cefotaxime and Clostridium-Infections

Topics: Aged; Anti-Bacterial Agents; Asthma; Bacteremia; Cefotaxime; Clostridium; Clostridium Infections; Diagnostic Errors; Drug Therapy, Combination; Female; Humans; Immunocompetence; Levofloxacin; Respiratory Tract Infections

The objectives were to determine the risk factors for recurrent healthcare facility-associated Clostridioides difficile infection (HCF-CDI) in a high CDI incidence, low antibiotic use setting and to determine if length of cefotaxime exposure is a risk factor for recurrent HCF-CDI.. The risk factors for recurrent HCF-CDI were evaluated with a retrospective nested case control study based on chart reading. The risk factors were evaluated univariately and multivariately. Length of risk antibiotic exposure was evaluated further in a subanalysis.. Risk factors for recurrent HCF-CDI were renal insufficiency (25.4% of cases compared to 15.4% of controls p = 0.006) and metronidazole treatment of initial CDI episode (88.4% compared to 71.7% p = 0.01). Exposure to cefotaxime and risk for recurrent CDI showed a dose-dependent relationship (linear by linear p = 0.028).. Renal insufficiency and metronidazole treatment were independent risk factors for recurrent HCF-CDI in our setting. The relationship between cefotaxime exposure and risk for recurrent HCF-CDI, dose-dependent, could be evaluated further in a setting with high cefotaxime use.

Topics: Anti-Bacterial Agents; Case-Control Studies; Cefotaxime; Clostridioides difficile; Clostridium Infections; Cross Infection; Delivery of Health Care; Humans; Metronidazole; Retrospective Studies; Risk Factors; Sweden

Red blood cell (RBC) Thomsen-Friedenreich antigen exposure (T activation) in infants with necrotizing enterocolitis (NEC) has occasionally been associated with posttransfusional intravascular hemolysis thought to be due to anti-T antibodies in the donor plasma.. We describe an infant with NEC and Clostridium perfringens infection complicated by severe hemolysis after plasma transfusion. After this case, infants with confirmed NEC were prospectively evaluated for T activation. We checked for hemolysis in patients with T activation receiving plasma-containing blood products.. The infant had received 80 mL of fresh-frozen plasma (FFP). His RBCs displayed strong T activation, and agglutination was observed with four of six ABO-compatible FFP units. A direct antiglobulin test was negative. IgM-class anti-T antibodies were present in small amounts (titer of 8) in the transfused FFP. Anti-T antibodies from the blood donor were not hemolytic in vitro. In the prospective study, T activation was observed in three of 28 infants with NEC (11%). One infant presented moderate T activation and two infants presented very strong T activation but only moderate decreases in sialic acid expression on the RBC membrane. These three infants presented no signs of hemolysis after transfusion with unwashed blood products or FFP.. Anti-T antibodies are unlikely to be the etiologic factor for the hemolytic reactions observed in infants with NEC and T activation. Massive RBC desialylation and the direct action of bacterial toxins are more probable causes. Strict avoidance of plasma-containing blood products does not seem justified in these infants.

Topics: Adult; Antibodies; Antigens, Tumor-Associated, Carbohydrate; Bacterial Proteins; Blood Donors; Cefotaxime; Clostridium Infections; Clostridium perfringens; Enterocolitis, Necrotizing; Erythrocytes; Female; Hemolysis; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Male; Middle Aged; Plasma Exchange; Prospective Studies

An 80-year-old woman with hilar cholangiocarcinoma was hospitalized due to sudden-onset abdominal pain. Computed tomography revealed hepatic necrosis accompanied with emphysematous change in the superior segment of the right liver (S7/S8), implying spontaneous rupture, based on the presence of perihepatic free air. Although urgent percutaneous drainage was performed, neither pus nor fluids were drained. These findings suggest emphysematous hepatitis with a hepatic mass. Despite the application of intensive care, the patient's condition deteriorated rapidly, and she died 3 days after admission to hospital. Liver gas has been reported in some clinical diseases (e.g., liver abscess) to be caused by gas-forming organisms; however, emphysematous hepatitis simulating emphysematous pyelonephritis is very rare. The case reported here was of fatal emphysematous hepatitis in a patient with hilar cholangiocarcinoma.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Cefotaxime; Cholangiocarcinoma; Clostridium Infections; Clostridium perfringens; Emphysema; Escherichia coli; Escherichia coli Infections; Female; Hepatitis; Humans; Metronidazole; Pneumoperitoneum; Tomography, X-Ray Computed

Topics: Cefotaxime; Clostridium Infections; Disease Outbreaks; Enterocolitis, Pseudomembranous; Humans; Ireland; Male

Topics: Adult; Aged; Cefotaxime; Clostridium Infections; Enterocolitis, Pseudomembranous; Female; Humans; Male; Middle Aged

A patient with rheumatoid arthritis-associated interstitial pneumonitis, treated with prednisolone, developed mild colitis due to Clostridium difficile in association with the use of cefotaxime (CTX). Diarrhea was successfully treated with the discontinuation of CTX and initiation of oral vancomycin.

Topics: Arthritis, Rheumatoid; Cefotaxime; Clostridium Infections; Colitis; Diarrhea; Female; Humans; Middle Aged; Prednisolone; Pulmonary Fibrosis; Vancomycin