Publications

TitleAbstractYear
Filter
PMID(sorted descending)
Filter
an outbreak of clostridium difficile ribotype 027 associated with length of stay in the intensive care unit and use of selective decontamination of the digestive tract: a case control study.an outbreak of clostridium difficile ribotype 027 infection (cdi) occurred at an university hospital, involving 19 departments. to determine what hospital-associated factors drove the outbreak of this particular strain we performed a case-control study.201627533048
reduction of healthcare-associated infections by exceeding high compliance with hand hygiene practices.improving hand hygiene from high to very high compliance has not been documented to decrease healthcare-associated infections. we conducted longitudinal analyses during 2013-2015 in an 853-bed hospital and observed a significantly increased hand hygiene compliance rate (p<0.001) and a significantly decreased healthcare-associated infection rate (p = 0.0066).201627532259
comparison of diagnostic algorithms for detecting toxigenic clostridium difficile in routine practice at a tertiary referral hospital in korea.since every single test has some limitations for detecting toxigenic clostridium difficile, multistep algorithms are recommended. this study aimed to compare the current, representative diagnostic algorithms for detecting toxigenic c. difficile, using vidas c. difficile toxin a&b (toxin elfa), vidas c. difficile gdh (gdh elfa, biomérieux, marcy-l'etoile, france), and xpert c. difficile (cepheid, sunnyvale, california, usa). in 271 consecutive stool samples, toxigenic culture, toxin elfa, gdh elf ...201627532104
accessory gene regulator-1 locus is essential for virulence and pathogenesis of clostridium difficile.clostridium difficile infection (cdi) is responsible for most of the definable cases of antibiotic- and hospital-associated diarrhea worldwide and is a frequent cause of morbidity and mortality in older patients. c. difficile, a multidrug-resistant anaerobic pathogen, causes disease by producing toxins a and b, which are controlled by an accessory gene regulator (agr) quorum signaling system. some c. difficile strains encode two agr loci in their genomes, designated agr1 and agr2 the agr1 locus ...201627531912
antibiotics as deep modulators of gut microbiota: between good and evil.the recent increase in our knowledge of human gut microbiota has changed our view on antibiotics. antibiotics are, indeed, no longer considered only beneficial, but also potentially harmful drugs, as their abuse appears to play a role in the pathogenesis of several disorders associated with microbiota impairment (eg, clostridium difficile infection or metabolic disorders). both drug-related factors (such as antibiotic class, timing of exposure or route of administration) and host-related factors ...201627531828
systematic review: adverse events of fecal microbiota transplantation.fecal microbiota transplantation (fmt) is a microbiota-based therapy that shows therapeutic potential in recurrent or refractory clostridium difficile infections and other intestinal or extra-intestinal disorders. nonetheless, adverse events (aes) remain a major challenge in the application of fmt.201627529553
analysis of risk factors and clinical manifestations associated with clostridium difficile disease in serbian hospitalized patients.clostridium difficile is the leading cause of infectious diarrhoea in hospitalized patients. the aim of this study was to determine the risk factors important for the development of hospital-acquired clostridium difficile-associated disease and clinical manifestations of clostridium difficile-associated disease. the clinical trial group included 37 hospitalized patients who were selected according to the inclusion criteria. a control group of 74 hospitalized patients was individually matched wit ...201727528082
total duration of antimicrobial therapy in veterans hospitalized with uncomplicated pneumonia: results of a national medication utilization evaluation.practice guidelines recommend the shortest duration of antimicrobial therapy appropriate to treat uncomplicated pneumonia be prescribed to reduce the emergence of resistant pathogens. a national evaluation was conducted to assess the duration of therapy for pneumonia.201627527659
multiorgan dysfunction syndrome from strongyloides stercoralis hyperinfection in a patient with human t-cell lymphotropic virus-1 coinfection after initiation of ivermectin treatment.strongyloides stercoralis is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. herein, we describe the case of a 62-year-old man with chronic strongyloidiasis and human t-cell lymphotropic virus-1 coinfection, who developed significant clinical worsening after 24-48 hours of initiation of treatment with ...201627527631
disease progression and resolution in rodent models of clostridium difficile infection and impact of antitoxin antibodies and vancomycin.clostridium difficile causes infections of the colon in susceptible patients. specifically, gut dysbiosis induced by treatment with broad-spectrum antibiotics facilitates germination of ingested c. difficile spores, expansion of vegetative cells, and production of symptom-causing toxins tcda and tcdb. the current standard of care for c. difficile infections (cdi) consists of administration of antibiotics such as vancomycin that target the bacterium but also perpetuate gut dysbiosis, often leadin ...201627527088
synthetic lipoteichoic acid glycans are potential vaccine candidates to protect from clostridium difficile infections.infections with clostridium difficile increasingly cause morbidity and mortality worldwide. bacterial surface glycans including lipoteichoic acid (lta) were identified as auspicious vaccine antigens to prevent colonization. here, we report on the potential of synthetic lta glycans as vaccine candidates. we identified lta-specific antibodies in the blood of c. difficile patients. therefore, we evaluated the immunogenicity of a semi-synthetic lta-crm197 glycoconjugate. the conjugate elicited lta-s ...201627524293
[characteristic of antibiotic-associated diarrhea in patients with acute cerebral circulation disorder].this full-design study included patients admitted to the regional vascular centre in 2013 and was aimed to obtain more detailed information on the need for medical aid, indications for antibacterial therapy and the spectrum of the drugs being prescribed 42 patients presented with antibiotic-associated diarrhea caused by clostridium difficile. the composition of antibiotics used for mono- and combined therapy was analysed, details of the clinical picture are described, the importance of timely di ...201627522728
restrictive antibiotic stewardship associated with reduced hospital mortality in gram-negative infection.antimicrobial stewardship has an important role in the control of clostridium difficile infection (cdi) and antibiotic resistance. an important component of uk stewardship interventions is the restriction of broad-spectrum beta-lactam antibiotics and promotion of agents associated with a lower risk of cdi such as gentamicin. while the introduction of restrictive antibiotic guidance has been associated with improvements in cdi and antimicrobial resistance, evidence of the effect on outcome follow ...201627521583
clostridium difficile bacteremia in a neonate. 201627521152
towards an automated analysis of bacterial peptidoglycan structure.peptidoglycan (pg) is an essential component of the bacterial cell envelope. this macromolecule consists of glycan chains alternating n-acetylglucosamine and n-acetylmuramic acid, cross-linked by short peptides containing nonstandard amino acids. structural analysis of pg usually involves enzymatic digestion of glycan strands and separation of disaccharide peptides by reversed-phase hplc followed by collection of individual peaks for maldi-tof and/or tandem mass spectrometry. here, we report a n ...201727520322
molecular characterisation of czech clostridium difficile isolates collected in 2013-2015.clostridium difficile is a leading nosocomial pathogen and molecular typing is a crucial part of monitoring its occurrence and spread. over a three-year period (2013-2015), clinical c. difficile isolates from 32 czech hospitals were collected for molecular characterisation. of 2201 c. difficile isolates, 177 (8%) were non-toxigenic, 2024 (92%) were toxigenic (tcda and tcdb) and of these, 677 (33.5%) carried genes for binary toxin production (cdta, cdtb). capillary-electrophoresis (ce) ribotyping ...201627519407
fecal microbiota therapy for clostridium difficile infection: a health technology assessment.fecal microbiota therapy is increasingly being used to treat patients with clostridium difficile infection. this health technology assessment primarily evaluated the effectiveness and cost-effectiveness of fecal microbiota therapy compared with the usual treatment (antibiotic therapy).201627516814
clostridium difficile infection in special high-risk populations.antibiotic use continues to be the most important risk factor for the development of clostridium difficile infection (cdi) through disruption of the indigenous microbiota of the colon. this factor, together with environmental contamination, makes hospital and other healthcare facilities the perfect breeding ground for the infection. several groups of patients are exposed to the hospital environment and, at the same time, affected by conditions that can make cdi more prevalent, more severe or mak ...201627515721
impact of a prevention bundle on clostridium difficile infection rates in a hospital in the southeastern united states.we sought to assess the impact of a multicomponent prevention program on hospital-acquired clostridium difficile infections in a hospital in the southeastern united states. we collected retrospective data of 140 patients from years 2009-2014 and applied the poisson regression model for analysis. we did not find any significant associations of increased risk of clostridium difficile infections for the preintervention group. further studies are needed to test multifaceted bundles in hospitals with ...201627515578
antimicrobial stewardship for the infection control practitioner.antibiotic misuse is a serious patient safety concern and a national public health priority. years of indiscriminant antibiotic use has promoted selection for antibiotic resistant bacteria and clostridium difficile this crisis has led to clinicians being faced with managing untreatable infections, often in the most vulnerable patient populations. this review summarizes the goals of antimicrobial stewardship programs, the essential members needed to initiate a program, various antimicrobial stewa ...201627515147
occupational health update: focus on preventing the acquisition of infections with pre-exposure prophylaxis and postexposure prophylaxis.health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis b virus, and hepatitis c virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, clostridium difficile). an effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and is ...201627515145
probiotic saccharomyces boulardii cncm i-745 prevents outbreak-associated clostridium difficile-associated cecal inflammation in hamsters.c. difficile infection (cdi) is a common debilitating nosocomial infection associated with high mortality. several cdi outbreaks have been attributed to ribotypes 027, 017, and 078. clinical and experimental evidence indicates that the nonpathogenic yeast saccharomyces boulardii cncm i-745 (s.b) is effective for the prevention of cdi. however, there is no current evidence suggesting this probiotic can protect from cdi caused by outbreak-associated strains. we used established hamster models infe ...201627514478
crystal structure of clostridium difficile toxin a.clostridium difficile infection is the leading cause of hospital-acquired diarrhoea and pseudomembranous colitis. disease is mediated by the actions of two toxins, tcda and tcdb, which cause the diarrhoea, as well as inflammation and necrosis within the colon(1,2). the toxins are large (308 and 270 kda, respectively), homologous (47% amino acid identity) glucosyltransferases that target small gtpases within the host(3,4). the multidomain toxins enter cells by receptor-mediated endocytosis and, u ...201627512603
the protein inventory of clostridium difficile grown in complex and minimal medium.the intestinal pathogen clostridium difficile is causing an increasing number of infections often characterized by severity and high relapse rates. profound knowledge of the physiology of the pathogen could help to develop new treatment strategies. proteomics, a valuable tool to study bacterial physiology, was used in this work to establish a benchmark proteome of reference strain c. difficile 630δerm with ms-based details on all identified proteins. our elaborate annotation and visualization of ...201627511832
risk factors for clostridium difficile infection in hemato-oncological patients: a case control study in 144 patients.evidence on risk factors for clostridium difficile infection (cdi) in hemato-oncologic patients is conflicting. we studied risk factors for cdi in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center study with a microbiologically confirmed cdi-associated diarrhea. patients were compared with 144 age and sex matched hemato-oncologic patients with cdi negative diarrhea. risk factors such as prior an ...201627510591
[new aspects on clostridium difficile infection].clostridium difficile infection (cdi) is a frequent and complex disease which is influenced by the repertoire of bacterial virulence factors, by host immunity and by the intestinal microbiome. these complex interaction opens a number of options which may be used for treatment in the future. one example for new treatment options is fecal microbiota transplantation (fmt). driven by c. difficile related research activities the knowledge of protective microorganism is increasing and it may be assume ...201627509341
clostridium difficile infections in medical intensive care units of a medical center in southern taiwan: variable seasonality and disease severity.critical patients are susceptible to clostridium difficile infections (cdis), which cause significant morbidity and mortality in the hospital. in taiwan, the epidemiology of cdi in intensive care units (icus) is not well understood. this study was aimed to describe the incidence and the characteristics of cdi in the icus of a medical center in southern taiwan. adult patients with diarrhea but without colostomy/colectomy or laxative use were enrolled. stool samples were collected with or without ...201627509051
a size-exclusion chromatography method for analysis of clostridium difficile vaccine toxins.high-performance size-exclusion chromatography (hpsec or sec) is a method that can be applied to measure size distribution of proteins, including aggregates, monomers, and fragments. in the biopharmaceutical industry the quantitation of aggregates contained in biotherapeutics and protein-based vaccines is critical given the potential impact on safety, immunogenicity, and efficacy. hence, aggregation analysis of therapeutic proteins or protein-based vaccine products is almost always a requirement ...201627507349
ion-exchange chromatography to analyze components of a clostridium difficile vaccine.ion-exchange (iex) chromatography is one of many separation techniques that can be employed to analyze proteins. the separation mechanism is based on a reversible interaction between charged amino acids of a protein to the charged ligands attached to a column at a given ph. this interaction depends on both the pi and conformation of the protein being analyzed. the proteins are eluted by increasing the salt concentration or ph gradient. here we describe the use of this technique to characterize t ...201627507348
a practical method for preparation of fecal microbiota transplantation.clostridium difficile is a challenging infection that can be difficult to treat with antibiotic therapy. this chapter outlines the processing material for fecal microbiota transplantation (fmt), also known as stool transplant. fecal transplantations are effective in treating recurrent c. difficile infection (cdi). fmt uses a stool sample collected from a healthy, screened donor to restore healthy microbiota in the colon of a patient with cdi for symptom resolution. here, we describe a rapid meth ...201627507347
minibioreactor arrays (mbras) as a tool for studying c. difficile physiology in the presence of a complex community.the commensal microbiome plays an important role in the dynamics of clostridium difficile infection. in this chapter, we describe minibioreactor arrays (mbras), an in vitro cultivation system that we developed that allows for c. difficile physiology to be assayed in the presence of complex fecal microbial communities. the small size of the bioreactors within the mbras allows for dozens of reactors to be run simultaneously and therefore several different variables can be tested with limited time ...201627507346
an in vitro model of the human colon: studies of intestinal biofilms and clostridium difficile infection.the in vitro gut model is an invaluable research tool to study indigenous gut microbiota communities, the behavior of pathogenic organisms, and the therapeutic and adverse effect of antimicrobial administration on these communities. the model has been validated against the intestinal contents of sudden death victims to reflect the physicochemical and microbiological conditions of the proximal to distal colon, and has been extensively used to investigate the interplay between gut microbiota popul ...201627507345
investigating transfer of large chromosomal regions containing the pathogenicity locus between clostridium difficile strains.the genomes of all sequenced clostridium difficile isolates contain multiple mobile genetic elements. the chromosomally located pathogenicity locus (paloc), encoding the cytotoxins tcda and tcdb, was previously hypothesized to be a mobile genetic element; however, mobility was not demonstrated. here we describe the methods used to facilitate and detect the transfer of the paloc from a toxigenic strain into non-toxigenic strains of c. difficile. although the precise mechanism of transfer has not ...201627507344
methods for determining transfer of mobile genetic elements in clostridium difficile.horizontal gene transfer by mobile genetic elements plays an important role in the evolution of bacteria, allowing them to rapidly acquire new traits, including antibiotic resistance. mobile genetic elements such as conjugative and mobilizable transposons make up a considerable part of the c. difficile genome. while sequence analysis has identified a large number of these elements, experimental analysis is required to demonstrate mobility and function. this chapter describes the experimental met ...201627507343
transfer of clostridium difficile genetic elements conferring resistance to macrolide-lincosamide-streptogramin b (mlsb) antibiotics.molecular analysis is an important tool to investigate clostridium difficile resistance to macrolide-lincosamide-streptogramin b (mlsb). in particular, the protocols described in this chapter have been designed to investigate the genetic organization of erm(b)-containing elements and to evaluate the capability of these elements to transfer in c. difficile recipient strains using filter mating assay.201627507342
induction and purification of c. difficile phage tail-like particles.due to the inherent limitations of conventional antibiotics for the treatment of c. difficile infection (cdi), there is a growing interest in the development of alternative treatment strategies. both bacteriophages and r-type bacteriocins, also known as phage tail-like particles (ptlps), show promise as potential antibacterial alternatives for treating cdi. similar to bacteriophages, but lacking a viral capsid and genome, ptlps remain capable of killing target bacteria. here we describe our expe ...201627507340
characterization of functional prophages in clostridium difficile.bacteriophages (phages) are present in almost, if not all ecosystems. some of these bacterial viruses are present as latent "prophages," either integrated within the chromosome of their host, or as episomal dnas. since prophages are ubiquitous throughout the bacterial world, there has been a sustained interest in trying to understand their contribution to the biology of their host. clostridium difficile is no exception to that rule and with the recent release of hundreds of bacterial genome sequ ...201627507339
inducing and quantifying clostridium difficile spore formation.the gram-positive nosocomial pathogen clostridium difficile induces sporulation during growth in the gastrointestinal tract. sporulation is necessary for this obligate anaerobe to form metabolically dormant spores that can resist antibiotic treatment, survive exit from the mammalian host, and transmit c. difficile infections. in this chapter, we describe a method for inducing c. difficile sporulation in vitro. this method can be used to study sporulation and maximize spore purification yields fo ...201627507338
isolating and purifying clostridium difficile spores.the ability for the obligate anaerobe, clostridium difficile to form a metabolically dormant spore is critical for the survival of this organism outside of the host. this spore form is resistant to a myriad of environmental stresses, including heat, desiccation, and exposure to disinfectants and antimicrobials. these intrinsic properties of spores allow c. difficile to survive long-term in an oxygenated environment, to be easily transmitted from host-to-host, and to persist within the host follo ...201627507337
intestinal epithelial cell response to clostridium difficile flagella.clostridium difficile is the bacterium responsible for most antibiotic-associated diarrhea in north america and europe. this bacterium, which colonizes the gut of humans and animals, produces toxins that are known to contribute directly to damage of the gut. it is known that bacterial flagella are involved in intestinal lesions through the inflammatory host response. the c. difficile flagellin recognizes tlr5 and consequently activates the nf-κb and the mapk signaling pathways which elicit the s ...201627507336
clostridium difficile adhesins.clostridium difficile is responsible for a large spectrum of intestinal diseases ranging from mild diarrhea to fatal colitis depending on the one hand on the strain virulence and on the other on the host. the pathogenesis of c. difficile infection could be seen as a three-step process that takes place after disruption of the digestive microbiota by antibiotics: (1) contamination by and germination of spores; (2) multiplication of vegetative cells in the colonic niche using colonization factors; ...201627507335
a fluorescent reporter for single cell analysis of gene expression in clostridium difficile.genetically identical cells growing under homogeneous growth conditions often display cell-cell variation in gene expression. this variation stems from noise in gene expression and can be adaptive allowing for division of labor and bet-hedging strategies. in particular, for bacterial pathogens, the expression of phenotypes related to virulence can show cell-cell variation. therefore, understanding virulence-related gene expression requires knowledge of gene expression patterns at the single cell ...201627507334
use of mcherryopt fluorescent protein in clostridium difficile.here we describe protocols for using the red fluorescent protein mcherryopt in clostridium difficile. the protocols can be readily adapted to similar fluorescent proteins (fps), such as green fluorescent protein (gfp) and cyan fluorescent protein (cfp). there are three critical considerations for using fps in c. difficile. (1) choosing the right color: blue and (especially) red are preferred because c. difficile exhibits considerable yellow-green autofluorescence. (2) codon optimization: most fp ...201627507333
clostridium difficile genome editing using pyre alleles.precise manipulation (in-frame deletions and substitutions) of the clostridium difficile genome is possible through a two-stage process of single-crossover integration and subsequent isolation of double-crossover excision events using replication-defective plasmids that carry a counterselection marker. use of a coda (cytosine deaminase) or pyre (orotate phosphoribosyltransferase) as counter selection markers appears equally effective, but there is considerable merit in using a pyre mutant as the ...201627507332
direct pcr-ribotyping of clostridium difficile.pcr-ribotyping, a method based on heterogeneity of ribosomal intergenic spacer region, is the preferred method for genotyping of clostridium difficile. standardly used procedure for pcr-ribotyping is culturing of c. difficile from fecal samples and subsequent typing. in this chapter, we describe a modified pcr-ribotyping method for direct detection of pcr-ribotypes directly in total stool dna extract, without prior need to isolate c. difficile.201627507330
restriction endonuclease analysis typing of clostridium difficile isolates.restriction endonuclease analysis (rea) typing using hindiii enzyme is a highly discriminatory, reproducible, and consistent method of genetic typing of clostridium difficile (cd) isolates. rea typing analyzes cd whole cellular dna on two levels of discrimination: rea group designation and rea type designation, which distinguishes specific subtypes within the rea group. this methodology has enabled the tracking of epidemiologically significant cd strains over time and in some cases has allowed d ...201627507329
colonization of toxigenic clostridium difficile among icu patients: a prospective study.a prospective study was performed to investigate the prevalence of colonization among icu patients and to examine whether asymptomatic carriers were the source of subsequent c. difficile infection (cdi) and acquisition of toxigenic c. difficile.201627506470
clostridium difficile infection is associated with lower inpatient mortality when managed by gi surgeons.patients admitted with clostridium difficile infection are managed in a variety of settings. if their care is inadequate, these patients can rapidly deteriorate.201627505114
diagnosis and outcome of clostridium difficile infection by toxin enzyme immunoassay and polymerase chain reaction in an island population.clostridium difficile infection (cdi) is a potentially life-threatening cause of diarrhea. correct laboratory diagnosis is essential to differentiate cdi from other causes of diarrhea. a positive fecal c. difficile toxin (cdt) is the best indicator of cdi, but the significance of a positive fecal nucleic acid amplification test (naat) remains unclear. our aim was to elucidate the significance of cdi diagnostics in patients in jersey.201727505006
prevalence of nosocominal toxigenic clostridium difficile in children under 5 years in hajar hospital, shahrekord, iran. 201627504373
intravenous adenovirus expressing a multi-specific, single-domain antibody neutralizing tcda and tcdb protects mice from clostridium difficile infection.clostridium difficile infection (cdi) is the most common cause of antibiotic-associated diarrhea and colitis in developed countries. the disease is mainly mediated via two major exotoxins tcda and tcdb secreted by the bacterium. we have previously developed a novel, potently neutralizing, tetravalent and bispecific heavy-chain-only single domain (vhh) antibody to both tcda and tcdb (designated as aba) that reverses fulminant cdi in mice. since aba has a short serum half-life, in this study a rep ...201627502696
can we improve the therapy of clostridium difficile infection in elderly patients?clostridium difficile infection (cdi) is becoming a serious problem predominantly in geriatric patients, who are a significant risk group. the goal of this study was to evaluate the risk factors for mortality in cdi patients and to construct a binary logistic regression model that describes the probability of mortality in geriatric patients suffering from cdi.201627501856
effect of metronidazole use on tacrolimus concentrations in transplant patients treated for clostridium difficile.two case reports suggest that metronidazole treatment for clostridium difficile infections (cdi) increases tacrolimus (tac) trough levels. the primary objective of this study was to determine the clinical significance of this potential interaction in transplant patients receiving cdi treatment. currently, no robust literature exists to estimate a magnitude of pharmacokinetic interaction between metronidazole and tac.201627501504
clostridium difficile infection and inflammatory bowel disease. 201627499718
efficacy of a diagnostic and therapeutic algorithm for clostridium difficile infection.in july 2012, metronidazole was approved for the treatment of clostridium difficile infection (cdi). to clarify the selection criteria for the drug in terms of cdi severity, we established a diagnostic and therapeutic algorithm with reference to the shea-idsa clinical practice guidelines. we compared patients whose treatments were guided by the algorithm (29 cases, october 2012-september 2013) with patients treated prior to the development of the algorithm (37 cases, october 2011-september 2012) ...201627498935
fecal microbial transplantation in a pediatric case of recurrent clostridium difficile infection and specific antibody deficiency. 201627496525
prevalence and impact of clostridium difficile infection in elderly residents of long-term care facilities, 2011: a nationwide study.the elderly population is particularly vulnerable to clostridium difficile infection (cdi), but the epidemiology of cdi in long-term care facilities (ltcfs) is unknown.we performed a retrospective cohort study and used us 2011 ltcf resident data from the minimum data set 3.0 linked to medicare claims. we extracted cdi cases based on international classification of diseases-9 coding, and compared residents with the diagnosis of cdi to those who did not have a cdi diagnosis during their ltcf stay. ...201627495022
shoe soles as a potential vector for pathogen transmission: a systematic review.shoe soles are possible vectors for infectious diseases. although studies have been performed to assess the prevalence of infectious pathogens on shoe soles and decontamination techniques, no systematic review has ever occurred. the aim of this study was to perform a systematic review of the literature to determine the prevalence of infectious agents on shoe bottoms and possible decontamination strategies. three electronic bibliographic databases were searched using a predefined search strategy ...201627495010
authors' correction for euro surveill. 2016;21(29). 201627494203
interview with professor mark wilcox.mark wilcox speaks to georgia patey, commissioning editor: professor mark wilcox is a consultant microbiologist and head of microbiology at the leeds teaching hospitals (leeds, uk), the professor of medical microbiology at the university of leeds (leeds, uk), and is the lead on clostridium difficile and the head of the uk c. difficile reference laboratory for public health england (phe). he was the director of infection prevention (4 years), infection control doctor (8 years) and clinical direct ...201627494150
fecal microbiota transplantation for inflammatory bowel disease.the gut bacterial microbiome, particularly its role in disease and inflammation, has gained international attention with the successful use of fecal microbiota transplantation (fmt) in the treatment of clostridium difficile infection. this success has led to studies exploring the role of fmt in other conditions, including inflammatory bowel disease (ibd). both crohn's disease and ulcerative colitis are chronic inflammatory conditions of the gastrointestinal system that have multifactorial etiolo ...201627493597
frequency and risks associated with clostridium difficile-associated diarrhea after pediatric solid organ transplantation: a single-center retrospective review.morbidity and mortality related to clostridium difficile infection (cdi) has increased, but epidemiology and risk factors within pediatric solid organ transplant (sot) recipients are uncertain.201627492796
fecal microbiota transplantation and its usage in neuropsychiatric disorders.fecal microbiota transplantation has a 1700-year history. this forgotten treatment method has been put into use again during the last 50 years. the interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. new evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. there is a large number of experimental and clinical researches in the field of gut-brain axis. there is limited information on fecal microbiota transplantation. despite this ...201627489376
enhanced surveillance of clostridium difficile infection occurring outside hospital, england, 2011 to 2013.there are limited national epidemiological data for community-associated (ca)-clostridium difficile infections (cdis). between march 2011 and march 2013, laboratories in england submitted to the clostridium difficile ribotyping network (cdrn) up to 10 diarrhoeal faecal samples from successive patients with ca-cdi, defined here as c. difficile toxin-positive diarrhoea commencing outside hospital (or less than 48 hours after hospital admission), including those cases associated with community-base ...201627487436
a genetic assay for gene essentiality in clostridium.essential genes of pathogens are potential therapeutic targets, but are difficult to verify. here, gene essentiality was determined by targeted knockout following engineered gene duplication. null mutants of candidate essential genes of clostridium difficile were viable only in the presence of a stable second copy of the gene.201627487328
extended-spectrum β-lactam resistance in the enteric flora of patients at a tertiary care medical centre.the dissemination of enterobacteriaceae expressing resistance to extended-spectrum cephalosporins, which are therapeutically used in both human and veterinary medicine, is of critical concern. the normal commensal flora of food animals may serve as an important reservoir for the zoonotic food-borne transmission of enterobacteriaceae harbouring β-lactam resistance. we hypothesized that the predominant ampc and esbl genes reported in us livestock and fresh retail meat products, blacmy-2 and blactx ...201727486061
a regional outbreak of clostridium difficile pcr-ribotype 027 infections in southeastern france from a single long-term care facility.objective to describe and analyze a large outbreak of clostridium difficile 027 (cd-027) infections. methods confirmed cd-027 cases were defined as cd infection plus real-time polymerase chain reaction assay (pcr) positive for cd-027. clinical and microbiological data on patients with cd-027 infection were collected from january 2013 to december 2015 in the provence-alpes-côte-d'azur region (southeastern france). results in total, 19 healthcare facilities reported 144 cd-027 infections (112 conf ...201627484769
clostridium difficile pcr ribotypes 001 and 176 - the common denominator of c. difficile infection epidemiology in the czech republic, 2014.in 2014, 18 hospitals in the czech republic participated in a survey of the incidence of clostridium difficile infections (cdi) in the country. the mean cdi incidence was 6.1 (standard deviation (sd):7.2) cases per 10,000 patient bed-days and 37.8 cases (sd: 41.4) per 10,000 admissions. the mean cdi testing frequency was 39.5 tests (sd: 25.4) per 10,000 patient bed-days and 255.8 tests (sd: 164.0) per 10,000 admissions. a total of 774 c. difficile isolates were investigated, of which 225 (29%) b ...201627484171
antimicrobial susceptibility patterns of clostridium difficile isolates from family dairy farms.a significant risk factor for developing clostridium difficile infection (cdi) in humans and animals is associated with the antimicrobial use. it has often been hypothesized that farm animals could be the source for human infection with clostridium difficile (cd). in the european union, family-run dairy farms are the predominant farming model, which are more interlinked within the community compared to large-scale intensive dairy or beef farms. therefore, it is important to investigate antimicro ...201727484050
gut microbiome predictors of treatment response and recurrence in primary clostridium difficile infection.clostridium difficile infection (cdi) may not respond to initial therapy and frequently recurs, but predictors of response and recurrence are inconsistent. the impact of specific alterations in the gut microbiota determining treatment response and recurrence in patients with cdi is unknown.201627481036
ultrastructure variability of the exosporium layer of clostridium difficile spores from sporulating cultures and biofilms.the anaerobic sporeformer clostridium difficile is the leading cause of nosocomial antibiotic-associated diarrhea in developed and developing countries. the metabolically dormant spore form is considered the morphotype responsible for transmission, infection, and persistence, and the outermost exosporium layer is likely to play a major role in spore-host interactions during recurrent infections, contributing to the persistence of the spore in the host. a recent study (m. pizarro-guajardo, p. cal ...201627474709
normal, regular and standard: scaling the body through fecal microbial transplants.in 1987, nancy scheper-hughes and margaret lock proposed "three bodies" to think through biomedicine and the kinds of subjects it produces. in the current article, i revise their theory of three bodies in two ways: first, i suggest that the three bodies are a scaling process, which allows medical governance to manage bodies across scales, from the individual to the group; second, i add two new levels of scalar analysis, the molecular and the microbial, in an attempt to flesh out the three bodies ...201627474685
applications of an automated and quantitative ce-based size and charge western blot for therapeutic proteins and vaccines.capillary electrophoresis (ce) is a versatile and indispensable analytical tool that can be applied to characterize proteins. in recent years, labor-intensive sds-page and ief slab gels have been replaced with ce-sds (cge) and ce-ief methods, respectively, in the biopharmaceutical industry. these two ce-based methods are now an industry standard and are an expectation of the regulatory agencies for biologics characterization. another important and traditional slab gel technique is the western bl ...201627473492
standardised surveillance of clostridium difficile infection in european acute care hospitals: a pilot study, 2013.clostridium difficile infection (cdi) remains poorly controlled in many european countries, of which several have not yet implemented national cdi surveillance. in 2013, experts from the european cdi surveillance network project and from the european centre for disease prevention and control developed a protocol with three options of cdi surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for cdi cases) and an 'enhanced' ...201627472820
partly fermented infant formulae with specific oligosaccharides support adequate infant growth and are well-tolerated.fermented formulae (ferm) and a specific mixture of 90% short-chain galacto-oligosaccharides and 10% long-chain fructo-oligosaccharides (scgos/lcfos; 9:1) have a potential beneficial effect on gastrointestinal function and microbiota development in infants. the present study assessed the safety and tolerance of the combination of partly fermented infant milk formulae and scgos/lcfos compared with either 1 feature, in healthy term infants.201627472478
a comparison of current guidelines of five international societies on clostridium difficile infection management.clostridium difficile infection (cdi) is increasingly recognized as an emerging healthcare problem of elevated importance. prevention and treatment strategies are constantly evolving along with the apperance of new scientific evidence and novel treatment methods, which is well-reflected in the differences among consecutive international guidelines. in this article, we summarize and compare current guidelines of five international medical societies on cdi management, and discuss some of the contr ...201627470257
diversity of clostridium difficile pcr ribotypes in europe: results from the european, multicentre, prospective, biannual, point-prevalence study of clostridium difficile infection in hospitalised patients with diarrhoea (euclid), 2012 and 2013.clostridium difficile infection (cdi) is the major cause of infective diarrhoea in healthcare environments. as part of the european, multicentre, prospective, biannual, point-prevalence study of clostridium difficile infection in hospitalised patients with diarrhoea (euclid), the largest c. difficile epidemiological study of its type, pcr ribotype distribution of c. difficile isolates in europe was investigated. pcr ribotyping was performed on 1,196 c. difficile isolates from diarrhoeal samples ...201627470194
survey of diagnostic and typing capacity for clostridium difficile infection in europe, 2011 and 2014.suboptimal laboratory diagnostics for clostridium difficile infection (cdi) impedes its surveillance and control across europe. we evaluated changes in local laboratory cdi diagnostics and changes in national diagnostic and typing capacity for cdi during the european c. difficile infection surveillance network (ecdis-net) project, through cross-sectional surveys in 33 european countries in 2011 and 2014. in 2011, 126 (61%) of a convenience sample of 206 laboratories in 31 countries completed a s ...201627469624
survey of clostridium difficile infection surveillance systems in europe, 2011.to develop a european surveillance protocol for clostridium difficile infection (cdi), existing national cdi surveillance systems were assessed in 2011. a web-based electronic form was provided for all national coordinators of the european cdi surveillance network (ecdis-net). of 35 national coordinators approached, 33 from 31 european countries replied. surveillance of cdi was in place in 14 of the 31 countries, comprising 18 different nationwide systems. three of 14 countries with cdi surveill ...201627469420
difficile indeed. 201627469287
successful treatments with polymyxin b hemoperfusion and recombinant human thrombomodulin for fulminant clostridium difficile-associated colitis with septic shock and disseminated intravascular coagulation: a case report.clostridium difficile (cd)-associated colitis (cdac) is endemic and a common nosocomial enteric disease encountered by surgeons in modern hospitals due to prophylactic or therapeutic antibiotic therapies. currently, the incidence of fulminant cdac, which readily causes septic shock followed by multiple organ dysfunction syndromes, is increasing. fulminant cdac requires surgeons to perform a prompt surgery, such as subtotal colectomy, to remove the septic source. it is known that fulminant cdac i ...201627468959
importance of glutamate dehydrogenase (gdh) in clostridium difficile colonization in vivo.clostridium difficile is the principal cause of antibiotic-associated diarrhea. major metabolic requirements for colonization and expansion of c. difficile after microbiota disturbance have not been fully determined. in this study, we show that glutamate utilization is important for c. difficile to establish itself in the animal gut. when the glud gene, which codes for glutamate dehydrogenase (gdh), was disrupted, the mutant c. difficile was unable to colonize and cause disease in a hamster mode ...201627467167
characterisation of clostridium difficile strains isolated from groote schuur hospital, cape town, south africa.the c. difficile infection rate in south africa is concerning. many strains previously isolated from diarrhetic patients at groote schuur hospital were ribotype 017. this study further characterised these strains with respect to their clonal relationships, antibiotic susceptibility, toxin production and various attributes impacting on pathogen colonisation. multilocus variable-number tandem-repeat analysis (mlva) was used to characterise all c. difficile isolates. antibiotic susceptibility was d ...201627465145
optimizing the diagnostic testing of clostridium difficile infection.clostridium difficile infection (cdi) is the leading cause of hospital-acquired diarrhea and is associated with a considerable health and cost burden. however, there is still not a clear consensus on the best laboratory diagnosis approach and a wide variation of testing methods and strategies can be encountered.201627462827
polonium-210 poisoning: a first-hand account.polonium-210 ((210)po) gained widespread notoriety after the poisoning and subsequent death of mr alexander litvinenko in london, uk, in 2006. exposure to (210)po resulted initially in a clinical course that was indistinguishable from infection or exposure to chemical toxins, such as thallium.201627461439
impact of malignancy on clostridium difficile infection.the purpose of this study was to investigate the impact of malignancy and chemotherapy on the clinical and microbiological characteristics of clostridium difficile infections (cdi).201627461221
european society of clinical microbiology and infectious diseases: update of the diagnostic guidance document for clostridium difficile infection.in 2009 the first european society of clinical microbiology and infectious diseases (escmid) guideline for diagnosing clostridium difficile infection (cdi) was launched. since then newer tests for diagnosing cdi have become available, especially nucleic acid amplification tests. the main objectives of this update of the guidance document are to summarize the currently available evidence concerning laboratory diagnosis of cdi and to formulate and revise recommendations to optimize cdi testing. th ...201627460910
rapid detection of clostridium difficile via magnetic bead aggregation in cost-effective polyester microdevices with cell phone image analysis.pathogen detection has traditionally been accomplished by utilizing methods such as cell culture, immunoassays, and nucleic acid amplification tests; however, these methods are not easily implemented in resource-limited settings because special equipment for detection and thermal cycling is often required. in this study, we present a magnetic bead aggregation assay coupled to an inexpensive microfluidic fabrication technique that allows for cell phone detection and analysis of a notable pathogen ...201627460478
dissimilar fitness associated with resistance to fluoroquinolones influences clonal dynamics of various multiresistant bacteria.fitness cost associated with resistance to fluoroquinolones was recently shown to vary across clones of methicillin-resistant staphylococcus aureus and extended-spectrum β-lactamase-producing klebsiella pneumoniae. the resulting dissimilar fitness should have influenced the clonal dynamics and thereby the rates of resistance for these pathogens. moreover, a similar mechanism was recently proposed for the emergence of the h30 and h30r lineages of esbl-producing e. coli and the major international ...201627458434
correction for alcalá et al., comparison of genomera c. difficile and xpert c. difficile as confirmatory tests in a multistep algorithm for diagnosis of clostridium difficile infection. 201627458271
adult intussusception caused by ileocecal clostridium difficile pseudomembranous colitis. 201627457842
clostridium difficile toxins tcda and tcdb cause colonic tissue damage by distinct mechanisms.as the major cause of antibiotic-associated diarrhea, clostridium difficile is a serious problem in health care facilities worldwide. c. difficile produces two large toxins, tcda and tcdb, which are the primary virulence factors in disease. the respective functions of these toxins have been difficult to discern, in part because the cytotoxicity profiles for these toxins differ with concentration and cell type. the goal of this study was to develop a cell culture model that would allow a side-by- ...201627456833
recombinant mucin-type fusion proteins with a galα1,3gal substitution as clostridium difficile toxin a inhibitors.the capability of a recombinant mucin-like fusion protein, p-selectin glycoprotein ligand-1/mouse igg2b (psgl-1/migg2b), carrying galα1,3galβ1,4glcnac determinants to bind and inhibit clostridium difficile toxin a (tcda) was investigated. the fusion protein, produced by a glyco-engineered stable cho-k1 cell line and designated c-pgc2, was purified by affinity and gel filtration chromatography from large-scale cultures. liquid chromatography-mass spectrometry was used to characterize o-glycans re ...201627456831
characterization of polymorphic forms of rifaximin.rifaximin is a gut-selective oral antimicrobial that has no systemic adverse effects compared with placebo. it is used for the treatment of hepatic encephalopathy, traveler's diarrhea, irritable bowel syndrome, clostridium difficile infection, ulcerative colitis, and acute diarrhea. the crystalline form present in rifaximin, α, has minimal systemic absorption compared to the amorphous form. the objective of this study was to obtain polymorphic forms of rifaximin using recrystallization processes ...201627455934
risk and severity of hospital-acquired clostridium difficile infection in patients taking proton pump inhibitors.to compare the rates and severity of hospital-acquired clostridium difficile infection (cdi) among patients taking proton pump inhibitors (ppis) versus those not taking ppis.201627455386
fecal transplantation - the new, inexpensive, safe, and rapidly effective approach in the treatment of gastrointestinal tract diseases.introduction. fecal transplantation was shown to effectively reduce the reoccurrence in patients with refractory clostridium difficile infection. new data suggest that fecal transplantation could also be efficient in other gastrointestinal diseases, for instance in inflammatory bowel disease, irritable bowel syndrome, but, there are also some data that could imply the efficacy outside the gastrointestinal tract. fecal transplantation should be considered a unique agent, capable of treating sever ...201727453747
fecal microbiota therapy as rescue therapy for life-threatening clostridium difficile infection in the critically ill: a small case series. 201627452730
candidemia in patients with body temperature below 37°c and admitted to internal medicine wards: assessment of risk factors.an increasing number of candidemia episodes has been reported in patients cared for in internal medicine wards. these usually older and frail patients may not be suspected as having candidemia because they lack fever at the onset of the episode. to identify the risk factors associated with the lack of fever at the onset of candidemia (ie, the collection of the first positive blood culture for candida spp.) in patients cared for in internal medicine wards, we compared 2 group of patients with or ...201627452680
longitudinal investigation of carriage rates, counts, and genotypes of toxigenic clostridium difficile in early infancy.asymptomatic infant carriers of toxigenic clostridium difficile are suggested to play a role in the transmission of c. difficile infection (cdi) in adults. however, the mode of c. difficile carriage in infants remains to be fully elucidated. we investigated longitudinal changes in carriage rates, counts, and strain types of toxigenic c. difficile in infants. stools collected from 111 healthy infants in belgium periodically from birth until the age of 6 months were examined by quantitative pcr ta ...201627451451
using expert process to combat clostridium difficile infections.in 2008, clostridium difficile rates were increasing in ontario, canada, and in response, hospitals were mandated by the ontario ministry of health to publicly report their c difficile infection (cdi) rates. in order to assist hospitals which had ongoing cdi outbreaks, a process of an external infection control resource team (icrt) was introduced. this article describes the function and process of the icrt, managed by public health ontario, and reviews the lessons learned over the first 5 years ...201627451312
Refresh
firstprev
...11121314151617181920...
nextlast
Displaying items 1101 - 1200 of 12134