Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| toxic megacolon. | toxic megacolon represents a dreaded complication of mainly inflammatory or infectious conditions of the colon. it is most commonly associated with inflammatory bowel disease (ibd), i.e., ulcerative colitis or ileocolonic crohn's disease. lately, the epidemiology has shifted toward infectious causes, specifically due to an increase of clostridium difficile-associated colitis possibly due to the extensive (ab)use of broad-spectrum antibiotics. other important infectious etiologies include salmone ... | 2011 | 22009735 |
| Antimicrobial prescribing practices in response to different Clostridium difficile diagnostic methodologies. | We evaluated treatment decisions and antimicrobial use related to 2 testing algorithms for Clostridium difficile infection (CDI). Our findings suggest that a 2-step testing algorithm using rapid polymerase chain reaction confirmatory testing leads to decreased unnecessary anti-CDI antimicrobial use. In addition, a significant proportion of patients with confirmed CDI were not treated according to recommended guidelines. | 2011 | 22011545 |
| a targeted strategy to wipe out clostridium difficile. | this study evaluated daily cleaning with germicidal bleach wipes on wards with a high incidence of hospital-acquired clostridium difficile infection (cdi). the intervention reduced hospital-acquired cdi incidence by 85%, from 24.2 to 3.6 cases per 10,000 patient-days, and prolonged the median time between hospital-acquired cdi cases from 8 to 80 days. | 2011 | 22011546 |
| bacillus coagulans gbi-30 (bc30) improves indices of clostridium difficile-induced colitis in mice. | abstract: | 2011 | 22014083 |
| aerial dissemination of clostridium difficile on a pig farm and its environment. | clostridium difficile is increasingly recognized as an important enteropathogen in both humans and animals. the finding of c. difficile in air samples in hospitals suggests a role for aerial dissemination in the transmission of human c. difficile infection. the present study was designed to investigate the occurrence of airborne c. difficile in, and nearby a pig farm with a high prevalence of c. difficile. airborne colony counts in the farrowing pens peaked on the moments shortly after or during ... | 2011 | 22014605 |
| prospective evaluation of the meridian illumigene™ loop-mediated amplification assay and the gen probe progastro™ cd polymerase chain reaction assay for the direct detection of toxigenic clostridium difficile from fecal samples. | clostridium difficile is the most common and important cause of toxigenic colitis in the health care setting. laboratory diagnostics have included bacterial culture with further identification of toxigenic stains, or more commonly, direct detection of preformed toxin in stool samples using biological or immunochemistry assays. recently, molecular amplification assays for the direct detection of toxin-encoding genes have become available commercially. we prospectively evaluated 2 fda-cleared mole ... | 2012 | 22015321 |
| Association Between Proton Pump Inhibitor Therapy and Clostridium difficile Infection in a Meta-Analysis. | BACKGROUND & AIMS: In the past decade, there has been a growing epidemic of Clostridium difficile infection (CDI). During this time, use of proton pump inhibitors (PPIs) has increased exponentially. We evaluated the association between PPI therapy and the risk of CDI by performing a meta-analysis. METHODS: We searched MEDLINE and 4 other databases for subject headings and text words related to CDI and PPI in articles published from 1990 to 2010. All observational studies that investigated the ri ... | 2011 | 22019794 |
| epidemiology and clinical characteristics of clostridium difficile infection in a korean tertiary hospital. | in order to investigate the incidence, clinical and microbiologic characteristics of clostridium difficile infection (cdi) in korea, a prospective observational study was performed. from september 2008 through january 2010, all patients whose stool was tested for toxin assay a&b and/or c. difficile culture were studied for clinical characteristics. toxin types of the isolates from stool were tested. the mean incidence of cdi per 100,000 patient-days was 71.6 by month (range, 52.5-114.0), and the ... | 2011 | 22022175 |
| The anti-sigma factor TcdC modulates hypervirulence in an epidemic BI/NAP1/027 clinical isolate of Clostridium difficile. | Nosocomial infections are increasingly being recognised as a major patient safety issue. The modern hospital environment and associated health care practices have provided a niche for the rapid evolution of microbial pathogens that are well adapted to surviving and proliferating in this setting, after which they can infect susceptible patients. This is clearly the case for bacterial pathogens such as Methicillin Resistant Staphylococcus aureus (MRSA) and Vancomycin Resistant Enterococcus (VRE) s ... | 2011 | 22022270 |
| Savings from the use of a probiotic formula in the prophylaxis of antibiotic-associated diarrhea. | Abstract Objective: Antibiotic-associated diarrhea (AAD) and particularly Clostridium difficile-associated diarrhea (CDAD) are the most common causes of healthcare associated infectious diarrhea. A double-blind, dose response, placebo-controlled trial of the probiotic formula (Bio-K+ Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R formula) for prophylaxis of AAD and CDAD was published in 2010. The Bio-K+ Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R formula ... | 2011 | 22023067 |
| Synthesis of Mutual Azo Prodrugs of Anti-inflammatory Agents and Peptides Facilitated by a-Aminoisobutyric Acid. | Reported is the synthesis of azo mutual prodrugs of the nonsteroidal anti-inflammatory agents (NSAIDs) 4-aminophenylacetic acid (4-APAA) or 5-aminosalicylic acid (5-ASA) with peptides, including an antibiotic peptide temporin analogue modified at the amino terminal by an a-aminoisobutyric acid (Aib) residue. These prodrugs are designed for colonic delivery of two agents to treat infection and inflammation by the bacterial pathogen Clostridium difficile . | 2011 | 22026631 |
| Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection. | Background. Diagnosis and management of Clostridium difficile infection (CDI) rely upon clinical assessments and diagnostic studies. Among diagnostic tests, lower gastrointestinal (GI) endoscopy in the setting of CDI remains controversial. Objective. To describe the role of lower endoscopy in CDI management. Methods. Retrospective study of lower endoscopies in CDI at four metropolitan hospitals, July 2005 through December 2007. Results. Of 1760 CDI inpatients, 45 lower endoscopies were performed ... | 2011 | 22028704 |
| Risk Factors and Outcomes Associated With Severe Clostridium difficile Infection in Children. | BACKGROUND:: The incidence and severity of Clostridium difficile infection (CDI) is increasing among adults; however, little is known about the epidemiology of CDI among children. METHODS:: We conducted a nested case-control study to identify the risk factors for and a prospective cohort study to determine the outcomes associated with severe CDI at 2 children's hospitals. Severe CDI was defined as CDI and at least 1 complication or =2 laboratory or clinical indicators consistent with severe dise ... | 2011 | 22031485 |
| Hypervirulent Clostridium difficile PCR-ribotypes exhibit resistance to widely used disinfectants. | The increased prevalence of Clostridium difficile infection (CDI) has coincided with enhanced transmissibility and severity of disease, which is often linked to two distinct clonal lineages designated PCR-ribotype 027 and 017 responsible for CDI outbreaks in the USA, Europe and Asia. We assessed sporulation and susceptibility of three PCR-ribotypes; 012, 017 and 027 to four classes of disinfectants; chlorine releasing agents (CRAs), peroxygens, quaternary ammonium compounds (QAC) and biguanides. ... | 2011 | 22039420 |
| recognition of greater diversity of bacillus species and related bacteria in human faeces. | in a study looking at culturable aerobic actinobacteria associated with the human gastrointestinal tract, the vast majority of isolates obtained from dried human faeces belonged to the genus bacillus and related bacteria. a total of 124 isolates were recovered from the faeces of 10 healthy adult donors. 16s rrna gene sequence analyses showed the majority belonged to the families bacillaceae (n=81) and paenibacillaceae (n=3), with bacillus species isolated from all donors. isolates tentatively id ... | 2011 | 22041546 |
| Scientists seek strategies to prevent Clostridium difficile infections. | 2011 | 22045758 | |
| [clostridium difficile infections: what is new?]. | c. difficile is the most common infectious cause of healthcare-associated diarrhea but now is increasingly recognized as a cause of diarrhea in outpatients and persons without apparent health care contacts. emergence and spread of new epidemic clones of c. difficile 027 (pcr-ribotype) and 078/126 (toxinotype) with increase toxin production, an aditional binary toxin and high level resistance to fluoroquinolones and increasing incidence of more rapidly progressive severe disease, require prompt c ... | 2011 | 22046768 |
| host and pathogen factors for clostridium difficile infection and colonization. | clostridium difficile infection is the leading cause of health care-associated diarrhea, and the bacterium can also be carried asymptomatically. the objective of this study was to identify host and bacterial factors associated with health care-associated acquisition of c. difficile infection and colonization. | 2011 | 22047560 |
| co-morbidities as predictors of mortality in clostridium difficile infection and derivation of the arc predictive score. | clostridium difficile associated diarrhoea (cdad) has increased significantly in the last 15 years, but predictors of outcome are inadequately understood. this was a cohort study of 2761 patients in north east england between 2002 and 2009, with the end-point of mortality at 30 days. the role of age, gender and co-morbidities was examined by binary logistic regression. rounded odds ratios were used to develop a predictive score. a predictive score based on age, renal disease and cancer (arc scor ... | 2011 | 22047977 |
| Detection of diarrhoeal pathogens in human faeces using an automated, robotic platform. | Infectious diarrhoeal diseases represent a major socio-economic burden to humans, and are linked to a range of pathogens, including viruses, bacteria and protists. The accurate detection of such pathogens is central to control. However, detection often relies on methods that have limited diagnostic sensitivity and specificity. Here, we assessed an automated, robotic platform for the simultaneous detection of eight major pathogens associated with infectious diarrhoea. Genomic DNA samples (n = 167 ... | 2011 | 22056326 |
| Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer. | Backgound The number of patients with chronic gastrointestinal (GI) symptoms after cancer therapies which have a moderate or severe impact on quality of life is similar to the number diagnosed with inflammatory bowel disease annually. However, in contrast to patients with inflammatory bowel disease, most of these patients are not referred for gastroenterological assessment. Clinicians who do see these patients are often unaware of the benefits of targeted investigation (which differ from those r ... | 2012 | 22057051 |
| protection from c. difficile toxin b-catalysed rac/cdc42 glucosylation by tauroursodeoxycholic acid-induced rac/cdc42 phosphorylation. | abstract toxin a (tcda) and toxin b (tcdb) are the major virulence factors of clostridium difficile-associated diarrhea (cdad). tcda and tcdb mono-glucoslyate small gtpases of the rho family, thereby causing actin re-organisation in colonocytes, resulting in the loss of colonic barrier function. the hydrophilic bile acid tauroursodeoxycholic acid (tudca) is an approved drug for the treatment of cholestasis and biliary cirrhosis. in this study, tudcainduced activation of akt 1 is presented to i ... | 2011 | 22059737 |
| multiresistant escherichia coli in aged care: the gathering storm. | 2011 | 22060066 | |
| prevalence of antimicrobial-resistant organisms in residential aged care facilities. | to assess the frequency of, and risk factors for, colonisation with vancomycin-resistant enterococci (vre), clostridium difficile and extended-spectrum β-lactamase (esbl)-producing organisms in residential aged care facilities (racfs). | 2011 | 22060088 |
| [Clostridium difficile-Associated Infections in a Septic Ward of a Level 1 Trauma Centre: An Analysis of 159 Patients.] | BACKGROUND: Clostridium difficile-associated infections are severe nosocomial infections. In recent studies, dramatic increases of CD-associated infections for the U.?S.?A. and Germany have been described, which leads to additional risk for patients and higher costs. Despite several studies, there is no study available which analyses the incidence of CD-associated infections on a septic ward at a level 1 trauma centre. Therefore, this study was performed to analyse the incidence and risk factors ... | 2011 | 22065373 |
| toxins-useful biochemical tools for leukocyte research. | leukocytes are a heterogeneous group of cells that display differences in anatomic localization, cell surface phenotype, and function. the different subtypes include e.g., granulocytes, monocytes, dendritic cells, t cells, b cells and nk cells. these different cell types represent the cellular component of innate and adaptive immunity. using certain toxins such as pertussis toxin, cholera toxin or clostridium difficile toxin, the regulatory functions of ga(i), gas and small gtpases of the rho fa ... | 2010 | 22069594 |
| toxin-specific antibodies for the treatment of clostridium difficile: current status and future perspectives. | therapeutic agents targeting bacterial virulence factors are gaining interest as non-antibiotic alternatives for the treatment of infectious diseases. clostridium difficile is a gram-positive pathogen that produces two primary virulence factors, enterotoxins a and b (tcda and tcdb), which are responsible for clostridium difficile-associated disease (cdad) and are targets for cdad therapy. antibodies specific for tcda and tcdb have been shown to effectively treat cdad and prevent disease relapse ... | 2010 | 22069622 |
| the enterotoxicity of clostridium difficile toxins. | the major virulence factors of clostridium difficile infection (cdi) are two large exotoxins a (tcda) and b (tcdb). however, our understanding of the specific roles of these toxins in cdi is still evolving. it is now accepted that both toxins are enterotoxic and proinflammatory in the human intestine. both purified tcda and tcdb are capable of inducing the pathophysiology of cdi, although most studies have focused on tcda. c. difficile toxins exert a wide array of biological activities by acting ... | 2010 | 22069662 |
| Clinical approach to severe Clostridium difficile infection: update for the hospital practitioner. | The rising incidence of Clostridium difficile (C. difficile) infection or CDI is now a problem of pandemic proportions. The NAP1 hypervirulent strain of C. difficile is responsible for a majority of recent epidemics and the widespread use of fluoroquinolone antibiotics may have facilitated the selective proliferation of this strain. The NAP1 strain also is more likely to cause severe and fulminant colitis characterized by marked leukocytosis, renal failure, hemodynamic instability, and toxic meg ... | 2011 | 22075280 |
| Clostridium difficile Mixed Infection and Reinfection. | Isolates from consecutive Clostridium difficile infection (CDI) fecal samples underwent multilocus sequence typing. Potential reinfections with different genotypes were identified in 88/560 (16%) sample pairs taken 1 to 1,414 days (median, 24; interquartile range [IQR], 1 to 52 days) apart; odds of reinfection increased by 58% for every doubling of time between samples. Of 109 sample pairs taken on the same day, 3 (3%) had different genotypes. Considering samples 0 to 7 days apart as the same CD ... | 2012 | 22075589 |
| Gas discharge plasmas are effective in inactivating Bacillus and Clostridium spores. | Bacterial spores are the most resistant form of life and have been a major threat to public health and food safety. Nonthermal atmospheric gas discharge plasma is a novel sterilization method that leaves no chemical residue. In our study, a helium radio-frequency cold plasma jet was used to examine its sporicidal effect on selected strains of Bacillus and Clostridium. The species tested included Bacillus subtilis, Bacillus stearothermophilus, Clostridium sporogenes, Clostridium perfringens, Clos ... | 2011 | 22075631 |
| Recurrent refractory Clostridium difficile colitis treated successfully with rifaximin and tigecycline: A case report and review of the literature. | Abstract Clostridium difficile colitis infection is on the rise and is considerably increasing the duration of hospital stay, as well as healthcare costs. The management of C. difficile colitis has become more challenging with the increasing failure of therapeutic response to metronidazole and oral vancomycin. Tigecycline is a new glycylcycline that has shown in vitro activity against C. difficile. We report herein a case of C. difficile colitis that failed to improve on a combination of metro ... | 2011 | 22077098 |
| lack of association of outcomes with treatment duration and microbiologic susceptibility data in clostridium difficile infections in a non-nap1/bi/027 setting. | abstract background: concerns regarding the poor response of severe clostridium difficile infection (cdi) treated with metronidazole have arisen over the last 5 y. methods: we conducted a prospective, non-interventional study of cdi cases at our institution to evaluate the role of drug resistance, co-morbidities, and the emergence of hypervirulent strains on patient outcomes. a total of 118 adult inpatients with diarrhea and a positive stool for c. difficile toxin immunoassay had positive stoo ... | 2011 | 22077148 |
| a point prevalence survey of health care-associated infections in canadian pediatric inpatients. | background: health care-associated infections (hais) cause considerable morbidity and mortality to hospitalized patients. the objective of this point prevalence study was to assess the burden of hais in the canadian pediatric population, updating results reported from a similar study conducted in 2002. methods: a point prevalence survey of pediatric inpatients was conducted in february 2009 in 30 pediatric or combined adult/pediatric hospitals. data pertaining to one 24-hour period were collecte ... | 2011 | 22078941 |
| preventing downstream clostridium difficile infections with upstream antibiotic management. | clostridium difficile infection (cdi) remains a devastating cause of hospital-acquired diarrhea. treatment modalities have centered traditionally on two antibiotics, metronidazole and oral vancomycin. both drugs, however, have been associated with variable relapse rates up to 20%. fidaxomicin, a new oral agent with targeted c. difficile activity, may reduce the chance of relapse, but has not yet entered mainstream clinical practice. cdi is associated with significant morbidity and mortality. in ... | 2012 | 22079651 |
| public reporting of clostridium difficile and improvements in diagnostic tests. | 2011 | 22080669 | |
| decreasing the prevalence of clostridium difficile in a long-term care facility. | 2011 | 22080670 | |
| Gastrointestinal infection as a trigger for inflammatory bowel disease. | There is accumulating evidence on the importance of microbes in the development and maintenance of both the intestinal and immune systems. This review focuses on the current findings on the role of gastrointestinal pathogens in the cause of chronic inflammatory bowel disease. | 2012 | 22080823 |
| approach to the patient with infectious colitis. | to provide current recommendations for evaluation and treatment of patients with infectious colitis. infectious colitis is diagnosed in someone with diarrhea and one or more of the following: fever and/or dysentery, stools containing inflammatory markers such as leukocytes, lactoferrin, or calprotectin, or positive stool culture for an invasive or inflammatory bacterial enteropathogen including shigella, salmonella, campylobacter, shiga toxin-producing escherichia coli (stec) or clostridium diff ... | 2012 | 22080825 |
| Spironolactone and colitis: Increased mortality in rodents and in humans. | BACKGROUND: Crohn's disease causes intestinal inflammation leading to intestinal fibrosis. Spironolactone is an antifibrotic medication commonly used in heart failure to reduce mortality. We examined whether spironolactone is antifibrotic in the context of intestinal inflammation. METHODS: In vitro, spironolactone repressed fibrogenesis in transforming growth factor beta (TGF-ß)-stimulated human colonic myofibroblasts. However, spironolactone therapy significantly increased mortality in two rode ... | 2011 | 22081497 |
| Nosocomial and non-nosocomial Clostridium difficile infections in hospitalised patients in Belgium: compulsory surveillance data from 2008 to 2010. | Surveillance of Clostridium difficile infection (CDI) is compulsory in Belgian hospitals. Our objectives were to compare incidence and case characteristics of nosocomial infections (Nc-CDI) with onset of diarrhoea more than two days after hospital admission, with non-nosocomial cases (Nnc-CDI). The database included inpatients from 2008 to 2010. Of 8,351 cases reported by 150 hospitals, 3,102 (37%) were classified as Nnc-CDI and 5,249 (63%) as Nc-CDI. In 2010, the mean incidence per 1,000 admiss ... | 2011 | 22085603 |
| Evaluation of chronic diarrhea. | Chronic diarrhea, defined as a decrease in stool consistency for more than four weeks, is a common but challenging clinical scenario. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. Watery diarrhea may be subdivided into osmotic, secretory, and functional types. Watery diarrhea includes irritable bowel syndrome, which is the most common cause of functional diarrhea. Another example of watery diarrhea is microscopic colitis, which is a secretory dia ... | 2011 | 22085666 |
| Enteropathogenic bacteria in dogs and cats: diagnosis, epidemiology, treatment, and control. | This report offers a consensus opinion on the diagnosis, epidemiology, treatment, and control of the primary enteropathogenic bacteria in dogs and cats, with an emphasis on Clostridium difficile, Clostridium perfringens, Campylobacter spp., Salmonella spp., and Escherichia coli associated with granulomatous colitis in Boxers. Veterinarians are challenged when attempting to diagnose animals with suspected bacterial-associated diarrhea because well-scrutinized practice guidelines that provide obje ... | 2011 | 22092607 |
| Durability of silver nanoparticulate films within a silica matrix by flame assisted chemical vapour deposition for biocidal applications. | Healthcare acquired infection (HCAI) rates have come under increasing scrutiny in recent years and been a major priority for health professionals in the UK and elsewhere. Of particular concern is the rise of so called 'superbugs', or those resistant to conventional antibiotics, such as Escherichia coli, Clostridium difficile and methicillin resistant Staphylococcus aureus (MRSA). The reasons for this rise are many and complex, but one important factor is bacterial survival rates on wards and oth ... | 2011 | 22097580 |
| Asymptomatic colonization by Clostridium difficile in older adults admitted to a geriatric unit: a prospective cohort study. | 2011 | 22098041 | |
| activity in vitro of hydrogen peroxide vapour against clostridium difficile spores. | clostridium difficile spores are shed in high numbers by infected patients and are resistant to desiccation and some disinfectants. we explored the in vitro activity of hydrogen peroxide vapour (hpv) against several strains of c. difficile spores using a spore-carrier test. spores were dried on polyvinyl chloride or laminate carriers at mean concentrations of 4.7-6.9 log(10) spores/carrier, which were then decontaminated using hpv. c. difficile was completely eradicated from the exposed carriers ... | 2012 | 22099497 |
| Clostridium difficile infection ward rounds. | 2012 | 22099499 | |
| application of activity-based protein profiling to the study of microbial pathogenesis. | activity-based protein profiling (abpp) is a powerful technology for the dissection of dynamic and complex enzyme interactions. the mechanisms involved in microbial pathogenesis are an example of just such a system, with a plethora of highly regulated enzymatic interactions between the infecting organism and its host. in this review we will discuss some of the cutting-edge applications of abpp to the study of bacterial and parasitic pathogenesis and virulence, with an emphasis on clostridium dif ... | 2011 | 22102218 |
| A two-stage algorithm for Clostridium difficile including PCR: can we replace the toxin EIA? | A two step, three-test algorithm for Clostridium difficile infection (CDI) was reviewed. Stool samples were tested by enzyme immunoassays for C. difficile common antigen glutamate dehydrogenase (G) and toxin A/B (T). Samples with discordant results were tested by polymerase chain reaction detecting the toxin B gene (P). The algorithm quickly identified patients with detectable toxin A/B, whereas a large group of patients excreting toxigenic C. difficile but with toxin A/B production below detect ... | 2012 | 22104474 |
| [treatment of recurrent clostridium difficile diarrhoea using sequential therapy with vancomycin followed by rifaximin.] | 2011 | 22105006 | |
| toxin assay is more reliable than icd-9 data and less time-consuming than chart review for public reporting of clostridium difficile hospital case rates. | objective: clostridium difficile-associated disease (cdad) is common and has a 6.1% mortality. governmental agencies have recommended surveillance, but reporting increases health care costs. we sought to identify a reliable method of reporting cdad that will not significantly increase health care costs. methods: patients were identified via database query for international statistical classification of diseases and related health problems, 9th edition (icd-9) codes and c. difficile toxin positiv ... | 2011 | 22106004 |
| seasonal variations in clostridium difficile infections are associated with influenza and respiratory syncytial virus activity independently of antibiotic prescriptions: a time series analysis in quebec, canada. | seasonal variations in clostridium difficile-associated diarrhea (cdad), with a higher incidence occurring during winter months, have been reported. although winter epidemics of respiratory viruses may be temporally associated with an increase in cdad morbidity, we hypothesized that this association is mainly due to increased antibiotic use for respiratory infections. the objective of this study was to evaluate the effect of the two most frequent respiratory viruses (influenza virus and respirat ... | 2011 | 22106208 |
| release of tcda and tcdb from clostridium difficile cdi 630 is not affected by functional inactivation of the tcde gene. | the small open reading frame tcde is located between the genes tcda and tcdb which encode toxin a (tcda) and b (tcdb), respectively, within the pathogenicity locus of clostridium difficile. sequence and structure similarities to bacteriophage-encoded holins have led to the assumption that tcde mediates the release of the toxins from c. difficile into the extracellular environment. a tcde-deficient c. difficile 630 strain was generated by insertional inactivation of the tcde gene. data revealed t ... | 2012 | 22107906 |
| the epidemiology of community-acquired clostridium difficile infection: a population-based study. | clostridium difficile infection (cdi) is a common hospital-acquired infection with increasing incidence, severity, recurrence, and associated morbidity and mortality. there are emerging data on the occurrence of cdi in nonhospitalized patients. however, there is a relative lack of community-based cdi studies, as most of the existing studies are hospital based, potentially influencing the results by referral or hospitalization bias by missing cases of community-acquired cdi. | 2011 | 22108454 |
| overview of strategies for overcoming the challenge of antimicrobial resistance. | the discovery of penicillin undoubtedly transformed the management of life-threatening bacterial infections. however, a less comfortable aspect of the antibiotic revolution was that within 10 years, over 80% of patients with acute bronchitis were receiving antibiotics without any evidence of clinical benefit. antibiotic use inevitably causes collateral damage to the normal human flora and increases the risk of infection with antibiotic-resistant bacteria and clostridium difficile. the twin aims ... | 2010 | 22111749 |
| Rifaximin Is Effective for the Treatment of Clostridium difficile-Associated Diarrhea: Results of an Open-Label Pilot Study. | Objectives. This open-label trial assessed the efficacy and safety of rifaximin as first-line therapy in hospitalized patients with Clostridium difficile-associated diarrhea (CDAD). Methods. We enrolled thirteen patients who had a confirmed diagnosis of CDAD characterized by =3 unformed stools/day and positive C. difficile toxin assay. Those patients received rifaximin 400?mg three times daily for 10 days. Resolution of symptoms, repeat assay 10 days after treatment, and followup for recurrence ... | 2011 | 22114587 |
| clostridium difficile: a problem of concern in developed countries and still a mystery in latin america. | clostridium difficile-associated disease (cdad) is caused by a spore-forming bacterium and can result in highly variable disease, ranging from mild diarrhoea to severe clinical manifestations. infections are most commonly seen in hospital settings and are often associated with on-going antibiotic therapy. incidences of cdad have shown a sustained increase worldwide over the last ten years and a hyper-virulent c. difficile strain, pcr ribotype 027/rea type bi/north american pulsed-field (nap) typ ... | 2011 | 22116982 |
| Novel therapy for C. difficile infections. Infusions of donated feces may help those with recurrent infections. | 2011 | 22121560 | |
| vaccination with parenteral toxoid b protects hamsters against lethal challenge with toxin a-negative, toxin b-positive clostridium difficile but does not prevent colonization. | toxin a has historically been regarded as the primary virulence determinant in clostridium difficile infection, but naturally occurring toxin a-negative, toxin b-positive (a-/b+) c. difficile strains are known to be virulent. to determine the role of toxin b in these strains, we immunized hamsters with a toxoid prepared from purified toxin b to determine whether they would be protected from lethal challenge with an a-/b+ strain of c. difficile. | 2012 | 22124129 |
| Surface proteins from Lactobacillus kefir antagonize in vitro cytotoxic effect of Clostridium difficile toxins. | In this work, the ability of S-layer proteins from kefir-isolated Lactobacillus kefir strains to antagonize the cytophatic effects of toxins from Clostridium difficile (TcdA and TcdB) on eukaryotic cells in vitro was tested by cell detachment assay. S-layer proteins from eight different L. kefir strains were able to inhibit the damage induced by C. difficile spent culture supernatant to Vero cells. Besides, same protective effect was observed by F-actin network staining. S-layer proteins from ag ... | 2011 | 22126976 |
| the clostridium difficile cell wall protein cwpv undergoes enzyme-independent intramolecular autoproteolysis. | clostridium difficile infection is a leading cause of antibiotic-associated diarrhoea, placing considerable economic pressure on healthcare systems and resulting in significant morbidity and mortality. the pathogen produces a proteinaceous array on its cell surface known as the s-layer, consisting primarily of the major s-layer protein slpa and a family of slpa homologues. cwpv is the largest member of this family and is expressed in a phase variable manner. the protein is post-translationally p ... | 2011 | 22128177 |
| evaluation of vaporized hydrogen peroxide, citrox and ph neutral ecasol for decontamination of an enclosed area: a pilot study. | hydrogen peroxide, ecasol and citrox aerosols were each tested for their ability to kill a range of nosocomial pathogens. hydrogen peroxide had the broadest microbicidal activity but operational issues limit its use. ecasol was effective against all micro-organisms, except clostridium difficile, while citrox aerosols were not effective against gram-negative bacilli. | 2012 | 22130097 |
| Clostridium difficile infection: an update on epidemiology, risk factors, and therapeutic options. | The incidence and severity of Clostridium difficile infection (CDI) around the world has increased over the past 20 years due to the emergence of hypervirulent strains, increased use and misuse of antibiotics, and the increase of susceptible at-risk populations. Treatments currently available for CDI are inadequate to impede the increasing spread and virulence of the infection, avoid recurrence in chronic patients or prevent infection in at-risk populations. | 2012 | 22134217 |
| [Epidemiology of Clostridium difficile infection in Spain.] | There has been increasing interest in Clostridium difficile infection (CDI) due its association with healthcare and its impact on morbidity and mortality in the elderly. During the last few years there has been a growing increase in the number of published studies on the incidence, changes on the clinical presentation and on the epidemiology, with the description of new risk factors. The frequency of CDI in Spain is not sufficiently characterised. The available data indicates that incidence is w ... | 2011 | 22136747 |
| Do admissions and discharges to long-term care facilities influence hospital burden of Clostridium difficile infection? | BACKGROUND: Substantial geographical clustering of Clostridium difficile infection (CDI) outbreaks in hospitals in the USA have previously been demonstrated. AIM: To test the hypothesis that hospital burden of CDI is associated with admission from and discharge to long-term care facilities (LTCFs). METHODS: Hospital discharge data from 19 states in the USA were used to identify all patients discharged with a diagnosis of CDI from 1 January 2002 to 31 December 2004. For every hospital, the propor ... | 2011 | 22137065 |
| Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk. | Toilet facilities in healthcare settings vary widely, but patient toilets are commonly shared and do not have lids. When a toilet is flushed without the lid closed, aerosol production may lead to surface contamination within the toilet environment. | 2012 | 22137761 |
| effects of different replicons in conjugative plasmids on transformation efficiency, plasmid stability, gene expression and n-butanol biosynthesis in clostridium tyrobutyricum. | clostridium tyrobutyricum atcc 25755 can produce butyric acid, acetic acid, and hydrogen as the main products from various carbon sources. in this study, c. tyrobutyricum was used as a host to produce n-butanol by expressing adhe2 gene under the control of a native thiolase promoter using four different conjugative plasmids (pmtl82151, 83151, 84151, and 85151) each with a different replicon (pbp1 from c. botulinum nctc2916, pcb102 from c. butyricum, pcd6 from clostridium difficile, and pim13 fro ... | 2011 | 22139042 |
| Engineered single-domain antibodies with high protease resistance and thermal stability. | The extreme pH and protease-rich environment of the upper gastrointestinal tract is a major obstacle facing orally-administered protein therapeutics, including antibodies. Through protein engineering, several Clostridium difficile toxin A-specific heavy chain antibody variable domains (V(H)Hs) were expressed with an additional disulfide bond by introducing Ala/Gly54Cys and Ile78Cys mutations. Mutant antibodies were compared to their wild-type counterparts with respect to expression yield, non-ag ... | 2011 | 22140551 |
| fidaxomicin: in clostridium difficile infection. | fidaxomicin is a first-in-class macrocyclic antibacterial that primarily demonstrates activity against species of clostridia, predominantly clostridium difficile, while having limited or no activity against normal faecal microflora. fidaxomicin is minimally absorbed following oral administration and is excreted almost solely in the faeces. fidaxomicin displayed a high level of antibacterial activity against c. difficile in vitro, with a minimum inhibitory concentration required to inhibit 90% of ... | 2011 | 22141387 |
| macrocyclic antibiotics: a novel class of drug for the treatment of clostridium difficile infection. | 2012 | 22142153 | |
| is clostridium difficile infection still a problem for hospitals? | 2011 | 22143231 | |
| the effect of hospital-acquired infection with clostridium difficile on length of stay in hospital. | the effect of hospital-acquired infection with clostridium difficile on length of stay in hospital is not yet fully understood. we determined the independent impact of hospital-acquired infection with c. difficile on length of stay in hospital. | 2011 | 22143235 |
| molecular analysis of relapses or reinfections of clostridium difficile-associated diarrhea. | recurrence is a major complication of clostridium difficile-associated diarrhea and occurs in 15 to 20% of patients after discontinuation of therapy. strains from 53 patients with clostridium difficile recurrences were fingerprinted by pcr ribotyping. reinfection with a different strain occurred in 15 out of 53 patients (28,3%), while 38 patients relapsed. these data suggest the need to perform molecular typing for implementation of infection control procedures and for a more appropriate therape ... | 2011 | 22143813 |
| development and evaluation of an ovine antibody-based platform for treatment of clostridium difficile infection. | treatment of clostridium difficile is a major problem as a hospital-associated infection which can cause severe, recurrent diarrhea. the currently available antibiotics are not effective in all cases and alternative treatments are required. in the present study, an ovine antibody-based platform for passive immunotherapy of c. difficile infection is described. antibodies with high toxin-neutralizing titers were generated against c. difficile toxins a and b and were shown to neutralize three seque ... | 2011 | 22144483 |
| clostridium difficile infection and proton pump inhibitor use in hospitalized pediatric cystic fibrosis patients. | children with cystic fibrosis (cf) often take proton pump inhibitors (ppis), which helps improve efficacy of fat absorption with pancreatic enzyme replacement therapy. however, ppi use is known to be associated with clostridium difficile-(c. diff-) associated diarrhea (cdad). we retrospectively evaluated the incidence of c. diff infection from all pediatric hospital admissions over a 5-year period at a single tertiary children's hospital. we found significantly more c. diff-positive stool tests ... | 2011 | 22144994 |
| Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. | BACKGROUND: Clostridium difficile infections (CDIs) are common in developed countries and affect >250?000 hospitalized patients annually in the USA. The most important risk factor for the disease is antibiotic therapy. METHODS: To determine the period at risk for CDI after cessation of antibiotics, we performed a multicentre case-control study in the Netherlands between March 2006 and May 2009. Three hundred and thirty-seven hospitalized patients with diarrhoea and a positive toxin test were com ... | 2011 | 22146873 |
| systemic dissemination of clostridium difficile toxins a and b is associated with severe, fatal disease in animal models. | (see the editorial commentary by johnson, on pages 353-4.) background. clostridium difficile infection (cdi) can cause a wide range of disease, from mild diarrhea to fulminant systemic disease. the incidence of systemic cdi with fatal consequence has increased rapidly in recent years. methods. using an ultrasensitive cytotoxicity assay, we measured c. difficile toxin a (tcda) and c. difficile toxin b (tcdb) in sera and body fluids of piglets and mice exposed to c. difficile to investigate the re ... | 2011 | 22147798 |
| Clostridium difficile Toxins and Severe C. difficile Infection. | 2011 | 22147800 | |
| clostridium difficile in the icu: the struggle continues. | clostridium difficile infection (cdi) management has become more daunting over the past decade because of alarming increases in cdi incidence and severity both in the hospital and in the community. this increase has concomitantly caused significant escalation of the health-care economic burden caused by cdi, and it will likely be translated to increased icu admission and attributable mortality. some possible causes for difficulty in management of cdi are as follows: (1) inability to predict and ... | 2011 | 22147824 |
| Suspected transmission of norovirus in eight long-term care facilities attributed to staff working at multiple institutions. | SUMMARYThis study reports on gastroenteritis outbreaks suspected of being norovirus infections in eight long-term care facilities. A descriptive epidemiological investigation was used to depict sources of infections and control measures. Outbreaks affected 299 (31%) of 954 residents and 95 (11%) of 843 staff. Attack rates were higher in residents (range 17-55%) than staff (range 3-35%). Person-to-person spread was suspected. The case-hospitalization rate was 2·5%, and no death occurred. Eight st ... | 2011 | 22152686 |
| Seasonality of Clostridium difficile infections in Southern Germany. | SUMMARYBetween 2000 and 2009, the total number of patients with Clostridium difficile infections increased considerably in Southeastern Germany. A clear seasonality was observed with a higher number of affected patients occurring in the winter months (January-March). Moxifloxacin and erythromycin-resistant C. difficile PCR ribotypes 001 (72%) and 027 (4·6%) were the most commonly isolated strains. | 2011 | 22152928 |
| Real-time polymerase chain reaction testing for Clostridium difficile reduces isolation time and improves patient management in a small community hospital. | BACKGROUND: The impact of a switch from a toxin A/B enzyme immunoassay (EIA) to a polymerase chain reaction (PCR) method for detection of toxigenic Clostridium difficile was assessed for C difficile infection (CDI) rates, patient isolation-days, and CDI-related treatment. METHODS: A 6-month retrospective study was done on symptomatic patients tested by the toxin A/B EIA and PCR assays. Data on the number of C difficile tests ordered, patient isolation-days, and treatment with metronidazole or va ... | 2011 | 22153847 |
| the role of toxin a and toxin b in the virulence of clostridium difficile. | during the past decade, there has been a striking increase in clostridium difficile nosocomial infections worldwide predominantly due to the emergence of epidemic or hypervirulent isolates, leading to an increased research focus on this bacterium. particular interest has surrounded the two large clostridial toxins encoded by most virulent isolates, known as toxin a and toxin b. toxin a was thought to be the major virulence factor for many years; however, it is becoming increasingly evident that ... | 2011 | 22154163 |
| Malignant neuroleptic syndrome and Clostridium difficile: Causal association or mere coincidence? | 2011 | 22154227 | |
| Fecal Transplantation, Through Colonoscopy, Is Effective Therapy for Recurrent Clostridium difficile Infection. | BACKGROUND & AIMS: Treatment of recurrent Clostridium difficile infection (CDI) with antibiotics leads to recurrences in up to 50% of patients. We investigated the efficacy of fecal transplantation in treatment of recurrent CDI. METHODS: We reviewed records from 70 patients with recurrent CDI who had undergone fecal transplantation. Fecal transplantation was performed at colonoscopy by infusing fresh donor feces into cecum. Before transplantation, the patients had whole-bowel lavage with polyeth ... | 2011 | 22155369 |
| fidaxomicin: a novel macrocyclic antibiotic approved for treatment of clostridium difficile infection. | fidaxomicin, a nonabsorbed macrocyclic compound, is the first antimicrobial agent approved by the fda for the treatment of clostridium difficile infection (cdi) in adults over the last 25 years. it is bactericidal, and its mechanism of action relates to inhibition of a rna polymerase at a site distinct from where rifamycins interact. fidaxomicin, 200 milligrams by mouth twice daily, is not inferior to vancomycin, 125 milligrams by mouth 4 times daily, for treatment of cdi as determined by clinic ... | 2011 | 22156854 |
| fecal microbiota transplantation for relapsing clostridium difficile infection in 26 patients: methodology and results. | : we aim to present a data detailing our success with fecal microbiota transplantation (fmt) and to provide a simple treatment protocol. | 2011 | 22157239 |
| efficacious outcome employing fecal bacteriotherapy in severe crohn's colitis complicated by refractory clostridium difficile infection. | 2011 | 22161290 | |
| clostridium difficile carriage in elderly subjects and associated changes in the intestinal microbiota. | clostridium difficile is an important nosocomial pathogen associated particularly with diarrhoeal disease in elderly individuals in hospitals and long-term care facilities. we examined the carriage rate of clostridium difficile by culture as a function of faecal microbiota composition in elderly subjects recruited from the community, outpatient and short term respite and long term hospital stay. the carriage rate ranged from 1.6% (n=123) for subjects in the community, 9.5% (n=43) in outpatient s ... | 2011 | 22162545 |
| [clostridium difficile-induced necrotizing enteritis]. | clostridium difficile infection usually manifests as pseudomembranous colitis. infection of the small intestine is rare. c. difficile enteritis has a high mortality rate due to secondary enteric necrosis and perforation. | 2011 | 22166175 |
| Clostridium difficile prevalence rates in a large healthcare system stratified according to patient population, age, gender, and specimen consistency. | We evaluated Clostridium difficile prevalence rates in 2,807 clinically indicated stool specimens stratified by inpatient (IP), nursing home patient (NH), outpatient (OP), age, gender, and specimen consistency using bacterial culture, toxin detection, and polymerase chain reaction (PCR) ribotyping. Rates were determined based on the detection of toxigenic C. difficile isolates. We identified significant differences in the rates between patient populations and with age. Specimens from NH had a hi ... | 2011 | 22167256 |
| [Pathogenicity factors of bacteria with glycosylating activity]. | A and B toxins of Clostridium difficile, a-toxin of C. novyi, lehal toxin of C. sordellii, and TpeL toxin of C. perfringens belong to the group of the so-called large Clostridium toxins. These toxins modify low-molecular weight guanosine triphosphate-binding proteins of the Rho/Ras family by their glycosylation that results in inactivation of major signal pathways in eukaryotic cells. Lgt glycosyltransferases, a new group of pathogenicity factors also capable of inactivating eukaryotic substrate ... | 2011 | 22168036 |
| Spread and persistence of Clostridium difficile spores during and after cleaning with sporicidal disinfectants. | 2011 | 22172407 | |
| Liver Graft Failure and Hyperbilirubinemia in Liver Transplantation Recipients After Clostridium difficile Infection. | Liver transplant recipients are at high risk for Clostridium difficile infection. We have recently encountered multiple cases of CDI in our liver transplant recipients and for some of them it led to severe hyperbilirubinemia, liver failure, and even death. Our goals are to report our experience and analyze the factors that contributed to unfavorable outcomes. | 2011 | 22172853 |
| Frequent Hospital Readmissions for Clostridium difficile Infection and the Impact on Estimates of Hospital-Associated C. difficile Burden. | Objective. Clostridium difficile infection (CDI) is associated with hospitalization and may cause readmission following admission for any reason. We aimed to measure the incidence of readmissions due to CDI. Design. Retrospective cohort study. Patients. Adult inpatients in Orange County, California, who presented with new-onset CDI within 12 weeks of discharge. Methods. We assessed mandatory 2000-2007 hospital discharge data for trends in hospital-associated CDI (HA-CDI) incidence, with and w ... | 2012 | 22173518 |
| evaluation of stethoscopes as vectors of clostridium difficile and methicillin-resistant staphylococcus aureus. | 2012 | 22173532 | |
| Spread and persistence of Clostridium difficile spores during and after cleaning with sporicidal disinfectants. | 2011 | 22177022 | |
| clostridium perfringens type c and clostridium difficile co-infection in foals. | clostridium perfringens type c is one of the most important agents of enteric disease in newborn foals. clostridium difficile is now recognized as an important cause of enterocolitis in horses of all ages. while infections by c. perfringens type c or c. difficile are frequently seen, we are not aware of any report describing combined infection by these two microorganisms in foals. we present here five cases of foal enterocolitis associated with c. difficile and c. perfringens type c infection. f ... | 2011 | 22177970 |
| clostridium difficile infection in hiv-seropositive individuals and transplant recipients. | immunocompromise is a commonly cited risk factor for clostridium difficile infection (cdi). we reviewed the experimental and epidemiological literature on cdi in three immunocompromised groups, hiv-seropositive individuals, haematopoietic stem cell or bone marrow transplant recipients and solid organ transplant recipients. all three groups have varying degrees of impairment of humoral immunity, a major factor influencing the outcome of cdi. soluble hiv proteins such as nef and immunosuppressive ... | 2011 | 22178989 |
| Pathology Consultation on Detection of Clostridium difficile. | Laboratory methods for detecting Clostridium difficile have undergone considerable evolution since the organism's etiologic association with antibiotic-associated diarrhea and colitis was established. Clearly, familiarity with the advantages and shortcomings of the various assays is essential for the laboratory director when choosing among these tests. For the consulting pathologist, furthermore, an understanding of the laboratory's role in securing a diagnosis of C difficile infection (CDI) is ... | 2012 | 22180472 |