoom football watch party. Or how about a recipe and meal prep virtual gathering? It’s normal for people with C. diff to feel isolated, so try turning social distancing into an opportunity to be more connected without the stress of, “What if I need to get to the bathroom quickly?” Embrace technologies like Zoom to safely connect with loved ones and take this opportunity to spin this constraint into a positive.

Although the holidays this year will look a little different, consider these tips as a guide to safely connect with your loved ones and enjoy this special season. Above all, continue to talk to your healthcare provider about your symptoms, and potential treatments. There have been a number of important advancements in therapies for recurrent C. diff that may help people feel better and lead better lives.

About C. diff:

Clostridioides difficile (C. diff) is a type of bacteria that can cause diarrhea, fever, abdominal pain, nausea, colitis, and in more serious cases, shock and death. According to the CDC, it’s estimated to cause almost half a million illnesses in the United States each year.5 After initial C. diff infection, up to 35% of patients may experience symptoms again, also known as recurrent C. diff infection.6

To learn more about the power of the microbiome and if it can be unlocked to break the cycle of recurrent C. diff infection, visit http://www.powerofmicrobiome.com/ and on Twitter, follow @FerringUSA.

This piece is sponsored by Ferring Pharmaceuticals, a research-driven, specialty biopharmaceutical group committed to helping people around the world build families and live better lives.

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steven-heisler-law-firm · 5 years ago

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Dr. John Cascone: Recognizing C. diff

About John Cascone: Dr. Cascone, is a Board Certified Internal Medicine and Infectious Disease Physician. His internal medicine residency was done at the University of Kansas and infectious disease follow up at the University of Missouri, Columbia. He is the Medical Director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long term care facilities, infectious disease consultations and telemedicine and infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, C diff, colitis, staphylococcus aureus, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.

In this episode, Steve and John discuss:

1. What is C. diff?

C. diff refers to the organism that formerly was identified as Clostridium difficile, but has now been changed to Clostridioides difficile. So the organism and as we’ll refer to it as C. diff, is essentially an organism that resides in our bowel and it is a spore forming organism, meaning within the gut exist as a bacteria that produces toxin that leads to the diarrhea that we’ll talk about in a bit. Outside of the gut, it converts to a spore. That spore is very hardy, difficult to kill and difficult to get rid of, which leads to the significant risk of transmission that occurs.

2. What is a spore?

A spore is essentially a non replicating form of an organism, meaning it is a hibernation type of the existence. So, the organism is no longer replicating in the way antibiotics work in killing bacteria. Typically bacteria has to be dividing and increasing in number. So a spore is a vegetative state that is highly resistant and impermeable to antibiotics.

3. Is it dangerous?

It is dangerous and very contagious.

4. What is a bacterial infection as opposed to a viral infection or another type of infection?

An infection refers to the invasion of an organism in a normally sterile site that leads to inflammation and disease. In this case, we’re talking about the bowel. So it doesn’t necessarily have to be a sterile site, but it has an organism that has led to some degree of inflammation and subsequent infection, whether it be a bacterial etiology or a viral etiology. The end result is inflammation of tissues, disruption of tissues and symptoms.

5. Is the affected organism the colon?

No, the effective organ is the colon. I said originally a sterile site. That is not a sterile site, the colon, but the organism leads to inflammation within that site.

6. So the spore or the seed is what causes the inflammation in the colon?

The way that works is C. diff is outside of the bowel. It is a replicating organism, it’s a bacteria. In the way C. diff causes colitis with diarrhea, it’s not the bug itself it is the toxin that is produced from the C. difficile. It produces two toxins toxin A, toxin B and in certain cases can produce a third toxin called a binary toxin. Those toxins are poisonous to the lining of the gut and they cause the gut to get inflamed, to leak water and leads to diarrhea and all types of other manifestations of the illness.

7. Is diarrhea the main symptom of C. diff?

Yes, so they have C. diff colitis and C. diff infection colitis. There has to be an infection of the colon to have had diarrhea. If there’s no diarrhea, then you do not have C. diff infection. You may still have C. diff in the bowel and up to 20% of people who are hospitalized, in 50% of people who reside in long term care facilities if you check their stool, will have C. diff present. But unless the patient has diarrhea, there’s no evidence of an infection. So you have to have the diarrhea to have the infection. A good rule of thumb for diarrhea is that the stool can no longer hold up a popsicle stick. So if it can’t hold up the stick, then that is considered diarrhea by definition.

8. If there’s no diarrhea, but there is C. diff in the bowel then it’s kind of laying dormant or it’s there and can lead to infection?

It’s there, it can lead to transmission, but if there’s no indication you don’t treat that. You shouldn’t be testing stool for C. diff in the first place. You should only perform C. diff studies or C. diff laboratory studies on stool in the presence of diarrhea.

9. In your opinion what exactly is the cause of C. diff?

The primary cause of C. diff is the use of antibiotics and antibiotics used to treat other infections in any antibiotic administration, even one dose can cause C. diff. That’s an unfortunate event, but that’s when used inappropriately. If antibiotics are used to treat a urinary tract infection and are used inappropriately, then it increases the risk of C. diff. That’s what has caused this rise of C. difficile colitis or C. difficile infections in this country over the last 10 to 15 years. The appropriate use of antibiotics requires that a BB gun be used as opposed to a shotgun. So, the most specific antibiotic to kill that infection, say a urinary tract infection to treat that for an appropriate duration. For instance, a urinary tract infection should be treated for three days. So, if antibiotics are used, or they are too broad a spectrum and are used for a long period of time, longer than what is indicated. It increases one’s risk of getting C. diff colitis.

10. Isn’t there a recognized protocol for how many days somebody should be taking antibiotics for urinary tract infection? Why would they be treated for more than the recommended protocol?

There are recommended protocols. The whole shift of infectious disease has been less antibiotic or more specific antibiotic for a shorter duration, we’re finding that, for instance, pneumonia, five days of treatment is adequate, no longer 10 to 14 days. There are medical guidelines, the Infectious Disease Society of America guidelines tell us how to treat infections, what antibiotics to use and for the duration. There’s no indication and there’s no reason to use anything longer than three to five days at the upper end of it for a simple urinary tract infection.

11. The aging well article that I referred to earlier also mentions a weakened immune system, long institutional stays and GI surgery as other causes of C. diff. So if you don’t have diarrhea, but you had a bad result from GI surgery, you stay in a nursing home and have been there a long time and your immune system is weakened, is that something that without diarrhea would not make the doctors even consider that it’s C. diff?

No they wouldn’t treat you for C. diff without diarrhea. They shouldn’t really even be finding C. diff because there’s no reason to do stool studies. Certainly, C. diff colitis is diarrhea but certainly those risk factors that you’ve mentioned, can lead to C. diff colitis. Not only the advanced age, but in antibiotic use, hospitalization, chemotherapy, inflammation and inflammatory bowel disease are all risk factors.

12. Most people in those situations are on antibiotics so all of it together creates the perfect storm, Correct?

Correct. That’s why you want to be vigilant in using antibiotics judiciously, not over prescribing them and keeping patients out of harm’s way when they don’t need to be there.

13. How dangerous is C. diff? What can be expected in a mild case of C. diff, as opposed to a severe case of C. diff?

The mortality of C. diff has a lot to do with the underlying condition of the patient. As we get older, we typically have more comorbid illnesses and we’re on other medications. We have other disease processes that are being treated, and then increases our risk for a bad outcome. C. diff can have a mortality of upwards 16 to 20% and, of course, if you’re sick with other illnesses, that mortality can go up even higher. The way C. diff presents as we talked about, it’s diarrhea but could also be worsening symptoms other than diarrhea, and that is abdominal distension, fever, nausea, vomiting, abdominal pain, or cramping. If C. diff colitis gets bad enough, it can actually shut the entire gut down, and patients no longer have bowel movements. So it can lead to constipation on the far end of the spectrum.

14. What can happen if not adequately dealt with what can be the consequences from that point on?

First and foremost, patients can become dehydrated from the diarrhea. In volume, salt water that’s passed to the stool. So dehydration, sepsis can certainly occur as a result of the inflammation in the colon, then multi organ failure and as mentioned in 15 to 20% of patients death.

15. Are seniors and the elderly the highest at risk part of the American population or world population? Why?

They probably are the population that is at highest risk for acquiring C. diff, and they are the population that is at highest risk for bad outcome. That is because the older we get, we typically have multiple other medical problems. That impairs our ability to fight infection, we’re typically on more medications that impair our ability to fight infection and our overall ability to overcome is reduced as we get older, we become more vulnerable. The health care provider needs to make sure that patients are appropriately diagnosed and treated and not over prescribed antibiotics to reduce the incidence of C. diff in our elderly patients.

16. What is it about senior care facilities or nursing homes that increase the risk of C. diff?

In senior care facilities, one increases the risk of contracting C. diff. Those facilities are where antibiotics are prescribed to other patients in the facility. So if there’s antibiotics prescribed in the facility where you live it impacts the risk of other patients getting C. diff, and then you contract it from somebody else. That’s the primary cause, just being close to others who are getting antibiotics and potentially could get C. diff and pass it to you.

17. Do you see C. diff in little kids or schools or only in the senior and elderly population because of the weakened immune system and all the aging?

It’s the weakened immune system in the population more at risk for getting C. diff and for having a bad outcome. Interesting about kids. The reason you don’t see C. diff in infants and nurseries, is because they don’t have the receptors for the toxin to bind to and cause inflammation. So they still have C. d-ff in fact, some people think they’re reservoirs of C. diff, but they don’t get C. diff colitis because the toxin is ineffective in them.

18. They’re probably not being over prescribed antibiotics like our senior and elderly population are?

Exactly. If you look at a gut it is populated with millions and billions of organisms. Bacterias that, for the most part, help us have a nice healthy bowel and the bacteria also keep the bad bacteria at bay. C. diff still is one of those bad bacteria. When somebody is prescribed antibiotics for a urinary tract infection or pneumonia, that antibiotic not only kills the bacteria causing the urinary tract infection, pneumonia, but it also kills all the good bacteria in the gut. When the good bacteria are killed the bad bacteria, like C. diff, are allowed to start repopulating and then cause colitis and diarrhea.

19. Would you advise our listeners to begin taking probiotics as a way to increase the good bacteria in the gut?

The jury really is out on probiotics. I don’t think there’s anything wrong with doing it. I’m just not sure it’s going to provide you with any benefit. Certainly, keeping the gut populated with good bacteria will be a benefit. The primary thing our elderly patient should do is when their doctor prescribes them an antibiotic, they should inquire and make sure that the physician is giving them the right antibiotic for the right duration. Shorter is better than longer when it comes to duration.

20. When our listeners are getting the information about what antibiotic they were recommended or prescribed and how long it was prescribed for, how do they know whether it’s over prescription or not?

Starting the dialogue with your provider should force him to think about his decision and the antibiotic that he’s using and for what duration. Some antibiotics that are really notorious are Levofloxacin, Levaquin, or Ciprofloxacin and these high powered antibiotics, really do a number if you will, on the gut and on the normal Flora the good bacteria in the gut and cause severe bouts of C. diff colitis. It’s important to always be inquisitive, to always ask your providers and take nothing for granted when they prescribe antibiotics. I think they’re probably the most overused, inappropriately used of all the drug classes out there.

21. What are nursing homes and senior care facilities doing to address the problem of overuse of antibiotics?

There’s been a real push and rightly so, toward antimicrobial stewardship in long term care facilities and hospitals. Microbial stewardship essentially is somebody such as an infectious disease physician, overseeing the use of antibiotics in a facility and making sure the antibiotics are used for an appropriate diagnosis and that the antibiotic prescribed is a narrow spectrum as opposed to a broad spectrum antibiotic and it is prescribed for the appropriate duration. That push with regards to the use of antibiotics appropriately, really has done wonders to reduce the incidence of C. diff. The other things nursing homes do and should do is good hand hygiene. Because the alcohol based solution that you rub on your hands does not C. diff. You need to wash your hands with soap and water for two minutes and in fact, the soap and water does not kill the C. diff. What it does is some mechanical action that gets the spores off of the hands in patients who have it. If you’re in a long term care facility, and your roommate has C. diff, you should be isolated from your roommate because there’s a risk of them giving it to you.

22. Wouldn’t disinfection of hospital rooms on a consistent basis, and healthcare providers wearing gowns and gloves also be part of the protocol?

Important preventive measures that are used in contact isolation when a patient has C. diff requires a gown, gloves, a throw away stethoscope so that the spores don’t get on your stethoscope and you pass to another patient. In addition room disinfecting is an important measure. The spores as I mentioned are very hardy and even the best disinfection of a room is not always adequate. In fact, studies have shown that if a patient in the room before you had C. diff, you are more likely to acquire C. diff during your stay in that room.

23. If somebody is demonstrating symptoms of C. diff, is there a standard test that they should be given or what is the test that is being utilized by the medical community to see if they have C diff? How reliable is it?

We use a standard test that’s called a PCR or a NAAT test, that looks for the toxin in the gut. It’s very reliable and if it’s present, you have it. If it’s not present, you don’t have it.

24. Do they just take a stool sample and put it under the microscope?

They take a stool sample that has to be a diarrheal stool sample. It has to be diarrhea, and then they run a chemical test on it, which looks for the production of toxin in the diarrheal stool.

25. What would be the goldstar treatment for somebody with C. diff?

Antibiotics, and the antibiotics we use our oral antibiotics, vancomycin, or fidaxomicin is the first choice. It is orally given by mouth and what it does is it stays within the gut and it does not get absorbed into the systemic system. It stays within the gut and it is specific for killing the C. difficile bacteria within the bowel. That treatment is 10 to 14 days. Sometimes you can be prescribed vancomycin for a longer period of time, if you’re on other antibiotics to treat another infection, sometimes they have to overlap. But typically it’s 10 to 14 days.

26. Are fecal transplants one of the additional types of treatments for individuals who have severe C. diff, and the antibiotics aren’t working?

Yes, fecal transplants are actually a very effective treatment for C. diff colitis. Fecal transplants provide stool from a donor and that stool is populated with all the good bacteria that normally resides in our bile. That sample is then put into the gut of the patient who has C. diff colitis and when you do that, you repopulate all the normal bacteria. The way vancomycin works is to kill the C. difficile. The way a fecal transplant works is to repopulate the good bacteria to suppress the production of the bad bacteria, which in this case is C. diff.

27. Fecal transplants sound a little radical, but how effective are they?

It’s very effective and oftentimes can be life saving.

28. What is the risk level for the general American population to develop C. diff?

1% of patients that are hospitalized, will get C. diff colitis. It’s important to note that there is such a thing as community, associated C. diff colitis. These are patients who have not been hospitalized have not been on antibiotics and develop C. diff colitis. What I don’t want our listeners to think is just because I haven’t been in the hospital, just because I haven’t gotten any recent antibiotics. There’s no way I can have C. diff. It’s uncommon, but it’s still possible and your doctor should check you for it.

29. What would you say to our listeners if they are in a nursing home, or they have a loved one in a nursing home, or a senior care facility and they’re starting to show symptoms of C. diff? What action steps would need to be taken?

If an elderly patient is in a nursing home and begins to develop diarrhea, abdominal pain, fevers, nausea, vomiting, whether they’ve recently gotten antibiotics or not, they should notify the provider, the nurse in charge immediately and then the patient should be checked with not only a stool sample to make sure C. diff isn’t present, but also with laboratory to make sure that kidneys are not getting affected from the diarrhea in terms of dehydration, and check the white blood cell count to make sure it’s not elevated due to the severe colitis. It’s not something they should wait on, they should notify the providers immediately.

“Practice good hand hygiene because the alcohol based solution that you rub on your hands does not kill C. diff. You need to wash your hands with soap and water for two minutes and in fact, the soap and water does not kill the C. diff it’s the mechanical action that gets the spores off of the hands. “ — John Cascone

To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530

Connect with John Cascone:

Email: [email protected]

CONNECT WITH STEVE H. HEISLER:

Website: http://www.injuredseniorhotline.com Facebook: https://www.facebook.com/attorneysteveheisler/ LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: [email protected]

Show notes by Podcastologist: Kristen Braun

Audio production by Turnkey Podcast Productions. You’re the expert. Your podcast will prove it.

The post Dr. John Cascone: Recognizing C. diff appeared first on The Maryland Injury Lawyer.

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jesseneufeld · 5 years ago

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C. difficile (C. diff): An urgent threat

Clostridioides (previously Clostridium) difficile (C. diff) is the most common cause of diarrhea among hospitalized patients and the most commonly reported bacteria causing infections in hospitals. In a 2019 report, the CDC referred to C. diff as “an urgent threat.”

Who is most at risk?

C. diff infection (CDI) occurs more commonly following antibiotic therapy or hospitalization, and among older adults or patients with weakened immune responses. In 2002, an epidemic strain of C. diff emerged, causing more severe disease with inflammation of the colon (colitis) and an increase in deaths. This strain adheres better to the intestine and produces more toxin, which is responsible for causing illness. Non-epidemic strains may cause less severe disease.

What makes C. diff so difficult to treat?

A high relapse rate poses challenges to treating people with CDI. Recurrence of diarrhea following initial treatment occurs in about 20% of cases. The risk of yet another relapse is even greater in the weeks following treatment for a recurrent CDI.

C. diff produces spores (dormant cells capable of surviving harsh conditions for prolonged periods) that can contaminate the environment. Spores are hearty and resistant to routine cleaning. But enhanced protective measures — careful hand washing, isolation precautions for infected patients (private room, gown, and gloves), and cleaning with agents capable of killing C. diff spores — are effective ways to prevent transmission and control CDI.

Antibiotics disrupt the healthy gut bacteria (microbiome), which then provides suitable conditions for ingested spores to flourish and result in CDI.

Hospitalized patients are at greater risk, although healthy individuals in the community who have not been treated with antibiotics can also become infected.

The World Society of Emergency Surgery released updated clinical practice guidelines in 2019, focusing on CDI in surgical patients. Surgery, particularly gastrointestinal surgery, is a known risk for CDI. (Ironically, surgery is also a potential treatment option for severe CDI.)

What is the difference between C. diff colonization and C. diff infection?

Up to 5% of people in the community, and an even greater percentage of people who are hospitalized, may be colonized with C. diff bacteria, but not experience any symptoms. The risk of progressing to disease varies, since not all C. diff strains produce toxin that makes you sick. People colonized with a non-toxin-producing strain of C. diff may actually be protected from CDI.

CDI is diagnosed based on symptoms, primarily watery diarrhea occurring at least three times a day, and stool that tests positive for C. diff. A positive test without symptoms represents colonization and does not require treatment. Patients colonized with toxin-producing strains are at risk for disease, particularly if exposed to antibiotics.

How is C. diff treated?

The most common antibiotics used to treat CDI are oral vancomycin or fidaxomicin. Extended regimens, lasting several weeks, have been used successfully to treat recurrences. Vancomycin enemas and intravenous metronidazole, another antibiotic, are also used in severe cases.

Fecal microbiota or stool transplant (FMT) from screened donors is an effective investigational treatment for those who do not respond to other treatment. However, it is not without risk. FMT capsules are effective and logistically easier.

Patients with severe CDI not responding to therapy may benefit from surgery, typically a colon resection or a colon-sparing procedure.

What can you do to prevent CDI?

Though there are no guarantees, there are many things you can do to help reduce your risk of CDI, particularly if you are scheduled for hospitalization or surgery.

If you are scheduled for surgery, discuss routine antibiotics to prevent infection with your surgeon. In most cases, according to the CDC, one dose of an antibiotic is sufficient. If you have an established (non-C. diff) bacterial infection, several recent studies show that shorter antibiotic courses are effective and may also reduce your risk of CDI. You should also ask your doctor about avoiding antibiotics that are more likely to result in CDI (clindamycin, fluoroquinolones, penicillins, and cephalosporins).

If you are hospitalized with CDI, you should use a designated bathroom and wash your hands frequently with soap and water, particularly after using the restroom. In the hospital, encourage staff to practice hand hygiene in your line of sight, and express appreciation to hospital staff for keeping your environment germ-free. If you are at high risk for a CDI recurrence (you are 65 or older, have a weakened immune response, or had a severe bout of CDI), discuss the potential value of bezlotoxumab with your provider. This monoclonal antibody can help to further reduce risk of recurrent CDI in those who are at high risk for recurrence.

There are other preventive measures that you can take whether or not you are hospitalized. Limit the use of antacids, particularly proton-pump inhibitors (PPIs). Don’t ask your doctor for antibiotics to treat colds, bronchitis, or other viral infections. Request education about side effects of prescribed antibiotics from your doctor or dentist, and discuss the shortest effective treatment duration for your condition. Let your doctor know that you want to minimize your risk for CDI. Practice exceptional hand hygiene before eating, and especially before and after visiting healthcare facilities.

For more information, visit the Peggy Lillis Foundation and the Centers for Disease Control and Prevention.

Follow me on Twitter @idandipacdoc

The post C. difficile (C. diff): An urgent threat appeared first on Harvard Health Blog.

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cdifffoundation · 5 years ago

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C. diff. Spores and More: Tuesday April 21st at 10:00 a.m. PST With Guest Maureen Spencer, RN, M.Ed., CIC To Discuss Coronavirus (COVID-19) Pandemic

C. diff. Spores and More Tuesday at 10 AM Pacific

April 21st 2020: Coronavirus COVID-19; A Time To Review the Basics Through Prevention, Symptoms, Treatment

The 2019–20 coronavirus pandemic is a pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified in Wuhan, Hubei, China in…

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mhealthb007 · 5 years ago

Link

Who is most at risk?

What makes C. diff so difficult to treat?

Antibiotics disrupt the healthy gut bacteria (microbiome), which then provides suitable conditions for ingested spores to flourish and result in CDI.

Hospitalized patients are at greater risk, although healthy individuals in the community who have not been treated with antibiotics can also become infected.

What is the difference between C. diff colonization and C. diff infection?

How is C. diff treated?

Patients with severe CDI not responding to therapy may benefit from surgery, typically a colon resection or a colon-sparing procedure.

What can you do to prevent CDI?

Though there are no guarantees, there are many things you can do to help reduce your risk of CDI, particularly if you are scheduled for hospitalization or surgery.

For more information, visit the Peggy Lillis Foundation and the Centers for Disease Control and Prevention.

Follow me on Twitter @idandipacdoc

The post C. difficile (C. diff): An urgent threat appeared first on Harvard Health Blog.

from Harvard Health Blog https://ift.tt/2P8vcgS Original Content By : https://ift.tt/1UayBFY

#Health #Fitness #Healthy #Fit #Health and Fitness #Being Healthy #Health maintenance #fitness mainte

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dorcasrempel · 5 years ago

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Why C. difficile infection spreads despite increased sanitation practices

New research from MIT suggests the risk of becoming colonized by Clostridium difficile (C. difficile) increases immediately following gastrointestinal (GI) disturbances that result in diarrhea.

Once widely considered an antibiotic- and hospital-associated pathogen, recent research into C. difficile has shown the infection is more frequently acquired outside of hospitals. Now, a team of researchers has shown that GI disturbances, such as those caused by food poisoning and laxative abuse, trigger susceptibility to colonization by C. difficile, and carriers remain C. difficile-positive for a year or longer.

“Our work helps show why the hospital and antibiotic association of C. difficile infections is an oversimplification of the risks and transmission patterns, and helps reconcile a lot of the observations that have followed the more recent revelation that transmission within hospitals is uncommon,” says David VanInsberghe PhD ’19, a recent graduate of the MIT Department of Biology and lead author of the study. “Diarrheal events can trigger long-term Clostridium difficile colonization with recurrent blooms” in Nature Microbiology, published on Feb. 10.

The researchers analyzed human gut microbiome time series studies conducted on individuals who had diarrhea illnesses and were not treated with antibiotics. Observing the colonization of C. difficile soon after the illnesses were acquired, they tested this association directly by feeding mice increasing quantities of laxatives while exposing them to non-pathogenic C. difficile spores. Their results suggest that GI disturbances create a window of susceptibility to C. difficile colonization during recovery.

Further, the researchers found that carriers shed C. difficile in highly variable amounts day-to-day; the number of C. difficile cells shed in a carrier’s stool can increase by over 1,000 times in one day. These recurrent blooms likely influence the transmissibility of C. difficile outside of hospitals, and their unpredictability questions the reliability of single time-point diagnostics for detecting carriers.

“In our study, two of the people we followed with high temporal resolution became carriers outside of the hospital,” says VanInsberghe, who is now a postdoc in the Department of Pathology at Emory University. “The observations we made from their data helped us understand how people become susceptible to colonization and what the short- and long-term patterns in C. difficile abundance in carriers look like. Those patterns told us a lot about how C. difficile can spread between people outside of hospitals.”

“I believe that there is a lot of rethinking of C. diff infections at the moment and I hope our study will help contribute to ultimately better manage the risks associated with it,” says Martin Polz, senior author of the study and a visiting professor in MIT’s Parsons Laboratory for Environmental Science and Engineering within the MIT Department of Civil and Environmental Engineering.

The research team also included Joseph A. Elsherbini, a graduate student in the MIT Department of Biology; Bernard Varian, a researcher in MIT’s Division of Comparative Medicine; Theofilos Poutahidis, a professor in the Department of Pathology within the College of Veterinary Medicine at Aristotle University in Greece; and Susan Erdman, a principal research scientist in MIT’s Division of Comparative Medicine.

Why C. difficile infection spreads despite increased sanitation practices syndicated from https://osmowaterfilters.blogspot.com/

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number06fan · 6 years ago

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C.Diff Threat to Elderly Hospital Patients

A kind of dangerous bacteria called Clostridioides difficile or C.Diff is posing a threat to very sick and elderly hospital patients. The bacteria are shown to survive on disposable hospital gowns and stainless-steel surfaces even after they have been scrubbed clean, according to a study.

The research was published in the journal Applied and Environmental Microbiology. It stated that C. diff is able to spread easily from disposable gowns used while surgery as well as stainless steel and vinyl surface even after disinfection.

“The [bacteria] also transferred to vinyl flooring, which was quite disturbing. We didn’t realise they would,” said Tina Joshi, lead author of the study and lecturer in molecular microbiology at the University of Plymouth in the UK.

Clostridioides difficile or C.Diff is an infection that causes severe damage to a person’s gut and lead to diarrhea or colitis (an inflammation of the colon). Around half a million infections occur in the US each year, according to the Centers for Disease Control and Prevention (CDC). And 29,000 of those infected die. 1 in 11 people aged above 65, who contract the disease, dies within a month of diagnosis. And 1 in 5 people who get infected with Clostridioides difficile gets it again.

Lab studies done by the researchers also showed that the bacteria didn’t die even when they tried to kill them with concentrated chlorine disinfectant. “Even if we applied 1000 parts per million of chlorine, it would allow spores to survive in the gowns,” Joshi told NBC News.

What’s more, these bacteria evolve. They like to stay one step ahead. With time, they will become more resistant even after using disinfectants and antibiotics.

It is also possible that an increased amount of chlorine can kill the bacteria, but it will only make them more resistant in just a matter of time, added researchers. After that, the strong concentrations won’t be able to kill them.

The bacteria can cause a patient to become sick when he is administered a broad spectrum of antibiotics to tackle another infection. These antibiotics can harm the person’s gut bacteria, and create a perfect space for C. diff to thrive. This allows the bacteria to proliferate through the gut. The person will now start shedding it in their feces. When anyone who gets the C.diff infection suffers from severe diarrhea, the bacteria gets launched into the air and spread to the surroundings. This is when it becomes vitally important that you disinfect clothing, tables, bed and the curtains.

If the decontamination doesn’t happen, the bacteria can infect hospital patients and people in nursing homes when they come in contact with tainted clothing and surfaces.

But if the traditional disinfectants aren’t killing the bacteria, what would work?

As the new study suggests, one option is UV light. By exposing the hospital surfaces to UV light, C. diff bacteria effectively gets killed. However, it is a challenging process. Don’t worry! The researchers have suggested an alternative too. Right now, highly concentrated bleach seems to be the best option, according to Joshi.

If you are caring for patients who are at more risk of getting C. diff infection at home, then using just alcohol-based hand sanitizers is ineffective against the bacteria. Instead, make a cleaning solution with one cup bleach with nine cups of water, leave it on for minimum 10 minutes before using on surfaces.

Meanwhile, it’s interesting to note that C. diff spores can survive on doctor’s coats, surgical gowns, scrubs worn by hospital personnel and other surfaces.

“That’s a real infection control hazard, because these spores can stick to fibers, We have proven that in this paper,” said lead author Tina Joshi.

Looming Threat of Clostridioides Difficile:

The anaerobic C.diff is so good at outwitting the attempts to kill it that it has existed for a million years but came into the radar of researchers only in the past 40 years and has been the focus of intense research for the past 15 years.

Rise of C.diff, powered by antibiotics ….

1970’s saw an increase in C.diff infections – triggered by widespread usage of antibiotic Clindamycin. And with time, use of broad spectrum of antibiotics fueled a C.diff epidemic. Sounds paradoxical? Aren’t antibiotics supposed to kill the bad bacteria? Yes, they are. But as they inhibit or kill the good bacteria, they cause a collateral damage to good bacteria in our gut. When healthy gut flora are disturbed, a void is created. And C.diff happily fills this void as and when it gets a chance.

The reason why C.diff is so common in hospital patients. When you are admitted to a hospital, you are given antibiotics along with other medications to make you feel better. But those antibiotics are like a welcoming dose for C.diff bacteria. The pathogen spreads rapidly through fecal to oral transmission and can cause symptoms like:

Diarrhea – loose, watery that can continue for several days

Stomach tenderness or pain

Fever

Nausea

Loss of appetite

The diagnosis is done through stool tests. Doctors and nurses are able to suspect C.diff when they know their treatment includes broad spectrum of antibiotics or they have other risk factors that can lead to infection. Nevertheless, a proper confirmation is necessary.

Once the infection is confirmed, the treatment includes identifying which antibiotics are triggering the infection and then administering antibiotic that would kill the bacteria. Most patients recover from the infection within 10 to 14 days. But if the infection was an ordinary one, that would be the end of the story. In 20% patients, C. diff returns again. For relapses, treatment includes a second dose of antibiotics, fecal microbiota transplant and probiotics. The effectiveness of the last one is controversial and research on advanced probiotics are currently ongoing.

To prevent C.diff, it is important that doctors use antibiotics wisely. This means only prescribing antibiotics when necessary, focusing on first spectrum of antibiotics and stopping the use of antibiotics when the job is done. Right now, the focus is to develop an antibiotic for C.diff that kills the bacteria without harming the beneficial bacteria in the human gut. The search is heavily funded in the US, by both private and public health institutions.

By: Pooja Sharma, Contributing Writer (Non-Lawyer)

The post C.Diff Threat to Elderly Hospital Patients appeared first on The Lange Law Firm.

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andersa · 6 years ago

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The Biggest Mistake of My Life and How It Will Help You

FEBRUARY 10, 2017

Reading comprehension. The biggest mistake of my life was a reading comprehension error regarding something most of us don’t think twice about.

Antibiotics.

Our oldest is a bright 15 year old with a dust mite allergy that leads to an occasional sinus infection. Cue the sinus infection just before Thanksgiving. Cue a 10 day course of antibiotics.

“Take 2 in the morning and 2 at night and you will feel better in no time,” I instructed as I handed over the prescription and rushed the kids out the door for several holiday overnighters with family.

A 10 day antibiotic course was accidently taken in 5 days due in part to the hustle and bustle of everything. I read the instructions too fast and gave her the wrong instructions. She listened all too well.

2 ER visits, 3 InstaCare visits, 2 regular doc visits, 2 GI specialist visits, 10%+ of her body weight lost and her bathroom on quarantine and disinfected only with a 10:1 bleach solution to kill the spores and prevent this highly contagious disease from spreading.

Imagine a nuclear bomb going off in your intestines. That is exactly what happened to her gut with an overdose of antibiotics.

Our first InstaCare visit led to my new favorite doctor gently telling me our daughter was very sick and needed to go to the ER. Which ER would we like so they could call ahead and let them know we were coming and would we like an ambulance?

WHOA. WHAT JUST HAPPENED? We went from stomach ache, cramps and scoots to would we like an ambulance in the course of the 45 minute visit.

Deep breath. Put on brave face. Head to the ER. She was REALLY sick.

Long story short, the overdose led to a party in her gut by a bacteria known as c. diff (clostridium difficile). C diff is commonly in our gut but it is kept in check by the good critters working in the depths below.

The first two rounds of drugs used to treat the c diff failed, meaning severe scoots and cramps returned. She is currently pounding down a 6 week tapered course of an antibiotic that kills the c diff. Once the taper ends we will pulse it another 3 weeks.

Praying like it’s all in God’s hands yet doing everything in our power to heal her along the way.

Needless to say, hours have been spent digging into learning more about c diff, our gut microbiome and how amazing our guts truly are.

As you can imagine, a few things have changed at our house when it comes to feeding, fueling and repairing our daughter.

Here is a quick rundown of things you could consider if you or yours

needs to rebuild immunity for whatever reason.

Caution: Exceptional long term heath may occur!

Carbohydrate only when occurring naturally in milk, fruits (take it easy on fruits for now too, fruit sugar is difficult to digest) veggies or whole grains

Minimal amounts of processed or packaged food –not much that comes in a wrapper is very good for your body

Avocado

Coconut Oil & Olive Oil

Sugar – limited to naturally occurring

Whole milk – she needs the calories, higher protein content and lower sugar level – if her stomach hurt after consuming dairy I would eliminate it all together but she is tolerating it well and only has one glass a day.

Kefir – homemade and purchased from the store (we LOVE the Lifeway brand raspberry and peach). As a fermented food it’s 99% lactose free = no problems digesting it plus it’s packed with probiotics!

Prebiotics – need the fiber from produce for fuel which fuels probiotics - in the form of raw or cooked and all throughout the day to continuously feed the critter below

Probiotics – yes, even though she is on an antibiotic (spaced at the mid-point of antibiotic dosingie- 8a and 8p dose = probiotics at 2p) Currently we are using Dr Axe SBO Probiotic – soil based with 50 Billion CFU’s - one capsule with lunch and the other when she comes home from school.

Lentils – we call them tiny spaceships…protein and fiber packed amazingness eaten with lunch and dinner by simply adding to whatever the meal (tacos, soup and even pasta). Prebiotics LOVE the fiber in lentils. Happy prebiotics = happy probiotics!

Greens – spinach and kale (packed in smoothies)

Bone Broth Protein Powder (we are using Dr Axe Vanilla and Pure)

Classic Scary Smoothie (70/30 fruit and veggies + homemade kefir) daily

Water – plenty of crystal clear amazing water!!!

Meditation – we use an app called Calm – outstanding! Used to managed pain, cramps and fear.

Less stress – we had to withdraw her from an AP class to decrease homework and stress load from missing so much school (20+ days)

Gentle exercise – everyone is happier when they move

Breakfast Gut Re-Builder Smoothie

1 cup spinach – fiber feeds the prebiotics which feed the probiotics and are one of the most powerful sources of phytonutrients a person can consume

1/3 banana – sweetness and masks the flavor of spinach

¼ cup raspberries, blackberries or blueberries – fantastic sources of antioxidants, phytonutrients, fiber which are all key in healing the body

½ cup raspberry kefir – probiotic source

¼ - ½ avocado – healthy fat

½ - 1 scoop vanilla bone broth protein powder

Water – enough to get the contents of the blender to churn

Antibiotics are scary dangerous drugs that are overused and underfeared. Learn from my mistake and be cautious as you read the directions. Most conditions will resolve without the use of these drugs. Consider that as a primary approach to better health. Your gut microbiome will thank you!

We are approaching 3 months of dealing with this beast and are not out of the woods yet. The light at the end of the tunnel is in sight but this rollercoaster will still have dips and curves. We are thankful the dips and curves are getting easier to handle.

Keep your gut healthy, you have life to live!

Brooke

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kathleenseiber · 6 years ago

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1 gene makes C. diff especially toxic

Researchers have identified a central regulator of toxin production in the bacterium C. difficile.

C. difficile is a major cause of persistent diarrhea, occurring most often after taking antibiotics, as well as the most common cause of healthcare-associated infections in the United States

The laboratory of Shonna McBride, assistant professor of microbiology and immunology at Emory University, investigates how C. difficile regulates toxin production and spore formation, the production of dormant cells that can survive long-term in the environment and hospital settings. Understanding the conditions during infection that promote toxin production could provide targets for new antibiotics and insights regarding how the bacteria control toxin synthesis.

C. difficile produces two toxins that damage intestinal cells and cause the symptoms of infection, but making these toxins requires a lot of energy. Environmental stress increases toxin production, but having an abundance of nutrients around, such as amino acids, peptides, and certain sugars, suppresses the production of toxin.

Working with McBride, instructor Adrianne Edwards had previously spotted a gene that regulates both toxin production and spore formation. They named it RstA, for “regulation of sporulation and toxins.” In their paper, the researchers show how the protein that RstA encodes controls toxin gene activity.

“This one protein is critical for preventing toxin production by controlling multiple factors that are important for toxin expression,” says McBride.

Edwards used specific DNA fragments from toxin genes as bait to pull the RstA protein out of bacterial cell extracts. Using this pulldown method, Edwards also demonstrated that RstA binds to the DNA of other regulatory genes that control toxin production.

Tracking the effects of mutating part of the protein, allowed the scientists to confirm that RstA acts directly as a DNA clamp to control toxin expression.

The predicted structure of RstA suggests that it is a “quorum-sensing” protein and is involved in sensing the presence of nearby bacteria by interacting with a small molecule bacteria produces.

Edwards showed that RstA likely interacts with a small molecule only C. difficile makes to allow it to bind DNA. However, the genome of C. difficile is organized in a way that is different from many closely related bacterial species, so it’s been more difficult to find the signal.

“Identification of the cofactor that controls RstA activity is a high priority, as this will likely provide insight into the physiological conditions and/or metabolites that influence C. difficile TcdA and TcdB [the toxin proteins] production,” the authors conclude.

The results appear in the journal mBio. Support for this research came from the National Institute of Allergy and Infectious Diseases.

Source: Emory University

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3ezentrum3-blog · 7 years ago

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Is There an Alternative Medicine Treatment For C. Difficile?

Do you experience the ill effects of perpetual looseness of the bowels after anti-microbials and you were informed that you have C. difficile contamination? Notwithstanding when you take anti-toxins, do you have backslides of watery looseness of the bowels with a particular foul stool smell or blood, or discharge in your stool? Is it true that you are always worn out? Do you have stomach torment, fever, queasiness and weight reduction?

You are not the only one. Analysts propose that about a large portion of a million of Americans every year experience the ill effects of anti-toxin related looseness of the bowels that is caused by organism C. difficile.

C. difficile is referred to likewise as Clostridium difficile, CDF, C. diff, pseudomembranous colitis; anti-microbial related colitis, necrotizing colitis. A few specialists and specialists call C. difficile a superbug, since it causes 30,000 passings for each year in United States alone. The disturbing actuality is that anti-infection agents can't murder the safe types of this microorganism.

Ten to fifteen percent of individuals have this microorganism in their digestive organs without clear side effects. It is realized that solid individuals don't by and large become ill from C. difficile. A solid individual has insurance from this superbug.

C. difficile happens normally in individuals after the course of the expansive range anti-microbials, and ordinarily it hits people with low resistant framework. Casualties of this superbug are elderly, little children, individuals after medical procedures, radiation, chemotherapy, a few prescriptions, heavy drinkers', patients with AIDS, and so forth. Before taking the wide range anti-infection agents, they felt sensibly well.

Specialists and scientists are consistent that C. difficile contamination happens for the most part in the wake of pulverizing the well disposed intestinal vegetation by anti-microbials. Human gastrointestinal tract is the harbor for in excess of 400 types of microorganisms. The majority of them are benevolent intestinal greenery. By similarity with the great occupants', they live in our body and "pay the lease".

These well disposed microorganisms enable us to process sustenance, expel poisons and cholesterol, help our invulnerable framework, and have hostile to disease property. The indispensable part of benevolent intestinal greenery is that it controls the development of purported pioneering contamination. Pioneering diseases are organisms, Candida-yeast, parasites, and so forth. They develop when they have a chance to develop; more often than not it happens when anti-microbials pulverize a well disposed vegetation.

C. difficile is visit entrepreneurial contamination that lives in the human body in the little sum. There are numerous spores of this microorganism in the water, air, nourishment, hands, and condition. Tired individuals discharge heaps of these spores around. Specialists found that up to 20 percent of people who are hospitalized and up to 50 percent of individuals in nursing homes convey C. difficile in their defecation. In any case, huge numbers of them don't have the runs or different side effects. That is the reason; the doctor's facilities and nursing homes are most sullied places with C. difficile with conceivable flare-ups'.

Basic treatment with anti-toxins and hostile to parasitic medications does not keep from backslides and prompts the improvement of the anti-infection safe types of the Clostridia. The financial weight of this ailment in the previous year is assessed to be $3.2 billion, and quantities of sick individuals develop each year.

For a few people, it sounds abnormal that elective medication can be helpful for this genuine therapeutic issue. Incessant looseness of the bowels isn't something new in medication; it goes with people for quite a long time, well before the time of anti-microbials. Non-tranquilize, normal strategies have a long history in treating endless looseness of the bowels.

Give us a chance to take a gander at my own involvement. For example, one dental specialist recommended a young lady solid anti-toxins'. In three weeks, she got watery loose bowels, stomach torment, queasiness, high temperature. Doctor made tests and C. difficile colitis was analyzed. She was put on steady course of anti-toxins, however at any rate, she got a few backslides. She had mucous, and blood in her stools, she shed pounds and felt frightfully weariness and discouraged. Following a half year of anguish, she chose to attempt non-tranquilize, normal approach. Her MD was strong and allowed her to end anti-microbials for some timeframe.

The objective of her elective treatment was to reestablish characteristic instrument that keeps sound individuals from pioneering disease, battle with Candida-yeast excess and SIBO-Small Intestine Bacterial Overgrowth, and intestinal irritation. It expected to reestablish her amicable intestinal verdure, the correct processing, and lift her invulnerability, recharge lack of the fundamental supplements.

She began with against Candida, basic eating routine. She took a major measure of different human strains, living probiotics. She alcoholic recuperating mineral water arranged from authentic Karlovy Vary warm spring salt and furthermore loads of natural teas. This young lady had various sessions of colon hydrotherapy and needle therapy with unwinding. She took minerals, vitamins, fundamental unsaturated fats, and so forth.

To a major astonishment of her MD, her condition was definitely enhanced in three weeks. Her stool was ordinary, she put on weight, and she began to work. Her tests affirmed that she was free from Clostridia poisons. There are no backslides for five months after.

For some, Americans, notwithstanding for medicinal experts, recuperating mineral water is obscure. In opposition to that, European specialists regularly prescribe drinking mending mineral water particularly for stomach related and metabolic scatters. Water from hot mineral spring in little Czech town-Karlovy Vary has been utilized for a considerable length of time. For individuals, who couldn't visit this place, fountain water was vaporized there for a long time.

Dissolving bona fide Karlovy Vary warm spring salt in the plain water gives the likelihood to utilize this mending water at home. Karlovy Vary mending mineral water is all around explored by European specialists. Minerals, bicarbonate, and follow components in water independent from anyone else are helpful for individuals with incessant the runs.

Water is regular alkalizing specialist; so it enhances capacity of the liver and pancreas. More points of interest how acridity slaughters pancreas and decimates assimilation can be found in my articles and eBook "solid pancreas, sound you". Karlovy Vary mending mineral water advances the development of the advantageous microscopic organisms in the digestion tracts, diminishes aggravation, and irritation, standardizes stool in the event of incessant loose bowels.

In instances of perpetual the runs, washing out poisons and waste by utilizing bowel purge has been in mankind's history for quite a while. At present, modern gear and very much prepared faculty make the colon hydrotherapy protected and powerful, non-medicate approach for constant the runs. Clean and decontaminate water flushes out C. difficile and its poisons from the colon dividers; thusly, makes a solid domain to increasing the valuable microorganisms.

Our predecessors sold herbs and flavors by cost of gold. They realized that flavors enhanced the essence of nourishments, as well as avoided loose bowels (sustenance harms). A few creators consider that flavors spare humankind from plague gastrointestinal infections. I think these specialists' are correct. I emphatically trust that mending estimations of flavors and fiery herbs rely on their one of a kind capacity to crush hurtful microscopic organisms and keep up inviting intestinal greenery. My pragmatic proof of utilizing herbs in the perpetual looseness of the bowels bolsters this thought.

For the present, a great many patients with C. difficile after anti-infection agents utilize normal helpful approach "find and crush" by solid anti-microbials. Lamentably, even the most grounded anti-toxins can't totally take care of this issue. At last, the patient with anti-microbial related endless looseness of the bowels that is caused by Clostridia difficile has a decision to reestablish characteristic process that fends off solid individuals from this superbug.

Non-sedate strategies for the elective drug cooperate with our body's guard framework and really bolster it. As well as can be expected be accomplished by close participation between the specialist, patient, his or her relatives, and learned, authorized elective solution professional.

The data contained here is exhibited for instructive, enlightening purposes as it were. It isn't planned to analyze, treat, fix, or keep any ailment. This data isn't to be utilized to supplant the administrations or directions of a doctor or qualified medicinal services specialist.

Diminish Melamed, PhD got his therapeutic training first as an enrolled attendant and afterward as a restorative specialist in Russia. He took specific preparing in anesthesiology, concentrated care, and inside solution. Filling in as a doctor, he ended up intrigued by all encompassing mending through his clinical involvement with herbs, needle therapy, recuperating mineral water, and inner purifying. He was conceded a permit to hone needle therapy in Russia in 1978, and from that time, he consolidated regular Western therapeutic treatment with herbs, needle therapy, and other non-medicate mending treatments.

In 1975, Peter Melamed set up Biotherapy as a characteristic, all encompassing way to deal with recuperating. Biotherapy consolidates the knowledge of conventional Russian society prescription, old Oriental restorative treatments, and European naturopathy with front line Western innovation.

In the wake of moving to the USA and passing every one of the exams, Peter Melamed prevailing with regards to beginning up a private practice in 1996 at the Biotherapy Alternative Medicine Clinic of San Francisco Bay Area.

He is the writer of the numerous articles and eBook: Healthy Pancreas, Healthy You http://www.biotherapystore.com/home.php?cat=28 This book is progressive new manual for mending pancreatic and other stomach related scatters without medicines and medical procedure. Get more information at: http://www.biotherapy-clinic.com/

Article Source: https://EzineArticles.com/master/Peter_Melamed_Ph.D./291031

Article Source: http://EzineArticles.com/7913273

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phooll123 · 7 years ago

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Bend Hospital Using Ultraviolet

Light to Kill Germs | Oregon News

By MARKIAN HAWRYLUK, The Bulletin

BEND, Ore. (AP) — After testing an ultraviolet light disinfection system for five months last year, St. Charles Bend has acquired three Tru-D SmartUVC devices that are now being used to kill some of the nastier germs found around the hospital.

Since the start of the year, the hospital has used the devices to combat the flu virus and to disinfect a surgical tool sterilization room after a sewage pipe leak. But their primary task has been to reduce the cases of hospital-acquired infections, particularly a bacteria known as Clostridium difficile, which doctors often call "C. diff."

"We have reduced the number of C. diffs that we're seeing; that's the good news," said Randy Barnes, director of hospitality services at St. Charles Bend. "The bad news is we have seen a spike in C. diff coming in."

C. diff is a particularly difficult bacteria to kill. It accounts for nearly a half million infections and 15,000 deaths each year. The bacteria form spores that can survive on surfaces for up to five months, and hospitals have traditionally relied on bleach as part of a labor-intensive manual cleaning process that often has less than ideal results.

Barnes said the hospital has used the UV devices to disinfect rooms after patients with C. diff are discharged with a goal of preventing other patients from acquiring the infection. But the hospital is seeing more patients infected with C. diff when they come to be treated for other concerns. C. diff is commonly thought of as a hospital-acquired infection, but people are often infected outside of the hospital, as well.

St. Charles Prineville had eight cases of C. diff last year, after years of having almost none. Barnes secured a loaner UV device for Prineville to test this year.

At the Bend hospital, two of the devices are used primarily for disinfecting patient rooms, while a third is used to sterilize operating rooms. Infection control staff prioritize use of the device targeting C. diff first, then Methicillin-resistant Staphylococcus aureus, known as MRSA, and vancomycin-resistant enterococci, or VRE.

If no rooms have been exposed to those pathogens, the devices are used to sterilize other patient rooms and for spot cleaning in other areas.

"We've expanded it throughout the whole hospital," Barnes said.

The devices have been used to sterilize the cardiac catheterization lab, as well as to disinfect the incubators used by preemies in the neonatal intensive care unit.

"They have a very complicated tubing system," he said. "To ensure infection prevention, we'll let the nurses clean them as usual, and then we'll have Tru-D bathe them."

The devices, which can be rolled from room to room, have long glass tubes that emit short-frequency ultraviolet C light which breaks up bacterial DNA. The light can bounce in all directions, and the devices monitor the flood of light shutting off once the room has been sufficiently bathed in UV light to damage bacterial DNA and keep it from multiplying.

After a patient is discharged, staffers complete a manual cleaning of the patient's room. The device is then rolled in and used. The room is cordoned off, as the UV light is harmful to human skin. If someone opens the door to the room during the disinfection process, the device will automatically shut off.

Barnes said the standard cleaning process after a C. diff patient is discharged calls for a manual cleaning, which takes about 30 minutes, followed by a bleach wipe-down that takes up to an hour.

"So we were up to 90 minutes to totally clean an isolation room that had a patient with C. diff," he said. "By moving in the light, it only takes 30 minutes."

St. Charles has been dealing with high demand for beds, and saving 30 minutes to make a room available for the next patient has helped to reduce backlogs. It's also helped to avoid cases where a piece of equipment is taken from an unsterilized room because it is needed elsewhere.

"By Tru-D-ing everything, we don't do that, and we've actually made it a safer environment," Barnes said. "And everybody is happy we're no longer using bleach wipes on a consistent basis. It's highly caustic and affects your respiratory system. It destroys equipment and furniture over time."

The devices have been used to sterilize 670 hospital rooms so far this year and to disinfect emergency room areas during the flu outbreak.

When a sewage pipe burst earlier this month, flooding a room where surgical tools are cleaned and sterilized, the hospital used all three Tru-Ds to bathe the area with UV light during renovation. Hospital officials planned one last UV sterilization of the room Friday night, before they resumed packing surgical equipment packs Saturday morning.

St. Charles Redmond and Madras do not have the volume of C. diff cases to justify purchasing a device of their own, but Barnes has taken units up to Redmond to disinfect operating rooms used for total joint replacements once a month.

"They leave a lot of bioburden, all the tissue and bone pieces," he said. "They wanted assurance that the one OR they use is infection prevention clean."

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jesseneufeld · 5 years ago

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C. difficile (C. diff): An urgent threat

Who is most at risk?

What makes C. diff so difficult to treat?

Antibiotics disrupt the healthy gut bacteria (microbiome), which then provides suitable conditions for ingested spores to flourish and result in CDI.

Hospitalized patients are at greater risk, although healthy individuals in the community who have not been treated with antibiotics can also become infected.

What is the difference between C. diff colonization and C. diff infection?

How is C. diff treated?

Patients with severe CDI not responding to therapy may benefit from surgery, typically a colon resection or a colon-sparing procedure.

What can you do to prevent CDI?

Though there are no guarantees, there are many things you can do to help reduce your risk of CDI, particularly if you are scheduled for hospitalization or surgery.

For more information, visit the Peggy Lillis Foundation and the Centers for Disease Control and Prevention.

Follow me on Twitter @idandipacdoc

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