Publications

clostridium difficile infection and candida colonization of the gut: is there a correlation?		2014	25091308
clostridium difficile infection after colorectal surgery: a rare but costly complication.	the incidence and virulence of clostridium difficile infection (cdi) are on the rise. the characteristics of patients who develop cdi following colorectal resection have been infrequently studied.	2014	25091840
antibiotics and community clostridium difficile infection.		2014	25095570
[antibiotic stewardship has been established at herlev hospital].	a high incidence of clostridium difficile and multiresistant organisms and increasing consumption of cephalosporins and quinolones have required an antibiotic stewardship programme, and antibiotic audits with feedback, revised guidelines and stringent prescription rules have been successful. the hospital intervention was managed by an antibiotic team combined with contact persons in all departments, a pocket edition of the guideline was available, and monthly commented reports about antibiotic c ...	2014	25095862
[successful measures to combat clostridium difficile at herlev hospital].	clostridium difficile is a common cause of health-care associated diarrhoea. we describe the supplementary measures taken at herlev hospital to combat a concerning rise in number of cases. the measures taken involve implementation of antibiotic stewardship; meetings every two weeks between the cleaning department, head nurses, infection control nurse and a clinical microbiologist with plans for near future actions; prompt isolation of patients with diarrhoea; rapid, pcr-based diagnostics; room d ...	2014	25095863
[clostridium difficile ribotype 027 is a challenge].	infection with clostridium difficile is the primary infective cause of antibiotic-associated diarrhoea. in 2008, a major outbreak of cd027 took place in north zealand, denmark. we described this infection in a single medical department. patients positive for c. difficile enlisted at medical department o, herlev hospital, in 2009 were included and demographic data were recorded. in total, 69 patients were included, average age 83 years, charlson comorbidity score 4. of all patients 24 died. furth ...	2014	25095864
[faecal transplantation as a treatment for clostridium difficile infection, ulcerative colitis and the metabolic syndrome].	faecal transplantation as a therapeutic tool is increasingly reported in the scientific literature. faecal transplantation is currently becoming a treatment for nosocomial, refractory infections with c. difficile. furthermore, faecal transplantation has been suggested as a treatment for ulcerative colitis as well as for the metabolic syndrome. in the accumulated literature faecal transplantations appear to be safe, effective and superior to current treatments. faecal transplantation remains a sp ...	2014	25095865
[recurrent clostridium difficile infection treated with faecal microbiota transplantation].	treatment of severe clostridium difficile infection (cdi) poses a clinical challenge. emerging evidence supports the use of faecal microbiota transplantation (fmt). an 81-year-old man was admitted with a third recurrent episode of cdi within two months. because of clinical deterioration with development of pancolitis in spite of two weeks of metronidazole and vanco-mycin treatment, fmt was performed using a duodenal tube. the patient recovered completely without further relapse during follow-up. ...	2014	25095866
nursing staff can be a source of clostridium difficile infection.		2014	25095957
cost-effectiveness analysis of fidaxomicin versus vancomycin in clostridium difficile infection.	fidaxomicin was non-inferior to vancomycin with respect to clinical cure rates in the treatment of clostridium difficile infections (cdis) in two phase iii trials, but was associated with significantly fewer recurrences than vancomycin. this economic analysis investigated the cost-effectiveness of fidaxomicin compared with vancomycin in patients with severe cdi and in patients with their first cdi recurrence.	2014	25096079
clostridium difficile infection in patients with inflammatory bowel disease.	clostridium difficile is a bacterium widely distributed in the human environment. in the last decade the incidence and severity of clostridium difficile infection has grown, particularly in europe and north america, making it one of the more common nosocomial infections. a group particularly susceptible to clostridium difficile infection are patients with inflammatory bowel disease, especially those with involvement of the colon. this paper presents relevant data on clostridium difficile infecti ...	2014	25097707
comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens.	the detection of pathogens associated with gastrointestinal disease may be important in certain patient populations, such as immunocompromised hosts, the critically ill, or individuals with prolonged disease that is refractory to treatment. in this study, we evaluated two commercially available multiplex panels (the filmarray gastrointestinal [gi] panel [biofire diagnostics, salt lake city, ut] and the luminex xtag gastrointestinal pathogen panel [gpp] [luminex corporation, toronto, canada]) usi ...	2014	25100818
vancomycin-resistant clostridium innocuum bacteremia following oral vancomycin for clostridium difficile infection.	an 85 year-old male initially admitted for septic shock due to urinary tract infection experienced clostridium difficile-associated diarrhea during hospitalization and was treated by oral vancomycin. his clinical course was complicated by cytomegalovirus colitis and then vancomycin-resistant clostridium innocuum bacteremia, which was cured by uneventfully parenteral piperacillin-tazobactam therapy.	2014	25102472
evaluation of the luminex xtag gastrointestinal pathogen panel and the savyon diagnostics gastrointestinal infection panel for the detection of enteric pathogens in clinical samples.	infectious gastrointestinal disease is caused by a diverse array of pathogens, and is a challenging syndrome to correctly diagnose and manage. conventional laboratory diagnostic methods are often time-consuming and frequently suffer from low detection rates. two commercial multiplex nucleic acid amplification tests [luminex xtag gastrointestinal pathogen panel (gpp) and savyon diagnostics gastrointestinal infection panel (gip)] were applied to 1000 stored diarrhoeal clinical stool samples. the l ...	2014	25102908
bacteriophage behavioral ecology: how phages alter their bacterial host's habits.	bacteriophages have an essential gene kit that enables their invasion, replication, and production. in addition to this "core" genome, they can carry "accessory" genes that dramatically impact bacterial biology, and presumably boost their own success. the content of phage genomes continue to surprise us by revealing new ways that viruses impact bacterial biology. the genome of a clostridium difficile myovirus, phicdhm1, contains homologs of three bacterial accessory gene regulator (agr) genes. t ...	2014	25105060
community hospital experience of refractory clostridium difficile colitis: treatment and efficacy of diverting loop ileostomy and colonic lavage.		2014	25105383
a mother cell-to-forespore channel: current understanding and future challenges.	formation of endospores allows some bacteria to survive extreme nutrient limitation. the resulting dormant cell, the spore, persists in the environment and is highly resistant to physical and chemical stresses. during spore formation, cells divide asymmetrically and the mother cell engulfs the developing spore, encasing it within a double membrane and isolating it from the medium. communication between mother cell and isolated forespore involves a specialised connection system that allows nurtur ...	2014	25105965
emergence of fecal microbiota transplantation as an approach to repair disrupted microbial gut ecology.	in the recent years fecal microbiota transplantation (fmt) has emerged as an effective therapeutic option for patients with refractory clostridium difficile infection that is not responding to antibiotic therapy. it results in implantation of donor microbiota into recipients and restoration of normal distal gut microbial community structure. we anticipate that this form of therapy represents merely the first entry into a new class of therapeutics. there is great interest in application of fmt or ...	2014	25106113
corticosteroid use is associated with a reduced incidence of clostridium difficile-associated diarrhea: a retrospective cohort study.	the impact of corticosteroid use on the incidence of clostridium difficile-associated diarrhea (cdad) was examined retrospectively in 532 patients receiving antibiotic treatment for respiratory infections. as determined by logistic regression, corticosteroids were associated with a decreased incidence of cdad (odds ratio 0.12, 95% confidence interval 0.006-0.95).	2014	25108272
clostridium difficile: improving the prevention paradigm in healthcare settings.	clostridium difficile infection (cdi) is a major public health problem worldwide with significant morbidity and mortality that is spread by spores and fecal oral transmission. a variety of risk factors have been identified. some risk factors such as age, are not amenable to change, while others such as antimicrobial utilization have resulted in broadly implemented antimicrobial stewardship programs. new risk factors are emerging such as proton pump inhibitor (ppi) use, irritable bowel disease (i ...	2014	25109301
identifying all at-risk patients for clostridium difficile infection.		2015	25110874
an agent-based simulation model for clostridium difficile infection control.	control of clostridium difficile infection (cdi) is an increasingly difficult problem for health care institutions. there are commonly recommended strategies to combat cdi transmission, such as oral vancomycin for cdi treatment, increased hand hygiene with soap and water for health care workers, daily environmental disinfection of infected patient rooms, and contact isolation of diseased patients. however, the efficacy of these strategies, particularly for endemic cdi, has not been well studied. ...	2015	25112595
association of clostridium difficile infections with acid suppression medications in children.	multiple studies have confirmed associations between acid suppression medication and clostridium difficile infections (cdis) in adults. therefore, we sought to evaluate an association between acid suppression medications and cdi in children.	2014	25112692
nfil3 is crucial for development of innate lymphoid cells and host protection against intestinal pathogens.	the bzip transcription factor nfil3 (also known as e4bp4) is required for the development of natural killer (nk) cells and type 1 innate lymphoid cells (ilc1s). we find that nfil3 plays a critical role in the development of other mucosal tissue-associated innate lymphocytes. type 3 ilcs (ilc3s), including lymphoid tissue inducer (lti)-like cells, are severely diminished in both numbers and function in nfil3-deficient mice. using mixed bone marrow chimeric mice, we demonstrate that nfil3 is criti ...	2014	25113970
proton pump inhibitors and risk for clostridium difficile associated diarrhea.	increased incidence of clostridium difficile infection (cdi) among in-patients is associated with significant increased mortality, morbidity, and stay in the hospitals. this has occurred despite heightened awareness of the risks of broad-spectrum antibiotics, overall reduction in antibiotic use and increased focus on hospital hygiene. so though the main risk factor for cdi is use of broad-spectrum antibiotics, the use of proton pump inhibitors (ppis) as a novel potential contributor has been imp ...	2014	25116712
laboratory detection of clostridium difficile in piglets in australia.	clostridium difficile is a well-known enteric pathogen of humans and the causative agent of high-morbidity enteritis in piglets aged 1 to 7 days. c. difficile prevalence in australian piglets is as high as 70%. the current diagnostic assays have been validated only for human infections, and there are no published studies assessing their performance in australian piglets. we evaluated the suitability of five assays for detecting c. difficile in 157 specimens of piglet feces. the assays included a ...	2014	25122859
clinical characteristics of patients who test positive for clostridium difficile by repeat pcr.	the high sensitivity of pcr assays for diagnosing clostridium difficile infection (cdi) has greatly reduced the need for repeat testing after a negative result. nevertheless, a small subset of patients do test positive within 7 days of a negative test. the aim of this study was to evaluate the clinical characteristics of these patients to determine when repeat testing may be appropriate. the results of all xpert c. difficile pcr (cepheid, sunnyvale ca) tests performed in the clinical microbiolog ...	2014	25122866
commentary: predictors of severe outcomes associated with clostridium difficile infection in inflammatory bowel disease patients.		2012	25123206
environmental sampling for clostridium difficile on alcohol-based hand rub dispensers in an academic medical center.	clostridum difficile is a gram-positive, spore-forming anaerobic bacillus that has substantial associated morbidity, mortality, and associated healthcare burdens. clostridium difficile spores are not destroyed by alcohol. alcohol gel dispensers are used commonly as the hand sanitization method of choice in hospitals. it is possible that gel dispensers are fomites for c. difficile.	2014	25126976
fulminant pseudomembranous colitis caused by clostridium difficile pcr ribotype 027 in a healthy young woman in japan.	in the past two decades, clostridium difficile polymerase chain reaction ribotype 027 strain has rapidly emerged as the leading cause of antibiotic-associated colitis in north america and europe; however, it has been reported only occasionally in japan. we report a case of fulminant pseudomembranous colitis caused by this strain in a healthy young woman in japan without any previous medical history. the strain isolated from our patient was susceptible to both gatifloxacin and moxifloxacin, thus ...	2014	25127156
action of nitroheterocyclic drugs against clostridium difficile.	the nitroheterocyclic classes of drugs have a long history of use in treating anaerobic infections, as exemplified by metronidazole as a first-line treatment for mild-to-moderate clostridium difficile infection (cdi). since direct comparisons of the three major classes of nitroheterocyclic drugs (i.e. nitroimidazole, nitazoxanide and nitrofurans) and nitrosating agents against c. difficile are under-examined, in this study their actions against c. difficile were compared. results show that whils ...	2014	25129314
concordance of the shea-idsa severity classification for clostridium difficile infection and the atlas bedside scoring system in hospitalized adult patients.	the society for healthcare epidemiology of america and infectious diseases society of america (shea-idsa) guidelines for the treatment of clostridium difficile infection (cdi) recommend initial treatment of cdi based on disease severity. this severity definition has not been validated or evaluated based on clinical outcomes. the atlas scoring system is a validated tool useful in predicting treatment response and mortality in cdi. the main purpose of this study is to evaluate the concordance of t ...	2014	25129565
comparative nutritional and chemical phenome of clostridium difficile isolates determined using phenotype microarrays.	clostridium difficile infection (cdi) is the leading cause of infectious diarrhea in north america and europe. the risk of cdi increases significantly in the case where antimicrobial treatment reduces the number of competing bacteria in the gut, thus leading to the increased availability of nutrients and loss of colonization resistance. the objective of this study was to determine comprehensive nutritional utilization and the chemical sensitivity profile of historic and newer c. difficile isolat ...	2014	25130165
investigation of sporulation in the desulfotomaculum genus: a genomic comparison with the genera bacillus and clostridium.	the genus desulfotomaculum, belonging to the firmicutes, comprises strictly anaerobic and endospore-forming bacteria capable of dissimilatory sulfate reduction. these microorganisms are metabolically versatile and are widely distributed in the environment. spore formation allows them to survive prolonged environmental stress. information on the mechanism of sporulation in desulfotomaculum species is scarce. herein, this process was probed from a genomic standpoint, using the bacillus subtilis mo ...	2014	25132579
pharmacological therapy of feed intolerance in the critically ills.	feed intolerance in the setting of critical illness is associated with higher morbidity and mortality, and thus requires promptly and effective treatment. prokinetic agents are currently considered as the first-line therapy given issues relating to parenteral nutrition and post-pyloric placement. currently, the agents of choice are erythromycin and metoclopramide, either alone or in combination, which are highly effective with relatively low incidence of cardiac, hemodynamic or neurological adve ...	2014	25133043
[diagnosis and therapy of clostridium difficile infection: czech national guidelines].	clostridium difficile infection (cdi) is a disease of varying severity. its manifestations range from mild diarrhea to life-threatening paralytic ileus, painful distension of the large bowel, and sepsis. another possible manifestation of the disease is recurring colitis that can exhaust the patient. for establishing the diagnosis, the patient's stool should be examined with two or three different microbiological methods (testing for clostridial toxins a and b; testing for clostridial glutamate d ...	2014	25135141
the post-translational modification of the clostridium difficile flagellin affects motility, cell surface properties and virulence.	clostridium difficile is a prominent nosocomial pathogen, proliferating and causing enteric disease in individuals with a compromised gut microflora. we characterized the post-translational modification of flagellin in c. difficile 630. the structure of the modification was solved by nuclear magnetic resonance and shown to contain an n-acetylglucosamine substituted with a phosphorylated n-methyl-l-threonine. a reverse genetics approach investigated the function of the putative four-gene modifica ...	2014	25135277
a bundle strategy including patient hand hygiene to decrease clostridium difficile infections.	prevention strategies for clostridium difficile infection traditionally have addressed barrier precautions, environmental disinfection, and health care worker hand hygiene. when applied as a bundle, this approach has been used widely as an evidence-based strategy to prevent hospital-acquired c. difficile infection. expanding the bundle to include patient hand hygiene is a nurse-driven approach to prevent c. difficile transmission.	2014	25137788
investigation of the mics of fidaxomicin and other antibiotics against hungarian clostridium difficile isolates.	the aim of this study was to investigate in vitro activities of fidaxomicin and other antibiotics against 188 clostridium difficile strains collected from different centers of hungary. c. difficile isolates showed minimum inhibitory concentration (mic) range for fidaxomicin of ≤0.008-0.5 mg/l, with a mic90 of 0.125 mg/l. only four isolates (2.1%) had 0.5 mg/l mic to fidaxomicin. the obtained mics showed identical distribution to those found in the eucast database for wild-type strains.	2015	25139122
clostridium difficile infection: an undeniably common problem among hematopoietic transplant recipients.		2014	25139684
intracolonic administration of vancomycin for clostridium difficile infection.		2014	25140945
iron fortification adversely affects the gut microbiome, increases pathogen abundance and induces intestinal inflammation in kenyan infants.	in-home iron fortification for infants in developing countries is recommended for control of anaemia, but low absorption typically results in >80% of the iron passing into the colon. iron is essential for growth and virulence of many pathogenic enterobacteria. we determined the effect of high and low dose in-home iron fortification on the infant gut microbiome and intestinal inflammation.	2015	25143342
reverse transcription polymerase chain reaction-based method for selectively detecting vegetative cells of toxigenic clostridium difficile.	the laboratory diagnostic methods for clostridium difficile infection (cdi) include toxigenic culture, enzyme immunoassays (eias) to detect the toxins of c. difficile, and nucleic acid amplification tests (naats) to detect c. difficile toxin genes, but each of these methods has disadvantages; toxigenic cultures require a long time to produce results, eias have low sensitivity, and naats that target dna cannot distinguish vegetative cells from spores and dead cells. here we report a new detection ...	2014	25145894
can rapid integrated polymerase chain reaction-based diagnostics for gastrointestinal pathogens improve routine hospital infection control practice? a diagnostic study.	every year approximately 5000-9000 patients are admitted to a hospital with diarrhoea, which in up to 90% of cases has a non-infectious cause. as a result, single rooms are 'blocked' by patients with non-infectious diarrhoea, while patients with infectious diarrhoea are still in open bays because of a lack of free side rooms. a rapid test for differentiating infectious from non-infectious diarrhoea could be very beneficial for patients.	2014	25146932
clostridium difficile hfq can replace escherichia coli hfq for most of its function.	a gene for the hfq protein is present in the majority of sequenced bacterial genomes. its characteristic hexameric ring-like core structure is formed by the highly conserved n-terminal regions. in contrast, the c-terminal forms an extension, which varies in length, lacks homology, and is predicted to be unstructured. in gram-negative bacteria, hfq facilitates the pairing of srnas with their mrna target and thus affects gene expression, either positively or negatively, and modulates srna degradat ...	2014	25147238
performance of severity of illness classification for clostridium difficile infection to predict need-for-colectomy or inpatient death.	in current state of practice, disease severity assessment for clostridium difficile infection (cdi) lacks consensus between different organizations. in the latest guidelines for management of cdi, authors have proposed a new disease severity classification. this classification has been derived from expert opinion and includes previously reported patient related factors that predict unfavorable outcome in cdi.	2014	25147642
use of adenosine 5'-triphosphate bioluminescence assays to measure cleaning: the role of spores and clostridium difficile infection rates.		2014	25148937
factors influencing the development of antibiotic associated diarrhea in ed patients discharged home: risk of administering iv antibiotics.	antibiotic-associated diarrhea (aad) and clostridium difficile infection (cdi) are well-known outcomes from antibiotic administration. because emergency department (ed) visits frequently result in antibiotic use, we evaluated the frequency of aad/cdi in adults treated and discharged home with new prescriptions for antibiotics to identify risk factors for acquiring aad/cdi.	2014	25149599
in vitro antibiotic susceptibility profile of clostridium difficile excluding pcr ribotype 027 outbreak strain in hungary.	our study showed the antibiotic susceptibility profile of toxigenic clostridium difficile isolated from nosocomial and community-acquired cdi between 2008 and 2010. mics of 200 c. difficile strains were determined using e®test method in the case of erythromycin, clindamycin, moxifloxacin, rifampicin, and metronidazole. all strains were susceptible to metronidazole in the study period. resistance rates to erythromycin, clindamycin and moxifloxacin were 31%, 29.5%, and 21.5%, respectively. in the ...	2014	25150212
the first case of severe clostridium difficile ribotype 027 infection in taiwan.		2015	25150914
tigecycline suppresses toxin a and b production and sporulation in clostridium difficile.	clostridium difficile infection (cdi) is mediated by potent extracellular toxins and is spread largely via bacterial spores. we and others have shown that some antibiotics stimulate c. difficile toxin production in a strain-specific manner; however, the effects of newer anti-c. difficile antibiotics on this process remain to be investigated.	2015	25151204
john g. bartlett: contributions to the discovery of clostridium difficile antibiotic-associated diarrhea.	in 1975 john bartlett began trials investigating the problem of antibiotic-associated diarrhea and pseudomembranous colitis. his work led the discovery of clostridium difficile and he identified it as the leading cause of hospital-associated infections.	2014	25151480
proton pump inhibitors induce changes in colonocyte gene expression that may affect clostridium difficile infection.	proton pump inhibitors seem to promote clostridium difficile infection (cdi). although the current literature suggests that this association is mediated through gastric acid suppression, there has been little investigation into whether a direct effect on expression of colonocyte genes may also have a role. the aim of this study was to investigate the effect of omeprazole on genome-wide gene expression in a human colonic cell line.	2014	25151556
clostridium difficile infection in elderly nursing home residents.	age-related changes in intestinal flora and host defences, the receipt of antibiotic treatment, and the presence of underlying diseases are some of the most common risk factors associated with clostridium difficile infection. therefore, retirement care facilities for elderly people have been pinpointed as frequent sources of contamination. there is only limited data regarding the presence and epidemiology of c. difficile in nursing homes, and this gap in the current literature emphasises the nee ...	2014	25152228
[diarrhea in the elderly].	the causes of acute and chronic diarrheal disorders and their underlying pathophysiologic mechanisms are common at all ages. the impact of diarrhea, however, may be more pronounced in the elderly due to various causes, such as age-related structural and functional intestinal changes, concomittant illnesses, consume of preventive and therapeutic drugs, impaired sense of hunger and thirst, compromised nutrition and hydration to withstand the effect of diarrhea, more frequent hospital admissions an ...	2014	25154690
is pediatric clostridium difficile infection associated with prior antibiotic exposure?		2014	25156370
update on clostridium difficile infections.	clostridium difficile infections (cdi) occur primarily in hospitalized patients with risk factors such as concomitant or recent use of antibiotics. cdi related additional costs are important for the global population and health-care facilities. cdi epidemiology has changed since 2003: they became more frequent boosted by large outbreaks, more severe, more resistant to antibiotic treatment, and spread to new groups of population without any risk factor. this is partly due to the emergence and wor ...	2014	25156678
clostridium difficile infection worsens the prognosis of ulcerative colitis.	the impact of clostridium difficile infections among ulcerative colitis (uc) patients is well characterized. however, there is little knowledge regarding the association between c difficile infections and postoperative complications among uc patients.	2016	25157528
the magnitude and duration of clostridium difficile infection risk associated with antibiotic therapy: a hospital cohort study.	antibiotic therapy is the principal risk factor for clostridium difficile infection (cdi), but little is known about how risks cumulate over the course of therapy and abate after cessation. we prospectively identified cdi cases among adults hospitalized at a tertiary hospital between june 2010 and may 2012. poisson regression models included covariates for time since admission, age, hospitalization history, disease pressure, and intensive care unit stay. impacts of antibiotic use through time we ...	2014	25157757
a multicentre feasibility study evaluating stress ulcer prophylaxis using hospital-based registry data.	it is unclear whether histamine-2 receptor blockers (h2rbs) or proton pump inhibitors (ppis) are preferred for stress ulcer prophylaxis (sup) in intensive care unit patients. suitably powered comparative effectiveness trials are warranted.	2014	25161016
opinions and practice of stress ulcer prophylaxis in australian and new zealand intensive care units.	intensivists frequently prescribe proton pump inhibitors (ppis) or histamine-2 receptor blockers (h2rbs) to intensive care unit patients for stress ulcer prophylaxis (sup). despite the common use of sup medicines, there is limited high-level evidence to support the choice between them.	2014	25161018
abundant and diverse clustered regularly interspaced short palindromic repeat spacers in clostridium difficile strains and prophages target multiple phage types within this pathogen.	clostridium difficile is an important human-pathogenic bacterium causing antibiotic-associated nosocomial infections worldwide. mobile genetic elements and bacteriophages have helped shape c. difficile genome evolution. in many bacteria, phage infection may be controlled by a form of bacterial immunity called the clustered regularly interspaced short palindromic repeats/crispr-associated (crispr/cas) system. this uses acquired short nucleotide sequences (spacers) to target homologous sequences ( ...	2014	25161187
fecal microbiota transplantation via nasogastric tube for recurrent clostridium difficile infection in pediatric patients.	fecal microbiota transplantation (fmt) is a safe and effective therapy for adults with recurrent clostridium difficile colitis, but data regarding fmt in children are limited and focus on colonoscopic administration of fmt. we present 10 consecutive children who received fmt via nasogastric tube for treatment of recurrent c difficile infection. median age was 5.4 years, and 30% were receiving simultaneous immunosuppression. median follow-up was 44 days, and 90% of patients resolved their c diffi ...	2015	25162365
extraction and sensitive detection of toxins a and b from the human pathogen clostridium difficile in 40 seconds using microwave-accelerated metal-enhanced fluorescence.	clostridium difficile is the primary cause of antibiotic associated diarrhea in humans and is a significant cause of morbidity and mortality. thus the rapid and accurate identification of this pathogen in clinical samples, such as feces, is a key step in reducing the devastating impact of this disease. the bacterium produces two toxins, a and b, which are thought to be responsible for the majority of the pathology associated with the disease, although the relative contribution of each is current ...	2014	25162622
the use of fidaxomicin for treatment of relapsed clostridium difficile infections in patients with cancer.	to report our experience with the use of fidaxomicin (fdx), an oral macrocyclic antibiotic, in cancer patients with clostridium difficile infection (cdi).	2014	25164587
the host immune response to clostridium difficile infection.	clostridium difficile infection (cdi) is the most common infectious cause of healthcare-acquired diarrhoea. outcomes of c. difficile colonization are varied, from asymptomatic carriage to fulminant colitis and death, due in part to the interplay between the pathogenic virulence factors of the bacterium and the counteractive immune responses of the host. secreted toxins a and b are the major virulence factors of c. difficile and induce a profound inflammatory response by intoxicating intestinal e ...	2013	25165542
the gap activity of type iii effector yope triggers killing of yersinia in macrophages.	the mammalian immune system has the ability to discriminate between pathogens and innocuous microbes by detecting conserved molecular patterns. in addition to conserved microbial patterns, the mammalian immune system may recognize distinct pathogen-induced processes through a mechanism which is poorly understood. previous studies have shown that a type iii secretion system (t3ss) in yersinia pseudotuberculosis leads to decreased survival of this bacterium in primary murine macrophages by unknown ...	2014	25165815
total synthesis of five lipoteichoic acids of clostridium difficile.	the emergence of hypervirulent resistant strains have made clostridium difficile a notorious nosocomial pathogen and has resulted in a renewed interest in preventive strategies, such as vaccines based on (synthetic) cell wall antigens. recently, the structure of the lipoteichoic acid (lta) of this species has been elucidated. additionally, this lta was found to induce the formation of protective antibodies against c. difficile in rabbits and mice. the lta from c. difficile is isolated as a micro ...	2014	25168290
agent-based model of fecal microbial transplant effect on bile acid metabolism on suppressing clostridium difficile infection: an example of agent-based modeling of intestinal bacterial infection.	agent-based modeling is a computational modeling method that represents system-level behavior as arising from multiple interactions between the multiple components that make up a system. biological systems are thus readily described using agent-based models (abms), as multi-cellular organisms can be viewed as populations of interacting cells, and microbial systems manifest as colonies of individual microbes. intersections between these two domains underlie an increasing number of pathophysiologi ...	2014	25168489
serum mannose-binding lectin concentration, but not genotype, is associated with clostridium difficile infection recurrence: a prospective cohort study.	mannose-binding lectin (mbl) plays a key role in the activation of the lectin-complement pathway of innate immunity, and its deficiency has been linked with several acute infections. however, its role in predisposing to, or modulating disease severity in, clostridium difficile infection (cdi) has not been investigated.	2014	25170052
evaluation of an automated rapid diagnostic test for detection of clostridium difficile.	the verigene clostridium difficile nucleic acid test (verigene cdf test) (nanosphere, northbrook, il, usa) is a new multiplex qualitative polymerase chain reaction (pcr) test used to detect c. difficile toxin genes in fecal specimens. to evaluate the performance of the new method, we tested 69 fecal samples from patients with suspected c. difficile infection using the verigene cdf test, an enzyme immunoassay (eia) and pcr following anaerobic fecal culture. the sensitivity, specificity, and accur ...	2014	25170836
calprotectin and lactoferrin faecal levels in patients with clostridium difficile infection (cdi): a prospective cohort study.	measurement of both calprotectin and lactoferrin in faeces has successfully been used to discriminate between functional and inflammatory bowel conditions, but evidence is limited for clostridium difficile infection (cdi). we prospectively recruited a cohort of 164 cdi cases and 52 controls with antibiotic-associated diarrhoea (aad). information on disease severity, duration of symptoms, 30-day mortality and 90-day recurrence as markers of complicated cdi were recorded. specimens were subject to ...	2014	25170963
clostridium difficile increases the risk for venous thromboembolism.	inflammatory bowel disease is associated with a higher risk for venous thromboembolism (vte). whether clostridium difficile infection similarly increases this risk is unknown.	2014	25175741
severe community onset healthcare-associated clostridium difficile infection complicated by carbapenemase producing klebsiella pneumoniae bloodstream infection.	clostridium difficile infection (cdi) and klebsiella pneumoniae carbapenemase producing-klebsiella pneumoniae (kpc-kp) bloodstream infection (bsi) are emerging health-care associated (hca) diseases of public health concern, in terms of morbidity, mortality, and insufficient response to antibiotic therapy. both agents can be acquired in the hospital but clinical disease can develop in a community setting, after discharge. we report here a putative link between the above-mentioned healthcare assoc ...	2014	25178451
epidemiology of clostridium difficile: a hospital-based descriptive study in argentina and mexico.	a prospective study was conducted in four tertiary hospitals in argentina and mexico in order to describe the occurrence of clostridium difficile infection (cdi) in these settings. the objective was to evaluate the incidence of cdi in at-risk populations in argentina (one center) and mexico (three centers) and to further explore potential study sites for vaccine development in this region. a prospective, descriptive, cdi surveillance study was conducted among hospitalized patients aged ≥40 years ...	2015	25179510
biofilm formation of clostridium difficile and susceptibility to manuka honey.	biofilm bacteria are relatively more resistant to antibiotics. the escalating trend of antibiotic resistance higlights the need for evaluating alternative potential therapeutic agents with antibacterial properties. the use of honey for treating microbial infections dates back to ancient times, though antimicrobial properties of manuka honey was discovered recently. the aim of this study was to demonstrate biofilm formation of specific clostridium difficile strains and evaluate susceptibility of ...	2014	25181951
ramoplanin at bactericidal concentrations induces bacterial membrane depolarization in staphylococcus aureus.	ramoplanin is an actinomycetes-derived antibiotic with broad-spectrum activity against gram-positive bacteria that has been evaluated in clinical trials for the treatment of gastrointestinal vancomycin-resistant enterococci (vre) and clostridium difficile infections. recent studies have proposed that ramoplanin binds to bacterial membranes as a c2 symmetrical dimer that can sequester lipid ii, which causes inhibition of cell wall peptidoglycan biosynthesis and cell death. in this study, ramoplan ...	2014	25182650
cost and impact on patient length of stay of rapid molecular testing for clostridium difficile.	a study was performed to assess the cost of a rapid molecular assay (pcr) for diagnosis of clostridium difficile infection (cdi) and the impact of its routine use on patient length of stay (los) in comparison with cell culture cytotoxin neutralization assay (ccna).	2014	25183400
clostridium difficile has a single sortase, srtb, that can be inhibited by small-molecule inhibitors.	bacterial sortases are transpeptidases that covalently anchor surface proteins to the peptidoglycan of the gram-positive cell wall. sortase protein anchoring is mediated by a conserved cell wall sorting signal on the anchored protein, comprising of a c-terminal recognition sequence containing an "lpxtg-like" motif, followed by a hydrophobic domain and a positively charged tail.	2014	25183427
evaluation of six pcr assays in combination with patient related data for the diagnosis of clostridium difficile-associated infections.	the aim of this multicenter study was to establish a diagnostic algorithm using molecular methods for the diagnosis of c. difficile-associated infection (cdi). in addition patient specific data were taken into consideration for the interpretation of the results.	2014	25185420
inflammatory bowel disease cause-specific mortality: a primer for clinicians.	inflammatory bowel disease (ibd), including crohn's disease (cd) and ulcerative colitis (uc) is perceived to harbor significant morbidity but limited excess mortality, thought to be driven by colon cancer, compared with the general population. recent studies suggest mortality rates seem higher than previously understood, and there are emerging threats to mortality. clinicians must be up to date and able to clearly convey the causes of mortality to arm individual patients with information to mean ...	2014	25185685
multi-institution case-control and cohort study of risk factors for the development and mortality of clostridium difficile infections in japan.	to examine risk factors for clostridium difficile infection (cdi) morbidity and mortality in japan.	2014	25186155
epidemiology and clinical features of toxigenic culture-confirmed hospital-onset clostridium difficile infection: a multicentre prospective study in tertiary hospitals of south korea.	hypervirulent clostridium difficile strains, most notably bi/nap1/027, have been increasingly emerging in western countries as local epidemics. we performed a prospective multicentre observational study from december 2011 to may 2012 to identify recent incidences of toxigenic culture-confirmed hospital-onset c. difficile infections (cdi) and their associated clinical characteristics in south korea. patients suspected of having been suffering from cdi more than 48 h after admission and aged ≥20 y ...	2014	25187603
performance of chromid clostridium difficile agar compared with bbl c. difficile selective agar for detection of c. difficile in stool specimens.	we evaluated the performance of a new chromogenic medium for detection of clostridium difficile, chromid c. difficile agar (cdif; biomérieux, france), by comparison with bbl c. difficile selective agar (cdsa; becton dickinson and company, usa). after heat pre-treatment (80℃, 5 min), 185 diarrheal stool samples were inoculated onto the two media types and incubated anaerobically for 24 hr and 48 hr for cdif and for 48 hr and 72 hr for cdsa. all typical colonies on each medium were examined by gra ...	2014	25187891
high frequency of nonadherence to clostridium difficile treatment guidelines.	the 2010 infectious diseases society of america/society for healthcare epidemiology of america treatment guidelines for clostridium difficile infections (cdi) recommend oral metronidazole for mild-to-moderate disease and oral vancomycin for severe disease. given that disease severity is easily determined by the peripheral white blood cell count and serum creatinine level, a computerized decision support (cds) pathway to guide treatment is inherently appealing. because providers often override or ...	2014	25188627
commentary on "high frequency of nonadherence to clostridium difficile treatment guidelines".		2014	25188628
context for practice: challenges in practice, cauti, clostridium difficile-associated diarrhea, hyperhydrosis, and the perils of cigarette smoking.		2016	25188795
stool management systems for preventing environmental spread of clostridium difficile: a comparative trial.	the purpose of this study was to compare contamination of the immediate environment with clostridium difficile spores and vegetative cells from 2 stool management systems over a period of 30 days in a controlled laboratory setting.	2016	25188802
expression of the large clostridial toxins is controlled by conserved regulatory mechanisms.	the clostridia cause many human and animal diseases, resulting in significant morbidity and mortality. host damage results from the action of potent exotoxins, an important group of which is the large clostridial toxins (lcts) produced by clostridium difficile, clostridium sordellii, clostridium perfringens and clostridium novyi. knowledge of the structure and function of these toxins has been attained, however, apart from c. difficile, the regulatory pathways that control lct production remain ...	2014	25190355
smt19969 as a treatment for clostridium difficile infection: an assessment of antimicrobial activity using conventional susceptibility testing and an in vitro gut model.	we investigated the efficacy of the novel antimicrobial agent smt19969 in treating simulated clostridium difficile infection using an in vitro human gut model.	2015	25190720
microbiome manipulation with faecal microbiome transplantation as a therapeutic strategy in clostridium difficile infection.	faecal microbiome transplantation (fmt) has generated huge recent interest as it presents a potential solution to a significant clinical problem--the increasing incidence of clostridium difficile infection (cdi). in the short term, however, there remain many practical questions regarding its use, including the optimal selection of donors, material preparation and the mechanics of delivery. in the longer term, enhanced understanding of the mechanisms of action of fmt may potentiate novel therapie ...	2015	25193538
antiinfective therapy with a small molecule inhibitor of staphylococcus aureus sortase.	methicillin-resistant staphylococcus aureus (mrsa) is the most frequent cause of hospital-acquired infection, which manifests as surgical site infections, bacteremia, and sepsis. due to drug-resistance, prophylaxis of mrsa infection with antibiotics frequently fails or incites nosocomial diseases such as clostridium difficile infection. sortase a is a transpeptidase that anchors surface proteins in the envelope of s. aureus, and sortase mutants are unable to cause bacteremia or sepsis in mice. h ...	2014	25197057
appendicostomy for intraluminal antibiotic administration and extracorporeal membrane oxygenation support in severe hirschsprung's enterocolitis.	a term male infant with hirschsprung's disease underwent an uncomplicated laparoscopic-assisted endorectal pull-through procedure. four weeks after discharge, the patient developed severe clostridium difficile enterocolitis with hemodynamic instability and peritonitis. bedside laparotomy confirmed intestinal viability and accommodated an appendicostomy for antegrade vancomycin colonic irrigations. the patient required venoarterial extracorporeal membrane oxygenation for physiological support for ...	2014	25197866
procalcitonin elevation suggests a septic source.	procalcitonin is used as a marker for sepsis but there is little known about the correlation of the procalcitonin elevation with the causative organism in sepsis. all patients aged 18 to 80 years who were admitted to the surgery service from june 2010 to may 2012 and who had a procalcitonin drawn were evaluated. culture data were reviewed to determine the causative organism. infections analyzed included pneumonia, urinary tract infection (uti), bloodstream infection, and clostridium difficile. o ...	2014	25197879
clostridium and bacillus binary enterotoxins: bad for the bowels, and eukaryotic being.	some pathogenic spore-forming bacilli employ a binary protein mechanism for intoxicating the intestinal tracts of insects, animals, and humans. these gram-positive bacteria and their toxins include clostridium botulinum (c2 toxin), clostridium difficile (c. difficile toxin or cdt), clostridium perfringens (ι-toxin and binary enterotoxin, or bec), clostridium spiroforme (c. spiroforme toxin or cst), as well as bacillus cereus (vegetative insecticidal protein or vip). these gut-acting proteins for ...	2014	25198129
novel risk factors for recurrent clostridium difficile infection in children.	clostridium difficile, a common cause of antibiotic-associated diarrhea, has been reported to recur in high rates in adults. the rates and risk factors for recurrent c difficile infection (rcdi) in children have not been well established.	2015	25199038
clostridium colitis: challenges in diagnosis and treatment.	clostridium difficile infection (cdi) has been reported to occur with increasing frequency and with more severe presentations being encountered. this article presents data from the alfred hospital highlighting the increased incidence, the increased severity and the broader clinical presentations observed. a case series highlights a variety of clinical scenarios that provided diagnostic and management challenges. we additionally describe a novel form of treatment for fulminant colitis.	2017	25201532
antimicrobial stewardship programs in inpatient hospital settings: a systematic review.	evaluate the evidence for effects of inpatient antimicrobial stewardship programs (asps) on patient, prescribing, and microbial outcomes.	2014	25203174
clinical and molecular characteristics of an outbreak caused by the pandemic (bi/nap1/027) clostridium difficile clone in a single center in israel.		2014	25203189
shared hoppers: a novel risk factor for the transmission of clostridium difficile.		2014	25203194