152
Views
3
CrossRef citations to date
0
Altmetric
Clinical Focus: Infectious Disease and In-Hospital Pain Management

Nosocomial Diarrhea: A Review of Pathophysiology, Etiology, and Treatment Strategies

, PharmD & , PharmD
Pages 130-138 | Published online: 13 Mar 2015

References

  • . Powell PH, Fleming VH. Diarrhea, constipation, and irritable bowel syndrome. In: DiPiro JT, Talbert RL, Yee GD, , eds. Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York, NY: McGraw-Hill; 2011:621–629
  • . Pawlowski SW, Warren CA, Guerrant R. Diagnosis and treatment of acute or persistent diarrhea. Gastroenterology. 2009;136(6):1874–1886
  • . Duggan C, Lasche J, McCarty M, . Oral rehydration solution for acute diarrhea prevents unscheduled follow-up visits. Pediatrics. 1999;104(3):e29
  • . Manatsathit S, Dupont H, Farthing M, ; Working Party of the Program Committ of the Bangkok World Congress of Gastroenterology 2002. Guideline for the management of acute diarrhea in adults. J Gastrogenterol Hepatol. 2002;17( suppl):S54–S71
  • . Guerrant RL, Van Gilder T, Steiner TS, ; Infectious Diseases Society of America. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001;32(3):331–350
  • . Hines J, Nachamkin I. Effective use of the clinical microbiology laboratory for diagnosing diarrheal diseases. Clin Infect Dis. 1996;23(6):1292–1301
  • . Morris AJ, Murray PR, Reller LB. Contemporary testing for enteric pathogens: the potential for cost, time, and health care savings. J Clin Microbiol 1996;34(7):1776–1778
  • . Morris AJ, Wilson ML, Reller LB. Application of rejection criteria for stool ovum and parasite examinations. J Clin Microbiol 1992;30(12):3213–3216
  • . Bartlett JG. Clinical practice. Antibiotic-associated diarrhea. N Engl J Med. 2002;346(5):334–349
  • . Kelly CP, Pothoulakis C, LaMont JT. Clostridium difficile colitis. N Engl J Med. 1994;330(4):257–262
  • . McFarland LV. Antibiotic-associated diarrhea: epidemiology, trends and treatment. Future Microbiol. 2008;3(5):563–578
  • . Murray PR, Rosenthal KS, Pfaller MA. Clostridium. In: Medical Microbiology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2009:377–389
  • . Voth DE, Ballard JD. Clostridium difficile toxins: mechanism of action and role in disease. Clin Microbiol Rev. 2005;18(2):247–263
  • . Mutters R, Nonnenmacher C, Susin C, Albrecht U, Kropatsch R, Schumacher S. Quantitative detection of Clostridium difficile in hospital environmental samples by real-time polymerase chain reaction. J Hosp Infect. 2009;71(1):43–48
  • . Gould LH, Limbago B. Clostridium difficile in food and domestic animals: a new foodborne pathogen? Clin Infect Dis. 2010;51(5):577–582
  • . Songer JG, Trinh HT, Kilgore GE, Thompson AD, McDonald LC, Limbago BM. Clostridium difficile in retail meat products, USA, 2007. Emerg Infect Dis. 2009;15(5):819–821
  • . Songer JG, Anderson MA. Clostridium difficile: an important pathogen of food animals. Anaerobe. 2006;12(1):1–4
  • . Siegel JD, Rhinehart E, Jackson M, Chiarello L; Health Care Infection Control Practices Advisory Committee. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control. 2007;35(10 suppl 2):S65–S164
  • . Cohen SH, Gerding DN, Johnston S, ; Society for Healthcare Epidemiology of America; Infectious Diseases Society of America. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31(5):431–455
  • . Rutala WA, Weber DJ; Healthcare Infection Control Practices Advisory Committee (HICPAC); Centers for Disease Control and Prevention; US Department of Health and Human Services. Guideline for disinfection and sterilization in healthcare facilities, 2008. http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf. Accessed November 16, 2011
  • . McFarland LV, Mulligan ME, Kwok RY, Stamm WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med. 1989;320(4):204–210
  • . Gerding DN, Olson MM, Peterson LR, . Clostridium difficile-associated diarrhea and colitis in adults. A prospective case-controlled epidemiologic study. Arch Intern Med. 1986;146(1):95–100
  • . Samore MH, DeGirolami PC, Tlucko A, Lichtenberg DA, Melvin ZA, Karchmer AW. Clostridium difficile colonization and diarrhea at a tertiary care hospital. Clin Infect Dis. 1994;18(2):181–187
  • . Fekety R, Kim KH, Brown D, Batts DH, Cudmore M, Silva J Jr. Epidemiology of antibiotic-associated colitis; isolation of Clostridium difficile from the hospital environment. Am J Med. 1981;70(4):906–908
  • . Riggs MM, Sethi AK, Zabarsky TF, Eckstein EC, Jump RL, Donskey CJ. Asymptomatic carriers are a potential source for transmission of epidemic and nonepidemic Clostridium difficile strains among long-term care facility residents. Clin Infect Dis. 2007;45(8):992–998
  • . Clabots CR, Johnson S, Olson MM, Peterson LR, Gerding DN. Acquisition of Clostridium difficile by hospitalized patients: evidence for colonized new admissions as a source of infection. J Infect Dis. 1992;166(3):561–567
  • . Loo VG, Bourgault AM, Poirier L, . Host and pathogen factors for Clostridium difficile infection and colonization. New Engl. J Med. 2011;365(18):1693–1703
  • . McDonald LC, Owings M, Jernigan DB. Clostridium difficile infection in patients discharged from US short-stay hospitals, 1996–2003. Emerg Infect Dis. 2006;12(3):409–415
  • . Anand A, GATT AE. Clostridium difficile infection associated with anti-neoplastic chemotherapy: a review. Clin Infect Dis. 1993;17(1):109–113
  • . Gorschlüter M, Glasmacher A, Hahn C, . Clostridium difficile infection inpatients with neutropenia. Clin Infect Dis. 2001;33(6):786–791
  • . Olson MM, Shanholtzer CJ, Lee JT Jr, Gerding DN. Ten years of prospective Clostridium difficile-associated disease surveillance and treatment at the Minneapolis VA Medical Center, 1982–1991. Infect Control Hosp Epidemiol. 1994;15(6):371–381
  • . Stevens V, Dumyati G, Fine LS, Fisher SG, van Wijngaarden E. Cumulative antibiotic exposures over time and the risk of Clostridium difficile infection. Clin Infect Dis. 2011;53(1):42–48
  • . Metzger R, Swenson BR, Bonatti Fl, . Identification of risk factors for the development of Clostridium difficile-associated diarrhea following treatment of polymicrobial surgical infections. Ann Surg. 2010;251(4):722–727
  • . Mullane KM, Miller MA, Weiss K, . Efficacy of fidaxomicin versus vancomycin as therapy for Clostridium difficile infection in individuals taking concomitant antibiotics for other concurrent infections. Clin Infect Dis. 2011;53(5)440–447
  • . Pepin J, Alary ME, Valiquette L, . Increasing risk of relapse after treatment of Clostridium difficile colitis in Quebec, Canada. Clin Infect Dis. 2005;40(11):1591–1597
  • . Yee J, Dixon CM, McLean AP, Meakins JL. Clostridium difficile disease in a department of surgery. The significance of prophylactic antibiotics. Arch Surg. 1991;126(2):241–246
  • . Blossom DB, McDonal LC. The challenges posed by reemerging Clostridium difficile infection. Clin Infect Dis. 2007;45(2):222–227
  • . Cunningham R, Dale B, Undy B, Gaunt N. Proton pump inhibitors as a risk factor for Clostridium difficile diarrhoea. J Hosp Infect. 2003;54(3):243–245
  • . Dial S, Alrasadi K, Manoukian C, Huang A, Menzies D. Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies. CMAJ. 2004;171(1):33–38
  • . Dial S, Delaney JA, Barkun AN, Suissa S. Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease. JAMA. 2005;294(23):2989–2995
  • . Howell MD, Novack V, Grgurich P, . Iatrogenic gastric acid suppression and the risk of nosocomial Clostridium difficile infection. Arch Intern Med. 2010;170(9):784–790
  • . McDonald LC, Killgore GE, Thompson A, . An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med. 2005;353(23):2433–2441
  • . Johnson S, Kent SA, O'Leary KJ, . Fatal pseudomembranous colitis associated with a variant Clostridium difficile strain not detected by toxin A immunoassay. Ann Intern Med. 2001;135(6):434–438
  • . Pépin J, Valiquette L, Alary ME, . Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity. CMAJ. 2004;171(5):466–472
  • . Stamper PD, Alcabasa R, Aird D, . Comparison of a commercial real-time PCR assay for tcdB detection to a cell culture cytotoxicity assay and toxigenic culture for direct detection of toxin-producing Clostridium difficile in clinical samples. J Clin Microbiol. 2009;47(2):373–378
  • . Deshpande A, Pasupuleti V, Rolston DD, . Diagnostic accuracy of real-time polymerase chain reaction in detection of Clostridium difficile in the stool samples of patients with suspected Clostridium difficile infection: a meta-analysis. Clin Infect Dis. 2011;53(7):e81–e90
  • . Reller ME, Lema CA, Perl TM, . Yield of stool culture with isolate toxin testing versus a two-step algorithm including stool toxin testing for detection of toxigenic Clostridium difficile. J Clin Microbiol. 2007;45(11):3601–3605
  • . Deshpande A, Pasupuleti V, Patel P, . Repeat stool testing to diag-nose Clostridium difficile infection using enzyme immunoassay does not increase diagnostic yield. Clin Gastroenterol Hepatol. 2011;9(8):665–669.el
  • . Zar FA, Bakkanagari SR, Moorthi KM, Davis MB. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis. 2007;45(3):302–307
  • . Louie T, Gerson M, Grimard D, . Results of a phase III trial comparing tolevamer, vancomycin and metronidazole in Clostridium difficile-associated diarrhea (CDAD). Presented at: 47th Interscience Conference on Antimicrobial Agents and Chemotherapy Meeting of the American Society for Microbiology; September 7–20, 2007; Washington, DC. Abstract K-425 A
  • . Lamontagne F, Labbé AC, Haeck O, . Impact of emergency colectomy on survival of patients with fulminant Clostridium difficile colitis during an epidemic caused by a hypervirulent strain. Ann Surg. 2007;245(2):267–272
  • . Hames A, Perry JD, Gould FK. In vitro effect of metronidazole and vancomycin in combination on Clostridium difficile. J Antimicrob Chemother. 2009;63(5):1076
  • . Apisarnthanarak A, Razavi B, Mundy LM. Adjunctive intracolonic vancomycin for severe Clostridium difficile colitis: case series and review of the literature. Clin Infect Dis. 2002;35(6):690–696
  • . Louie TJ, Miller MA, Mullane KM, ; OPT-80-003 Clinical Study Group. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med. 2011;364(5):422–431
  • . Koo HL, Koo DC, Musher DM, DuPont HL. Antimotility agents for the treatment of Clostridium difficile diarrhea and colitis. Clin Infect Dis. 2009;48(5):598–605
  • . Wilcox MH, Howe R. Diarrhoea caused by Clostridium difficile: response time for treatment with metronidazole and vancomycin. J Antimicrob Chemother. 1995;36(4):673–679
  • . McFarland LV. Evidence-based review of probiotics for antibiotic-associated diarrhea and Clostridium difficile infections. Anaerobe. 2009;15(6):274–280
  • . Hu MY, Katchar K, Kyne L, . Prospective derivation and validation of a clinical prediction rule for recurrent Clostridium difficile infection. Gastroenterology. 2009;136(4):1206–1214
  • . Pépin J, Routhier S, Gagnon S, Brazeau I. Management and outcomes of a first recurrence of Clostridium difficile-associated disease in Quebec, Canada. Clin Infect Dis. 2006;42(6):758–764
  • . Dubberke ER, Reske KA, Noble-Wang J, . Prevalence of Clostridium difficile environmental contamination and strain variability in multiple health care facilities. Am J Infect Control. 2007;35(5):315–318
  • . Atmar RL, Opekun AR, Gilger MA, . Norwalk virus 1 after experimental human infection. Emerg Infect Dis. 2008;14(10):1553–1557
  • . White C. Scale of norovirus outbreak may have been exaggerated. BMJ. 2008;336(7635):66
  • . Glass RI, Parashar UD, Estes MK. Norovirus gastroenteritis. N Eng J Med. 2009;361(18):1776–1785
  • . Patel MM, Hall AJ, Vinjé J, Parashar UD. Noroviruses: a comprehensive review. J Clin Virol. 2009;44(1):1–8
  • . National Center for Immunization and Respiratory Diseases, Division of Viral Diseases; Centers for Disease Control and Prevention. Norovirus illness: key facts, http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-keyfacts.htm. Updated May 20, 2011. Accessed November 15, 2011
  • . Gorkiewicz G. Nosocomial and antibiotic-associated diarrhoea caused by organisms other than Clostridium difficile. Int J Antimicrob Agents. 2009;33( suppl 1):S37–S41
  • . Jain V, Pitchumoni CS. Gastrointestinal side effects of prescription medications in the older adult. J Clin Gastroenterol. 2009;43(2):103–110
  • . de Vrese M, Marteau PR. Probiotic and prebiotics: effects on diarrhea. J Nutr. 2007;137(3 suppl 2):803S–811S
  • . Guarino A, Lo Vecchio A, Canani RB. Probiotics as prevention and treatment for diarrhea. Curr Opin Gastroenterol. 2008;25(1):18–23
  • . Isakow W, Morrow LE, Kollef MH. Probiotics for preventing and treating nosocomial infections: review of current evidence and recommendations. Chest. 2007;132(1):286–294
  • . Sharma R, Tobin P, Clarke SJ. Management of chemotherapy-induced nausea, vomiting, oral mucositis, and diarrhoea. Lancet Oncol. 2005;6(2):93–102
  • . Benson AB 3rd, Ajani JA, Catalano RB, . Recommended guidelines for the treatment of cancer treatment-induced diarrhea. J Clin Oncol. 2004;22(14):2918–2926
  • . Maroun JA, Anthony LB, Blais N, . Prevention and management of chemotherapy induced diarrhea in patients with colorectal cancer: a consensus statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea. Curr Oncol. 2007;14(1):13–20
  • . Cascinu S, Fedeli A, Fedeli SL, Catalano G. Octreotide versus loperamide in the treatment of fluorouracil-induced diarrhea: a randomized trial. J Clin Oncol. 1993;11(1):148–151
  • . Gebbia V, Carreca I, Testa A, . Subcutaneous octreotide versus oral loperamide in the treatment of diarrhea following chemotherapy. Anticancer Drugs. 1993;4(4):443–445
  • . Goumas P, Naxakis S, Christopoulou A, Chrysanthopoulos C, Nikolopoulou VV, Kalofonos HP. Octreotide acetate in the treatment of fluorouracil-induced diarrhea. Oncologist. 1998;3(1):50–53
  • . Savarese D, Al-Zoubi A, Boucher J, . Glutamine for irinotecan diarrhea. J Clin Oncol. 2000;18(2):450–451
  • . Bankhead R, Boullata J, Brantley S, ; A.S.P.E.N. Board of Directors. Enteral nutrition practice recommendations. JPEN J Parenter Enteral Nutr. 2009;33(2):122–167
  • . Barrett JS, Shepherd SJ, Gibson PR. Strategies to manage gastrointestinal symptoms complicating enteral feeding. JPEN J Parenter Enteral Nutr. 2009;33(1):21–26
  • . Guenter PA, Settle G, Perlmutter S, Marino PL, DeSimone GA, Rolandelli RH. Tube feeding-related diarrhea in acutely ill patients. JPEN J Parenter Enteral Nutr. 1991;15(3):277–280
  • . Ferrie S, Daley M. Lactobacillus GG as treatment for diarrhea during enteral feeding in critical illness: randomized controlled trial. JPEN J Parenter Enteral Nutr. 2011;35(1):43–49
  • . Williams NT. Medication administration through enteral feeding tubes. Am J Health Syst Pharm. 2008;65(24):2347–2357
  • . Panel on Antiretroviral Guidelines for Adults and Adolescents; Centers for Disease Control and Prevention; US Department of Health and Human Services. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents, http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Published October 14, 2001. Accessed January 19, 2012

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.