Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| clostridium difficile toxin b-induced necrosis is mediated by the host epithelial cell nadph oxidase complex. | clostridium difficile infection (cdi) is a leading cause of health care-associated diarrhea and has increased in incidence and severity over the last decade. pathogenesis is mediated by two toxins, tcda and tcdb, which cause fluid secretion, inflammation, and necrosis of the colonic mucosa. tcdb is a potent cytotoxin capable of inducing enzyme-independent necrosis in both cells and tissue. in this study, we show that tcdb-induced cell death depends on assembly of the host epithelial cell nadph o ... | 2013 | 24167244 |
| clostridium difficile infection in hospitalized patients at university clinical center tuzla, bosnia and herzegovina: a 4 year experience. | clostridium difficile (c. difficile) is currently the leading cause of healthcare-associated diarrhea, but almost nothing is known about the extent of c. difficile infection (cdi) in bosnia and herzegovina. | 2013 | 24167425 |
| predictors of first recurrence of clostridium difficile infections in children. | little is known regarding the risk of recurrence of clostridium difficile infection (cdi) in children. in a 9-year cohort, 12% of hospitalized children with cdi had recurrent disease. receipt of concomitant antibiotics and community-associated cdi were independently associated with recurrent disease in children hospitalized with cdi. antibiotics administered for reasons other than treatment of cdi should be discontinued whenever possible. | 2014 | 24168983 |
| toxin-producing clostridium difficile strains as long-term gut colonizers in healthy infants. | clostridium difficile is a colonizer of the human gut, and toxin-producing strains may cause diarrhea if the infectious burden is heavy. infants are more frequently colonized than adults, but they rarely develop c. difficile disease. it is not known whether strains of c. difficile differ in the capacity to colonize and persist in the human gut microbiota. here, we strain typed isolates of c. difficile that had colonized 42 healthy infants followed from birth to ≥12 months of age by using pcr rib ... | 2014 | 24172156 |
| validation of a clinical prediction scale for hospital-onset clostridium difficile infection. | the aim of this study was to validate a clinical prediction scale for hospital-onset clostridium difficile infection (cdi). | 2015 | 24172178 |
| quality focus: clostridium difficile. | 2013 | 24175503 | |
| fever in the postoperative patient. | postprocedure fevers vary in the timing of their occurrence, duration, and severity. such fevers do not all have an infectious cause, but they all require thorough investigation to rule out life-threatening conditions. this article summarizes the principles of diagnosis and management of postprocedure fevers for the emergency care provider. | 2013 | 24176478 |
| genetic analysis of tn916-like elements conferring tetracycline resistance in clinical isolates of clostridium difficile. | as an important clinically relevant pathogen, clostridium difficile has a high multidrug resistance rate. conjugative transposons play a vital role in its resistance phenotype. in the present study, 34 tetracycline-resistant clinical isolates of c. difficile were studied to detect tetracycline resistance genes and the presence of transposons. thirty-two isolates were found to harbour tn916-like elements carrying the tet(m) resistance gene, of which only one copy existed in the genome by southern ... | 2014 | 24176599 |
| antibiotic-associated complications following lower limb arthroplasty: a comparison of two prophylactic regimes. | as part of a wider drive to reduce clostridium difficile rates (cdad), our trust switched from cefuroxime to gentamicin and flucloxacillin prophylaxis for joint replacement surgery. anecdotal evidence suggested that we were seeing an increased incidence of acute kidney injury (aki) following elective total hip replacement (thr) and total knee replacement (tkr) since this change. the aim of this study was to compare rates of aki and post-operative infection between the two antibiotic regimes. | 2014 | 24178085 |
| hypersensitivity reactions associated with fidaxomicin use. | we report hypersensitivity reactions associated with fidaxomicin, an antibacterial drug approved for the treatment of clostridium difficile-associated diarrhea. these reactions are viewed as significant because of severity and unexpected because fidaxomicin is minimally absorbed. the fidaxomicin labeling was revised to include information about the possibility of hypersensitivity reactions. | 2014 | 24178248 |
| clostridium difficile: epidemiology, diagnostic and therapeutic possibilities-a systematic review. | this literature review looks at the epidemiology, clinical manifestations, diagnostics and current medical and surgical management of clostridium difficile (c. difficile) infection. a literature search of pubmed and cochrane database regarding c. difficile infection was performed. information was extracted from 43 published articles from 2000 to the present day which met inclusion criteria. c. difficile is a gram-positive, anaerobic bacillus, which is widely found in the environment, especially ... | 2014 | 24178946 |
| bacteremia due to clostridium difficile: case report and review of the literature. | the purpose of this study is to report a case of c. difficile bacteremia in a crohn's disease patient and to review the literature on previously reported cases. | 2009 | 24179365 |
| [the use of molecular methods in the diagnosis of clostridium difficile infections]. | the aim of this study was to use molecular methods to identify selected strains of c. difficile isolated from patients hospitalized at independent public central teaching hospital [sp csk] between 2008 and 2011 in order to demonstrate their toxicgenic character and to determine their epidemic potential, including the incidence of a suspected c. difficile strain 027/nap1/b1. | 2013 | 24180138 |
| clostridium difficile infection in children with inflammatory bowel disease: current evidence. | inflammatory bowel disease (ibd) is a chronic, immune-mediated disease of the gastrointestinal tract that develops in genetically susceptible individuals. questions about the role of infections in the development and exacerbations of inflammatory bowel disease remain unanswered. among numerous bacteria that have been linked to ibd, the most frequently associated is clostridium difficile. clinical symptoms of c. difficile infection and an exacerbation of inflammatory bowel disease are often indis ... | 2014 | 24180405 |
| acute oxalate nephropathy associated with clostridium difficile colitis. | we report the case of a 69-year-old man who presented with acute kidney injury in the setting of community-acquired clostridium difficile-associated diarrhea and biopsy-proven acute oxalate nephropathy. we discuss potential mechanisms, including increased colonic permeability to oxalate. we conclude that c difficile-associated diarrhea is a potential cause of acute oxalate nephropathy. | 2014 | 24183111 |
| evolution of interventional vancomycin trials in light of new antibiotic development in the usa, 1999-2012. | use of vancomycin has increased following the emergence of resistant gram-positive bacterial infections. investigation into recent vancomycin clinical studies provides insight into the optimal use of vancomycin and the development of novel antibiotics for the treatment of resistant infections. interventional vancomycin trials registered in clinicaltrials.gov from january 1999 to december 2012 were identified. trial trends and characteristics were evaluated in the context of vancomycin use and ne ... | 2014 | 24183801 |
| bacteremia as an adverse event of fecal microbiota transplantation in a patient with crohn's disease and recurrent clostridium difficile infection. | 2014 | 24184170 | |
| bacterial counts from five over-the-counter probiotics: are you getting what you paid for? | there is concern that the bacterial colony counts present at the time of manufacture and listed on the probiotic package may not be reflective of the numbers viable colonies at the time of purchase and patient consumption thereby diminishing efficacy. we performed a colony count study of three separate samples of five different probiotics purchased from three different stores: bifidobacterium infantis (align(®)); lactobacillus acidophilus cl1285(®) and lactobacillus casei lbc80r(®) (bio-k+(®)); ... | 2014 | 24184290 |
| incidence and mortality associated with clostridium difficile infection at a japanese tertiary care center. | although increases in clostridium difficile infection (cdi) incidence and severity have been observed in numerous countries, the incidence of cdi in japan remains unclear. the goal of this study was to determine the incidence and outcomes of cdi at a japanese tertiary care center. | 2014 | 24184291 |
| clostridium difficile infection in the community: are proton pump inhibitors to blame? | once a nosocomial disease, clostridium difficile infection (cdi) now appears frequently in the community in the absence of exposure to antibiotics. prior studies have shown that patients with community-acquired cdi are younger, more likely to be female, and have fewer comorbidities compared to patients with hospital-associated cdi. because most studies of cdi are hospital-based, comparatively little is known about community-acquired cdi. the recent study by chitnis has received widespread attent ... | 2013 | 24187445 |
| predicting a complicated course of clostridium difficile infection at the bedside. | clostridium difficile infections (cdis) are a common cause of antibiotic-associated diarrhoea and associated with cdi-related mortality in c. 10%. to date, there is no prediction model in use that guides clinicians to identify patients at high risk for complicated cdi. from 2006 to 2009, nine dutch hospitals included hospitalized cdi patients in a prospective cohort. potential predictors of a complicated course (icu admission, colectomy or death due to cdi) were evaluated in uni- and multivariat ... | 2014 | 24188103 |
| possible association between obesity and clostridium difficile infection. | 2013 | 24188730 | |
| health care use and serious infection prevalence associated with penicillin "allergy" in hospitalized patients: a cohort study. | penicillin is the most common drug "allergy" noted at hospital admission, although it is often inaccurate. | 2014 | 24188976 |
| gastrointestinal infections, active component, u.s. armed forces, 2002-2012. | acute gastroenteritis and other infectious disorders of the gastrointestinal system are common in civilian and military populations. during the years 2002 through 2012, there were 286,305 cases of gastrointestinal infection (gi) diagnosed among members of the active component of the u.s. armed forces. the distribution of presumed causes of these illnesses (as reported in administrative medical records) was bacterial (29%), viral (68%), and parasitic (3%). most recorded diagnoses did not specify ... | 2013 | 24191767 |
| editorial: ppis and recurrent c. difficile infection: no association? | a rigorously conducted cohort study published in this edition of the american journal of gastroenterology shows that the use of a proton-pump inhibitor is not associated with recurrent clostridium difficile infection among hospitalized patients. this contradicts the findings of previous studies that, however, were at a high risk of bias. where does the truth lie? regardless of the answer, it is important that proton-pump inhibitors, not dissimilar to any other drug, are used appropriately. | 2013 | 24192949 |
| more nutritional research needed to prevent and treat clostridium difficile infections. | 2013 | 24192962 | |
| clinical comparison of simplexa universal direct and bd geneohm tests for detection of toxigenic clostridium difficile in stool samples. | we compared the performance characteristics of the simplexa universal direct (focus diagnostics, cypress, ca) and bd geneohm (bd diagnostics/geneohm sciences, san diego, ca) tests for detection of toxigenic clostridium difficile in 459 stool samples (9.4% positive). the observed agreement for the results of the two tests with 452 samples with valid test results was 98.2% (kappa, 0.9; p value of 0.73 by the mcnemar test). when samples with discordant or invalid results were retested, the agreemen ... | 2014 | 24197886 |
| clostridium difficile infection in children hospitalized due to diarrhea. | the frequency of clostridium difficile infection (cdi)-related hospitalizations is increasing. the aim of this study was to determine the extent of cdi among children hospitalized with diarrhea, risk factors or predictors for severe cdi, the prevalence of nap1, and to compare the course of cdi depending on bacteria toxicity profile. a retrospective analysis of case records of 64 children (age range 3 months-16 years, median age 2.12 years) with cdi as defined by diarrheal disease and positive po ... | 2014 | 24213847 |
| accuracy of administrative code data for the surveillance of healthcare-associated infections: a systematic review and meta-analysis. | administrative code data (acd), such as international classifications of diseases, ninth revision, clinical modification codes, are widely used in surveillance and public reporting programs that seek to identify healthcare-associated infections (hais); however, little is known about their accuracy. this systematic review summarizes evidence for the accuracy of acd for the detection of selected hais, including catheter-associated urinary tract infection, clostridium difficile infection (cdi), cen ... | 2014 | 24218103 |
| whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with clostridium difficile. | whole-genome sequencing was used to determine whether the reductions in recurrence of clostridium difficile infection observed with fidaxomicin in pivotal phase 3 trials occurred by preventing relapse of the same infection, by preventing reinfection with a new strain, or by preventing both outcomes. paired isolates of c. difficile were available from 93 of 199 participants with recurrences (28 were treated with fidaxomicin, and 65 were treated with vancomycin). given c. difficile evolutionary ra ... | 2014 | 24218500 |
| constructing identities in the media: newspaper coverage analysis of a major uk clostridium difficile outbreak. | to examine how a major clostridium difficile outbreak in the uk was represented in the media. | 2014 | 24224760 |
| the impact of observation units on the rate of hospital-acquired infection. | using clostridium difficile as an example, we calculated the impact that reduced inpatient-day denominators resulting from implementation of hospital observation units would have on hospital-acquired infection rates. using proposed scenarios of reduced inpatient-days, we estimated an increase in the hospital-acquired c. difficile infection rate of up to 12%. | 2013 | 24225619 |
| clostridium difficile 027 emerging outbreak in marseille, france. | 2013 | 24225631 | |
| histologic findings and clinical characteristics in acutely symptomatic ulcerative colitis patients with superimposed clostridium difficile infection. | to examine biopsy specimens for histologic features suggestive of clostridium difficile infection in patients with ulcerative colitis (uc). | 2013 | 24225751 |
| comparison of simplexa universal direct pcr with cytotoxicity assay for diagnosis of clostridium difficile infection: performance, cost, and correlation with disease. | simplexa clostridium difficile universal direct pcr, a real-time pcr assay for the detection of the c. difficile toxin b (tcdb) gene using the 3m integrated cycler, was compared with a two-step algorithm which includes the c. diff chek-60 glutamate dehydrogenase (gdh) antigen assay followed by cytotoxin neutralization. three hundred forty-two liquid or semisolid stools submitted for diagnostic c. difficile testing, 171 gdh antigen positive and 171 gdh antigen negative, were selected for the stud ... | 2014 | 24226924 |
| role of lactobacillus in the prevention of clostridium difficile-associated diarrhea: a meta-analysis of randomized controlled trials. | clostridium difficile-associated diarrhea (cdad) is a major public health problem because of significant morbidity and mortality, and many clinicians pay attention to lactobacillus as a potentially effective treatment. the purpose of this meta-analysis was to evaluate the efficacy of lactobacillus in the prevention of cdad. | 2013 | 24229690 |
| all-cause mortality in hospitalized patients with infectious diarrhea: clostridium difficile versus other enteric pathogens in austria from 2008 to 2010. | clostridium difficile infection is the leading cause of gastroenteritis-associated deaths in the industrialized world, followed by infection with norovirus. | 2016 | 24231157 |
| spo0a differentially regulates toxin production in evolutionarily diverse strains of clostridium difficile. | clostridium difficile is an important pathogen of humans and animals, representing a significant global healthcare problem. the last decade has seen the emergence of epidemic bi/nap1/027 and ribotype 078 isolates, associated with the onset of more severe disease and higher rates of morbidity and mortality. however, little is known about these isolates at the molecular level, partly due to difficulties in the genetic manipulation of these strains. here we report the development of an optimised tn ... | 2013 | 24236153 |
| discrepancies among three laboratory methods for clostridium difficile detection and a proposal for their optimal use. | clostridium difficile is the major cause of nosocomial diarrhoea. several detection methods are available for the laboratory diagnosis of c. difficile, but these vary in terms of sensitivity and specificity. in this study, we compared the performance of three following laboratory tests to detect c. difficile: in-house real-time pcr aiming for toxin b gene (tcdb), eia for detection of toxins a and b (premier toxins a & b) and c. difficile culture in selective medium (biomerieux). our results were ... | 2014 | 24236508 |
| progress in the discovery of treatments for c. difficile infection: a clinical and medicinal chemistry review. | clostridium difficile is an anaerobic, gram-positive pathogen that causes c. difficile infection, which results in significant morbidity and mortality. the incidence of c. difficile infection in developed countries has become increasingly high due to the emergence of newer epidemic strains, a growing elderly population, extensive use of broad spectrum antibiotics, and limited therapies for this diarrheal disease. because treatment options currently available for c. difficile infection have some ... | 2014 | 24236721 |
| fecal microbiota transplantation: facts and controversies. | to review the current evidence on fecal microbiota transplantations (fmts) for recurrent clostridium difficile infections (cdis), metabolic syndrome and inflammatory bowel disease. | 2014 | 24241245 |
| differential stress transcriptome landscape of historic and recently emerged hypervirulent strains of clostridium difficile strains determined using rna-seq. | c. difficile is the most common cause of nosocomial diarrhea in north america and europe. genomes of individual strains of c. difficile are highly divergent. to determine how divergent strains respond to environmental changes, the transcriptomes of two historic and two recently isolated hypervirulent strains were analyzed following nutrient shift and osmotic shock. illumina based rna-seq was used to sequence these transcriptomes. our results reveal that although c. difficile strains contain a la ... | 2013 | 24244315 |
| bile salt inhibition of host cell damage by clostridium difficile toxins. | virulent clostridium difficile strains produce toxin a and/or toxin b that are the etiological agents of diarrhea and pseudomembranous colitis. treatment of c. difficile infections (cdi) has been hampered by resistance to multiple antibiotics, sporulation, emergence of strains with increased virulence, recurrence of the infection, and the lack of drugs that preserve or restore the colonic bacterial flora. as a result, there is new interest in non-antibiotic cdi treatments. the human conjugated b ... | 2013 | 24244530 |
| prospects and challenges for intestinal microbiome therapy in pediatric gastrointestinal disorders. | fecal microbiome (microbiota) transplantation is an emerging treatment not only for refractory/recurrent clostridium difficile infections and chronic gastrointestinal diseases, but also for metabolic syndrome, and even possibly for neurological disorders. this non-conventional therapy has been perhaps more appropriately designated as fecal bacteriotherapy (fb) as well. the employment of fb is spreading into pediatric gastroenterology. this focused review highlights the pediatric applications of ... | 2013 | 24244876 |
| comparative in vitro activities of smt19969, a new antimicrobial agent, against 162 strains from 35 less frequently recovered intestinal clostridium species: implications for clostridium difficile recurrence. | we determined the comparative activity of smt19969 (smt) against 162 strains representing 35 well-characterized clostridium species in clusters i to xix and 13 clostridium species that had no 16s rrna match. smt mics ranged from 0.06 to >512 μg/ml and were not species related. smt might have less impact on normal gut microbiota than other clostridium difficile infection (cdi) antimicrobials. | 2014 | 24247123 |
| [severe colitis due to community-acquired ribotype 027 clostridium difficile]. | 2014 | 24252599 | |
| clostridium difficile binary toxin cdt: mechanism, epidemiology, and potential clinical importance. | binary toxin (cdt) is frequently observed in clostridium difficile strains associated with increased severity of c. difficile infection (cdi). cdt belongs to the family of binary adp-ribosylating toxins consisting of two separate toxin components: cdta, the enzymatic adp-ribosyltransferase which modifies actin, and cdtb which binds to host cells and translocates cdta into the cytosol. cdtb is activated by serine proteases and binds to lipolysis stimulated lipoprotein receptor. adp-ribosylation i ... | 2015 | 24253566 |
| phage ϕc2 mediates transduction of tn6215, encoding erythromycin resistance, between clostridium difficile strains. | in this work, we show that clostridium difficile phage ϕc2 transduces erm(b), which confers erythromycin resistance, from a donor to a recipient strain at a frequency of 10(-6) per pfu. the transductants were lysogenic for ϕc2 and contained the erm(b) gene in a novel transposon, tn6215. this element is 13,008 bp in length and contains 17 putative open reading frames (orfs). it could also be transferred at a lower frequency by filter mating. | 2013 | 24255122 |
| gastrointestinal infections after transplantation. | recipients of both solid organ transplant and hematopoietic stem cell transplantation are at increased risk for infectious morbidity and mortality after transplantation due to on-going immunosuppression. gastrointestinal infections have been increasingly reported in these populations. | 2014 | 24257036 |
| therapeutic faecal microbiota transplantation: current status and future developments. | faecal microbiota transplantation (fmt) has undergone dramatic progression over the past year and continues to evolve as knowledge of the gastrointestinal microbiota (gimb) develops. this review summarizes therapeutic advances in fmt, latest fmt therapies and presents the potential of fmt therapeutics in other gastrointestinal and extra-intestinal conditions. | 2014 | 24257037 |
| mortality following rasburicase-induced methemoglobinemia. | to report a case of mortality following rasburicase-induced methemoglobinemia. | 2013 | 24259700 |
| pseudomembranous colitis associated with a triple therapy for helicobacter pylori eradication. | helicobacter pylori (h. pylori) is one of the most common chronic bacterial infections in humans, affecting half of world's population. therapy for h. pylori infection has proven to be both effective and safe. the one-week triple therapy including proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole is still recommended as a first-line treatment to eradicate h. pylori infection in countries with low clarithromycin resistance. generally, this therapy is well-tolerated, with onl ... | 2013 | 24259981 |
| surface-layer protein a (slpa) is a major contributor to host-cell adherence of clostridium difficile. | clostridium difficile is a leading cause of antibiotic-associated diarrhea, and a significant etiologic agent of healthcare-associated infections. the mechanisms of attachment and host colonization of c. difficile are not well defined. we hypothesize that non-toxin bacterial factors, especially those facilitating the interaction of c. difficile with the host gut, contribute to the initiation of c. difficile infection. in this work, we optimized a completely anaerobic, quantitative, epithelial-ce ... | 2013 | 24265687 |
| asymptomatic clostridium difficile colonisation and onward transmission. | combined genotyping/whole genome sequencing and epidemiological data suggest that in endemic settings only a minority of clostridium difficile infection, cdi, is acquired from other cases. asymptomatic patients are a potential source for many unexplained cases. | 2013 | 24265690 |
| clinical and microbiologic characteristics of clostridium difficile infection caused by binary toxin producing strain in korea. | binary toxin-producing clostridium difficile infections (cdi) are known to be more severe and to cause higher case fatality rates than those by binary toxin-negative isolates. there has been few data of binary toxin-producing cdi in korea. objective of the study is to characterize clinical and microbiological trait of cdi cause by binary-toxin producing isolates in korea. | 2013 | 24265965 |
| diagnosis of clostridium difficile infection: the molecular approach. | diagnosis of clostridium difficile infection is based on clinical presentation and laboratory tests. although numerous laboratory methods are now available, the diagnosis of c. difficile infection remains challenging. nucleic acid amplification tests (naats) are the most recent marketed methods. these methods detect genes for toxins a and/or b. they are very sensitive compared with the reference method (toxigenic culture) and are thus very promising, despite their cost. however, a positive naat ... | 2013 | 24266358 |
| acute inflammatory surgical disease. | infectious and inflammatory diseases comprise some of the most common gastrointestinal disorders resulting in hospitalization in the united states. accordingly, they occupy a significant proportion of the workload of the acute care surgeon. this article discusses the diagnosis, management, and treatment of appendicitis, acute cholecystitis/cholangitis, acute pancreatitis, diverticulitis, and clostridium difficile colitis. | 2014 | 24267493 |
| clostridium difficile infection in the elderly. | clostridium difficile-associated illness is an increasingly prevalent and morbid condition. the elderly population is at a disproportionate risk of developing symptomatic disease and associated complications, including progression to severe or fulminant disease, and development of recurrent infections. this article analyzes the factors that influence c difficile disease propensity and severity, with particular attention directed toward features relevant to the rapidly aging population. | 2014 | 24267604 |
| characterization of the collagen-like exosporium protein, bcla1, of clostridium difficile spores. | spores of clostridium difficile are essential for infection, persistence and transmission of c. difficile infections (cdi). proteins of the surface of c. difficile spores are thought to be essential for initiation and persistence of cdi. in this work, we demonstrate that three c. difficile collagen-like exosporium proteins (bcla) encoded in the c. difficile 630 genome are expressed during sporulation and localize to the spore via their n-terminal domains. using polyclonal antibodies against the ... | 2014 | 24269655 |
| use of proton pump inhibitors for the provision of stress ulcer prophylaxis: clinical and economic consequences. | the provision of stress ulcer prophylaxis (sup) for the prevention of clinically significant bleeding is widely recognized as a crucial component of care in critically ill patients. nevertheless, sup is often provided to non-critically ill patients despite a risk for clinically significant bleeding of roughly 0.1 %. the overuse of sup therefore introduces added risks for adverse drug events and cost, with minimal expected benefit in clinical outcome. historically, histamine-2-receptor antagonist ... | 2014 | 24271943 |
| clostridium difficile toxins facilitate bacterial colonization by modulating the fence and gate function of colonic epithelium. | the contribution of clostridium difficile toxin a and b (tcda and tcdb) to cellular intoxication has been studied extensively, but their impact on bacterial colonization remains unclear. by setting up 2- and 3-dimensional in vitro models of polarized gut epithelium, we investigated how c. difficile infection is affected by host cell polarity and whether tcda and tcdb contribute to such events. indeed, we observed that c. difficile adhesion and penetration of the mucosal barrier are substantially ... | 2014 | 24273043 |
| investigating clostridium difficile. | 2013 | 24273764 | |
| identification of clostridium difficile: evaluation of genotypic, phenotypic and proteomic methods. | 2013 | 24273901 | |
| multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study. | laboratory diagnosis and clinical management of inpatients with diarrhoea is complex and time consuming. tests are often requested sequentially and undertaken in different laboratories. this causes prolonged unnecessary presumptive isolation of patients, because most cases are non-infectious. a molecular multiplex test (luminex(®) gastrointestinal pathogen panel (gpp)) was compared with conventional testing over 8 months to determine diagnostic accuracy, turnaround times, laboratory costs, use o ... | 2014 | 24274687 |
| fecal microbiota transplantation for clostridium difficile infection: benefits and barriers. | the incidence and severity of clostridium difficile infection (cdi) have increased worldwide in the past two decades. a principal function of the gut microbiota is to protect the intestine against colonization by exogenous pathogens. increasingly, the gut microbiota have been shown to influence susceptibility to other genetic and environmentally acquired conditions. transplantation of healthy donor fecal material in patients with cdi may re-establish the normal composition of the gut microbiota ... | 2014 | 24275671 |
| emerging infectious colitis. | the present review will highlight recent advances in the knowledge of emerging pathogens causing infectious colitis and provide a description of the most important food-borne outbreaks. | 2014 | 24275672 |
| probing the metal specificity mechanism of superoxide dismutase from human pathogen clostridium difficile. | the molecular mechanism of the metal specificity to superoxide dismutase from human pathogen c. difficile (sodcd) was investigated by x-ray crystallography, spectroscopy, sod activity assay, electrochemistry, and dft calculations, and the results indicate that the cognate metal characters tuned by the metal micro-environment dominate the metal specificity of the sodcd. | 2014 | 24275896 |
| in vitro and in vivo antibacterial evaluation of cadazolid, a new antibiotic for treatment of clostridium difficile infections. | clostridium difficile is a leading cause of health care-associated diarrhea with significant morbidity and mortality, and new options for the treatment of c. difficile-associated diarrhea (cdad) are needed. cadazolid is a new oxazolidinone-type antibiotic that is currently in clinical development for treatment of cdad. here, we report the in vitro and in vivo antibacterial evaluation of cadazolid against c. difficile. cadazolid showed potent in vitro activity against c. difficile with a mic rang ... | 2014 | 24277020 |
| investigations of the mode of action and resistance development of cadazolid, a new antibiotic for treatment of clostridium difficile infections. | cadazolid is a new oxazolidinone-type antibiotic currently in clinical development for the treatment of clostridium difficile-associated diarrhea. here, we report investigations on the mode of action and the propensity for spontaneous resistance development in c. difficile strains. macromolecular labeling experiments indicated that cadazolid acts as a potent inhibitor of protein synthesis, while inhibition of dna synthesis was also observed, albeit only at substantially higher concentrations of ... | 2014 | 24277035 |
| a simulation-based assessment of strategies to control clostridium difficile transmission and infection. | clostridium difficile is one of the most common and important nosocomial pathogens, causing severe gastrointestinal disease in hospitalized patients. although "bundled" interventions have been proposed and promoted, optimal control strategies remain unknown. | 2013 | 24278304 |
| the p2y6 receptor mediates clostridium difficile toxin-induced cxcl8/il-8 production and intestinal epithelial barrier dysfunction. | c. difficile is a gram-positive spore-forming anaerobic bacterium that is the leading cause of nosocomial diarrhea in the developed world. the pathogenesis of c. difficile infections (cdi) is driven by toxin a (tcda) and toxin b (tcdb), secreted factors that trigger the release of inflammatory mediators and contribute to disruption of the intestinal epithelial barrier. neutrophils play a key role in the inflammatory response and the induction of pseudomembranous colitis in cdi. tcda and tcdb alt ... | 2013 | 24278446 |
| in vitro evaluation of antimicrobial activity of lactic acid bacteria against clostridium difficile. | clostridium difficile infection (cdi) has become a significant threat to public health. although broad-spectrum antibiotic therapy is the primary treatment option for cdi, its use has evident limitations. probiotics have been proved to be effective in the treatment of cdi and are a promising therapeutic option for cdi. in this study, 4 strains of lactic acid bacteria (lab), namely, lactobacillus rhamnosus (lr5), lactococcuslactis (sl3), bifidobacterium breve (br3), and bifidobacterium lactis (bl ... | 2013 | 24278635 |
| more on antidepressant drugs and infectious disease. | three observational studies have suggested that depression and/or antidepressant drug use is associated with an increased risk of developing clostridium difficile (c. difficile) infection (cdi), which is a clinically significant cause of diarrhea typically associated with the use of antibiotic drugs. establishing causality from observed associations requires evidence from a variety of different scientific perspectives. the authors of these studies do not consider the complex relationship among d ... | 2013 | 24278963 |
| [new treatment options for infections with clostridium difficile]. | currently available broad spectrum antibiotics are not sufficiently effective against recurrent clostridium difficile infections (cdi). donor faecal microbiota transplantation is a very effective treatment for second and recurrent infection but is time-consuming and requires careful screening of donors. the new narrow spectrum antibiotic fidaxomicin is a good alternative in a first cdi or a first recurrence, but treatment is expensive and there are no data on its effectiveness in a second or lat ... | 2013 | 24279951 |
| clostridium difficile and inflammatory bowel disease: role in pathogenesis and implications in treatment. | clostridium difficile (c. difficile) is the leading cause of antibiotic associated colitis and nosocomial diarrhea. patients with inflammatory bowel disease (ibd) are at increased risk of developing c. difficile infection (cdi), have worse outcomes of cdi-including higher rates of colectomy and death, and experience higher rates of recurrence. however, it is still not clear whether c. difficile is a cause of ibd or a consequence of the inflammatory state in the intestinal environment. the burden ... | 2013 | 24282348 |
| risk factors of mild rectal bleeding in very low birth weight infants: a case control study. | mild rectal bleeding (mrb) is a particular clinical entity different from necrotizing enterocolitis, which significantly influences neonatal care in preterm infants. we aimed to determine the risk factors and to evaluate prospectively the clinical course of mrb. | 2013 | 24283213 |
| cags clinical practice committee report: the science of clostridium difficile and surgery. | 2013 | 24284142 | |
| microbiota transplantation restores normal fecal bile acid composition in recurrent clostridium difficile infection. | fecal microbiota transplantation (fmt) has emerged as a highly effective therapy for refractory, recurrent clostridium difficile infection (cdi), which develops following antibiotic treatments. intestinal microbiota play a critical role in the metabolism of bile acids in the colon, which in turn have major effects on the lifecycle of c. difficile bacteria. we hypothesized that fecal bile acid composition is altered in patients with recurrent cdi and that fmt results in its normalization. general ... | 2014 | 24284963 |
| the changing epidemiology of clostridium difficile infection. | clostridium difficile infection (cdi) is a growing concern and has a substantial impact on morbidity and mortality. epidemiology of cdi has dramatically changed over the last decade. diagnostic and treatment strategies are even more complicated given the wide variety of available diagnostic methods and the emergence of refractory or recurrent cdi. this review is intended to provide information on current cdi epidemiology and guidance for evidence-based diagnosis and management strategies. | 2014 | 24285002 |
| environmental contaminants in hospital settings and progress in disinfecting techniques. | medical devices, such as stethoscopes, and other objects found in hospital, such as computer keyboards and telephone handsets, may be reservoirs of bacteria for healthcare-associated infections. in this cross-over study involving an italian teaching hospital we evaluated microbial contamination (total bacterial count (tbc) at 36°c/22°c, staphylococcus spp., moulds, enterococcus spp., pseudomonas spp., e. coli, total coliform bacteria, acinetobacter spp., and clostridium difficile) of these devic ... | 2013 | 24286078 |
| patients with cystic fibrosis have a high carriage rate of non-toxigenic clostridium difficile. | thirty-year-old observations report frequent asymptomatic clostridium difficile carriage among cystic fibrosis (cf) patients. in this case-control study, we found more carriers among cf patients than controls (47% versus 11%), but most strains carried by cf patients were non-toxigenic (77% versus 17%). among cf patients, carriers were younger, with more severe pulmonary disease than non-carriers. strains belonged to multiple pcr-ribotypes, suggesting that these cf patients did not acquire strain ... | 2014 | 24286342 |
| aptamer biosensor for sensitive detection of toxin a of clostridium difficile using gold nanoparticles synthesized by bacillus stearothermophilus. | a sensitive electrochemical biosensor was developed to detect toxin a (toa) of clostridium difficile based on an aptamer selected by the systematic evolution of ligands using exponential enrichment and gold nanoparticles (gnps) synthesized by bacillus stearothermophilus. the thiolated single-stranded dna used as the capture probe (cp) was first self-assembled on a nafion-thionine-gnps-modified screen-printed electrode (spe) through an au-thiol interaction. the horseradish peroxidase (hrp)-labele ... | 2014 | 24287407 |
| spread of epidemic clostridium difficile nap1/027 in latin america: case reports in panama. | the rate and severity of clostridium difficile infection (cdi) have been linked to the emergence and spread of the hypervirulent toxigenic strain nap1/027. this strain has been responsible for large outbreaks in healthcare facilities in north america and europe and most recently in latin america. this is the first report of the nap1 strain in panama. it suggests that the spread of c. difficile nap1 throughout latin america could be a possibility as evidenced in the following case reports. five i ... | 2014 | 24287669 |
| bioavailability of the anti-clostridial bacteriocin thuricin cd in gastrointestinal tract. | thuricin cd is a two component narrow spectrum bacteriocin comprising two peptides with targeted activity against clostridium difficile. this study examined the bioavailability of thuricin with a view to developing it as an effective antimicrobial against intestinal infection. one of the peptides, trn-β, was found to be degraded by the gastric enzymes pepsin and α-chymotrypsin both in vitro and in vivo, whereas trn-α was resistant to digestion by these enzymes and hence was detected in the intes ... | 2014 | 24287693 |
| to the editor: molecular epidemiology of toxigenic clostridium difficile isolates in korea. | 2014 | 24290036 | |
| the prolongation of length of stay because of clostridium difficile infection. | clostridium difficile infection (cdi) possibly extends hospital length of stay (los); however, the current evidence does not account for the time-dependent bias, ie, when infection is incorrectly analyzed as a baseline covariate. the aim of this study was to determine whether cdi increases los after managing this bias. | 2014 | 24290226 |
| the emergence of community-onset clostridium difficile infection in a tertiary hospital in singapore: a cause for concern. | increasing rates of clostridium difficile infection (cdi) among those without traditional risk factors have been reported mainly in europe and north america. here we describe the epidemiology, clinical features and ribotypes of cdi at national university hospital (nuh), a 1000-bed tertiary care hospital in singapore, from december 2011 to may 2012. all laboratory-confirmed cdi cases ≥21 years old who gave informed consent were included. clinical data were collected prospectively and participants ... | 2014 | 24290727 |
| probiotics reduce symptoms of antibiotic use in a hospital setting: a randomized dose response study. | probiotics are known to reduce antibiotic associated diarrhea (aad) and clostridium difficile associated diarrhea (cdad) risk in a strain-specific manner. the aim of this study was to determine the dose-response effect of a four strain probiotic combination (howaru(®) restore) on the incidence of aad and cdad and severity of gastrointestinal symptoms in adult in-patients requiring antibiotic therapy. patients (n=503) were randomized among three study groups: howaru(®) restore probiotic 1.70×10(1 ... | 2014 | 24291194 |
| surgical management of clostridium difficile colitis. | clostridium difficile infection (cdi) will progress to fulminant disease in 3 to 5% of cases. with the emergence of hypervirulent, multidrug-resistant strains, the incidence and severity of disease are continuing to rise. prompt identification, early resuscitation, and treatment are critical in preventing morbidity and mortality in this increasingly common condition. discontinuation of antibiotics and treatment with oral vancomycin and intravenous or oral metronidazole are first-line treatments, ... | 2012 | 24294121 |
| variations in virulence and molecular biology among emerging strains of clostridium difficile. | clostridium difficile is a gram-positive, spore-forming organism which infects and colonizes the large intestine, produces potent toxins, triggers inflammation, and causes significant systemic complications. treating c. difficile infection (cdi) has always been difficult, because the disease is both caused and resolved by antibiotic treatment. for three and a half decades, c. difficile has presented a treatment challenge to clinicians, and the situation took a turn for the worse about 10 years a ... | 2013 | 24296572 |
| faecal microbiota transplantation in 2013: developing human gut microbiota as a class of therapeutics. | although the idea of faecal transplantation dates back many decades, only with advances in scientific technologies can we begin systematic development of this new class of therapeutics. the primary focus remains on treatment of clostridium difficile infection—new applications are beginning to emerge, but a long journey remains ahead. | 2014 | 24296579 |
| a rare case intractable diarrhea secondary to clostridium difficile and cytomegalovirus coinfection. | male, 63 final diagnosis: cytomegalo virus (cmv) infection symptoms: diarrhea medication:- clinical procedure:- specialty: infectious diseases. | 2013 | 24298304 |
| proton pump inhibitors: clostridium difficile infections. | data on the adverse effect profile of proton pump inhibitors continue to accumulate. in addition to increasing the risk of bacterial pneumonia, proton pump inhibitors appear to increase the risk of intestinal clostridium difficile infection. a meta-analysis of epidemiological studies showed a statistically significant increase in c. difficile infection among patients taking proton pump inhibitors, most of whom were hospital patients.the estimated relative risk was 1.7 for primary infections (95% ... | 2013 | 24298587 |
| [recurrent clostridium difficile infections: the importance of the intestinal microbiota]. | clostridium difficile infections (cdi) represent 20-30% of diarrhea caused by antibiotics and relapse in more than 25% of cases after treatment with metronidazole or vancomycin. given the high prevalence of cdi and the significant rate of recurrence despite successful initial treatment, cdi therapy represents a real challenge. a better understanding of the intestinal microbiota and its role in cdi opens the way to promising new therapeutic approaches, such as fecal transplantation. the studies p ... | 2013 | 24298714 |
| cost-effectiveness of fidaxomicin for clostridium difficile treatment. | 2014 | 24300043 | |
| improved detection of gastrointestinal pathogens using generalised sample processing and amplification panels. | we aimed to streamline the diagnosis of gastrointestinal disease by producing multiplexed real time polymerase chain reaction (pcr) panels employing universal sample processing for dna and rna containing pathogens. a total of 487 stored, previously characterised stool samples comprising bacterial, viral, protozoan and clostridium difficile positive samples were tested using four multiplexed real time pcr panels. a further 81 pre-selected clinical samples from a teaching hospital were included to ... | 2014 | 24300711 |
| immunization using groel decreases clostridium difficile intestinal colonization. | clostridium difficile is a pathogen which is responsible for diarrhea and colitis, particularly after treatment with antibiotics. clinical signs are mainly due to two toxins, tcda and tcdb. however, the first step of pathogenesis is the colonization process. we evaluated c. difficile surface proteins as vaccine antigens in the hamster model to prevent intestinal colonization. this vaccination induced a partial protection of hamsters against death after a c. difficile challenge. a proteomic analy ... | 2013 | 24303034 |
| identification of a novel zinc metalloprotease through a global analysis of clostridium difficile extracellular proteins. | clostridium difficile is a major cause of infectious diarrhea worldwide. although the cell surface proteins are recognized to be important in clostridial pathogenesis, biological functions of only a few are known. also, apart from the toxins, proteins exported by c. difficile into the extracellular milieu have been poorly studied. in order to identify novel extracellular factors of c. difficile, we analyzed bacterial culture supernatants prepared from clinical isolates, 630 and r20291, using liq ... | 2013 | 24303041 |
| microbiota dynamics in patients treated with fecal microbiota transplantation for recurrent clostridium difficile infection. | clostridium difficile causes antibiotic-associated diarrhea and pseudomembraneous colitis and is responsible for a large and increasing fraction of hospital-acquired infections. fecal microbiota transplantation (fmt) is an alternate treatment option for recurrent c. difficile infection (rcdi) refractory to antibiotic therapy. it has recently been discussed favorably in the clinical and scientific communities and is receiving increasing public attention. however, short- and long-term health conse ... | 2013 | 24303043 |
| predictors of clostridium difficile infection severity in patients hospitalised in medical intensive care. | to describe and analyse factors associated with clostridium difficile infection (cdi) severity in hospitalised medical intensive care unit patients. | 2013 | 24307797 |