Publications
| Title | Abstract | Year Filter | PMID(sorted descending) Filter |
|---|
| clostridium difficile in the pediatric population of monroe county, new york. | clostridium difficile infection (cdi) incidence in hospitalized children has increased over the past decade and disease has been reported in the community. therefore, population surveillance that includes nonhospitalized cases is important to accurately estimate the burden of cdi in children. we describe the epidemiology of cdi in the pediatric population of monroe county, new york. | 2014 | 26625381 |
| diagnosis and management of clostridium difficile infection by pediatric infectious diseases physicians. | the incidence of c difficile infection (cdi) has risen among children; however, optimal management of cdi within a diverse pediatric population remains unclear. although adult guidelines recommend oral vancomycin for treatment of second recurrence or severe cdi, dedicated pediatric data to support pediatric specific management guidelines are lacking. our objective was to describe current cdi management practices by pediatric infectious diseases (id) physicians. | 2014 | 26624906 |
| follow-up of pseudomembranous colitis in children using colonoscopy: a case report. | pseudomembranous colitis (pmc) occurs mainly in adults and is believed to be caused almost exclusively by toxins produced by clostridium difficile. colonoscopy found that pmc occurs mainly in the colon, sigmoid colon and rectum in up to 80% ~ 100% of cases. colonoscopy is simple and fast. it has the significance of making a definite diagnosis and can be used as the main examination method of diagnosis. reports of children suffering from pmc are rare. herein, we report a case of pmc in a child. t ... | 2015 | 26624602 |
| a review of clostridium difficile infection at the university hospital of the west indies, jamaica. | this study examined the frequency of clostridium difficile infection (cdi) among hospital admission and diarrhoeal stool samples over a six-year period. | 2015 | 26624597 |
| clostridium difficile outbreak caused by nap1/bi/027 strain and non-027 strains in a mexican hospital. | clostridium difficile infections caused by the nap1/b1/027 strain are more severe, difficult to treat, and frequently associated with relapses. | 2016 | 26620948 |
| [recurrent disease due to ribotype 027 clostridium difficile]. | 2017 | 26620602 | |
| clostridium difficile infection. | the incidence and severity of clostridium difficile infections have increased over the past few decades. new challenges have developed in the treatment and prevention of both hospital- and community-acquired disease. as mentioned by tamma and sandora [ 1] in their recent review, many questions about c difficile management in children remain unanswered, forcing pediatricians to rely on adult studies for guidance. the following is a brief synopsis of a few recent publications that focused on c dif ... | 2013 | 26619449 |
| mortality benefits of antibiotic computerised decision support system: modifying effects of age. | antibiotic computerised decision support systems (cdsss) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. we conducted a prospective cohort study in a 1500-bed tertiary-care hospital in singapore, to evaluate the effectiveness of the hospital's antibiotic cdss on patients' clinical outcomes, and the modification of these effects by patient factors. to account for clustering, we used multilevel logistic regression models. one-quarter of 1886 eli ... | 2015 | 26617195 |
| incidence of clostridium difficile infection in patients receiving high-risk antibiotics with or without a proton pump inhibitor. | considering the incidence and severity of clostridium difficile infection (cdi), risk reduction strategies are crucial. prior studies suggest that proton pump inhibitor (ppi) use can increase the risk of cdi over antibiotics alone; however, data and guidelines have been conflicting. | 2016 | 26616410 |
| the or environment--hand hygiene, cleaning, and clostridium difficile. | 2015 | 26616318 | |
| fecal transplantation successfully treats recurrent d-lactic acidosis in a child with short bowel syndrome. | d-lactic acidosis can occur in patients with short bowel syndrome (sbs) when excessive malabsorbed carbohydrate (cho) enters the colon and is metabolized by colonic bacteria to d-lactate. d-lactate can be absorbed systemically, and increased serum levels are associated with central nervous system toxicity manifested by confusion, ataxia, and slurred speech. current therapy, usually directed toward suppressing intestinal bacterial overgrowth and limiting ingested cho, is not always successful. fe ... | 2015 | 26616138 |
| toxicity assessment of clostridium difficile toxins in rodent models and protection of vaccination. | clostridium difficile is the leading cause of hospital-acquired diarrhea, also known as c. difficile associated diarrhea. the two major toxins, toxin a and toxin b are produced by most c. difficile bacteria, but some strains, such as bi/nap1/027 isolates, produce a third toxin called binary toxin. the precise biological role of binary toxin is not clear but it has been shown to be a cytotoxin for vero cells. we evaluated the toxicity of these toxins in mice and hamsters and found that binary tox ... | 2016 | 26614590 |
| the challenge of clostridium difficile infection: overview of clinical manifestations, diagnostic tools and therapeutic options. | the most important infectious cause of antibiotic-associated diarrhoea and colitis is clostridium difficile, which is a gram-positive, anaerobic, spore-forming, toxin-producing bacillus. in this overview we will discuss the diagnostic and therapeutic management of patients presenting with suspected or proven c. difficile infection (cdi). the clinical spectrum varies from asymptomatic c. difficile carriers to fulminant colitis with multi-organ failure. the onset of symptoms is usually within 2 we ... | 2015 | 26612229 |
| use of the cobas 4800 system for the rapid detection of toxigenic clostridium difficile and methicillin-resistant staphylococcus aureus. | the new cobas® cdiff and cobas® mrsa/sa tests were compared with conventional methods for the rapid detection of toxigenic clostridium difficile and methicillin-resistant staphylococcus aureus. the final concordance between cobas cdiff test and gdh/toxin gene screening was 97.62% and between cobas mrsa/sa test and chromogenic culture, 91.30%, respectively. | 2016 | 26611812 |
| the first report of a previously undescribed ebv-negative nk-cell lymphoma of the gi tract presenting as chronic diarrhoea with eosinophilia. | a 74-year-old man presented with a 2-month history of watery diarrhoea. his complete blood count showed lymphopaenia and marked eosinophilia. investigations for common infectious causes including clostridium difficile toxin, stool culture, ova and parasites were negative. endoscopy revealed extensive colitis and a ct of the abdomen identified numerous large abdominal lymph nodes suspicious for lymphoma. multiple tissue samples were obtained; colon, mesenteric lymph node and bone marrow biopsy, a ... | 2015 | 26611482 |
| epidemiology and factors associated with candidaemia following clostridium difficile infection in adults within metropolitan atlanta, 2009-2013. | we assessed prevalence of and risk factors for candidaemia following clostridium difficile infection (cdi) using longitudinal population-based surveillance. of 13 615 adults with cdi, 113 (0·8%) developed candidaemia in the 120 days following cdi. in a matched case-control analysis, severe cdi and cdi treatment with vancomycin + metronidazole were associated with development of candidaemia following cdi. | 2016 | 26608090 |
| in the endemic setting, clostridium difficile ribotype 027 is virulent but not hypervirulent - erratum. | 2016 | 26607744 | |
| amoebiasis masquerading as inflammatory bowel disease. | a 60-year-old japanese man presented with bloody diarrhoea. he stated that he had been diagnosed with ulcerative colitis (uc) 3 years prior, but discontinued follow-up care as treatment was ineffective. one year later, he came to our hospital with anorexia and weight loss. the abdomen was soft and flat without tenderness. laboratory tests were unremarkable; faecal culture and clostridium difficile toxin were negative. findings and biopsy from a subsequent colonoscopy reconfirmed his diagnosis of ... | 2015 | 26607188 |
| analysis of morbidity and mortality outcomes in postoperative clostridium difficile infection in the veterans health administration. | this study analyzes and reports clostridium difficile infection (cdi) rates, risk factors, and associations with postoperative outcomes in the veterans health administration (vha). | 2016 | 26606675 |
| anti-infectious human vaccination in historical perspective. | a brief history of vaccination is presented since the jenner's observation, through the first golden age of vaccinology (from pasteur's era to 1938), the second golden age (from 1940 to 1970), until the current period. in the first golden age, live, such as bacille calmette guérin (bcg), and yellow fever, inactivated, such as typhoid, cholera, plague, and influenza, and subunit vaccines, such as tetanus and diphtheria toxoids, have been developed. in the second golden age, the cell culture techn ... | 2016 | 26606466 |
| the high stakes of postoperative clostridium difficile infection. | 2016 | 26606279 | |
| economic burden of clostridium difficile in five hospitals of the florence health care system in italy. | despite the awareness about the increasing rates of clostridium difficile infection (cdi) and the economic burden arising from its management (prolonged hospitalization, laboratory tests, visits, surgical treatment, environmental sanitation), few studies are available in italy on the economic costs directly attributable to the cdi. the florence health care system has designed a study with the aim of describing the costs attributable to the cdi and defines the incremental economic burden associat ... | 2015 | 26604846 |
| memory of germinant stimuli in bacterial spores. | bacterial spores, despite being metabolically dormant, possess the remarkable capacity to detect nutrients and other molecules in their environment through a biochemical sensory apparatus that can trigger spore germination, allowing the return to vegetative growth within minutes of exposure of germinants. we demonstrate here that bacterial spores of multiple species retain memory of transient exposures to germinant stimuli that can result in altered responses to subsequent exposure. the magnitud ... | 2015 | 26604257 |
| the aged gut in inflammatory bowel diseases. | senescence is accompanied by various anatomical and functional alterations starting from mastication and deglutition and consequent modifications of nutrition. in addition, the widespread use of proton pump inhibitors and non-steroidal anti-inflammatory drugs in aged subjects weakens the gastric barrier, thus contributing to easier entry of microbes into the gastrointestinal tract. the microbiota of the elderly is less stable than that of younger adults, therefore, gut dysbiosis is more frequent ... | 2015 | 26603728 |
| binding and entry of clostridium difficile toxin b is mediated by multiple domains. | clostridium difficile is responsible for a number of serious gastrointestinal diseases caused primarily by two exotoxins, tcda and tcdb. these toxins enter host cells by binding unique receptors, at least partially via their combined repetitive oligopeptides (crops) domains. our study investigated structural determinants necessary for binding and entry of tcdb. deletion analyses identified tcdb residues 1372-1493 as essential for cytotoxicity in three cell lines. consistent with this observation ... | 2015 | 26602083 |
| investigation of a cluster of clostridium difficile infections in a pediatric oncology setting. | we investigated an increase in clostridium difficile infection (cdi) among pediatric oncology patients. | 2016 | 26601705 |
| cost-effectiveness in clostridium difficile treatment decision-making. | to develop a framework for the clinical and health economic assessment for management of clostridium difficile infection (cdi). | 2015 | 26601096 |
| gastrointestinal dysbiosis and the use of fecal microbial transplantation in clostridium difficile infection. | the impact of antibiotics on the human gut microbiota is a significant concern. antibiotic-associated diarrhea has been on the rise for the past few decades with the increasing usage of antibiotics. clostridium difficile infections (cdi) have become one of the most prominent types of infectious diarrheal disease, with dramatically increased incidence in both the hospital and community setting worldwide. studies show that variability in the innate host response may in part impact upon cdi severit ... | 2015 | 26600975 |
| the effectiveness of lactobacillus beverages in controlling infections among the residents of an aged care facility: a randomized placebo-controlled double-blind trial. | to clarify the usefulness of lactobacillus casei strain shirota (lcs)-fermented milk in the normalization of bowel movements and improvement of infection control for the elderly residents and staff of facilities for the elderly. | 2016 | 26599038 |
| regulation of type iv pili contributes to surface behaviors of historical and epidemic strains of clostridium difficile. | the intestinal pathogen clostridium difficile is an urgent public health threat that causes antibiotic-associated diarrhea and is a leading cause of fatal nosocomial infections in the united states. c. difficile rates of recurrence and mortality have increased in recent years due to the emergence of so-called "hypervirulent" epidemic strains. a great deal of the basic biology of c. difficile has not been characterized. recent findings that flagellar motility, toxin synthesis, and type iv pilus ( ... | 2015 | 26598364 |
| making a case for pediatric antimicrobial stewardship programs. | although antimicrobials are commonly used in children, it is important to remember that they can have a profound impact on this unique patient population. inadvertent consequences of antiinfective use in children include antimicrobial resistance, infection caused by clostridium difficile, increased risk of obesity, and adverse drug events. in addition, compared with adults, children have different dosing requirements, antimicrobial formulation needs, pharmacokinetics, and antimicrobial susceptib ... | 2015 | 26598095 |
| probiotics and fecal microbiota transplant for primary and secondary prevention of clostridium difficile infection. | clostridium difficile infection (cdi) is the most common cause of nosocomial diarrhea and is associated with an increased risk of mortality. the use of probiotics and fecal microbiota transplantation (fmt) has been studied to reduce the incidence and severity of this infection, but variable efficacy and safety data have been reported. probiotics are hypothesized to be effective in the management of cdi through a number of mechanisms that include maintenance of normal gastrointestinal flora, anti ... | 2015 | 26598094 |
| virulence factors of clostridium difficile and their role during infection. | clostridium difficile is the prominent etiological agent of healthcare-associated diarrhea. the disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. the main risk factor for developing an infection after contamination by the resistant spores is the disruption of the gut microbiota, allowing the spores to germinate. the colonization of the gut is likely to be governed by the bacterial resistance to the host response and the bacterial adhesion to the mucosa. to d ... | 2016 | 26596863 |
| effectiveness of probiotic in preventing and treating antibiotic-associated diarrhoea and/or clostridium difficile-associated diarrhoea in patients with spinal cord injury: a protocol of systematic review of randomised controlled trials. | probiotics may prevent antibiotic-associated and clostridium difficile-associated diarrhoea (aad/cdad). many spinal cord injury centre (scic) practitioners consider probiotics generically and may not realise that efficacy can be strain-, dose- and disease-specific. in order to confirm these effects and fully evaluate the extent of probiotic effectiveness in these patients, a systematic review and meta-analysis is indicated. | 2015 | 26596269 |
| routine detection of clostridium difficile in western australia. | despite increasing infection rates, clostridium difficile is not currently routinely tested for in all diarrhoeal faecal specimens in australia. in july 2014, all diarrhoeal specimens submitted to a diagnostic laboratory in western australia were surveyed to determine the true prevalence of c. difficile. in total, 1010 diarrhoeal non-duplicate faecal specimens were received during the month. testing for c. difficile was requested, or the criteria for a c. difficile investigation were met, for 67 ... | 2016 | 26592987 |
| assessment of clostridium difficile burden in patients over time with first episode infection following fidaxomicin or vancomycin. | in patients with first episode clostridium difficile infection treated with vancomycin or fidaxomicin, more patients receiving fidaxomicin achieved at least 2 log10 colony-forming units/g reduction in spores at the follow-up visit (p=.02). similar to published literature, a higher proportion of patients receiving fidaxomicin demonstrated sustained clinical response. | 2016 | 26592763 |
| clarifying the management of clostridium difficile infection. | 2015 | 26584845 | |
| quantitative lipoproteomics in clostridium difficile reveals a role for lipoproteins in sporulation. | bacterial lipoproteins are surface exposed, anchored to the membrane by s-diacylglyceryl modification of the n-terminal cysteine thiol. they play important roles in many essential cellular processes and in bacterial pathogenesis. for example, clostridium difficile is a gram-positive anaerobe that causes severe gastrointestinal disease; however, its lipoproteome remains poorly characterized. here we describe the application of metabolic tagging with alkyne-tagged lipid analogs, in combination wit ... | 2015 | 26584780 |
| [recent antibiotic use in german acute care hospitals - from benchmarking to improved prescribing and quality care]. | in view of increasing rates of bacterial resistance and clostridium difficile infections efforts to enhance appropriate and intelligent antibiotic prescribing have become important. a prerequisite is the availability of reliable antibiotic use data. so far antibiotic consumption data in this country had only a very limited coverage of acute care hospitals. | 2015 | 26583825 |
| concomitant medical conditions and therapies preclude accurate classification of children with severe or severe complicated clostridium difficile infection. | severe and severe complicated clostridium difficile infections (scdi/sccdi) were retrospectively assessed in a pediatric cohort. underlying medical conditions and concomitant medical therapy preclude accurate classification of children with scdi/sccdi, using current cdi severity definitions. revised cdi definitions in children should focus on more objective, age-appropriate, and cdi-specific markers of severity. | 2015 | 26582882 |
| clinical and healthcare burden of multiple recurrences of clostridium difficile infection. | clostridium difficile infection (cdi) is associated with a high risk of recurrence (rcdi). few studies have focused on multiple recurrences. to evaluate the potential of novel treatments targeting recurrence, we assessed the burden and severity of rcdi. | 2016 | 26582748 |
| development and evaluation of double locus sequence typing for molecular epidemiological investigations of clostridium difficile. | despite the development of novel typing methods based on whole genome sequencing, most laboratories still rely on classical molecular methods for outbreak investigation or surveillance. reference methods for clostridium difficile include ribotyping and pulsed-field gel electrophoresis, which are band-comparing methods often difficult to establish and which require reference strain collections. here, we present the double locus sequence typing (dlst) scheme as a tool to analyse c. difficile isola ... | 2016 | 26581425 |
| application of density gradient for the isolation of the fecal microbial stool component and the potential use thereof. | the idea of considering the gut microbiota as a virtual human organ has led to the concept of fecal microbiota transplantation (fmt), which has recently been extremely successful in the treatment of cases of recurrent clostridium difficile infection. administration of safe, viable, and representative fecal microbiota is crucial for fmt. to our knowledge, suitable techniques and systematic conditions for separating the fecal microbiota from stool samples have not been thoroughly investigated. in ... | 2015 | 26581409 |
| clostridium difficile colonization in asymptomatic infants 1 to 12 months old, admitted to a community hospital. | 2016 | 26581362 | |
| asymptomatic clostridium difficile colonization: epidemiology and clinical implications. | the epidemiology of clostridium difficile infection (cdi) has changed over the past decades with the emergence of highly virulent strains. the role of asymptomatic c. difficile colonization as part of the clinical spectrum of cdi is complex because many risk factors are common to both disease and asymptomatic states. in this article, we review the role of asymptomatic c. difficile colonization in the progression to symptomatic cdi, describe the epidemiology of asymptomatic c. difficile colonizat ... | 2015 | 26573915 |
| neutralization of clostridium difficile toxin b mediated by engineered lactobacilli that produce single-domain antibodies. | clostridium difficile is the primary cause of nosocomial antibiotic-associated diarrhea in the western world. the major virulence factors of c. difficile are two exotoxins, toxin a (tcda) and toxin b (tcdb), which cause extensive colonic inflammation and epithelial damage manifested by episodes of diarrhea. in this study, we explored the basis for an oral antitoxin strategy based on engineered lactobacillus strains expressing tcdb-neutralizing antibody fragments in the gastrointestinal tract. va ... | 2015 | 26573738 |
| [diagnostic workup and therapy of infectious diarrhea. current standards]. | infectious diarrhea is very common; its severity ranges from uncomplicated, self-limiting courses to potentially life-threatening disease. a rapid diagnostic workup providing detailed information on the suspected pathogen should be performed only in patients at risk, analyzing one single stool sample for salmonella, shigella, campylobacter, and norovirus. in the presence of risk factors, such as a history of antibiotic exposure within the last 3 months, testing for clostridium difficile should b ... | 2015 | 26573083 |
| the effect of broader, directed antimicrobial prophylaxis including fungal coverage on perioperative infectious complications after radical cystectomy. | radical cystectomy (rc) with urinary diversion has a significant risk of infection. in an effort to decrease the rate of infectious complications, we instituted a broader, culture-based preoperative antimicrobial regimen, including fungal coverage, and studied its effect on infectious complications after rc. | 2016 | 26572724 |
| treatment of clostridium difficile infection in mice with vancomycin alone is as effective as treatment with vancomycin and metronidazole in combination. | clostridium difficile is a major cause of nosocomial infectious diarrhoea. treatment of c. difficile infection (cdi) depends on disease severity. a combination of vancomycin and metronidazole is often recommended in severe cases. the aim of this study was to examine, in a murine model of cdi, if mice treated with a combination of vancomycin and metronidazole had a better clinical outcome than mice treated with vancomycin or metronidazole alone. | 2015 | 26568840 |
| fecal microbiota transplantation: current clinical efficacy and future prospects. | fecal microbiota transplantation (fmt) has gained mainstream attention with its remarkable efficacy in treating recurrent clostridium difficile infection (rcdi) when there are no other effective therapies. methods of selecting donors and routes of administration vary among studies, but there are now randomized controlled trials showing efficacy of fmt in treating rcdi. ongoing trials of fmt for other disease such as inflammatory bowel disease are underway; this therapy should not be used for the ... | 2015 | 26566371 |
| a high rate of alternative diagnoses in patients referred for presumed clostridium difficile infection. | we evaluated a cohort of patients referred to our center for presumed recurrent clostridium difficile infection (cdi) to determine final diagnoses and outcomes. | 2016 | 26565971 |
| novel therapeutic strategies for clostridium difficile infections. | in recent years, clostridium difficile has become the primary cause of antibiotic-associated diarrhea and pseudomembranous colitis, resulting in long and complicated hospital stays that represent a serious burden for patients as well as health care systems. currently, conservative treatment of c. difficile infection (cdi) relies on the antibiotics vancomycin, metronidazole or fidaxomicin, or in case of multiple recurrences, fecal microbiota transplantation (fmt). | 2016 | 26565670 |
| safety and durability of rbx2660 (microbiota suspension) for recurrent clostridium difficile infection: results of the punch cd study. | managing recurrent clostridium difficile infection (cdi) presents a significant challenge for clinicians and patients. fecal microbiota transplantation (fmt) is a highly effective therapy for recurrent cdi, yet availability of a standardized, safe, and effective product has been lacking. our aim in this study was to assess the safety and effectiveness of rbx2660 (microbiota suspension), a commercially prepared fmt drug manufactured using standardized processes and available in a ready-to-use for ... | 2016 | 26565008 |
| inactivation of clostridium difficile in sewage sludge by anaerobic thermophilic digestion. | there has been an increase in community-associated clostridium difficile infections with biosolids derived from wastewater treatment being identified as one potential source. the current study evaluated the efficacy of thermophilic digestion in decreasing levels of c. difficile ribotype 078 associated with sewage sludge. five isolates of c. difficile 078 were introduced (final density of 5 log cfu/g) into digested sludge and subjected to anaerobic digestion at mesophilic (36 or 42 °c) or thermop ... | 2016 | 26564276 |
| correction for zhang et al., toxin-mediated paracellular transport of antitoxin antibodies facilitates protection against clostridium difficile infection. | 2015 | 26556881 | |
| inhibitory effect of epigallocatechin gallate on the virulence of clostridium difficile pcr ribotype 027. | clostridium difficile infection (cdi) is the most prevalent cause of health-care-associated infections. cdi-related health-care costs and deaths are both increasing annually on a global scale. c. difficile have been reported in food products in canada, europe, and the united states; however, the systematic transmission of c. difficile between humans and animals is yet to be understood. because of the limitations of current therapeutic options, there is a need for the development of new patient t ... | 2015 | 26556797 |
| diagnostic testing for clostridium difficile in italian microbiological laboratories. | a laboratory diagnosis survey of clostridium difficile infection (cdi) was performed in italy in 2012-2013. questionnaires from 278 healthcare settings from 15 regions of italy were collected and analysed. eighty seven percent of the laboratories declared to routinely perform cdi diagnosis, 99% of them only after the clinician's request. among the 216 laboratories providing information on the size of the hospitals in which they were located, 65 had more than 500 beds (large hospitals), while 151 ... | 2016 | 26555737 |
| nisin is an effective inhibitor of clostridium difficile vegetative cells and spore germination. | clostridium difficile is the most frequently identified enteric pathogen in patients with nosocomial antibiotic-associated diarrhoea and pseudomembranous colitis. several clinically isolated c. difficile strains are resistant to antibiotics other than metronidazole and vancomycin. recently, bacteriocins of lactic acid bacteria have been proposed as an alternative or complementary treatment. the aim of this study was to investigate the inhibitory effect of nisin, a bacteriocin produced by several ... | 2016 | 26555543 |
| defining appropriate use of proton-pump inhibitors among medical inpatients. | proton-pump inhibitors (ppis) are commonly used among medical inpatients, both for prophylaxis against upper gastrointestinal bleeding (ugib) and continuation of outpatient use. while ppis reduce the risk of ugib, they also appear to increase the risk of hospital-acquired pneumonia (hap) and clostridium difficile infection (cdi). depending upon the underlying risks of these conditions and the changes in those risks with ppis, use of proton-pump inhibitors may lead to a net benefit or net harm am ... | 2016 | 26553337 |
| susceptibility of clostridium difficile isolates of varying antimicrobial resistance phenotypes to smt19969 and 11 comparators. | we determined the in vitro activity of smt19969 and 11 comparators, including metronidazole, vancomycin, and fidaxomicin, against 107 c. difficile isolates of different antimicrobial resistance phenotypes. fidaxomicin and smt19969 were the most active. the fidaxomicin and smt19969 geometric mean mics were highest in ribotypes known to show multiple resistance. coresistance to linezolid and moxifloxacin was evident in ribotypes 001, 017, 027, and 356. the high-level ceftriaxone resistance in ribo ... | 2015 | 26552981 |
| cost analysis of hospitalized clostridium difficile-associated diarrhea (cdad). | clostridium difficile-associated diarrhea (cdad) causes heavy financial burden on healthcare systems worldwide. as with all hospital-acquired infections, prolonged hospital stays are the main cost driver. previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. to date, a survey of actual cost has not yet been conducted. | 2015 | 26550553 |
| a whole new ball game: stem cell-derived epithelia in the study of host-microbe interactions. | recent advances in developmental and stem cell biology have resulted in techniques that enable the generation and maintenance of complex epithelium in vitro. while these models have been utilized to study host development and disease, a renewed appreciation of host-microbe interactions has sparked interest in employing these new techniques to study microbes at the epithelial interface. here we review the current advances in host-microbe interactions that have resulted from experiments using thes ... | 2016 | 26549696 |
| clostridium difficile infection and intestinal microbiota interactions. | clostridium difficile remains the leading cause of healthcare-associated diarrhoea and outbreaks continue to occur worldwide. aside from nosocomial c. difficile infection, the bacterium is also increasingly important as a community pathogen. furthermore, asymptomatic carriage of c. difficile in neonates, adults and animals is also well recognised. the investigation of the gut's microbial communities, in both healthy subjects and patients suffering c. difficile infection (cdi), provides findings ... | 2015 | 26549493 |
| [utility of a simultaneous detection kit for glutamate dehydrogenase and toxin a/b with toxigenic culture in the diagnosis and treatment of clostridium difficile infection]. | we examined how doctors evaluate the results of c. diff quik chek complete (complete) in the diagnosis and treatment of clostridium difficile infection (cdi). a total of 887 stool samples submitted from 2012 to 2013 were examined with complete. requested specimens among samples with discrepant results were inoculated onto ccma plates and incubated under anaerobic conditions for 48 h, then retested by complete if positive culture results were obtained. of the 887 specimens, 198 (22.3%) were gluta ... | 2015 | 26548233 |
| evaluation of a clostridium difficile infection management policy with clinical pharmacy and medical microbiology involvement at a major canadian teaching hospital. | clostridium difficile infection (cdi) represents a spectrum of disease and is a significant concern for healthcare institutions. our study objective was to assess whether implementation of a regional cdi management policy with clinical pharmacy and medical microbiology and infection control involvement would lead to an improvement in concordance in prescribing practices to an evidence-based cdi disease severity assessment and pharmacological treatment algorithm. | 2015 | 26547905 |
| small molecules take a big step against clostridium difficile. | effective treatment of clostridium difficile infections demands a shift away from antibiotics towards toxin-neutralizing agents. work by bender et al., using a drug that attenuates toxin action in vivo without affecting bacterial survival, demonstrates the exciting potential of small molecules as a new modality in the fight against c. difficile. | 2015 | 26547239 |
| inactivation of clostridium difficile spores by microwave irradiation. | spores are a potent agent for clostridium difficile transmission. therefore, factors inhibiting spores have been of continued interest. in the present study, we investigated the influence of microwave irradiation in addition to conductive heating for c. difficile spore inactivation in aqueous suspension. the spores of 15 c. difficile isolates from different host origins were exposed to conductive heating and microwave irradiation. the complete inhibition of spore viability at 10(7) cfu/ml was en ... | 2016 | 26546732 |
| antibiotic prophylaxis and risk of clostridium difficile infection after coronary artery bypass graft surgery. | antibiotic use, particularly type and duration, is a crucial modifiable risk factor for clostridium difficile. cardiac surgery is of particular interest because prophylactic antibiotics are recommended for 48 hours or less (vs ≤24 hours for noncardiac surgery), with increasing vancomycin use. we aimed to study associations between antibiotic prophylaxis (duration/vancomycin use) and c difficile among patients undergoing coronary artery bypass grafting. | 2016 | 26545971 |
| investigation of clostridium difficile interspecies relatedness using multilocus sequence typing, multilocus variable-number tandem-repeat analysis and antimicrobial susceptibility testing. | multilocus sequence typing (mlst), multilocus variable-number tandem-repeat analysis (mlva) and antimicrobial susceptibility were performed on 37 animal and human c. difficile isolates belonging to 15 different pcr-ribotypes in order to investigate the relatedness of human and animal isolates and to identify possible transmission routes. mlva identified a total of 21 different types while mlst only distinguished 12 types. identical c. difficile strains were detected in the same animal species fo ... | 2015 | 26545846 |
| molecular characterization of nosocomial clostridium difficile infection in pediatric ward in iran. | clostridium difficile is recognized as a major cause of nosocomial acquired antibiotic-associated diarrhea and pseudomembranous colitis. it is a significant financial burden on modern healthcare resources. this study aimed to assess the molecular characterization of c. difficile strains isolated from children under 5 years old suffered from nosocomial diarrhea. one hundred diarrheic and 130 non-diarrheic fecal samples were collected from pediatrics less than 5 years old. samples were cultured an ... | 2015 | 26543762 |
| neomycin and bacitracin reduce the intestinal permeability in mice and increase the expression of some tight-junction proteins. | tight-junction (tj) proteins regulate paracellular permeability. gut permeability can be modulated by commensal microbiota. manipulation of the gut microbiota with antibiotics like bacitracin and neomycin turned out to be useful for the treatment of diarrhoea induced by clostridium difficile or chemotherapy drugs. | 2015 | 26541656 |
| multidisciplinary performance improvement team for reducing health care-associated clostridium difficile infection. | clostridium difficile is the most frequent cause of health care-associated diarrhea and is a significant cause of morbidity and mortality. it is also associated with a considerable financial burden. a concerted multidisciplinary approach is required for prevention. | 2016 | 26541068 |
| outcomes of clostridium difficile infection in pediatric solid organ transplant recipients. | the incidence of clostridium difficile infection (cdi) is increasing in the pediatric population. pediatric recipients of solid organ transplantation (sot) may be at a higher risk for cdi in part because of chemotherapy and prolonged hospitalization. | 2016 | 26538348 |
| bugs and guts: practical applications of probiotics for gastrointestinal disorders in children. | probiotics are foods or products that contain live microorganisms that benefit the host when administered. in this clinical review, we evaluate the literature associated with using probiotics in common pediatric gastrointestinal disorders, focusing specifically on antibiotic-associated diarrhea, acute gastroenteritis, clostridium difficile infection (cdi), colic, inflammatory bowel disease, and functional gastrointestinal diseases. meta-analysis of several randomized controlled trials have confi ... | 2015 | 26538058 |
| hospital-based clostridium difficile infection surveillance reveals high proportions of pcr ribotypes 027 and 176 in different areas of poland, 2011 to 2013. | as part of the european clostridium difficile infections (cdi) surveillance network (ecdis-net), which aims to build capacity for cdi surveillance in europe, we constructed a new network of hospital-based laboratories in poland. we performed a survey in 13 randomly selected hospital-laboratories in different sites of the country to determine their annual cdi incidence rates from 2011 to 2013. information on c. difficile laboratory diagnostic testing and indications for testing was also collected ... | 2015 | 26536049 |
| economic evaluation of fecal microbiota transplantation for the treatment of recurrent clostridium difficile infection in australia. | 2015 | 26533526 | |
| the cost of treating recurrent clostridium difficile infection in patients attending infectious disease clinics at four hospitals in sweden. | 2015 | 26533275 | |
| health-economic evaluation of clostridium difficile infection (cdi) and epidemiology in england and merseyside. | 2015 | 26533270 | |
| healthcare associated infections. impact and costs of diagnosis and management of clostridium difficile infections (cdi). the experience of a university hospital in rome. | 2015 | 26532060 | |
| administration of defined microbiota is protective in a murine salmonella infection model. | salmonella typhimurium is a major cause of diarrhea and causes significant morbidity and mortality worldwide, and perturbations of the gut microbiota are known to increase susceptibility to enteric infections. the purpose of this study was to investigate whether a microbial ecosystem therapeutic (met-1) consisting of 33 bacterial strains, isolated from human stool and previously used to cure patients with recurrent clostridium difficile infection, could also protect against s. typhimurium diseas ... | 2015 | 26531327 |
| diagnostic accuracy of loop-mediated isothermal amplification in detection of clostridium difficile in stool samples: a meta-analysis. | clostridium difficile infection (cdi) remains a diagnostic challenge for clinicians. more recently, loop-mediated isothermal amplification (lamp) has become readily available for the diagnosis of cdi, and many studies have investigated the usefulness of lamp for rapid and accurate diagnosis of cdi. however, the overall diagnostic accuracy of lamp for cdi remains unclear. in this meta-analysis, our aim was to establish the overall diagnostic accuracy of lamp in detection of clostridium difficile ... | 2015 | 26528332 |
| acute infectious and inflammatory enterocolitides. | infectious and inflammatory enterocolitides can present with an acute abdomen. the most common entities are ulcerative colitis, crohn disease, and clostridium difficile colitis. this article reviews the clinical and imaging findings of patients who present acutely with infectious and inflammatory enterocolitides. the acute abdomen can be defined as the sudden onset (generally <24 hours) of severe localized or generalized abdominal pain that prompts the patient to seek immediate medical assistanc ... | 2015 | 26526437 |
| fluoroquinolone and macrolide exposure predict clostridium difficile infection with the highly fluoroquinolone- and macrolide-resistant epidemic c. difficile strain bi/nap1/027. | antibiotics have been shown to influence the risk of infection with specific clostridium difficile strains as well as the risk of c. difficile infection (cdi). we performed a retrospective case-control study of patients infected with the epidemic bi/nap1/027 strain in a u.s. hospital following recognition of increased cdi severity and culture of stools positive by c. difficile toxin immunoassay. between 2005 and 2007, 72% (103/143) of patients with first-episode cdis were infected with the bi st ... | 2015 | 26525793 |
| clostridium difficile secreted pro-pro endopeptidase ppep-1 (zmp1/cd2830) modulates adhesion through cleavage of the collagen binding protein cd2831. | the clostridium difficile cd2830 gene product is a secreted metalloprotease, named pro-pro endopeptidase (ppep-1). ppep-1 cleaves c. difficile cell surface proteins (e.g. cd2831). here, we confirmed that ppep-1 has a unique preference for prolines surrounding the scissile bond. moreover, we show that it exhibits a high preference for an asparagine at the p2 position and hydrophobic residues at the p3 position. using a ppep-1 knockout c. difficile strain, we demonstrate that the removal of the co ... | 2015 | 26522134 |
| impact of clostridium difficile-associated diarrhea on acute care length of stay, hospital costs, and readmission: a multicenter retrospective study of inpatients, 2009-2011. | the recent epidemiologic changes of clostridium difficile-associated diarrhea (cdad) have resulted in substantial economic burden to u.s. acute care hospitals. past studies evaluating cdad-attributable costs have been geographically and demographically limited. here, we describe cdad-attributable burden in inpatients, overall, and in vulnerable subpopulations from the premier hospital database, a large, diverse cohort with a wide range of high-risk subgroups. | 2015 | 26521932 |
| an assessment of the aga and ccfa quality indicators in a sample of patients diagnosed with inflammatory bowel disease. | inflammatory bowel disease (ibd) is a chronic relapsing disease characterized by activation of the mucosal immune system and inflammation of the gastrointestinal tract. management of ibd places a significant burden on the health care system because of the complexity of treatment, variability in patient outcomes, and chronic nature of the disease. | 2015 | 26521118 |
| analysis of norovirus outbreaks reveals the need for timely and extended microbiological testing. | norovirus outbreaks in hospitals remain a substantial threat despite many recommendations for prevention published recently. | 2015 | 26520593 |
| the analysis of the occurrence of nosocomial infections in the neurosurgical ward in the district hospital from 2003-2012. | the patients in the neurosurgical ward are exposed to many risk factors causing nosocomial infections. these factors are related to operations, invasive diagnosing and monitoring of the nervous system and mechanical support of vital functions. therefore, the objective of the undertaken studies was to assess the prevalence and structure of the healthcare-associated infections (hai) in patients hospitalized in the neurosurgical ward in the st. lukas district hospital in tarnów. | 2015 | 26519848 |
| donor species richness determines faecal microbiota transplantation success in inflammatory bowel disease. | faecal microbiota transplantation is a successful therapy for patients with refractory clostridium difficile infections. it has also been suggested as a treatment option for inflammatory bowel disease, given the role of the intestinal microbiota in this disease. we assessed the impact of faecal microbiota transplantation in patients with inflammatory bowel disease and studied predictors of clinical (non-)response in microbial profiles of donors and patients. | 2016 | 26519463 |
| hiv-related opportunistic infections are still relevant in 2015. | the incidence of hiv-related opportunistic infections (ois) has declined in the united states with the increasing use of effective antiretroviral therapy for the treatment of hiv infection. however, the absolute number of patients with ois remains high and there continues to be considerable associated mortality. oi guidelines from the national institutes of health, centers for disease control and prevention, and infectious diseases society of america continue to be updated on a regular basis, se ... | 2015 | 26518395 |
| oral teicoplanin for successful treatment of severe refractory clostridium difficile infection. | clostridium difficile is the leading cause of hospital-acquired diarrhoea. there is no defined protocol for treating severe clostridium difficile infection (cdi) refractory to vancomycin or vancomycin and metronidazole combination therapy. the aim of this study was to evaluate the rate of clinical cure, time to resolution of diarrhoea and recurrence rate in patients with severe refractory cdi treated with oral teicoplanin. | 2015 | 26517480 |
| clinical and microbiologic assessment of cases of pediatric community-associated clostridium difficile infection reveals opportunities for improved testing decisions. | most children with clostridium difficile infection (cdi) experience community onset of cdi symptoms. | 2016 | 26517329 |
| single fluorophore melting curve analysis for detection of hypervirulent clostridium difficile. | this study demonstrates a novel detection assay able to identify and subtype strains of clostridium difficile. primers carefully designed for melting curve analysis amplify dna from three c. difficile genes, tcdb, tcdc and cdtb, during quantitative (q)pcr. the tcdb gene allows for confirmation of organism presence, whilst the tcdc and cdtb genes allow for differentiation of virulence status, as deletions in the tcdc gene and the concurrent presence of the cdtb gene, which produces binary toxin, ... | 2016 | 26516039 |
| natural history of elderly-onset ulcerative colitis: results from a territory-wide inflammatory bowel disease registry. | data on the natural history of elderly-onset ulcerative colitis [uc] are limited. we aimed to investigate clinical features and outcomes of patients with elderly-onset uc. | 2016 | 26512132 |
| differential outcome of an antimicrobial stewardship audit and feedback program in two intensive care units: a controlled interrupted time series study. | antimicrobial decision making in intensive care units (icus) is challenging. unnecessary antimicrobials contribute to the development of resistant pathogens, clostridium difficile infection and drug related adverse events. however, inadequate antimicrobial therapy is associated with mortality in critically ill patients. antimicrobial stewardship programs are increasingly being implemented to improve antimicrobial prescribing, but the optimal approach in the icu setting is unknown. we assessed th ... | 2015 | 26511839 |
| clinical utility of laboratory detection of clostridium difficile strain bi/nap1/027. | clostridium difficile strain bi/nap1/027 is associated with increased c. difficile infection (cdi) rates and severity, and the efficacy of some cdi therapies may be strain dependent. although cultured c. difficile isolates can be reliably subtyped by various methods, the long turnaround times, high cost, and limited availability of strain typing preclude their routine use. nucleic acid amplification tests identify bi/nap1/027 rapidly from stool, but the emergence of closely related strains compr ... | 2016 | 26511742 |
| an update on clostridium difficile toxinotyping. | toxinotyping is a pcr-restriction fragment length polymorphism (rflp)-based method for differentiation of clostridium difficile strains according to the changes in the pathogenicity locus (paloc), a region coding for toxins a and b. toxinotypes are a heterogenous group of strains that are important in the development of molecular diagnostic tests and vaccines and are a good basis for c. difficile phylogenetic studies. here we describe an overview of the 34 currently known toxinotypes (i to xxxiv ... | 2016 | 26511734 |
| obesity is independently associated with infection in hospitalised patients with end-stage liver disease. | infection is the most common cause of mortality in end-stage liver disease (esld). the impact of obesity on infection risk in esld is not established. | 2015 | 26510540 |
| association between outpatient antibiotic prescribing practices and community-associated clostridium difficile infection. | background. antibiotic use predisposes patients to clostridium difficile infections (cdi), and approximately 32% of these infections are community-associated (ca) cdi. the population-level impact of antibiotic use on adult ca-cdi rates is not well described. methods. we used 2011 active population- and laboratory-based surveillance data from 9 us geographic locations to identify adult ca-cdi cases, defined as c difficile-positive stool specimens (by toxin or molecular assay) collected from out ... | 2015 | 26509182 |
| defective mutations within the translocation domain of clostridium difficile toxin b impair disease pathogenesis. | the clostridium difficile toxin b is one of the main virulence factors and plays an important role in the pathogenesis of c. difficile infection (cdi). we recently revealed crucial residues in the translocation domain of tcdb for the pore formation and toxin translocation. in this study, we investigated the effects of mutating a critical site involved in pore formation, leu-1106, to residues that differ in size and polarity (phe, ala, cys, asp). we observed a broad range of effects on tcdb funct ... | 2016 | 26507679 |