Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| enterotoxins and the enteric nervous system--a fatal attraction. | although there has been extensive investigation of the biochemical consequences of the interactions between bacterial enterotoxins and intestinal epithelial cells and the mechanisms by which they induce intestinal secretion, relatively little attention has been given to other aspects of the host response to these enterotoxins. there is now compelling evidence that the enteric nervous system has a major role in enhancing the secretory state induced by cholera toxin, the e. coli enterotoxins and p ... | 2000 | 11111932 |
| treatment and prevention of antibiotic associated diarrhea. | mild or severe episodes of antibiotic-associated diarrhea (aad) are common side effects of antibiotic therapy. the incidence of aad differs with the antibiotic and varies from 5 to 25%. the major form of intestinal disorders is the pseudomembranous colitis associated with clostridium difficile which occurs in 10-20% of all aad. in most cases of aad discontinuation or replacement of the inciting antibiotic by another drug with lower aad risk can be effective. for more severe cases involving c. di ... | 2000 | 11118872 |
| cytosolic delivery and characterization of the tcdb glucosylating domain by using a heterologous protein fusion. | tcdb from clostridium difficile glucosylates small gtpases (rho, rac, and cdc42) and is an important virulence factor in the human disease pseudomembranous colitis. in these experiments, in-frame genetic fusions between the genes for the 255 amino-terminal residues of anthrax toxin lethal factor (lfn) and the tcdb(1-556) coding region were constructed, expressed, and purified from escherichia coli. lfntcdb(1-556) was enzymatically active and glucosylated recombinant rhoa, rac, cdc42, and substra ... | 2001 | 11119561 |
| comparative in vitro activities of abt-773 against 362 clinical isolates of anaerobic bacteria. | the activity of abt-773, a novel ketolide antibiotic, against clinical isolates of anaerobic bacteria was determined and compared to the activities of other antimicrobial agents. mics at which 90% of isolates were inhibited (mic(90)s) were </=0.06 microg/ml for actinomyces spp., clostridium perfringens, peptostreptococcus spp., propionibacterium spp., and porphyromonas spp. the mic(50)s and mic(90)s were </=0.06 and >32 microg/ml, respectively, for eubacterium spp., lactobacillus spp., clostridi ... | 2001 | 11120995 |
| postpartum clostridium sordellii infection associated with fatal toxic shock syndrome. | clostridium bacteria are anaerobic gram positive spore-form-ing bacilli, known to cause distinct clinical syndromes such as botulism, tetanus, pseudomembranous colitis and myonecrosis. the natural habitats of clostridium species are soil, water and the gastrointestinal tract of animals and humans. in 5-10% of all women, clostridium species are also found to be normal inhabitants in the microbial flora of the female genital tract. in case of a non-sexually transmitted genital tract infection, clo ... | 2000 | 11130102 |
| clostridium difficile toxins a and b can alter epithelial permeability and promote bacterial paracellular migration through ht-29 enterocytes. | clostridium difficile toxins a and b are the widely recognized etiologic agents of antibiotic-associated diseases ranging from diarrhea to pseudomembranous colitis. we hypothesized that c. difficile toxins may alter intestinal epithelial permeability and facilitate bacterial penetration of the intestinal epithelial barrier. experiments were designed to clarify the effects of c. difficile toxins a and b on the flux of inert particles across ht-29 enterocyte monolayers, and to correlate these resu ... | 2000 | 11131913 |
| fecal leukocyte stain has diagnostic value for outpatients but not inpatients. | the methylene blue stain for fecal leukocytes (fl) is widely used as an adjunct to slower but more accurate tests of diarrheal etiology, such as stool culture (scx) or toxin assays for clostridium difficile. prior studies investigating the utility of fl for predicting scx and c. difficile toxin assay (cdta) results did not evaluate the importance of inpatient versus outpatient status. we conducted a study of patients who submitted a stool specimen to the stanford hospital microbiology laboratory ... | 2001 | 11136781 |
| clostridium difficile, disinfectant, and elemental diet. | 2000 | 11145517 | |
| clostridium difficile and vancomycin-resistant enterococcus: the new nosocomial alliance. | the aims of this study were to determine the frequency of the association between clostridium difficile (c. difficile) and vancomycin-resistant enterococcus (vre) and delineate the role of c. difficile coinfection as a predictor of vre infection versus colonization and adverse outcome. | 2000 | 11151886 |
| frequency of antibiotic-associated diarrhoea in 2462 antibiotic-treated hospitalized patients: a prospective study. | the frequency of antibiotic-associated diarrhoea (aad) and clostridium difficile-associated diarrhoea (cdad) was prospectively determined in a population of 2462 patients recruited from five swedish hospitals, including divisions for infectious diseases, orthopaedics, surgery, geriatrics, nephrology and internal medicine. aad developed in 4.9% of the treated patients. faecal samples were obtained from 69% of patients with aad and 55.4% were positive for c. difficile cytotoxin b. the frequency of ... | 2001 | 11152430 |
| low ph-induced formation of ion channels by clostridium difficile toxin b in target cells. | clostridium difficile toxin b (269 kda), which is one of the causative agents of antibiotic-associated diarrhea and pseudomembranous colitis, inactivates rho gtpases by glucosylation. here we studied the uptake and membrane interaction of the toxin with eukaryotic target cells. bafilomycin a1, which prevents acidification of endosomal compartments, blocked the cellular uptake of toxin b in chinese hamster ovary cells cells. extracellular acidification (ph </= 5.2) induced uptake of toxin b into ... | 2001 | 11152463 |
| cytomegalovirus infection as a cause of pseudomembrane colitis: a report of four cases. | pseudomembranous colitis is very commonly encountered in patients with acquired immune deficiency syndrome (aids), and has been characteristically associated with clostridium difficile infection. we present four cases of aids-related diarrhea and pseudomembrane formation on endoscopy with pathologic features consistent with cytomegalovirus (cmv) colitis. our findings indicate that cmv colitis should be considered in the differential diagnosis of pseudomembranous colitis in immunocompromised pati ... | 2001 | 11154179 |
| age and disease related changes in intestinal bacterial populations assessed by cell culture, 16s rrna abundance, and community cellular fatty acid profiles. | the normal intestinal microflora plays an important role in host metabolism and provides a natural defence mechanism against invading pathogens. although the microbiota in adults has been extensively studied, little is known of the changes that occur in the microflora with aging. these may have important consequences in elderly people, many of whom are receiving antibiotic therapy and who are most susceptible to intestinal dysbiosis. | 2001 | 11156640 |
| protection from gastrointestinal diseases with the use of probiotics. | probiotics are nonpathogenic microorganisms that, when ingested, exert a positive influence on the health or physiology of the host. they can influence intestinal physiology either directly or indirectly through modulation of the endogenous ecosystem or immune system. the results that have been shown with a sufficient level of proof to enable probiotics to be used as treatments for gastrointestinal disturbances are 1) the good tolerance of yogurt compared with milk in subjects with primary or se ... | 2001 | 11157353 |
| in vitro activity of new quinolones against clostridium difficile. | we evaluated the in vitro activities of ofloxacin, levofloxacin, grepafloxacin, trovafloxacin and ciprofloxacin against clostridium difficile. the mic(90) was 128 mg/l for ofloxacin and levofloxacin, 64 mg/l for ciprofloxacin, 16 mg/l for grepafloxacin and 8 mg/l for trovafloxacin. thirty per cent of isolates were resistant to trovafloxacin, and rates of resistance to ofloxacin, levofloxacin, grepafloxacin and ciprofloxacin were considerably higher. none of the antimicrobials studied would be a ... | 2001 | 11157906 |
| antibiotic activity against genotypically distinct and indistinguishable clostridium difficile isolates. | 2001 | 11157920 | |
| demonstration that the group ii intron from the clostridial conjugative transposon tn5397 undergoes splicing in vivo. | previous work has identified the conjugative transposon tn5397 from clostridium difficile. this element was shown to contain a group ii intron. tn5397 can be conjugatively transferred from c. difficile to bacillus subtilis. in this work we show that the intron is spliced in both these hosts and that nonspliced rna is also present. we constructed a mutation in the open reading frame within the intron, and this prevented splicing but did not prevent the formation of the circular form of the conjug ... | 2001 | 11157942 |
| comparison of toxinotyping and pcr ribotyping of clostridium difficile strains and description of novel toxinotypes. | toxinotyping and pcr ribotyping are two methods that have been used to type clostridium difficile isolates. toxinotyping is based on pcr-rflp analysis of a 19 kb region encompassing the c. difficile pathogenicity locus. pcr ribotyping is based on comparison of patterns of pcr products of the 16s-23s rrna intergenic spacer region. representative strains (101) from a c. difficile pcr ribotype library and 22 strains from previously described toxinotypes were analysed to compare ribotyping with toxi ... | 2001 | 11158361 |
| safety and immunogenicity of increasing doses of a clostridium difficile toxoid vaccine administered to healthy adults. | clostridium difficile is a major cause of nosocomial diarrhea in industrialized countries. although most illnesses respond to available therapy, infection can increase morbidity, prolong hospitalization, and produce life-threatening colitis. vaccines are being explored as an alternative means for protecting high-risk individuals. we assessed the safety, immunogenicity, and dose response of a parenteral vaccine containing c. difficile toxoids a and b. thirty healthy adults were assigned to receiv ... | 2001 | 11159994 |
| rac and phosphatidylinositol 3-kinase regulate the protein kinase b in fc epsilon ri signaling in rbl 2h3 mast cells. | fcepsilonri signaling in rat basophilic leukemia cells depends on phosphatidylinositol 3-kinase (pi3-kinase) and the small gtpase rac. here, we studied the functional relationship among pi3-kinase, its effector protein kinase b (pkb), and rac using inhibitors of pi3-kinase and toxins inhibiting rac. wortmannin, an inhibitor of pi3-kinase, blocked fcepsilonri-mediated tyrosine phosphorylation of phospholipase cgamma, inositol phosphate formation, calcium mobilization, and secretion of hexosaminid ... | 2001 | 11160204 |
| groel (hsp60) of clostridium difficile is involved in cell adherence. | previous results have demonstrated that adherence of clostridium difficile to tissue culture cells is augmented by various stresses; this study focussed on whether the groel heat shock protein is implicated in this process. the 1940 bp groesl operon of c. difficile was isolated by pcr. the 1623 bp groel gene is highly conserved between various c. difficile isolates as determined by rflp-pcr and dna sequencing, and the operon is present in one copy on the bacterial chromosome. the 58 kda groel pr ... | 2001 | 11160803 |
| clostridium difficile toxin and faecal lactoferrin assays in adult patients. | clostridium difficile is the primary aetiological agent of antibiotic-associated diarrhoea. the faecal lactoferrin (fl) assay is a simple in vitro test which is highly sensitive to the presence of a marker of polymorphonuclear cells. we evaluated the use of the fl assay in conjunction with the c. difficile toxin assay in faecal samples obtained from 231 adult patients. the relationship between c. difficile toxin and fl in both negative and positive status was highly significant statistically (p ... | 2000 | 11165926 |
| comparison of the e test to the reference agar dilution method for antibiotic susceptibility testing of clostridium difficile. | 2000 | 11168094 | |
| randomized, double-blind, multicenter trial comparing clinafloxacin with imipenem as empirical monotherapy for febrile granulocytopenic patients. | in a double-blind, multicenter trial, 541 febrile granulocytopenic patients were randomized to receive either intravenous (iv) clinafloxacin (200 mg every 12 h) or i.v. imipenem (500 mg every 6 h) as empirical monotherapy. more baseline pathogens were susceptible to clinafloxacin (259 [99%] of 262 organisms) than to imipenem (253 [95%] of 265; p=.03). initial favorable clinical response rates for clinafloxacin (88 [32%] of 272 patients) and imipenem (89 [33%] of 269) were similar. after addition ... | 2001 | 11170945 |
| infectious complications the year after autologous bone marrow transplantation or peripheral stem cell transplantation for treatment of breast cancer. | few studies have examined the specific incidence of infections after autologous bone marrow transplantation (bmt) or peripheral stem cell transplantation (psct) for treatment of breast cancer. we reviewed the medical records of 127 consecutive patients who underwent autologous bmt or psct for breast cancer at the university of pennsylvania medical center from 1 may 1991 through 31 march 1995 and through 1 year of follow-up. the mean duration of neutropenia after transplantation was 10 days. init ... | 2001 | 11170946 |
| performance of two rapid, single-use immunoassays for the detection of clostridium difficile toxin a. | two rapid, single-use immunoassays for c. difficile toxin a, the clearview c. diff a (wampole laboratories, cranbury, n.j.) and the immunocard toxin a assays (meridian diagnostics inc., cincinnati, ohio) were compared to the cytotoxin assay for their ability to detect c. difficile toxin in fecal specimens. a total of 537 specimens were tested and 47 (8.8%) were positive by the cytotoxin assay. the sensitivity, specificity, positive predictive value, and negative predictive value of the toxin a a ... | 2001 | 11173187 |
| derivation and validation of guidelines for stool cultures for enteropathogenic bacteria other than clostridium difficile in hospitalized adults. | the yield of in-hospital stool cultures performed more than 72 hours after admission is low, and a commonly used policy dictates that laboratories reject these cultures to save costs. however, enteropathogenic bacteria other than clostridium difficile (epb) may cause nosocomial illness that would be missed by use of such a "3-day rule." | 2001 | 11176841 |
| therapeutic efficacy of oral lactobacillus preparation for antibiotic-associated enteritis in guinea pigs. | enteritis is a potential complication of antimicrobial agent use, particularly in certain species of rodents. the organism most frequently implicated in this disease is clostridium difficile. anecdotal information suggests that administration of yogurt or other lactobacillus-containing products in conjunction with antimicrobial agents will prevent or minimize the effects of antibiotic-associated enteritis. we wanted to determine whether a single subcutaneous injection of clindamycin phosphate co ... | 2000 | 11178313 |
| clostridium difficile toxins disrupt epithelial barrier function by altering membrane microdomain localization of tight junction proteins. | the anaerobic bacterium clostridium difficile is the etiologic agent of pseudomembranous colitis. c. difficile toxins tcda and tcdb are udp-glucosyltransferases that monoglucosylate and thereby inactivate the rho family of gtpases (w. p. ciesla, jr., and d. a. bobak, j. biol. chem. 273:16021-16026, 1998). we utilized purified reference toxins of c. difficile, tcda-10463 (tcda) and tcdb-10463 (tcdb), and a model intestinal epithelial cell line to characterize their influence on tight-junction (tj ... | 2001 | 11179295 |
| regulation of intercellular tight junctions by zonula occludens toxin and its eukaryotic analogue zonulin. | the intestinal epithelium represents the largest interface between the external environment and the internal host milieu and constitutes the major barrier through which molecules can either be absorbed or secreted. there is now substantial evidence that tight junctions (tj) play a major role in regulating epithelial permeability by influencing paracellular flow of fluid and solutes. tj are one of the hallmarks of absorptive and secretory epithelia. evidence now exists that tj are dynamic rather ... | 2000 | 11193578 |
| effects of clostridium difficile toxins on epithelial cell barrier. | clostridium difficile is the primary agent responsible for many patients with antibiotic-associated diarrhea and almost all patients with pseudomembranous colitis following antibiotic therapy. c. difficile infection is the most frequent form of colitis in hospitals and nursing homes and affects millions of patients in the united states and abroad. the first event in the pathogenesis of c. difficile infection involves alterations of the indigenous colonic microflora by antibiotics, followed by co ... | 2000 | 11193598 |
| [diarrhea of nosocomial origin in an adult population]. | 2000 | 11196591 | |
| clostridium difficile-associated diarrhea in a va medical center: clustering of cases, association with antibiotic usage, and impact on hiv-infected patients. | a case-control study of patients with stools assayed for clostridium difficile toxin over a 24-month period at a veterans affairs hospital found that the majority of cases (70.6%) occurred in temporal clusters. clustering was particularly evident on a designated human immunodeficiency virus (hiv) unit. thirty-four (75.5%) of 45 hiv-infected patients with c difficile-associated diarrhea (cdad) died during their hospitalization. third-generation cephalosporins were the antibiotics most strongly as ... | 2001 | 11198022 |
| fusidic acid disk diffusion testing of clostridium difficile can be calibrated using single-strain regression analysis. | single-strain regression analysis (sra) was employed to calibrate the disk diffusion antibiotic susceptibility test for fusidic acid and clostridium difficile. mic determinations of 40 clinical isolates of c. difficile were performed with the e-test. the disk diffusion test was standardized according to the swedish reference group for antibiotics (srga). disks used for sra contained 1.5, 5, 15, 50 and 150 microg fusidic acid and the routine disk contained 50 microg fusidic acid. a control strain ... | 2000 | 11200373 |
| microbes and microbial toxins: paradigms for microbial-mucosal interactions ii. the integrated response of the intestine to clostridium difficile toxins. | clostridium difficile, the major etiologic factor of antibiotic-associated diarrhea and colitis, mediates its effects by releasing two large protein exotoxins, toxins a and b. a major toxin effect is related to the disassembly of actin microfilaments, leading to impairment of tight junctions in human colonocytes. the mechanism of actin disaggregation involves monoglucosylation of the signaling proteins rho a, rac, and cdc 42, which control stress fiber formation directly by toxins a and b. an im ... | 2001 | 11208538 |
| clostridium difficile colitis following antibiotic prophylaxis for dental procedures. | clostridium difficile-induced diarrhea and colitis are common complications of therapeutic courses of antibiotics in the hospital setting. we report a case of clostridium difficile colitis following antibiotic prophylaxis for endocarditis prior to dental procedures in the community setting. the infection necessitated hospital admission and a prolonged hospital stay. dental practitioners must be aware of the significance of the disease and the risk associated with antibiotics, whether they are us ... | 2001 | 11209501 |
| role of antibody response in outcome of antibiotic-associated diarrhoea. | 2001 | 11213086 | |
| association between antibody response to toxin a and protection against recurrent clostridium difficile diarrhoea. | we have reported that symptom-free carriers of clostridium difficile have a systemic anamnestic immune response to toxin a. the aim of this study was to determine whether an acquired immune response to toxin a, during an episode of c. difficile diarrhoea, influences risk of recurrence. | 2001 | 11213096 |
| clostridial enterocolitis. | equine clostridial enterocolitis is being recognized with increasing frequency. it has been identified in foals with diarrhea, antibiotic-associated enterocolitis, or nosocomial enterocolitis. the sporadic occurrence of clostridial enterocolitis, the variety of types of clostridia involved, and the difficulty of experimentally reproducing the disease suggest that it is a poorly defined multifactorial syndrome. the risk factors associated with susceptibility to colonization and progressive infect ... | 2000 | 11219344 |
| evaluating the ct diagnosis of clostridium difficile colitis: should ct guide therapy? | the purpose of this study was to further characterize the ct findings of clostridium difficile colitis and to provide for the first time a diagnostic sensitivity, specificity, positive predictive value, and negative predictive value to help clinicians decide whether antibiotic treatment is warranted on the basis of ct findings while awaiting stool test results (which may take as long as 48 hr). | 2001 | 11222194 |
| thymic emigrants isolated by a new method possess unique phenotypic and functional properties. | t cells that emigrate from the thymus have primarily been studied in vivo using fluorescent dye injection of the thymus. this study examined the properties of thymocytes that emigrate from cultured thymic lobes in organ culture. under these conditions, thymic emigrants displayed the expected phenotype, that of mature thymocytes expressing high levels of t-cell receptor (tcr-alphabeta) and either cd4 or cd8, and were observed to emigrate within 24 hours of positive selection. emigration was inhib ... | 2001 | 11222381 |
| clarithromycin and risk of clostridium difficile-associated diarrhoea. | 2001 | 11222572 | |
| yield of vancomycin-resistant enterococci and multidrug-resistant enterobacteriaceae from stools submitted for clostridium difficile testing compared to results from a focused surveillance program. | it has been suggested that a method of performing surveillance for vancomycin-resistant enterococci (vre) is to screen specimens submitted for clostridium difficile testing. we compared this approach to our focused surveillance program of high-risk units during october 1997 to compare the yield of vre and multidrug-resistant enterobacteriaceae (mdre) with both methods. of the stools submitted for c. difficile testing, 14% were positive for vre or mdre, whereas rectal swabs from routine surveilla ... | 2001 | 11230446 |
| molecular characterization of flid gene encoding flagellar cap and its expression among clostridium difficile isolates from different serogroups. | the flid gene encoding the flagellar cap protein (flid) of clostridium difficile was studied in 46 isolates belonging to serogroups a, b, c, d, f, g, h, i, k, x, and s3, including 30 flagellated strains and 16 nonflagellated strains. in all but three isolates, amplification by pcr and reverse transcription-pcr demonstrated that the flid gene is present and transcribed in both flagellated and nonflagellated strains. pcr-restriction fragment length polymorphism (rflp) analysis of amplified flid ge ... | 2001 | 11230454 |
| phylogenetic analyses of two "archaeal" genes in thermotoga maritima reveal multiple transfers between archaea and bacteria. | the genome sequence of thermotoga maritima revealed that 24% of its open reading frames (orfs) showed the highest similarity scores to archaeal genes in blast analyses. here we screened 16 strains from the genus thermotoga and other related thermotogales for the occurrence of two of these "archaeal" genes: the gene encoding the large subunit of glutamate synthase (gltb) and the myo-inositol 1p synthase gene (ino1). both genes were restricted to the thermotoga species within the thermotogales. th ... | 2001 | 11230537 |
| requirement for rho gtpases and pi 3-kinases during apoptotic cell phagocytosis by macrophages. | in vivo, apoptotic cells are removed by surrounding phagocytes, a process thought to be essential for tissue remodeling and the resolution of inflammation [1]. although apoptotic cells are known to be efficiently phagocytosed by macrophages, the mechanisms whereby their interaction with the phagocytes triggers their engulfment have not been described in mammals. here, we report that primary murine bone marrow-derived macrophages (using alpha(v)beta(3) integrin for apoptotic cell uptake) extend l ... | 2001 | 11231156 |
| resistance to induced apoptosis in the human neuroblastoma cell line sk-n-sh in relation to neuronal differentiation. role of bcl-2 protein family. | much evidence suggests that apoptosis plays a crucial role in cell population homeostasis that depends on the expression of various genes implicated in the control of cell life and death. the sensitivity of human neuroblastoma cells sk-n-sh to undergo apoptosis induced by thapsigargin was examined. sk-n-sh were previously differentiated into neuronal cells by treatments with retinoic acid (ra), 4 beta-phorbol 12-myristate 13-acetate (pma) which increases protein kinase c (pkc) activity, and stau ... | 2001 | 11231287 |
| p-hydroxyphenylacetate decarboxylase from clostridium difficile. a novel glycyl radical enzyme catalysing the formation of p-cresol. | the human pathogenic bacterium clostridium difficile is a versatile organism concerning its ability to ferment amino acids. the formation of p-cresol as the main fermentation product of tyrosine by c. difficile is unique among clostridial species. the enzyme responsible for p-cresol formation is p-hydroxyphenylacetate decarboxylase. the enzyme was purified from c. difficile strain dmsz 1296(t) and initially characterized. the n-terminal amino-acid sequence was 100% identical to an open reading f ... | 2001 | 11231288 |
| impact of nosocomial infection on length of stay and functional improvement among patients admitted to an acute rehabilitation unit. | to identify factors predictive of length of stay (los) and the level of functional improvement achieved among patients admitted to an acute rehabilitation unit for the first time, with special reference to the role of nosocomial infection. | 2001 | 11232883 |
| liver abscess caused by clostridium difficile. | we report the first case of an infected cyst and liver abscess caused by clostridium difficile. it recurred 11 months later, despite therapy with vancomycin and percutaneous drainage. administration of metronidazole following percutaneous drainage achieved a favorable outcome. | 2001 | 11234983 |
| fulminant clostridium difficile colitis associated with paclitaxel and carboplatin chemotherapy. | resnik e, lefevre ca. fulminant clostridium difficile colitis associated with paclitaxel and carboplatin chemotherapy. pseudomembranous colitis is commonly associated with the use of antibiotics. some antineoplastic agents even without associated antibiotic use can predispose patients to developing infection with clostridium difficile. the infection is usually mild; however, in rare cases severe forms of pseudomembranous colitis may be encountered. a 66 year-old female with stage iiic suboptimal ... | 1999 | 11240821 |
| bovine milk antibodies for health. | the immunoglobulins of bovine colostrum provide the major antimicrobial protection against microbial infections and confer a passive immunity to the newborn calf until its own immune system matures. the concentration in colostrum of specific antibodies against pathogens can be raised by immunising cows with these pathogens or their antigens. immune milk products are preparations made of such hyperimmune colostrum or antibodies enriched from it. these preparations can be used to give effective sp ... | 2000 | 11242458 |
| [role of the microbiology laboratory in the diagnosis of nosocomial diarrhea]. | diarrhea that occurs in hospitalized patients is frequent and may be due to infectious or noninfectious causes. in adults with nosocomial diarrhea, the most commonly detected agent is clostridium difficile; in children, rotaviruses are predominant. various studies have shown that bacterial enteric pathogens (e.g. salmonella spp., shigella spp., campylobacter spp...) or parasites are common causes of community-acquired diarrhea but rarely cause nosocomial enteritis. stool cultures for these patho ... | 2000 | 11244602 |
| [epidemiology, risk factors and prevention of clostridium difficile nosocomial infections]. | clostridium difficile is responsible for 10-25% of cases of antibiotic-associated diarrhea (aad) and for virtually all cases of antibiotic-associated pseudo-membranous colitis (pmc). this anaerobic spore-forming bacterium has been identified as the leading cause of nosocomial infectious diarrhea in adults. pathogenesis relies on a disruption of the normal bacterial flora of the colon, a colonization by c. difficile and the release of toxins a and b that cause mucosal damage and inflammation. inc ... | 2000 | 11244603 |
| [nosocomial diarrhea in adults due to microorganisms other than clostridium difficile]. | nosocomial diarrhea of the adult is to the largest extend caused by clostridium difficile. however, one must not underestimate the importance of other bacteria such as salmonella or shigella, which are most common in developing countries. other viruses and parasites can equally be responsible for causing such infections. | 2000 | 11244604 |
| [pediatric nosocomial diarrhea]. | nosocomial diarrhea are an important cause of childhood morbidity and mortality. rotavirus has been recognized as the most important cause of nosocomial gastroenteritidis particularly in infants during winter months. nosocomial diarrhea are also, caused by bacterial pathogen like clostridium difficile, salmonella, shigella, campylobacter. clostridium difficile toxin assay should be considered for patients who are receiving antibiotics. modifications of hygiene procedures and preventive measures ... | 2000 | 11244605 |
| five-year surveillance of patients with communicable diseases nursed in isolation. | during a five year surveillance program of patients with communicable diseases nursed in isolation, we gathered information on 2880 patients who were nursed in isolation for 28 145 days, from january 1994 to december 1998. the mean number of patients nursed in isolation was 575.4 (range, 427-709) per year. on average 2.4% of patients admitted yearly to the university medical center (umc) were nursed in isolation. the mean number of days nursed in isolation was 9.8 days per patient.1996 was a pea ... | 2001 | 11247681 |
| delivery of proteins into living cells by reversible membrane permeabilization with streptolysin-o. | the pore-forming toxin streptolysin o (slo) can be used to reversibly permeabilize adherent and nonadherent cells, allowing delivery of molecules with up to 100 kda mass to the cytosol. using fitc-labeled albumin, 10(5)-10(6) molecules were estimated to be entrapped per cell. repair of toxin lesions depended on ca(2+)-calmodulin and on intact microtubules, but was not sensitive to actin disruption or to inhibition of protein synthesis. resealed cells were viable for days and retained the capacit ... | 2001 | 11248053 |
| clostridium difficile--associated diarrhea: a review. | clostridium difficile causes 300 000 to 3 000 000 cases of diarrhea and colitis in the united states every year. antibiotics most frequently associated with the infection are clindamycin, ampicillin, amoxicillin, and cephalosporins, but all antibiotics may predispose patients to c difficile infection. the clinical presentation varies from asymptomatic colonization to mild diarrhea to severe debilitating disease, with high fever, severe abdominal pain, paralytic ileus, colonic dilation (or megaco ... | 2001 | 11252111 |
| pancytopenia and colitis with clostridium difficile in a rheumatoid arthritis patient taking methotrexate, antibiotics and non-steroidal anti-inflammatory drugs. | methotrexate (mtx) is widely used despite its side-effects. we describe a rheumatoid arthritis (ra) patient taking low-dose mtx who developed severe pancytopenia and colitis with clostridium difficile after the administration of antibiotics for acute pyelonephritis. our case suggests that low-dose mtx may seriously interact with antibiotics and that these side-effects should always be considered when ra patients are treated with mtx and antibiotics. | 2001 | 11254248 |
| endogenous corticosteroids modulate clostridium difficile toxin a-induced enteritis in rats. | we examined the role of glucocorticoids in acute inflammatory diarrhea mediated by clostridium difficile toxin a. toxin a (5 microg) or buffer was injected in rat ileal loops, and intestinal responses were measured after 30 min to 4 h. ileal toxin a administration increased plasma glucocorticoids after 1 h, at which time the toxin-stimulated secretion was not significant. administration of the glucocorticoid analog dexamethasone inhibited toxin a-induced intestinal secretion and inflammation and ... | 2001 | 11254479 |
| characterization of a cell surface protein of clostridium difficile with adhesive properties. | our laboratory has previously shown that clostridium difficile adherence to cultured cells is enhanced after heat shock at 60 degrees c and that it is mediated by a proteinaceous surface component. the present study was undertaken to identify the surface molecules of this bacterium that could play a role in its adherence to the intestine. the cwp66 gene, encoding a cell surface-associated protein of c. difficile 79-685, was isolated by immunoscreening of a c. difficile gene library with polyclon ... | 2001 | 11254569 |
| saccharomyces boulardii stimulates intestinal immunoglobulin a immune response to clostridium difficile toxin a in mice. | saccharomyces boulardii is a nonpathogenic yeast that protects against antibiotic-associated diarrhea and recurrent clostridium difficile colitis. the administration of c. difficile toxoid a by gavage to s. boulardii-fed balb/c mice caused a 1.8-fold increase in total small intestinal immunoglobulin a levels (p = 0.003) and a 4.4-fold increase in specific intestinal anti-toxin a levels (p < 0.001). enhancing host intestinal immune responses may be an important mechanism for s. boulardii-mediated ... | 2001 | 11254650 |
| [diarrhea caused by adenovirus and astrovirus in hospitalized immunodeficient patients]. | acute or chronic diarrheal illness are common complications in immunosuppressed patients such as human immunodeficiency virus (hiv)-infected, bone marrow or solid organ transplanted patients and those with leukaemias or other immune deficiency disorders. due to the importance of recognizing the feasible etiologies of diarrhea in order to give the proper antimicrobial chemotherapy or to avoid a misdiagnosis of rejection in the case of transplanted patients, we have investigated adenovirus and ast ... | 2001 | 11256256 |
| oligomerization-dependent regulation of motility and morphogenesis by the collagen xviii nc1/endostatin domain. | collagen xviii (c18) is a triple helical endothelial/epithelial basement membrane protein whose noncollagenous (nc)1 region trimerizes a cooh-terminal endostatin (es) domain conserved in vertebrates, caenorhabditis elegans and drosophila. here, the c18 nc1 domain functioned as a motility-inducing factor regulating the extracellular matrix (ecm)-dependent morphogenesis of endothelial and other cell types. this motogenic activity required es domain oligomerization, was dependent on rac, cdc42, and ... | 2001 | 11257123 |
| analysis of the physicochemical interactions between clostridium difficile toxins and cholestyramine using liquid chromatography with post-column derivatization. | a potential therapy for antibiotic-associated pseudomembranous colitis is to bind clostridium difficile toxins a and b using cholestyramine, a hydrophobic anion exchange medium. frontal analysis in isotonic phosphate buffer was studied using post-column derivatization with o-phthalaldehyde, which gave a highly sensitive (> or =30 ng) flow-through analysis. following load (1.5-3.0 microg toxin/3.6 mg), toxin a was bound at a slightly higher capacity than b, due to slower kinetics. a salt gradient ... | 2001 | 11257520 |
| cell volume kinetics of adherent epithelial cells measured by laser scanning reflection microscopy: determination of water permeability changes of renal principal cells. | the water channel aquaporin-2 (aqp2), a key component of the antidiuretic machinery in the kidney, is rapidly regulated by the antidiuretic hormone vasopressin. the hormone exerts its action by inducing a translocation of aqp2 from intracellular vesicles to the cell membrane. this step requires the elevation of intracellular cyclic amp. we describe here a new method, laser scanning reflection microscopy (lsrm), suitable for determining cellular osmotic water permeability coefficient changes in p ... | 2001 | 11259291 |
| rho gtpases are involved in the regulation of nf-kappab by genotoxic stress. | a common cellular response to genotoxic agents and inflammatory cytokines is the activation of nf-kappab. here, we addressed the question of whether small gtpases of the rho family are involved in the stimulation of nf-kappab signaling by genotoxic agents or tnfalpha in hela cells. inhibition of isoprenylation of rho proteins by use of the hmg-coa reductase inhibitor lovastatin attenuated uv-, doxorubicin-, and tnfalpha-induced degradation of ikappabalpha as well as drug-stimulated dna binding a ... | 2001 | 11262181 |
| [clostridium difficile-associated diarrhea--a growing problem in geriatric care]. | from 1994 to 1998 the incidence of clostridium difficile-associated diarrhoea (cdad) in the department of geriatric medicine, huddinge university hospital increased from 0.5% to 2.2% of all admissions. corresponding figures for the whole hospital were 0.3% and 0.6%, respectively. the increase in cdad at the department of geriatric medicine was parallel with a more than doubled consumption of antibiotics. all geriatric patients with cdad had been treated with antibiotics before onset of diarrhoea ... | 2001 | 11265569 |
| in vitro activity of telithromycin (hmr 3647) against 502 strains of anaerobic bacteria. | in a previous study, we compared hmr 3004 with azithromycin, clarithromycin, erythromycin and roxithromycin against 502 anaerobic bacteria using nccls-approved procedures. this report extends this study by reporting the activity of telithromycin (hmr 3647) against these strains. telithromycin inhibited 10% of bacteroides fragilis, 50% of other b. fragilis group organisms and 93% of other bacteroides spp. telithromycin inhibited all porphyromonas spp. and 98% of prevotella spp. activity against b ... | 2001 | 11266423 |
| an inhibitory role of rho in the vasopressin-mediated translocation of aquaporin-2 into cell membranes of renal principal cells. | vasopressin regulates water reabsorption in renal collecting duct principal cells by a camp-dependent translocation of the water channel aquaporin-2 (aqp2) from intracellular vesicles into the cell membrane. in the present work primary cultured inner medullary collecting duct cells were used to study the role of the proteins of the rho family in the translocation of aqp2. clostridium difficile toxin b, which inhibits all members of the rho family, clostridium limosum c3 toxin, which inactivates ... | 2001 | 11278652 |
| clostridium difficile infection: risk factors, medical and surgical management. | clostridium difficile has become recognized as a cause of nosocomial infection which may progress to a fulminant disease. | 2000 | 11279333 |
| medical diagnoses and procedures associated with clostridium difficile colitis. | the aim of this study was to examine the associations of clostridium difficile colitis with other comorbid conditions and procedural interventions among hospitalized patients. | 2001 | 11280548 |
| analysis of clostridium difficile isolates from nosocomial outbreaks at three hospitals in diverse areas of japan. | clostridium difficile isolates recovered from patients with c. difficile-associated diarrhea (cdad) at three hospitals located in diverse areas of japan were analyzed by three typing systems, pcr ribotyping, pulsed-field gel electrophoresis (pfge), and western immunoblotting. at the three hospitals examined, a single pcr ribotype strain (type smz) was predominant and accounted for 22 (65%) of 34, 18 (64%) of 28, and 11 (44%) of 25 isolates, respectively. all of the 51 isolates that represented p ... | 2001 | 11283061 |
| [intestinal flora of patients with suspected antibiotic associated diarrhea (aad). i. clostridium perfringens]. | stool samples of 158 patients suspected of antibiotic-associated diarrhoea (aad) were studied. toxin a of c. difficile and enterotoxin of c. perfringens were detected in stool samples by immunoenzymatic assays and pcr. in 35 stool samples toxin a of c. difficile was detected and in 48 cases (30%) c. difficile strains were cultured from 21 stool samples (13%). the presence of the cpe gene of c. perfringens, enabling the production of enterotoxin, could not be detected by pcr, both in stool sample ... | 2000 | 11286179 |
| management and prevention of clostridium difficile-associated diarrhea. | clostridium difficile is a major cause of antibiotic-associated diarrhea. while treatment regimens for c. difficile have been available for decades, they remain less than optimal due to the frequent recurrences that occur after therapy is completed. moreover, the morbidity and expense associated with c. difficile have underscored the need for more effective preventive measures than are currently available. in this review, we outline the current recommendations for treatment and prevention of c. ... | 2001 | 11286650 |
| clostridium difficile infections in hiv-positive patients. | the prevalence of clostridium difficile infections in hiv-positive patients with regard to the presence of its enterotoxin was investigated. enzyme immunoassay (eia, meridian diagnostic inc) was used for the detection of c. difficile enterotoxin in stool specimens collected from 201 hiv-positive and 271 hiv-negative diarrheal patients. culture was performed on cycloserine cefoxitin fructose agar. chromosomal dna types of c. difficile isolates were determined by pulsed-field gel electrophoresis ( ... | 2000 | 11289016 |
| molecular and genomic analysis of genes encoding surface-anchored proteins from clostridium difficile. | the gene slpa, encoding the s-layer precursor protein in the virulent clostridium difficile strains c253 and 79--685, was identified. the precursor protein carries a c-terminal highly conserved anchoring domain, similar to the one found in the cwp66 adhesin (previously characterized in strain 79--685), an slh domain, and a variable n-terminal domain mediating cell adherence. the genes encoding the s-layer precursor proteins and the cwp66 adhesin are present in a genetic locus carrying 17 open re ... | 2001 | 11292772 |
| clostridium difficile infection, hospital geography and time-space clustering. | to analyse spatial and temporal relationships of clostridium difficile-associated disease in an inner-city hospital, we retrospectively evaluated 283 episodes of confirmed c. difficile diarrhoea in the chelsea and westminster hospital between 1995 and 1998, against a background of relatively stable case mix, antibiotic usage and admission numbers, using knox analysis to determine the presence of disease clustering in time and space. we found five time-space clusters on four medical wards and bet ... | 2001 | 11294965 |
| evaluation of six commercial assays for the rapid detection of clostridium difficile toxin and/or antigen in stool specimens. | to evaluate six commercially available assays for the detection of clostridium difficile toxin and/or antigen in stool samples: one latex agglutination test (culturette brand cdt, becton dickinson), two elisas (culturette brand toxin cd, becton dickinson, and ridascreen c. difficile toxin a/b, r-biopharm), two chromatographic assays (clearview c. difficile a, oxoid, and colorpac toxin a, becton dickinson) and one enzyme immunoassay for the simultaneous detection of c. difficile common antigen an ... | 2001 | 11298143 |
| when are stool cultures indicated for hospitalized patients with diarrhea not caused by clostridium difficile (c-diff)? | 2001 | 11300978 | |
| extracolonic manifestations of clostridium difficile infections. presentation of 2 cases and review of the literature. | clostridium difficile is most commonly associated with colonic infection. it may, however, also cause disease in a variety of other organ systems. small bowel involvement is often associated with previous surgical procedures on the small intestine and is associated with a significant mortality rate (4 of 7 patients). when associated with bacteremia, the infection is, as expected, frequently polymicrobial in association with usual colonic flora. the mortality rate among patients with c. difficile ... | 2001 | 11307591 |
| glutaraldehyde-induced colitis. | to describe the etiology and clinical course of acute colitis occurring after flexible endoscopy. | 2001 | 11308232 |
| laboratory-based surveillance for vancomycin-resistant enterococci: utility of screening stool specimens submitted for clostridium difficile toxin assay. | to study vancomycin-resistant enterococci (vre) gastrointestinal colonization prevalence in high-risk hospitalized patients and to assess the cost and utility of this laboratory-based surveillance. | 2001 | 11310695 |
| statistical inference for serial dilution assay data. | serial dilution assays are widely employed for estimating substance concentrations and minimum inhibitory concentrations. the poisson-bernoulli model for such assays is appropriate for count data but not for continuous measurements that are encountered in applications involving substance concentrations. this paper presents practical inference methods based on a log-normal model and illustrates these methods using a case application involving bacterial toxins. | 1999 | 11315070 |
| probiotic activities of lactobacillus casei rhamnosus: in vitro adherence to intestinal cells and antimicrobial properties. | the interest of probiotics as remedies for a broad number of gastrointestinal and other infectious diseases has gained wide interest over the last few years, but little is known about their underlying mechanism of action. in this study, the probiotic activities of a human isolate of lactobacillus casei subsp. rhamnosus strain (lcr35) were investigated. using intestinal caco-2 cell line in an in vitro model, we demonstrated that this strain exhibited adhesive properties. the inhibitory effects of ... | 2001 | 11316370 |
| clostridium beijerinckii and clostridium difficile detoxify methylglyoxal by a novel mechanism involving glycerol dehydrogenase. | in contrast to gram-negative bacteria, little is known about the mechanisms by which gram-positive bacteria degrade the toxic metabolic intermediate methylglyoxal (mg). clostridium beijerinckii br54, a tn1545 insertion mutant of the ncimb 8052 strain, formed cultures that contained significantly more (free) mg than wild-type cultures. moreover, br54 was more sensitive to growth inhibition by added mg than the wild type, suggesting that it has a reduced ability to degrade mg. the single copy of t ... | 2001 | 11319074 |
| clostridium difficile toxins and enterococcal translocation in vivo and in vitro. | clostridium difficile toxins alter permeability in cultured enterocytes and may alter intestinal epithelial permeability to bacteria in vivo. experiments were designed to test the effects of c. difficile toxins on in vitro interactions of enterococcus gallinarum with cultured enterocytes, as well as on translocation of e. gallinarum in mice. | 2001 | 11319888 |
| comparison of tn5397 from clostridium difficile, tn916 from enterococcus faecalis and the cw459tet(m) element from clostridium perfringens shows that they have similar conjugation regions but different insertion and excision modules. | comparative analysis of the conjugative transposons tn5397 from clostridium difficile and tn916 from enterococcus faecalis, and the cw459tet(m) element from clostridium perfringens, has revealed that these tetracycline-resistance elements are closely related. all three elements contain the tet(m) resistance gene and have sequence similarity throughout their central region. however, they have very different integration/excision modules. instead of the int and xis genes that are found in tn916, tn ... | 2001 | 11320127 |
| regulation of toxin synthesis in clostridium difficile by an alternative rna polymerase sigma factor. | clostridium difficile, a causative agent of antibiotic-associated diarrhea and its potentially lethal form, pseudomembranous colitis, produces two large protein toxins that are responsible for the cellular damage associated with the disease. the level of toxin production appears to be critical for determining the severity of the disease, but the mechanism by which toxin synthesis is regulated is unknown. the product of a gene, txer, that lies just upstream of the tox gene cluster was shown to be ... | 2001 | 11320220 |
| evaluation of biosite triage clostridium difficile panel for rapid detection of clostridium difficile in stool samples. | one hundred two stool samples were tested by both the rapid triage clostridium difficile panel (triage panel) and the cytotoxin cell culture assay. five samples positive by both the c. difficile toxin a (tox a) and common antigen components of the triage panel had cytotoxin titers of > or =10,000. twenty-three samples were triage panel tox a negative but common antigen positive. ten of these had cytotoxin titers of 10 to 1,000, but 13 were cytotoxin negative. bacterial isolates obtained from 8 o ... | 2001 | 11326003 |
| laboratory diagnosis of clostridium difficile-associated diarrhea and colitis: usefulness of premier cytoclone a+b enzyme immunoassay for combined detection of stool toxins and toxigenic c. difficile strains. | detection of clostridium difficile toxins a and b in stools by premier cytoclone a+b enzyme immunoassay (eia) was compared with detection by stool culture for c. difficile followed by detection of toxigenic isolates using the same eia. chart reviews were performed to evaluate the likelihood of c. difficile-associated diarrhea and colitis (cadc) for all patients with at least one positive toxin assay. while the toxins were detected in 58 of 85 consecutive cadc patients by both assays, cadc in 5 p ... | 2001 | 11326033 |
| ureidopenicillins and risk of clostridium difficile infection. | 2001 | 11328794 | |
| in vitro activity of sitafloxacin against clostridium difficile. | 2001 | 11328798 | |
| [evaluation of three methods of diagnosis of clostridium difficile infection]. | 2001 | 11333611 | |
| molecular typing and long-term comparison of clostridium difficile strains by pulsed-field gel electrophoresis and pcr-ribotyping. | thirty-two related and 68 unrelated isolates of clostridium difficile, isolated in different italian hospitals since 1987, were analysed by pfge and pcr-ribotyping to investigate their genetic relatedness. the isolates were classified into 28 groups by pfge and 20 ribotypes by pcr-ribotyping. a single clone of c. difficile was recognised as the cause of three geographically and chronologically distant outbreaks. the correlation between pfge and pcr-ribotyping results was good, with agreement for ... | 2001 | 11339247 |
| novel helicobacter species isolated from rhesus monkeys with chronic idiopathic colitis. | chronic, idiopathic diffuse colitis is a well recognised clinical and pathological entity in captive rhesus monkeys. six rhesus monkeys were diagnosed with clinically debilitating, chronic diarrhoea. histologically, colonic tissues were characterised as chronic, moderate to severe colitis and typhlitis, with diffuse mononuclear inflammation of lamina propria, reactive lymphoid hyperplasia and multifocal micro-abscesses. colonic tissues were cultured for salmonella spp. and shigella spp.; all res ... | 2001 | 11339249 |
| probiotic agents and infectious diseases: a modern perspective on a traditional therapy. | there is an increasing scientific and commercial interest in the use of beneficial microorganisms, or "probiotics," for the prevention and treatment of disease. the microorganisms most frequently used as probiotic agents are lactic-acid bacteria such as lactobacillus rhamnosus gg (lgg), which has been extensively studied in recent literature. multiple mechanisms of action have been postulated, including lactose digestion, production of antimicrobial agents, competition for space or nutrients, an ... | 2001 | 11340528 |
| suspected clostridium difficile-associated diarrhea in two cats. | two adult cats from the same household developed acute diarrhea. clostridium difficile toxins were detected in the feces of both cats, whereas other recognized causes of diarrhea were not identified. supportive medical treatment and metronidazole were administered and both cats responded well. a fecal sample obtained from 1 of the affected cats after treatment and a fecal sample obtained from a clinically normal cat in the household did not contain c difficile toxins. the role of c difficile in ... | 2001 | 11345306 |
| in vitro activities of ertapenem (mk-0826) against recent clinical bacteria collected in europe and australia. | ertapenem (mk-0826, l-749,345) is a 1-beta-methyl carbapenem with a long serum half-life. its in vitro activity was determined by broth microdilution against 3,478 bacteria from 12 centers in europe and australia, with imipenem, cefepime, ceftriaxone, and piperacillin-tazobactam used as comparators. ertapenem was the most active agent tested against members of the family enterobacteriaceae, with mics at which 90% of isolates are inhibited (mic(90)s) of < or =1 microg/ml for all species. ertapene ... | 2001 | 11353638 |