Publications
| Title | Abstract | Year Filter | PMID(sorted descending) Filter |
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| nicotine inhibits clostridium difficile toxin a-induced colitis but not ileitis in rats. | nicotine is protective in ulcerative colitis but not crohn's disease of the small intestine, but little is known about the effects of nicotine on clostridium difficile toxin a-induced enteritis. isolated ileal or colonic segments in anesthetized rats were pretreated with nicotine bitartrate or other pharmacological agents before intraluminal injection of toxin a. after 3 hours, the treated segments were removed and inflammation was assessed. nicotine biphasically inhibited toxin a colitis but no ... | 2016 | 26881175 |
| complications of hospital-onset healthcare facility-associated clostridium difficile infections among veterans. | complications within 30 days of a clinically confirmed hospital-onset clostridium difficile infection diagnosis from july 1, 2012, through june 30, 2015, in 127 acute care veterans health administration facilities were evaluated. pooled rates for attributable intensive care unit admissions, colectomies, and deaths were 2.7%, 0.5%, and 0.4%, respectively. infect control hosp epidemiol 2016;37:717-719. | 2016 | 26880482 |
| integrating time-varying and ecological exposures into multivariate analyses of hospital-acquired infection risk factors: a review and demonstration. | objectives hospital-acquired infections (hais) develop rapidly after brief and transient exposures, and ecological exposures are central to their etiology. however, many studies of hais risk do not correctly account for the timing of outcomes relative to exposures, and they ignore ecological factors. we aimed to describe statistical practice in the most cited hai literature as it relates to these issues, and to demonstrate how to implement models that can be used to account for them. methods we ... | 2016 | 26880280 |
| persisting variation in testing and reporting clostridium difficile cases. | previous evidence suggested a significant variation in the testing algorithms used across the united kingdom for the diagnosis of clostridium difficile infection (cdi) and new national guidelines were issued in 2012. the main aim of this paper was to explore if such variation in testing and reporting is still present, to compare the management of cdi cases, and to investigate if there is any significant variation in the antibiotic policies among different hospitals. using london hospitals as a s ... | 2015 | 26877769 |
| an integrated metabolomic and microbiome analysis identified specific gut microbiota associated with fecal cholesterol and coprostanol in clostridium difficile infection. | clostridium difficile infection (cdi) is characterized by dysbiosis of the intestinal microbiota and a profound derangement in the fecal metabolome. however, the contribution of specific gut microbes to fecal metabolites in c. difficile-associated gut microbiome remains poorly understood. using gas-chromatography mass spectrometry (gc-ms) and 16s rrna deep sequencing, we analyzed the metabolome and microbiome of fecal samples obtained longitudinally from subjects with clostridium difficile infec ... | 2016 | 26871580 |
| the challenge and potential of metagenomics in the clinic. | the bacteria, fungi, and viruses that live on and in us have a tremendous impact on our day-to-day health and are often linked to many diseases, including autoimmune disorders and infections. diagnosing and treating these disorders relies on accurate identification and characterization of the microbial community. current sequencing technologies allow the sequencing of the entire nucleic acid complement of a sample providing an accurate snapshot of the community members present in addition to the ... | 2016 | 26870044 |
| toxin b pcr cycle threshold as a predictor of poor outcome of clostridium difficile infection: a derivation and validation cohort study. | prediction of patients with poor outcome is necessary in order to plan the proper management of clostridium difficile infection (cdi); however, clinical criteria are insufficient. in a previous study, we observed that high toxigenic c. difficile cfu stool counts at diagnosis were associated with a poor outcome. our objective was to investigate the role of the pcr toxin b amplification cycle threshold (ct) in the prediction of cdi poor outcome and to derive and validate a high-risk prediction rul ... | 2016 | 26869691 |
| a prospective study of two isothermal amplification assays compared with real-time pcr, ccna and toxigenic culture for the diagnosis of clostridium difficile infection. | new molecular methods of detecting clostridium difficile infection (cdi) provide the routine lab with a sensitive random access method to produce results that are available in a shorter time than traditional methods. | 2016 | 26868647 |
| molecular characterization and antimicrobial susceptibility of tcda-negative clostridium difficile isolates from guangzhou, china. | this study aimed to investigate the molecular characteristics and antimicrobial susceptibility of clostridium difficile clinical isolates in guangzhou, china. one hundred twenty isolates were collected from guangzhou general hospital at the guangzhou military command in china from march 2014 to april 2015, and 9 isolates were identified as tcda-negative/tcdb-positive (a(-)b(+)) strains. results showed that all of the strains were confirmed to be st37 and 0 single nucleotide variants (snvs) were ... | 2016 | 26867962 |
| prospective evaluation of a novel two-step protocol for screening of clostridium difficile infection in hospitalized adult patients. | abstract. clostridium difficile infection (cdi) is one of the most common nosocomial infections in thailand and worldwide. the clinical spectrum ranges from annoy- ing diarrhea to severe life-threatening disease. enzyme-linked immunofluorescent assay for cytotoxins a/b (cytotoxins a/b elfa), which has been widely used in our institute, generally is considered as having low sensitivity for diagnosis of cdi. the study was a prospective evaluation of a novel two-step diagnostic algorithm, in which ... | 2015 | 26867362 |
| evaluation of luminex xtag gastrointestinal pathogen panel assay for detection of multiple diarrheal pathogens in fecal samples in vietnam. | diarrheal disease is a complex syndrome that remains a leading cause of global childhood morbidity and mortality. the diagnosis of enteric pathogens in a timely and precise manner is important for making treatment decisions and informing public health policy, but accurate diagnosis is a major challenge in industrializing countries. multiplex molecular diagnostic techniques may represent a significant improvement over classical approaches. we evaluated the luminex xtag gastrointestinal pathogen p ... | 2016 | 26865681 |
| effect of a clostridium difficile infection prevention initiative in veterans affairs acute care facilities. | rates of clinically confirmed hospital-onset healthcare facility-associated clostridium difficile infections from july 1, 2012, through march 31, 2015, in 127 acute care veterans affairs facilities were evaluated. quarterly pooled national standardized infection ratios decreased 15% from baseline by the final quarter of the analysis period (p=.01, linear regression). infect control hosp epidemiol 2016;37:720-722. | 2016 | 26864803 |
| the effect of statins on the outcome of clostridium difficile infection in hospitalized patients. | several studies have shown an association between exposure to statins and favorable clinical outcomes for various types of infections. we aimed to assess the impact of statin use on mortality, disease severity and complications among hospitalized patients with clostridium difficile infection (cdi). data were analyzed from a retrospectively collected database of 499 patients diagnosed with cdi during 2009-2014. we compared infection outcomes between 178 statin (36 %) users and 321 (64 %) non-user ... | 2016 | 26864041 |
| top ten facts you need to know about clostridium difficile. | 2015 | 26863828 | |
| recent advances in the understanding of antibiotic resistance in clostridium difficile infection. | clostridium difficile epidemiology has changed in recent years, with the emergence of highly virulent types associated with severe infections, high rates of recurrences and mortality. antibiotic resistance plays an important role in driving these epidemiological changes and the emergence of new types. while clindamycin resistance was driving historical endemic types, new types are associated with resistance to fluoroquinolones. furthermore, resistance to multiple antibiotics is a common feature ... | 2016 | 26862400 |
| uptake and levels of the antibiotic berberine in individual dormant and germinating clostridium difficile and bacillus cereus spores as measured by laser tweezers raman spectroscopy. | spores of clostridium difficile and bacillus cereus are major causes of nosocomial diarrhoea and foodborne disease. our aim was to measure the dynamics of the uptake of the antibiotic berberine by individual germinating spores and the levels of berberine accumulated in germinated spores. | 2016 | 26861569 |
| opportunities for improvement in the care of patients hospitalized for inflammatory bowel disease-related colitis. | algorithms for the diagnosis, management, and follow-up have been proposed for patients hospitalized for inflammatory bowel disease (ibd) colitis flare. the degree to which providers adhere to these algorithms is unknown. this study evaluated the quality of care in ibd patients hospitalized for disease-associated exacerbations and factors correlated with higher degrees of care. | 2016 | 26860508 |
| the importance of matrix-assisted laser desorption ionization-time of flight mass spectrometry for correct identification of clostridium difficile isolated from chromid c. difficile chromogenic agar. | the clinical workflow of using chromogenic agar and matrix-assisted laser desorption ionization time-of-fight mass spectrometry (maldi-tof ms) for clostridium difficile identification was evaluated. the addition of maldi-tof ms identification after the chromid c. difficile chromogenic agar culture could significantly improve the diagnostic accuracy of c. difficile. | 2016 | 26860352 |
| a comparison of clostridium difficile diagnostic methods for identification of local strains in a south african centre. | accurate diagnosis of clostridium difficile infection is essential for disease management. a clinical and molecular analysis of c. difficile isolated from symptomatic patients at groote schuur hospital, south africa, was conducted to establish the most suitable clinical test for the diagnosis and characterisation of locally prevalent strains. c. difficile was detected in stool samples using enzyme-based immunoassays (eia) and nucleic acid amplification methods, and their performance was compared ... | 2016 | 26860329 |
| breakthroughs in the treatment and prevention of clostridium difficile infection. | this review summarizes the latest advances in the treatment and prevention of clostridium difficile infection (cdi), which is now the most common health-care-associated infection in the usa. as traditional, standard cdi antibiotic therapies (metronidazole and vancomycin) are limited by their broad spectrum and further perturbation of the intestinal microbiota, which result in unacceptably high recurrence rates, novel therapeutic strategies for cdi are needed. emerging cdi therapies are focused o ... | 2016 | 26860266 |
| identification of medicare recipients at highest risk for clostridium difficile infection in the us by population attributable risk analysis. | population attributable risk percent (par%) is an epidemiological tool that provides an estimate of the percent reduction in total disease burden if that disease could be entirely eliminated among a subpopulation. as such, par% is used to efficiently target prevention interventions. due to significant limitations in current clostridium difficile infection (cdi) prevention practices and the development of new approaches to prevent cdi, such as vaccination, we determined the par% for cdi in variou ... | 2016 | 26859403 |
| intestinal microbiota in pediatric surgical cases administered bifidobacterium breve: a randomized controlled trial. | the efficacy of perioperative probiotic administration has been reported in adults. we examined the effects of orally administered bifidobacterium breve strain yakult (bbg-01) on outcomes in pediatric surgical cases by assessing intestinal and blood microbiota. bbg-01 was well tolerated without adverse effects, and postoperative infectious complications were significantly decreased. fecal analysis showed increased bifidobacterium and decreased enterobacteriaceae, clostridium difficile, and pseud ... | 2016 | 26859092 |
| hospital clostridium difficile infection rates and prediction of length of stay in patients without c. difficile infection. | background inpatient length of stay (los) has been used as a measure of hospital quality and efficiency. patients with clostridium difficile infections (cdi) have longer los. objective to describe the relationship between hospital cdi incidence and the los of patients without cdi. design retrospective cohort analysis. methods we predicted average los for patients without cdi at both the hospital and patient level using hospital cdi incidence. we also controlled for hospital characteristics (eg, ... | 2016 | 26858126 |
| introduction to the special issue on clostridium difficile and the history of the international clostridium difficile symposium (icds). | 2016 | 26856973 | |
| prevention of stress-related ulcer bleeding at the intensive care unit: risks and benefits of stress ulcer prophylaxis. | stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit (icu). it poses a risk of clinically relevant upper gastrointestinal (gi) bleeding. therefore, stress ulcer prophylaxis (sup) is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. proton pump inhibitors (ppi) and, less effectively, histamine 2 receptor antagonists (h2ra) prevent gi bleeding in critically ill patient ... | 2016 | 26855894 |
| a response to the relationship between different types of sharps containers and clostridium difficile infection rates in acute care hospitals. | 2016 | 26852081 | |
| reply to dikon in response to "a response to the relationship between different types of sharps containers and clostridium difficile infection rates in acute care hospitals". | 2016 | 26851197 | |
| coexisting cytomegalovirus infection in immunocompetent patients with clostridium difficile colitis. | cytomegalovirus (cmv) colitis usually occurs in immunocompromised patients with human immunodeficiency virus infection, organ transplantation, and malignancy receiving chemotherapy or ulcerative colitis receiving immunosuppressive agents. however, cmv colitis is increasingly recognized in immunocompetent hosts. notably, cmv colitis coexisting with clostridium difficile infection (cdi) in apparently healthy individuals has been published in recent years, which could result in high morbidity and m ... | 2016 | 26850320 |
| ultrastructural variability of the exosporium layer of clostridium difficile spores. | 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 transmission, infectious, and persistent morphotype, and the outermost exosporium layer is likely to play a major role in spore-host interactions during the first contact of c. difficile spores with the host and for spore persistence during recurrent episodes of infection. although some stud ... | 2016 | 26850296 |
| clostridium difficile associated risk of death score (cards): a novel severity score to predict mortality among hospitalised patients with c. difficile infection. | clostridium difficile infection (cdi) is a public health threat and associated with significant mortality. however, there is a paucity of objectively derived cdi severity scoring systems to predict mortality. | 2016 | 26849527 |
| telephone survey of infection-control and antibiotic stewardship practices in long-term care facilities in maryland. | multidrug-resistant organisms are an emerging and serious threat to the care of patients. long-term care facilities are considered a reservoir of these organisms partly because of the over-prescribing of antibiotics. antibiotic use is common in long-term care facilities. antibiotic stewardship programs have been shown to reduce antibiotic consumption in acute-care facilities. the purpose of our study is to investigate existing infection-control practices and antibiotic stewardship programs in lo ... | 2016 | 26848066 |
| beneficial effects of fecal microbiota transplantation on ulcerative colitis in mice. | ulcerative colitis (uc) is a chronic condition and the most common form of inflammatory bowel disease. the goal of standard treatment is mainly to induce and maintain remission with anti-inflammatory, immunosuppressive agents, and/or colectomy. fecal microbiota transplantation (fmt) has been used successfully to treat relapsing or refractory clostridium difficile infection. the alteration of microbiota in mouse models of uc as well as in patients suggested the possibility of treating uc with fmt ... | 2016 | 26846120 |
| predicting the risk of clostridium difficile infection upon admission: a score to identify patients for antimicrobial stewardship efforts. | increasing morbidity and health care costs related to clostridium difficile infection (cdi) have heightened interest in methods to identify patients who would most benefit from interventions to mitigate the likelihood of cdi. | 2016 | 26845084 |
| does alkaline colonic ph predispose to clostridium difficile infection? | clostridium difficile caused nearly 500,000 infections and was associated with approximately 29,000 deaths in 2011, according to data from the centers for disease control and prevention. c. difficile is a bacterium that causes diarrhea and, often, severe illness in healthcare facilities, as well as the community. our objective was to determine whether alkaline colonic ph predisposes to colonization and infection with c. difficile. | 2016 | 26840963 |
| immunogenicity and protective efficacy of recombinant clostridium difficile flagellar protein flic. | clostridium difficile is a gram-positive bacillus and is the leading cause of toxin-mediated nosocomial diarrhea following antibiotic use. c. difficile flagella play a role in colonization, adherence, biofilm formation, and toxin production, which might contribute to the overall virulence of certain strains. human and animal studies indicate that anti-flagella immune responses may play a role in protection against colonization by c. difficile and subsequent disease outcome. here we report that r ... | 2016 | 26839147 |
| clostridium difficile-associated diarrhoea in primary joint arthroplasty in aneurin bevan university health board south. | the choice of perioperative antibiotics to reduce the prevalence of infection after joint arthroplasty should be considered carefully to minimise the risk of nosocomial infections. dramatic increases in the incidence and severity of healthcare-associated clostridium difficile infection with clostridium difficile-associated diarrhoea (cdad) have occurred since 2000. | 2016 | 26836055 |
| bacterial probiotics as an aid in the control of clostridium difficile disease in neonatal pigs. | although clostridium difficile infection (cdi) is a common disease in swine, there is a lack of prevention strategies. the objectives of this study were to evaluate: i) the effectiveness of lactobacillus spp. and ii) non-toxigenic c. difficile (ntcd) as prevention for the development of cdi in piglets. cesarean-derived piglets (n = 150) were randomly assigned to 6 groups: group 1 - negative control (n = 10); group 2 - ntcd only (n = 13); group 3 - lactobacillus spp. only (n = 14); group 4 - posi ... | 2016 | 26834271 |
| antibacterials developed to target a single organism: mechanisms and frequencies of reduced susceptibility to the novel anti-clostridium difficile compounds fidaxomicin and lff571. | clostridium difficile is the most common cause of antibacterial-associated diarrhea. clear clinical presentation and rapid diagnostics enable targeted therapy for c. difficile infection (cdi) to start quickly. cdi treatment includes metronidazole and vancomycin (van). despite decades of use for cdi, no clinically meaningful resistance to either agent has emerged. fidaxomicin (fdx), an rna polymerase inhibitor, is also approved to treat cdi. mutants with reduced susceptibility to fdx have been se ... | 2016 | 26834162 |
| treatment of clostridium difficile infection using sq641, a capuramycin analogue, increases post-treatment survival and improves clinical measures of disease in a murine model. | clostridium difficile infection (cdi) is a primary cause of antibiotic-associated diarrhoeal illness. current therapies are insufficient as relapse rates following antibiotic treatment range from 25% for initial treatment to 60% for treatment of recurrence. in this study, we looked at the efficacy of sq641 in a murine model of cdi. sq641 is an analogue of capuramycin, a naturally occurring nucleoside-based compound produced by streptomyces griseus. | 2016 | 26832756 |
| host-microbiota interactions in the pathogenesis of antibiotic-associated diseases. | improved understanding of the interplay between host and microbes stands to illuminate new avenues for disease diagnosis, treatment, and prevention. here, we provide a high-resolution view of the dynamics between host and gut microbiota during antibiotic-induced intestinal microbiota depletion, opportunistic salmonella typhimurium and clostridium difficile pathogenesis, and recovery from these perturbed states in a mouse model. host-centric proteome and microbial community profiles provide a nua ... | 2016 | 26832403 |
| a multi-laboratory comparison of two molecular methods for the detection of toxigenic clostridium difficile. | diarrheal disease due to toxigenic clostridium difficile (cd) accounts for an increased number of hospitalizations and deaths each year. published guidelines recommend reflex testing of cd antigen-positive samples to molecular testing or testing samples directly by a molecular assay. this multicenter study was designed to compare the accuracy of two different molecular methods targeting different cd genes: xpert c. difficile epi ruo rt-pcr assay (xpcr) which targets toxin b (cepheid, sunnyvale, ... | 2016 | 26829538 |
| peripheral neuropathy after fecal microbiota transplantation for clostridium difficile infection: a case report. | we present a case of a 71-year-old man with clostridium difficile infection who underwent fecal transplantation. the patient was found to have a predominantly demyelinating sensorimotor peripheral polyneuropathy upon electrodiagnostic testing. to our knowledge, only one case of peripheral neuropathy after fecal transplantation has previously been reported. although the exact cause of this patient's neuropathy cannot be confirmed, it has been speculated that the pathophysiology is an immune-media ... | 2016 | 26826616 |
| genome sequence and analysis of peptoclostridium difficile strain zjcdc-s82. | peptoclostridium difficile (clostridium difficile) is the major pathogen associated with infectious diarrhea in humans. concomitant with the increased incidence of c. difficile infection worldwide, there is an increasing concern regarding this infection type. this study reports a draft assembly and detailed sequence analysis of c. difficile strain zjcdc-s82. the de novo assembled genome was 4.19 mb in size, which includes 4,013 protein-coding genes, 41 rrna genes, and 84 trna genes. along with t ... | 2016 | 26823648 |
| prevalence of probiotic use among inpatients: a descriptive study of 145 u.s. hospitals. | to inform clinical guidance, public health efforts, and research directions, probiotic use in u.s. health care needs to be better understood. this work aimed to assess the prevalence of inpatient probiotic use in a sample of u.s. hospitals. | 2016 | 26822808 |
| fecal transplantation for clostridium difficile-"all stool may not be created equal". | clostridium difficile is a gram-positive bacterium that is recognized as a causative organism of pseudomembranous enterocolitis. this infection has become a major public health challenge and is a source of considerable morbidity and mortality in those infected. we present a 62-year-old african american female with a long history of hiv infection, who presented with abdominal pain and continuous diarrhea due to pseudomembranous colitis. after failing multiple episodes of conventional therapy, it ... | 2016 | 26821578 |
| infection prevention in transplantation. | the number of patients undergoing hematopoietic cell and solid organ transplantation are increasing every year, as are the number of centers both transplanting and caring for these patients. improvements in transplant procedures, immunosuppressive regimens, and prevention of transplant-associated complications have led to marked improvements in survival in both populations. infections remain one of the most important sources of excess morbidity and mortality in transplant, and therefore, infecti ... | 2016 | 26820654 |
| difficult case of cronkhite-canada syndrome with small intestinal bacterial overgrowth, clostridium difficile infection and polymyalgia rheumatica. | a 64-year-old woman presented with heavy diarrhoea, nausea and weight loss accompanied by alopecia and dystrophic fingernails and toenails. the preceding diagnosis of an inflammatory bowel disease, a common pitfall, was excluded by endoscopic work up. instead, cronkhite-canada syndrome (ccs), a rare polyposis condition, was identified as the reason for this almost pathognomonic combination of diagnostic findings including various polyps throughout the entire intestine and ectodermal abnormalitie ... | 2016 | 26818813 |
| inappropriate antibiotic use and gastric acid suppression preceding clostridium difficile infection. | 2016 | 26818749 | |
| oscillating behavior of clostridium difficile min proteins in bacillus subtilis. | in rod-shaped bacteria, the proper placement of the division septum at the midcell relies, at least partially, on the proteins of the min system as an inhibitor of cell division. the main principle of min system function involves the formation of an inhibitor gradient along the cell axis; however, the establishment of this gradient differs between two well-studied gram-negative and gram-positive bacteria. while in gram-negative escherichia coli, the min system undergoes pole-to-pole oscillation, ... | 2016 | 26817670 |
| decolonization in prevention of health care-associated infections. | colonization with health care-associated pathogens such as staphylococcus aureus, enterococci, gram-negative organisms, and clostridium difficile is associated with increased risk of infection. decolonization is an evidence-based intervention that can be used to prevent health care-associated infections (hais). this review evaluates agents used for nasal topical decolonization, topical (e.g., skin) decolonization, oral decolonization, and selective digestive or oropharyngeal decontamination. alt ... | 2016 | 26817630 |
| microbiome regulation of autoimmune, gut and liver associated diseases. | extensive analysis of the complexity and diversity of microbiota using metagenomics in the gut and other body sites has provided evidence that dysbiosis occurs in many disease states. with the application of next generation sequencing technology this research is starting to uncover the impact of microbiota on metabolic, physiological and immunological pathways and elucidate the cellular and molecular mechanisms involved. to highlight these advances we have focused on autoimmunity and gut and liv ... | 2015 | 26817477 |
| cervical spine fractures in the elderly: morbidity and mortality after operative treatment. | although there are currently many different strategies and recommendations in the therapy of cervical spine fractures in elderly patients, there are still no generally accepted treatment algorithms. the aim of the present study was to analyze the morbidity, mortality, and outcome of operated cervical spine injuries in the elderly. | 2013 | 26815442 |
| is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? a natural experiment with non-equivalent controls. | a wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. however, studies have been limited to the us with limited evidence from elsewhere. the aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. | 2016 | 26811373 |
| tigecycline as last resort in severe refractory clostridium difficile infection: a case report. | 2016 | 26810610 | |
| a detrimental role of immunosuppressive drug, dexamethasone, during clostridium difficile infection in association with a gastrointestinal microbial shift. | we investigated the increased risk of clostridium difficile infection (cdi) caused by the combined use of antibiotics and an immunosuppressive drug in a mouse model. our data showed that an approximate return to pretreatment conditions of gut microbiota occurred within days after cessation of the antibiotic treatment, whereas the recovery of gut microbiota was delayed with the combined treatment of antibiotics and dexamethasone, leading to an increased severity of cdi. an alteration of gut micro ... | 2016 | 26809802 |
| potassium acetate blocks clostridium difficile toxin a-induced microtubule disassembly by directly inhibiting histone deacetylase 6, thereby ameliorating inflammatory responses in the gut. | clostridium difficile toxin a is known to cause deacetylation of tubulin proteins, which blocks microtubule formation and triggers barrier dysfunction in the gut. based on our previous finding that the clostridium difficile toxin a-dependent activation of histone deacetylase 6 (hdac-6) is responsible for tubulin deacetylation and subsequent microtubule disassembly, we herein examined the possible effect of potassium acetate (pa; whose acetyl group prevents the binding of tubulin to hdac-6) as a ... | 2016 | 26809801 |
| effect of variation in test methods on performance of ultraviolet-c radiation room decontamination. | to determine the effect of variation in test methods on performance of an ultraviolet-c (uv-c) room decontamination device. | 2016 | 26809607 |
| older is not wiser, immunologically speaking: effect of aging on host response to clostridium difficile infections. | clostridium difficile infection (cdi) is the most common cause of antibiotic-associated diarrhea and a significant burden on the health care system. aging has been identified in the literature as a risk factor for cdi as well as adverse outcome from cdi. although this effect of advanced age on cdi could be partially explained by clinical factors associated with aging, biologic factors are important. innate immune system, responsible for immediate response to acute infections, plays a major role ... | 2016 | 26809495 |
| adverse events in faecal microbiota transplant: a review of the literature. | faecal microbiota transplant (fmt) is the infusion of donor faeces into the gut with the aim of improving microbial diversity. the procedure has gained significant interest recently in the treatment of recurrent clostridium difficile infection (cdi). the literature is currently dominated by small case series and isolated case reports. there is no standardization of methods and recording of outcomes. | 2016 | 26803556 |
| clostridium difficile recurrences in stockholm. | sixty-eight hospital-admitted patients with a first episode of clostridium difficile infection (cdi) were included and followed up during 1 year. faeces samples were collected at 1, 2, 6 and 12 months after inclusion and analyzed for the presence of c. difficile toxin b, genes for toxin a, toxin b, binary toxin and tcdc deletion by pcr. all strains were also pcr-ribotyped and the mics of the isolates were determined against eight antimicrobial agents. in 68 patients initially included, antibioti ... | 2016 | 26802875 |
| burden of nursing home-onset clostridium difficile infection in the united states: estimates of incidence and patient outcomes. | background. approximately 4 million americans receive nursing home (nh) care annually. nursing home residents commonly have risk factors for clostridium difficile infection (cdi), including advanced age and antibiotic exposures. we estimated national incidence of nh-onset (nho) cdi and patient outcomes. methods. we identified nho-cdi cases from population-based surveillance of 10 geographic areas in the united states. cases were defined by c difficile-positive stool collected in an nh (or from ... | 2016 | 26798767 |
| descriptive epidemiology of infectious gastrointestinal illnesses in sydney, australia, 2007-2010. | there is a lack of information about the prevalence of gastrointestinal illnesses in australia. current disease surveillance systems capture only a few pathogens. the aim of this study is to describe the epidemiology of infectious gastrointestinal illnesses in sydney, australia. | 2017 | 26798556 |
| reactive oxygen species as additional determinants for cytotoxicity of clostridium difficile toxins a and b. | clostridium difficile infections can induce mild to severe diarrhoea and the often associated characteristic pseudomembranous colitis. two protein toxins, the large glucosyltransferases tcda and tcdb, are the main pathogenicity factors that can induce all clinical symptoms in animal models. the classical molecular mode of action of these homologous toxins is the inhibition of rho gtpases by mono-glucosylation. rho-inhibition leads to breakdown of the actin cytoskeleton, induces stress-activated ... | 2016 | 26797634 |
| asymptomatic rectal colonization with carbapenem-resistant enterobacteriaceae and clostridium difficile among residents of a long-term care facility in new york city. | residents of long-term care facilities (ltcfs) are at increased risk for colonization and development of infections with multidrug-resistant organisms. this study was undertaken to determine prevalence of asymptomatic rectal colonization with clostridium difficile (and proportion of 027/nap1/bi ribotype) or carbapenem-resistant enterobacteriaceae (cre) in an ltcf population. | 2016 | 26796684 |
| development and validation of a clostridium difficile health-related quality-of-life questionnaire. | patients with clostridium difficile infection (cdi) can experience long-term symptoms and poor quality of life due to the disease. despite this, a health-related quality of life (hrqol) instrument specific for patients with cdi does not exist. the aim of this study was to develop and validate a disease-specific instrument to assess hrqol in patients with cdi. | 2016 | 26796081 |
| acquisition of clostridium difficile on hands of healthcare personnel caring for patients with resolved c. difficile infection. | in an observational study, we found that healthcare personnel frequently acquired clostridium difficile on their hands when caring for patients with recently resolved c. difficile infection (cdi) (<6 weeks after treatment) who were no longer under contact precautions. continuing contact precautions after diarrhea resolves may be useful to reduce transmission. | 2016 | 26795900 |
| [fecal bacteriotherapy for the treatment of recurrent clostridium difficile colitis used in the clinic of infectious diseases of the university hospital brno in 2010-2014 - a prospective study]. | the aim of the study is to assess the efficacy of fecal bacteriotherapy in the treatment of clostridium difficile colitis. | 2015 | 26795227 |
| in vivo synthesis of cyclic-di-gmp using a recombinant adenovirus preferentially improves adaptive immune responses against extracellular antigens. | there is a compelling need for more effective vaccine adjuvants to augment induction of ag-specific adaptive immune responses. recent reports suggested the bacterial second messenger bis-(3'-5')-cyclic-dimeric-guanosine monophosphate (c-di-gmp) acts as an innate immune system modulator. we recently incorporated a vibrio cholerae diguanylate cyclase into an adenovirus vaccine, fostering production of c-di-gmp as well as proinflammatory responses in mice. in this study, we recombined a more potent ... | 2016 | 26792800 |
| association of healthcare exposure with acquisition of different clostridium difficile strain types in patients with recurrent infection or colonization after clinical resolution of initial infection. | following the resolution of an episode of clostridium difficile infection (cdi), the factors associated with acquisition of different c. difficile strain types in patients with recurrent infection or persistent colonization have not been evaluated. | 2016 | 26792686 |
| faecal microbiota transplantation for recurrent clostridium difficile infection and beyond: risks and regulation. | 2016 | 26792682 | |
| clostridium difficile flagella predominantly activate tlr5-linked nf-κb pathway in epithelial cells. | clostridium difficile has become the most common enteropathogen responsible for intestinal nosocomial post-antibiotic infections. this has coincided with the appearance of serious cases related to the emergence of hypervirulent strains. the toxins are the main virulence factors and elicit an inflammatory response during c. difficile infection. however, other bacterial components appear to be involved in the inflammatory process. in some pathogens, flagella play a role in pathogenesis through abn ... | 2016 | 26790921 |
| changes in colonic bile acid composition following fecal microbiota transplantation are sufficient to control clostridium difficile germination and growth. | fecal microbiota transplantation (fmt) is a highly effective therapy for recurrent clostridium difficile infection (r-cdi), but its mechanisms remain poorly understood. emerging evidence suggests that gut bile acids have significant influence on the physiology of c. difficile, and therefore on patient susceptibility to recurrent infection. we analyzed spore germination of 10 clinical c. difficile isolates exposed to combinations of bile acids present in patient feces before and after fmt. bile a ... | 2016 | 26789728 |
| prevalence and clinical outcomes of clostridium difficile infection in the intensive care unit: a systematic review and meta-analysis. | background. intensive care unit (icu) patients are at higher risk for clostridium difficile infection (cdi). | 2016 | 26788544 |
| the stealthy superbug: the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of st228 methicillin-resistant staphylococcus aureus. | whole-genome sequencing (wgs) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant staphylococcus aureus (mrsa) sequence type 228 (st228) sccmec i that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of st228, rather than repeated introductions ... | 2016 | 26787833 |
| impact of surotomycin on the gut microbiota of healthy volunteers in a phase 1 clinical trial. | clostridium difficile-associated diarrhea has been associated with disruption of the normal intestinal microbiota, particularly thebacteroides fragilisgroup andprevotellaspecies. surotomycin is a bactericidal cyclic lipopeptide in development for treatment ofclostridium difficile-associated diarrhea that has selective and potent activity againstc. difficileand other gram-positive bacteria and a minimal impact on intestinal gram-negative organisms. the impacts of ascending doses of surotomycin on ... | 2016 | 26787687 |
| assessing the activity of microbicides against bacterial spores: knowledge and pitfalls. | bacterial endospores (spores) have a higher intrinsic resistance to microbicides as compared to other microbial forms, most likely due to their impermeable outer layers and low water content. though structural differences between the spores of various bacterial species may account for observed variations in their resistance to microbicides, flaws in methods for testing the sporicidal activity of microbicides often exaggerate the differences. this has major implications when considering the selec ... | 2016 | 26784857 |
| evaluation of a low-intensity ultraviolet-c radiation device for decontamination of computer keyboards. | computer keyboards are a potential source for dissemination of pathogenic microorganisms. we demonstrated that a low-intensity ultraviolet-c (uv-c) radiation device was effective in reducing methicillin-resistant staphylococcus aureus, carbapenem-resistant escherichia coli, and clostridium difficile spores on steel carriers and significantly reduced bacterial counts on in-use keyboards. | 2016 | 26781219 |
| a case of primary invasive aspergillus colitis masquerading as clostridium difficile infection. | 2016 | 26780696 | |
| organism burden, toxin concentration, and lactoferrin concentration do not distinguish between clinically significant and nonsignificant diarrhea in patients with clostridium difficile. | clostridium difficile infection is often overdiagnosed in patients with mild diarrhea. we evaluated 4 biomarkers as surrogates for clinically significant diarrhea (≥ 3 episodes in 24 hours) in 59 pcr-positive patients with and 59 pcr-positive patients without clinically significant diarrhea. organism burden (median tcdb cycle threshold value, 26.9 versus 27.1, p=0.25) and toxin a and b concentrations (toxin a, median, 0 versus 0 ng/ml, p=0.42; toxin b, median, 0 versus 0 ng/ml, p=0.25) were not ... | 2016 | 26778484 |
| effects of a predictive preventive model for prevention of clostridium difficile infection in patients in intensive care units. | health care-acquired clostridium difficile infection (hacdi) is associated with adverse outcomes at both the organization and patient level. factors that increase risk for development of hacdi have been identified. objectives of this study were to develop a predictive screening tool to identify patients at risk for hacdi and implement a bundle of mitigation interventions. | 2016 | 26775936 |
| bile acid modifications at the microbe-host interface: potential for nutraceutical and pharmaceutical interventions in host health. | bile acids have emerged as important signaling molecules in the host, as they interact either locally or systemically with specific cellular receptors, in particular the farnesoid x receptor (fxr) and tgr5. these signaling functions influence systemic lipid and cholesterol metabolism, energy metabolism, immune homeostasis, and intestinal electrolyte balance. through defined enzymatic activities, the gut microbiota can significantly modify the signaling properties of bile acids and therefore can ... | 2016 | 26772409 |
| novel therapies for severe clostridium difficile colitis. | clostridium difficile infection (cdi) is becoming a large healthcare burden with increasing incidence, high recurrence rates, and associated morbidity and mortality. disease severity varies from mild to severe and complicated presentations. current mainstays of therapy in severe cdi include: fluid resuscitation, support of organ dysfunction, discontinuation of inciting agents, and antibiotic treatment. | 2016 | 26771898 |
| prophylactic use of gentamicin/flucloxacillin versus cefuroxime in surgery: a meta analysis of clinical studies. | to conduct meta-analyses of all available studies comparing efficacies of prophylactic cefuroxime and prophylactic gentamicin/flucloxacillin (gen/flu) in preventing post-operative wound infections and their association with risks of clostridium difficile infections and post-operative renal impairment. | 2015 | 26770380 |
| advanced chronic kidney disease: a strong risk factor for clostridium difficile infection. | it has been suggested that chronic kidney disease (ckd) is a risk factor for clostridium difficile infection (cdi) and is associated with increased mortality among patients infected with c. difficile. however, recent studies of the clinical impact of ckd on cdi in asians are still insufficient. we sought to determine the relationship between ckd and cdi in a korean population. | 2016 | 26767866 |
| quality outcomes in the surgical intensive care unit after electronic health record implementation. | the electronic health record (ehr) is increasingly viewed as a means to provide more coordinated, patient-centered care. few studies consider the impact of ehrs on quality of care in the intensive care unit (icu) setting. | 2015 | 26767058 |
| shaping public health initiatives in kidney diseases: the peer kidney care initiative. | while broad-based societal efforts to improve public health have targeted disorders such as cardiovascular disease and cancer for several decades, efforts devoted to kidney disease have developed only more recently. the peer kidney care initiative, a novel effort designed to address knowledge gaps in the care of patients with kidney disease, examines key disease processes, the roles of geography and seasonality on outcomes, and longitudinal trends in outcomes over time. | 2016 | 26765683 |
| non-toxigenic clostridium difficile to prevent recurrent c. difficile infection. | 2016 | 26763618 | |
| clostridium perfringens type a netf and nete positive and clostridium difficile co-infection in two adult dogs. | the aim of this study was to report two cases of clostridium perfringens type a and clostridium difficile co-infection in adult dogs. both animals were positive for a/b toxin. toxigenic c. difficile and c. perfringens type a positive for nete and netf-encoding genes were isolated. this report reinforces the necessity of studying a possible synergism of c. difficile and c. perfringens in enteric disorders. | 2016 | 26762654 |
| potential of lactoferrin to prevent antibiotic-induced clostridium difficile infection. | clostridium difficile infection (cdi) is a global healthcare problem. recent evidence suggests that the availability of iron may be important for c. difficile growth. this study evaluated the comparative effects of iron-depleted (1% fe(3+) saturated) bovine apo-lactoferrin (apo-blf) and iron-saturated (85% fe(3+) saturated) bovine holo-lactoferrin (holo-blf) in a human in vitro gut model that simulates cdi. | 2016 | 26759363 |
| frozen vs fresh fecal microbiota transplantation and clinical resolution of diarrhea in patients with recurrent clostridium difficile infection: a randomized clinical trial. | clostridium difficile infection (cdi) is a major burden in health care and community settings. cdi recurrence is of particular concern because of limited treatment options and associated clinical and infection control issues. fecal microbiota transplantation (fmt) is a promising, but not readily available, intervention. | 2016 | 26757463 |
| expanded evidence for frozen fecal microbiota transplantation for clostridium difficile infection: a fresh take. | 2016 | 26757461 | |
| probiotics for the prevention of antibiotic-associated diarrhea in children. | this article provides recommendations, developed by the working group (wg) on probiotics of the european society for pediatric gastroenterology, hepatology, and nutrition, for the use of probiotics for the prevention of antibiotic-associated diarrhea (aad) in children based on a systematic review of previously completed systematic reviews and of randomized controlled trials published subsequently to these reviews. the use of probiotics for the treatment of aad is not covered. the recommendations ... | 2016 | 26756877 |
| oral and parenteral versus parenteral antibiotic prophylaxis in elective laparoscopic colorectal surgery (jmto prev 07-01): a phase 3, multicenter, open-label, randomized trial. | to confirm the efficacy of oral and parenteral antibiotic prophylaxis (abx) in the elective laparoscopic colorectal surgery. | 2016 | 26756752 |
| efficacy of vancomycin extended-dosing regimens for treatment of simulated clostridium difficile infection within an in vitro human gut model. | effects of two vancomycin extended-dosing regimens on microbiota populations within an in vitro gut model of simulated clostridium difficile infection (cdi) were evaluated. | 2016 | 26755495 |
| analysis of tcdb proteins within the hypervirulent clade 2 reveals an impact of rhoa glucosylation on clostridium difficile proinflammatory activities. | clostridium difficile strains within the hypervirulent clade 2 are responsible for nosocomial outbreaks worldwide. the increased pathogenic potential of these strains has been attributed to several factors but is still poorly understood. during a c. difficile outbreak, a strain from this clade was found to induce a variant cytopathic effect (cpe), different from the canonical arborizing cpe. this strain (nap1v) belongs to the nap1 genotype but to a ribotype different from the epidemic nap1/rt027 ... | 2016 | 26755157 |
| first recurrence of clostridium difficile infection: clinical relevance, risk factors, and prognosis. | therapy for recurrent clostridium difficile-associated diarrhea (cdad) is challenging. we evaluated the frequency, associated risk factors, and prognosis of first cdad recurrences. prospective cohort study of all consecutive cases of primary cdad diagnosed in a university hospital from january 2006 to june 2013. recurrent infection was defined as reappearance of symptoms within 8 weeks of the primary diagnosis, provided that cdad symptoms had previously resolved and a new toxin test was positive ... | 2016 | 26753991 |
| antimicrobial stewardship in a long-term acute care hospital using offsite electronic medical record audit. | objective to offer antimicrobial stewardship to a long-term acute care hospital using telemedicine. methods we conducted an uninterrupted time-series analysis to measure the impact of antimicrobial stewardship on hospital-acquired clostridium difficile infection (cdi) rates and antimicrobial use. simple linear regression was used to analyze changes in antimicrobial use; poisson regression was used to estimate the incidence rate ratio in cdi rates. the preimplementation period was april 1, 2010-m ... | 2016 | 26752662 |
| discontinuation of systematic surveillance and contact precautions for vancomycin-resistant enterococcus (vre) and its impact on the incidence of vre faecium bacteremia in patients with hematologic malignancies. | objective to study the effect of discontinuation of systematic surveillance for vancomycin-resistant enterococcus (vre) and contact isolation of colonized patients on the incidence of vre bacteremia setting a hematology-oncology unit with high prevalence of vre colonization characterized by predominantly sporadic molecular epidemiology participants inpatients with hematologic malignancies and recipients of hematopoietic stem cell transplantation methods the incidence of vre bacteremia was measur ... | 2016 | 26750087 |
| fidaxomicin: a novel agent for the treatment of clostridium difficile infection. | due to the limitations of existing treatment options for clostridium difficile infection (cdi), new therapies are needed. | 2017 | 26744587 |
| severe refractory clostridium difficile infection with good response to fecal microbiota transplantation: a case report. | a 49-year-old woman diagnosed with pseudomembranous enterocolitis was transferred to our hospital for medical treatment. she responded poorly to treatment with vancomycin hydrochloride and metronidazole, so she underwent fecal microbiota transplantation. treatment effects were observed the next day, and the diarrhea disappeared within 3 days. colonoscopy 4 days later revealed the resolution of pseudomembranes, and no recurrences were reported within the first year after discharge. | 2017 | 26743554 |