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[systematic detection of toxigenic strains of clostridium difficile--is it useful?].the incidence of clostridium difficile (cd) infection is rising and cd in fact is now endemic in many hospitals. during the past 4 years we analyzed our data concerning diarrhea caused by cd in our 700 beds hospital. a positive case was defined as a cd cytotoxine positive with or without positive culture for cd. in the present study 120 episodes of cd associated diarrhea occurred in 102 patients. 1101 stools were cultured from 921 patients. since 1995 we choose to systematically evaluate cd in d ...19989769867
diarrhea and clostridium difficile infection in latin american patients with aids. working group on aids in peru.diarrhea and wasting are among the most debilitating and deadly manifestations of aids, yet only limited information is available regarding the etiology, clinical consequences, and immunologic effects of infection with diarrheal agents. peruvian aids patients presenting with and without diarrhea were followed prospectively to examine the relations among diarrheal pathogens, clinical presentations, cd4 lymphocyte count, weight loss, and survival. patients with chronic diarrhea had lower cd4 lymph ...19989770145
the bcl-2 gene is differentially regulated by il-2 and il-4: role of the transcription factor nf-at.the murine ts1alphabeta t cell line expresses the anti-apoptotic protein bcl-2 upon il-2 stimulation, whereas il-4-mediated growth of this cell line proceeds in the absence of bcl-2 expression. in addition, il-4 stimulation inhibits bcl-2 expression and modulates its mrna level. il-2-induced dna binding activity for these transcription factors is sensitive to phosphatidylinositol 3 kinase inhibitor wortmannin and to rho inhibitor clostridium difficile toxin b, which inhibit il-2-induced bcl-2 ex ...19989771966
clostridium difficile colitis: factors influencing treatment failure and relapse--a prospective evaluation.the aim of this study was to identify patient related factors that may influence the treatment response and relapse following clostridium difficile (c. difficile) colitis.19989772047
[choose preparations that affect the intestinal ecosystem as little as possible!].the administration of antimicrobials often causes ecological disturbances in the normal microflora, such as decreased colonisation resistance which may result in overgrowth of potentially pathogenic micro-organisms such as yeasts and clostridium difficile. another possible consequence is the establishment of resistant strains which may spread within the host, or from person to person, causing infection. resistant bacteria can also transfer resistance genes to their own or other species. the arti ...19989772776
risk factors for clostridium difficile infection.a systematic review of the literature to identify risk factors associated with clostridium difficile infection was conducted. two main outcomes were considered: c. difficile diarrhoea and c. difficile carriage. a qualitative assessment, based on a set of defined and consistently applied criteria, appeared to be the best approach for risk factors other than antibiotic use, as an approach based on meta-analysis would have utilized only the information provided by a minority of the studies. risk fa ...19989777516
[drug-associated hemorrhagic enteritis].drug-associated hemorrhagic colitis are divided into antibiotic associated hemorrhagic colitis (aahc) and other drug associated hemorrhagic colitis. aahc are mainly caused by oral usage of ampicillin and its derivatives (85%). initially aahc are believed to be caused by klebsiella oxytoca overgrowth. however, these organisum has no exotoxin like clostridium difficile and pathogenesis of aahc are still unresolved. typical aahc are diagnosed by colonoscopy with diffuse hemorrhage and edema mainly ...19989780724
human enteric pathogens identified in a london teaching hospital and a rural public health laboratory: 1994.two microbiology laboratories, one serving an inner city hospital and one a rural public health laboratory, collected data on the outcome of examining faecal specimens in 1994. overall, 6.7% of the investigations were positive, but the rates were lower for hospital inpatients, for recently described pathogens, and in the absence of relevant clinical details; rates were higher for patients with a history of foreign travel. no benefit was gained by examining more than two specimens from any patien ...19989782627
gastrointestinal toxicity and clostridium difficile diarrhea in patients treated with paclitaxel-containing chemotherapy regimens.the objective of this study was to determine the incidence of grade 3 and 4 gastrointestinal toxicity and the prevalence of clostridium difficile-associated diarrhea (cdad) in patients with gynecologic malignancies treated with paclitaxel-based chemotherapy regimens.19989784328
activation of rho gtpases by escherichia coli cytotoxic necrotizing factor 1 increases intestinal permeability in caco-2 cells.the cytotoxic necrotizing factor 1 (cnf1) activates rho gtpases by deamidation of glutamine-63 and thereby induces redistribution of the actin cytoskeleton and formation of stress fibers. here, we have studied the effects of cnf1 on the transepithelial resistance of caco-2 cells, a human intestinal epithelial cell line, in comparison with the rho-inactivating toxin b of clostridium difficile. whereas toxin b decreased the transepithelial resistance of caco-2 cells by about 80% after 4 h, cnf1 re ...19989784513
effect of clostridium difficile toxin a on human colonic lamina propria cells: early loss of macrophages followed by t-cell apoptosis.we have previously shown that clostridium difficile toxin a induces detachment of human colonic epithelial cells from the basement membrane and subsequent cell death by apoptosis. because these cells require adhesion-dependent signalling from the extracellular matrix for survival, their detachment from the basement membrane by other means also induces apoptosis. the role of toxin a in the induction of apoptosis therefore remains to be determined. in addition, sensitivities to c. difficile toxin ...19989784558
extraintestinal clostridium difficile: 10 years' experience at a tertiary-care hospital.to determine the clinical characteristics of patients with extraintestinal clostridium difficile (ecd).19989787741
binding of clostridium difficile toxin a to human milk secretory component.toxigenic clostridium difficile is isolated from a majority of healthy human infants. the exact mechanism of asymptomatic colonisation is unclear; however, previous studies in this laboratory have shown that components of both the immunoglobulin and non-immunoglobulin fractions of human milk bind to toxin a and prevent its interaction with hamster intestinal brush border membranes (bbms). secretory iga (siga) is the primary immunoglobulin found in human milk. as siga resists digestion in the inf ...19989788811
mechanisms of drug-induced diarrhoea in the elderly.in the rapidly increasing elderly population, diarrhoea as a result of drug therapy is an important consideration. the elderly consume a disproportionately large number of drugs for multiple acute and chronic diseases. drugs can compromise both immune and nonimmune responses. aging decreases the quality and proportion of t cells which in turn reduces the production of secretory iga, the primary immune response of the gut. acid production in the stomach decreases with increasing age and this comp ...19989789728
the enzymatic domain of clostridium difficile toxin a is located within its n-terminal region.clostridium difficile, an anaerobic pathogen encountered in human enteric disease, produces two major virulence factors, toxins a and b, which are members of a clostridial family of large cytotoxins. these are glucosyltransferases, which use a udp-sugar as co-substrate to glucosylate and inactivate small gtpases of the rho or ras families, culminating in cytotoxicity. clinically, toxin a is perhaps the most important family member, because it causes major tissue damage in the course of disease, ...19989790914
neutropenic enterocolitis. 19989798019
mechanisms and management of antibiotic-associated diarrhea.only 10%-20% of all cases of antibiotic-associated diarrhea (aad) are caused by infection with clostridium difficile. other infectious organisms causing aad include clostridium perfringens, staphylococcus aureus, klebsiella oxytoca, candida species, and salmonella species. most of the clinically mild aad cases are due to functional disturbances of intestinal carbohydrate or bile acid metabolism, to allergic and toxic effects of antibiotics on intestinal mucosa, or to pharmacological effects on m ...19989798020
fc receptor-mediated phagocytosis requires cdc42 and rac1.at the surface of phagocytes, antibody-opsonized particles are recognized by surface receptors for the fc portion of immunoglobulins (fcrs) that mediate their capture by an actin-driven process called phagocytosis which is poorly defined. we have analyzed the function of the rho proteins rac1 and cdc42 in the high affinity receptor for ige (fcepsilonri)-mediated phagocytosis using transfected rat basophil leukemia (rbl-2h3) mast cells expressing dominant inhibitory forms of cdc42 and rac1. bindi ...19989799231
prevention of iatrogenic illness: adverse drug reactions and nosocomial infections in hospitalized older adults.adverse drug reactions and nosocomial infections are two important aspects of iatrogenesis in hospitalized older adults. adverse drug reactions are related to changes in pharmacodynamics and pharmacokinetics that occur with aging as well as polypharmacy. strategies for limiting iatrogenesis due to medications are discussed. nosocomial infections continue to complicate older inpatients' care despite advances in understanding and treating institutional infections. in particular, urinary tract infe ...19989799474
clostridium difficile infection in patients with reactive arthritis of undetermined etiology.in this study clostridium difficile infection, which has been reported to induce reactive arthritis (rea), was investigated in patients with rea of undetermined etiology. one hundred patients with acute arthritis were included to in the study. the diagnosis of arthritis and/or infectious agents that are capable of causing rea were determined in 69 of them. the remaining 31 patients (study group) with rea of undetermined etiology were further investigated for c. difficile toxin a (cdta). the cont ...19989808399
fibronectin and laminin binding of eighteen clostridium species.the ability of clostridium difficile, clostridium perfringens, clostridium sporogenes and fifteen other clostridium species to bind to human serum fibronectin or laminin was tested by using protein-coated latex particles. three groups of clostridium species were formed, namely the pseudomembranous colitis-causing species clostridium difficile, the gas gangrene-causing clostridium species and other clostridium species, which are infrequently found in human infections. significantly more strains o ...19959810669
clostridium difficile-associated diarrhea in a patient with rheumatoid arthritis: comment on the article by ramos et al. 19989811067
high-dose infusional doxorubicin and cyclophosphamide: a feasibility study of tandem high-dose chemotherapy cycles without stem cell support.the purpose of this study was to determine the maximally tolerated dose of doxorubicin administered during two cycles of intensive chemotherapy with cyclophosphamide and doxorubicin without stem cell support in patients with advanced cancer and to assess the cumulative cardiac toxicity of the regimen by noninvasive radionuclide imaging and by pre-and postchemotherapy endomyocardial biopsies. thirty-eight patients (thirty-six with high risk or metastatic breast cancer) were treated in a dose-esca ...19979815632
[probiotic therapy of pseudomembranous colitis. combination of intestinal lavage and oral administration of escherichia coli].an 82-year-old woman was admitted because of acute left heart failure with pulmonary oedema. there was a right basal pneumonia with congestion which was treated with amoxycillin and clavulanic acid. severe watery diarrhoea with more than 10 stools daily occurred. clostridium difficile was not isolated.19989817997
low rate of clostridium difficile colonization in ambulatory and hospitalized hiv-infected patients in a hospital unit: a prospective survey.to determine the frequency of clostridium difficile carriage in hiv-infected in- and out-patients, and to assess the role of this carriage in nosocomial transmission of c. difficile.19989821082
clostridium difficile-associated diarrhea and colitis: clinical manifestations, diagnosis, and treatment.this review examines the pathogenesis, clinical manifestations, diagnosis, and current medical and operative strategies in the treatment of clostridium difficile diarrhea and colitis. prevention and future avenues of research are also investigated.19989823813
pneumatosis intestinalis with clostridium difficile colitis as a cause of acute abdomen after lung transplantation. 19989824133
clostridium difficile colitis associated with chronic renal failure.clostridium difficile-associated diarrhoea (cdad) is a potentially life-threatening illness which has been shown to be more common and more severe in patients with chronic renal failure (crf) than in other groups. a review of cdad in our nephrology unit was carried out.19989829488
identification of two distinct mechanisms of phagocytosis controlled by different rho gtpases.the complement and immunoglobulin receptors are the major phagocytic receptors involved during infection. however, only immunoglobulin-dependent uptake results in a respiratory burst and an inflammatory response in macrophages. rho guanosine triphosphatases (molecular switches that control the organization of the actin cytoskeleton) were found to be essential for both types of phagocytosis. two distinct mechanisms of phagocytosis were identified: type i, used by the immunoglobulin receptor, is m ...19989831565
single toxin detection is inadequate to diagnose clostridium difficile diarrhea in pediatric patients.clostridium difficile is an important cause of symptomatic diarrhea in pediatric patients. the bacterium produces two toxins, although many laboratories assay for only one. we questioned this diagnostic approach when patients had positive results for c. difficile at our institution, but initially had tested negative at outside laboratories.19989834258
[diarrhea associated with clostridium difficile. one-year retrospective study at a tertiary hospital].diarrhea associated with clostridium difficile is a health care problem of growing importance in the last few years specially in the hospital environment. the epidemiologic data and factors associated with this disease have not, to date, been sufficiently studied in spain.19989835150
evaluation of an interdisciplinary re-isolation policy for patients with previous clostridium difficile diarrhea.diarrhea caused by clostridium difficile is increasingly recognized as a nosocomial problem. the effectiveness and cost of a new program to decrease nosocomial spread by identifying patients scheduled for readmission who were previously positive for toxin was evaluated.19989836843
effectiveness of infection control program in controlling nosocomial clostridium difficile.to report the effectiveness of use of comprehensive infection control measures to reduce the incidence of clostridium difficile (cd) in an acute-care teaching hospital.19989836844
clostridium difficile colitis requiring subtotal colectomy in a renal transplant recipient: a case report and review of literature. 19989838712
dioctahedral smectite neutralization activity of clostridium difficile and bacteroides fragilis toxins in vitro.the neutralization activity of dioctahedral smectite for ten toxigenic clostridium difficile and eight enterotoxigenic bacteroides fragilis strains was studied using mccoy and ht 29/c1 cell lines, respectively. minimalization of the cytopathic effect of c. difficile toxin b on mccoy cell lines by dioctahedral smectite dissolved in pbs was observed. after incubation with dioctahedral smectite the toxic effects of b. fragilis enterotoxins on ht/29c1 (human colon adenocarcinoma cell line) were elim ...19989839376
bacterial translocation, intestinal microflora and morphological changes of intestinal mucosa in experimental models of clostridium difficile infection.bacteraemia and subsequent sepsis is one possible complication of clostridium difficile infection. the aim of this study was to examine a correlation between bacterial translocation with morphological changes of intestinal mucosa and shifts of intestinal microflora in experimental models of c. difficile infection. a mouse model was used to study post-antibiotic shifts and mild c. difficile infection, and hamsters were used to study fatal enterocolitis. the influence of pro- and pre-biotics (lact ...19989839563
clostridium difficile associated with acute colitis in mares when their foals are treated with erythromycin and rifampicin for rhodococcus equi pneumonia.in sweden, mares sometimes develop acute, often fatal, colitis when their foals are treated orally with erythromycin and rifampicin for rhodococcus (r.) equi infection. clostridium (c.) difficile, or its cytotoxin, was demonstrated in faecal samples from 5 of 11 (45%) mares with diarrhoea. by contrast c. difficile was not found in the faecal flora of 12 healthy mares with foals treated for r. equi infection or in 56 healthy mares with healthy untreated foals. no other enteric pathogen was isolat ...19989844966
guidelines for optimal surveillance of clostridium difficile infection in hospitals.the availability of surveillance data on c. difficile infection in hospitals in england and wales is being jeopardised by the trend not to culture the organism for diagnostic purposes. nhs trust laboratories that no longer have the ability to isolate c. difficile cannot investigate putative outbreaks or monitor antimicrobial susceptibilities. these laboratories may now need to rely on their local public health laboratory for such investigations. recent recommendations from the department of heal ...19989854878
[detection of toxin producing strains of clostridium difficile using rapid diagnostic methods].feces of 53 patients from different hospital wards suffering from long term post-antibiotic therapy diarrhea were tested. for direct detection of c. difficile toxin a, in samples tcd (becton-dickinson), and c. difficile toxin a test (oxoid) tests were used. toxin a was detected in 16 samples (29.6% tested). c. difficile strains were isolated from 40% of the fecal samples. toxin a was detected in 25 clostridium difficile strains with commercial tests and toxin b was detected using mccoy cell line ...19989857614
saccharomyces boulardii protease inhibits the effects of clostridium difficile toxins a and b in human colonic mucosa.saccharomyces boulardii is a nonpathogenic yeast used in the treatment of clostridium difficile diarrhea and colitis. we have reported that s. boulardii inhibits c. difficile toxin a enteritis in rats by releasing a 54-kda protease which digests the toxin a molecule and its brush border membrane (bbm) receptor (i. castagliuolo, j. t. lamont, s. t. nikulasson, and c. pothoulakis, infect. immun. 64:5225-5232, 1996). the aim of this study was to further evaluate the role of s. boulardii protease in ...19999864230
[molecular epidemiology and pathogenicity of clostridium difficile]. 19989865068
increasing hospitalization and death possibly due to clostridium difficile diarrheal disease.this study calculated yearly estimated national hospital discharge (1985 to 1994) and age-adjusted death rates (1980 to 1992) due to bacterial, viral, protozoal, and ill-defined enteric pathogens. infant and young child hospitalization (but not death) rates in each category increased more than 50% during 1990 to 1994. age-adjusted death and hospitalization rates due to enteric bacterial infections and hospitalizations due to enteric viral infections have increased since 1988. the increases in ho ...19989866738
acquisition of clostridium difficile and clostridium difficile-associated diarrhea in hospitalized patients receiving tube feeding.clostridium difficile is the most common infectious cause of nosocomial diarrhea, but its role in diarrhea associated with tube feeding has not been rigorously investigated.19989867755
clostridium difficile diarrhea after use of tacrolimus following renal transplantation. 19989868682
community-acquired pneumonia. 19989872273
regulation of phospholipase d activity in synaptosomes permeabilized with staphylococcus aureus alpha-toxin.in order to investigate the regulation of presynaptic phospholipase d (pld) activity by calcium and g proteins, we established a permeabilization procedure for rat cortical synaptosomes using staphylococcus aureus alpha-toxin (30-100 microg/ml). in permeabilized synaptosomes, pld activity was significantly stimulated when the concentration of free calcium was increased from 0.1 microm to 1 microm. this activation was inhibited in the presence of kn-62 (1 microm), an inhibitor of calcium/calmodul ...19989872388
monocyte adherence induced by lipopolysaccharide involves cd14, lfa-1, and cytohesin-1. regulation by rho and phosphatidylinositol 3-kinase.mechanisms regulating lipopolysaccharide (lps)-induced adherence to intercellular adhesion molecule (icam)-1 were examined using thp-1 cells transfected with cd14-cdna (thp-1wt). thp-1wt adherence to icam-1 was lps dose-related, time-dependent, and inhibited by antibodies to either cd14 or leukocyte function associated antigen (lfa)-1, but was independent of any change in the number of surface expressed lfa-1 molecules. a potential role for phosphatidylinositol (pi) 3-kinase (pi 3-kinase) in lps ...19999873050
clostridial pathogenicity in experimental necrotising enterocolitis in gnotobiotic quails and protective role of bifidobacteria.the pathogenesis of neonatal necrotising enterocolitis (nec) remains unclear. gnotobiotic quails fed a lactose diet have been used to investigate the role of clostridial strains originating from faecal specimens of neonates through the intestinal lesions, the changes in microflora balance and the production of bacterial metabolites, i.e., short-chain fatty acids and hydrogen. bifidobacteria are thought to exert various beneficial effects on host health, including interaction with the colonic mic ...19989879939
pcr-ribotyping and pyrolysis mass spectrometry fingerprinting of environmental and hospital isolates of clostridium difficile.the relationships between environmental isolates of clostridium difficile were examined by two typing methods, pcr ribotyping and pyrolysis mass spectrometry (pyms). the 184 isolates were divided into 23 different pcr ribotypes, 13 of which were producers of toxins a and b; the remaining 10 types did not produce either toxin a or b. pyms analysis resolved 31 groups with 60 (32.5%) isolates in one group (group 9). in both methods most of the isolates showed similar clustering. pcr ribotypes of th ...19989879953
prospective study of the risk of clostridium difficile diarrhoea in elderly patients following treatment with cefotaxime or piperacillin-tazobactam.rates of clostridium difficile diarrhoea have recently been rising, with the elderly being at highest risk.19989882029
silver sulfadiazine induced clostridium difficile toxic megacolon in a burn patient: case report.a 53 yr old diabetic male presented with a 34% total body surface area (tbsa) deep partial- and full-thickness burns. on post burn days 4 and 9, all of his burns were excised and grafted. although he had only been treated with topical antibiotics, he developed clostridium difficile colitis after his second surgery that progressed to toxic megacolon and perforation. the incidence and treatment of toxic megacolon secondary to c. difficile is reviewed. early diagnosis and treatment with colonoscopi ...19989882070
effectiveness of antibiotic prophylaxis in critically ill patients. antibiotic prophylaxis can lead to contamination with clostridium difficile. 19989882129
inhibition of small g proteins by clostridium sordellii lethal toxin activates cdc2 and map kinase in xenopus oocytes.the lethal toxin (lt) from clostridium sordellii is a glucosyltransferase that modifies and inhibits small g proteins of the ras family, ras and rap, as well as rac proteins. lt induces cdc2 kinase activation and germinal vesicle breakdown (gvbd) when microinjected into full-grown xenopus oocytes. toxin b from clostridium difficile, that glucosylates and inactivates rac proteins, does not induce cdc2 activation, indicating that proteins of the ras family, ras and/or rap, negatively regulate cdc2 ...19989882492
nosocomial infections in hand surgery.the active and experienced hand surgeon should have enough knowledge to recognize both common and uncommon hand infections. control of hospital-acquired infections, including surgical site infections, requires a knowledge of potential personal risk factors and ongoing surveillance systems to aid in prevention and early detection. current national trends may soon require that surgical-site infections be diagnosed by specific criteria that will allow comparisons of data from various locations. alt ...19989884892
pcr targeted to the 16s-23s rrna gene intergenic spacer region of clostridium difficile and construction of a library consisting of 116 different pcr ribotypes.a reference library of types of clostridium difficile has been constructed by pcr ribotyping isolates (n = 2,030) from environmental (n = 89), hospital (n = 1,386), community practitioner (n = 395), veterinary (n = 27), and reference (n = 133) sources. the library consists of 116 distinct types identified on the basis of differences in profiles generated with pcr primers designed to amplify the 16s-23s rrna gene intergenic spacer region. isolates from 55% of infections in hospitals in the united ...19999889244
bovine immunoglobulin concentrate-clostridium difficile retains c difficile toxin neutralising activity after passage through the human stomach and small intestine.bovine immunoglobulin concentrate (bic)-clostridium difficile is prepared from the colostrum of cows immunised against c difficile toxins and contains high concentrations of neutralising igg antitoxin.19999895380
serum antitoxin antibodies mediate systemic and mucosal protection from clostridium difficile disease in hamsters.clostridium difficile is the bacterial pathogen identified as the cause of pseudomembranous colitis and is principally responsible for nosocomial antibiotic-associated diarrhea and colitis. the pathologic findings associated with this infection are believed to be caused by two large (approximately 300-kda) exotoxins, toxins a and b. because of the mucosal nature of this infection, vaccination strategies aimed at providing prophylactic or therapeutic immune protection have included immunization b ...19999916055
comparative anti-anaerobic activity of men 10700, a penem antibiotic.the in vitro activity of men 10700, a new penem, has been compared with that of metronidazole, clindamycin, ciprofloxacin, co-amoxiclav, imipenem and three third generation cephalosporins against 120 strains of anaerobes. the organisms tested comprised clostridium perfringens, clostridium difficile, bacteroides fragilis and speciated members of the genera fusobacterium, veillonella and peptostreptococcus. men 10700 showed activity similar to that of imipenem, and was more potent than metronidazo ...19989916909
reactive oligoarthritis in a patient with clostridium difficile pseudomembranous colitis. review of the literature.a 57-year-old man developed oligoarthritis of the right sacroiliac joint, knee and elbow in the wake of clostridium difficile pseudomembranous colitis. he was hla b27-positive and had a history of reiter's syndrome. his joint manifestations resolved after a course of nonsteroidal antiinflammatory drug therapy and injection of the right knee with triamcinolone acetonide. clostridium difficile should be recognized as a rare cause of reactive arthritis.19989923050
multicentre evaluation of a commercial test for the rapid diagnosis of clostridium difficile-mediated antibiotic-associated diarrhoea.an immunoassay for the detection of clostridium difficile toxin a in stool samples (clearview c. diff a; unipath, uk) was evaluated against the cell cytotoxicity assay using 407 stool samples from patients suspected to have, or considered at risk of, antibiotic-associated diarrhoea. of the samples tested, 98 were positive and 280 were negative by both tests (sensitivity 83.1%, specificity 96.9%). following resolution of the 29 discrepant results, the sensitivity and specificity of the immunoassa ...19989923521
clostridium difficile: a survey of fecal carriage in cats in a veterinary medical teaching hospital.fecal samples collected from 245 cats over a 6-month period were analyzed for the presence of clostridium difficile. after culture on selective media, isolates were identified by a latex agglutination test, and the presence of toxin a and toxin b gene sequences was determined by polymerase chain reaction. clostridium difficile was isolated from 23 (9.4%) of the cats, and 34.8% of that group were colonized with toxigenic strains. all of the cats colonized with toxigenic c. difficile had > or = 1 ...19999925212
association of clostridium difficile with enterocolitis and lactose intolerance in a foal.diagnoses of clostridium difficile enterocolitis and lactose intolerance were made in a neonatal foal with persistent diarrhea. it was determined that the foal had lactose intolerance on the basis of the results of a lactose tolerance test, and a diagnosis of c difficile enterocolitis was subsequently made. the foal responded to oral administration of metronidazole and lactase. lactose intolerance is a secondary problem most commonly associated with rotavirus infection, but it can be caused by a ...19999926015
differing epidemiology of clostridium difficile-associated diarrhea between an oncology ward and a general medicine ward. 19999927258
recurrent clostridium difficile disease: epidemiology and clinical characteristics.to describe the epidemiology, diagnosis, risk factors, patient impact, and treatment strategies for recurrent clostridium difficile-associated disease (cdad).19999927265
[clostridium difficile as an inducer of inflammatory diarrhea].clostridium difficile has been pointed out as an important agent of diarrheal diseases associated with antibiotic use. however, due to its complexity, the physiopathology of these diseases is only partially elucidated, although a series of scientific works has demonstrated the importance of toxins a and b in the pathogenesis of the inflammatory diarrhea induced by this microorganism. the inflammatory mechanisms involved in the biological activities of these toxins are complex. there are some stu ...19999927825
[resistance of respiratory and enteral bacteria to antibiotics]. 19989927887
atypical presentation of clostridium difficile colitis in patients with cystic fibrosis.objective: this report describes the unusual presentation of clostridium difficile colitis in five patients with cystic fibrosis and the role of ct in first suggesting the correct diagnosis in this group of patients. because of the absence of watery diarrhea and the presence of abdominal bloating and decreased stooling, cystic fibrosis patients with c. difficile colitis will be treated for stool impaction, meconium ileus equivalent, or distal intestinal obstruction syndrome. ct of the abdomen, p ...19999930816
a double-blind, placebo-controlled, parallel group study of oral trovafloxacin on bowel microflora in healthy male volunteers.treatment with oral antibiotic drugs generally influences normal fecal flora. these changes can be both beneficial (eg, elimination of aerobic, gram-negative bacilli) and detrimental (eg, the appearance of resistant pathogenic micro-organisms). trovafloxacin, a new fluoroquinolone with in vitro activity against anaerobes, and gram-negative, gram-positive, and atypical pathogens, is a potentially beneficial antimicrobial for bowel sterilization. this double-blind trial investigated the effect of ...19989935254
participation of reactive oxygen metabolites in clostridium difficile toxin a-induced enteritis in rats.reactive oxygen metabolites (roms) contribute to the pathophysiology of intestinal inflammation. our aim was to ascertain the involvement of roms in experimental ileitis in rats produced by toxin a of clostridium difficile. intraluminal toxin a caused a significant increase in hydroxyl radical and hydrogen peroxide production by ileal microsomes starting 1 h following toxin exposure and peaking at 2-3 h, and this was inhibited by pretreatment with dmso, a rom scavenger, or superoxide dismutase ( ...19999950823
human diseases caused by exotoxins produced by anaerobes and their rapid detection.major human diseases caused by exotoxins produced by anaerobes include botulisms, tetanus, foodborne illness caused by enterotoxin-producing clostridium perfringens, and diarrhea/colitis caused by toxigenic clostridium difficile. recently, enterotoxigenic bacteroides fragilis (etbf) has been recognized, that may be related to childhood diarrheal disease. detection test of botulinal neurotoxin is hardly performed at clinical laboratories since the most reliable means of detection and identificati ...199810036379
recognizing and managing clostridium difficile-associated diarrhea.clostridium difficile-associated diarrhea poses a significant physical risk and cost to the recovery of hospitalized older adults. c. difficile is responsible for 75% or more of the diarrhea-associated enteric infections acquired during a hospital stay (gerding, johnson, peterson, mulligan, & silva, 1995). c. difficile is easily spread by direct or indirect contact, therefore placing other patients at great risk for contamination by this organism. nursing plays a significant role in early identi ...199810036439
antimicrobial activities of synthetic bismuth compounds against clostridium difficile.clostridium difficile is a major nosocomial pathogen responsible for pseudomembranous colitis and many cases of antibiotic-associated diarrhea. because of potential relapse of disease with current antimicrobial therapy protocols, there is a need for additional and/or alternative antimicrobial agents for the treatment of disease caused by c. difficile. we have synthesized a systematic series of 14 structurally simple bismuth compounds and assessed their biological activities against c. difficile ...199910049270
the in-vitro activity of hmr 3647, a new ketolide antimicrobial agent.the in-vitro activity of hmr 3647, a novel ketolide, was investigated in comparison with those of erythromycin a, roxithromycin, clarithromycin (14-membered ring macrolides), amoxycillin-clavulanate and ciprofloxacin against 719 recent clinical gram-positive, gram-negative and anaerobic isolates and type cultures. hmr 3647 generally demonstrated greater activity than the other compounds with mic90s of < or =0.5 mg/l, except for staphylococcus epidermidis (mic90 > 128 mg/l), haemophilus influenza ...199810052892
clostridium difficile-associated disease. implications for midwifery practice.clostridium difficile-associated disease (cdad), a gastrointestinal infection with a wide range of manifestations whose primary symptom is diarrhea, occurs when antibiotic medications, or rarely other drugs or conditions, disrupt the normal colonic microflora, making it susceptible to the growth of toxigenic c difficile. it is a significant nosocomial infection and an increased incidence has been noted in recent years. although infrequently seen in midwifery practices, it does occur and may incr ...199910063221
evaluation of microbicidal activity of a new disinfectant: sterilox 2500 against clostridium difficile spores, helicobacter pylori, vancomycin resistant enterococcus species, candida albicans and several mycobacterium species.the microbicidal activity of a new disinfectant sterilox, a super-oxidized water, containing a mixture of oxidizing substances, was tested against clostridium difficile spores, helicobacter pylori, vancomycin resistant enterococcus species, candida albicans and several mycobacterium species using membrane filters. all tests were performed in duplicate with and without added horse serum at 1% and 5% v/v. distilled water, 0.35% peracetic acid (nu-cidex) and 2% glutaraldehyde were included as contr ...199910063471
rapid detection of toxigenic clostridium difficile from stool samples by a nested pcr of toxin b gene.toxigenic clostridium difficile is the aetiologic agent of most cases of antibiotic-associated diarrhoea and pseudomembranous colitis. the present standard method for c. difficile diagnosis is a cytotoxicity assay, performed on human fibroblast cultures. it is time consuming and requires special facilities. a nested-pcr assay detecting toxin b gene within a few hours was designed. one hundred and two stool samples were collected during four months. all samples were processed for toxin b-pcr, cul ...199910063477
prevalence of clostridium difficile toxin in kidney transplant recipients. 199810066067
toxins from anaerobic bacteria: specificity and molecular mechanisms of action.major advances have been made in the past five years in the identification of cellular targets of toxins produced by anaerobic bacteria. these targets include the vesicular membrane docking and fusion apparatus, the actin cytoskeleton, the signal transduction machinery and the cell membrane. the recent discovery that large clostridial toxins (clostridium difficile a and b toxins, c. sordellii lethal and hemorrhagic toxins, and alpha c. novyi toxin) are monoglucosyltransferases, together with the ...199810066460
clostridium difficile and antibiotic-associated diarrhoea--importance of c. difficile for the nephrologist. 199910069176
monocytic cell necrosis is mediated by potassium depletion and caspase-like proteases.apoptosis is a physiological cell death that culminates in mitochondrial permeability transition and the activation of caspases, a family of cysteine proteases. necrosis, in contrast, is a pathological cell death characterized by swelling of the cytoplasm and mitochondria and rapid plasma membrane disruption. necrotic cell death has long been opposed to apoptosis, but it now appears that both pathways involve mitochondrial permeability transition, raising the question of what mediates necrotic c ...199910070000
[choice of antibiotics in diarrhea due to clostridium difficile]. 199910074847
neurotensin is a proinflammatory neuropeptide in colonic inflammation.the neuropeptide neurotensin mediates several intestinal functions, including chloride secretion, motility, and cellular growth. however, whether this peptide participates in intestinal inflammation is not known. toxin a, an enterotoxin from clostridium difficile, mediates pseudomembranous colitis in humans. in animal models, toxin a causes an acute inflammatory response characterized by activation of sensory neurons and intestinal nerves and immune cells of the lamina propria. here we show that ...199910079105
how intestinal bacteria cause disease.an improved understanding of how intestinal bacteria cause disease has become increasingly important because of the emergence of new enteric pathogens, increasing threats of drug resistance, and a growing awareness of their importance in malnutrition and diarrhea. reviewed here are the varied ways that intestinal bacteria cause disease, which provide fundamental lessons about microbial pathogenesis as well as cell signaling. following colonization, enteric pathogens may adhere to or invade the e ...199910081504
the role of local actin instability in axon formation.the role of localized instability of the actin network in specifying axonal fate was examined with the use of rat hippocampal neurons in culture. during normal neuronal development, actin dynamics and instability polarized to a single growth cone before axon formation. consistently, global application of actin-depolymerizing drugs and of the rho-signaling inactivator toxin b to nonpolarized cells produced neurons with multiple axons. moreover, disruption of the actin network in one individual gr ...199910082468
antibiotic administration in patients undergoing common surgical procedures in a community teaching hospital: the chaos continues.the influence of recently published guidelines by the surgical infection society (sis) on current surgical practice are not well documented. the appropriateness of antibiotic administration in a cohort of surgical patients undergoing elective and emergency surgery in a department of surgery in an urban, community-based, private, 560-bed teaching hospital was retrospectively reviewed. the following were the criteria defining administration as appropriate as modified from sis guidelines: prophylac ...199910085388
minimizing the threat of c. difficile. 199910085882
[pseudomembranous colitis (clostridium difficile infection)]. 199910088328
pseudomembranous colitis: causes and cures.clostridium difficile is the most common nosocomial pathogen of the gastrointestinal tract and has increased in frequency over time. typical symptoms of c. difficile infection include diarrhea, which is usually nonbloody, or colitis associated with severe abdominal pain, fever and/or gross or occult blood in the stools. pseudomembranous colitis (pmc), the severest form of this disease, occurs as a result of a severe inflammatory response to the c. difficile toxins. this review focuses on pmc, as ...199910095149
clostridium difficile-associated diarrhea in acute and long-term care facilities.this report presents an overview of the epidemiology, diagnosis, complications, and treatment of clostridium difficile-associated diarrhea in acute and long-term care facilities. more studies are needed to understand the epidemiology of this disease in long-term care facilities, to identify the risk factors for its recurrence, and to evaluate new treatment modalities.199810099071
managing hospital infections.major infections in hospitals may cause, or contribute to, patient deaths and, at best, disrupt hospital routines. elaine leaver describes the management response to a major infection in the hospital environment.199210121488
improved linen handling cuts risks, ups efficiency. 199410131501
a rapid eia test for clostridium difficile toxin a. 199110148228
a rapid test for c. difficile. 199310148873
evaluation of a commercial latex agglutination assay for screening for clostridium difficile-associated disease.to determine if the clostridium difficile latex agglutination assay is an effective screening procedure for the diagnosis of c. difficile-associated disease (cdad).199410150387
how to identify the cause of antibiotic-associated diarrhea.most cases of antibiotic-associated diarrhea are due to clostridium difficile or are of enigmatic etiology. the antibiotics most often implicated are clindamycin, ampicillin or amoxicillin, and the cephalosporins. clinical signs of antibiotic-associated diarrhea may be limited to watery stools; however, evidence of colitis (fever, cramps, leukocytosis, fecal leukocytes) suggests c. difficile infection. the tissue culture assay for c. difficile toxin remains the gold standard for diagnosis, but t ...199410150699
antibiotic-associated diarrhoea. a costly problem. 199610160466
decrease in expenditures and selected nosocomial infections following implementation of an antimicrobial-prescribing improvement program.to evaluate changes in antimicrobial use and expenditures and the rates of selected nosocomial infections due to resistant organisms associated with implementation of an antimicrobial-prescribing improvement program.199710176026
a novel cytotoxin from clostridium difficile serogroup f is a functional hybrid between two other large clostridial cytotoxins.the large clostridial cytotoxins (lcts) constitute a group of high molecular weight clostridial cytotoxins that inactivate cellular small gtp-binding proteins. we demonstrate that a novel lct (tcdb-1470) from clostridium difficile strain 1470 is a functional hybrid between "reference" tcdb-10463 and clostridium sordellii tcsl-1522. it bound to the same specific receptor as tcdb-10463 but glucosylated the same gtp-binding proteins as tcsl-1522. all three toxins had equal enzymatic potencies but w ...199910196187
clostridium difficile-associated diarrhoea.at our hospital, the number of cases of clostridium difficile-associated diarrhoea increased from 29 in 1993 to 210 in 1995. the case notes of 110 patients with c difficile-associated diarrhoea during the first 6 months of 1995 were analysed retrospectively. the majority of the patients (106) had received antibiotics before the onset of diarrhoea; 46 had received three or more different antibiotics and 28 had received metronidazole. in 19 patients, the first stool sample after the onset of diarr ...199810197216
clostridium difficile colitis. 199910201505
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