Publications

prevention of clindamycin-induced colitis in hamsters by clostridium sordellii antitoxin.	toxins produced by clostridium difficile have been implicated in the etiology of antibiotic-induced colitis. clostridium difficile antitoxin is not available, but recent studies have shown that toxins present in the feces of patients with this disease are neutralized by clostridium sordellii antitoxin. we found that c. sordellii antitoxin neutralized toxins produced in broth cultures of either c. sordellii or c. difficile and that passive immunization with c. sordellii antitoxin before challenge ...	1979	759263
neutralization of clostridium difficile toxin by clostridium sordellii antitoxins.	neutralization of clostridium difficile toxin by clostridium sordellii antitoxin was studied by cytotoxicity assay in tissue culture. the sources of toxin were stools from two patients with pseudomembranous colitis and a culture filtrate of c. difficile isolated from one of the patients. c. sordellii antitoxin was available either in monovalent form or as gas gangrene polyvalent antitoxin. the potency of antitoxins against c. difficile determined by cytotoxicity assay did not correlate with the ...	1978	730363
role of clostridium difficile in antibiotic-associated pseudomembranous colitis.	tissue cultures were performed on stools from 189 patients to detect a cytopathic toxin which is neutralized by clostridium sordellii antitoxin. specimens satisfying these criteria were considered positive in the tissue culture assay. stools from 26 of 27 patients with antibiotic-associated pseudomembranous colitis were positive and 16 of these specimens showed toxin titers of 10(-3) dilutions or greater. the tissue culture assay was positive with specimens from 9 of 63 patients with antibiotic- ...	1978	700321
antibiotic-induced lethal enterocolitis in hamsters: studies with eleven agents and evidence to support the pathogenic role of toxin-producing clostridia.	clindamycin-induced enterocolitis in hamsters was studied, using a tissue culture assay to detect clostridial toxin. it was found that animals with lethal enterocolitis had a cytopathogenic substance in cecal contents and blood that was neutralized by clostridial antitoxins. cultures of the cecal flora yielded numerous species of clostridia, but only 1 organism was detected which produced a toxin which was cytopathic in tissue culture. this organism, clostridium difficile, was consistently prese ...	1978	697162
clindamycin-induced enterocolitis in hamsters as a model of pseudomembranous colitis in patients.	stools from a patient with antibiotic-associated colitis and cecal contents from a hamster with clindamycin-induced enterocolitis were compared in a cytotoxicity assay to determine common properties. both specimens produced actinomorphic changes in human amnion cells at 10(-7) dilutions. the toxin was acid labile, heat labile, nonether extractable, non-dialyzable, and produced maximum activity at 60% with ammonium sulfate precipitation. cytotoxicity was neutralized with clostridial antitoxin but ...	1978	669810
clostridium difficile toxin and antimicrobial agent-induced diarrhea.		1978	659927
clindamycin-induced enterocolitis in hamsters.	a lethal enterocolitis was induced in hamsters by oral or parenteral administration of clindamycin in amounts comparable to those used in treatment of humans. the intestinal lesions were characterized histologically as an acute inflammatory reaction with pseudomembrane formation and resembled the lesions seen in humans with antibiotic-induced colitis. results of quantitative stool cultures showed the numbers of peptostreptococcus and corynebacterium decreased in animals with colitis after challe ...	1978	649990
identification of clostridium difficile as a cause of pseudomembranous colitis.		1978	630301
induction of colitis in hamsters by topical application of antibiotics.	syrian hamsters are exquisitely sensitive to clindamycin; as little as 1 mg/kg of clindamycin given systemically causes a fatal colitis. clindamycin and erythromycin were applied topically daily to the shaved backs of syrian hamsters in a hydroalcoholic vehicle. a daily dose of 0.1 mg of clindamycin was lethal to more than half the hamsters and 1 mg to all the animals. the antibiotic-associated toxin from clostridium difficile was present in their cecal material. based on body surface areas and ...	1979	571698
antibiotic-associated colitis: effects of antibiotics on clostridium difficile and the disease in hamsters.	fifteen isolates of clostridium difficile from hamsters and human patients were inhibited or killed by low concentrations of metronidazole, vancomycin, penicillin, and ampicillin; the isolates were often reesistant to tetracycline, cephalosporins, trimethoprim-sulfamethoxazole, clindamycin, erythromycin, and aminoglycosides. antibiotics to which c. difficile was susceptible were able to prevent or postpone the colitis caused by clindamycin in hamsters. colitis could be produced by treatment of ...	1979	549190
partial purification and characterization of a cytotoxin from clostridium difficile.	a trypsin-sensitive, heat-labile cytotoxin was purified from the supernatant of a culture of clostridium difficile by a procedure that included ultrafiltration, precipitation with (nh4)2so4, gel filtration, and ion-exchange chromatography. the procedure resulted in recovery of 20% of the cytotoxin and an estimated 1,500-fold increase in cytotoxic activity. the minimal amount of protein required to give an actinomorphic response in wi-38 cell cultures was 1.4 ng/ml. the estimated molecular weight ...	1979	549189
colitis induced by clostridium difficile.	clostridium difficile has been implicated as the major cause of antibiotic-associated pseudomembranous colitis. the current laboratory diagnostic test of choice is a tissue culture assay that demonstrates the presence of a cytopathic toxin neutralized by antitoxin to clostridium sordellii. this toxin was found in stools from 42 of 43 patients with antibiotic-associated pseudomembranous colitis and in stools from 12 of 78 patients with antibiotic-associated diarrhea. specimens from patients with ...	1979	549188
clostridium difficile-associated colitis after neomycin treated with metronidazole.		1979	526821
cultures for clostridium difficile in stools containing a cytotoxin neutralized by clostridium sordellii antitoxin.	stools from patients with antibiotic-associated diarrhea or colitis were cultured to detect the presence of clostridium difficile. all specimens contained a cytotoxin which was neutralized by clostridium sordellii antitoxin. initial testing employed several methods with comparative merits in recovering this organism. these included the use of nonselective media, antibiotic-incorporated media, alcohol shock, and paracresol-containing broth. optimal results were achieved with primary plating of se ...	1979	521486
antibiotic-associated colitis--a review of 66 cases.	we have reviewed 66 cases of antibiotic-associated colitis since march 1975, which have been associated with a 27 per cent mortality. we believe antibiotics may predispose patients to this condition which is caused by a toxin produced by clostridium difficile. although the disease is rare, it is more common than previously reported. the presentation, methods of diagnosis and treatment are discussed.	1979	509051
cephalosporin-associated pseudomembranous colitis due to clostridium difficile.		1979	501864
[antibiotic-induced pseudomembranous clostridium difficile colitis. a new etiopathogenetically definable infectious disease].	pseudomembranous colitis has been recognized as a complication of antimicrobial therapy since 1952. most recently, evidence has been accumulated showing that a heat labile toxin is involved. though little is known so far about the normal ecology of c. difficile and the host factors of potential importance in the development of colitis by this anaerobe, antimicrobial agent-induced suppression of the normal gut flora seems to be a major factor leading to the intestinal proliferation of resistant t ...	1979	488887
antibiotic susceptibility of clostridium difficile.		1979	479065
purification and characterization of clostridium difficile toxin.	recent evidence indicates that toxigenic clostridium difficile strains are a major cause of antimicrobial-associated ileocecitis in laboratory animals and pseudomembranous colitis in humans. c. difficile atcc 9689 was cultivated in a synthetic medium to which 3% ultrafiltrated proteose peptone was added. purification of the toxin from broth filtrate was accomplished through ultrafiltration (100,000 nominal-molecular-weight-limit membrane), precipitation with 75% (nh4)2so4, and chromatographic se ...	1979	478634
oral metronidazole in clostridium difficile colitis.		1979	476461
oral metronidazole in clostridium difficile colitis.		1979	466143
ultrastructural changes of cultured human amnion cells by clostridiu difficile toxin.	the ultrastructure of the surface of primary human amnion monolayer cells undergoing cytopathology induced by clostridium difficile toxin was examined by scanning electron microscopy. our observations indicated that the type and distribution of cell surface projections were altered dramatically by this toxin. the patterns of such surface changes were specific for the two different types of cells found in this cell culture. cells with demarcated borders showed rearrangement of microvilli into glo ...	1979	457259
[a case of antibiotic-associated diarrhea caused by clostridium difficile and treated with vancomycin].		1979	449466
selective and differential medium for isolation of clostridium difficile.	clostridium difficile is a recognized cause of pseudomembranous (antimicrobial agent-associated) colitis and may be one of the causes of antimicrobial agent-induced diarrhea. a selective and differential agar medium that contains cycloserine, cefoxitin, fructose, and egg yolk (ccfa) was developed to facilitate the isolation of c. difficile from fecal specimens. quantitative cultures of 16 stock strains of c. difficile on this medium (and on a medium containing cycloserine, fructose, and egg yolk ...	1979	429542
diarrhea and colitis associated with antimicrobial therapy in man and animals.	antimicrobial agent-induced ileocecitis of laboratory animals and colitis of man share common features. the significance of a newly described toxin in these two entities, the apparent source of the toxin (clostridium difficile) and characteristics of the toxin are reviewed. methods of toxin detection, isolation and rapid identification of c. difficile, and possible modes of therapy for antimicrobial agent-associated colitis of man are discussed.	1979	367148
experimental reproduction of neonatal diarrhea in young gnotobiotic hares simultaneously associated with clostridium difficile and other clostridium strains.	clostridium difficile, c. perfringens, and c. tertium are very often present simultaneously in the feces of conventional diarrheic young hares, whereas these three bacterial species are rarely encountered and never present simultaneously in the feces of healthy young hares. when a strain of each of the three bacterial species was monoassociated with axenic young hares, the appearance of pathological disorders was only observed in animals monoassociated with c. difficile, when the number of c. di ...	1979	222683
effect of phenoxymethylpenicillin and clindamycin on the oral, throat and faecal microflora of man.	phenoxymethylpenicillin in capsules was given orally in doses of 800 mg twice daily for 7 days to 10 subjects. saliva, throat and faecal specimens were taken up to 29 days for cultivation of aerobic and anaerobic bacteria. no changes in the normal flora in saliva, throat or faeces were noticed during the observation period. clindamycin was given orally in doses of 150 mg 4 times daily to 10 other subjects. no changes in the aerobic oral flora were observed, while a significant decrease in the nu ...	1979	118526
[initiation of germination of clostridium difficile spores by lysozyme].	the germination rate of spores of c. difficile which is usually lower than 10(-5) is raised to about 5.10(-3) in presence of lysozyme. all spores are initiated by lysozyme when previously treated by sodium thioglycolate. these spores are indeed lysozyme-dependent for germination.	1978	103645
aetiology of antimicrobial-agent-associated colitis.	clostridium difficile was isolated from the faeces of a patient with clindamycin-associated pseudomembranous colitis (p.m.c.). the presence of a preformed faecal toxin and the toxigenicity of both the faecal isolate of c. difficile and a reference strain of c. difficile were demonstrated by tissue-culture assay. the toxin of both strains of c. difficile and that in the patient's faeces were neutralised by heating and by incubation with antitoxin to c. sordellii, but not by incubation with antito ...	1978	85818
diarrhoea and pseudomembranous colitis after gastrointestinal operations. a prospective study.	241 patients who had gastrointestinal operations were studied prospectively. postoperative diarrhoea occurred in 58 patients (24%) and was significantly more common after exposure to antibiotics. 9 patients (4%) had high titres of a neutralisable faecal toxin characteristic of pseudomembranous colitis. toxigenic clostridium difficile strains were isolated from the stools of all patients with neutralisable faecal toxin. if pseudomembranous colitis is defined as the presence of neutralisable faeca ...	1978	82138
clostridium difficile and the aetiology of pseudomembranous colitis.	bacterial isolates from 5 patients with pseudomembranous colitis (p.m.c.) were screened for toxin production. strains of clostridium from 4 patients produced in vitro a toxin similar to that found in p.m.c. faecal suspension. these were identified as c. difficile. use of the strains from 2 patients induced a fatal enterocolitis when inoculated orally into hamsters pretreated with vancomycin. the c. difficile that produced the toxin in vitro was then re-isolated from hamster caecal contents. thes ...	1978	77366
clostridium difficile.	seventy-five meconium samples were examined for the presence of cl. difficile; 3 strains were isolated. additionally 45 laboratory animal faeces specimens were tested for the same purpose, a further 2 cases were isolated. these five suspicious strains were identified as cl. difficle according to the tests mentioned in the previous paragraphs. the organisms isolated here showed the same characteristics as five of the strains received and also as the organisms isolated from the inoculated animals ...	1975	60044
clostridium defficiel in the urogenital tract of males and females.	a study of the occurrence of clostridium difficile in the urogenital tract of males and females revealed higher isolation-rates in patients attending the special (venereal-disease) clinic than in patients attending family-planning and urological clinics. the presence of cl. difficile in patients with venereal diseases is being investigated to see if the organism is simply an opportunist infecting a urethra disturbed by some antecedent disease, or if it is perhaps a primary cuase of disease.	1975	48610
effect of environmental stress on clostridium difficile toxin levels during continuous cultivation.	a method for the continuous culture of clostridium difficile has been described. it has been shown that subjecting continuous cultures of this microorganism to environmental stress results in increased levels of toxin in culture medium. factors found to cause this release include alteration of the eh from --360 to +100 mv or increasing the temperature from 37 to 45 degrees c. the increased toxin levels were not associated with a change in viable cell density or the numbers of spores present. add ...	1979	44176