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intestinal epithelial restitution after tcdb challenge and recovery from clostridium difficile infection in mice with alanyl-glutamine treatment.clostridium difficile is an anaerobic bacterium that causes antibiotic-associated diarrhea. it produces toxin a and toxin b (tcdb), which cause injury to the gut epithelium. glutamine is a fundamental fuel for enterocytes, maintaining intestinal mucosal health. alanyl-glutamine (aq) is a highly soluble dipeptide derivative of glutamine. we studied whether administration of aq ameliorates the effects of tcdb in the intestinal cells and improves the outcome of c. difficile infection in mice.201323359592
pseudomembranous colitis within radiotherapy field following concurrent chemoradiation therapy: a case report.development of nonantibiotic-associated pseudomembranous colitis has been reported in patients receiving chemotherapy. herein, we report a case of a 70-year-old man with diabetes mellitus and hypertension who received concurrent chemoradiation therapy after surgery for stage iii pt3n1m0 rectal cancer. after completion of the therapy, the patient presented with a 2-week history of intermittent watery diarrhea (seven to nine times per day). however, the patient was afebrile and laboratory examinat ...201323359785
probiotics for the prevention of clostridium difficile-associated diarrhea: a systematic review and meta-analysis.antibiotic treatment may disturb the resistance of gastrointestinal flora to colonization. this may result in complications, the most serious of which is clostridium difficile–associated diarrhea (cdad).201223362517
evaluation of an algorithmic approach in comparison with the illumigene assay for laboratory diagnosis of clostridium difficile infection.the following three diagnostic algorithms were evaluated in comparison with the illumigene assay as a stand-alone test for clostridium difficile detection: glutamate dehydrogenase antigen screen (gdh) followed by toxin a/b antigen testing (tox a/b) with the cell cytotoxicity assay for discordant specimens (algorithm 1), gdh followed by the illumigene (algorithm 2), and gdh followed by tox a/b with the illumigene for discordant specimens (algorithm 3). a total of 428 stool specimens submitted to ...201323363829
clostridium difficile infection and fecal bacteriotherapy.clostridium difficile, also called "c. diff," is a gram-positive bacillus associated with nosocomial infections involving diarrhea, most often seen in developing countries. the severity of c. diff-associated diarrhea varies tremendously from mild and self-limiting to fulminant and life-threatening. c. diff has become an extremely important pathogen in community health but can be minimized with attention to proper hygiene. this article presents a case study regarding the treatment and management ...201323364365
a probiotics-containing biscuit modulates the intestinal microbiota in the elderly.evaluation of the impact of a biscuit containing the probiotics bifidobacterium longum bar33 and lactobacillus helveticus bar13 on the intestinal microbiota in the elderly.201323364497
current application and future perspectives of molecular typing methods to study clostridium difficile infections.molecular typing is an essential tool to monitor clostridium difficile infections and outbreaks within healthcare facilities. molecular typing also plays a key role in defining the regional and global changes in circulating c. difficile types. the patterns of c. difficile types circulating within europe (and globally) remain poorly understood, although international efforts are under way to understand the spatial and temporal patterns of c. difficile types. a complete picture is essential to pro ...201323369393
clostridium difficile outbreak in costa rica: control actions and associated factors.to describe interventions implemented during a nosocomial outbreak of clostridium difficile in a general hospital in costa rica from december 2009 to april 2010 in order to achieve outbreak control and the factors determined to be associated with c. difficile infection.201223370184
coinfection in acute gastroenteritis predicts a more severe clinical course in children.the objectives of this study were to determine the incidence of enteric pathogens causing acute gastroenteritis (age) among hospitalized children in a large italian hospital, to measure the incidence of coinfections, and to compare the clinical characteristics of those infected with one versus multiple agents. a prospective study was conducted from march 2010 to april 2011 at the bambino gesù pediatric hospital in rome, italy. all patients between 1 month and 16 years of age admitted to the pedi ...201323370970
surgical treatment of clostridium colitides.infection with clostridium difficile (cdi) is the most frequent cause of nosocomial diarrhoeas. most cases are successfully treated by antibiotic therapy, but nearly 10% may progress to the fulminative form of this condition. the objective of the work is retrospective evaluation of the results of surgical treatment in patients with the fulminative form of clostridium colitis with revealing of risk factors leading to serious post-operative morbidity and mortality.201223373360
preoperative risk factors for postoperative clostridium difficile infection in colectomy patients.wide variation among hospitals in the rate of clostridium difficile infection (cdi) after surgery was hypothesized to be related to different prophylactic antibiotic practices.201323375705
fecal microbiota transplantation for recurrent c difficile infection: ready for prime time?recurrent clostridium difficile infection has been a major challenge for patients and clinicians. recurrence of infection after treatment with standard antibiotics is becoming more common with the emergence of more-resistant strains of c difficile. fecal microbiota transplantation is an alternative treatment for recurrent c difficile infection, but it is not yet widely used.201323376915
[dificid: fewer recurrences of clostridium difficile]. 201523379054
effect of age on treatment outcomes in clostridium difficile infection.to determine the effect of advancing age on the clinical outcomes of clostridium difficile (cdi) treatment.201323379974
bacterial infections of the small intestine.the purpose of this study is to summarize the recent developments in small intestinal bacterial infections.201323380575
risk of clostridium difficile infection with acid-suppressive therapy; pitfalls in accurate estimation. 201323381074
does confounding explain the association between ppis and clostridium difficile-related diarrhea? 201323381076
proteases and sonication specifically remove the exosporium layer of spores of clostridium difficile strain 630.clostridium difficile spores are the means through which this anaerobic pathogen may persist in hospital surfaces and in the host. there is a lack of knowledge in the proteins that localize to the surface of c. difficile spores primarily due to the lack of established methods to efficiently separate the outermost layer, the exosporium. in this work, we propose methods to remove the exosporium layer of c. difficile spores through either protease digestion or sonication treatment leaving the spore ...201323384826
phylogenetic analysis of dysbiosis in ulcerative colitis during remission.presence of intestinal microbes is a prerequisite for the development of ulcerative colitis (uc), although deviation of the normal intestinal microbiota composition, dysbiosis, is presumably implicated in the etiology of uc.201323385241
fidaxomicin in the treatment of clostridium difficile-associated diarrhoea. 201323386229
substrate specificity of clostridial glucosylating toxins and their function on colonocytes analyzed by proteomics techniques.clostridium difficile is the major cause of intestinal infections in hospitals. the major virulence factors are toxin a (tcda) and toxin b (tcdb), which belong to the group of clostridial glucosylating toxins (cgt) that inactivate small gtpases. after a 24 h incubation period with tcda or a glucosyltransferase-deficient mutant tcda (gdtcda), quantitative changes in the proteome of colonic cells (caco-2) were analyzed using high-resolution lc-ms/ms and the silac technique. the changes in abundanc ...201323387933
comparison of 2 clostridium difficile surveillance methods: national healthcare safety network's laboratory-identified event reporting module versus clinical infection surveillance.to determine whether the centers for disease control and prevention's national healthcare safety network (nhsn) laboratory-identified (labid) event reporting module for clostridium difficile infection (cdi) is an adequate proxy measure of clinical cdi for public reporting purposes by comparing the 2 surveillance methods.201323388363
effectiveness of hand hygiene for removal of clostridium difficile spores from hands.this study determined whether surrogate organisms can predict activity against clostridium difficile spores and compared the efficacy of hand hygiene preparations against c. difficile. our data suggest that surrogate organisms were not predictive of c. difficile spore removal. four preparations were significantly more effective than tap water at removing c. difficile.201323388366
potential for transmission of spores by patients awaiting laboratory testing to confirm suspected clostridium difficile infection.in a prospective study of inpatients tested for clostridium difficile infection (cdi), skin and environmental contamination were common at the time of the order for cdi testing, and there were often delays in completion of testing. preemptive isolation of patients with suspected cdi may reduce the risk of transmission.201323388367
development and optimization of a novel assay to measure neutralizing antibodies against clostridium difficile toxins.clostridium difficile produces two major virulence toxins, toxin a (tcda) and toxin b (tcdb). antitoxin antibodies, especially neutralizing antibodies, have been shown to be associated with a lower incidence of c. difficile infection (cdi) recurrence, and antibody levels are predictive of asymptomatic colonization. the development of an assay to detect the presence of neutralizing antibodies in animal and human sera for the evaluation of vaccine efficacy is highly desired. we have developed such ...201323389929
significance of proton pump inhibitor types for clostridium difficile infection. 201323391870
cross-sectional study reveals high prevalence of clostridium difficile non-pcr ribotype 078 strains in australian veal calves at slaughter.recent reports in north america and europe of clostridium difficile being isolated from livestock and retail meats of bovine origin have raised concerns about the risk to public health. to assess the situation in australia, we investigated the prevalence and genetic diversity of c. difficile in adult cattle and calves at slaughter. carcass washings, gastrointestinal contents, and feces were collected from abattoirs across five australian states. selective culture, toxin profiling, and pcr riboty ...201323396338
an improved qpcr protocol for rapid detection and quantification of clostridium difficile in cattle feces.clostridium difficile (cd) can cause a significant and transmissible disease in animals and humans, with poorly understood epidemiology. animals have been suggested as a possible source of infection and environment contamination. it is necessary that a precise and rapid diagnostic tool is available for the detection of cd from clinical and/or environmental samples. a quantitative real-time pcr (qpcr) protocol for cd detection defined by penders et al. (fems microbiol lett, 243, 2005, 141-147) wa ...201323397963
two-stage algorithm for clostridium difficile: glutamate-dehydrogenase-positive toxin-negative enzyme immunoassay results may require further testing.this study investigated 102 episodes in which a glutamate dehydrogenase-positive enzyme immunoassay (eia)-toxin-negative result was obtained with a c. difficile testing protocol. of these 102 stool samples, 46% were culture positive with a toxigenic strain and nine were followed by an eia-toxin-positive result within 2-32 days. the data accord with our policy of keeping these patients in side-rooms until asymptomatic and of encouraging treatment of those with otherwise unexplained persistent dia ...201323399483
gut microbiota of healthy canadian infants: profiles by mode of delivery and infant diet at 4 months.the gut microbiota is essential to human health throughout life, yet the acquisition and development of this microbial community during infancy remains poorly understood. meanwhile, there is increasing concern over rising rates of cesarean delivery and insufficient exclusive breastfeeding of infants in developed countries. in this article, we characterize the gut microbiota of healthy canadian infants and describe the influence of cesarean delivery and formula feeding.201323401405
s-adenosyl-l-methionine protects the probiotic yeast, saccharomyces boulardii, from acid-induced cell death.saccharomyces boulardii is a probiotic yeast routinely used to prevent and to treat gastrointestinal disorders, including the antibiotic-associated diarrhea caused by clostridium difficile infections. however, only 1-3% of the yeast administered orally is recovered alive in the feces suggesting that this yeast is unable to survive the acidic environment of the gastrointestinal tract.201323402325
community-associated clostridium difficile infection: how real is it?community-associated clostridium difficile infection (ca-cdi) represents 32% of all cdi cases based on u.s. population-based data. the current epidemic strain, nap1, is the most prevalent strain causing these infections. although complications, recurrence and death are uncommon, one-fourth of the ca-cdi patients are hospitalized within 7 days after the diagnosis.201323403280
[long-term use of proton pump inhibitors: who needs prophylaxis?].proton pump inhibitors (ppi) are among the most frequently prescribed drugs worldwide. recently, several side effects of chronic ppi therapy have been identified. reduced intestinal absorption of vitamin b12 or calcium, an increased rate of bone fractures, an interference with the metabolism of other drugs (e.g., clopidogrel), and an increased incidence of clostridium difficile-associated colitis are discussed. so far, data on such side effects of ppi are mainly supported by retrospective and/or ...201323404267
expanding the repertoire of gene tools for precise manipulation of the clostridium difficile genome: allelic exchange using pyre alleles.sophisticated genetic tools to modify essential biological processes at the molecular level are pivotal in elucidating the molecular pathogenesis of clostridium difficile, a major cause of healthcare associated disease. here we have developed an efficient procedure for making precise alterations to the c. difficile genome by pyre-based allelic exchange. the robustness and reliability of the method was demonstrated through the creation of in-frame deletions in three genes (spo0a, cwp84, and mtld) ...201323405251
correlation between coinfection with parasites, cytomegalovirus, and clostridium difficile and disease severity in patients with ulcerative colitis.a cross-sectional study was undertaken to determine whether there was any association between intestinal infection (with parasites, cytomegalovirus, or clostridium difficile) and clinical disease severity in patients with ulcerative colitis (uc). consecutive cases of uc were enrolled after history and clinical examination, evaluated for presence of stool parasites (routine/special stains) and c. difficile toxins a and b (cdt) in stools. segmental biopsies at colonoscopy were assessed for cytopat ...201323408260
the epidemiology of clostridium difficile infection in children: a population-based study.the incidence of clostridium difficile infection (cdi) is increasing, even in populations previously thought to be at low risk, including children. most incidence studies have included only hospitalized patients and are thus potentially influenced by referral or hospitalization biases.201323408679
structural and functional analysis of the cspb protease required for clostridium spore germination.spores are the major transmissive form of the nosocomial pathogen clostridium difficile, a leading cause of healthcare-associated diarrhea worldwide. successful transmission of c. difficile requires that its hardy, resistant spores germinate into vegetative cells in the gastrointestinal tract. a critical step during this process is the degradation of the spore cortex, a thick layer of peptidoglycan surrounding the spore core. in clostridium sp., cortex degradation depends on the proteolytic acti ...201323408892
[infections caused by clostridium difficile].the epidemiology of clostridium difficile infections (cdis) has dramatically changed over the last decade in both north america and europe, and it has become more frequent, more severe, more refractory to standard therapy, and more likely to relapse. these changes have been associated with the emergence of a "hypervirulent" strain known as bi/nap1/027 which has become endemic in some areas, although, other hypervirulent genotypes (e.g. pcr ribotype 078) have also been described. to reduce the in ...201323411363
prospective comparison of a commercial multiplex real-time polymerase chain reaction and an enzyme immunoassay with toxigenic culture in the diagnosis of clostridium difficile-associated infections.clostridium difficile infections (cdi) is a leading cause of nosocomial infections worldwide. the changes in the epidemiology of cdi during the past years, including the appearance of new epidemic strains of c. difficile that cause cdi episodes with increased severity, have led to the development of molecular methods with improved sensitivity and specificity. this study was designed to compare the performances of one antigen assay (vidas, biomérieux) and one molecular assay (genexpert, cepheid). ...201323415540
clostridium-dt(db): a comprehensive database for potential drug targets of clostridium difficile.clostridium difficile is considered to be one of the most important causes of health care-associated infections currently. the prevalence and severity of c. difficile infection have increased significantly worldwide in the past decade which has led to the increased research interest. here, using comparative genomics strategy coupled with bioinformatics tools we have identified potential drug targets in c. difficile and determined their three-dimensional structures in order to develop a database, ...201323415847
[probiotics in gastroenterology -- from a different angle].after a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. the indications of probiotic administration have been defined and extended in recent years. the author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. probiotics are useful in preventing and treating diarrhoea caused by antibi ...201323419530
improved detection of clostridium difficile in animals by using enrichment culture followed by lightcycler real-time pcr.the performance of our previously published taqman real-time pcr (tmrtpcr) for the detection of clostridium difficile directly from animal faeces was found to be inadequate due to tmrtpcr false negative results. therefore, we developed a new internally controlled lightcycler real-time pcr (lc rtpcr) capable of detecting variant strains in diarrhoeic and subclinical animals by using two hybridisation probes instead of one hydrolysis probe used in tmrtpcr. while lc rtpcr did not provide better res ...201323419821
secular trends in the epidemiology of clostridium difficile infection (cdi): relationship with alcohol gel and antimicrobial usage in a hospital.clostridium difficile-associated diarrhea (cdad) has shown increasing incidence, morbidity, and mortality in recent years. we assessed the number of cdad tests requested, cdad positivity rates, the use of alcohol-based hand rubs, and antimicrobial utilization.201323419978
regarding "clostridium difficile ribotype does not predict severe infection". 201323420817
antimicrobial activity of lff571 and three treatment agents against clostridium difficile isolates collected for a pan-european survey in 2008: clinical and therapeutic implications.in november 2008, a study was performed with support from the european centre for disease prevention and control (ecdc) to obtain an overview of clostridium difficile infections (cdis) in european hospitals. a collection of 398 c. difficile isolates obtained from this hospital-based survey was utilized to identify antimicrobial susceptibility patterns of common c. difficile pcr ribotypes across europe.201323420839
a potential new tool for managing clostridium difficile infection. 201323420904
a new strategy for the prevention of clostridium difficile infection.clostridium difficile infection (cdi) is a leading cause of antibiotic-associated diarrhea. the infective form of c. difficile is the spore, but the vegetative bacterium causes the disease. because c. difficile spore germination is required for symptomatic infection, antigermination approaches could lead to the prevention of cdi. we recently reported that camsa, a bile salt analog, inhibits c. difficile spore germination in vitro.201323420906
novel avenues for clostridium difficile infection drug discovery.clostridium difficile is the etiologic agent of nosocomial and community-acquired diarrhea associated with exposure to antibiotics that disrupt the normal colonic flora. as antibacterials currently used for primary c. difficile infections favor recurrences, new agents able to neutralize the bacterium without affecting the gut microbiota are badly needed.201323427910
[risk factors for relapsing and severe colitis caused by clostridium difficile infection].describe risk factors for relapsing and severe clostridium difficile infection (cdi) in a set of patients hospitalized at the clinic of infectious diseases the university hospital brno.201323427999
effects of ciprofloxacin on the expression and production of exotoxins by clostridium difficile.hypervirulent bi/nap1/027 strains of clostridium difficile have been associated with increased mortality of c. difficile infection (cdi). the emergence of highly fluoroquinolone (flq)-resistant bi/nap1/027 strains suggests that flq exposure may be a risk factor for cdi development. however, the mechanism for this is not clear. we compared the effects of subinhibitory concentrations of ciprofloxacin on toxin a and b gene expression and protein production in recent (strain 039) and historical (str ...201323429695
clostridium difficile outcomes difficult to generalize. 201323433315
concurrent outbreaks with co-infection of norovirus and clostridium difficile in a long-term-care facility.we describe an outbreak of simultaneous clostridium difficile and norovirus infections in a long-term-care facility. thirty patients experienced acute gastroenteritis, and four had co-infection with identical c. difficile 027 and genotype ii.4 new orleans norovirus strains. co-occurring infection requires improved understanding of risk factors, clinical impact, and testing strategies.201323433360
isolation and characterization of clostridium difficile associated with beef cattle and commercially produced ground beef.the incidence of clostridium difficile infection has recently increased in north american and european countries. this pathogen has been isolated from retail pork, turkey, and beef products and reported associated with human illness. this increase in infections has been attributed to the emergence of a toxigenic strain designated north america pulsed-field gel electrophoresis type 1 (nap1). the nap1 strain has been isolated from calves as well as ground meat products, leading to speculation of i ...201323433373
isolation of a toxigenic and clinical genotype of clostridium difficile in retail meats in costa rica.we isolated a regional toxigenic genotype of clostridium difficile, previously found in human infection in 4 of 200 (2%) samples of retail meats for human consumption: 1 of 67 samples of beef, 2 of 66 of pork, and 1 of 67 of poultry meat. these four isolates were positive for the tcda and tcdb genes but negative for deletion of the tcdc and cdtb genes. all strains induced cytopathic effects in hela cells. however, they were susceptible to some antibiotics to which clinical isolates are often res ...201323433387
defining acute renal dysfunction as a criterion for the severity of clostridium difficile infection in patients with community-onset vs hospital-onset infection.acute renal dysfunction can be used to define severe clostridium difficile infection (cdi). the society for healthcare epidemiology of america (shea) and infectious disease society of america (idsa) guidelines define acute renal dysfunction as serum creatinine (srcr) ≥1.5 times the premorbid level.201323433867
probiotics in clostridium difficile infection: reviewing the need for a multistrain probiotic.in the past two years an enormous amount of molecular, genetic, metabolomic and mechanistic data on the host-bacterium interaction, a healthy gut microbiota and a possible role for probiotics in clostridium difficile infection (cdi) has been accumulated. also, new hypervirulent strains of c. difficile have emerged. yet, clinical trials in cdi have been less promising than in antibiotic associated diarrhoea in general, with more meta-analysis than primary papers on cdi-clinical-trials. the fact t ...201323434948
hyperimmune bovine colostrum for treatment of gi infections: a review and update on clostridium difficile.hyperimmune bovine colostrum (hbc), produced by vaccination of a cow during gestation, is rich in targeted immunoglobulins, and can be used to treat a variety of diseases. the published history of hbc use for treating gastrointestinal infections in humans has developed over the past several decades and demonstrates the promise of this type of therapeutic for gi infectious disease. hbc, or purified derivative products, have been used successfully for treatment or prevention of cryptosporidiosis, ...201323435084
comparative analysis of different methods to detect clostridium difficile infection.the increased incidence and severity of clostridium difficile infection, particularly in north america and europe, have brought renewed focus on the most appropriate method to detect c. difficile and/or its toxins in stools. this prospective study evaluated the usefulness of the illumigene tm c. difficile assay in diagnostic practice for the detection of toxigenic c. difficile dna in clinical samples. a total of 88 out of 306 stool samples analysed were positive both by illumigene and the combin ...201323435816
using phenotype microarrays to determine culture conditions that induce or repress toxin production by clostridium difficile and other microorganisms.toxin production is a central issue in the pathogenesis of clostridium difficile and many other pathogenic microorganisms. toxin synthesis is influenced by a variety of known and unknown factors of genetics, physiology, and environment. to facilitate the study of toxin production by c. difficile, we have developed a new, reliable, quantitative, and robust cell-based cytotoxicity assay. then we combined this new assay with phenotype microarrays (pm) technology which provides high throughput testi ...201323437164
guidelines for diagnosis, treatment, and prevention of clostridium difficile infections.clostridium difficile infection (cdi) is a leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system. patients with cdi typically have extended lengths-of-stay in hospitals, and cdi is a frequent cause of large hospital outbreaks of disease. this guideline provides recommendations for the diagnosis and management of patients with cdi as well as for the prevention and control of outbreaks while supplementing previously published guidelines. n ...201323439232
mortality in clostridium difficile infection: a prospective analysis of risk predictors.to date, the vast majority of studies investigating risk factors for mortality in clostridium difficile infection (cdi) have been based on retrospective, routinely collected data, and have not specifically tested the capacity of risk factors to predict outcome. we aimed to prospectively evaluate predictors of mortality in patients with cdi, utilizing established metrics of risk prediction to assess their ability to prognosticate.201323442414
risk factors for clostridium difficile acquisition in infants: importance of study design. 201323442761
diverticular disease of the colon does not increase risk of repeat c. difficile infection.studies have suggested that colonic diverticulosis might increase the likelihood of repeat clostridium difficile infection (cdi). our study was designed to compare rates of repeat infection in patients with and without colon diverticula.201623442832
emergence of clostridium difficile infection in tuberculosis patients due to a highly rifampicin-resistant pcr ribotype 046 clone in poland.clostridium difficile infection (cdi) is a major cause of nosocomial diarrhea. cdi is known to develop after antibiotic administration, but anti-tuberculosis agents have rarely been implicated. we documented an outbreak caused by a highly rifampicin-resistant c. difficile strain of polymerase chain reaction (pcr) ribotype 046 in patients with active tuberculosis.201323443474
epidemiology of clostridium difficile infection and risk factors for unfavorable clinical outcomes: results of a hospital-based study in barcelona, spain.prospective hospital-based surveillance for clostridium difficile-associated disease (cdad) was conducted in barcelona (spain) to describe the epidemiology of this condition and investigate the risk factors for an unfavorable outcome. all patients diagnosed with cdad during 2009 were included. using logistic regression modeling, we analyzed the potential risk factors associated with recurrent and complicated cdad, defined as a need for colectomy or death within 30 days. there were 365 episodes o ...201323447638
contamination of ready-to-eat raw vegetables with clostridium difficile in france.the presence of clostridium difficile in food like shellfish, vegetables and meat has been reported in several publications during the past few years. the objective of this study was to assess the prevalence of ready-to-eat raw vegetables contaminated with c. difficile in france. one hundred and four ready-to-eat salads and vegetables were studied. toxigenic c. difficile strains were isolated in three samples (2.9 %): two ready-to-eat salads (one heart of lettuce and one lamb's lettuce salad) an ...201323449876
detection of clostridium difficile in retail ground meat products in manitoba.the aim of the present study was to determine whether clostridium difficile was present in uncooked retail ground beef and ground pork products sold in winnipeg, manitoba. using an alcohol treatment protocol and inoculation of cultures on c difficile moxalactam norfloxacin (cdmn), toxigenic c difficile was found in 6.3% of 48 meat samples. the c difficile isolates belonged to different pulsotypes, all of which had been previously isolated from the stool of manitoba patients with c difficile dise ...201223450202
[clostridium difficile infection as interdisciplinary challenge. current discussions in respect to epidemiology, diagnostic methods, risk classification as well as treatment options].within the last decade, the incidence ofclostridium difficile infection (cdi) has increased in many regions all over the world including the highly virulent b1/nap1/027 strain. meanwhile, the value of predisposing risk factors and diagnostic measures as well as the spectrum of therapeutic options has been elucidated in more detail. most commonly applied antiinfective agents include metronidazole, vancomycin and fidaxomicin, however, several questions remain unanswered in respect to their optimiz ...201323451705
clostridium difficile infection of a prosthetic knee joint requiring amputation. 201323451730
detection of a/b toxin and isolation of clostridium difficile and clostridium perfringens from foals.toxin detection and screening could contribute to knowledge of the transmission patterns, risk factors and epidemiology of clostridium difficile and clostridium perfringens.201323452044
in vitro biological effects of two anti-diabetic medicinal plants used in benin as folk medicine.extracts from polygonum senegalensis (polygonaceae) and pseudocedrela kotschyi (meliaceae) are two important traditionally used medicinal plants in rural benin to treat many diseases and notably type 2 diabetes. the aim of the study was to investigate the α-glucosidase inhibition, antioxidant and antibacterial activities of those plants extract: polygonum senegalensis leaves, and pseudocedrela kotschyi root.201323452899
statewide costs of health care-associated infections: estimates for acute care hospitals in north carolina.state-specific, health care-associated infection (hai) cost estimates have not been calculated to guide department of public health efforts and investments.201323453162
in vitro activity of cadazolid against clostridium difficile strains isolated from primary and recurrent infections in stockholm, sweden.one hundred thirty-three clostridium difficile strains were collected from 71 patients and analyzed for the presence of c. difficile toxin b by the cell cytotoxicity neutralization assay, genes for toxin a, toxin b, binary toxin and tcdc deletion by pcr. all strains were also pcr-ribotyped and analyzed for sporulation frequency. the mics of the isolates were determined against cadazolid and seven other antimicrobial agents by the agar dilution method. all isolates were positive for toxin b by th ...201323454525
clostridium difficile infection in children.clostridium difficile is the most common cause of health care-associated diarrhea among adults in the united states and is associated with significant morbidity and mortality. during the past decade, the epidemiology of c difficile infection (cdi) has changed, including a rise in the rate and severity of infection related to the emergence of a hypervirulent strain as well as an increase in disease among outpatients in community settings. although less is known about cdi among pediatric patients, ...201323460123
successful use of fidaxomicin in recurrent clostridium difficile infection in a child. 201323463209
relationship between bacterial strain type, host biomarkers, and mortality in clostridium difficile infection.despite substantial interest in biomarkers, their impact on clinical outcomes and variation with bacterial strain has rarely been explored using integrated databases.201323463640
does infection with specific clostridium difficile strains or clades influence clinical outcome? 201323463642
clostridium difficile infections in solid organ transplantation. 201323464997
environmental prevention of infection in stem cell transplant recipients: a survey of the infectious diseases working party of the european group for blood and marrow transplantation.the developments of peripheral blood stem cells in autologous hematopoietic stem cell transplantation (auto-hct), and of reduced-intensity conditioning (ric) regimens in allogeneic hct (allo-hct), have considerably changed the transplant approach. prolonged neutropenia combined with severe mucosal damage and organ dysfunction is no longer the rule in the early post-hct pancytopenic phase. although strict isolation during pancytopenia was followed by most hct units in the past, this may not be th ...201323465046
antibacterial and cytotoxic activity of isoprenylated coumarin mammea a/aa isolated from mammea africana.the stem bark of mammea africana is widely distributed in tropical africa and commonly used in traditional medicine. this study aims to identify the active compound in mammea africana and to evaluate its antimicrobial and antiproliferative activity.201323466248
electronic health record-based detection of risk factors for clostridium difficile infection relapse.a major challenge in treating clostridium difficile infection (cdi) is relapse. many new therapies are being developed to help prevent this outcome. we sought to establish risk factors for relapse and determine whether fields available in an electronic health record (ehr) could be used to identify high-risk patients for targeted relapse prevention strategies.201323466915
transfer of clostridium difficile spores by nonsporicidal wipes and improperly used hypochlorite wipes: practice + product = perfection. 201323466922
clostridium difficile infection: it's a family affair. 201323466923
clostridium difficile-associated diarrhea in an ocelot (leopardus pardalis).the aim of this study is to report a case of clostridium difficile-associated diarrhea in an ocelot (leopardus pardalis) in the state of mato grosso do sul, brazil. the animal, a 24-month-old male, was referred to the centro de reabilitação de animais silvestres (cras) with a history of having been run over and tibia and fibula fractures. after a surgery to repair the fractures, the ocelot underwent antibiotic therapy with two doses of sodium cefovecin, during which he presented with diarrhea. a ...201323467074
fecal transplant in refractory clostridium difficile colitis.clostridium difficile infections are becoming more common, more severe, and more likely to recur. conventional treatment with antibiotics often fails to eradicate the infection; even when it succeeds, recurrent infection is common. complementary treatment with probiotic agents to reconstitute the physiological intestinal flora does not yield any consistent benefit. in recent years, fecal transplantation has been used in the english-speaking countries with cure rates of about 87%, but the availab ...201323468820
gut microbiota patterns associated with colonization of different clostridium difficile ribotypes.c. difficile infection is associated with disturbed gut microbiota and changes in relative frequencies and abundance of individual bacterial taxons have been described. in this study we have analysed bacterial, fungal and archaeal microbiota by denaturing high pressure liquid chromatography (dhplc) and with machine learning methods in 208 faecal samples from healthy volunteers and in routine samples with requested c. difficile testing. the latter were further divided according to stool consisten ...201323469128
the association between histamine 2 receptor antagonist use and clostridium difficile infection: a systematic review and meta-analysis.clostridium difficile infection (cdi) is a major health problem. epidemiological evidence suggests that there is an association between acid suppression therapy and development of cdi.201323469173
deadly diarrhea: clostridium difficile infection.diarrhea is often only a minor inconvenience, but sometimes it can be deadly--especially if it results from a clostridium difficile infection. clostridium difficile colitis is becoming increasingly common and more virulent, and patients with kidney failure are at increased risk for development of a clostridium disfficile infection. this article provides information about clostridium difficile infection, its incidence, diagnosis, and treatment. in addition, the article discusses how to combat the ...201223469412
predictors of mortality after emergency colectomy for clostridium difficile colitis: an analysis of acs-nsqip.to evaluate clinical factors associated with mortality in emergency colectomies performed for clostridium difficile colitis.201423470584
in vitro inhibition of clostridium difficile and clostridium perfringens by commercial probiotic strains.probiotics have gained importance in human and veterinary medicine to prevent and control clostridial enteric disease. limited information is available on the ability of different probiotic bacteria used in food products to inhibit clostridium difficile and clostridium perfringens. the objective of this study was to examine the in vitro inhibitory effects of selected commercial bacterial strains on pathogenic clostridia and their growth characteristics under simulated gastrointestinal conditions ...201323471038
effectiveness of supportive care measures to reduce infections in pediatric aml: a report from the children's oncology group.objective was to describe the effect of antibiotic and granulocyte colony-stimulating factor (g-csf) prophylaxis and discharge policy on infection risk and nonrelapse-related mortality (nrm) during chemotherapy for children with acute myeloid leukemia. patients were non-down syndrome children enrolled on children's oncology group (cog) trial aaml0531. we surveyed sites to determine institutional standards for systemic antibacterial, antifungal, and g-csf prophylaxis, and mandatory hospitalizatio ...201323471307
analysis of nosocomial acquired clostridium difficile infection in an italian research and teaching hospital.clostridium difficile (cd) infection is a nosocomial plague which is correlated with several clinical and medical factors such as antibiotics intake. it is known that prevention is possible through infection control measures both clinical and epidemiological.201323471449
the clostridium difficile problem: a south african tertiary institution's prospective perspective.the aim of this study is to report the incidence of clostridium difficile-associated disease (cdad) in a tertiary-care hospital in south africa and to identify risk factors, assess patient outcomes and determine the impact of the hypervirulent strain of the organism referred to as north american pulsed-field type 1 (nap1).201323472693
expression and display of clostridium difficile protein flid on the surface of bacillus subtilis spores.the endospores of bacillus subtilis can serve as a tool for surface presentation of heterologous proteins. the unique properties of the spore protective layers make them perfect vehicles for orally administered vaccines. in this study, we successfully displayed a fragment of clostridium difficile flid protein on the surface of b. subtilis spores using the cotb, cotc, cotg and cotz spore coat proteins. the presence of the fusion proteins in the spore coat was verified by western blotting and immu ...201323475909
trends in clostridium difficile infection and risk factors for hospital acquisition of clostridium difficile among children with cancer.to study the trend of clostridium difficile infection (cdi) and risk factors for hospital acquired cdi (ha-cdi) among children with cancer.201323477996
health care burden of clostridium difficile infection in hospitalized children with inflammatory bowel disease.children with inflammatory bowel disease (ibd), similar to adults, are at increased risk of acquiring a clostridium difficile infection (cdi). our objective was to characterize the health care burden associated with cdi in hospitalized pediatric patients with ibd.201323478808
meta-analysis of antibiotics and the risk of community-associated clostridium difficile infection.the rising incidence of clostridium difficile infection (cdi) could be reduced by lowering exposure to high-risk antibiotics. the objective of this study was to determine the association between antibiotic class and the risk of cdi in the community setting. the embase and pubmed databases were queried without restriction to time period or language. comparative observational studies and randomized controlled trials (rcts) considering the impact of exposure to antibiotics on cdi risk among nonhosp ...201323478961
clostridium difficile colitis in patients undergoing lower-extremity arthroplasty: rare infection with major impact.the prevalence of clostridium difficile colitis is reportedly increasing in surgical patients and can negatively impact their outcome. however, as yet there are no clear estimates of the c difficile infection colitis rate and its consequences among patients undergoing total joint arthroplasty (tja).201323479237
[infusion of donor feces in recurrent clostridium difficile infection? - infusion of donor feces: promising intervention with several question marks]. 201323483414
clostridium difficile infection in patients with inflammatory bowel disease. 201223483861
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