Publications

effectiveness of probiotic in preventing and treating antibiotic-associated diarrhoea and/or clostridium difficile-associated diarrhoea in patients with spinal cord injury: a protocol of systematic review of randomised controlled trials.	probiotics may prevent antibiotic-associated and clostridium difficile-associated diarrhoea (aad/cdad). many spinal cord injury centre (scic) practitioners consider probiotics generically and may not realise that efficacy can be strain-, dose- and disease-specific. in order to confirm these effects and fully evaluate the extent of probiotic effectiveness in these patients, a systematic review and meta-analysis is indicated.	2015	26596269
virulence factors of clostridium difficile and their role during infection.	clostridium difficile is the prominent etiological agent of healthcare-associated diarrhea. the disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. the main risk factor for developing an infection after contamination by the resistant spores is the disruption of the gut microbiota, allowing the spores to germinate. the colonization of the gut is likely to be governed by the bacterial resistance to the host response and the bacterial adhesion to the mucosa. to d ...	2016	26596863
probiotics and fecal microbiota transplant for primary and secondary prevention of clostridium difficile infection.	clostridium difficile infection (cdi) is the most common cause of nosocomial diarrhea and is associated with an increased risk of mortality. the use of probiotics and fecal microbiota transplantation (fmt) has been studied to reduce the incidence and severity of this infection, but variable efficacy and safety data have been reported. probiotics are hypothesized to be effective in the management of cdi through a number of mechanisms that include maintenance of normal gastrointestinal flora, anti ...	2015	26598094
making a case for pediatric antimicrobial stewardship programs.	although antimicrobials are commonly used in children, it is important to remember that they can have a profound impact on this unique patient population. inadvertent consequences of antiinfective use in children include antimicrobial resistance, infection caused by clostridium difficile, increased risk of obesity, and adverse drug events. in addition, compared with adults, children have different dosing requirements, antimicrobial formulation needs, pharmacokinetics, and antimicrobial susceptib ...	2015	26598095
regulation of type iv pili contributes to surface behaviors of historical and epidemic strains of clostridium difficile.	the intestinal pathogen clostridium difficile is an urgent public health threat that causes antibiotic-associated diarrhea and is a leading cause of fatal nosocomial infections in the united states. c. difficile rates of recurrence and mortality have increased in recent years due to the emergence of so-called "hypervirulent" epidemic strains. a great deal of the basic biology of c. difficile has not been characterized. recent findings that flagellar motility, toxin synthesis, and type iv pilus ( ...	2015	26598364
the effectiveness of lactobacillus beverages in controlling infections among the residents of an aged care facility: a randomized placebo-controlled double-blind trial.	to clarify the usefulness of lactobacillus casei strain shirota (lcs)-fermented milk in the normalization of bowel movements and improvement of infection control for the elderly residents and staff of facilities for the elderly.	2016	26599038
gastrointestinal dysbiosis and the use of fecal microbial transplantation in clostridium difficile infection.	the impact of antibiotics on the human gut microbiota is a significant concern. antibiotic-associated diarrhea has been on the rise for the past few decades with the increasing usage of antibiotics. clostridium difficile infections (cdi) have become one of the most prominent types of infectious diarrheal disease, with dramatically increased incidence in both the hospital and community setting worldwide. studies show that variability in the innate host response may in part impact upon cdi severit ...	2015	26600975
cost-effectiveness in clostridium difficile treatment decision-making.	to develop a framework for the clinical and health economic assessment for management of clostridium difficile infection (cdi).	2015	26601096
investigation of a cluster of clostridium difficile infections in a pediatric oncology setting.	we investigated an increase in clostridium difficile infection (cdi) among pediatric oncology patients.	2016	26601705
binding and entry of clostridium difficile toxin b is mediated by multiple domains.	clostridium difficile is responsible for a number of serious gastrointestinal diseases caused primarily by two exotoxins, tcda and tcdb. these toxins enter host cells by binding unique receptors, at least partially via their combined repetitive oligopeptides (crops) domains. our study investigated structural determinants necessary for binding and entry of tcdb. deletion analyses identified tcdb residues 1372-1493 as essential for cytotoxicity in three cell lines. consistent with this observation ...	2015	26602083
the aged gut in inflammatory bowel diseases.	senescence is accompanied by various anatomical and functional alterations starting from mastication and deglutition and consequent modifications of nutrition. in addition, the widespread use of proton pump inhibitors and non-steroidal anti-inflammatory drugs in aged subjects weakens the gastric barrier, thus contributing to easier entry of microbes into the gastrointestinal tract. the microbiota of the elderly is less stable than that of younger adults, therefore, gut dysbiosis is more frequent ...	2015	26603728
memory of germinant stimuli in bacterial spores.	bacterial spores, despite being metabolically dormant, possess the remarkable capacity to detect nutrients and other molecules in their environment through a biochemical sensory apparatus that can trigger spore germination, allowing the return to vegetative growth within minutes of exposure of germinants. we demonstrate here that bacterial spores of multiple species retain memory of transient exposures to germinant stimuli that can result in altered responses to subsequent exposure. the magnitud ...	2015	26604257
economic burden of clostridium difficile in five hospitals of the florence health care system in italy.	despite the awareness about the increasing rates of clostridium difficile infection (cdi) and the economic burden arising from its management (prolonged hospitalization, laboratory tests, visits, surgical treatment, environmental sanitation), few studies are available in italy on the economic costs directly attributable to the cdi. the florence health care system has designed a study with the aim of describing the costs attributable to the cdi and defines the incremental economic burden associat ...	2015	26604846
the high stakes of postoperative clostridium difficile infection.		2016	26606279
anti-infectious human vaccination in historical perspective.	a brief history of vaccination is presented since the jenner's observation, through the first golden age of vaccinology (from pasteur's era to 1938), the second golden age (from 1940 to 1970), until the current period. in the first golden age, live, such as bacille calmette guérin (bcg), and yellow fever, inactivated, such as typhoid, cholera, plague, and influenza, and subunit vaccines, such as tetanus and diphtheria toxoids, have been developed. in the second golden age, the cell culture techn ...	2016	26606466
analysis of morbidity and mortality outcomes in postoperative clostridium difficile infection in the veterans health administration.	this study analyzes and reports clostridium difficile infection (cdi) rates, risk factors, and associations with postoperative outcomes in the veterans health administration (vha).	2016	26606675
amoebiasis masquerading as inflammatory bowel disease.	a 60-year-old japanese man presented with bloody diarrhoea. he stated that he had been diagnosed with ulcerative colitis (uc) 3 years prior, but discontinued follow-up care as treatment was ineffective. one year later, he came to our hospital with anorexia and weight loss. the abdomen was soft and flat without tenderness. laboratory tests were unremarkable; faecal culture and clostridium difficile toxin were negative. findings and biopsy from a subsequent colonoscopy reconfirmed his diagnosis of ...	2015	26607188
in the endemic setting, clostridium difficile ribotype 027 is virulent but not hypervirulent - erratum.		2016	26607744
epidemiology and factors associated with candidaemia following clostridium difficile infection in adults within metropolitan atlanta, 2009-2013.	we assessed prevalence of and risk factors for candidaemia following clostridium difficile infection (cdi) using longitudinal population-based surveillance. of 13 615 adults with cdi, 113 (0·8%) developed candidaemia in the 120 days following cdi. in a matched case-control analysis, severe cdi and cdi treatment with vancomycin + metronidazole were associated with development of candidaemia following cdi.	2016	26608090
the first report of a previously undescribed ebv-negative nk-cell lymphoma of the gi tract presenting as chronic diarrhoea with eosinophilia.	a 74-year-old man presented with a 2-month history of watery diarrhoea. his complete blood count showed lymphopaenia and marked eosinophilia. investigations for common infectious causes including clostridium difficile toxin, stool culture, ova and parasites were negative. endoscopy revealed extensive colitis and a ct of the abdomen identified numerous large abdominal lymph nodes suspicious for lymphoma. multiple tissue samples were obtained; colon, mesenteric lymph node and bone marrow biopsy, a ...	2015	26611482
use of the cobas 4800 system for the rapid detection of toxigenic clostridium difficile and methicillin-resistant staphylococcus aureus.	the new cobas® cdiff and cobas® mrsa/sa tests were compared with conventional methods for the rapid detection of toxigenic clostridium difficile and methicillin-resistant staphylococcus aureus. the final concordance between cobas cdiff test and gdh/toxin gene screening was 97.62% and between cobas mrsa/sa test and chromogenic culture, 91.30%, respectively.	2016	26611812
the challenge of clostridium difficile infection: overview of clinical manifestations, diagnostic tools and therapeutic options.	the most important infectious cause of antibiotic-associated diarrhoea and colitis is clostridium difficile, which is a gram-positive, anaerobic, spore-forming, toxin-producing bacillus. in this overview we will discuss the diagnostic and therapeutic management of patients presenting with suspected or proven c. difficile infection (cdi). the clinical spectrum varies from asymptomatic c. difficile carriers to fulminant colitis with multi-organ failure. the onset of symptoms is usually within 2 we ...	2015	26612229
toxicity assessment of clostridium difficile toxins in rodent models and protection of vaccination.	clostridium difficile is the leading cause of hospital-acquired diarrhea, also known as c. difficile associated diarrhea. the two major toxins, toxin a and toxin b are produced by most c. difficile bacteria, but some strains, such as bi/nap1/027 isolates, produce a third toxin called binary toxin. the precise biological role of binary toxin is not clear but it has been shown to be a cytotoxin for vero cells. we evaluated the toxicity of these toxins in mice and hamsters and found that binary tox ...	2016	26614590
fecal transplantation successfully treats recurrent d-lactic acidosis in a child with short bowel syndrome.	d-lactic acidosis can occur in patients with short bowel syndrome (sbs) when excessive malabsorbed carbohydrate (cho) enters the colon and is metabolized by colonic bacteria to d-lactate. d-lactate can be absorbed systemically, and increased serum levels are associated with central nervous system toxicity manifested by confusion, ataxia, and slurred speech. current therapy, usually directed toward suppressing intestinal bacterial overgrowth and limiting ingested cho, is not always successful. fe ...	2015	26616138
the or environment--hand hygiene, cleaning, and clostridium difficile.		2015	26616318
incidence of clostridium difficile infection in patients receiving high-risk antibiotics with or without a proton pump inhibitor.	considering the incidence and severity of clostridium difficile infection (cdi), risk reduction strategies are crucial. prior studies suggest that proton pump inhibitor (ppi) use can increase the risk of cdi over antibiotics alone; however, data and guidelines have been conflicting.	2016	26616410
mortality benefits of antibiotic computerised decision support system: modifying effects of age.	antibiotic computerised decision support systems (cdsss) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. we conducted a prospective cohort study in a 1500-bed tertiary-care hospital in singapore, to evaluate the effectiveness of the hospital's antibiotic cdss on patients' clinical outcomes, and the modification of these effects by patient factors. to account for clustering, we used multilevel logistic regression models. one-quarter of 1886 eli ...	2015	26617195
clostridium difficile infection.	the incidence and severity of clostridium difficile infections have increased over the past few decades. new challenges have developed in the treatment and prevention of both hospital- and community-acquired disease. as mentioned by tamma and sandora [ 1] in their recent review, many questions about c difficile management in children remain unanswered, forcing pediatricians to rely on adult studies for guidance. the following is a brief synopsis of a few recent publications that focused on c dif ...	2013	26619449
[recurrent disease due to ribotype 027 clostridium difficile].		2017	26620602
clostridium difficile outbreak caused by nap1/bi/027 strain and non-027 strains in a mexican hospital.	clostridium difficile infections caused by the nap1/b1/027 strain are more severe, difficult to treat, and frequently associated with relapses.	2016	26620948
a review of clostridium difficile infection at the university hospital of the west indies, jamaica.	this study examined the frequency of clostridium difficile infection (cdi) among hospital admission and diarrhoeal stool samples over a six-year period.	2015	26624597
follow-up of pseudomembranous colitis in children using colonoscopy: a case report.	pseudomembranous colitis (pmc) occurs mainly in adults and is believed to be caused almost exclusively by toxins produced by clostridium difficile. colonoscopy found that pmc occurs mainly in the colon, sigmoid colon and rectum in up to 80% ~ 100% of cases. colonoscopy is simple and fast. it has the significance of making a definite diagnosis and can be used as the main examination method of diagnosis. reports of children suffering from pmc are rare. herein, we report a case of pmc in a child. t ...	2015	26624602
diagnosis and management of clostridium difficile infection by pediatric infectious diseases physicians.	the incidence of c difficile infection (cdi) has risen among children; however, optimal management of cdi within a diverse pediatric population remains unclear. although adult guidelines recommend oral vancomycin for treatment of second recurrence or severe cdi, dedicated pediatric data to support pediatric specific management guidelines are lacking. our objective was to describe current cdi management practices by pediatric infectious diseases (id) physicians.	2014	26624906
clostridium difficile in the pediatric population of monroe county, new york.	clostridium difficile infection (cdi) incidence in hospitalized children has increased over the past decade and disease has been reported in the community. therefore, population surveillance that includes nonhospitalized cases is important to accurately estimate the burden of cdi in children. we describe the epidemiology of cdi in the pediatric population of monroe county, new york.	2014	26625381
variation in risk of hospital-onset clostridium difficile infection across β-lactam antibiotics in children with new-onset acute lymphoblastic leukemia.	antibiotic exposure is common among children with leukemia. however, limited data exist regarding the risk of clostridium difficile infection (cdi) across anti-pseudomonal β-lactam antibiotics commonly used for fever and neutropenia.	2014	26625453
problems after restorative proctocolectomy: assessment and therapy.	restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice for patients with ulcerative colitis or familial adenomatous polyposis who require colectomy. although the surgical procedure significantly improves the patients' quality of life, complications are common. mechanical or structural complications related to surgical techniques as well as chronic pouchitis are common after the procedure.	2016	26628102
establishing a fecal microbiota transplant service for the treatment of clostridium difficile infection.	recurrent or refractory clostridium difficile infection (cdi) has become an increasing problem in the past decade. fecal microbiota transplant (fmt) is a highly efficacious treatment for recurrent cdi; however, a number of technical, logistical, and regulatory issues have hampered the development of an fmt capability at many hospitals. the development of a frozen stool bank of screened donor stool is an important step in the standardization of the procedure. this gives clinicians rapid access to ...	2016	26628567
[clinical characteristics of metronidazole-induced encephalopathy: a report of two cases and a review of 32 japanese cases in the literature].	metronidazole is an antibiotic classically used against most anaerobic bacteria and protozoa. because an intravenous form of metronidazole has recently entered the market, the use of this antibiotic is attracting renewed interest in many clinical settings in japan. however, neurotoxicity is a major adverse event: in the central nervous system metronidazole-induced encephalopathy is a rare but serious condition. we performed a literature review of 34 cases including 2 of our cases, 25 from domest ...	2015	26630786
good's syndrome patients hospitalized for infections: a single-center retrospective study.	good's syndrome (gs) is a rare combination of thymoma and hypogammaglobulinemia, resulting in immunodeficiency. patients with gs are highly susceptible to bacterial infection, particularly encapsulated bacterial infection in upper and lower respiratory tracts. good's syndrome patients with moderate-to- severe infection are often hospitalized. clinical features of gs patients remain to be characterized.patients with the discharge diagnosis of gs and simultaneous infection from peking union medica ...	2015	26632723
[clinic and epidemiologic description of clostridium difficile infection in a pediatric population].	clostridium difficile (cuj-associated disease (cdad) and the role of the hypervirulent strain nap1 have not been well characterized in pediatrics.	2015	26633108
[clostridium difficile associated diarrhea in children].	clostridium difficile is the most commonly isolated organism in antimicrobial and health care-associated diarrhea and is growing in relevance in community-acquired infections. it is a gram-positive bacillus acquired via the fecal-oral route in the community and in hospital setting.	2015	26633112
the role of rho gtpases in toxicity of clostridium difficile toxins.	clostridium difficile (c. difficile) is the main cause of antibiotic-associated diarrhea prevailing in hospital settings. in the past decade, the morbidity and mortality of c. difficile infection (cdi) has increased significantly due to the emergence of hypervirulent strains. toxin a (tcda) and toxin b (tcdb), the two exotoxins of c. difficile, are the major virulence factors of cdi. the common mode of action of tcda and tcdb is elicited by specific glucosylation of rho-gtpase proteins in the ho ...	2015	26633511
clostridium difficile carriage in healthy pregnant women in china.	infection with clostridium difficile has been shown to have particularly poor outcomes for pregnant women, including an increased risk of death. the purpose of this study was to investigate the prevalence, genotypic distribution, and characterization of c. difficile strains isolated from pregnant women without diarrhea in china. as part of this study, 3.7% (37 out of 1009) of samples acquired from pregnant females tested positive for c. difficile. of these positive samples, 27.0% (10) were toxig ...	2016	26633756
implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis.	asymptomatic bacteriuria in the elderly commonly results in antibiotic administration and, in turn, contributes to antimicrobial resistance, adverse drug events, and increased costs. this is a major problem in the long-term care facility (ltcf) setting, where residents frequently transition to and from the acute-care setting, often transporting drug-resistant organisms across the continuum of care. the goal of this study was to assess the feasibility and efficacy of antimicrobial stewardship pro ...	2015	26634119
metagenomic approach for identification of the pathogens associated with diarrhea in stool specimens.	the potential to rapidly capture the entire microbial community structure and/or gene content makes metagenomic sequencing an attractive tool for pathogen identification and the detection of resistance/virulence genes in clinical settings. here, we assessed the consistency between pcr from a diagnostic laboratory, quantitative pcr (qpcr) from a research laboratory, 16s rrna gene sequencing, and metagenomic shotgun sequencing (mss) for clostridium difficile identification in diarrhea stool sample ...	2016	26637379
[microbiological diagnosis of clostridium difficile infection].	the clinical microbiology laboratory plays an essential role in the management of clostri- dium difficile infections, showing an increase in frequency and severity. many tests (culture, eia, pcr), detecting bacteria or their antigens, toxin genes or free toxins, allow the microbio- logist to provide the clinician and the infection control specialist with a reliable diagnosis as- sistance, which meet essential criteria for ra- pidity, sensitivity and specificity. this review presents the diagnost ...	2015	26638514
antimicrobial therapy of acute diarrhoea: a clinical review.	diarrhoea is one of the most commonly occurring diseases. this article presents a review of the current state of the treatment of acute infectious diarrhoea, as well as of the most important pathogens. the general principles of the therapy of diarrhoea are exemplified, followed by a description of the targeted antimicrobial therapy of the most important bacterial gastrointestinal infections, including salmonellosis, shigellosis and campylobacter infections, as well as infections with pathogenic ...	2016	26641310
bacteriophage combinations significantly reduce clostridium difficile growth in vitro and proliferation in vivo.	the microbiome dysbiosis caused by antibiotic treatment has been associated with both susceptibility to and relapse of clostridium difficile infection (cdi). bacteriophage (phage) therapy offers target specificity and dose amplification in situ, but few studies have focused on its use in cdi treatment. this mainly reflects the lack of strictly virulent phages that target this pathogen. while it is widely accepted that temperate phages are unsuitable for therapeutic purposes due to their transduc ...	2016	26643348
novel approaches to treating clostridium difficile-associated colitis.	clostridium difficile is being recognized as a growing threat to many health-care systems. epidemiology data shows that infection rates are soaring and the disease burden is increasing. despite the efficacy of standard treatments, it is becoming evident that novel therapeutics will be required to tackle this disease. these new treatments aim to enhance the intestinal microbial barrier, activate the immune system and neutralize the toxins that mediate this disease. many of these therapies are sti ...	2016	26643655
clostridium difficile infections among adults and children in mwanza/tanzania: is it an underappreciated pathogen among immunocompromised patients in sub-saharan africa?	little is known regarding the epidemiology clostridium difficile in developing countries. fresh stool samples from patients with diarrhoea were cultured anaerobically. c. difficile was detected in nine (6.4%) of 141 (95% confidence interval 4.2-13.1), of which seven (77.8%) were from children. hiv infection, prolonged hospitalization and antibiotic use were independent factors associated with the occurrence of c. difficile in the gastrointestinal tract. two of the toxigenic isolates were typed a ...	2015	26649183
clinical significance of clostridium difficile in children less than 2 years old: a case-control study.	the significance of clostridium difficile (cd) in the stools of children 2 years old or younger remains unclear. the aim of this study was to investigate risk factors and clinical evolution of diarrheic children ≤2 years old with or without cd in their stools.	2016	26650114
clostridium difficile infection: a rarity in patients receiving chronic antibiotic treatment for crohn's disease.	prolonged antibiotic use is limited by several adverse effects, one of which is clostridium difficile infection (cdi). the aim of this study was to determine the incidence of cdi in patients receiving chronic antibiotic treatment for crohn's disease (cd).	2016	26650148
clostridium difficile infection in texas hospitals, 2007-2011.		2016	26651237
colectomy in pediatric ulcerative colitis: a single center experience of indications, outcomes, and complications.	there is a paucity of data on outcomes and complications of colectomy for pediatric ulcerative colitis (uc). this study reports the experience of a regional center for 18years.	2016	26653944
association of clostridium difficile infection in hospital mortality: a systematic review and meta-analysis.	the purpose of this study was to evaluate whether clostridium difficile infection (cdi) contributed to hospital mortality and whether the correlation between intensive care units (icus) and surgical wards in hospital cdi risk still remain controversial.	2015	26654234
hydrogen peroxide vapor room disinfection and hand hygiene improvements reduce clostridium difficile infection, methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococci, and extended-spectrum β-lactamase.	we report a statistically significant reduction in clostridium difficile infection (from 1.38 to 0.90 cases per 1,000 patient days), vancomycin-resistant enterococci (from 0.21 to 0.01 cases per 1,000 patient days), and extended-spectrum β-lactamase-producing gram-negative bacteria (from 0.16 to 0.01 cases per 1,000 patient days) associated with the introduction of hydrogen peroxide vapor for terminal decontamination of patient rooms and improvements in hand hygiene compliance.	2015	26654237
an intervention to reduce health care personnel hand contamination during care of patients with clostridium difficile infection.	in a quasi-experimental study, an educational intervention to improve the technique for personal protective equipment (ppe) removal in conjunction with disinfection of gloves before removal of ppe reduced acquisition of clostridium difficile spores on the hands of health care personnel caring for patients with c difficile infection.	2015	26654239
prevention of infections in nursing homes: antibiotic prophylaxis versus infection control and antimicrobial stewardship measures.	because of the lack of structural and human resources for implementing more effective and safe preventive procedures, antimicrobial prophylaxis is often used to prevent infections in nursing homes. however, if data on the efficacy of antibiotic prophylaxis in nursing homes are null, there is a plenty of evidence that the inappropriate use of antimicrobials in this setting is associated with a high rate of colonization and infection with multi-drug-resistant organisms (mdros), and of clostridium ...	2016	26655286
the insect peptide copa3 increases colonic epithelial cell proliferation and mucosal barrier function to prevent inflammatory responses in the gut.	the epithelial cells of the gut form a physical barrier against the luminal contents. the collapse of this barrier causes inflammation, and its therapeutic restoration can protect the gut against inflammation. egf enhances mucosal barrier function and increases colonocyte proliferation, thereby ameliorating inflammatory responses in the gut. based on our previous finding that the insect peptide copa3 promotes neuronal growth, we herein tested whether copa3 could increase the cell proliferation o ...	2016	26655716
clostridium difficile-diagnostic and clinical challenges.		2016	26656133
subinhibitory concentrations of metronidazole increase biofilm formation in clostridium difficile strains.	resistance mechanism to metronidazole is still poorly understood, even if the number of reports on clostridium difficile strains with reduced susceptibility to this antibiotic is increasing. in this study, we investigated the ability of the c. difficile strains 7032994, 7032985 and 7032989, showing different susceptibility profiles to metronidazole but all belonging to the pcr ribotype 010, to form biofilm in vitro in presence and absence of subinhibitory concentrations of metronidazole. the qua ...	2016	26656887
proton pump inhibitors affect the gut microbiome.	proton pump inhibitors (ppis) are among the top 10 most widely used drugs in the world. ppi use has been associated with an increased risk of enteric infections, most notably clostridium difficile. the gut microbiome plays an important role in enteric infections, by resisting or promoting colonisation by pathogens. in this study, we investigated the influence of ppi use on the gut microbiome.	2016	26657899
probiotics in digestive diseases: focus on lactobacillus gg.	probiotics are becoming increasingly important in basic and clinical research, but they are also a subject of considerable economic interest due to their expanding popularity. they are live micro-organisms which, when administered in adequate amounts, confer a health benefit to the host. from this very well-known definition, it is clear that, unlike drugs, probiotics might be useful in healthy subjects to reduce the risk of developing certain diseases or to optimise some physiological functions. ...	2015	26657927
the role of glutamate dehydrogenase (gdh) testing assay in the diagnosis of clostridium difficile infections: a high sensitive screening test and an essential step in the proposed laboratory diagnosis workflow for developing countries like china.	the incidence and severity of clostridium difficile infection (cdi) in north america and europe has increased significantly since the 2000s. however, cdi is not widely recognized in china and other developing countries due to limited laboratory diagnostic capacity and low awareness. most published studies on laboratory workflows for cdi diagnosis are from developed countries, and thus may not be suitable for most developing countries. therefore, an alternative strategy for developing countries i ...	2015	26659011
ultrasensitive detection and quantification of toxins for optimized diagnosis of clostridium difficile infection.	recently developed ultrasensitive and quantitative methods for detection of clostridium difficile toxins provide new tools for diagnosis and, potentially, for management of c. difficile infection (cdi). compared to methods that detect toxigenic organism, ultrasensitive toxin detection may allow diagnosis of cdi with increased clinical specificity, without sacrificing clinical sensitivity; measurement of toxin levels may also provide information relevant to disease prognosis. this minireview prov ...	2016	26659205
effect of an antimicrobial stewardship bundle for patients with clostridium difficile infection.	the study objective was to determine whether there was an improvement in compliance with recommended clostridium difficile infection (cdi) treatment after introduction of an institutional cdi bundle with daily antimicrobial stewardship assessment.	2016	26661392
the impact of the introduction of fidaxomicin on the management of clostridium difficile infection in seven nhs secondary care hospitals in england: a series of local service evaluations.	clostridium difficile infection (cdi) is associated with high mortality. reducing incidence is a priority for patients, clinicians, the national health service (nhs) and public health england alike. in june 2012, fidaxomicin (fdx) was launched for the treatment of adults with cdi. the objective of this evaluation was to collect robust real-world data to understand the effectiveness of fdx in routine practice. in seven hospitals introducing fdx between july 2012 and july 2013, data were collected ...	2016	26661400
persistence of clostridium difficile in wastewater treatment-derived biosolids during land application or windrow composting.	to determine the persistence of clostridium difficile spores in biosolids during composting or when amended into soil and held under natural environmental climatic conditions.	2016	26661445
peri-transplant clostridium difficile infections in patients undergoing allogeneic hematopoietic progenitor cell transplant.	clostridium difficile infections (cdi) remain the leading cause of infectious diarrhea among hospitalized patients in this country. patients with hematologic malignancies, especially those who undergo hematopoietic progenitor cell transplants are particularly at risk for developing cdi. one hundred and forty seven consecutive allogeneic hematopoietic progenitor cell transplants were analyzed for peri-transplant clostridium difficile infections (pt-cdi). sixteen patients (11%) developed pt-cdi (m ...	2016	26661725
systematic review with meta-analysis: long-term outcomes of faecal microbiota transplantation for clostridium difficile infection.	clostridium difficile infection is a major cause of nosocomial diarrhoea.	2016	26662643
diagnostic yield of routine enteropathogenic stool tests in pediatric ulcerative colitis.	it can be important to exclude infectious etiologies prior to adjusting immunosuppressive therapy in patients with ulcerative colitis (uc) exacerbation. we sought to determine the diagnostic yield of routine infectious stool studies in pediatric uc patients.	2015	26663793
reexamining the germination phenotypes of several clostridium difficile strains suggests another role for the cspc germinant receptor.	clostridium difficile spore germination is essential for colonization and disease. the signals that initiate c. difficile spore germination are a combination of taurocholic acid (a bile acid) and glycine. interestingly, the chenodeoxycholic acid class (cdca) bile acids competitively inhibit taurocholic acid-mediated germination, suggesting that compounds that inhibit spore germination could be developed into drugs that prophylactically prevent c. difficile infection or reduce recurring disease. ...	2015	26668265
clostridium difficile infection is a frequent but well-controlled event after hematopoietic cell transplantation.		2017	26670398
clostridium difficile infection in chilean patients submitted to hematopoietic stem cell transplantation.	patients submitted to hematopoietic stem cell transplantation have an increased risk of clostridium difficile infection and multiple risk factors have been identified. published reports have indicated an incidence from 9% to 30% of transplant patients however to date there is no information about infection in these patients in chile.	2017	26670401
discovery and development of surotomycin for the treatment of clostridium difficile.	the primary challenge for treating clostridium difficile infections (cdi) is maintenance of clinical response after the end of treatment (sustained clinical response). disease recurrence following a positive clinical response occurs in approximately 6-25 % of patients after the first episode and in up to 65 % for subsequent recurrences. surotomycin, a novel cyclic lipopeptide antibiotic with a core derived by streptomyces roseosporus fermentation, disrupts c. difficile cellular membrane activity ...	2016	26670919
the susceptibility of celiac disease intestinal microbiota to clostridium difficile infection.		2015	26673511
coxiella burnetii phagocytosis is regulated by gtpases of the rho family and the rhoa effectors mdia1 and rock.	the gtpases belonging to the rho family control the actin cytoskeleton rearrangements needed for particle internalization during phagocytosis. rock and mdia1 are downstream effectors of rhoa, a gtpase involved in that process. coxiella burnetii, the etiologic agent of q fever, is internalized by the host´s cells in an actin-dependent manner. nevertheless, the molecular mechanism involved in this process has been poorly characterized. this work analyzes the role of different gtpases of the rho fa ...	2015	26674774
optimal screening and donor management in a public stool bank.	fecal microbiota transplantation is an effective treatment for recurrent clostridium difficile infection and is being investigated as a treatment for other microbiota-associated diseases. to facilitate these activities, an international public stool bank has been created, which screens donors and processes stools in a standardized manner. the goal of this research is to use mathematical modeling and analysis to optimize screening and donor management at the stool bank.	2015	26675010
clostridium difficile ribotypes in humans and animals in brazil.	clostridium difficile is an emerging enteropathogen responsible for pseudomembranous colitis in humans and diarrhoea in several domestic and wild animal species. despite its known importance, there are few studies about c. difficile polymerase chain reaction (pcr) ribotypes in brazil and the actual knowledge is restricted to studies on human isolates. the aim of the study was therefore to compare c. difficile ribotypes isolated from humans and animals in brazil. seventy-six c. difficile strains ...	2015	26676318
a catalytic dna activated by a specific strain of bacterial pathogen.	pathogenic strains of bacteria are known to cause various infectious diseases and there is a growing demand for molecular probes that can selectively recognize them. here we report a special dnazyme (catalytic dna), rfd-cd1, that shows exquisite specificity for a pathogenic strain of clostridium difficile (c. difficile). rfd-cd1 was derived by an in vitro selection approach where a random-sequence dna library was allowed to react with an unpurified molecular mixture derived from this strain of c ...	2015	26676768
impact of variations in test method parameters on in vitro activity of surotomycin against clostridium difficile and surotomycin quality control limits for broth microdilution and agar dilution susceptibility testing.	test parameter variations were evaluated for their effects on surotomycin mics. calcium concentration was the only variable that influenced mics; therefore, 50 μg/ml (standard for lipopeptide testing) is recommended. quality control ranges for clostridium difficile (0.12 to 1 μg/ml) and eggerthella lenta (broth, 1 to 4 μg/ml; agar, 1 to 8 μg/ml) were approved by the clinical and laboratory standards institute based on these data.	2016	26677246
biomedical applications of nisin.	nisin is a bacteriocin produced by a group of gram-positive bacteria that belongs to lactococcus and streptococcus species. nisin is classified as a type a (i) lantibiotic that is synthesized from mrna and the translated peptide contains several unusual amino acids due to post-translational modifications. over the past few decades, nisin has been used widely as a food biopreservative. since then, many natural and genetically modified variants of nisin have been identified and studied for their u ...	2016	26678028
persistence of clostridium difficile rt 237 infection in a western australian piggery.	clostridium difficile is commonly associated with healthcare-related infections in humans, and is an emerging pathogen in food animal species. there is potential for transmission of c. difficile from animals or animal products to humans. this study aimed to determine if c. difficile rt 237 had persisted in a western australian piggery or if there had been a temporal change in c. difficile diversity. c. difficile carriage in litters with and without diarrhea was investigated, as was the acquisiti ...	2016	26679487
increased toxin expression in a clostridium difficile mfd mutant.	the symptoms of clostridium difficile infection are mediated primarily by two toxins, tcda and tcdb, the expression of which is governed by a multitude of factors including nutrient availability, growth phase and cell stress. several global regulators have been implicated in the regulation of toxin expression, such as ccpa and cody.	2015	26679502
clostridium difficile infection incidence: impact of audit and feedback programme to improve room cleaning.	audit and feedback programmes (afps) using fluorescent marking lead to improvements in room cleaning but have not been linked to reduced clostridium difficile infection (cdi) incidence.	2016	26679727
a novel, sporicidal formulation of ethanol for glove decontamination to prevent clostridium difficile hand contamination during glove removal.	decontamination of gloves before removal could reduce the risk for contamination of hands of personnel caring for patients with clostridium difficile infection. we demonstrated that a novel sporicidal formulation of ethanol rapidly reduced c. difficile spores on gloved hands without adverse odor, respiratory irritation, or staining of clothing.	2016	26679745
time-resolved amino acid uptake of clostridium difficile 630δerm and concomitant fermentation product and toxin formation.	clostridium difficile is one of the major nosocomial threats causing severe gastrointestinal infections. compared to the well documented clinical symptoms, little is known about the processes in the bacterial cell like the regulation and activity of metabolic pathways. in this study, we present time-resolved and global data of extracellular substrates and products. in a second part, we focus on the correlation of fermentation products and substrate uptake with toxin production.	2015	26680234
two patients with fulminant clostridium difficile enteritis who had not undergone total colectomy: a case series and review of the literature.	introduction. clostridium difficile is the most common cause of healthcare associated infectious diarrhea, and its most common clinical manifestation is pseudomembranous colitis. small bowel enteritis is reported infrequently in the literature and typically occurs only in patients who have undergone ileal pouch anastomosis due to inflammatory bowel disease or total abdominal colectomy for other reasons. presentation of cases. we report here two cases in which patients developed small bowel c. di ...	2015	26682082
the sos response master regulator lexa is associated with sporulation, motility and biofilm formation in clostridium difficile.	the lexa regulated sos network is a bacterial response to dna damage of metabolic or environmental origin. in clostridium difficile, a nosocomial pathogen causing a range of intestinal diseases, the in-silico deduced lexa network included the core sos genes involved in the dna repair and genes involved in various other biological functions that vary among different ribotypes. here we describe the construction and characterization of a lexa clostron mutant in c. difficile r20291 strain. the mutat ...	2015	26682547
editorial commentary: whole-genome sequencing of clostridium difficile: exquisitely sensitive but not yet optimally applied.		2016	26683316
genome-based infection tracking reveals dynamics of clostridium difficile transmission and disease recurrence.	accurate tracking of clostridium difficile transmission within healthcare settings is key to its containment but is hindered by the lack of discriminatory power of standard genotyping methods. we describe a whole-genome phylogenetic-based method to track the transmission of individual clones in infected hospital patients from the epidemic c. difficile 027/st1 lineage, and to distinguish between the 2 causes of recurrent disease, relapse (same strain), or reinfection (different strain).	2016	26683317
crystal structure of the ctp1l endolysin reveals how its activity is regulated by a secondary translation product.	bacteriophages produce endolysins, which lyse the bacterial host cell to release newly produced virions. the timing of lysis is regulated and is thought to involve the activation of a molecular switch. we present a crystal structure of the activated endolysin ctp1l that targets clostridium tyrobutyricum, consisting of a complex between the full-length protein and an n-terminally truncated c-terminal cell wall binding domain (cbd). the truncated cbd is produced through an internal translation sta ...	2016	26683375
postdischarge decontamination of mrsa, vre, and clostridium difficile isolation rooms using 2 commercially available automated ultraviolet-c-emitting devices.	two ultraviolet-c (uvc)-emitting devices were evaluated for effectiveness in reducing methicillin-resistant staphylococcus aureus (mrsa), vancomycin-resistant enterococci (vre), and clostridium difficile (cd).	2016	26684367
impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital.	the role of contaminated environments in the spread of hospital-associated infections has been well documented. this study reports the impact of a pulsed xenon ultraviolet no-touch disinfection system on infection rates in a community care facility.	2016	26684369
clostridium difficile infections in veterans health administration long-term care facilities.	a nationwide initiative was implemented in february 2014 to decrease clostridium difficile infections (cdi) in veterans affairs (va) long-term care facilities. we report a baseline of national cdi data collected during the 2 years before the initiative.	2016	26686361
contamination of australian newborn calf carcasses at slaughter with clostridium difficile.	in north america and europe, reports of a genetic overlap between toxigenic strains of clostridium difficile isolated from humans, livestock and retail meat suggest that food-borne transmission may be occurring. we investigated the prevalence, concentration and genetic diversity of c. difficile on the carcasses (n = 300) and in the faeces (n = 30) of neonatal veal calves at three abattoirs in australia in 2013. selective culture (both direct and enrichment) was performed, and all isolates were c ...	2016	26686811
clostridium difficile: the more we learn, the less we know.		2016	26687712
immunogenicity and protective efficacy of clostridium difficile spore proteins.	clostridium difficile is a spore-forming, anaerobic, gram-positive organism that is the leading cause of antibiotic-associated infectious diarrhea, commonly known as c. difficile infection (cdi). c. difficile spores play an important role in the pathogenesis of cdi. spore proteins, especially those that are surface-bound may play an essential role in the germination, colonization and persistence of c. difficile in the human gut. in our current study, we report the identification of two surface-b ...	2016	26688279
clostridium difficile infection in pediatric inflammatory bowel disease.	children with inflammatory bowel disease (ibd) are disproportionately susceptible to clostridium difficile infection (cdi) and the incidence is increasing. there has also been growing recognition of asymptomatic c. difficile colonization in pediatric ibd, which can sometimes be very difficult to distinguish from symptomatic c. difficile-associated disease in this population. in this study, we discuss the current knowledge of c. difficile infection in children with ibd, reviewing epidemiology, ri ...	2016	26689599
the effect of lactobacillus plantarum 299v on the incidence of clostridium difficile infection in high risk patients treated with antibiotics.	lactobacillus plantarum 299v (lp299v) has been used in order to reduce gastrointestinal symptoms during antibiotic exposure. however, it remains controversial whether or not probiotics are effective in the prevention of clostridium difficile infections (cdi) among patients receiving antibiotics. the aim of this study was to analyze the cdi among patients receiving antibiotics and hospitalized in the period before and after starting routine use of lp299v as a prevention of this infection.	2015	26690209