New advances in Clostridium difficile infection: changing epidemiology, diagnosis, treatment and control
Bibliographic record
Abstract
PURPOSE OF REVIEW: Clostridium difficile infection and Clostridium difficile-associated diarrhea (CDAD) are growing worldwide health threats. Recent studies have identified new host risk factors, diagnostic approaches and therapies of CDAD. The present review focuses on scientific papers published in the past 18 months in an attempt to provide the latest information on the topic. RECENT FINDINGS: We are seeing an increasing number of patients with Clostridium difficile infection developing their illness in the community, although many were recently discharged from a healthcare setting suggesting an acquisition of infection in the hospital environment. The use of gastric acid-altering drugs that facilitate intestinal transit of the bacteria, antibacterial drugs that deplete colonic flora and presence of inflammatory bowel disease are risk factors for CDAD. Fulminant CDAD is increasing, complicated by leukocytosis (peripheral white blood cell count >16,000/mm), hypoalbuminemia, renal failure and emergency colectomy, with overall rise in CDAD disease mortality rates. Although vancomycin is recommended for severe cases of CDAD, recurrence rates remain high. Control of Clostridium difficile infection in the hospital setting focuses on disinfection of the environment and antibiotic stewardship policies. Anti-Clostridium difficile vaccines are in development. SUMMARY: CDAD is an increasing health problem throughout the United States, Canada and Europe with rising mortality rate. Occurrence of CDAD outside of healthcare settings and in pediatric populations represents newly emerging problems. New treatments are needed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".