Fool Me Thrice: The Evolving Story of Multiply Recurrent <i>Clostridium difficile</i> Infection
Authors: Sameer D. Saini, Akbar K. Waljee
Journal: Annals of Internal Medicine (2017)

Editorials1 August 2017Fool Me Thrice: The Evolving Story of Multiply Recurrent Clostridium difficile InfectionSameer D. Saini, MD, MS and Akbar K. Waljee, MD, MScSameer D. Saini, MD, MSFrom VA Ann Arbor Center for Clinical Management Research and University of Michigan, Ann Arbor, Michigan.Search for more papers by this author and Akbar K. Waljee, MD, MScFrom VA Ann Arbor Center for Clinical Management Research and University of Michigan, Ann Arbor, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-1565 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fool me once, shame on you. Fool me twice, shame on me.—ProverbThe capacity to blunder slightly is the real marvel of DNA. Without this special attribute, we would still be anaerobic bacteria and there would be no music.—Lewis ThomasIt has been nearly a century since Hall and O'Toole used the name Bacillus difficilis to describe a new bacterium isolated from the stool of newborn infants “because of the unusual difficulty which was encountered in its isolation and study” (1). The authors also speculated about the potential pathogenic role of a toxin elaborated by this anaerobe, commenting presciently that ...References1. Hall IC, O'Toole E. Intestinal flora in new-born infants: with a description of a new pathogenic anaerobe, Bacillus difficilis. Am J Dis Child. 1935;49:390-402. doi:10.1001/archpedi.1935.01970020105010 CrossrefGoogle Scholar2. Bartlett JG, Chang TW, Gurwith M, Gorbach SL, Onderdonk AB. Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med. 1978;298:531-4. [PMID: 625309] CrossrefMedlineGoogle Scholar3. Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372:825-34. [PMID: 25714160] doi:10.1056/NEJMoa1408913 CrossrefMedlineGoogle Scholar4. Desai K, Gupta SB, Dubberke ER, Prabhu VS, Browne C, Mast TC. Epidemiological and economic burden of Clostridium difficile in the United States: estimates from a modeling approach. BMC Infect Dis. 2016;16:303. [PMID: 27316794] doi:10.1186/s12879-016-1610-3 CrossrefMedlineGoogle Scholar5. Vardakas KZ, Polyzos KA, Patouni K, Rafailidis PI, Samonis G, Falagas ME. Treatment failure and recurrence of Clostridium difficile infection following treatment with vancomycin or metronidazole: a systematic review of the evidence. Int J Antimicrob Agents. 2012;40:1-8. [PMID: 22398198] doi:10.1016/j.ijantimicag.2012.01.004 CrossrefMedlineGoogle Scholar6. Ma GK, Brensinger CM, Wu Q, Lewis JD. Increasing incidence of multiply recurrent Clostridium difficile infection in the United States. A cohort study. Ann Intern Med. 2017;167:152-8. doi:10.7326/M16-2733 LinkGoogle Scholar7. Lessa FC, Gould CV, McDonald LC. Current status of Clostridium difficile infection epidemiology. Clin Infect Dis. 2012;55 Suppl 2:S65-70. [PMID: 22752867] doi:10.1093/cid/cis319 CrossrefMedlineGoogle Scholar8. Abou Chakra CN, Pepin J, Sirard S, Valiquette L. Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review. PLoS One. 2014;9:e98400. [PMID: 24897375] doi:10.1371/journal.pone.0098400 CrossrefMedlineGoogle Scholar9. Kelly CR, Khoruts A, Staley C, Sadowsky MJ, Abd M, Alani M, et al. Effect of fecal microbiota transplantation on recurrence in multiply recurrent Clostridium difficile infection: a randomized trial. Ann Intern Med. 2016;165:609-616. [PMID: 27547925]. doi:10.7326/M16-0271 LinkGoogle Scholar10. D'Agostino RB, Collins SH, Pencina KM, Kean Y, Gorbach S. Risk estimation for recurrent Clostridium difficile infection based on clinical factors. Clin Infect Dis. 2014;58:1386-93. [PMID: 24599770] doi:10.1093/cid/ciu107 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From VA Ann Arbor Center for Clinical Management Research and University of Michigan, Ann Arbor, Michigan.Acknowledgment: The authors thank Krishna Rao and Mohamed Noureldin at the University of Michigan for their critical revisions on an earlier version of this manuscript. No other individuals contributed significantly to this work.Financial Support: Dr. Waljee's research is supported by a Veterans Affairs Health Services Research and Development Career Development Award (CDA 11-217).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1565.Corresponding Author: Sameer D. Saini, MD, MS, VA Ann Arbor Medical Center, 2215 Fuller Road – 111D, Ann Arbor, MI 48105; e-mail, [email protected]edu.Current Author Addresses: Drs. Saini and Waljee: VA Ann Arbor Medical Center, 2215 Fuller Road – 111D, Ann Arbor, MI 48105.This article was published at Annals.org on 4 July 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIncreasing Incidence of Multiply Recurrent Clostridium difficile Infection in the United States Gene K. Ma , Colleen M. Brensinger , Qufei Wu , and James D. Lewis Metrics Cited byImpact of Oral Fidaxomicin Administration on the Intestinal Microbiota and Susceptibility to Clostridium difficile Colonization in MiceIncreasing Incidence of Multiply Recurrent Clostridium difficile InfectionJodie A. Barkin, MD, Neil Stollman, MD, and Jamie S. Barkin, MD 1 August 2017Volume 167, Issue 3Page: 202-203KeywordsAntibioticsDatabasesDisclosureEpidemiologyForecastingMedical risk factorsNosocomial infectionsPathogensToxinsTransplantation ePublished: 4 July 2017 Issue Published: 1 August 2017 PDF downloadLoading ...