Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| methods for determining transfer of mobile genetic elements in clostridium difficile. | horizontal gene transfer by mobile genetic elements plays an important role in the evolution of bacteria, allowing them to rapidly acquire new traits, including antibiotic resistance. mobile genetic elements such as conjugative and mobilizable transposons make up a considerable part of the c. difficile genome. while sequence analysis has identified a large number of these elements, experimental analysis is required to demonstrate mobility and function. this chapter describes the experimental met ... | 2016 | 27507343 |
| investigating transfer of large chromosomal regions containing the pathogenicity locus between clostridium difficile strains. | the genomes of all sequenced clostridium difficile isolates contain multiple mobile genetic elements. the chromosomally located pathogenicity locus (paloc), encoding the cytotoxins tcda and tcdb, was previously hypothesized to be a mobile genetic element; however, mobility was not demonstrated. here we describe the methods used to facilitate and detect the transfer of the paloc from a toxigenic strain into non-toxigenic strains of c. difficile. although the precise mechanism of transfer has not ... | 2016 | 27507344 |
| an in vitro model of the human colon: studies of intestinal biofilms and clostridium difficile infection. | the in vitro gut model is an invaluable research tool to study indigenous gut microbiota communities, the behavior of pathogenic organisms, and the therapeutic and adverse effect of antimicrobial administration on these communities. the model has been validated against the intestinal contents of sudden death victims to reflect the physicochemical and microbiological conditions of the proximal to distal colon, and has been extensively used to investigate the interplay between gut microbiota popul ... | 2016 | 27507345 |
| minibioreactor arrays (mbras) as a tool for studying c. difficile physiology in the presence of a complex community. | the commensal microbiome plays an important role in the dynamics of clostridium difficile infection. in this chapter, we describe minibioreactor arrays (mbras), an in vitro cultivation system that we developed that allows for c. difficile physiology to be assayed in the presence of complex fecal microbial communities. the small size of the bioreactors within the mbras allows for dozens of reactors to be run simultaneously and therefore several different variables can be tested with limited time ... | 2016 | 27507346 |
| a practical method for preparation of fecal microbiota transplantation. | clostridium difficile is a challenging infection that can be difficult to treat with antibiotic therapy. this chapter outlines the processing material for fecal microbiota transplantation (fmt), also known as stool transplant. fecal transplantations are effective in treating recurrent c. difficile infection (cdi). fmt uses a stool sample collected from a healthy, screened donor to restore healthy microbiota in the colon of a patient with cdi for symptom resolution. here, we describe a rapid meth ... | 2016 | 27507347 |
| ion-exchange chromatography to analyze components of a clostridium difficile vaccine. | ion-exchange (iex) chromatography is one of many separation techniques that can be employed to analyze proteins. the separation mechanism is based on a reversible interaction between charged amino acids of a protein to the charged ligands attached to a column at a given ph. this interaction depends on both the pi and conformation of the protein being analyzed. the proteins are eluted by increasing the salt concentration or ph gradient. here we describe the use of this technique to characterize t ... | 2016 | 27507348 |
| a size-exclusion chromatography method for analysis of clostridium difficile vaccine toxins. | high-performance size-exclusion chromatography (hpsec or sec) is a method that can be applied to measure size distribution of proteins, including aggregates, monomers, and fragments. in the biopharmaceutical industry the quantitation of aggregates contained in biotherapeutics and protein-based vaccines is critical given the potential impact on safety, immunogenicity, and efficacy. hence, aggregation analysis of therapeutic proteins or protein-based vaccine products is almost always a requirement ... | 2016 | 27507349 |
| clostridium difficile infections in medical intensive care units of a medical center in southern taiwan: variable seasonality and disease severity. | critical patients are susceptible to clostridium difficile infections (cdis), which cause significant morbidity and mortality in the hospital. in taiwan, the epidemiology of cdi in intensive care units (icus) is not well understood. this study was aimed to describe the incidence and the characteristics of cdi in the icus of a medical center in southern taiwan. adult patients with diarrhea but without colostomy/colectomy or laxative use were enrolled. stool samples were collected with or without ... | 2016 | 27509051 |
| [new aspects on clostridium difficile infection]. | clostridium difficile infection (cdi) is a frequent and complex disease which is influenced by the repertoire of bacterial virulence factors, by host immunity and by the intestinal microbiome. these complex interaction opens a number of options which may be used for treatment in the future. one example for new treatment options is fecal microbiota transplantation (fmt). driven by c. difficile related research activities the knowledge of protective microorganism is increasing and it may be assume ... | 2016 | 27509341 |
| risk factors for clostridium difficile infection in hemato-oncological patients: a case control study in 144 patients. | evidence on risk factors for clostridium difficile infection (cdi) in hemato-oncologic patients is conflicting. we studied risk factors for cdi in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center study with a microbiologically confirmed cdi-associated diarrhea. patients were compared with 144 age and sex matched hemato-oncologic patients with cdi negative diarrhea. risk factors such as prior an ... | 2016 | 27510591 |
| the protein inventory of clostridium difficile grown in complex and minimal medium. | the intestinal pathogen clostridium difficile is causing an increasing number of infections often characterized by severity and high relapse rates. profound knowledge of the physiology of the pathogen could help to develop new treatment strategies. proteomics, a valuable tool to study bacterial physiology, was used in this work to establish a benchmark proteome of reference strain c. difficile 630δerm with ms-based details on all identified proteins. our elaborate annotation and visualization of ... | 2016 | 27511832 |
| crystal structure of clostridium difficile toxin a. | clostridium difficile infection is the leading cause of hospital-acquired diarrhoea and pseudomembranous colitis. disease is mediated by the actions of two toxins, tcda and tcdb, which cause the diarrhoea, as well as inflammation and necrosis within the colon(1,2). the toxins are large (308 and 270 kda, respectively), homologous (47% amino acid identity) glucosyltransferases that target small gtpases within the host(3,4). the multidomain toxins enter cells by receptor-mediated endocytosis and, u ... | 2016 | 27512603 |
| probiotic saccharomyces boulardii cncm i-745 prevents outbreak-associated clostridium difficile-associated cecal inflammation in hamsters. | c. difficile infection (cdi) is a common debilitating nosocomial infection associated with high mortality. several cdi outbreaks have been attributed to ribotypes 027, 017, and 078. clinical and experimental evidence indicates that the nonpathogenic yeast saccharomyces boulardii cncm i-745 (s.b) is effective for the prevention of cdi. however, there is no current evidence suggesting this probiotic can protect from cdi caused by outbreak-associated strains. we used established hamster models infe ... | 2016 | 27514478 |
| occupational health update: focus on preventing the acquisition of infections with pre-exposure prophylaxis and postexposure prophylaxis. | health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis b virus, and hepatitis c virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, clostridium difficile). an effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and is ... | 2016 | 27515145 |
| antimicrobial stewardship for the infection control practitioner. | antibiotic misuse is a serious patient safety concern and a national public health priority. years of indiscriminant antibiotic use has promoted selection for antibiotic resistant bacteria and clostridium difficile this crisis has led to clinicians being faced with managing untreatable infections, often in the most vulnerable patient populations. this review summarizes the goals of antimicrobial stewardship programs, the essential members needed to initiate a program, various antimicrobial stewa ... | 2016 | 27515147 |
| impact of a prevention bundle on clostridium difficile infection rates in a hospital in the southeastern united states. | we sought to assess the impact of a multicomponent prevention program on hospital-acquired clostridium difficile infections in a hospital in the southeastern united states. we collected retrospective data of 140 patients from years 2009-2014 and applied the poisson regression model for analysis. we did not find any significant associations of increased risk of clostridium difficile infections for the preintervention group. further studies are needed to test multifaceted bundles in hospitals with ... | 2016 | 27515578 |
| clostridium difficile infection in special high-risk populations. | antibiotic use continues to be the most important risk factor for the development of clostridium difficile infection (cdi) through disruption of the indigenous microbiota of the colon. this factor, together with environmental contamination, makes hospital and other healthcare facilities the perfect breeding ground for the infection. several groups of patients are exposed to the hospital environment and, at the same time, affected by conditions that can make cdi more prevalent, more severe or mak ... | 2016 | 27515721 |
| fecal microbiota therapy for clostridium difficile infection: a health technology assessment. | fecal microbiota therapy is increasingly being used to treat patients with clostridium difficile infection. this health technology assessment primarily evaluated the effectiveness and cost-effectiveness of fecal microbiota therapy compared with the usual treatment (antibiotic therapy). | 2016 | 27516814 |
| molecular characterisation of czech clostridium difficile isolates collected in 2013-2015. | clostridium difficile is a leading nosocomial pathogen and molecular typing is a crucial part of monitoring its occurrence and spread. over a three-year period (2013-2015), clinical c. difficile isolates from 32 czech hospitals were collected for molecular characterisation. of 2201 c. difficile isolates, 177 (8%) were non-toxigenic, 2024 (92%) were toxigenic (tcda and tcdb) and of these, 677 (33.5%) carried genes for binary toxin production (cdta, cdtb). capillary-electrophoresis (ce) ribotyping ... | 2016 | 27519407 |
| towards an automated analysis of bacterial peptidoglycan structure. | peptidoglycan (pg) is an essential component of the bacterial cell envelope. this macromolecule consists of glycan chains alternating n-acetylglucosamine and n-acetylmuramic acid, cross-linked by short peptides containing nonstandard amino acids. structural analysis of pg usually involves enzymatic digestion of glycan strands and separation of disaccharide peptides by reversed-phase hplc followed by collection of individual peaks for maldi-tof and/or tandem mass spectrometry. here, we report a n ... | 2017 | 27520322 |
| clostridium difficile bacteremia in a neonate. | 2016 | 27521152 | |
| restrictive antibiotic stewardship associated with reduced hospital mortality in gram-negative infection. | antimicrobial stewardship has an important role in the control of clostridium difficile infection (cdi) and antibiotic resistance. an important component of uk stewardship interventions is the restriction of broad-spectrum beta-lactam antibiotics and promotion of agents associated with a lower risk of cdi such as gentamicin. while the introduction of restrictive antibiotic guidance has been associated with improvements in cdi and antimicrobial resistance, evidence of the effect on outcome follow ... | 2016 | 27521583 |
| [characteristic of antibiotic-associated diarrhea in patients with acute cerebral circulation disorder]. | this full-design study included patients admitted to the regional vascular centre in 2013 and was aimed to obtain more detailed information on the need for medical aid, indications for antibacterial therapy and the spectrum of the drugs being prescribed 42 patients presented with antibiotic-associated diarrhea caused by clostridium difficile. the composition of antibiotics used for mono- and combined therapy was analysed, details of the clinical picture are described, the importance of timely di ... | 2016 | 27522728 |
| synthetic lipoteichoic acid glycans are potential vaccine candidates to protect from clostridium difficile infections. | infections with clostridium difficile increasingly cause morbidity and mortality worldwide. bacterial surface glycans including lipoteichoic acid (lta) were identified as auspicious vaccine antigens to prevent colonization. here, we report on the potential of synthetic lta glycans as vaccine candidates. we identified lta-specific antibodies in the blood of c. difficile patients. therefore, we evaluated the immunogenicity of a semi-synthetic lta-crm197 glycoconjugate. the conjugate elicited lta-s ... | 2016 | 27524293 |
| disease progression and resolution in rodent models of clostridium difficile infection and impact of antitoxin antibodies and vancomycin. | clostridium difficile causes infections of the colon in susceptible patients. specifically, gut dysbiosis induced by treatment with broad-spectrum antibiotics facilitates germination of ingested c. difficile spores, expansion of vegetative cells, and production of symptom-causing toxins tcda and tcdb. the current standard of care for c. difficile infections (cdi) consists of administration of antibiotics such as vancomycin that target the bacterium but also perpetuate gut dysbiosis, often leadin ... | 2016 | 27527088 |
| multiorgan dysfunction syndrome from strongyloides stercoralis hyperinfection in a patient with human t-cell lymphotropic virus-1 coinfection after initiation of ivermectin treatment. | strongyloides stercoralis is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. herein, we describe the case of a 62-year-old man with chronic strongyloidiasis and human t-cell lymphotropic virus-1 coinfection, who developed significant clinical worsening after 24-48 hours of initiation of treatment with ... | 2016 | 27527631 |
| total duration of antimicrobial therapy in veterans hospitalized with uncomplicated pneumonia: results of a national medication utilization evaluation. | practice guidelines recommend the shortest duration of antimicrobial therapy appropriate to treat uncomplicated pneumonia be prescribed to reduce the emergence of resistant pathogens. a national evaluation was conducted to assess the duration of therapy for pneumonia. | 2016 | 27527659 |
| analysis of risk factors and clinical manifestations associated with clostridium difficile disease in serbian hospitalized patients. | clostridium difficile is the leading cause of infectious diarrhoea in hospitalized patients. the aim of this study was to determine the risk factors important for the development of hospital-acquired clostridium difficile-associated disease and clinical manifestations of clostridium difficile-associated disease. the clinical trial group included 37 hospitalized patients who were selected according to the inclusion criteria. a control group of 74 hospitalized patients was individually matched wit ... | 2017 | 27528082 |
| systematic review: adverse events of fecal microbiota transplantation. | fecal microbiota transplantation (fmt) is a microbiota-based therapy that shows therapeutic potential in recurrent or refractory clostridium difficile infections and other intestinal or extra-intestinal disorders. nonetheless, adverse events (aes) remain a major challenge in the application of fmt. | 2016 | 27529553 |
| antibiotics as deep modulators of gut microbiota: between good and evil. | the recent increase in our knowledge of human gut microbiota has changed our view on antibiotics. antibiotics are, indeed, no longer considered only beneficial, but also potentially harmful drugs, as their abuse appears to play a role in the pathogenesis of several disorders associated with microbiota impairment (eg, clostridium difficile infection or metabolic disorders). both drug-related factors (such as antibiotic class, timing of exposure or route of administration) and host-related factors ... | 2016 | 27531828 |
| accessory gene regulator-1 locus is essential for virulence and pathogenesis of clostridium difficile. | clostridium difficile infection (cdi) is responsible for most of the definable cases of antibiotic- and hospital-associated diarrhea worldwide and is a frequent cause of morbidity and mortality in older patients. c. difficile, a multidrug-resistant anaerobic pathogen, causes disease by producing toxins a and b, which are controlled by an accessory gene regulator (agr) quorum signaling system. some c. difficile strains encode two agr loci in their genomes, designated agr1 and agr2 the agr1 locus ... | 2016 | 27531912 |
| comparison of diagnostic algorithms for detecting toxigenic clostridium difficile in routine practice at a tertiary referral hospital in korea. | since every single test has some limitations for detecting toxigenic clostridium difficile, multistep algorithms are recommended. this study aimed to compare the current, representative diagnostic algorithms for detecting toxigenic c. difficile, using vidas c. difficile toxin a&b (toxin elfa), vidas c. difficile gdh (gdh elfa, biomérieux, marcy-l'etoile, france), and xpert c. difficile (cepheid, sunnyvale, california, usa). in 271 consecutive stool samples, toxigenic culture, toxin elfa, gdh elf ... | 2016 | 27532104 |
| reduction of healthcare-associated infections by exceeding high compliance with hand hygiene practices. | improving hand hygiene from high to very high compliance has not been documented to decrease healthcare-associated infections. we conducted longitudinal analyses during 2013-2015 in an 853-bed hospital and observed a significantly increased hand hygiene compliance rate (p<0.001) and a significantly decreased healthcare-associated infection rate (p = 0.0066). | 2016 | 27532259 |
| an outbreak of clostridium difficile ribotype 027 associated with length of stay in the intensive care unit and use of selective decontamination of the digestive tract: a case control study. | an outbreak of clostridium difficile ribotype 027 infection (cdi) occurred at an university hospital, involving 19 departments. to determine what hospital-associated factors drove the outbreak of this particular strain we performed a case-control study. | 2016 | 27533048 |
| community-acquired clostridium difficile infection, queensland, australia. | 2016 | 27533328 | |
| infection-related hospitalizations in the first year after inflammatory bowel disease diagnosis. | with the rapid increase in the incidence of inflammatory bowel disease (ibd) in asia, the natural course of the early phase of disease in these patients remains poorly defined. this study aimed to determined the incidence and characteristics of infection-related hospitalization in the first year in patients newly diagnosed with ibd in hong kong sar, china. | 2016 | 27533786 |
| physical pre-treatment improves efficient dna extraction and qpcr sensitivity from clostridium difficile spores in faecal swine specimens. | a considerable fraction of the faecal microbiota is spore-forming. molecular quantification of bacteria may be underestimated if preceded with nucleic acid extraction without special treatment to extract recalcitrant bacterial spores. the objective of this study was to improve the dna extraction regarding the presence of clostridium difficile spores in faecal swine specimens. sow faeces were inoculated with spores of c. difficile (10(6) cfu), frozen at - 30 °c overnight and subjected to dna extr ... | 2016 | 27534405 |
| distribution of pcr ribotypes among recent clostridium difficile isolates collected in two districts of hungary using capillary gel electrophoresis and review of changes in the circulating ribotypes over time. | following the first description of a clostridium difficile case caused by ribotype 027 in hungary in 2007, the rapid spread of c. difficile infection in different hospitals within the country was observed. the aim of this pilot study was to investigate the distribution of different pcr ribotypes among inpatient and outpatient isolates obtained in two geographically different parts of hungary. one hundred and ninety-two toxigenic c. difficile isolates collected between 1 october and 1 december 20 ... | 2016 | 27534855 |
| bolaamphiphile-based nanocomplex delivery of phosphorothioate gapmer antisense oligonucleotides as a treatment for clostridium difficile. | despite being a conceptually appealing alternative to conventional antibiotics, a major challenge toward the successful implementation of antisense treatments for bacterial infections is the development of efficient oligonucleotide delivery systems. cationic vesicles (bolasomes) composed of dequalinium chloride ("dqasomes") have been used to deliver plasmid dna across the cardiolipin-rich inner membrane of mitochondria. as cardiolipin is also a component of many bacterial membranes, we investiga ... | 2016 | 27536102 |
| an update on antibody-based immunotherapies for clostridium difficile infection. | clostridium difficile continues to be one of the most prevalent hospital-acquired bacterial infections in the developed world, despite the recent introduction of a novel and effective antibiotic agent (fidaxomicin). alternative approaches under investigation to combat the anaerobic gram-positive bacteria include fecal transplantation therapy, vaccines, and antibody-based immunotherapies. in this review, we catalog the recent advances in antibody-based approaches under development and in the clin ... | 2016 | 27536153 |
| a multi-center study of fidaxomicin use for clostridium difficile infection. | fidaxomicin use in real-world clinical practice, especially for severe clostridium difficile infection (cdi), is mainly based on single-center observational studies. the purpose of this pharmacoepidemiology study was to assess outcomes of patients given fidaxomicin based on episode number and use of concomitant antibiotics. | 2016 | 27536508 |
| a phenotypically silent vanb2 operon carried on a tn1549-like element in clostridium difficile. | in the last decade, clostridium difficile infection (cdi) has reached an epidemic state with increasing incidence and severity in both health care and community settings. vancomycin is an important first-line therapy for cdi, and the emergence of resistance would have significant clinical consequences. in this study, we describe for the first time a vanb2 vancomycin resistance operon in c. difficile, isolated from an australian veal calf at slaughter. the operon was carried on an ~42-kb element ... | 2017 | 27536735 |
| surveillance of antibiotic resistance among hospital- and community-acquired toxigenic clostridium difficile isolates over 5-year period in kuwait. | clostridium difficile infection (cdi) is a leading and an important cause of diarrhea in a healthcare setting especially in industrialized countries. community-associated cdi appears to add to the burden on healthcare setting problems. the aim of the study was to investigate the antimicrobial resistance of healthcare-associated and community-acquired c. difficile infection over 5 years (2008-2012) in kuwait. a total of 111 hospital-acquired (ha-cd) and 35 community-acquired clostridium difficile ... | 2016 | 27536994 |
| identification of an essential region for translocation of clostridium difficile toxin b. | clostridium difficile toxin a (tcda) and toxin b (tcdb) are the major virulence factors involved in c. difficile-associated diarrhea and pseudomembranous colitis. tcda and tcdb both contain at least four distinct domains: the glucosyltransferase domain, cysteine protease domain, receptor binding domain, and translocation domain. few studies have investigated the translocation domain and its mechanism of action. recently, it was demonstrated that a segment of 97 amino acids (aa 1756-1852, designa ... | 2016 | 27537911 |
| [new aspects on clostridium difficile infection]. | 2016 | 27538120 | |
| antimicrobial stewardship in paediatrics. | antibiotics are among the drugs most commonly prescribed to children in hospitals and communities. unfortunately, a great number of these prescriptions are unnecessary or inappropriate. antibiotic abuse and misuse have several negative consequences, including drug-related adverse events, the emergence of multidrug resistant bacterial pathogens, the development of clostridium difficile infection, the negative impact on microbiota, and undertreatment risks. in this paper, the principle of and stra ... | 2016 | 27538503 |
| a sialic acid aldolase from peptoclostridium difficile nap08 with 4-hydroxy-2-oxo-pentanoate aldolase activity. | sialic acid aldolases (e.c.4.1.3.3) catalyze the reversible aldol cleavage of n-acetyl-d-neuraminic acid (neu5ac) to from n-acetyl-d-mannosamine (mannac) and pyruvate. in this study, a sialic acid aldolase (pdnal) from peptoclostridium difficile nap08 was expressed in escherichia coli bl21 (de3). this homotetrameric enzyme was purified with a specific activity of 18.34u/mg for the cleavage of neu5ac. the optimal ph and temperature for aldol addition reaction were 7.4 and 65°c, respectively. pdna ... | 2016 | 27542750 |
| antimicrobial susceptibility of brazilian clostridium difficile strains determined by agar dilution and disk diffusion. | clostridium difficile is a leading cause of diarrhea in hospitalized patients worldwide. while metronidazole and vancomycin are the most prescribed antibiotics for the treatment of this infection, teicoplanin, tigecycline and nitazoxanide are alternatives drugs. knowledge on the antibiotic susceptibility profiles is a basic step to differentiate recurrence from treatment failure due to antimicrobial resistance. because c. difficile antimicrobial susceptibility is largely unknown in brazil, we ai ... | 2017 | 27542867 |
| false negative results in clostridium difficile testing. | accurate diagnosis of clostridium difficile infection (cdi) is paramount for patient management. the wrong diagnosis places patients at risk, delays treatment, and/ or contributes to transmission of infection in the healthcare setting. although amplification of the toxin b gene by polymerase chain reaction (pcr) is a sensitive method for detecting toxigenic c. difficile, false negative results still occur and could impact the diagnosis and treatment of this infection. | 2016 | 27543102 |
| impact of a pharmacist-driven protocol to decrease proton pump inhibitor use in non-intensive care hospitalized adults. | results of a pharmacist-driven protocol to decrease proton pump inhibitor (ppi) use in non-intensive care unit (icu) hospitalized adults are presented. | 2016 | 27543598 |
| acyldepsipeptide antibiotics as a potential therapeutic agent against clostridium difficile recurrent infections. | alternative antimicrobial therapies based on acyldepsipeptides may hold promising results, based on the fact that they have shown to efficiently eradicate persister cells, stationary cells and cell in biofilm structures of several pathogenic bacteria from the infected host. clostridium difficile infection is considered the result of extensive hospital use of expanded-spectrum antibiotics, which cause dysbiosis of the intestinal microbiota, enhancing susceptibility to infection and persistence. c ... | 2016 | 27546386 |
| nursing home residence is associated with spread of clostridium difficile ribotype 027 in central italy. | 2016 | 27546454 | |
| typhlocolitis associated with clostridium difficile ribotypes 078 and 110 in neonatal piglets from a commercial irish pig herd. | clostridium difficile is a recognised cause of typhlocolitis and diarrhoea in neonatal pigs but has never been confirmed in association with pathology and disease in irish pigs. | 2015 | 27547375 |
| tracking inhibitory alterations during interstrain clostridium difficile interactions by monitoring cell envelope capacitance. | global threats arising from the increasing use of antibiotics coupled with the high recurrence rates of clostridium difficile (c. difficile) infections (cdi) after standard antibiotic treatments highlight the role of commensal probiotic microorganisms, including nontoxigenic c. difficile (ntcd) strains in preventing cdi due to highly toxigenic c. difficile (htcd) strains. however, optimization of the inhibitory permutations due to commensal interactions in the microbiota requires probes capable ... | 2016 | 27547818 |
| effect of fecal microbiota transplantation on recurrence in multiply recurrent clostridium difficile infection: a randomized trial. | to date, evidence for the efficacy of fecal microbiota transplantation (fmt) in recurrent clostridium difficile infection (cdi) has been limited to case series and open-label clinical trials. | 2016 | 27547925 |
| any future for fecal microbiota transplantation as treatment strategy for inflammatory bowel diseases? | fecal microbiota transplantation (fmt) is a novel therapeutic procedure aiming at restoring a normal intestinal microbiota by application of fecal microorganisms from a healthy subject into the gastrointestinal tract of a patient. fmt is the most effective treatment for recurrent clostridium difficile infections (cdi). these infections also occur in patients with inflammatory bowel diseases (ibds), where case series demonstrated a successful treatment of cdi by fmt in 83-92% of patients. the eff ... | 2017 | 27548724 |
| eosinophils, probiotics, and the microbiome. | there is currently substantial interest in the therapeutic properties of probiotic microorganisms as recent research suggests that oral administration of specific bacterial strains may reduce inflammation and alter the nature of endogenous microflora in the gastrointestinal tract. eosinophils are multifunctional tissue leukocytes, prominent among the resident cells of the gastrointestinal mucosa that promote local immunity. recent studies with genetically altered mice indicate that eosinophils n ... | 2016 | 27549754 |
| performance of the artus c. difficile qs-rgq kit for the detection of toxigenic clostridium difficile. | nucleic acid amplification tests are commonly used for the direct detection of toxigenic clostridium difficile. we evaluated the diagnostic performance of newly launched, artus c. difficile qs-rgq kit (artus c. difficile, qiagen, hilden, germany), in comparison with toxigenic culture (tc) and xpert c. difficile (cepheid, sunnyvale, ca, usa). | 2017 | 27556286 |
| coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection. | clostridium difficile (peptoclostridium difficile) is a common health care-associated infection with a disproportionately high incidence in elderly patients. disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. around 20% of patients may suffer recurrent disease, which often requires rehospitalization of patients. c. difficile was isolated from stool samples from a patient with two recurrent c. difficile infections. pcr ribotyping, whole-genome sequencing, and ... | 2016 | 27558181 |
| cost of hospital management of clostridium difficile infection in united states-a meta-analysis and modelling study. | clostridium difficile infection (cdi) is the leading cause of infectious nosocomial diarrhoea but the economic costs of cdi on healthcare systems in the us remain uncertain. | 2016 | 27562241 |
| identification of signet ring cell change in colonic subserosa in the setting of clostridium difficile colitis. | signet ring cell change of intestinal epithelial cells is a rare but well-known mimicker of signet ring cell carcinoma and is often associated with ischemic and/or pseudomembranous colitis. instead, signet ring cell change involving nonepithelial cells in the subserosa of the intestine is an extremely rare finding with only a single case report in the literature to date. we report a new case of benign signet ring cell change localized in the subserosa of the large bowel incidentally identified i ... | 2017 | 27562801 |
| hospital acquired clostridium difficile infection in pediatric wards: a retrospective case-control study. | clostridium difficile is a major cause of antibiotic-associated diarrhea and frequently results in healthcare-associated infections. the aim of this study was to determine the incidence and potential risk factors for c. difficile infection (cdi) in hospitalized children who developed diarrhea. a retrospective study was performed at a university hospital in istanbul over a three-year period (2012-2014). | 2016 | 27563524 |
| coordination between t helper cells, inkt cells, and their follicular helper subsets in the humoral immune response against clostridium difficile toxin b. | activation of inkt cells with the cd1d-binding glycolipid adjuvant α-galactosylceramide (α-gc) enhances humoral immunity specific for coadministered t-dependent ag. however, the relationship between the inkt cell and the classic t helper (th) or t follicular helper (tfh) function following this immunization modality remains unclear. we show that immunization with the c-terminal domain (ctd) of clostridium difficile toxin b (tcdb), accompanied by activation of inkt cells with α-gc, led to enhance ... | 2017 | 27566831 |
| efficacy of oral vancomycin in preventing recurrent clostridium difficile infection in patients treated with systemic antimicrobial agents. | 2016 | 27567123 | |
| clostridium difficile infection health disparities by race among hospitalized adults in the united states, 2001 to 2010. | recognition of health disparities in clostridium difficile infection (cdi) is an initial step toward improved resource utilization and patient health. the purpose of this study was to identify health disparities by black vs. white race among hospitalized adults with cdi in the united states (u.s.) over 10 years. | 2016 | 27568176 |
| molecular characteristics of clostridium difficile isolates from human and animals in the north eastern region of india. | a total of 1034 samples were collected from different sources and c. difficile was isolated from 18 (9.04%) of 199 human, 9 (4.89%) of 184 cattle, 29 (12.44%) of 233 pig, and from 23 (13.94%) of 165 poultry samples. variations were observed on the rate of isolation according to age and clinical conditions (diarrhoea). none of the samples from cow, sheep, goat, local chicken, and wild animals yielded any c. difficile. out of those isolates, 8, 2, 19 and 6 isolates from human, cattle, pig and poul ... | 2016 | 27569848 |
| crystal structure of clostridium difficile toxin a. | clostridium difficile infection is the leading cause of hospital-acquired diarrhoea and pseudomembranous colitis. disease is mediated by the actions of two toxins, tcda and tcdb, which cause the diarrhoea, as well as inflammation and necrosis within the colon. the toxins are large (308 and 270 kda, respectively), homologous (47% amino acid identity) glucosyltransferases that target small gtpases within the host. the multidomain toxins enter cells by receptor-mediated endocytosis and, upon exposu ... | 2016 | 27571750 |
| role of coinfecting strains in recurrent clostridium difficile infection. | the contribution of mixed infection in recurrent clostridium difficile infection (cdi) episodes is not known. among paired isolates from 52 patients, mixed infection due to >1 toxigenic strain of c. difficile was identified in 8% of first episodes. among recurrences, relapse from 1 or both co-infecting strains was uncommon; it was detected in a single case each. infect control hosp epidemiol 2016;1481-1484. | 2016 | 27572118 |
| mortality and costs in clostridium difficile infection among the elderly in the united states. | objective to examine attributable mortality and costs of clostridium difficile infection (cdi) in the medicare population. design a population-based cohort study among us adults aged at least 65 years in the 2008-2010 medicare 5% sample, with follow-up of 12 months. patients incident cdi episode was defined by the international classification of diseases, ninth revision, clinical modification code of 008.45 and no other occurrences within the preceding 12 months. to quantify the adjusted mortali ... | 2016 | 27572289 |
| the binary toxin cdt enhances clostridium difficile virulence by suppressing protective colonic eosinophilia. | clostridium difficile is the most common hospital acquired pathogen in the usa, and infection is, in many cases, fatal. toxins a and b are its major virulence factors, but expression of a third toxin, known as c. difficile transferase (cdt), is increasingly common. an adenosine diphosphate (adp)-ribosyltransferase that causes actin cytoskeletal disruption, cdt is typically produced by the major, hypervirulent strains and has been associated with more severe disease. here, we show that cdt enhanc ... | 2016 | 27573114 |
| evaluation of gastrointestinal leakage using serum (1→3)-β-d-glucan in a clostridium difficile murine model. | gastrointestinal (gi) leakage in clostridium difficile-associated diarrhea (cdad) is well known but is not routinely assessed in clinical practice. serum (1→3)-β-d-glucan (bg), a fungal cell wall component used as a biomarker for invasive fungal disease, was tested in a cdad mouse model with and without probiotics. higher serum fluorescein isothiocyanate-dextran (fitc-dextran) and spontaneous gram-negative bacteremia, gi leakage indicators, were frequently found in cdad mice, which died compared ... | 2016 | 27573235 |
| clostridium difficile colitis: pathogenesis and host defence. | clostridium difficile is a major cause of intestinal infection and diarrhoea in individuals following antibiotic treatment. recent studies have begun to elucidate the mechanisms that induce spore formation and germination and have determined the roles of c. difficile toxins in disease pathogenesis. exciting progress has also been made in defining the role of the microbiome, specific commensal bacterial species and host immunity in defence against infection with c. difficile. this review will sum ... | 2016 | 27573580 |
| endoscopic peroral jejunal fecal microbiota transplantation. | fecal microbiota transplantation (fmt) is a valuable treatment modality for recurrent clostridium difficile (c. difficile) colitis. multiple questions including the best delivery route and volume remain unanswered. here, we report a case series of high-volume fmt using endoscopic jejunal application route. | 2016 | 27575658 |
| proton pump inhibitors do not increase risk for clostridium difficile infection in the intensive care unit. | patients in the intensive care unit (icu) frequently receive proton pump inhibitors (ppis) and have high rates of clostridium difficile infection (cdi). ppis have been associated with cdi in hospitalized patients, but icu patients differ fundamentally from non-icu patients and few studies have focused on ppi use exclusively in the critical care setting. we performed a retrospective cohort study to determine the associations between ppis and health-care facility-onset cdi in the icu. | 2016 | 27575714 |
| crispr diversity and microevolution in clostridium difficile. | virulent strains of clostridium difficile have become a global health problem associated with morbidity and mortality. traditional typing methods do not provide ideal resolution to track outbreak strains, ascertain genetic diversity between isolates, or monitor the phylogeny of this species on a global basis. here, we investigate the occurrence and diversity of clustered regularly interspaced short palindromic repeats (crispr) and crispr-associated genes (cas) in c. difficile to assess the poten ... | 2016 | 27576538 |
| infective thoracic aortic aneurysm caused by clostridium difficile after endovascular aortic repair. | clostridium difficile generally causes enterocolitis by producing pathogenic toxins, while extraintestinal infections with c. difficile are extremely rare. here we report the first documented case of an infective thoracic aortic aneurysm caused by nontoxic c. difficile that occurred after vascular interventions including endovascular aortic repair. the present case illustrates that endovascular interventions may expose patients to the rare infection by yielding the ischemic intestinal tract as a ... | 2017 | 27578027 |
| epidemiology of diarrheal illness in pediatric oncology patients. | diarrhea is common in children with cancer, but this has not been systematically studied to date. | 2016 | 27578209 |
| high mobility group box1 protein is involved in endoplasmic reticulum stress induced by clostridium difficile toxin a. | high mobility group box1 (hmgb1), a damage-associated inflammatory factor, plays an important role in the pathogenesis of numerous chronic inflammatory and autoimmune diseases. in this study, the role of the hmgb1 in tcda-induced er stress was identified. clostridium difficile toxin a is one of the major virulence factors of c. difficile infection (cdi) and has been proved to induce apoptotic cell death through er stress. our results showed that hmgb1 might play an important role in the tcda-ind ... | 2016 | 27579314 |
| cost-effectiveness analysis of the use of probiotics for the prevention of clostridium difficile-associated diarrhea in a provincial healthcare system - erratum. | 2016 | 27580173 | |
| fecal microbiota transplantation is safe and efficacious for recurrent or refractory clostridium difficile infection in patients with inflammatory bowel disease. | new treatments are needed as clostridium difficile infection (cdi) is becoming increasingly formidable. fecal microbiota transplantation (fmt) has a 90% success rate in the treatment of recurrent cdi. however, evidence regarding its safety, efficacy, and effect on disease activity in patients with inflammatory bowel disease (ibd) is lacking. | 2016 | 27580384 |
| a quantitative analysis of fda adverse event reports with oral bisphosphonates and clostridium difficile. | studies have shown associations between clostridium difficile infection (cdi) and non-antimicrobial medications including proton pump inhibitors, osteoporosis medications, and antidepressants. | 2016 | 27582058 |
| clostridium difficile infection and takotsubo cardiomyopathy: is there a relation? | takotsubo cardiomyopathy (tcm) mimics acute coronary syndrome and is accompanied by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. it is a transient condition that typically precedes physical or emotional triggers. | 2016 | 27583241 |
| vaccines against major icu pathogens: where do we stand? | multidrug resistance of bacterial pathogens has confronted physicians around the world with the threat of inefficacy of the antibiotic regime, which is particularly important for patients with sepsis. antibiotic resistance has revived search for alternative nonantibiotic strategies. among them, prophylaxis by vaccination is an appealing concept. | 2016 | 27583587 |
| draft genome sequence of clostridium difficile belonging to ribotype 018 and sequence type 17. | clostridium difficile, belonging to ribotype 018 (rt018), is one of the most prevalent genotypes circulating in hospital settings in italy. here, we report the draft genome of c. difficile cd8-15 belonging to rt018, isolated from a patient with fatal c. difficile-associated infection. | 2016 | 27587821 |
| variability in testing policies and impact on reported clostridium difficile infection rates: results from the pilot longitudinal european clostridium difficile infection diagnosis surveillance study (lucid). | lack of standardised clostridium difficile testing is a potential confounder when comparing infection rates. we used an observational, systematic, prospective large-scale sampling approach to investigate variability in c. difficile sampling to understand c. difficile infection (cdi) incidence rates. in-patient and institutional data were gathered from 60 european hospitals (across three countries). testing methodology, testing/cdi rates and case profiles were compared between countries and insti ... | 2016 | 27590621 |
| generic aspects of the airborne spread of human pathogens indoors and emerging air decontamination technologies. | indoor air can be an important vehicle for a variety of human pathogens. this review provides examples of airborne transmission of infectious agents from experimental and field studies and discusses how airborne pathogens can contaminate other parts of the environment to give rise to secondary vehicles leading air-surface-air nexus with possible transmission to susceptible hosts. the following groups of human pathogens are covered because of their known or potential airborne spread: vegetative b ... | 2016 | 27590695 |
| epidemiology of multidrug resistant bacterial organisms and clostridium difficile in german hospitals in 2014: results from a nationwide one-day point prevalence of 329 german hospitals. | one important aspect in combatting resistance to antibiotics is to increase the awareness and knowledge by epidemiological studies. we therefore conducted a german-wide point-prevalence survey for multidrug resistant bacterial organisms (mdros) and clostridium difficile (cd) to assess the epidemiology and structure quality of infection control in german hospitals. | 2016 | 27590879 |
| effect of an antimicrobial stewardship intervention on outcomes for patients with clostridium difficile infection. | although antimicrobial stewardship programs (asps) are uniquely positioned to improve treatment of clostridium difficile infection (cdi) through targeted interventions, studies to date have not rigorously evaluated the influence of asp involvement on clinical outcomes attributed to cdi. | 2016 | 27592160 |
| comparison of agar dilution and broth microdilution methods for clostridium difficile antimicrobial susceptibility testing. | in this study, the performance of the broth microdilution (bmd) method for testing the antimicrobial susceptibility of clostridium difficile in comparison with the agar dilution (ad) method used by the clinical and laboratory standards institute (clsi) was evaluated. in total, 70 non-duplicate c. difficile clinical isolates were used in this study. the minimum inhibitory concentrations (mics) of clindamycin, moxifloxacin, metronidazole and vancomycin were examined using ad and bmd. the results s ... | 2016 | 27598055 |
| growth patterns of clostridium difficile - correlations with strains, binary toxin and disease severity: a prospective cohort study. | a broad spectrum of symptoms has been associated with c. difficile infection (cdi). several studies indicate that toxin-production correlates with growth rates of c. difficile. this study aimed to correlate growth rates of c. difficile with disease severity and strain characteristics. from 01/2003 to 10/2011, strains from a prospective cohort of all inpatients with cdi at the university hospital basel, switzerland were analyzed regarding binary toxin, presence of the tcdc deletion and ribotype. ... | 2016 | 27598309 |
| use of intravenous tigecycline in patients with severe clostridium difficile infection: a retrospective observational cohort study. | there are only a limited number of antimicrobials for treating severe clostridium difficile infection (scdi). tigecycline shows significant in vitro effect against c. difficile and is approved for management of complicated intra-abdominal infections. our aim was to analyse the efficacy of tigecycline compared with standard therapy (oral vancomycin plus intravenous metronidazole) in adults treated for scdi. a retrospective cohort study of such patients hospitalized at our department from january ... | 2016 | 27599690 |
| rapid detection of clostridium difficile toxins and laboratory diagnosis of clostridium difficile infections. | clostridium difficile is an anaerobic, spore-forming and gram-positive bacillus. it is the major cause of antibiotic-associated diarrhea prevailing in hospital settings. the morbidity and mortality of c. difficile infection (cdi) has increased significantly due to the emergence of hypervirulent strains. because of the poor clinical different between cdi and other causes of hospital-acquired diarrhea, laboratory test for c. difficile is an important intervention for diagnosis of cdi. | 2016 | 27601055 |
| [a scoring system for prescribing fidaxomicin in clostridium diffícile infection]. | recurrences of clostridium difficile infections lead to hospital readmissions and high costs, in addition to the suffering and frustration for the patients. fidaxomicin has recently been introduced as a new antibiotic that has been shown to significantly reduce the recurrence of this infection. despite this superiority, its high cost has led to very restrictive policies in its use, as such that many institutions only use it in patients with multiple recurrences. while waiting for new predictive ... | 2016 | 27601193 |
| bed utilisation and increased risk of clostridium difficile infections in acute hospitals in england in 2013/2014. | the study aimed to identify thresholds for hospital bed utilisation which are independently associated with significantly higher risks for clostridium difficile infections (cdi) in acute hospitals in england. | 2016 | 27601687 |
| clostridium difficile infection in production animals and avian species: a review. | clostridium difficile is the leading cause of antibiotic-associated diarrhea and colitis in hospitalized humans. recently, c. difficile infection (cdi) has been increasingly recognized as a cause of neonatal enteritis in food animals such as pigs, resulting in stunted growth, delays in weaning, and mortality, as well as colitis in large birds such as ostriches. c. difficile is a strictly anaerobic spore-forming bacterium, which produces two toxins a (tcda) and b (tcdb) as its main virulence fact ... | 2016 | 27602596 |
| the epidemiology of clostridium difficile infection in patients with cancer. | clostridium difficile infection (cdi) is a significant cause of healthcare-associated diarrhoea, and the emergence of endemic strains resulting in poorer outcomes is recognised worldwide. patients with cancer are a specific high-risk group for development of infection. areas covered: in this review, modifiable and non-modifiable risk factors for cdi in adult patients with haematological malignancy or solid tumours are evaluated. in particular, the contribution of antimicrobial exposure, hospital ... | 2016 | 27606976 |
| oral, frozen fecal microbiota transplant (fmt) capsules for recurrent clostridium difficile infection. | fecal microbiota transplantation (fmt) has been shown to be safe and effective in treating refractory or relapsing c. difficile infection (cdi), but its use has been limited by practical barriers. we recently reported a small preliminary feasibility study using orally administered frozen fecal capsules. following these early results, we now report our clinical experience in a large cohort with structured follow-up. | 2016 | 27609178 |
| healthcare personnel attire and devices as fomites: a systematic review. | background transmission of pathogens within the hospital environment remains a hazard for hospitalized patients. healthcare personnel clothing and devices carried by them may harbor pathogens and contribute to the risk of pathogen transmission. objective to examine bacterial contamination of healthcare personnel attire and commonly used devices. methods systematic review. results of 1,175 studies screened, 72 individual studies assessed contamination of a variety of items, including white coats, ... | 2016 | 27609491 |
| thrombocytopenia in hospitalized patients with severe clostridium difficile infection. | clostridium difficile infection (cdi) is a common cause of nosocomial diarrhea and colitis. the incidence and prognostic significance of thrombocytopenia as related to mode of acquisition (hospital vs. community), nap1/027 strain, and disease severity has not been examined. we performed a single-institution retrospective analysis of all adult inpatients from 2013 to 2014 diagnosed with cdi during their hospitalization to document the incidence/prevalence of thrombocytopenia and associated outcom ... | 2017 | 27614757 |
| asymptomatic clostridium difficile colonization in two australian tertiary hospitals, 2012-2014: prospective, repeated cross-sectional study. | to investigate the prevalence and risk factors for asymptomatic toxigenic (tcd) and nontoxigenic clostridium difficile (ntcd) colonization in a broad cross section of the general hospital population over a 3-year period. | 2017 | 27615716 |