Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| detection of clostridium difficile and salmonella in feral swine population in north carolina. | we sampled 161 feral pigs in eastern north carolina, usa, to determine the prevalence and antimicrobial resistance profile of clostridium difficile and salmonella. seven (4.4%) and eight (5.0%) pigs tested positive for c. difficile and salmonella, respectively, highlighting the importance of determining the epidemiology of these pathogens in feral pigs. | 2011 | 21719851 |
| clostridium difficile colitis: factors associated with outcome and assessment of mortality at a national level. | previous descriptions of clostridium difficile colitis (cdc) epidemics may overestimate cost and mortality of cdc. | 2011 | 21720924 |
| epidemiology of suspected clostridium difficile-associated hospital-acquired diarrhea in hospitalized patients at siriraj hospital. | clostridium difficile-associated disease (cdad) is an important cause of hospital-acquired diarrhea. | 2011 | 21721449 |
| diagnostic testing for clostridium difficile: a comprehensive survey of laboratories in england. | recent studies have shown poor performance of commonly used toxin enzyme immunoassays (eias) for laboratory testing for clostridium difficile infection (cdi). in 2009-2010, the uk health protection agency and the european society of clinical microbiology and infectious diseases stated that toxin eia testing alone is suboptimal, and recommended a two-step testing protocol (i.e. screening with one method and confirming the results with another method). all acute english national health service tru ... | 2011 | 21724296 |
| prevalence and genotypic characteristics of clostridium difficile in a closed and integrated human and swine population. | recently, an apparent rise in the number of cases attributed to community-acquired clostridium difficile infection has led researchers to explore additional sources of infection. the finding of c. difficile in food animals and retail meat has raised concern about potential food-borne and occupational exposures. the objective of this study was to compare c. difficile isolated from a closed population of healthy individuals consisting of both humans and swine in order to investigate possible food ... | 2011 | 21724899 |
| evaluation of hospitalization for infections that are present on admission. | hospitals have experienced increasing requirements for public reporting of various infection rates using clinical and administrative data. until recently, such reports have not included analysis of "present on admission" (poa), an indicator designed to assess whether such infections are hospital acquired. the authors evaluated the frequency of the poa coding designation for 167 university healthsystem consortium hospitals for sepsis/septicemia (s-s), methicillin-resistant staphylococcus aureus ( ... | 2011 | 21724961 |
| evaluation of a simultaneous detection kit for the glutamate dehydrogenase antigen and toxin a/b in feces for diagnosis of clostridium difficile infection. | rapid detection kits for toxin a/b in feces are widely used as a diagnostic tool for clostridium difficile infection (cdi). their low sensitivity, however, has been considered a problem. in this study, we evaluated a new rapid diagnostic kit for simultaneous detection of the glutamate dehydrogenase (gdh) antigen and toxin a/b, c. diff quik chek complete. a total of 60 stool specimens from 60 patients with antibiotic-associated diarrhea were examined. using c. difficile culture as the reference m ... | 2011 | 21725661 |
| increased health burden associated with clostridium difficile diarrhoea in inflammatory bowel disease. | 2011 | 21726248 | |
| chapter 2-12-7. anaerobic infections (individual fields): antibiotic-associated diarrhea and enterocolitis. | 2011 | 21728113 | |
| unnecessary use of fluoroquinolone antibiotics in hospitalized patients. | abstract: | 2011 | 21729289 |
| [apoptosis-inducing effect of clostridium difficile toxin a on k562 cells and its mechanism]. | this study was purposed to investigate the growth inhibition and apoptosis-inducing effect of clostridium difficile toxin a (tcda) on the leukemia cell line k562. the proliferative activity of k562 cells exposed to tcd a was tested by mtt assay, cell apoptosis was detected by flow cytometry; immunocytochemistry and colorimetric assay were employed to detect the protein expressions of bcl-2/bax and the activity of caspase-3, respectively. the results indicated that the proliferation of k562 cells ... | 2011 | 21729540 |
| tigecycline for the treatment of severe clostridium difficile infection. | to evaluate the evidence for the use of tigecycline in the treatment of clostridium difficile infection (cdi). | 2011 | 21730279 |
| busulfan and metronidazole: an often forgotten but significant drug interaction. | to report the case of a clinically significant drug interaction between intravenous busulfan and oral metronidazole observed through busulfan therapeutic drug monitoring (tdm). | 2011 | 21730282 |
| proton pump inhibitor-associated pneumonia: not a breath of fresh air after all? | over the past two decades, proton pump inhibitors (ppis) have emerged as highly effective and relatively safe agents for the treatment of a variety of gastrointestinal disorders. unfortunately, this desirable pharmacological profile has also contributed to superfluous and widespread use in both the inpatient and outpatient settings. while generally well-tolerated, research published over the last decade has associated these agents with increased risks of clostridium difficile disease, fractures ... | 2011 | 21731913 |
| bacteria as trigger for chronic gastrointestinal disorders. | apart from acute infections, microorganisms may also induce or perpetuate chronic inflammatory diseases and reversible or irreversible proliferation of various cells in the gastrointestinal tract (the extreme being adenocarcinoma and lymphoma). helicobacter pylori is not only involved in the pathogenesis of lymphoma and gastric adenocarcinoma. the steps and mechanisms of the carcinogenic process involve host predisposition, environmental factors, and strain virulence. the steps of lymphoma genes ... | 2011 | 21734380 |
| pyrosequencing-based molecular monitoring of the intestinal bacterial colonization in preterm infants. | objectives:: to investigate the previously unexplored diversity of neonatal intestinal microbiota and monitor early intestinal colonization patterns in korean preterm infants using high-throughput pyrosequencing technology combined with 16s rdna- based molecular methods methods:: a total of 46,369 partial 16s rdna sequences obtained from 30 fecal samples serially taken from 10 very low birth weight preterm infants were analyzed. results:: a significant proportion of the molecular species (21.9%) ... | 2011 | 21734604 |
| healthcare cost and utilization project (hcup) statistical briefs | this statistical brief presents data from the healthcare cost and utilization project (hcup) on the trend in cdad from 1993 to 2005 and provides details on cdad hospitalizations for 2005. a recent evaluation of surveillance for cdad in hospitals found high sensitivity (78%) and specificity (99.7%) when using international classification of diseases, 9th revision (icd-9) codes. although it is not possible to determine whether these infections originated in a healthcare setting or were community a ... | 2006 | 21735570 |
| risk factors for recurrence of clostridium difficile infection: effect of vancomycin-resistant enterococci colonization. | recurrent clostridium difficile infection (cdi) is one of the most difficult problems in healthcare infection control. we evaluated the risk factors associated with recurrence in patients with cdi. a retrospective cohort study of 84 patients with cdi from december 2008 through october 2010 was performed at pusan national university yangsan hospital. recurrence occurred in 13.1% (11/84) of the cases and in-hospital mortality rate was 7.1% (6/84). stool colonization with vancomycin-resistant enter ... | 2011 | 21738336 |
| a role for tlr4 in clostridium difficile infection and the recognition of surface layer proteins. | clostridium difficile is the etiological agent of antibiotic-associated diarrhoea (aad) and pseudomembranous colitis in humans. the role of the surface layer proteins (slps) in this disease has not yet been fully explored. the aim of this study was to investigate a role for slps in the recognition of c. difficile and the subsequent activation of the immune system. bone marrow derived dendritic cells (dcs) exposed to slps were assessed for production of inflammatory cytokines, expression of cell ... | 2011 | 21738466 |
| real numbers tell real stories in health services management. | in the words of one hospital manager, "hospital data is currently indigestible and alien to the average user." drawing upon the experience of an academic hospital that, contrary to established practice, published real numbers alongside rates and ratios during a clostridium difficile outbreak, the authors examined the pitfalls of publishing only abstract performance measures and the advantages of releasing real numbers to the public. this article identifies lessons for hospital board governance, ... | 2010 | 21739823 |
| management of gram-positive bacterial infections in patients with cancer. | abstract bacterial infections, particularly those due to gram-positive bacteria, continue to predominate in patients with cancer. coagulase-negative and coagulase-positive staphylococci and enterococci remain as common pathogenic microorganisms. clostridium difficile has emerged as a significant pathogen. major clinical syndromes include vascular catheter-related infection, febrile neutropenia, diarrhea and colitis. rising antimicrobial resistance among gram-positive bacteria is of serious con ... | 2011 | 21740298 |
| Rifaximin: new therapeutic indication and future directions. | Rifaximin is a nonabsorbable oral antibiotic that acts locally in the gastrointestinal tract with minimal systemic adverse effects. Rifaximin received new labeling for reduction in the risk of the recurrence of overt hepatic encephalopathy (HE) in patients with advanced liver disease in March of 2010. | 2011 | 21741091 |
| laboratory diagnosis of clostridium difficile infection in spain: a population-based survey. | a survey of laboratory diagnosis of clostridium difficile infection (cdi) was conducted in 103 spanish hospitals. a mean of 23.2 stool specimens/1000 admissions were processed to detect cdi. overall, 35.9% of the laboratories specifically selected stool specimens for diagnostic c.-ádifficile toxin testing. the most commonly used criteria were loose or watery stools, previous antibiotic therapy and nosocomial diarrhoea. most laboratories (95.1%) processed the stool specimens in house, mainly five ... | 2011 | 21741114 |
| comparative effects of the immediate and the extended release formulations of ciprofloxacin on normal human intestinal microflora. | ciprofloxacin is a well-known fluoroquinolone, active in vitro against most gram-negative and gram-positive bacteria. the purpose of the present study was to evaluate the ecological effects of an orally administered extended-release formulation of ciprofloxacin in comparison with an immediate-release formulation of ciprofloxacin on the normal human intestinal microflora. thirty-six healthy female subjects were included in the study. the extended-release formulation of ciprofloxacin was given as ... | 2011 | 21742583 |
| clinical features of clostridium difficile infection and molecular characterization of the isolated strains in a cohort of danish hospitalized patients. | the purpose of this study was to compare clinical features of clostridium difficile infection (cdi) to toxin gene profiles of the strains isolated from danish hospitalized patients. c. difficile isolates were characterized by pcr based molecular typing methods including toxin gene profiling and analysis of deletions and truncating mutations in the toxin regulating gene tcdc. clinical features were obtained by questionnaire. thirty percent of the cdi cases were classified as community-acquired. i ... | 2011 | 21744281 |
| identification of a novel virulence factor in clostridium difficile modulating toxin sensitivity of cultured epithelial cells. | two glucosylating toxins named toxins a and b play a role in pathogenesis of clostridium difficile infection. the interaction of the toxins with host cell factors proceeds to downstream stages of cytotoxic effects in cells, in which involvement of other c. difficile factors remains unknown. we utilized culture filtrate of c. difficile with a low dilution to characterize the influence of putative minor proteins on the organization of the actin cytoskeleton in cultured epithelial cells and found a ... | 2011 | 21746858 |
| molecular epidemiology and susceptibility profiles of clostridium difficile in new zealand, 2009. | the aim of this study was to provide baseline information on the molecular epidemiology and the antimicrobial susceptibility of clostridium difficile (c. difficile) clinical isolates from patients throughout new zealand. | 2011 | 21747423 |
| epidemic strains of clostridium difficile are present in auckland, new zealand. | 2011 | 21747433 | |
| binary toxin and death after clostridium difficile infection. | we compared 30-day case-fatality rates for patients infected with clostridium difficile possessing genes for toxins a and b without binary toxin (n = 212) with rates for patients infected with c. difficile possessing genes for a, b, and binary toxin. the latter group comprised patients infected with strains of pcr ribotype 027 (cd027, n = 193) or non-027 (cd non-027, n = 72). patients with binary toxin had higher case-fatality rates than patients without binary toxin, in univariate analysis (rel ... | 2011 | 21749757 |
| [the disease caused by clostridium difficile in geriatric patients]. | the disease caused by the bacterium clostridium difficile/clostridium difficile associated disease/diarrhoea (cdad) is becoming a serious problem especially in geriatric patients, who are now relatively often treated by broad-spectrum antibiotics. the goal of our study was to evaluate the occurrence of the risk factors and to evaluate the complex of relations and coherence which lead to the cdad disease in a selected group of seniors treated at our institution. | 2011 | 21751507 |
| [the use of immunoglobulins in the treatment of infectious diseases]. | the use of immunoglobulins in the treatment of infectious diseases has a long tradition. initially immunoglobulins from hyperimmunised animals were used for their antitoxic and antimicrobial activity. the development of preparations of human intravenous immunoglobulin (ivig) and the observations of their long-term use enabled to assess their usefulness in the treatment of the diseases of proven or probable infectious etiology. in the treatment of infectious diseases ivig are currently used as im ... | 2011 | 21751556 |
| novel inhibitors of surface layer processing in clostridium difficile. | clostridium difficile, a leading cause of hospital-acquired bacterial infection, is coated in a dense surface layer (s-layer) that is thought to provide both physicochemical protection and a scaffold for host-pathogen interactions. the key structural components of the s-layer are two proteins derived from a polypeptide precursor, slpa, via proteolytic cleavage by the protease cwp84. here, we report the design, synthesis and in vivo characterization of a panel of protease inhibitors and activity- ... | 2011 | 21752656 |
| genome mining for radical sam protein determinants reveals multiple sactibiotic-like gene clusters. | thuricin cd is a two-component bacteriocin produced by bacillus thuringiensis that kills a wide range of clinically significant clostridium difficile. this bacteriocin has recently been characterized and consists of two distinct peptides, trnβ and trnα, which both possess 3 intrapeptide sulphur to α-carbon bridges and act synergistically. indeed, thuricin cd and subtilosin a are the only antimicrobials known to possess these unusual structures and are known as the sactibiotics (sulplur to alpha ... | 2011 | 21760885 |
| incidence of and risk factors for community-associated clostridium difficile infection: a nested case-control study. | abstract: background: clostridium difficile is the most common cause of nosocomial infectious diarrhea in the united states. however, recent reports have documented that c. difficile infections (cdis) are occurring among patients without traditional risk factors. the purpose of this study was to examine the epidemiology of ca-cdi, by estimating the incidence of ca-cdi and ha-cdi, identifying patient-related risk factors for ca-cdi, and describing adverse health outcomes of ca-cdi. methods: we co ... | 2011 | 21762504 |
| impact of changes in clostridium difficile diagnostic testing on detection of c. difficile infection and all england mandatory surveillance data. | following the report of the centre for evidence-based purchasing, which suggested poor performance of clostridium difficile testing kits, revised guidance was issued by the department of health (england) recommending a two-test algorithm. the aim of this study was to survey english national health service (nhs) diagnostic microbiology laboratories using an electronic questionnaire to investigate changes in laboratory procedures in response to the guidance and model the impact these changes had o ... | 2011 | 21764171 |
| clinical and infection control implications of clostridium difficile infection with negative enzyme immunoassay for toxin. | in a prospective study of 132 patients with a diagnosis of clostridium difficile infection (cdi) by polymerase chain reaction, 43 (32%) had enzyme immunoassay (eia) results negative for toxin. eia-negative patients with cdi did not differ in clinical presentation from eia-positive patients and presented a similar risk for transmission of spores. | 2011 | 21765078 |
| clostridium difficile: trouble for adults and children. | 2011 | 21765334 | |
| best strategies in recurrent or persistent clostridium difficile infection. | abstract background: clostridium difficile infection (cdi) is the primary cause of antibiotic-associated colitis and 15-25% of nosocomial antibiotic-associated diarrhea. its clinical manifestations can range from mild diarrhea to toxic megacolon, bowel perforation, septic shock, and death. over the past decade, more virulent strains have become increasingly common causes, and the incidence of cdi has risen, especially in elderly patients. these developments have led to an increase in recurrent c ... | 2011 | 21767157 |
| reproducibility of broth microdilution and comparison to agar dilution for testing cb-183,315 against clinical isolates of clostridium difficile. | this study evaluated the reproducibility and agreement of broth microdilution to agar dilution (ad) for testing cb-183,315, a novel lipopeptide antibiotic for clostridium difficile. reproducibility was 100% within ± one 2-fold dilution for 10 strains tested; agreement was 90-95% within one 2-fold dilution with ad for 103 clinical isolates. | 2011 | 21767714 |
| clostridium difficile infection after malaria chemoprophylaxis with doxycycline: is there an association? | malaria chemoprophylaxis with doxycycline is commonly used in the united kingdom and in many other countries. it is considered to be associated with an increased risk of clostridium difficile associated diarrhea (cdad). we describe a case of diarrhea and a positive stool assay for c. difficile in a returning traveler, and review available literature. the commonly held concept of an association between doxycycline chemoprophylaxis and cdad is not supported by available data. | 2011 | 21767993 |
| pneumocystis carinii interactions with lung epithelial cells and matrix proteins induce expression and activity of the pcste20 kinase with subsequent phosphorylation of the downstream cell wall biosynthesis kinase pccbk1. | eukaryotic cell proliferation and phenotype are highly regulated by contact dependent mechanisms. we have previously shown that the binding and interaction of the opportunistic fungal pathogen pneumocystis carinii (pc) to lung epithelial cells and extracellular matrix proteins induces mrna expression of both the map kinase pcste20 and the cell wall remodeling enzyme pccbk1 (16). herein, we report that in addition to up-regulation of pcste20 mrna expression, pneumocystis pcste20 kinase activity i ... | 2011 | 21768277 |
| membrane translocation of binary actin-adp-ribosylating toxins from clostridium difficile and clostridium perfringens is facilitated by cyclophilin a and hsp90. | some hypervirulent strains of clostridium difficile produce the binary actin-adp-ribosylating toxin cdt in addition to the rho-glucosylating toxins a and b. it has been suggested that the presence of cdt increases the severity of the c. difficile-associated diseases including pseudomembranous colitis. cdt contains a binding and translocation component cdtb, which mediates the transport of the separate enzyme component cdta into the cytosol of target cells, where cdta modifies actin. here, we hav ... | 2011 | 21768281 |
| terminal decontamination of patient rooms using an automated mobile uv light unit. | objective. to determine the ability of a mobile uv light unit to reduce bacterial contamination of environmental surfaces in patient rooms. methods. an automated mobile uv light unit that emits uv-c light was placed in 25 patient rooms after patient discharge and operated using a 1- or 2-stage procedure. aerobic colony counts were calculated for each of 5 standardized high-touch surfaces in the rooms before and after uv light decontamination (uvld). clostridium difficile spore log reductions ac ... | 2011 | 21768755 |
| awareness about clostridium difficile infection among internal medicine residents in the united states. | clostridium difficile infection (cdi) is the leading infective cause of antibiotic associated diarrhea. the principal objective of this study was to assess the knowledge and awareness of internal medicine (im) residents regarding the epidemiology, clinical recognition, diagnosis and management of cdi. | 2011 | 21769073 |
| multidrug resistance in european clostridium difficile clinical isolates. | objectives multidrug resistance and antibiotic resistance mechanisms were investigated in 316 clostridium difficile clinical isolates collected during the first european surveillance on c. difficile in 2005. methods mics of eight different antibiotics were determined using etest. reserpine- and carbonyl cyanide m-chlorophenylhydrazone-sensitive efflux was tested using the agar dilution method. molecular analysis of the resistance mechanisms was performed using pcr assays, pcr mapping and sequenc ... | 2011 | 21771851 |
| laboratory diagnosis of clostridium difficile infection: in a state of transition or confusion or both? | 2011 | 21775016 | |
| spread and persistence of clostridium difficile spores during and after cleaning with sporicidal disinfectants. | 2011 | 21775017 | |
| at least it won't hurt: the personal risks of antibiotic exposure. | this review presents recent evidence regarding the adverse effects of antibiotic therapy mediated by collateral damage to commensal flora. two major drivers have characterized recent research in this field: new perspectives into human microbiota afforded by next-generation dna sequencing techniques and ongoing attention to antimicrobial resistance. new molecular techniques have illustrated that antibiotic therapy can disturb human microbiota, and that these changes are associated with infection. ... | 2011 | 21775205 |
| comparison of a commercially available rep-pcr system (diversilab(r)) with pcr-ribotyping for typing of clostridium difficile strains. | this study compared a rep-pcr method (diversilab® system) to pcr-ribotyping. the discriminatory power of rep-pcr was 0.997. among the pcr-ribotype 027, different rep-types could be distinguished. rep-pcr showed a higher discriminatory power than pcr-ribotyping. nevertheless, this method requires technical skill and visual interpretation of rep-pcr fingerprint patterns may be difficult. | 2011 | 21775548 |
| the impact of recombination on dn/ds within recently emerged bacterial clones. | the development of next-generation sequencing platforms is set to reveal an unprecedented level of detail on short-term molecular evolutionary processes in bacteria. here we re-analyse genome-wide single nucleotide polymorphism (snp) datasets for recently emerged clones of methicillin resistant staphylococcus aureus (mrsa) and clostridium difficile. we note a highly significant enrichment of synonymous snps in those genes which have been affected by recombination, i.e. those genes on mobile elem ... | 2011 | 21779170 |
| emergence of clostridium difficile ribotype 027 in korea. | clostridium difficile infection (cdi) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in north america and europe since 2003. the aims of this study were to determine the prevalence of ribotype 027 among c. difficile isolates in korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of cdi in patients infected with these isolates. | 2011 | 21779194 |
| direct detection of clostridium difficile 027 in diarrhoeal stool samples. | 2011 | 21783275 | |
| the relation between farm specific factors and prevalence of clostridium difficile in slaughter pigs. | foodborne ingestion through pork products of clostridium difficile has been suggested a possible route of transmission of c difficile from pigs to humans. to determine whether c. difficile bacteria are present in the intestines of slaughter pigs, rectum contents of 677 slaughter pigs from 52 farms were collected at the slaughterhouse. data on farm specific factors were collected and the association of these factors with the presence of c. difficile in pig herds from 39 farms was assessed. the pr ... | 2011 | 21783332 |
| localization of the clostridium difficile cysteine protease cwp84 and insights into its maturation process. | clostridium difficile is a nosocomial pathogen involved in antibiotic-associated diarrhea. c. difficile expresses a cysteine protease, cwp84, which has been shown to degrade some proteins of the extracellular matrix and play a role in the maturation of the precursor of the s-layer proteins. we sought to analyze the localization and the maturation process of this protease. two identifiable forms of the protease were found to be associated in the bacteria: a form of about 80 kda and a cleaved one ... | 2011 | 21784932 |
| a quantitative proteomic analysis of the heat stress response in <i>clostridium difficile</i> strain 630. | <i>clostridium difficile</i> is a serious nosocomial pathogen whose prevalence worldwide is increasing. post genomic technologies can now be deployed in order to develop understanding of the evolution and diversity of this important human pathogen, yet little is known about the adaptive ability of <i>c. difficile</i>. we used itraq labelling and 2d-lc-ms/ms driven proteomics to investigate the response of <i>c. difficile</i> 630 to a mild, but clinically relevant heat stress. a statistically val ... | 2011 | 21786815 |
| role of faecal gas analysis for the diagnosis of ibd. | the diagnosis of ibd (inflammatory bowel disease) is based on the clinical evaluation of symptoms and signs leading to a series of investigations. the investigations used are often unpleasant for patients; they are invasive, costly and potentially dangerous. patients often report that the odour of flatus, or the gas emitted from faeces, is abnormal during a flare of their ibd. our group has characterized the vocs (volatile organic compounds) in the headspace gas emitted from faecal samples from ... | 2011 | 21787351 |
| mutagenic analysis of the clostridium difficile flagellar proteins, flic and flid, and their contribution to virulence in hamsters. | although toxins a and b are known to be important contributors to the acute phase of clostridium difficile infection (cdi), the role of colonization and adherence to host tissues in the overall pathogenesis of these organisms remains unclear. consequently, we used the recently introduced intron-based clostron gene interruption system to eliminate the expression of two reported c. difficile colonization factors, the major flagellar structural subunit (flic) and the flagellar cap protein (flid), t ... | 2011 | 21788384 |
| update on the management of ulcerative colitis. | the treatment options for inflammatory bowel disease have expanded with the introduction of biological therapies. recently published controlled clinical trials were searched and those that impact the clinical management of ulcerative colitis (uc) are discussed in this review. in the management of mild to moderate uc, mesalamine still remains the first choice of drug. the newly developed once daily formulations have shown equal efficacy to divided doses and possibly portend better compliance owin ... | 2011 | 21789495 |
| clostridium difficile and methicillin-resistant staphylococcus aureus shedding by slaughter-age pigs. | abstract: background: clostridium difficile and methicillin-resistant staphylococcus aureus are critical human pathogens and of increasing concern in food animals. because of the apparent impact of age on prevalence of these organisms, studies of slaughter age pigs are important when considering the potential for contamination of food. this study evaluated c. difficile and mrsa shedding by slaughter age pigs from farms across canada. results: clostridium difficile was isolated from 30/436 (6.9%) ... | 2011 | 21791057 |
| impact of a multipronged education strategy on antibiotic prescribing in quebec, canada. | background. antibiotic overuse and resistance have become a major threat in the last 2 decades. many programs tried to optimize antibiotic consumption in the inpatient setting, but the outpatient environment that represents the bulk of antibiotic use has been challenging. following a significant rise of clostridium difficile infections, all the health care stakeholders in the province of quebec, canada initiated a global education program targeting physicians and pharmacists. methods. a bundle a ... | 2011 | 21791439 |
| [risk factors for clostridium difficile infections in hospitalized patients.] | background and objectives: to identify risk factors, and to estimate the crude effects attributable to hospital acquired clostridium difficile infection (cdi). patients and methods: case-control study matched by age, gender, and admission date. patient and healthcare risk factors were evaluated. hospital stays and mortality were compared. results: thirty-eight cases and 76 controls were included (mean age 73 years). cases presented worse charlson index (p .02), higher pre-infection stay (median ... | 2011 | 21794881 |
| a clostridium difficile infection "intervention": change in toxin assay results in fewer c difficile infection cases without changes in patient outcomes. | background: clostridium difficile infection (cdi) is most commonly diagnosed using toxin enzyme immunoassays (eias). a sudden decrease in cdi incidence was noted after a change in the eia used at barnes-jewish hospital in st louis. the objective of this study was to determine whether the decreased cdi incidence related to the change in eia resulted in adverse patient outcomes. methods: electronic hospital databases were used to collect data on demographics, outcomes, and treatment of inpatients ... | 2011 | 21794950 |
| a call to arms: the imperative for antimicrobial stewardship. | antimicrobial resistance is a major public health crisis. the prevalence of drug-resistant organisms, such as the emerging nap1 strain of clostridium difficile, now highly resistant to fluoroquinolones, acinetobacter species, klebsiella pneumoniae carbapenemase-producing organisms, and methicillin-resistant staphylococcus aureus, is increasing nationwide. the sources of antimicrobial resistance are manifold, but there is a well-documented causal relationship between antimicrobial use and misuse ... | 2011 | 21795727 |
| expression, purification, crystallization and preliminary crystallographic analysis of a putative clostridium difficile surface protein cwp19. | cwp19 is a putatively surface-located protein from clostridium difficile. a recombinant n-terminal protein (residues 27-401) lacking the signal peptide and the c-terminal cell-wall-binding repeats (pfam04122) was crystallized using the sitting-drop vapour-diffusion method and diffracted to 2 å resolution. the crystal appeared to belong to the primitive monoclinic space group p2(1), with unit-cell parameters a = 109.1, b = 61.2, c = 109.2 å, ß = 111.85°, and is estimated to contain two molecules ... | 2011 | 21795789 |
| high alpha-1 antitrypsin clearance predicts severity of gut graft-versus-host disease (gvhd) in children. | hagen lem, schechter t, luk y, brodovitch a, gassas a, doyle jj. high alpha-1 antitrypsin clearance predicts severity of gut graft-versus-host disease (gvhd) in children. pediatr transplantation 2011. © 2011 john wiley & sons a/s. abstract: the clinical evaluation and management of gut gvhd is a significant challenge in pediatric hsct. it is often difficult to obtain pathological evidence to confirm diagnosis and/or to determine response to treatment. the severity of the disease itself may not ... | 2011 | 21797957 |
| mortality and associated risk factors in consecutive patients admitted to a uk nhs trust with community acquired bacteraemia. | purpose within the uk, there is lack of contemporary data on clinical outcomes in patients admitted to hospital with severe community acquired infection. the purpose of this study was to determine outcomes and risk factors associated with mortality in consecutive patients admitted to a uk nhs trust with community acquired infections that cause bacteraemia. methods from september 2007 to august 2008, demographic, clinical and microbiological data were collected on patients with laboratory confirm ... | 2011 | 21798969 |
| fidaxomicin-the next step? a new narrow-spectrum macrocyclic antibiotic for the management of clostridium difficile infection. | 2011 | 21801724 | |
| evaluation of the sporicidal activity of different chemical disinfectants used in hospitals against clostridium difficile. | decontamination of surfaces and medical equipment is integral to the control of clostridium difficile transmission, and many products claim to inactivate this bacterium effectively. thirty-two disinfectants were tested against spores of c. difficile in a suspension test based on european standard bs en 13704:2002, with contact times of 1 and 60min in simulations of clean (0.3% albumin) and dirty (3% albumin) conditions. the addition of a 1-min contact time was chosen as a more realistic simulati ... | 2011 | 21802172 |
| structure-based modification of a clostridium difficile targeting endolysin affects activity and host range. | endolysin cd27l causes cell lysis of the pathogen c. difficile, a major cause of nosocomial infection. we report a structural and functional analysis of the catalytic activity of cd27l against c. difficile and other bacterial strains. we show that truncation of the endolysin to the n-terminal domain cd27l(1-179) gave an increased lytic activity against cells of c. difficile, while the c-terminal region cd27l(180-270) failed to produce lysis. cd27l(1-179) also has increased activity against other ... | 2011 | 21803993 |
| disinfection methods for spores of bacillus atrophaeus, b. anthracis, clostridium tetani, c. botulinum and c. difficile. | to evaluate disinfection methods for environments contaminated with bioterrorism-associated microorganism (bacillus anthracis), we performed the following experiments. first, the sporicidal effects of sodium hypochlorite on spores of five bacterial species were evaluated. bacillus atrophaeus was the most resistant to hypochlorite, followed in order by b. anthracis, clostridium botulinum and clostridium tetani, and clostridium difficile. subsequently, using b. atrophaeus spores that were the most ... | 2011 | 21804226 |
| both, toxin a and toxin b, are important in clostridium difficile infection. | the bacterium clostridium difficile is the leading cause of healthcare associated diarrhoea in the developed world and thus presents a major financial burden. the main virulence factors of c. difficile are two large toxins, a and b. over the years there has been some debate over the respective roles and importance of these two toxins. to address this, we recently constructed stable toxin mutants of c. difficile and found that they were virulent if either toxin a or toxin b was functional. this u ... | 2011 | 21804353 |
| the interplay between microbiome dynamics and pathogen dynamics in a murine model of clostridium difficile infection. | clostridium difficile infection (cdi) arises in the setting of antibiotic administration where disruption of the normal indigenous gut microbiota leads to susceptibility to c. difficile colonization and colitis. using a murine model of cdi, we demonstrate that changes in the community structure of the indigenous gut microbiota are associated with the loss of colonization resistance against c. difficile. several antibiotic regimens were tested in combination for the ability to overcome colonizati ... | 2011 | 21804357 |
| clostridium difficile-associated diarrhea in radiooncology: an underestimated problem for the feasibility of the radiooncological treatment? | abstract: background and purpose: over the last years an increasing incidence of clostridium difficile-associated diarrhea (cdad) has been reported. especially haematology-oncology patients are at risk of developing cdad. the aim of this analysis is to determine the incidence of cdad in radiooncological patients and to find out what relevance cdad has for the feasibility of the radiooncological treatment, as well as to detect and describe risk factors. patients and methods: in a retrospective an ... | 2011 | 21806799 |
| the insect peptide, coprisin, prevents clostridium difficile-mediated acute inflammation and mucosal damage through selective antimicrobial activity. | clostridium difficile-associated diarrhea and pseudomembranous colitis are typically treated with vancomycin or metronidazole, but recent increases in relapse incidence and the appearance of drug-resistant strains of c. difficile indicate the need for new antibiotics. we previously isolated an antibacterial peptide from copris tripartitus, a korean dung beetle, and identified a nine-amino-acid peptide (coprisin: llcialrkk) that had antimicrobial activity. here, we examined whether coprisin treat ... | 2011 | 21807975 |
| clostridium difficile infection causing multiple organ failure and small-bowel enteritis. | 2011 | 21809490 | |
| the management of clostridium difficile-associated diarrhoea in a community hospital. | to review the management of patients with clostridium difficile-associated diarrhoea (cdad). | 2011 | 21809713 |
| molecular epidemiology of clostridium difficile in a tertiary medical center in israel: emergence of the polymerase chain reaction ribotype 027. | the rate of infection with clostridium difficile colitis and its associated mortality have been increasing in the last decade. the molecular epidemiology of c. difficile in israel has not been studied. | 2011 | 21809729 |
| fidaxomicin: first-in-class macrocyclic antibiotic. | the incidence of clostridium difficile has doubled over the past 15 years, and rising mortality rates associated with this infection have followed in its wake. c. difficile infection (cdi) has supplanted methicillin-resistant staphylococcus aureus as the major cause of nosocomial infection. an insufficient response rate to currently available cdi therapies has prompted the search for new and alternative treatment modalities for this disease. the investigational pipeline includes evaluation of ne ... | 2011 | 21810048 |
| the emergence of clostridium difficile infection among peripartum women: a case-control study of a c. difficile outbreak on an obstetrical service. | objective. an outbreak of 20 peripartum clostridium difficile infections (cdi) occurred on the obstetrical service at the university of washington medical center (uwmc) between april 2006 and june 2007. in this report, we characterize the clinical manifestations, describe interventions that appeared to reduce cdi, and determine potential risk factors for peripartum cdi. methods. an investigation was initiated after the first three peripartum cdi cases. based on the findings, enhanced infection c ... | 2011 | 21811379 |
| clostron-mediated engineering of clostridium. | the genus clostridium is a diverse assemblage of gram positive, anaerobic, endospore-forming bacteria. whilst certain species have achieved notoriety as important animal and human pathogens (e.g. clostridium difficile, clostridium botulinum, clostridium tetani, and clostridium perfringens), the vast majority of the genus are entirely benign, and are able to undertake all manner of useful biotransformations. prominent amongst them are those species able to produce the biofuels, butanol and ethano ... | 2011 | 21815105 |
| what would we do without metronidazole? | metronidazole is a treatment of choice for several types of infections, but coexisting conditions or concomitant medications may preclude its use. although tinidazole, a newer nitroimidazole, may be an option in cases where drug interactions make the use of metronidazole inadvisable, similar absolute contraindications exist. in situations where nitroimidazole use is contraindicated or inadvisable, clinicians may have difficulty deciding on efficacious treatment options. for the treatment of tric ... | 2011 | 21817887 |
| structural basis for a kolbe-type decarboxylation catalyzed by a glycyl radical enzyme. | 4-hydroxyphenylacetate decarboxylase is a [4fe-4s] cluster containing glycyl radical enzyme proposed to use a glycyl/thiyl radical dyad to catalyze the last step of tyrosine fermentation in clostridia. the decarboxylation product p-cresol (4-methylphenol) is a virulence factor of the human pathogen clostridium difficile . here we describe the crystal structures at 1.75 and 1.81 +à resolution of substrate-free and substrate-bound 4-hydroxyphenylacetate decarboxylase from the related clostridium s ... | 2011 | 21823587 |
| clostridium difficile infection: monoclonal or polyclonal genesis? | clostridium difficile is considered to be a leading cause of hospital-acquired diarrhea. c. difficile (cdi) infection shows a high rate of recurrence. there would have to be a predominantly monoclonal mechanism of cdi within individual patients in order for molecular epidemiologic tools such as polymerase chain reaction (pcr) ribotyping to be useful in outbreak investigation or differentiation between infection relapse versus re-infection. it was the aim of our study to determine whether cdi is ... | 2011 | 21826436 |
| clostridium difficile outbreak strain bi is highly endemic in chicago area hospitals. | objective.ôçâdescribe the clinical and molecular epidemiology of incident clostridium difficile infection (cdi) cases in chicago area acute healthcare facilities (hcfs). design and setting.ôçâlaboratory, clinical, and epidemiologic information was collected for patients with incident cdi who were admitted to acute hcfs in february 2009. stool cultures and restriction endonuclease analysis typing of the recovered c. difficile isolates was performed. patients.ôçâtwo hundred sixty-three patients fr ... | 2011 | 21828970 |
| impact of pcr testing for clostridium difficile on incident rates and potential on public reporting: is the playing field level? | 2011 | 21828981 | |
| Over-diagnosis of Clostridium difficile. | 2011 | 21831939 | |
| differential risk of clostridium difficile infection with proton pump inhibitor use by level of antibiotic exposure. | purpose: clostridium difficile infection (cdi) is a major cause of hospital-acquired diarrhea worldwide. we examined the risk of cdi associated with the use of acid-suppressive agents (proton pump inhibitors [ppi] and histamine-2 receptor blockers) and determined whether this risk varied by number or type of antibiotic (high or low cdi risk) received during hospitalization. methods: we conducted a retrospective cohort study of hospitalizations among adult patients at an academic teaching hospita ... | 2011 | 21833992 |
| predictors of severity in ischaemic colitis. | purpose: ischaemic colitis (ic) is an inadequate perfusion leading to potentially life-threatening colonic inflammation. the aim was to identify patient characteristics that predict severity in biopsy-confirmed ic. methods: a retrospective study of consecutive patients admitted with a robust diagnosis of ic over a 5-year period was performed. as ic is often misdiagnosed, strict inclusion criteria including supporting histopathology, exclusion of inflammatory bowel disease, absence of recent anti ... | 2011 | 21842142 |
| emergency colectomy for fulminant clostridium difficile colitis: striking the right balance. | abstract the number of reported cases of clostridium difficile (cd) infections has increased markedly worldwide. cd causes a spectrum of clinical syndromes, ranging from mild diarrhea to a very severe illness in the form of pseudomembranous colitis (pmc), toxic megacolon, leading to colonic perforation, peritonitis, and even death. in today's practice, toxic megacolon is more often caused by pseudomembranous colitis than ulcerative colitis. there is urgent need to establish clear guidelines abou ... | 2011 | 21843039 |
| efficacy of fidaxomicin versus vancomycin as therapy for clostridium difficile infection in individuals taking concomitant antibiotics for other concurrent infections. | background.ôçâtreatment guidelines recommend stopping all implicated antibiotics at the onset of clostridium difficile infection (cdi), but many individuals have persistent or new infections necessitating the use of concomitant antibiotics (cas). we used data from 2 phase 3 trials to study effects of cas on response to fidaxomicin or vancomycin. methods.ôçâsubjects with cdi were treated for 10 days with fidaxomicin 200 mg every 12 hours or vancomycin 125 mg every 6 hours, assessed for resolution ... | 2011 | 21844027 |
| comparative susceptibilities of fidaxomicin (opt-80) of isolates collected at baseline, recurrence, and failure from patients in two fidaxomicin phase iii trials of clostridium difficile infection. | background: a 10-day course of oral fidaxomicin (200 mg bid), a potent new macrocyclic drug, was compared to vancomycin (125 mg qid) in 1,164 adults (1,105 modified intention to treat (mitt) population ) with cdi in two phase 3 randomized, double-blind trials at sites in north america and 7 european countries. results: of 1,105 mitt patients: 792 (71.7%) including 719/999 (72.0%) of the per-protocol population (pp) provided a c. difficile strain at baseline of which 356 received fidaxomicin with ... | 2011 | 21844318 |
| the intestinal microbiota and chronic disorders of the gut. | mucosal surfaces of the gut are colonized by large numbers of heterogeneous bacteria that contribute to intestinal health and disease. in genetically susceptible individuals, a 'pathogenic community' may arise, whereby abnormal gut flora contributes to alterations in the mucosa and local immune system leading to gastrointestinal disease. these diseases include enteric infections, such as clostridium difficile infection, small intestinal bacterial overgrowth, functional gastrointestinal disorders ... | 2011 | 21844910 |
| laboratory testing for clostridium difficile infection: light at the end of the tunnel. | clostridium difficile infection (cdi) is changing as evidenced by increasing virulence, rising incidence, unresponsiveness to metronidazole therapy, and worse outcomes. thus, it is critical that cdi diagnosis be accurate so ongoing epidemiology, disease prevention, and treatment remain satisfactory. we tested 10 diagnostic assays, including 1 commercial real-time polymerase chain reaction (qpcr) test for the laboratory detection of toxigenic c difficile on 1,000 stool samples. sensitive culture ... | 2011 | 21846912 |
| fewer recurrent infections of c. difficile seen with fidaxomicin. this new class of antibiotic--the macrocycles--has a greater sustained response against re-infection than vancomycin. | 2011 | 21848202 | |
| Impact of clostridial glucosylating toxins on the proteome of colonic cells determined by isotope-coded protein labeling and LC-MALDI. | ABSTRACT: | 2011 | 21849038 |
| csi: a severity index for clostridium difficile infection at the time of admission. | clostridium difficile is a common cause of nosocomial diarrhoea in the usa. to develop a score model that would help to identify severe versus mild or moderate c. difficile infection (cdi) upon admission we performed a retrospective cohort study. between january 2004 and december 2007, 255 patients met inclusion criteria for this study. severe cdi was defined as cases that required colectomy, intensive care unit management, ended in death, or hospitalisation of >10 days. data recorded included p ... | 2011 | 21849220 |
| extended multilocus variable-number tandem-repeat analysis of clostridium difficile correlates exactly with ribotyping and enables identification of hospital transmission. | pcr ribotyping is currently used in many countries for epidemiological investigation to track transmission and to identify emerging variants of clostridium difficile. although pcr ribotyping differentiates over 300 types, it is not always sufficiently discriminatory for epidemiological investigations particularly for common ribotypes, e.g., ribotypes 027, 106, and 017. multilocus variable-number tandem-repeat analysis (mlva) is a highly discriminatory molecular subtyping method that has been app ... | 2011 | 21849691 |
| Presumptive identification of Clostridium difficile strain 027/NAP1/BI on Cepheid Xpert: interpret with caution. | 2011 | 21849697 | |
| Infection control. Trusts blame new C diff testing for failed targets. | 2011 | 21853573 | |
| Laboratory diagnosis of Clostridium difficile infection can molecular amplification methods move us out of uncertainty? | The laboratory diagnosis of Clostridium difficile infection (CDI) continues to be challenging. Recent guidelines from professional societies in the United States note that enzyme immunoassays for toxins A and B do not have adequate sensitivity to be used alone for detecting CDI, yet the optimal method for diagnosing this infection remains unclear. Nucleic acid amplification tests (NAATs) that target chromosomal toxin genes (usually the toxin B gene, tcdB) show high sensitivity and specificity, p ... | 2011 | 21854871 |