Prognosis of Clostridium difficile infection in adult oncohaematological patients: experience from a large prospective observational study.

The aim of the study is to evaluate demographics, epidemiology, clinical characteristics, treatment and outcomes of Clostridium difficile infection (CDI) in patients with and without concurrent cancer. This is a prospective cohort study of consecutive primary CDI episodes in adults (January 2006-December 2016). CDI was diagnosed on the presence of diarrhoea and positive stool testing for toxigenic C. difficile. Univariate analysis assessed differences between cancer and non-cancer patients. Risk factors of all-cause 30-day mortality were determinate using the logistic multivariable procedure. In total, 787 CDI episodes were recorded, 191 in cancer patients (median age 64, IQR 50-73). Of these, 120 (63%) had solid and 71 (37%) haematological malignancies (24 received a stem cell transplant). At the CDI diagnosis, 158 (82.7%) cancer patients had prior antibiotics and 150 (78.5%) were receiving proton pump inhibitors. Fifty-seven (80.3%) patients with haematological and 52 (43.3%) with solid malignancies were under chemotherapy at diagnosis; 25 (35.2%) with haematological and 11 (9.2%) with solid malignancies had an absolute neutrophil count < 1000/mm3. Overall, 30-day mortality was higher in cancer patients than in those without (19.2 vs. 8.6% respectively, p < 0.001); recurrence rates did not vary significantly (11.1 vs. 11%, p = 0.936). By type of neoplasm, 30-day mortality was higher in patients with haematological malignancies and solid tumours than in patients without cancer (respectively, 25.4 vs. 8.6%; p < 0.001 and 15 vs. 8.6%; p < 0.001). Our results suggest that the prognosis of CDI (30-day mortality) is poorer in patients with cancer than in those without although percentages of recurrent infection are similar in these two patient populations.

Evaluation of the novel DiaSorin LIAISON®Campylobacter assay for the rapid detection of Campylobacter spp.

INTRODUCTION: Campylobacter spp. infection is one of the leading causes of foodborne diarrhoeal illness in humans worldwide. The purpose of this study was to evaluate the DiaSorin LIAISON®Campylobacter assay for human campylobacteriosis diagnosis. METHODOLOGY: A total of 645 stool samples from 640 patients suspected of having gastrointestinal infection were included. A stool culture was simultaneously performed with the DiaSorin LIAISON®Campylobacter assay to detect the presence of Campylobacter spp. RESULTS: Taking the conventional culture to be the perfect gold standard, sensitivity and specificity rates of the DiaSorin LIAISON®Campylobacter assay were 100% and 97.7%, respectively; and 99.1% and 98.6%, respectively, when taking the culture to be the imperfect gold standard (Bayesian Model). CONCLUSION: This new assay might be a useful tool especially for the screening of negative results.

Evaluation of the novel DiaSorin LIAISON(R) Campylobacter assay for the rapid detection of Campylobacter spp / Evaluación de la nueva plataforma DiaSorin LIAISON(R) Campylobacter assay para la detección rápida de Campylobacter spp

INTRODUCTION: Campylobacter spp. infection is one of the leading causes of foodborne diarrhoeal illness in humans worldwide. The purpose of this study was to evaluate the DiaSorin LIAISON(R) Campylobacter assay for human campylobacteriosis diagnosis. METHODOLOGY: A total of 645 stool samples from 640 patients suspected of having gastrointestinal infection were included. A stool culture was simultaneously performed with the DiaSorin LIAISON(R) Campylobacter assay to detect the presence of Campylobacter spp. RESULTS: Taking the conventional culture to be the perfect gold standard, sensitivity and specificity rates of the DiaSorin LIAISON(R)Campylobacter assay were 100% and 97.7%, respectively; and 99.1% and 98.6%, respectively, when taking the culture to be the imperfect gold standard (Bayesian Model). CONCLUSION: This new assay might be a useful tool especially for the screening of negative results

INTRODUCCIÓN: La infección por Campylobacter spp. es una de las principales causas de enfermedades diarreicas de transmisión alimentaria en el ser humano. Este estudio tuvo como objetivo evaluar la plataforma DiaSorin LIAISON(R) Campylobacter assay para el diagnóstico de la campilobacteriosis humana. METODOLOGÍA: Se incluyeron un total de 645 muestras de heces de 640 pacientes con sospecha de infección gastrointestinal. Se realizaron simultáneamente coprocultivo y DiaSorin LIAISON(R) Campylobacter assay para detectar la presencia de Campylobacter spp. RESULTADOS: Asumiendo el cultivo convencional como el método de referencia perfecto, DiaSorin LIAISON(R) Campylobacter assay obtuvo una sensibilidad y una especificidad del 100% y 97,7%, respectivamente; y del 99,1% y 98,6%, respectivamente, asumiendo el cultivo como método de referencia imperfecto (modelo bayesiano)

Differences in virulence factors among clinical isolates of Escherichia coli causing cystitis and pyelonephritis in women and prostatitis in men.

Differences in the presence of nine urovirulence factors among clinical isolates of Escherichia coli causing cystitis and pyelonephritis in women and prostatitis in men have been studied. Hemolysin and necrotizing factor type 1 occur significantly more frequently among isolates causing prostatitis than among those causing cystitis (P < 0.0001) or pyelonephritis (P < 0.005). Moreover, the papGIII gene occurred more frequently in E. coli isolates associated with prostatitis (27%) than in those associated with pyelonephritis (9%) (P < 0.05). Genes encoding aerobactin and PapC occurred significantly less frequently in isolates causing cystitis than in those causing prostatitis (P < 0.01 and P < 0.0001, respectively) and pyelonephritis (P < 0.01 and P < 0.0001, respectively). No differences in the presence of Sat or type 1 fimbriae were found. Finally, AAFII and Bfp fimbriae are no longer considered uropathogenic virulence factors since they were not found in any of the strains analyzed. Overall, the results showed that clinical isolates producing prostatitis need greater virulence than isolates producing pyelonephritis in women or, in particular, cystitis in women (P < 0.05). Overall, the results suggest that clinical isolates producing prostatitis are more virulent that those producing pyelonephritis or cystitis in women.