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clostridium difficile in normal infants and sudden infant death syndrome: an association with infant formula feeding.large numbers clostridium difficile were found in the stools of two victims of sudden infant death syndrome (sids). this prompted a study of normal infants in the sids age group. thirty-two infants were studied, using two selective culture techniques and two assays for bacterial products. thirteen of the normal infants (39%) were found to carry c difficile, and fecal toxins were detected in eight of these, four with cytotoxin detectable at 10(-4) or higher dilution. colonization was observed in ...19827088640
clostridium difficile: epidemiology and clinical features.to determine the epidemiologic features of clostridium difficile in halifax, nova scotia, the authors studied two groups of hospitalized patients, one group of outpatients and a fourth group of 54 healthy subjects. the first group consisted of 29 patients with diarrhea, whose stool was found to contain c. difficile or its cytotoxin, or both. twenty-two underwent sigmoidoscopic examinations; of these, 18 had abnormal colonic mucosa and 6 of the 18 had pseudomembranous colitis. in the second group ...19827093841
discontinuous counterimmunoelectrophoresis in the diagnosis of antibiotic-associated colitis.discontinuous counterimmunoelectrophoresis (dcie) was employed to detect the toxin of clostridium difficile, etiologic antibiotic-associated colitis (aac), in bacteria-free stool filtrates from 51 patients with diarrhea. stool samples from 31 patients contained c. difficile toxin as determined by tissue-culture assay. a positive result was obtained by dcie in 20 of the 31 patients (65%) and was influenced by the titer of toxin present. when toxin was present by tissue-culture assay in a dilution ...19827096958
[recurrence of antibiotic associated diarrhea caused by clostridium difficile]. 19827101511
possible evidence for a shwartzman reaction in pseudomembranous colitis.pseudomembranous colitis is a potentially fatal disorder associated with gastrointestinal surgery and the use of antibiotics. the aetiological agent has been shown to be clostridium difficile but the pathogenesis of the disease is unknown. it has been suggested that the lesions produced are due to a local shwartzman effect. such an effect may be accompanied by activation of the serum complement system and we therefore looked for evidence of complement consumption in 4 patients with the diagnosti ...19827106415
myoelectric effects of clostridium difficile: motility-altering factors distinct from its cytotoxin and enterotoxin in rabbits.clostridium difficile is a bacterium that causes antibiotic-associated pseudomembraneous enterocolitis. this bacterium produces a cytotoxin that induces tissue culture assay positivity and an enterotoxin that causes in vivo mucosal injury. in previous studies we have described two altered myoelectric patterns in response to certain diarrheagenic organisms in an in vivo rabbit model. the first pattern was called the migrating action potential complex and is associated with noninvasive agents; the ...19827106514
clostridium difficile and its cytotoxin in feces of patients with antimicrobial agent-associated diarrhea and miscellaneous conditions.fecal specimens from 223 subjects were evaluated for the presence of clostridium difficile by use of a selective medium developed in our laboratory and for the presence of c. difficile cytotoxin. c. difficile and cytotoxin were detected in 89 and 83%, respectively, of patients with antimicrobial agent-associated pseudomembranous colitis (pmc). in patients in whom pmc was not documented, c. difficile and cytotoxin were present in only 37 and 21%, respectively. c. difficile and cytotoxin were also ...19827107838
differential effects of clostridium difficile toxins on tissue-cultured cells.two immunologically distinct clostridium difficile toxins elicited similar morphological changes on cultured cells, although there were differences in both toxin potency and cell sensitivities.19827107845
varying results of counterimmunoelectrophoresis for the detection of clostridium difficile toxins. 19827108287
immunochemistry of the cell-surface carbohydrate antigens of clostridium difficile.two carbohydrate cell-surface antigens were extracted from clostridium difficile. one was extracted from pure cell walls by naoh and contained glucose, mannose, galactosamine and phosphate in the approximate molar proportions of 2:0.65:1:0.63. the other antigen was extracted with phenol from the disrupted contents of whole cells and purified by chromatography on sepharose 6b and an immunoabsorbent column; it contained glucose, glucosamine, phosphate and fatty acid in the approximate molar propor ...19827119739
clostridium difficile: the epidemiology and prevention of hospital-acquired infection. 19827129641
clostridium difficile and cytotoxin in feces of patients with antimicrobial agent-associated pseudomembranous colitis.thirty patients with antimicrobial agent-associated pseudomembranous colitis (pmc) were studied for the presence of clostridium difficile and its cytotoxin in feces. either colonoscopy or barium enema radiography was required in three patients for the diagnosis of pmc because of nondiagnostic findings at sigmoidoscopy. both the organism and cytotoxin were detected in 27 of the 30 patients; staphylococcus aureus was excluded as the cause of pmc in two of the remaining patients. eighteen of 19 pat ...19827129642
toxin-induced cell membrane injury in guinea pigs given lincomycin.guinea pigs treated with lincomycin developed colitis, acute cholecystitis and abnormalities in red blood cell morphology. the present study was designed to study the production of clostridial toxins after lincomycin treatment. lincomycin produced abnormalities in conventional but not in germ-free guinea pigs. clostridium difficile was cultured from cecal contents of conventional guinea pigs treated with lincomycin. cecal filtrate from sick guinea pigs was subjected to sepharose 4b-cl and sephad ...19827133762
clostridium difficile toxin in faecal specimens of healthy children and children with diarrhoea.presence of cytopathogenic effect (cpe) that could be inhibited by an antitoxin to clostridium sordelli, known to cross-react with clostridium difficile toxin, was sought in faecal specimens from 101 infants. of the children, 45 were healthy, while 56 had been hospitalized because of diarrhoea. cpe was found in 12 of the healthy infants and in 5 of those hospitalized. faecal specimens of these 5 gave a cpe at titres of 10(3-4), whereas in the 12 healthy infants the titres were 10(1-2). studies o ...19827136636
epidemiology of clostridium difficile in infants.the epidemiology of clostridium difficile was studied prospectively in 451 newborn infants by daily screening of fecal samples. colonization rates in three postnatal wards ranged from 2% to 52%. many colonizations were sporadic, but on two wards there was evidence of clustering. on one of these occasions prospective environmental sampling yielded c. difficile organisms from a potential common source. mothers were shown not to be the sources of their infants' organisms. both toxin-producing and n ...19827142747
survey of the extrachromosomal gene pool of clostridium difficile.pseudomembranous colitis, a severe diarrheal disease, has been linked to the administration of antibiotics and to two toxins produced by clostridium difficile. eighty-two strains of c. difficile isolated from humans and hamsters were assayed for the presence of plasmid dna. agarose gel electrophoresis of sarkosyl-lysed cells indicated that 18% of the strains contained from one to four plasmids. the plasmid dna in these strains ranged in molecular weight from 2.7 x 10(6) to 60 x 10(6). strains wi ...19827153313
isolation of clostridium difficile from hospitalized patients without antibiotic-associated diarrhea or colitis.stool samples from 100 hospitalized patients and 21 healthy adults, obtained between march and june 1980, were cultured on a special selective medium containing cefoxitin and cycloserine to detect clostridium difficile. this organism was isolated from 13 of the hospitalized patients and from 1 healthy subject. none of the patients with positive cultures had received antimicrobial therapy in the 3 preceding months. the observed rate of c. difficile isolation from adults not suffering from antibio ...19827153315
effect of incubation time, and calcium carbonate and glucose in the growth medium, upon the fermentation end-product profile of clostridium difficile.the effects of time, glucose and calcium carbonate upon fermentation profiles of clostridium difficile were determined. the test organism was grown in three media, viz. fastidious anaerobe broth (fab), fab with 1% w/v glucose, and fab with 1% glucose plus calcium carbonate. fermentation products were analysed after 24, 48 and 72 h incubation. by 48 h, qualitatively 'typical' profiles could be produced. glucose supplementation of fab suppressed formation of certain branched-chain carboxylic acids ...19827154979
clostridium difficile in a pediatric outpatient population.clostridium difficile has been implicated as one cause of hospital-acquired diarrhea in children, yet the prevalence of this organism in outpatient children with diarrhea has not been established. over a 1-year period, 306 outpatient children ranging in age from 2 weeks to 16 years were cultured for c. difficile and potential bacterial pathogens. c. difficile was isolated from 7.0% of patients with diarrhea (12 of 171) and 14.8% of controls with nondiarrheal illnesses (20 of 135). the 32 patient ...19827155966
investigation of an outbreak of antibiotic-associated colitis by various typing methods.during an outbreak of diarrheal disease due to clostridium difficile in a surgical ward, 16 c. difficile isolates were cultured from fecal samples of 15 patients. agarose gel electrophoresis for the detection of plasmid dna, crossed immunoelectrophoresis for the detection of extracellular antigens and toxins, polyacrylamide gel electrophoresis for analyses of soluble proteins, assays for cytotoxicity, and a comparison of susceptibility to antimicrobial agents were employed. at least 12 of the 16 ...19827161375
biochemical and pathological effects of clostridium difficile toxins in mice.toxins produced by clostridium difficile are lethal to mice after i.p. administration. among the alterations observed when mice were given a preparation containing both toxin a and toxin b were a 1.6 +/- 0.2 degrees c (mean +/- s.e., n = 7) depression of rectal body temperature, blood in the liver (318 +/- 13% of control levels) and a decrease in glutathione concentration (74 +/- 2% of control). purified toxin a and purified toxin b were both able to alter these parameters. toxin b, however, had ...19827164114
effect of clindamycin on cytotoxin production by clostridium difficile.a total of 80 strains of clostridium difficile, 33 toxigenic and 11 nontoxigenic clindamycin (cldm)-sensitive (mic less than 12.5 micrograms/ml), and 23 toxigenic and 13 nontoxigenic cldm-resistant (mic 200 to 6,400 micrograms/ml) were tested for cytotoxin production in the presence of cldm. none of the 24 nontoxigenic strains produced cytotoxin regardless of the presence of cldm and only six out of the 56 toxigenic strains showed 16- to 64-fold higher levels of cytotoxic activity in the presenc ...19827167065
further experience with augmentin in the treatment of skin infections.thirty-two patients with skin infections were treated with augmentin, a combination of amoxycillin with the beta-lactamase inhibitor clavulanic acid. these infections were primary skin sepsis (7), infected eczema (11), infected trauma (10) and leg ulcers (4). the majority of cases were caused by amoxycillin-resistant staphylococcus aureus either alone or in combination with streptococcus pyogenes. thirty patients (94%) responded to treatment with only one withdrawal (for side effects). side effe ...19827167811
intestinal occurrence of campylobacter fetus subspecies jejuni and clostridium difficile in children in sweden.stool samples were cultured from 356 children in different states of health and in different age groups between birth and six years of age in order to investigate the occurrence of campylobacter jejuni and clostridium difficile. campylobacter jejuni was isolated from two of 56 children with diarrhoea but was not isolated from any of 300 healthy children or children recently treated with antibiotics. campylobacter jejuni does not seem to be a common cause of diarrhoea in children in sweden and is ...19827173168
clostridium difficile typhlitis in hamsters not associated with antibiotic therapy--. 19827174490
inhibition of clostridium difficile by faecal streptococci.the inhibitory activity of seven strains of faecal streptococci against 34 strains of clostridium difficile was examined in vitro after growth of the streptococci for 24 and 48 h. all strains of c. difficile were inhibited at 48 h but at 24 h the inhibition was variable. streptococcus faecium, a group d streptococcus and an ungroupable streptococcus exhibited the most striking inhibitory activity. lowering of ph of the medium occurred at the site of inhibition, but the ph change alone did not ex ...19827175918
[role of clostridium difficile in human and animal pathology]. 19827178505
clostridium difficile from a peri-anal abscess. 19807185937
clostridium difficile in paediatric infections. 19827185999
[mild spontaneous course of a case of pseudomembranous colitis. case report and literature review].pseudomembranous colitis (pmc) caused by a toxin produced by clostridium difficile is described in the literature as a severe diarrheal disease with a high mortality rate. a case which tends to absolve pmc from this reputation is reported involving an outpatient who developed well documented pmc subsequent to ampicillin therapy but required no treatment. the number of unreported cases of antibiotic-associated colitis with and without pseudomembrane formation is probably very high, since only sev ...19817194502
association of clostridium difficile toxin with symptomatic relapse of chronic inflammatory bowel disease. 19817202941
occurrence of clostridium difficile toxin during the course of inflammatory bowel disease.clostridium difficile toxin, the presumed mechanism of antibiotic-associated pseudomembranous colitis, has been suggested as a contributory factor to mucosal injury in inflammatory bowel disease. we evaluated its incidence and apparent role in 65 consecutive patients with diarrheal and inflammatory bowel diseases. toxin was demonstrated in 3 of 18 patients with ulcerative colitis (17%), 1 of 26 with crohn's colitis (4%), and 5 of 21 with a variety of diarrheal illnesses (24%). toxin appeared onl ...19817202942
clostridium difficile and inflammatory bowel disease. 19817202955
case report. clindamycin associated pseudomembranous colitis.pseudomembranous colitis is rare in children. we describe a case associated with clindamycin in which clostridium difficile and its enterotoxin were isolated from the stool. treatment with oral vancomycin brought about a prompt and complete recovery.19817211374
epidemiology of antibiotic-associated colitis; isolation of clostridium difficile from the hospital environment.clostridium difficile is the most important cause of antibiotic-associated colitis. using selective media, it was found that contamination with this organism was common in the environment of patients in the hospital with the disease. it was often found on floors, hoppers, toilets, bedding, mops, scales and furniture. this organism was also present on these items, but less often, in areas in which patients known to carry this hardy spore-forming organism had not been detected. air, food and walls ...19817211925
neutralizing activity against clostridium difficile toxin in the supernatants of cultured colostral cells.human colostral specimens were obtained from 60 japanese postpartum women within the first 3 days after delivery. neutralizing activity against clostridium difficile toxin was evaluated with y1 adrenal cells in miniculture. when y1 adrenal cells were exposed briefly to the toxin, they showed a rounding response in culture, resembling that effected by escherichia coli enterotoxin; however, preincubation of the toxin with aqueous phase of colostrum significantly reduced its cytopathic effect on y1 ...19807216424
a second relapse of clostridium difficile colitis. 19817216943
clostridium difficile in relation to enteric bacterial pathogens.all feces samples (n = 2,390) sent to the bacteriological laboratory, göteborg, sweden over 43 days were, in addition to the standard procedure, cultivated to detect clostridium difficile by using a special selective medium. c. difficile was found in 81 of the 2,390 samples (3%). these 81 samples represented 56 patients. fifty of the 56 patients had diarrhea. in 20 of the 56 patients (36%), salmonella, campylobacter, or yersinia were also found. of the 2,390 samples 252 (11%) from 132 patients r ...19807217331
isolation of clostridium difficile from the environment and contacts of patients with antibiotic-associated colitis.clostridium difficile is the most important cause of antibiotic-associated colitis, but its epidemiology remains unknown. using a selective medium for the isolation of c. difficile, cultures were obtained from the environment and contacts of hospitalized patients carrying c. difficile in their stools. in areas where carriers had diarrhea, 85 (9.3%) of 910 cultures of floors and other surfaces, especially those subject to fecal contamination, were positive. in areas where there were no known carr ...19817217711
studies on the epidemiology of colitis due to clostridium difficile in hamsters.hamsters treated with vancomycin developed enterocolitis significantly more often in a conventional animal room than in a room designed to prevent cross-infection with clostridium difficile. in the conventional room c. difficile was isolated from cages, food racks, floors, buckets, the hands of caretakers, and the stools of animals with enterocolitis but not from untreated hamsters, air, or food from freshly opened bags. c. difficile was not isolated from environmental sources in the clean room. ...19817217712
recurrent pseudomembranous colitis unassociated with prior antibiotic therapy.fulminant and recurring pseudomembranous colitis developed in an elderly woman without prior antibiotic administration within the previous year. stool culture yielded clostridium difficile, and tissue cultures showed c difficile cytotoxin. treatment with vancomycin hydrochloride was initially successful, but a serious relapse after its discontinuation necessitated low-dose long-term prophylaxis. clostridium difficile may be responsible for pseudomembranous colitis unassociated with antibiotic th ...19817224749
arthritis in pseudomembranous colitis associated with an antibody to clostridium difficile toxin. 19807230227
pseudomembranous colitis with sparing of transplanted colon.there is strong evidence that pseudomembranous colitis (pmc) is caused by the toxin of clostridium difficile. a case of pmc which occurred in a patient who underwent colon interposition for a benign oesophageal stricture is presented, which had all the features of a florid pmc, but the changes were confined to the normally sited colon, and did not occur in the interposed loop. no similar case report could be found in the literature. this case is in accord with the view that pmc is produced by th ...19817231256
antimicrobial agent-associated colitis and diarrhea.although antimicrobial agent-associated colitis has been recognized as a clinicopathologic entity for years, the cause of this disease has been determined only recently. virtually all cases of pseudomembranous colitis and some cases of antimicrobial agent-associated nonspecific colitis or diarrhea have been shown to be caused by a toxin of clostridium difficile. methods for cultivating c difficile from feces and for detecting the toxin have been developed. oral administration of vancomycin has p ...19807233892
clostridium difficile: a new enteric pathogen. 19807233895
isolation rates and toxigenic potential of clostridium difficile isolates from various patient populations.stool specimens in various patient populations were examined to determine isolation rates of clostridium difficile and the frequency with which this organism produces a cytopathic toxin in vitro. clostridium difficile was isolated from 13 of 45 healthy neonates who had never received antimicrobials and the cytotoxin was detected in 12. with 23 healthy children aged 4 to 24 mo the organism was recovered from 2 children and the cytotoxin was detected in 1. neither the organism nor the cytotoxin wa ...19817239125
antitoxin production in antibiotic-associated colitis?the production of antitoxin after clostridium difficile-induced diarrhoea has not been reported previously. the stool of a patient with prolonged antibiotic-associated diarrhoea contained c. difficile toxin, and the serum neutralised the cytopathic effect of c. difficile toxin in tissue culture.19817240430
clostridium difficile antitoxin neutralization of cecal toxin(s) from guinea pigs with penicillin-associated colitis. 19817242013
antibiotic-associated pseudomembranous colitis in children.ten cases of antibiotic-associated pseudomembranous colitis in children are reviewed. the ages ranged from 4 years to 17 years; the most frequently implicated antimicrobial agents were penicillins in six children and clindamycin in two. stool assays showed specimens from all ten patients yielded a cytopathic toxin which was neutralized by clostridium sordellii antitoxin with titers ranging from 1:40 to 1:40,000. bacterial cultures of nine specimens uniformly yielded clostridium difficile with a ...19817243476
recovery of clostridium difficile from children.the occurrence of clostridium difficile in faecal specimens of 218 children, aged 2 weeks to 15 years, was studied. the organism was recovered from 43 (20%) of the children (range 2 weeks to 10 years). the isolation frequency was significantly correlated to age. thus, in children 1 to 8 months of age the organism occurred in 64%, while in children below and above that age c. difficile could only be recovered in 4%. no significant difference in the recovery frequency could be demonstrated between ...19817244558
the biological and clinical significance of clostridium difficile. 19817249664
aetiology of acute diarrhoea in adults.we have studied 73 adults with acute diarrhoea and identified a micro-organism or toxin likely to be the cause in 58%. in addition to routinely cultured bacteria, campylobacter coli/jejuni and clostridium difficile were important pathogens in the community. patients who developed diarrhoea after antibiotic use had a distinctive clinical syndrome and comprised the third largest group of cases. clinical, epidemiological, and histological features in an additional group with negative cultures and n ...19817250751
faecal toxin and severity of antibiotic-associated pseudomembranous colitis.the relationship between faecal toxin titre, histological evidence of pseudomembrane in the rectum, and severity of antibiotic-associated colitis has been analysed from data on 62 patients whose faeces contained clostridium difficile toxin. there was a significant correlation between a toxin titre of 6400 or more and the presence of pseudomembrane (p less than 005). there was no correlation between toxin titre, duration of diarrhoea, total white cell count, temperature, serum albumin or serum or ...19817251895
antimicrobial agents implicated in clostridium difficile toxin-associated diarrhea of colitis.records were reviewed for 329 patients who had antibiotic-associated diarrhea or colitis with stools showing a cytopathic toxin which is neutralized by clostridium sordellii antitoxin. previous studies indicate that the detection of this toxin implicate clostridium difficile as the responsible pathogen. a spectrum of anatomical results in the colonic mucosa were found ranging from pseudomembranous colitis in 136 patients to an entirely normal endoscopic condition in 36 patients. the most frequen ...19817253364
isolation of clostridium difficile from the feces and the antibody in sera of young and elderly adults.attempts were made to isolate clostridium difficile from a total of 431 fecal specimens from 149 young and 213 elderly healthy adults, and 69 elderly adults with cerebrovascular disease but no gastrointestinal disease. c difficile was isolated from 49 specimens, and the frequency of isolation was 15.4% in healthy young adults, 7.0% in healthy elderly adults, and 15.9% in elderly adults with cerebrovascular disease. thirty-four (about 70%) of the 49 c. difficile strains isolated produced cytotoxi ...19817253967
presence of clostridium difficile toxin in guinea pigs with penicillin-associated colitis.cecal filtrates from guinea pigs treated with penicillin contained a toxin which produced cytotoxic changes in hela cell cultures and was lethal to guinea pigs when administered intracecally. the cytotoxicity could be neutralized by clostridium difficile and c. sordellii antitoxins, but not by other clostridial antitoxins. rabbit immunization with toxic cecal extracts produced antibody which neutralized the cytotoxicity of guinea pig cecal extracts, of stool extracts from humans with antibiotic- ...19817254132
survival after necrotizing enterocolitis of leukemia treated with oral vancomycin.a 56-yr-old female with chronic lymphocytic leukemia developed hemolytic anemia and thrombocytopenia. prednisone therapy was instituted, but her disease was further complicated by the development of necrotizing enterocolitis. no specific enteropathogens were identified, and the stools were consistently negative for clostridium difficile toxin. treatment with vancomycin was instituted and resulted in complete recovery. in view of the high mortality and poor results of treatment in necrotizing ent ...19817262524
relative frequency of clostridium difficile in patients with diarrheal disease.we have studied 161 patients with diarrheal disease to determine the frequency with which clostridium difficile occurs in such patients. c. difficile or its toxin or both were detected in stools from 19 patients (11.9%), 17 of whom had previously received antimicrobial agents. enteric pathogens other than c. difficile were recovered less frequently, with salmonella sp., giardia lamblia, and campylobacter fetus being recovered from 4.1, 2.5, and 1.3%, respectively, of the patients studied. these ...19817263852
role of clostridium difficile in ulcerative colitis. 19817270555
transferable tetracycline resistance in clostridium difficile.the transfer of tetracycline resistance among strains of clostridium difficile is described. transfer occurred by a conjugation-like event that was insensitive to deoxyribonuclease, could not be mediated by donor culture filtrates or chloroform-treated donor cultures, and required cell-to-cell contact. tetracycline-resistant progeny recovered from matings displayed a resistance phenotype identical to that of the donor in level of resistance, constitutive expression, and transmissibility. althoug ...19817271279
[isolation of clostridium difficile toxin from the feces of a patient with ulcerative colitis (author's transl)]. 19817277815
clostridium difficile toxin. 19817280010
clostridium difficile associated with pseudomembranous colitis. occurrence in a 12-week-old infant without prior antibiotic therapy.in a previously healthy 12-week-old male infant with a two-week history of poor feeding, colic, and bloody stools, pseudomembranous colitis developed. no prior antibiotics were administered although the child had received dicyclomine hydrochloride. clostridium difficile and its toxin were detected in the child's stool. severe disseminated intravascular coagulopathy developed; the patient required total colectomy but eventually recovered. clostridium difficile colonization has not, to our knowled ...19817282658
detection of clostridium difficile toxin by counterimmunoelectrophoresis: a note of caution.recent methods for detection of clostridium difficile toxin by counterimmunoelectrophoresis might lead to errors. false-positives may be attributable to soluble cell surface antigens reacting with impure antitoxin.19817287891
pseudomembranous enterocolitis and the aetiological role of clostridium difficile. an overview of the recent literature. 19817292202
nonantibiotic-associated enterocolitis caused by clostridium difficile in an infant. 19817299553
occurrence of toxin-producing clostridium difficile in antibiotic-associated diarrhea in sweden.from 1324 patients with antibiotic-associated diarrhea (aad) 1643 stool samples were analyzed by a cell test for clostridium difficile toxin in stool filtrates and cultivation for occurrence of c. difficile strains. in patients with no detectable toxin in their stool strains of c. difficile were isolated in 2.2% whereas when toxin was detectable, the isolation rate varied from 17% to 36%. furthermore, there was a correlation between toxin titre in stool filtrate and production of cytotoxin in vi ...19817300801
treatment of clostridium difficile colitis and diarrhea with vancomycin.toxigenic clostridium difficle is the major cause of antibiotic-associated colitis and is susceptible to vancomycin at fecal concentrations achieved with oral therapy. the effect of oral vancomycin was studied in 16 patients with c. difficile-related diarrhea or colitis, 12 of whom had colitis documented by endoscopy, biopsy, and/or barium enema. four patients had antibiotic-associated diarrhea and possibly antibiotic-associated colitis, because sigmoidoscopy either showed normal results (two pa ...19817304654
suppression of clostridium difficile by normal hamster cecal flora and prevention of antibiotic-associated cecitis.administration of normal cecal homogenates decreased numbers of viable clostridium difficile and prevented cecitis in antibiotic-challenged hamsters. cecal anaerobes appeared to suppress c. difficile.19817309245
agglutination, toxigenicity and sorbitol fermentation of clostridium difficile.a total of 79 clostridium difficile strains from different sources (50 strains from the fecal specimens of healthy adults, 13 from patients receiving antibiotics without gastrointestinal complications, 13 from antibiotic-associated pseudomembranous colitis (pmc) or diarrhea patients, and three strains from atcc) were investigated for agglutinability, using formol-treated cells as antigen, in relation to toxigenicity. c. difficile strains tested were divided into four serovars, i, ii, iii, and iv ...19817311886
[the role of clostridium difficile in diarrhea appearing after antibiotic treatment: a study of 87 cases]. 19817315125
[the absorption, excretion and influence on bowel flora of oral paromomycin sulfate (author's transl)].the absorption, excretion and influence on bowel flora of oral paromomycin sulfate (aminosidine, prm) were studied in ten normal volunteers taking a normal diet, and the following results were obtained. 1. serum levels of prm were observed 0.46 micrograms/ml at a half hour, 1.14 micrograms/ml at 1 hour, 1.48 micrograms/ml at 2 hours, 0.70 micrograms/ml at 4 hours, 0.29 micrograms at 6 hours and were almost faded out at 12 hours after 4 grams of oral administration. 2. during 0 approximately 2 ho ...19817321186
[clostridium difficile colitis without previous antibiotic therapy]. 19817321698
comparative in vitro activity of new beta-lactam antibiotics against anaerobic bacteria.several new beta-lactam antimicrobial agents have been introduced in the last few years. in this investigation, the in vitro activities of several recently introduced cephalosporins (cefoperazone, cefotaxime, ceftazidime, and ceftizoxime), moxalactam, and n-formimidoyl thienamycin were compared with those of cefoxitin, clindamycin, and metronidazole against 203 strains of anaerobic bacteria. at achievable serum levels, all of the antimicrobial agents were active against essentially 100% of the s ...19817325628
clostridium difficile colitis in a rabbit following antibiotic therapy for pasteurellosis. 19817332710
comparison of two toxins produced by clostridium difficile.clostridium difficile was shown to produce a toxin which could be biochemically separated from the previously described cytotoxin of the same organism. the two proteins differ in biological activity and physical properties. antiserum prepared to the second toxin does not neutralize the biological activity of the cytotoxin, and immunological cross-reactivity could not be demonstrated. however, some relationship may exist between the two toxins, since the newly described toxin degrades on polyacry ...19817333662
clostridium difficile--a toxigenic pathogen. 19817334919
clostridium difficile isolated from a goat. 19817336534
[clostridium difficile in antibiotics induced colitis (author's transl)]. 19817342624
cephalosporin-associated colitis and clostridium difficile.a case of cephalosporin-associated colitis occurred in which a tissue-cultured morphologic-altering activity was demonstrated in the patient's feces during the active episode. neutralization of the tissue culture activity by antiserum directed against a partially purified toxin of clostridium difficile provided a more suggestive link between the colitis and this clostridial species.19807362397
binding of clostridium difficile cytotoxin and vancomycin by anion-exchange resins.cholestyramine and colestipol were tested for binding of clostridium difficile cytotoxin with use of batch absorption and column chromatography. the toxin was bound by both resins and could not be eluted from cholestyramine with either an ionic of a ph gradient. vancomycin bound to cholestyramine more strongly than to colestipol. cholestyramine and vancomycin were also tested for therapeutic efficacy in the hamster model of clindamycin-induced cecitis. both compounds delayed death and reduced le ...19807365273
bacitracin treatment of antibiotic-associated colitis and diarrhea caused by clostridium difficile toxin.four cases of antibiotic-associated colitis and diarrhea caused by clostridium difficile were successfully treated with oral bacitracin, 25,000 units four times daily for 7-10 days. diarrhea resolved in all of the cases, in 2 days, with disappearance of clostridium difficile toxin in the stools in 3 out of 4 patients so measured. two of the patients treated had relapses after vancomycin, while the other 2 were experiencing the first episodes. one patient relapsed after bacitracin treatment, but ...19807372074
isolation of toxin producing clostridium difficile from two children with oxacillin- and dicloxacillin-associated diarrhea.clostridium difficile was isolated from the feces of two infants who had developed watery diarrhea with blood-tinged stain. one child suffered from diarrhea after five days of parenteral oxacillin therapy; the diarrhea subsided within three days of cessation of therapy. the other infant developed diarrhea following four days of oral dicloxacillin; the diarrhea subsided within two days of cessation of therapy. c difficile was no longer detectable in the stools of the infants at that time. tissue ...19807375240
clostridium difficile in gnotobiotic mice.germfree mice associated with clostridium difficile developed intestinal disease characterized by polymorphonuclear cell infiltration of the lamina propria, diarrhea, and cecal cytotoxin concentrations positive at a 10(-6) dilution. the numbers of viable bacteria never exceeded 10(10) colony-forming units per g (dry weight). despite the high toxin levels and chronic inflammation over a 30-day period, the mortality rate was low (less than 2%). daily treatment of these animals with two oral doses ...19807380566
identification of toxigenic clostridium difficile by counterimmunoelectrophoresis.a counterimmunoelectrophoresis (cie) technique which reacted positively with culture filtrates of clostridium difficile was developed and compared with a cytotoxicity assay in human embryonic lung cell cultures. cie, employing c. sordellii antitoxin, detected 17 of 17 c. difficile strains. of those positive by cie, 13 were cytotoxic in cell culture. fourteen clostridium species other than c. difficile, c. sordellii, and c. bifermentans were negative by cie. c. sordellii and c. bifermentans gave ...19807381011
treatment of antibiotic-associated clostridium difficile diarrhea with oral vancomycin. 19807381635
clostridium difficile isolated from the stool of a patient with pseudomembranous colits following ampicillin plus flucloxacillin (magnapen) therapy.a case is reported of the isolation of clostridium difficile from the stool of a patient with antibiotic-related pseudomembranous colitis.19807383956
colitis associated with metronidazole therapy.a 46-year-old woman was treated with oral metronidazole for trichomonal vaginitis and developed diarrhea, which persisted for five weeks. tissue culture assay of stool supernatant showed a cytopathic toxin that was neutralized by clostridium sordellii antitoxin, and cultures yielded clostridium difficile, which produced a similar or identical cytotoxin in vitro. this isolate proved sensitive to metronidazole at 0.25 microgram/ml. prior reports have indicated that metronidazole may also be used t ...19807391617
relapse of antibiotic-associated colitis after vancomycin therapy.antibiotic-associated colitis, although occasionally fatal, is a disease which is considered to be self-limiting and non-recurring. recently, specific treatment with oral vancomycin directed at the trigger organism, clostridium difficile, has been shown to be effective. a case in which antibiotic-associated colitis was treated with vancomycin and subsequently recurred is described. the fact that such relapse can occur indicates that further evaluation of the efficacy of vancomycin is required.19807393060
in vitro susceptibility of clostridium difficile isolates from patients with antibiotic-associated diarrhea or colitis.in vitro susceptibility tests were performed on 84 strains of clostridium difficile to 11 antimicrobial agents. all isolates were from the stools of patients with antibiotic-associated diarrhea or colitis in which there was a cytopathic toxin that was neutralized by clostridium sordellii antitoxin. over 95% of the strains were susceptible to vancomycin, penicillin g, ampicillin, and metronidazole at concentrations of 4 microgram/ml. susceptibility to clindamycin was variable; 60% of the strains ...19807396460
production of clostridium difficile antitoxin.we have produced antitoxin to the toxin of clostridium difficile in rabbits and in goats. antitoxin dilutions of 1/8,000 and 1/5,120 were capable of neutralizing lethal doses of the toxin in mice and in tissue culture, respectively.19807399686
role of clostridium difficile in a case of nonantibiotic-associated pseudomembranous colitis.a 57-yr-old woman with chronic diarrhea, mild azotemia, and red cell casts in her urine was found to have pseudomembranous colitis. she had not received antimicrobial agents for at least 2 yr. membranoproliferative glomerulonephritis was found in kidney biopsy, and her renal function improved spontaneously. pseudomembranous colitis was diagnosed by endoscopic biopsy. her stool contained a cytophatic toxin that was neutralized by clostridium sordellii antitoxin, and clostridium difficile was cult ...19807419019
vancomycin therapy for clostridium difficile. 19807421667
vancomycin therapy clostridium difficile. 19807421668
antimicrobial susceptibilities of clostridium difficile.the antimicrobial susceptibilities of 78 strains of clostridium difficile isolated from patients with and without gastrointestinal symptoms were determined and compared. strains from patients with symptoms were more likely to show resistance to antibiotics. the antimicrobial susceptibilities of toxigenic and non-toxigenic strains were found to be similar.19807430354
clinical and laboratory observations in clostridium difficile colitis. 19807435423
studies on the epidemiology of antibiotic-associated clostridium difficile colitis.vancomycin protects hamsters from the development of clostridium difficile colitis after treatment with clindamycin, and vancomycin is useful in treatment of humans with the disease. relapses have occurred in both hamsters and humans when vancomycin is discontinued. vancomycin appears to enhance susceptibility to colonization with c. difficile by eliminating competing intestinal organisms. the nature of these organisms is not known, but various tools are now available to aid in identifying them. ...19807435424
epidemiological aspects of clostridium difficile-induced diarrhea and colitis.clostridium difficile has been shown to be a cause of antimicrobial agent-associated diarrhea and colitis. the source from which this organism gains access to the gastrointestinal tract is not known. cultures of the hospital environments of six of eight patients whose fecal cultures were positive for c. difficile yielded this organism, whereas cultures of control hospital sites were almost invariably negative. these data suggest that hospital environmental contamination may be a potential source ...19807435425
epidemiology of experimental enterocecitis due to clostridium difficile.hamsters can survive a course of clindamycin if they are held in a protected environment. inoculation of clostridium difficile regularly results in fatal enterocecitis in such animals but is without effect in untreated animals. these findings suggest that in the development of enterocecitis, clindamycin treatment and infection with c. difficile are separate events, and they imply that hamsters usually acquire c. difficile from environmental sources. environments appear to differ in the risk of e ...19807441010
[antibiotic-related colitis and clostridium difficile]. 19807445210
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