Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| [clostridium difficile infections, specific issues in the elderly]. | clostridium difficile is a well-established cause of infectious nosocomial diarrhea in adults. each time diarrhea is observed in a patient receiving antibiotic treatment, clostridium colitis should be suspected; diagnosis should be confirmed by the identification of toxin in the patient's stools. its incidence is increasing due to growing use of several classes of antibiotics, and is associated with a high relapse rate and a significant case-fatality rate. the elderly are particularly at risk fo ... | 2013 | 24308141 |
| portrait toxigenic clostridium difficile assay, an isothermal amplification assay detects toxigenic c. difficile in clinical stool specimens. | the portrait toxigenic clostridium difficile assay is a rapid, qualitative assay for the detection of the tcdb gene of c. difficile in stool specimens from patients suspected of c. difficile infections, and received 510(k) clearance by the us fda in march 2012. the portrait toxigenic c. difficile assay combines novel blocked-primer-mediated helicase-dependent multiplex amplification (bphda) technology and chip-based detection in an automated sample-to-result format. the assay requires minimal sa ... | 2014 | 24308336 |
| a high-dose preparation of lactobacilli and bifidobacteria in the prevention of antibiotic-associated and clostridium difficile diarrhoea in older people admitted to hospital: a multicentre, randomised, double-blind, placebo-controlled, parallel arm trial (placide). | antibiotic-associated diarrhoea (aad) occurs most commonly in older people admitted to hospital and within 12 weeks of exposure to broad-spectrum antibiotics. although usually a mild and self-limiting illness, the 15-39% of cases caused by clostridium difficile infection [c. difficile diarrhoea (cdd)] may result in severe diarrhoea and death. previous research has shown that probiotics, live microbial organisms that, when administered in adequate numbers, are beneficial to health, may be effecti ... | 2013 | 24309198 |
| proton pump inhibitor therapy and potential long-term harm. | this review summarizes the recent literature on the potential side-effects of proton pump inhibitors (ppis) and known interactions with the metabolism/absorption of other drugs. | 2014 | 24310148 |
| prevention and treatment of diarrhoea with saccharomyces boulardii in children with acute lower respiratory tract infections. | the aim of this study was to determine whether saccharomyces boulardii prevents and treats diarrhoea and antibiotic-associated diarrhoea (aad) in children. a total of 333 hospitalised children with acute lower respiratory tract infection were enrolled in a 2-phase open randomised controlled trial. during the 1st phase, all children received intravenous antibiotics (ab). they were randomly allocated to group a (s. boulardii 500 mg/day + ab, n=167) or group b (ab alone, n=166) and followed for 2 w ... | 2013 | 24311316 |
| structural basis for antibody recognition in the receptor-binding domains of toxins a and b from clostridium difficile. | clostridium difficile infection is a serious and highly prevalent nosocomial disease in which the two large, rho-glucosylating toxins tcda and tcdb are the main virulence factors. we report for the first time crystal structures revealing how neutralizing and non-neutralizing single-domain antibodies (sdabs) recognize the receptor-binding domains (rbds) of tcda and tcdb. surprisingly, the complexes formed by two neutralizing antibodies recognizing tcda do not show direct interference with the pre ... | 2014 | 24311789 |
| closure of a broncho-pleural fistula using an atrial septal defect occluder. | broncho-pleural fistulae (bpf) are recognised as a rare complication following pneumonectomy. we describe a patient, who after failing conservative treatment, underwent closure of a persistent fistula with an atrial septal defect (asd) occluder. additionally we review the literature regarding management of bpf and the emerging role of cardiac defect closure devices as a possible treatment option. | 2014 | 24315634 |
| carriage of clostridium difficile by wild urban norway rats (rattus norvegicus) and black rats (rattus rattus). | clostridium difficile is an important cause of enteric infections in humans. recently, concerns have been raised regarding whether animals could be a source of c. difficile spores. although colonization has been identified in a number of domestic species, the ability of commensal pests to serve as a reservoir for c. difficile has not been well investigated. the objective of this study was to determine whether urban rats (rattus spp.) from vancouver, canada, carry c. difficile. clostridium diffic ... | 2014 | 24317079 |
| histological damage of colonic epithelium is associated with clinical severity and outcome in colectomized critically ill patients. | severe intestinal mucosal damage and organ failure has been associated in experimental models. our purpose was to determine whether there is any association between histopathological findings and postoperative mortality among icu patients undergoing emergency colectomies for various illnesses. | 2014 | 24318408 |
| development of a novel method for detection of clostridium difficile using hs-spme-gc-ms. | a novel method has been developed that allows successful differentiation between clostridium difficile culture-positive and culture-negative stool samples based on volatile organic compound (voc) evolution and detection by headspace solid-phase microextraction coupled with gas chromatography mass spectrometry (hs-spme-gc-ms). | 2014 | 24320174 |
| comparison of antimicrobial susceptibility among clostridium difficile isolated from an integrated human and swine population in texas. | clostridium difficile can be a major problem in hospitals because the bacterium primarily affects individuals with an altered intestinal flora; this largely occurs through prolonged antibiotic use. proposed sources of increased community-acquired infections are food animals and retail meats. the objective of this study was to compare the antimicrobial resistance patterns of c. difficile isolated from a closed, integrated population of humans and swine to increase understanding of the bacterium i ... | 2014 | 24320797 |
| severe mucositis and clostridium difficile infection in adult autologous stem cell recipients: another question of the chicken or the egg? | 2014 | 24321748 | |
| antibiotics and hospital-acquired clostridium difficile infection: update of systematic review and meta-analysis. | to update the evidence for associations between antibiotic classes and hospital-acquired clostridium difficile infection (ha-cdi). | 2014 | 24324224 |
| medication risk factors associated with healthcare-associated clostridium difficile infection: a multilevel model case-control study among 64 us academic medical centres. | the main objective of this study was to determine patient- and hospital-level medication risk factors associated with clostridium difficile infection (cdi) occurrence among patients clustered within hospitals using a multilevel model. | 2014 | 24327619 |
| could fecal microbiota transplantation cure all clostridium difficile infections? | 2014 | 24328373 | |
| how enteric pathogens know they hit the sweet spot. | ng km, ferreyra ja, higginbottom sk et al. microbiota-liberated host sugars facilitate post-antibiotic expansion of enteric pathogens. nature 502(7469), 96-99 (2013). the human gut microbiota is a complex system of commensal microorganisms required for normal host physiology. disruption of this protective barrier by antibiotics creates opportunities for enteric pathogens to establish infections. although the correlation between the use of antibiotics and enteric infections have been known for so ... | 2014 | 24328376 |
| antimicrobial effects of virgin coconut oil and its medium-chain fatty acids on clostridium difficile. | clostridium difficile is the leading cause of hospital-acquired antibiotic-associated diarrhea worldwide; in addition, the proliferation of antibiotic-resistant c. difficile is becoming a significant problem. virgin coconut oil (vco) has been shown previously to have the antimicrobial activity. this study evaluates the lipid components of vco for the control of c. difficile. vco and its most active individual fatty acids were tested to evaluate their antimicrobial effect on c. difficile in vitro ... | 2013 | 24328700 |
| penicillin allergy as a public health measure. | 2014 | 24332220 | |
| [clostridium difficile infection due to ribotype 027: description of an imported case in spain]. | 2014 | 24332712 | |
| quantifying sources of bias in national healthcare safety network laboratory-identified clostridium difficile infection rates. | to assess the effect of multiple sources of bias on state- and hospital-specific national healthcare safety network (nhsn) laboratory-identified clostridium difficile infection (cdi) rates. | 2014 | 24334790 |
| contamination of healthcare workers' hands with clostridium difficile spores after caring for patients with c. difficile infection. | we determined the percentage of healthcare workers' (hcws') hands contaminated with clostridium difficile spores after caring for patients with c. difficile infection (cdi) and risk factors associated with contamination. | 2014 | 24334792 |
| healthcare workers' hands and clostridium difficile spores: making progress? | 2014 | 24334793 | |
| a mathematical model to evaluate the routine use of fecal microbiota transplantation to prevent incident and recurrent clostridium difficile infection. | fecal microbiota transplantation (fmt) has been suggested as a new treatment to manage clostridium difficile infection (cdi). with use of a mathematical model of c. difficile within an intensive care unit (icu), we examined the potential impact of routine fmt. | 2014 | 24334794 |
| active surveillance for carbapenem-resistant enterobacteriaceae using stool specimens submitted for testing for clostridium difficile. | active surveillance to identify asymptomatic carriers of carbapenem-resistant enterobacteriaceae (cre) is a recommended strategy for cre control in healthcare facilities. active surveillance using stool specimens tested for clostridium difficile is a relatively low-cost strategy to detect cre carriers. further evaluation of this and other risk factor-based active surveillance strategies is warranted. | 2013 | 24334803 |
| increased clostridium difficile recurrences following combined proton pump inhibitor-metronidazole therapy. | 2014 | 24334808 | |
| identification of clostridium difficile ribotype 027 for the first time in mainland china. | 2014 | 24334809 | |
| long term effect of infection control practices and associated factors during a major clostridium difficile outbreak in costa rica. | the c. difficile bi/nap 1 hyper virulent strain has been responsible for the nosocomial outbreaks in several countries. the present study describes the infection control strategies utilized to achieve outbreak control as well as the factors associated with a c. difficile bi/nap 1 hyper virulent strain outbreak in costa rica. | 2013 | 24334937 |
| analysis of the intestinal microbiome of a recovered clostridium difficile patient after fecal transplantation. | clostridium difficile infections upon antibiotic disruption of the gut microbiota are potentially lethal. fecal microbiota transplantation (fmt) is a promising treatment option for recurrent c. difficile-associated disease (cdad). here, we present a patient with recurrent cdad that received fmt, leading to full recovery for what has now been 3 years. we performed metagenomic sequencing on stool samples to assess if there are indications for recolonization with c. difficile and changes in the gut ... | 2013 | 24335204 |
| microbial and metabolic interactions between the gastrointestinal tract and clostridium difficile infection. | antibiotics disturb the gastrointestinal tract microbiota and in turn reduce colonization resistance against clostridium difficile. the mechanism for this loss of colonization resistance is still unknown but likely reflects structural (microbial) and functional (metabolic) changes to the gastrointestinal tract. members of the gut microbial community shape intestinal metabolism that provides nutrients and ultimately supports host immunity. this review will discuss how antibiotics alter the struct ... | 2013 | 24335555 |
| evolutionary history of the clostridium difficile pathogenicity locus. | the symptoms of clostridium difficile infection are caused by toxins expressed from its 19 kb pathogenicity locus (paloc). stable integration of the paloc is suggested by its single chromosomal location and the clade specificity of its different genetic variants. however, the paloc is variably present, even among closely related strains, and thus resembles a mobile genetic element. our aim was to explain these apparently conflicting observations by reconstructing the evolutionary history of the ... | 2014 | 24336451 |
| postoperative clostridium difficile infection with pcr ribotype 078 strain identified at necropsy in five thoroughbred racehorses. | clostridium difficile is an important cause of acute enterocolitis in horses. we describe five cases of c difficile infection occurring postoperatively in thoroughbred racehorses. following diarrhoea or colic accompanied by a marked increase in packed cell volume (to ≥60 per cent) and leucopenia (≤4000 cells/μl) within two to four days after surgery in all five horses, four of them died or were euthanased because of colitis or severe diarrhoea. in these four horses, necrotising entero-typhlo-col ... | 2013 | 24336792 |
| inhaled colistin for treatment of pneumonia due to colistin-only-susceptible acinetobacter baumannii. | colistin is used for the treatment of pneumonia associated with multidrug- resistant acinetobacter baumannii and pseudomonas aeruginosa. however, the best route of administration and dosage is not known. we report our experience with aerosolized colistin in twelve patients with pneumonia caused by colistin-only-susceptible (cos) a. baumannii. | 2013 | 24339296 |
| an analysis of risk factors of clostridiumdifficile infection in patients hospitalized in the teaching hospital in 2008. | the last decade saw an increase in the incidence of clostridium difficile infections.approximately 80% of these infections occur in hospitalized patients. there are ongoing studies on the increase in the incidence of infections with this microorganism. | 2013 | 24340558 |
| the prevention and management of infections due to multidrug resistant organisms in haematology patients. | infections due to resistant and multidrug resistant (mdr) organisms in haematology patients and haematopoietic stem cell transplant recipients are an increasingly complex problem of global concern. we outline the burden of illness and epidemiology of resistant organisms such as gram-negative pathogens, vancomycin-resistant enterococcus faecium (vre), and clostridium difficile in haematology cohorts. intervention strategies aimed at reducing the impact of these organisms are reviewed: infection p ... | 2015 | 24341410 |
| recombinant antigens based on toxins a and b of clostridium difficile that evoke a potent toxin-neutralising immune response. | infection with the bacterium clostridium difficile causes symptoms ranging from mild to severe diarrhoea with life-threatening complications and remains a significant burden to healthcare systems throughout the developed world. two potent cytotoxins, tcda and tcdb are the prime mediators of the syndrome and rapid neutralisation of these would afford significant benefits in disease management. in the present study, a broad range of non-toxic, recombinant fragments derived from tcda and tcdb were ... | 2014 | 24342251 |
| [survival advantage for colectomy in fulminant clostridium difficile colitis: results of a systematic review of the literature]. | 2014 | 24342951 | |
| predictors of clostridium difficile infections in hospitalized children. | recent studies report an increasing incidence of clostridium difficile infections (cdis) in children and suggest that cdis may occur outside known populations at risk. | 2014 | 24343932 |
| treating clostridium difficile infection. | 2014 | 24344151 | |
| molecular epidemiology of clostridium difficile in a tertiary hospital of china. | clostridium difficile infection (cdi) is caused by toxin-producing strains. it accounts for 20-30 % of antibiotic-associated diarrhoea and particularly accounts for 90 % of pseudomembranous colitis. the epidemiological study of c. difficile is thus important. in this study, we report the molecular epidemiology and ward distribution of c. difficile in a tertiary hospital of china. a total of 161 toxigenic strains were isolated from 1845 patients originating from different wards and the strains we ... | 2014 | 24344206 |
| ecological modeling from time-series inference: insight into dynamics and stability of intestinal microbiota. | the intestinal microbiota is a microbial ecosystem of crucial importance to human health. understanding how the microbiota confers resistance against enteric pathogens and how antibiotics disrupt that resistance is key to the prevention and cure of intestinal infections. we present a novel method to infer microbial community ecology directly from time-resolved metagenomics. this method extends generalized lotka-volterra dynamics to account for external perturbations. data from recent experiments ... | 2013 | 24348232 |
| probiotics for the prevention of antibiotic-associated diarrhea and clostridium difficile infection among hospitalized patients: systematic review and meta-analysis. | antibiotic-associated diarrhea (aad) and clostridium difficile infection (cdi) are associated with high morbidity, mortality, and health care costs. probiotics may mitigate the existing disease burden. we performed a systematic review and meta-analysis to evaluate the efficacy of co-administration of probiotics with antibiotics in preventing these adverse outcomes in adult inpatients. | 2013 | 24348885 |
| the incidence and clinical symptomatology of clostridium difficile infections in a community setting in a cohort of danish patients attending general practice. | clostridium difficile infection (cdi) is gradually being recognised as a cause of morbidity in the community. we investigated the incidence and clinical characteristics of cdi in a community setting and characterised the c. difficile strains by toxin gene profiling and polymerase chain reaction (pcr) ribotyping. patients included in the study had attended general practice, primarily because of diarrhoea; cdi patients (259 patients; 121 <2 years of age) had positive cultures for toxigenic c. diff ... | 2014 | 24352841 |
| comparison of illumigene, simplexa, and amplivue clostridium difficile molecular assays for diagnosis of c. difficile infection. | we compared the performance of the simplexa universal direct (focus diagnostics) and amplivue (quidel corporation) assays to that of the illumigene assay (meridian bioscience, inc.) for the diagnosis of clostridium difficile infection. two hundred deidentified remnant diarrheal stool specimens were tested by the simplexa, amplivue, and illumigene methods. specimens with discrepant results among the three assays and a representative number of concordant specimens were further evaluated by toxigen ... | 2014 | 24352999 |
| faecal microbiota transplantation and bacteriotherapy for recurrent clostridium difficile infection: a retrospective evaluation of 31 patients. | recurrent clostridium difficile infection (cdi) is a significant problem due to its increased incidence and severity. failure rates for standard antibiotic therapies are high. in our hospital, faecal microbiota transplantation (fmt), or instillation of a culture mixture of known enteric bacteria in saline as rectal bacteriotherapy (rbt), has long been used as 'rescue therapy' in patients with recurrent disease, in whom repeated courses of standard antibiotic treatment have failed. we wanted to e ... | 2014 | 24354958 |
| the relationship of bedside nurses' emotional intelligence with quality of care. | emotional intelligence, a predictor of productivity and success, may impact behaviors responsible for quality of care. this study examined if emotional intelligence of units' bedside nurses is related to the quality of care delivered to the patients. in this study, emotional intelligence was found to be correlated to the number of clostridium difficile infections, mrsa infections, patient falls with injury, and pressure ulcer screenings (p < .001) in the inpatient acute care setting. | 2015 | 24356579 |
| treatment strategies for recurrent clostridium difficile infection. | recurrent clostridium difficile infection represents a major clinical challenge. treatment is often based on empiric selection from relatively few options supported by limited clinical evidence. | 2013 | 24357868 |
| characterization of the sigd regulon of c. difficile and its positive control of toxin production through the regulation of tcdr. | clostridium difficile intestinal disease is mediated largely by the actions of toxins a (tcda) and b (tcdb), whose production occurs after the initial steps of colonization involving different surface or flagellar proteins. in b. subtilis, the sigma factor sigd controls flagellar synthesis, motility, and vegetative autolysins. a homolog of sigd encoding gene is present in the c.difficile 630 genome. we constructed a sigd mutant in c. difficile 630 ∆erm to analyze the regulon of sigd using a glob ... | 2013 | 24358307 |
| diarylacylhydrazones: clostridium-selective antibacterials with activity against stationary-phase cells. | current antibiotics for treating clostridium difficile infections (cdi), that is, metronidazole, vancomycin and more recently fidaxomicin, are mostly effective but treatment failure and disease relapse remain as significant clinical problems. the shortcomings of these agents are attributed to their low selectivity for c. difficile over normal gut microflora and their ineffectiveness against c. difficile spores. this letter reports that certain diarylacylhydrazones identified during a high-throug ... | 2014 | 24360560 |
| [outbreak of clostridium difficile infection in a hematopoietic stem cell transplantation unit]. | 2014 | 24361148 | |
| structure of clostridium difficile pilj exhibits unprecedented divergence from known type iv pilins. | type iv pili are produced by many pathogenic gram-negative bacteria and are important for processes as diverse as twitching motility, cellular adhesion, and colonization. recently, there has been an increased appreciation of the ability of gram-positive species, including clostridium difficile, to produce type iv pili. here we report the first three-dimensional structure of a gram-positive type iv pilin, pilj, demonstrate its incorporation into type iv pili, and offer insights into how the type ... | 2013 | 24362261 |
| mitogen-activated protein kinase/iκb kinase/nf-κb-dependent and ap-1-independent cx3cl1 expression in intestinal epithelial cells stimulated with clostridium difficile toxin a. | clostridium difficile toxin a causes acute colitis associated with inflammatory cell infiltration and increased production of proinflammatory mediators. although cx3cl1 (fractalkine) plays a role in chemoattracting monocytes/macrophages, nk cells, and t cells, little information is available on the regulated expression of cx3cl1 in response to toxin a stimulation. in this study, we investigated the role of c. difficile toxin a on cx3cl1 induction in intestinal epithelial cells. stimulation of mu ... | 2014 | 24362517 |
| rifaximin is safe and well tolerated for long-term maintenance of remission from overt hepatic encephalopathy. | rifaximin is a gut-selective, oral antimicrobial agent shown to reduce the recurrence of overt hepatic encephalopathy (he) and he-related hospitalizations in a 6-month, randomized, controlled trial (rct). we performed a phase 3, open-label maintenance study to assess the safety and rate of hospitalization with long-term rifaximin use. | 2014 | 24365449 |
| cost-effectiveness of histamine receptor-2 antagonist versus proton pump inhibitor for stress ulcer prophylaxis in critically ill patients*. | to examine the cost-effectiveness of using histamine receptor-2 antagonist or proton pump inhibitor for stress ulcer prophylaxis. | 2014 | 24365863 |
| antibiotic prophylaxis for hip fracture surgery: three-dose cefuroxime versus single-dose gentamicin and amoxicillin. | to compare a 3-dose cefuroxime regimen with a single-dose gentamicin and amoxicillin regimen as antibiotic prophylaxis for hip hemiarthroplasty in terms of microbiological outcome. | 2013 | 24366793 |
| fecal microbiota transplantation: a practical update for the infectious disease specialist. | fecal microbiota transplantation (fmt) has been shown to be a superior therapeutic modality for the treatment of recurrent clostridium difficile infection (rcdi). recently the us food and drug administration (fda) determined that human stool should be classified as a biological agent and its use should be regulated to ensure patient safety. consequently, the fda determined that prescribers of fmt must possess an approved investigational new drug (ind) permit to administer fmt for the purpose of ... | 2014 | 24368622 |
| predictors of first recurrence in clostridium difficile-associated disease. a study of 306 patients hospitalized in a romanian tertiary referral center. | clostridium difficile is recognized as the major cause of nosocomial gastroenteritis usually related to antibiotic treatment. although treatable, c. difficile--associated disease (cdad) tends to recur in many patients. the purpose of the study was to analyze the risk factors for recurrence in patients with cdad after the first treatment with vancomycin, metronidazole or both. | 2013 | 24369321 |
| small animal models for the study of clostridium difficile disease pathogenesis. | clostridium difficile is the leading cause of bacterial antibiotic-associated diarrhoea in hospitals in the developed world. despite this notoriety, the complex mechanisms employed by this pathogen to overcome innate host defences and induce fulminant disease are poorly understood. various animal models have been used extensively for c. difficile research to study disease pathogenesis. until recently, the most commonly used c. difficile disease model has utilised hamsters; however, mouse and pig ... | 2014 | 24372713 |
| faecal microbiota transplantation for clostridium difficile infection. | to review the current clinical literature regarding the use of fecal microbiota transplantation (fmt) for severe and recurrent clostridium difficile disease (cdad). | 2014 | 24372725 |
| epidemiology of clostridium difficile infection among active duty united states military personnel (1998-2010). | clostridium difficile associated disease (cdad) has risen in incidence and the experience in the us military has not been described. | 2013 | 24373384 |
| single nucleotide polymorphisms of the tcdc gene and presence of the binary toxin gene predict recurrent episodes of clostridium difficile infection. | to identify clostridium difficile genotypes, which are associated with recurrent c difficile infection (rcdi). | 2014 | 24374512 |
| comparison of oral vancomycin capsule and solution for treatment of initial episode of severe clostridium difficile infection. | vancomycin is recommended as a first-line therapy for severe clostridium difficile infection (cdi). due to the high cost of commercially available vancomycin capsules, hospitals frequently compound oral solution despite a lack of data comparing outcomes. this study was conducted to determine treatment outcome differences based on oral vancomycin formulation. | 2015 | 24375999 |
| parameters for the mathematical modelling of clostridium difficile acquisition and transmission: a systematic review. | mathematical modelling of clostridium difficile infection dynamics could contribute to the optimisation of strategies for its prevention and control. the objective of this systematic review was to summarise the available literature specifically identifying the quantitative parameters required for a compartmental mathematical model of clostridium difficile transmission. | 2013 | 24376797 |
| clostridium difficile-associated disease: adherence with current guidelines at a tertiary medical center. | to assess adherence with the the society for healthcare epidemiology of america (shea)/ the infectious diseases society of america (idsa) guidelines for management of clostridium difficile (c. difficile)-associated disease (cdad) at a tertiary medical center. | 2013 | 24379582 |
| low vitamin d level is an independent predictor of poor outcomes in clostridium difficile-associated diarrhea. | the incidence, recurrence, and all-cause mortality rate for clostridium difficile-associated diarrhea (cdad) has increased markedly over the past 10 years despite treatment. low vitamin d levels are known to impair immune responses to infection and are associated with increased mortality. we compared the role of patient comorbidity measured by the charlson comorbidity index (cci) with vitamin d levels to ascertain whether vitamin d levels were an independent variable affecting the outcome of cda ... | 2014 | 24381644 |
| new routes towards reutericyclin analogues. | a range of n-acylpyrrolo[3,4-c]isoxazoles and derived n-acyltetramides has been prepared via a nitrile oxide dipolar cycloaddition approach, as analogues of the acyltetramic acid metabolite reutericyclin, of interest for its antibiotic potential against gram-positive bacteria including hospital-acquired infections of resistant clostridium difficile. | 2014 | 24382380 |
| a clinician's primer on the role of the microbiome in human health and disease. | the importance of the commensal microbiota that colonizes the skin, gut, and mucosal surfaces of the human body is being increasingly recognized through a rapidly expanding body of science studying the human microbiome. although, at first glance, these discoveries may seem esoteric, the clinical implications of the microbiome in human health and disease are becoming clear. as such, it will soon be important for practicing clinicians to have an understanding of the basic concepts of the human mic ... | 2014 | 24388028 |
| clostridium difficile: deleterious impact on hematopoietic stem cell transplantation. | c. difficile infection (cdi), the most common cause of hospital-acquired diarrhea, is very frequent after hematopoietic stem cell transplantation (hsct). recent publications suggest it affects between 6 % and 20 % of hsct recipients during the first year and is more common following allogeneic transplant (allo-hsct). the best diagnostic strategy remains to be defined, but molecular testing for the toxin genes by polymerase chain reaction (pcr) seems to be replacing the traditional enzyme immunoa ... | 2014 | 24390550 |
| the roles of toxin a and toxin b in clostridium difficile infection: insights from the gnotobiotic piglet model. | we recently published our findings indicating that anti-tcdb antibodies were effective as treatment for c. difficile infection, but that anti-tcda actually worsened prognosis in the gnotobiotic piglet model. to further investigate the roles of the two toxins, we administered purified toxins separately or together, systemically, to piglets and found that both toxins, either alone or together, are able to elicit severe lesions systemically and are also able to cross into the gut lumen and cause la ... | 2016 | 24394234 |
| evaluation of the diagnostic performance of the xpert clostridium difficile assay and its comparison with the toxin a/b enzyme-linked fluorescent assay and in-house real-time pcr assay used for the detection of toxigenic c. difficile. | clostridium difficile genes or toxin can be detected using several laboratory techniques. in this study, we compared the performance of the xpert c. difficile assay with that of a toxin a/b enzyme-linked fluorescent immunoassay (elfa) and an in-house real-time pcr assay for the tcdb gene. | 2014 | 24395702 |
| characterization of clostridium perfringens in the feces of adult horses and foals with acute enterocolitis. | up to 60% of cases of equine colitis have no known cause. to improve understanding of the causes of acute colitis in horses, we hypothesized that clostridium perfringens producing enterotoxin (cpe) and/or beta2 toxin (cpb2) are common and important causes of severe colitis in horses and/or that c. perfringens producing an as-yet-undescribed cytotoxin may also cause colitis in horses. fecal samples from 55 horses (43 adults, 12 foals) with clinical evidence of colitis were evaluated by culture fo ... | 2014 | 24396174 |
| fecal microbiota transplantation: effectiveness, complexities, and lingering concerns. | the mammalian colon is home to a microbial ecosystem that enhances resistance to infection, stimulates mucosal immune defenses, synthesizes essential vitamins, and promotes caloric uptake by hydrolyzing complex carbohydrates. the bacterial populations inhabiting the gut are complex and vary between different individuals. clinical and experimental studies reveal that the colonic microbiota can enhance or ameliorate intestinal and systemic inflammatory diseases. because of its potential to enhance ... | 2014 | 24399149 |
| use of fidaxomicin through a nasogastric tube for the treatment of septic shock caused by clostridium difficile infection in a patient with oral cancer admitted to the surgical critical care unit. | 2013 | 24399354 | |
| proteomic analysis of a nap1 clostridium difficile clinical isolate resistant to metronidazole. | clostridium difficile is an anaerobic, gram-positive bacterium that has been implicated as the leading cause of antibiotic-associated diarrhea. metronidazole is currently the first-line treatment for mild to moderate c. difficile infections. our laboratory isolated a strain of c. difficile with a stable resistance phenotype to metronidazole. a shotgun proteomics approach was used to compare differences in the proteomes of metronidazole-resistant and -susceptible isolates. | 2014 | 24400070 |
| patients' experience and perception of hospital-treated clostridium difficile infections: a qualitative study. | clostridium difficile is the leading cause of antibiotic-associated diarrhea and an important source of nosocomial infection. clinical manifestations can range from mild diarrhea to lethal pseudomembranous colitis. little is known about the burden of c. difficile infections (cdi) in patients. | 2014 | 24403096 |
| prevention of clostridium difficile infection in rural hospitals. | prevention of clostridium difficile infection (cdi) remains challenging across the spectrum of health care. there are limited data on prevention practices for cdi in the rural health care setting. | 2014 | 24406257 |
| vitamin d status and severity of clostridium difficile infections: a prospective cohort study in hospitalized adults. | clostridium difficile is the most common cause of nosocomial diarrhea, affecting up to 10% of hospitalized patients. preliminary studies suggest an association between vitamin d status and c difficile infections (cdis). our goal was to investigate whether serum 25-hydroxyvitamin d (25(oh)d) levels are associated with cdi severity. | 2015 | 24408036 |
| clostridium difficile infection: molecular pathogenesis and novel therapeutics. | the gram-positive anaerobic bacterium clostridium difficile produces toxins a and b, which can cause a spectrum of diseases from pseudomembranous colitis to c. difficile-associated diarrhea. a limited number of c. difficile strains also produce a binary toxin that exhibits adp ribosyltransferase activity. here, the structure and the mechanism of action of these toxins as well as their role in disease are reviewed. nosocomial c. difficile infection is often contracted in hospital when patients tr ... | 2014 | 24410618 |
| antibiotic resistance: the challenge from an industry perspective. | trained in medical microbiology and infectious diseases in the uk, glenn tillotson has over 20 years pharmaceutical experience in various areas, including clinical research, marketing, scientific communications, strategic development and global launch programs. mainly in the field of anti-infectives, tillotson has been instrumental in the development of ciprofloxacin and moxifloxacin, as well as other drugs in the bayer portfolio. after leaving bayer, he worked as a consultant microbiologist and ... | 2009 | 24410641 |
| from stool transplants to next-generation microbiota therapeutics. | the epidemic of clostridium difficile infection fueled by new virulent strains of the organism has led to increased use of fecal microbiota transplantation (fmt). the procedure is effective for even the most desperate cases after failure of multiple courses of antibiotics. the approach recognizes microbiota to be integral to normal human physiology, and microbiota being used in fmt represents a new class of therapeutics. imbalance in the composition and altered activity of the microbiota are ass ... | 2014 | 24412527 |
| antimicrobial stewardship program implementation in a medical intensive care unit at a tertiary care hospital in saudi arabia. | antimicrobial stewardship programs (asps) have shown to prevent the emergence of antimicrobial resistance associated with an inappropriate antimicrobial use. the primary objective of this study was to compare the prescribing appropriateness rate of the empirical antibiotic therapy before and after the asp implementation in a tertiary care hospital. secondary objectives include the rate of clostridium difficile-associated diarrhea (cdad), physicians' acceptance rate, patient's intensive care unit ... | 2015 | 24413857 |
| a low complexity rapid molecular method for detection of clostridium difficile in stool. | here we describe a method for the detection of clostridium difficile from stool using a novel low-complexity and rapid extraction process called heat elution (he). the he method is two-step and takes just 10 minutes, no specialist instruments are required and there is minimal hands-on time. a test method using he was developed in conjunction with loop-mediated isothermal amplification (lamp) combined with the real-time bioluminescent reporter system known as bart targeting the toxin b gene (tcdb ... | 2014 | 24416173 |
| treatment of relapsing clostridium difficile infection using fecal microbiota transplantation. | clostridium difficile infection (cdi) has become a global concern over the last decade. in the united states, cdi escalated in incidence from 1996 to 2005 from 31 to 64/100,000. in 2010, there were 500,000 cases of cdi with an estimated mortality up to 20,000 cases a year. the significance of this problem is evident from the hospital costs of over 3 billion dollars annually. fecal microbiota transplant (fmt) was first described in 1958 and since then about 500 cases have been published in litera ... | 2013 | 24421645 |
| combination of culture, antigen and toxin detection, and cytotoxin neutralization assay for optimal clostridium difficile diagnostic testing. | there has been a growing interest in developing an appropriate laboratory diagnostic algorithm for clostridium difficile, mainly as a result of increases in both the number and severity of cases of c difficile infection in the past decade. a c difficile diagnostic algorithm is necessary because diagnostic kits, mostly for the detection of toxins a and b or glutamate dehydrogenase (gdh) antigen, are not sufficient as stand-alone assays for optimal diagnosis of c difficile infection. in addition, ... | 2013 | 24421808 |
| comparison of chromid agar and clostridium difficile selective agar for effective isolation of c. difficile from stool specimens. | chromid clostridium difficile agar (idcd; biomérieux sa, france) is a recently developed chromogenic medium for rapid and specific isolation of c. difficile. we compared the performance of idcd with that of clostridium difficile selective agar (cdsa). | 2014 | 24422190 |
| prevention of clostridium difficile spore formation by sub-inhibitory concentrations of tigecycline and piperacillin/tazobactam. | sporulation of clostridium difficile during infection and persistence of spores within the gut could partly explain treatment failures and recurrence. however, the influence of antibiotics on sporulation is unclear. the objective of our study was to evaluate the impact of ciprofloxacin, metronidazole, piperacillin/tazobactam, tigecycline, and vancomycin on c. difficile sporulation in vitro. | 2014 | 24422950 |
| colonization with clostridium difficile in children with cancer. | clostridium difficile is a gram-positive, anaerobic, spore-forming bacillus. usually it does not cause disease unless a patient who is colonized with toxin-producing strains has been treated with antibiotics, particularly those that change the anaerobic flora of the large intestine. | 2013 | 24427503 |
| an examination of longitudinal cauti, ssi, and cdi rates from key hhs data systems. | in response to the growing concern about healthcare-associated infections (hais), us department of health and human services (hhs) developed the national action plan to prevent healthcare-associated infections. a key focus of the action plan is the setting of hai metrics and targets and the enhancement and development of data systems to support hai surveillance. | 2014 | 24430270 |
| fecal microbiota transplantation for refractory clostridium difficile colitis in solid organ transplant recipients. | fecal microbiota transplantation (fmt) has been shown to be safe and efficacious in individuals with refractory clostridium difficile. it has not been widely studied in individuals with immunosuppression due to concerns about infectious complications. we describe two solid organ transplant recipients, one lung and one renal, in this case report that both had resolution of their diarrhea caused by c. difficile after fmt. both recipients required two fmts to achieve resolution of their symptoms an ... | 2014 | 24433460 |
| a novel subtyping assay for detection of clostridium difficile virulence genes. | this proof-of-concept study demonstrates the application of a novel nucleic acid detection platform to detect clostridium difficile in subjects presenting with acute diarrheal symptoms. this method amplifies three genes associated with c. difficile infection, including genes and deletions (cdtb and tcdc) associated with hypervirulence attributed to the nap1/027/bi strain. amplification of dna from the tcdb, tcdc, and cdtb genes was performed using a droplet-based sandwich platform with quantitat ... | 2014 | 24434086 |
| efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent clostridium difficile infection. | the prevalence of recurrent clostridium difficile infection (rcdi) is increasing; fecal microbiota transplantation (fmt) is an effective therapy. however, there have been no studies of the efficacy of a single session of combined enteral and colonic fmt or characterizations of changes in the microbiota between donors and recipients. we performed a study of 27 patients with rcdi who were given a fixed volume of processed fecal filtrate via enteroscopy and colonoscopy in a single session. patients ... | 2014 | 24440222 |
| acidified nitrite: a host defence against colonization with c. difficile spores? | proton pump inhibitor (ppi) use increases the risk of clostridium difficile infection (cdi) despite c. difficile spores being acid resistant. swallowed saliva contains nitrite which reacts with gastric acid, producing bactericidal nitrogen oxides. with 5mm nitrite at ph 2 (reflecting normal gastric conditions) all c. difficile spores were killed within 15 min. no reduction in count was seen with the same nitrite concentration at ph 5, representing gastric conditions in patients taking ppis, even ... | 2014 | 24440371 |
| fecal microbiota transplantation for the treatment of clostridium difficile infection: a systematic review. | by systematic review, we assessed the impact of fecal microbiota transplantation (fmt) for the treatment of clostridium difficile (cd)-associated diarrhea. | 2014 | 24440934 |
| comparison of 3 severity criteria for clostridium difficile infection. | effective severity criteria are needed to guide management of clostridium difficile infection (cdi). in this retrospective study, outcomes were compared between patients with mild-moderate versus severe cdi according to 3 different severity criteria: those included in the 2010 society for healthcare epidemiology of america/infectious diseases society of america guidelines, those from a recent clinical trial, and our hospital-specific guidelines. | 2014 | 24442086 |
| a randomized trial of soap and water hand wash versus alcohol hand rub for removal of clostridium difficile spores from hands of patients. | 2014 | 24442089 | |
| antibiotic-induced shifts in the mouse gut microbiome and metabolome increase susceptibility to clostridium difficile infection. | antibiotics can have significant and long-lasting effects on the gastrointestinal tract microbiota, reducing colonization resistance against pathogens including clostridium difficile. here we show that antibiotic treatment induces substantial changes in the gut microbial community and in the metabolome of mice susceptible to c. difficile infection. levels of secondary bile acids, glucose, free fatty acids and dipeptides decrease, whereas those of primary bile acids and sugar alcohols increase, r ... | 2014 | 24445449 |
| comparative proteomic analysis of clostridium difficile isolates of varying virulence. | the soluble proteome of three clostridium difficile strains of varying pathogenic potential, designated b-1, tra 5/5 and 027 sm, were compared using differential in-gel electrophoresis in which the proteins of each strain were labelled with cydyes. this enabled visual inspection of the 2d profiles of strains and identification of differentially expressed proteins using image analysis software. unlabelled protein reference maps of the predominant proteins were then generated for each strain using ... | 2014 | 24445512 |
| a case study of a real-time evaluation of the risk of disease transmission associated with a failure to follow recommended sterilization procedures. | failures to follow recommendations for reprocessing of surgical instruments may place patients at risk for exposure to pathogenic microorganisms. when such failures occur, medical facilities often face considerable uncertainty and challenges in assessing the actual risks of disease transmission. | 2014 | 24447336 |
| ribotype 027 clostridium difficile infections with measurable stool toxin have increased lactoferrin and are associated with a higher mortality. | we evaluated clinical and diagnostic indicators of severe c. difficile infection (cdi) and their association with poor clinical outcome. a total of 210 patients positive according to pcr (toxin b: tcdb) were included, with patients having a median age of 62 years and a charlson co-morbidity index (ci) score of 5. ninety-one percent (n = 191) were positive by toxigenic culture and 61% (n = 129) had stool toxin. toxin-positive patients had significantly higher fecal lactoferrin (mean 316 μg/g vers ... | 2014 | 24449345 |
| detection of nosocomial clostridium difficile infections with toxigenic strains despite negative toxin a and b testing on stool samples. | a two-step diagnostic algorithm is recommended to detect clostridium difficile infections; however, samples are regularly found that are glutamate dehydrogenase (gdh) positive but stool toxin negative. in the present single-centre prospective study we focused on these 'difficult-to-interpret' samples and characterized them by anaerobic culture, toxigenic culture, slpa sequence typing and multiplex pcr (genotype cdiff). the majority of stool toxin a and b-negative samples have been caused by toxi ... | 2014 | 24450741 |
| reductions in intestinal clostridiales precede the development of nosocomial clostridium difficile infection. | antimicrobial use is thought to suppress the intestinal microbiota, thereby impairing colonization resistance and allowing clostridium difficile to infect the gut. additional risk factors such as proton-pump inhibitors may also alter the intestinal microbiota and predispose patients to clostridium difficile infection (cdi). this comparative metagenomic study investigates the relationship between epidemiologic exposures, intestinal bacterial populations and subsequent development of cdi in hospit ... | 2013 | 24450844 |