Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| leukocyte-endothelial cell interactions: molecular mechanisms and implications in gastrointestinal disease. | leukocyte-endothelial cell adhesion is now recognized to represent an early and rate-limiting step in the leukocyte infiltration and accompanying tissue injury that is associated with acute and chronic inflammatory diseases of the gastrointestinal tract. adhesive interactions such as leukocyte rolling, adherence, and transendothelial migration are influenced by a variety of physical, chemical, and molecular factors that ultimately result in a net up-regulation or down-regulation of the inflammat ... | 1998 | 9558298 |
| metronidazole may inhibit intestinal colonization with clostridium difficile. | antibiotics suppress normal gut flora, allowing overgrowth of acquired or native clostridium difficile, with release of toxins that cause mucosal inflammation. oral metronidazole is used to treat antibiotic-associated colitis (pseudomembranous colitis). this study was designed to determine whether oral metronidazole, as part of preoperative bowel preparation, prevents or decreases incidence of antibiotic-associated colitis after elective colonic and rectal procedures. | 1998 | 9559631 |
| nosocomial diarrhea. | nosocomial diarrheas are an important problem in hospitals, and in critical care units in particular. hospital-acquired diarrhea may be on an infectious or noninfectious basis. common noninfectious causes of nosocomial diarrhea include medication-induced changes in the fecal flora or changes secondary to enteral hyperalimenation. infectious causes of nosocomial diarrhea are due to enteric pathogens in outbreak situations and virtually all of the causes are due to clostridium difficile. c. diffic ... | 1998 | 9561820 |
| risk factors for early recurrent clostridium difficile-associated diarrhea. | recurrence is a common sequela of clostridium difficile-associated diarrhea (cdd) and may increase morbidity, costs, and treatment-related antimicrobial resistance. because recurrent cdd (rcdd) frequently occurs very soon after an initial episode, our goal was to determine the risk factors for early rcdd (occurring < or = 45 days after the initial episode). we conducted a case-control study, comparing 13 patients with early rcdd (case patients) with 46 patients who had only one cdd episode (cont ... | 1998 | 9564482 |
| molecular analysis of the promoter region of the clostridium difficile toxin b gene that is functional in escherichia coli. | clostridium difficile is a human pathogen that produces two types of toxins, a and b, that cause a potentially lethal gastrointestinal syndrome termed pseudomembranous colitis. virtually nothing is known about the mechanism of regulation of toxin production in this organism, and cis-regulatory regions of neither toxin have yet been identified, thus prompting this investigation. a motif homologous with the shine-dalgarno sequence of escherichia coli occurs upstream from the putative initiation co ... | 1998 | 9568996 |
| the lack of therapeutic effect of saccharomyces boulardii in the prevention of antibiotic-related diarrhoea in elderly patients. | diarrhoea is a common side effect of antibiotic therapy, especially in the elderly. saccharomyces boulardii is a non-pathogenic yeast which has been demonstrated to reduce the frequency of diarrhoea in patients due to a variety of causes. we set out to assess its role in preventing antibiotic-related diarrhoea. consecutive patients over the age of 65 admitted to medical wards, and who were being prescribed antibiotics, were randomized to receive either s. boulardii 113 g twice daily or placebo f ... | 1998 | 9570649 |
| nonspecific binding of clostridium difficile toxin a to murine immunoglobulins occurs via the fab component. | clostridium difficile toxin a binds nonspecifically to a mouse monoclonal antibody (mab) immunoglobulin g3 lambda chain [igg3(lambda)], through the fab component. this binding, which is retained even after boiling the mab, is temperature dependent, with more toxin bound at 4 than 37 degrees c (p = 0.0024). the nonspecific binding was decreased by incubation of the igg3 lambda mab with alpha- or beta-galactosidase (p = 0.0001 and 0.029, respectively), indicating that toxin a binds to a carbohydra ... | 1998 | 9573079 |
| antibodies to recombinant clostridium difficile toxins a and b are an effective treatment and prevent relapse of c. difficile-associated disease in a hamster model of infection. | clostridium difficile causes antibiotic-associated diarrhea and colitis in humans through the actions of toxin a and toxin b on the colonic mucosa. at present, broad-spectrum antibiotic drugs are used to treat this disease, and patients suffer from high relapse rates after termination of treatment. this study examined the role of both toxins in pathogenesis and the ability of orally administered avian antibodies against recombinant epitopes of toxin a and toxin b to treat c. difficile-associated ... | 1998 | 9573084 |
| [diarrhea associated with clostridium difficile]. | 1998 | 9580506 | |
| gtpgammas-induced actin polymerisation in vitro: atp- and phosphoinositide-independent signalling via rho-family proteins and a plasma membrane-associated guanine nucleotide exchange factor. | in a cell-free system from neutrophil cytosol gtp(&ggr ;)s can induce an increase in the number of free filament barbed ends and massive actin polymerisation and cross-linking. gtp(&ggr ;)s stimulation was susceptible to an excess of gdp, but not bordetella pertussis toxin and could not be mimicked by aluminium fluoride, myristoylated gtpgammas.gialpha2 or gbeta1gamma2 subunits of trimeric g proteins. in contrast, rhogdi and clostridium difficile toxin b (inactivating rho family proteins) comple ... | 1998 | 9580566 |
| [outbreak of nosocomial diarrhea by clostridium difficile in a department of internal medicine]. | clostridium difficile (dcd) is the main etiologic agent of nosocomial diarrhea of infectious origin. most of the cases of dcd have been detected in a hospital environment. | 1998 | 9586362 |
| clinical quiz. diffuse pseudomembranous colitis. | 1998 | 9586762 | |
| a valid and reliable tool to quantify stool output in tube-fed patients. | a major problem in determining whether diarrhea exists in tube-fed patients is the quantification of stool output. on the basis of this need a stool output assessment tool was developed and tested for validity and reliability. interrater reliability and construct validity were determined by using staff nurses' and principal investigators' observations. observers blindly rated the bowel movement (bm) on size and consistency and on whether the bm was thought to represent "diarrhea." interrater rel ... | 1998 | 9586792 |
| [value of rectosigmoidoscopy with bacteriological culture of colonic biopsies in the diagnosis of post-antibiotic hemorrhagic colitis related to klebsiella oxytoca]. | we report 7 cases of antibiotic-associated and hemorrhagic colitis due to klebsiella oxytoca. the diagnosis was performed by sigmoidoscopy with bacteriological biopsy culture. | 1997 | 9587518 |
| rho protein inhibition blocks protein kinase c translocation and activation. | small gtp-binding proteins of the ras and rho family participate in various important signalling pathways. large clostridial cytotoxins inactivate gtpases by udp-glucosylation. using clostridium difficile toxin b-10463 (tcdb) for inactivation of rho proteins (rhoa/rac/cdc42) and clostridium sordellii lethal toxin-1522 (tcsl) for inactivation of ras-proteins (ras/rac/ral, rap) the role of these gtpases in protein kinase c (pkc) stimulation was studied. phorbol-myristate-acetate (pma) induced a ra ... | 1998 | 9588200 |
| clostridium difficile toxin b induces apoptosis in intestinal cultured cells. | toxigenic strains of the anaerobic bacterium clostridium difficile produce at least two large, single-chain protein exotoxins involved in the pathogenesis of antibiotic-associated diarrhea and colitis. toxin a (cda) is a cytotoxic enterotoxin, while toxin b (cdb) is a more potent cytotoxin lacking enterotoxic activity. this study dealt with cdb, providing the first evidence that intestinal cells exposed to this toxin exhibit typical features of apoptosis in that a significant proportion of the t ... | 1998 | 9596731 |
| effects of toxin a from clostridium difficile on mast cell activation and survival. | toxins a and b from clostridium difficile are the main cause of antibiotic-associated diarrhea and pseudomembranous colitis. they cause fluid accumulation, necrosis, and a strong inflammatory response when inoculated in intestinal loops. since mast cells are a rich source of inflammatory mediators, abundant in the gut, and known to be involved in c. difficile-induced enteritis, we studied the in vitro effect of toxin a on isolated mast cells. normal rats sensitized by infection with nippostrongi ... | 1998 | 9596744 |
| clostridium difficile--associated diarrhea. | 1998 | 9597221 | |
| clostridium difficile colitis: a possible cause of unexplained elevation of serum alkaline phosphatase levels in patients with aids. | 1998 | 9597276 | |
| recent trends in diagnosis and treatment of clostridium difficile in a tertiary care facility. | with the prevalence of antibiotic use, the diagnosis and management of clostridium difficile disease requires assessment. | 1998 | 9600288 |
| determination and validation of a predictive model for clostridium difficile diarrhea in hospitalized oncology patients. | clostridium difficile colitis in the cancer patient receiving chemotherapy is a frequent cause of morbidity which may prolong hospitalization. techniques for identifying infection often delay the initiation of therapy. | 1998 | 9602265 |
| hospital-acquired infection in elderly patients. | increasing numbers of elderly people are being treated in hospitals and are at particular risk of acquiring infections. the incidence, risk factors and types of hospital-acquired infection (hai) in the elderly are reviewed. special reference is made to urinary tract infections, respiratory tract infections, gastrointestinal infections including clostridium difficile, bacteraemia, skin and soft tissue infections and infections with antibiotic-resistant organisms. | 1998 | 9602974 |
| inhibition of insulin-stimulated glucose transport in 3t3-l1 cells by clostridium difficile toxin b, clostridium sordellii lethal toxin, and clostridium botulinum c2 toxin. | the role of the actin cytoskeleton and/or gtpases of the rho/rac-family in glucose transport regulation was investigated in 3t3-l1 cells with clostridial toxins which depolymerize actin by inactivation of rho/rac (clostridium difficile toxin b and clostiridium sordellii lethal toxin (lt)) or by direct adp-ribosylation (clostridium botulinum c2 toxin). toxin b and c2 reduced insulin-stimulated, but not basal, 2-deoxyglucose (2-dog) uptake rates in 3t3-l1 fibroblasts. in parallel, the toxins produ ... | 1998 | 9606023 |
| antibiotic associated diarrhoea and enterocolitis. | c. difficile is the major aetiological agent of aad and pmc and results from overgrowth of c. difficile already present endogenously or of newly acquired exogenous organisms after suppression of competing gut flora. c. difficile produces two kinds of toxins a and b. these toxins attack the colonic mucosa which becomes necrotic with the formation in fulminating cases of an exudative pseudomembrane. toxigenic and non-toxigenic strains of c. difficile may be present together in an individual suffer ... | 1997 | 9612093 |
| an update on clostridium difficile infection. | 1997 | 9612094 | |
| reduction in vancomycin-resistant enterococcus and clostridium difficile infections following change to tympanic thermometers. | to contain a nosocomial outbreak of vancomycin-resistant enterococcus (vre). | 1998 | 9613694 |
| inhibition of rho is required for camp-induced melanoma cell differentiation. | up-regulation of the camp pathway by forskolin or alpha-melanocyte stimulating hormone induces melanocyte and melanoma cell differentiation characterized by stimulation of melanin synthesis and dendrite development. here we show that forskolin-induced dendricity is associated to a disassembly of actin stress fibers. since rho controls actin organization, we studied the role of this guanosine triphosphate (gtp)-binding protein in camp-induced dendrite formation. clostridium botulinum c3 exotransf ... | 1998 | 9614180 |
| increased incidence of clostridium difficile infection. | 1998 | 9617691 | |
| detection of bacteroides fragilis enterotoxin gene by pcr. | bacteroides fragilis constitutes about 1% of the bacterial flora in intestines of normal humans. enterotoxigenic strains of b. fragilis have been associated with diarrheal diseases in humans and animals. the enterotoxin produced by these isolates induces fluid changes in ligated intestinal loops and an in vitro cytotoxic response in ht-29 cells. we developed a nested pcr to detect the enterotoxin gene of b. fragilis in stool specimens. after dna extraction, a 367-bp fragment was amplified with t ... | 1998 | 9620408 |
| [clostridium difficile-associated diarrhea treated with homologous feces]. | 1998 | 9621767 | |
| community-acquired clostridium difficile-associated diarrhoea in a patient with colonic carcinoma. | in the vast majority of cases, clostridium difficile-associated diarrhoea and pseudomembranous colitis develop following the use of antibiotics. we report a case in which c. difficile-associated diarrhoea was diagnosed in the absence of previously reported predisposing factors. it transpired that the patient had a colonic carcinoma. we suggest that a diagnosis of c. difficile-associated diarrhoea in the absence of a history of antibiotics or other established causes should prompt a colonoscopy t ... | 1998 | 9624800 |
| the cause of diarrhea in hospitalized patients. | 1998 | 9625156 | |
| hospital-wide restriction of clindamycin: effect on the incidence of clostridium difficile-associated diarrhea and cost. | widespread antibiotic use has been associated with increases in both bacterial resistance and nosocomial infection. | 1998 | 9625685 |
| clostridium difficile colitis associated with a 'triple' regimen, containing clarithromycin and metronidazole, to eradicate helicobacter pylori. | we describe a 54-year-old man with helicobacter pylori (+) duodenal ulcer who developed clostridium difficile associated colitis, 5 days after commencing a 'triple' regimen consisting of omeprazole 20 mg b.d., metronidazole 500 mg b.d. and clarithromycin 500 mg b.d., to eradicate h. pylori. despite the fact that oral metronidazole did not prevent the disease, the patient did well after treatment with oral metronidazole plus a yeast preparation (saccharomyces bulardii). no relapse occurred. | 1998 | 9627163 |
| differentiating ischemic colitis from other colitides. | 1998 | 9630187 | |
| clostridium difficile--setting the scene. | 1998 | 9630368 | |
| clinical impact and associated costs of clostridium difficile-associated disease. | toxin-producing clostridium difficile is the commonest cause of nosocomial diarrhoea and, as such, poses a major problem in our hospitals. the main population susceptible to disease is the elderly, for reasons that remain unclear. by contrast, carriage rates in neonates are high, but disease is low. the organism also has a major clinical impact in the immunosuppressed host, patients undergoing surgery (especially gastrointestinal) and those with severe underlying disease and longer hospital stay ... | 1998 | 9630369 |
| pathogenesis of clostridium difficile infection. | clostridium difficile produces two major toxins referred to as toxins a and b. these are thought to be primarily responsible for the virulence of the bacterium and the major contributors to the pathogenesis of antibiotic-associated gastrointestinal disease. the molecular organization and control of expression of toxins a and b is now starting to be understood, and the cellular mechanism of action of both toxins, glucosylation of rho family proteins, has been discovered. other factors, such as pr ... | 1998 | 9630370 |
| the role of antimicrobial agents in the aetiology of clostridium difficile-associated disease. | high clostridium difficile disease rates were originally associated with clindamycin use, but this association has declined in recent years following the decline in the clinical use of clindamycin, and disease is now particularly associated with the use of broad-spectrum antibiotics, especially the cephalosporins. there are now sufficient reports in the literature to merit the discontinuation of the widespread use of cephalosporins, especially in the elderly, by the substitution, wherever possib ... | 1998 | 9630371 |
| the diagnosis of clostridium difficile-associated disease. | there are well-documented risk factors associated with the development of antibiotic-associated diarrhoea; knowledge of these and of the typical signs and symptoms should alert the clinician to the possibility of clostridium difficile-associated diarrhoea (cdad). it is therefore common practice in large general hospitals for clinicians to request, and for laboratories to include, investigations for c. difficile on in-patient stool specimens to confirm a diagnosis of cdad. the laboratory methods ... | 1998 | 9630372 |
| treatment of clostridium difficile infection. | the treatment options for clostridium difficile infection remain limited, although promising agents are currently being assessed. metronidazole is the first-line drug of choice for those patients requiring specific anti-c. difficile treatment. much of the interest in alternative therapies has centred on the difficult management issues posed by patients with multiple symptomatic recurrences of c. difficile infection. however, it is now clear that the majority of these episodes are due to reinfect ... | 1998 | 9630373 |
| the epidemiology and typing of clostridium difficile. | clostridium difficile is normally a harmless environmental bacterium but, under certain circumstances, it can cause hospital outbreaks of disease. to understand the disease epidemiology, outbreaks have been investigated by many different methods. the phenotypic and genotypic approaches to typing are reviewed here and the epidemiology of c. difficile-associated disease is elucidated in light of recent information. | 1998 | 9630374 |
| infection control and prevention of clostridium difficile infection. | clostridium difficile has become a major problem as a nosocomial pathogen that is associated with the use of antibiotics. in the prevention and control of c. difficile disease it is important that programmes are directed at primary and secondary prevention. the three main elements of prevention are: (i) restricted use of antibiotics; (ii) strict enteric precautions when looking after patients with diarrhoea; and (iii) meticulous cleaning of clinical areas. although poor handwashing is known to p ... | 1998 | 9630375 |
| clostridium difficile infections of the gut: the unanswered questions. | 1998 | 9630376 | |
| clostridium difficile infection: appendix. | 1998 | 9630377 | |
| clostridium difficile toxins a and b are cation-dependent udp-glucose hydrolases with differing catalytic activities. | toxins a and b of clostridium difficile are udp-glucose glucosyltransferases that exert their cellular toxicity primarily through their abilities to monoglucosylate, and thereby inactivate, rho family small gtpases. toxin a also hydrolyzes udp-glucose, although this activity is not well characterized. in this study, we measured the kinetics of udp-glucose hydrolysis by toxins a and b and found significant differences in the catalytic activities of these two structurally homologous toxins. the to ... | 1998 | 9632652 |
| case records of the massachusetts general hospital. weekly clinicopathological exercises. case 19-1998. a 70-year-old man with diarrhea, polyarthritis, and a history of reiter's syndrome. | 1998 | 9634361 | |
| clostridium difficile toxin a stimulates macrophage-inflammatory protein-2 production in rat intestinal epithelial cells. | neutrophil infiltration of the colonic mucosa is a hallmark of clostridium difficile toxin a-mediated enterocolitis. macrophage-inflammatory protein-2 (mip-2) is a potent neutrophil chemoattractant secreted by rat macrophages and epithelial cells in response to inflammatory stimuli. in this work, we report that administration of toxin a into rat ileal loops increased mucosal levels of mip-2 before the onset of fluid secretion and mucosal neutrophil infiltration. administration of rabbit anti-mip ... | 1998 | 9637520 |
| effect of isoleucine on toxin production by clostridium difficile in a defined medium. | supplementation of a carbohydrate-free minimal medium with a high level (100 mm) of histidine, methionine, valine, isoleucine, proline and leucine, in particular isoleucine, markedly increased toxin production by clostridium difficile vpi 10463. the effect of isoleucine was further examined. increasing the concentration of isoleucine from 20 to 100 mm remarkably increased toxin production, while bacterial growth decreased gradually. amino acid analysis of the culture revealed that, at 100 mm iso ... | 1998 | 9638867 |
| genetic rearrangements in the pathogenicity locus of clostridium difficile strain 8864--implications for transcription, expression and enzymatic activity of toxins a and b. | the pathogenicity locus (paloc) of clostridium difficile isolate 8864 was investigated to locate genetic rearrangements that would explain the exceptional pathogenicity of this particular isolate. two major changes were defined: an insertion of 1.1 kb between the two genes tcda and tcde, coding for the enterotoxin and an accessory protein of unknown function, respectively, and a deletion of 5.9 kb encompassing the 3' ends of tcda and tcdc. transcription of the tcda-e genes is severely affected b ... | 1998 | 9645428 |
| acceptor hydroxyl group mapping for calf thymus alpha-(1-->3)-galactosyltransferase and enzymatic synthesis of alpha-d-galp-(1-->3)-beta-d-galp-(1-->4)-beta d-glcpnac analogs. | the epitope of the acceptor substrate for alpha-(1-->3)-galactosyltransferase from calf thymus has been mapped by using a series of mono-deoxygenated and mono-o-alkylated type ii (beta-d-ga1p-(1-->4)-beta-d-g1cpnac) disaccharides. the 4-oh group of the beta-d-galactopyranosyl residue is a key polar group essential for glycosyl transfer, tolerating neither deoxygenation nor o-alkylation. substitution at positions 6 and 6' by a variety of polar alkyl substituents was readily tolerated, allowing th ... | 1997 | 9648265 |
| isolation and characterization of two bacteriocins of lactobacillus acidophilus lf221. | lactobacillus acidophilus lf221 produced bacteriocin-like activity against different bacteria including some pathogenic and food-spoilage species. besides some lactic acid bacteria, the following species were inhibited: bacillus cereus, clostridium sp., listeria innocua, staphylococcus aureus, streptococcus d. l. acidophilus lf221 produced at least two bacteriocins, acidocin lf221 a and acidocin lf221 b, which were purified by ammonium sulphate precipitation, ion-exchange chromatography, hydroph ... | 1998 | 9650259 |
| survey of incidence of clostridium difficile infection in canadian hospitals and diagnostic approaches. | a questionnaire relating to clostridium difficile disease incidence and diagnostic practices was sent to 380 canadian hospitals (all with > 50 beds). the national questionnaire response rate was 63%. in-house testing was performed in 17.6, 61.5, and 74.2% of the hospitals with < 300, 300 to 500, and > 500 beds, respectively. the average test positivity rates were 17.2, 15.3, and 13.2% for hospitals with < 300, 300 to 500, and > 500 beds, respectively. the average disease incidences were 23.5, 30 ... | 1998 | 9650966 |
| substance p receptor expression in intestinal epithelium in clostridium difficile toxin a enteritis in rats. | we previously reported that the inflammatory effects of clostridium difficile toxin a on rat intestine can be significantly inhibited with a specific neurokinin-1 receptor (nk-1r) antagonist. in this study we investigated the localization and expression of nk-1r mrna and protein in rat intestine by in situ hybridization, northern blot analysis, and immunohistochemistry, respectively, after exposure to toxin a. northern blot analysis showed increased mucosal levels of nk-1r mrna starting 30 min a ... | 1998 | 9655686 |
| a review of the use of teicoplanin in haematological malignancy. | factors determining the change in patterns of antibiotic use in patients with haematological malignancies include the growing numbers of infections caused by gram-positive pathogens, the increasing reliance on indwelling catheters, and strategic movement away from inpatient therapy towards day-case and non-inpatient therapy. the suitability of teicoplanin in this context is examined. the indications for teicoplanin use are now established as: early use in clinically infected patients; as a secon ... | 1998 | 9658685 |
| managing c. difficile-associated diarrhea. | 1998 | 9659963 | |
| ashp therapeutic position statement on the preferential use of metronidazole for the treatment of clostridium difficile-associated disease. | ashp supports preferential use of oral metronidazole for treating cdad when antimicrobial therapy is indicated. oral vancomycin should be reserved for severe, potentially life-threatening cases or when oral metronidazole cannot be used. oral metronidazole is as safe and effective as oral vancomycin and is considerably less costly. in addition, preliminary data suggest that routine use of oral vancomycin for cdad may contribute to the spread of vre--emerging nosocomial pathogens that can be extra ... | 1998 | 9659970 |
| chloramphenicol resistance in clostridium difficile is encoded on tn4453 transposons that are closely related to tn4451 from clostridium perfringens. | the chloramphenicol resistance gene catd from clostridium difficile was shown to be encoded on the transposons tn4453a and tn4453b, which were structurally and functionally related to tn4451 from clostridium perfringens. tn4453a and tn4453b excised precisely from recombinant plasmids, generating a circular form, as is the case for tn4451. evidence that this process is mediated by tn4453-encoded tnpx genes was obtained from experiments which showed that in trans these genes complemented a tn4451t ... | 1998 | 9660983 |
| community-acquired clostridium difficile infection. | clostridium difficile-associated disease (cdad) is primarily a nosocomial condition. community-acquired disease has been reported but the incidence is felt to be low and the rate of disease resulting in hospitalization is reported as negligible. we recently experienced a 6-month outbreak of cdad (january to june 1995): 139 patients were involved and four deaths were attributable to pseudomembranous colitis. early in the outbreak period we were aware that many new admissions presented with c. dif ... | 1998 | 9661938 |
| review article: treatment of clostridium difficile infection. | a systematic review of controlled trials of therapy of clostridium difficile intestinal infection using methodology described by the cochrane collaboration. | 1997 | 9663822 |
| clostridium difficile: a pathogen of the nineties. | 1998 | 9665293 | |
| comparative in vitro activity of bay 12-8039 and five other antimicrobial agents against anaerobic bacteria. | the in vitro activity of bay 12-8039 against 360 anaerobic clinical isolates was determined by the agar dilution method and compared to that of five other antimicrobial agents. bay 12-8039 and imipenem were the most active agents tested. the following mic90 values were determined for bay 12-8039: peptostreptococcus spp. (50 isolates), 1 mg/l; propionibacterium acnes (30 isolates). 0.25 mg/l; clostridium perfringens (30 isolates), 0.5 mg/l; clostridium difficile (50 isolates), 2 mg/l; bacteroides ... | 1998 | 9665302 |
| identification of toxin a-negative, toxin b-positive clostridium difficile by pcr. | toxigenic strains of clostridium difficile have been reported to produce both toxins a and b nearly always, and nontoxigenic strains have been reported to produce neither of these toxins. recent studies indicate that it is not always true. we established a pcr assay to differentiate toxin a-negative, toxin b-positive (toxin a-, toxin b+) strains from both toxin-positive (toxin a+, toxin b+) strains and both toxin-negative (toxin a-, toxin b-) strains as an alternative to cell culture assay and e ... | 1998 | 9665986 |
| a novel toxinotyping scheme and correlation of toxinotypes with serogroups of clostridium difficile isolates. | two hundred nineteen clostridium difficile isolates from 22 serogroups were screened for changes in the genes coding for toxin b (tcdb) and toxin a (tcda). parts of the toxin genes were amplified, and the pcr fragments were checked for length polymorphisms and cut with several restriction enzymes to monitor restriction fragment length polymorphisms (rflps). for 47 strains (21%), differences in the toxin genes were found compared to the toxin genes of reference strain vpi 10,463. polymorphisms we ... | 1998 | 9665999 |
| clostridium difficile colitis associated with treatment of helicobacter pylori infection. | helicobacter pylori infection of the stomach is being detected and treated more often now than ever before. this is likely to result in an increase in complications such as antibiotic-associated diarrhea. however, there is no literature on the incidence of such diarrhea, particularly clostridium difficile colitis, in patients treated for helicobacter pylori infection. we report the case of a patient who developed clostridium difficile colitis after treatment for helicobacter pylori infection wit ... | 1998 | 9672359 |
| small gtp-binding proteins of the rho- and ras-subfamilies are not involved in the actin rearrangements induced by attaching and effacing escherichia coli. | attaching and effacing escherichia coli (aeec) are extracellular pathogens that induce the formation of actin-rich structures at their sites of attachment to eukaryotic host cells. we analysed whether small gtp-binding proteins of the rho- and ras-subfamilies, which control the cellular actin system, are essential for these bacterial-induced microfilament reorganizations. for this purpose we specifically inactivated them using the clostridium difficile toxins tcdb-10463 and tcdb-1470. such treat ... | 1998 | 9673012 |
| isolation of a clostridium exotoxin producer other than clostridium difficile from a patient with diarrhea. | 1998 | 9675699 | |
| the role of surgery in pseudomembranous enterocolitis. | pseudomembranous enterocolitis is an inflammatory bowel disorder caused by clostridium difficile toxins. classical presentation includes abdominal pain, pyrexia, diarrhoea and leucocytes. the management is mainly conservative but in extreme cases surgery is necessary. resectional procedures (colectomy) carry a better prognosis than diversion procedures (colostomy). a careful history, a high index of suspicion, and early diagnosis and treatment would reduce the associated morbidity and mortality ... | 1998 | 9683974 |
| [clostridium difficile infections. current aspects]. | clostridium difficile is a gram-positive anaerobe that forms subterminal spores. it is now one of major nosocomial pathogens, mainly in older patients, because of its ability to persist in the environment and to become established in the gastrointestinal tract once the natural microflora has been modified by antibiotic therapy. toxigenic strains of c. difficile produce toxin a (enterotoxin) or toxin b (cytotoxin) or both with cause the cytotoxic effect "rounding". c. difficile can spread from pa ... | 1998 | 9691734 |
| clostridium difficile and older adults: what primary care providers should know. | clostridium difficile poses particular risk for older adults, who are subject to more serious symptoms than younger patients. antibiotic exposure and other risk factors are associated with the pathogenesis of c. difficile-associated disease. treatment goals include prescribing anti-c. difficile activity agents (when indicated), attending to volume status and prescribing oral rehydration therapy as needed, avoiding the use of antiperistaltic drugs, discontinuing any offending antibiotics, avoidin ... | 1998 | 9695082 |
| incidence and impact of clostridium difficile infection in the uk, 1993-1996. | questionnaires were sent to 360 uk medical microbiologists to determine the incidence of clostridium difficile infection in the uk between 1993-1996, and to establish the current laboratory testing protocols. replies were received from 104 laboratories (29% response rate), 86, 7, 4 and 3% of which are in england, scotland, wales and northern ireland, respectively. the laboratories serve a total of approximately 90,000 hospital beds (median 750). c. difficile testing was performed by 83% of the l ... | 1998 | 9699137 |
| antimicrobial associations of an outbreak of diarrhoea due to clostridium difficile. | an increased incidence of diarrhoea due to clostridium difficile (cdd) at the northern general hospital, sheffield, prompted an investigation into antibiotic use on the renal, medical and geriatric wards, those mostly affected. for the first half of 1997 affected patients on these wards were identified and data collected as to which antimicrobials they had taken between admission and diagnosis. rates were then calculated of the number of affected patients on a drug over the quantity prescribed ( ... | 1998 | 9699138 |
| clostridium difficile in district general hospitals. | 1998 | 9699145 | |
| a randomized crossover study of disposable thermometers for prevention of clostridium difficile and other nosocomial infections. | to test the hypothesis that use of disposable thermometers would result in lower rates of nosocomial clostridium difficile diarrhea and of total nosocomial infections, compared with electronic thermometers. | 1998 | 9702571 |
| prevalence of astroviruses in a children's hospital. | an enzyme immunoassay for astrovirus was used to screen 357 stool samples from 267 symptomatic inpatients at a tertiary-care children's hospital. thirty stool samples from 26 patients contained astrovirus antigen, while rotavirus was found in 34 samples and clostridium difficile toxin was found in 40. half of the astrovirus infections were nosocomial. additional pathogens were identified in six of the astrovirus antigen-positive stool samples. most (80%) of the astroviruses recovered were of ser ... | 1998 | 9705394 |
| clindamycin formulary restriction lowers costs, antimicrobial resistance. | 1998 | 9706176 | |
| enterococci and vancomycin resistance. | the frequency of infections with multiply antibiotic-resistant gram-positive bacteria is increasing, and in some cases these organisms remain susceptible only to the glycopeptides vancomycin and teicoplanin. the appearance of transferable high-level glycopeptide resistance in enterococci--producing some strains that are now resistant to all available antibiotics--is thus a cause for concern. the enterococci readily colonize the bowel, spread rapidly among hospital patients, and transfer their an ... | 1998 | 9710674 |
| [pseudomembranous colitis]. | 1998 | 9711015 | |
| back to basics in management of clostridium difficile infections. | 1998 | 9716052 | |
| in vitro activity of hmr 3647 against anaerobic bacteria. | the aim of the present investigation was to determine the in vitro activity of hmr 3647 compared with other antimicrobial agents against anaerobic bacteria. the activity of hmr 3647 was determined against 342 clinical isolates of anaerobic bacteria by the agar dilution method and was compared with azithromycin, clarithromycin, roxithromycin, erythromycin, cefoxitin, imipenem, clindamycin and metronidazole. among the macrolides hmr 3647 and among the beta-lactams imipenem were the most active age ... | 1998 | 9720465 |
| the complete dna sequence and analysis of the large virulence plasmid of escherichia coli o157:h7. | the complete dna sequence of po157, the large virulence plasmid of ehec strain o157:h7 edl 933, is presented. the 92 kb f-like plasmid is composed of segments of putative virulence genes in a framework of replication and maintenance regions, with seven insertion sequence elements, located mostly at the boundaries of the virulence segments. one hundred open reading frames (orfs) were identified, of which 19 were previously sequenced potential virulence genes. forty-two orfs were sufficiently simi ... | 1998 | 9722640 |
| prolonged depletion of guanosine triphosphate induces death of insulin-secreting cells by apoptosis. | inhibitors of imp dehydrogenase, such as mycophenolic acid (mpa) and mizoribine, which deplete cellular gtp, are used clinically as immunosuppressive drugs. the prolonged effect of such agents on insulin-secreting beta-cells (hit-t15 and ins-1) was investigated. both mpa and mizoribine inhibited mitogenesis, as reflected by [3h]thymidine incorporation. cell number, dna and protein contents, and cell (metabolic) viability were decreased by about 30%, 60%, and 80% after treatment of hit cells with ... | 1998 | 9724027 |
| in vitro evidence that rabbit distal colonic muscularis mucosae has a clostridium difficile toxin a receptor. | in the rabbit ileum clostridium difficile toxin a causes inflammation and mucosal damage via a specific glycoprotein receptor that contains alpha-d-galactose. in rabbit colon toxin a also causes inflammation, and this is associated with increased myoelectric activity and eicosanoid production. the present in vitro study was undertaken to determine if a toxin a receptor on one or more layers of colonic smooth muscle could mediate the motor effects of this agent. toxin a (20-100 microg/ml) was wit ... | 1998 | 9724250 |
| tyrosine-phosphorylation-dependent and rho-protein-mediated control of cellular phosphatidylinositol 4,5-bisphosphate levels. | the polyphosphoinositide ptdins(4,5)p2, best known as a substrate for phospholipase c isozymes, has recently been recognized to be involved in a variety of other cellular processes. the aim of this study was to examine whether the cellular levels of this versatile phospholipid are controlled by tyrosine phosphorylation. the studies were performed in human embryonic kidney (hek)-293 cells stably expressing the m3 muscarinic acetylcholine receptor. inhibition of tyrosine phosphatases by pervanadat ... | 1998 | 9729471 |
| chronic diarrhoea among hiv-infected adult patients in nairobi, kenya. | chronic diarrhoea and wasting are well recognized features of aids in africa. however, because of resource constraints few comprehensive aetiological studies have been conducted in sub-saharan africa which have included a broad range of microbiological investigations. we undertook a prospective cross-sectional study of adult patients admitted to a government hospital in nairobi, kenya, to determine possible bacterial, mycobacterial, parasitic and viral causes of diarrhoea; to consider which may ... | 1998 | 9733379 |
| symptomless colonisation by clostridium difficile and risk of diarrhoea. | 1998 | 9734912 | |
| inhibition of enhanced toxin production by clostridium difficile in biotin-limited conditions. | production of toxins a and b by clostridium difficile is enhanced in a defined medium with biotin-limited conditions. in the present study compounds inhibitory to enhanced toxin production by a c. difficile strain were examined. increases in biotin concentration from 0.05 nm to 50 nm accelerated growth and inhibited enhanced toxin production. asparagine, glutamic acid and glutamine (10 mm) showed an effect on growth and toxin production similar to that of biotin. lysine (10 mm) suppressed growth ... | 1998 | 9736158 |
| gastrointestinal complications after aortic surgery. | a major gastrointestinal complication (gic) after aortic surgery may be disastrous, but these complications have received scant attention. this study was performed to determine the risk factors, associated events, and outcomes for patients with gic. | 1998 | 9737449 |
| comparison of restriction enzyme analysis, arbitrarily primed pcr, and protein profile analysis typing for epidemiologic investigation of an ongoing clostridium difficile outbreak. | during an outbreak of diarrhea in a general hospital in 1992, 166 clostridium difficile isolates from 102 patients were typed by restriction enzyme analysis (rea), arbitrarily primed pcr (ap-pcr), and protein profile analysis (pp) techniques. a total of 18 types and 5 subtypes were identified by rea, 32 types were identified by ap-pcr, and 9 types were identified by pp. analysis of the data indicated the presence of a predominant strain among 76, 75, and 84% of the isolates by rea, ap-pcr, and p ... | 1998 | 9738050 |
| intestinal secretory factor released by macrophages stimulated with clostridium difficile toxin a: role of interleukin 1beta. | clostridium difficile toxin a is associated with enterocolitis in animals and humans. however, the mechanisms of its secretory and damaging effects are not totally understood. in this work, we examined the intestinal secretion of electrolytes and water caused by supernatants from macrophages stimulated with toxin a in rabbit ileal mucosa mounted in ussing chambers. we also investigated the mechanism by which the intestinal secretory factor (isf) is released from stimulated macrophages. supernata ... | 1998 | 9746596 |
| [some aspects of the clostridium difficile infection]. | clostridium difficile is now regarded as the most common nosocomial enteric pathogen. c. difficile infection has a wide spectrum of a clinical presentation ranging from asymptomatic carriage to the fulminant colitis. antibiotic therapy is the most important risk factor in pathogen contagion, however other factors are also involved. typical pathophysiology: 1. alteration of the indigenous colonic flora by antibodies, 2. ingestion of spores, 3. colonization by clostridium difficile, 4. production ... | 1998 | 9748892 |
| [selenium deficiency favors the appearance of heart failure after multiple injury]. | a 47-year-old multiple trauma patient, experiencing a c. difficile colitis with diarrhoea, developed diffuse oedema with peritoneal and pleural effusion due to global heart failure. selenium deficiency, reported in trauma patients, may explain the occurrence of cardiomyopathy. the role of selenium in cardiac dysfunction and the various situations inducing a selenium deficiency are discussed. | 1997 | 9750622 |
| brewer's yeast and saccharomyces boulardii both attenuate clostridium difficile-induced colonic secretion in the rat. | saccharomyces boulardii (sb), a nonpathogenic yeast, has been used to prevent recurrences of clostridium difficile (c.diff) -associated diarrhea. a single report suggested that treatment with saccharomyces cerevisiae (sc), commonly called brewer's yeast (by), facilitates treatment of persistent c.diff infection. we conducted this experiment to determine whether c.diff toxin a-induced colonic secretion in the rat is blunted by pretreatment with either sb or by. we employed closed cecal pouches in ... | 1998 | 9753273 |
| implementation of sequential therapy programs--a microbiologist's view. | sequential antimicrobial therapy is not new, but confusion about the timing and nature of the switch often negates perceived advantages. a common problem is the choice of oral antibiotic to follow empirical administration of an intravenous second or third generation cephalosporin. where guidelines do not exist, particularly when data are lacking as the the best option, the delphi technique of obtaining a consensus agreement by review of a series of case histories is recommended. majority verdict ... | 1998 | 9756370 |
| in vitro effects of clostridium difficile toxins on hepatocytes. | clostridium difficile infections are associated with development of the systemic inflammatory response, including the production of hepatic acute phase proteins. lipopolysaccharide (lps) directly stimulates the production of at least one of these proteins, a 23-kda acute phase protein (the lps-induced protein, or lip) by murine hepatocytes in vitro. the aim of the present study was to determine if c. difficile toxins also stimulated the synthesis of this protein in vitro. | 1998 | 9758734 |
| [clostridium difficile pseudo-membranous colitic secondary to taking diclofenac]. | 1998 | 9762175 | |
| coordinate activation of activator protein 1 and inflammatory cytokines in response to neisseria gonorrhoeae epithelial cell contact involves stress response kinases. | neisseria gonorrhoeae (ngo), the etiologic agent of gonorrhea, induce a number of proinflammatory cytokines by contact to epithelial cells. cytokine genes and a variety of other immune response genes are activated as a result of the regulatory function of immediate early response transcription factors including activator protein 1 (ap-1). since it is established that phosphorylation of c-jun, the central component of ap-1, by the stress-activated c-jun nh2-terminal kinase (jnk) increases the tra ... | 1998 | 9763607 |
| adenovirus endocytosis requires actin cytoskeleton reorganization mediated by rho family gtpases. | adenovirus (ad) endocytosis via alphav integrins requires activation of the lipid kinase phosphatidylinositol-3-oh kinase (pi3k). previous studies have linked pi3k activity to both the ras and rho signaling cascades, each of which has the capacity to alter the host cell actin cytoskeleton. ad interaction with cells also stimulates reorganization of cortical actin filaments and the formation of membrane ruffles (lamellipodia). we demonstrate here that members of the rho family of small gtp bindin ... | 1998 | 9765425 |
| [emergence of gram-positive bacteria in nosocomial transmission]. | 1998 | 9767768 | |
| review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. | there is presently a lack of well conducted clinical trials demonstrating any significant benefits of probiotics in humans. with the exception of diarrhoea due to rotavirus infection in children there is little evidence from randomized, double-blind, placebo-controlled studies that bacterial probiotics have a significant beneficial action in preventing diarrhoea of any cause. the yeast saccharomyces boulardii has been shown to be of benefit in the prevention of antibiotic-associated diarrhoea bu ... | 1998 | 9768523 |