Publications
| Title | Abstract | Year Filter | PMID(sorted descending) Filter |
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| variation in germination of clostridium difficile clinical isolates correlates to disease severity. | over the past two decades, clostridium difficile infections have been increasing in both number and severity throughout the world. as with other spore forming bacteria, germination is a vital step in the life cycle of this pathogen. studies have examined differences in sporulation and toxin production among a number of c. difficile clinical isolates; however, few have examined differences in germination and the relationship between this phenotype and disease severity. here, over 100 c. difficile ... | 2015 | 25681667 |
| automated tracking and ordering of precautions for multidrug-resistant organisms. | the transmission and infection risk associated with multidrug-resistant organism (mdro) carriers necessitates surveillance and tracking to provide proper contact precautions. as mdros increase in scope, automated electronic health record (ehr) systems may help with surveillance demands. | 2015 | 25681303 |
| development and validation of an internationally-standardized, high-resolution capillary gel-based electrophoresis pcr-ribotyping protocol for clostridium difficile. | pcr-ribotyping has been adopted in many laboratories as the method of choice for c. difficile typing and surveillance. however, issues with the conventional agarose gel-based technique, including inter-laboratory variation and interpretation of banding patterns have impeded progress. the method has recently been adapted to incorporate high-resolution capillary gel-based electrophoresis (ce-ribotyping), so improving discrimination, accuracy and reproducibility. however, reports to date have all r ... | 2015 | 25679978 |
| [clostridium difficile spores and its relevance in the persistence and transmission of the infection]. | c. difficile is an anaerobic spore former pathogen and the most important etiologic agent of nosocomial and community acquired antibiotics associated diarrheas. c. difficile infections (cdi) are responsible for an elevated rate of morbidity in developed and developing countries. although the major virulence factors responsible for clinical symptoms of cdi are the two toxins tcda and tcdb, c. difficile spores are the main vehicle of infection, persistence and transmission of cdi. recent work has ... | 2014 | 25679927 |
| [performance of prognostic index in severe clostridium difficile-associated infection: retrospective analysis in a university hospital]. | by consensus severe, clostridium difficile-associated infection (cdai) is one that results in hospitalization in icu, colectomy or death within 30 days. multiple prognostic indices (ip) attempt to predict these adverse events. | 2014 | 25679920 |
| preface: clostridium difficile infection. | 2015 | 25677709 | |
| the prospect for vaccines to prevent clostridium difficile infection. | clostridium difficile is a spore-forming anaerobic gram-positive organism that is the leading cause of antibiotic-associated nosocomial infectious diarrhea in the western world. this article describes the evolving epidemiology of c difficile infection (cdi) in the twenty-first century, evaluates the importance of vaccines against the disease, and defines the roles of both innate and adaptive host immune responses in cdi. the effects of passive immunotherapy and active vaccination against cdi in ... | 2015 | 25677708 |
| the potential of probiotics to prevent clostridium difficile infection. | exposure to antibiotics is the major risk factor for clostridium difficile diarrhea (cdd), suggesting that impairment of colonization resistance due to depletion of the gut flora is a significant underlying disease susceptibility factor. many properties of probiotic organisms indicate that they may be able to replenish the depleted gut flora and restore colonization resistance. however, despite numerous clinical trials, the evidence base for probiotics in the prevention of cdd remains weak. a re ... | 2015 | 25677707 |
| the morbidity, mortality, and costs associated with clostridium difficile infection. | clostridium difficile infection (cdi) is the most common cause of infectious health care-associated diarrhea and is a major burden to patients and the health care system. the incidence and severity of cdi remain at historically high levels. this article reviews the morbidity, mortality, and costs associated with cdi. | 2015 | 25677706 |
| fecal microbiota transplantation for the management of clostridium difficile infection. | this article discusses the use of fecal microbiota transplantation (fmt) for the treatment of recurrent clostridium difficile infection (cdi). the disruption of the normal gut microbiota is central to the pathogenesis of cdi, and disruption persists in recurrent disease. the use of fmt for recurrent cdi is characterized by a high response rate and short term safety is excellent, although the long-term effects of fmt are as yet unknown. | 2015 | 25677705 |
| is the prevalence of antibiotic-resistant organisms changing in canadian hospitals? comparison of point-prevalence survey results in 2010 and 2012. | a national point-prevalence survey for infection or colonization with methicillin-resistant staphylococcus aureus (mrsa) and vancomycin-resistant enterococcus (vre), and for clostridium difficile infection (cdi) was done in canadian hospitals in 2010. a follow-up survey was done in november 2012 to determine whether there were any changes in the prevalence of these organisms; we also determined the prevalence of extended-spectrum β-lactamase (esbl)-producing enterobacteriaceae, and carbapenem-re ... | 2015 | 25677630 |
| faecal microbiota transplantation for clostridium difficile infection in the united kingdom. | faecal microbiota transplantation (fmt) has been shown to be highly effective in treating recurrent clostridium difficile infection, but to date there have been no data from the united kingdom. an electronic survey was developed at portsmouth hospitals' national health service (nhs) trust and sent out to uk hospital specialists utilizing the contact databases of the british infection association and the royal college of gastroenterologists. a total of 162 responses were received, representing ne ... | 2015 | 25677629 |
| potential role of post-transplant hypogammaglobulinemia in the risk of clostridium difficile infection after kidney transplantation: a case-control study. | to identify reversible risk factors for clostridium difficile infection (cdi) after kidney transplantation (kt) that could lead to a reduction in its incidence and associated complications. | 2015 | 25676130 |
| clonalframeml: efficient inference of recombination in whole bacterial genomes. | recombination is an important evolutionary force in bacteria, but it remains challenging to reconstruct the imports that occurred in the ancestry of a genomic sample. here we present clonalframeml, which uses maximum likelihood inference to simultaneously detect recombination in bacterial genomes and account for it in phylogenetic reconstruction. clonalframeml can analyse hundreds of genomes in a matter of hours, and we demonstrate its usefulness on simulated and real datasets. we find evidence ... | 2015 | 25675341 |
| clostridium difficile pcr ribotype 027 emerges in taiwan. | clostridium difficile pcr ribotype 027 is a hypervirulent strain that has caused significant nosocomial diarrhea in many countries but has not yet been reported or isolated in taiwan previously. here, we present the characteristics of a case of c. difficile pcr ribotype 027 identified in taiwan. taiwan is located in a key transportation center of asia. this report is important for alerting hospitals and public health departments in asia about the emergence of this hypervirulent strain so that cl ... | 2015 | 25672348 |
| immune-based treatment and prevention of clostridium difficile infection. | clostridium difficile (c. difficile) causes over 500,000 infections per year in the us, with an estimated 15,000 deaths and an estimated cost of $1-3 billion. moreover, a continual rise in the incidence of severe c. difficile infection (cdi) has been observed worldwide. currently, standard treatment for cdi is the administration of antibiotics. while effective, these treatments do not prevent and may contribute to a disease recurrence rate of 15-35%. prevention of recurrence is one of the most c ... | 2014 | 25668664 |
| clostridium difficile infections in hiv-positive patients with diarrhoea. | patients with hiv/aids are at a high risk of being infected with toxin-producing strains of clostridium difficile (c. difficile) because of frequent hospitalization, exposure to antibiotics and antibiotic prophylaxis for opportunistic infections. there are little data from india on the prevalence of c. difficile infection in such patients. | 2015 | 25668083 |
| neuronal apoptosis induced by selective inhibition of rac gtpase versus global suppression of rho family gtpases is mediated by alterations in distinct mitogen-activated protein kinase signaling cascades. | rho family gtpases play integral roles in neuronal differentiation and survival. we have shown previously that clostridium difficile toxin b (toxb), an inhibitor of rhoa, rac1, and cdc42, induces apoptosis of cerebellar granule neurons (cgns). in this study, we compared the effects of toxb to a selective inhibitor of the rac-specific guanine nucleotide exchange factors tiam1 and trio (nsc23766). in a manner similar to toxb, selective inhibition of rac induces cgn apoptosis associated with enhanc ... | 2015 | 25666619 |
| the detection rate of enteric viruses and clostridium difficile in a waste water treatment plant effluent. | waste water treatment plant (wwtp) is considered as an important source of surface water contamination by enteric pathogens. in this study, we describe the occurrence of enteric viruses (group a rotaviruses, noroviruses, astroviruses, sapoviruses, hepatitis a virus, and hepatitis e virus) and clostridium difficile in the effluent of a wastewater treatment plant during a 1-year period. enteric viruses were simultaneously and efficiently concentrated in a single step using methacrylate monolithic ... | 2015 | 25663146 |
| is obesity a risk factor for clostridium difficile infection? | the epidemiology of clostridium difficile infection (cdi) has become an important area of investigation, especially in light of the global increase in both hospital-acquired (ha) and community-acquired (ca) cdi. recently, obesity was found to be associated with cdi and was suggested to represent an independent risk factor for it. | 2015 | 25660175 |
| the role of flagella in clostridium difficile pathogenicity. | clostridium difficile is widely publicised as a problem in the health-care system. disruption of the normal gut microbiota by antibiotic therapy allows c. difficile to colonise the colon. on colonisation, c. difficile produces two toxins that lead to disease, with symptoms ranging from mild-to-severe diarrhoea, to fulminant and often fatal pseudomembranous colitis (pmc). how c. difficile establishes initial colonisation of the host is an area of active investigation. recently there has been incr ... | 2015 | 25659185 |
| pulsed faecal microbiota transplantation for recalcitrant recurrent clostridium difficile infection. | 2015 | 25658573 | |
| recurrent clostridium difficile infection is associated with increased mortality. | clostridium difficile infections (cdi) are associated with decreased survival, and up to 30% of cdi patients may experience a recurrence. data on the impact of recurrent cdi on mortality are scarce. the purpose of this study was to determine whether recurrent cdi was independently associated with decreased 6-month survival compared with patients with cdi who did not develop a recurrence. we performed a retrospective cohort study at an academic, urban, tertiary care hospital. data were collected ... | 2015 | 25658560 |
| predicting the risk of clostridium difficile infection following an outpatient visit: development and external validation of a pragmatic, prognostic risk score. | increasing morbidity related to clostridium difficile infection (cdi) has heightened interest in the identification of patients who would most benefit from recognition of risk and intervention. we sought to develop and validate a prognostic risk score to predict cdi risk for individual patients following an outpatient healthcare visit. we assembled a cohort of kaiser permanente northwest (kpnw) patients with an index outpatient visit between 2005 and 2008, and identified cdi in the year followin ... | 2015 | 25658533 |
| burdening questions about clostridium difficile in pediatric inflammatory bowel diseases. | 2015 | 25658059 | |
| a prediction model for clostridium difficile recurrence. | clostridium difficile infection (cdi) is a growing problem in the community and hospital setting. its incidence has been on the rise over the past two decades, and it is quickly becoming a major concern for the health care system. high rate of recurrence is one of the major hurdles in the successful treatment of c. difficile infection. there have been few studies that have looked at patterns of recurrence. the studies currently available have shown a number of risk factors associated with c. dif ... | 2015 | 25656667 |
| manganese superoxide dismutase from human pathogen clostridium difficile. | clostridium difficile is a human pathogen that causes severe antibiotic-associated clostridium difficile infection (cdi). herein the mnsodcd from c. difficile was cloned, expressed in escherichia coli,and characterized by x-ray crystallography, uv/vis and epr spectroscopy, and activity assay, et al. the crystal structure of mnsodcd (2.32 å) reveals a manganese coordination geometry of distorted trigonal bipyramidal, with his111, his197 and asp193 providing the equatorial ligands and with his56 a ... | 2015 | 25655385 |
| emergence of an outbreak-associated clostridium difficile variant with increased virulence. | the prevalence of clostridium difficile infections has increased due to the emergence of epidemic variants from diverse genetic lineages. here we describe the emergence of a novel variant during an outbreak in a costa rican hospital that was associated with severe clinical presentations. this c. difficile variant elicited higher white blood cell counts and caused disease in younger patients than did other strains isolated during the outbreak. furthermore, it had a recurrence rate, a 30-day attri ... | 2015 | 25653402 |
| in vitro susceptibility of clostridium difficile to smt19969 and comparators, as well as the killing kinetics and post-antibiotic effects of smt19969 and comparators against c. difficile. | smt19969 is a novel antimicrobial under clinical development for the treatment of clostridium difficile infection (cdi). the objective was to determine the comparative susceptibility of 82 c. difficile clinical isolates (which included ribotype 027 isolates and isolates with reduced metronidazole susceptibility) to smt19969, fidaxomicin, vancomycin and metronidazole and to determine the killing kinetics and post-antibiotic effects of smt19969, fidaxomicin and vancomycin against c. difficile. | 2015 | 25652750 |
| smt19969 for clostridium difficile infection (cdi): in vivo efficacy compared with fidaxomicin and vancomycin in the hamster model of cdi. | smt19969 is a novel narrow-spectrum antimicrobial under development for the treatment of clostridium difficile infection (cdi). the objectives were to assess the relative efficacies of smt19969, vancomycin and fidaxomicin in the hamster model of cdi. | 2015 | 25652749 |
| morphological and genetic characterization of group i clostridium botulinum type b strain 111 and the transcriptional regulator spoiiid gene knockout mutant in sporulation. | clostridium botulinum is a heat-resistant spore-forming bacterium that causes the serious paralytic illness botulism. heat-resistant spores may cause food sanitation hazards and sporulation plays a central role in the survival of c. botulinum. we observed morphological changes and investigated the role of the transcriptional regulator spoiiid in the sporulation of c. botulinum type b strain 111 in order to elucidate the molecular mechanism in c. botulinum. c. botulinum type b formed heat-resista ... | 2015 | 25652599 |
| environmental transmission of clostridium difficile: association between hospital room size and c. difficile infection. | to evaluate the association between hospital room square footage and acquisition of nosocomial clostridium difficile infection (cdi). | 2015 | 25652311 |
| manipulating the gut microbiota to maintain health and treat disease. | the intestinal microbiota composition varies between healthy and diseased individuals for numerous diseases. although any cause or effect relationship between the alterations in the gut microbiota and disease is not always clear, targeting the intestinal microbiota might offer new possibilities for prevention and/or treatment of disease. | 2015 | 25651995 |
| current status of the treatment of fulminant colitis. | fulminant colitis is not a well-defined entity, that constitutes a severe complication. it usually occurs in the course of úlcerative colitis and clostridium difficile colitis. a multidisciplinary management combining gastroenterologist and surgeons is crucial with intensive medical treatment and early surgery in non-responders. it is important to distinguish if we are facing a flare of ibd or, on the contrary, it is an infectious colitis, due to the fact that although general therapeutic measur ... | 2015 | 25649534 |
| clostridium difficile surface proteins are anchored to the cell wall using cwb2 motifs that recognise the anionic polymer psii. | gram-positive surface proteins can be covalently or non-covalently anchored to the cell wall and can impart important properties on the bacterium in respect of cell envelope organisation and interaction with the environment. we describe here a mechanism of protein anchoring involving tandem cwb2 motifs found in a large number of cell wall proteins in the firmicutes. in the clostridium difficile cell wall protein family, we show the three tandem repeats of the cwb2 motif are essential for correct ... | 2015 | 25649385 |
| prevalence and characterization of enterotoxigenic bacteroides fragilis and toxigenic clostridium difficile in a taipei emergency department. | enterotoxigenic bacteroides fragilis (etbf) and toxin-encoding clostridium difficile (txcd) are associated with gastroenteritis. routine anaerobic blood culture for recovery of these anaerobic pathogens is not used for the detection of their toxins, especially for toxin-variant txcd. the aim of this study was to investigate the prevalence and risk factors of the genotypes of these anaerobes in patients with acute diarrheal illnesses. | 2017 | 25648668 |
| high temporal resolution of glucosyltransferase dependent and independent effects of clostridium difficile toxins across multiple cell types. | clostridium difficile toxins a and b (tcda and tcdb), considered to be essential for c. difficile infection, affect the morphology of several cell types with different potencies and timing. however, morphological changes over various time scales are poorly characterized. the toxins' glucosyltransferase domains are critical to their deleterious effects, and cell responses to glucosyltransferase-independent activities are incompletely understood. by tracking morphological changes of multiple cell ... | 2015 | 25648517 |
| diverse mechanisms regulate sporulation sigma factor activity in the firmicutes. | sporulation allows bacteria to survive adverse conditions and is essential to the lifecycle of some obligate anaerobes. in bacillus subtilis, the sporulation-specific sigma factors, σ(f), σ(e), σ(g), and σ(k), activate compartment-specific transcriptional programs that drive sporulation through its morphological stages. the regulation of these sigma factors was predicted to be conserved across the firmicutes, since the regulatory proteins controlling their activation are largely conserved. howev ... | 2015 | 25646759 |
| acid-suppressing agents and risk for clostridium difficile infection in pediatric patients. | acid-suppressing agents have been associated with increased clostridium difficile infection (cdi) in adults. the objective of this study was to evaluate the association of acid-suppressing therapy with the development of cdi in the pediatric population. | 2015 | 25644650 |
| diagnosis and management of clostridium difficile infection. | there have been dramatic changes in the epidemiology of clostridium difficile infection (cdi), with increases in incidence and severity of disease, attributed to the emergence of a fluoroquinolone-resistant "hypervirulent" strain, ribotype 027. c. difficile is now the most common pathogen causing hospital-acquired infection in u.s. hospitals, and community-acquired infections are increasing. the diagnosis of cdi is based on a combination of signs and symptoms, confirmed by laboratory tests. clin ... | 2015 | 25643269 |
| prevalence and risk factors associated with clostridium difficile shedding in veal calves in italy. | the aim of this study is to describe the prevalence and risk factors of clostridium difficile shedding in six farms belonging to two companies in northern italy. four hundred and twenty veal calves, randomly selected and individually identified, were sampled three times: at 0-16, 90-120, and 150 days after introduction. c. difficile was isolated at least once from 87 out of the 420 calves (20.7%). the prevalence of shedding was 20.24% at the first sampling and dropped to 0.72% at the second samp ... | 2015 | 25638401 |
| role of obesity and adipose tissue-derived cytokine leptin during clostridium difficile infection. | obesity is among the most pressing health concerns in the world since it is increasingly common even in the developing world, and is clearly associated with increased risk for chronic debilitating diseases and death. furthermore, obesity can influence the pathogenesis of infectious diseases by affecting the balance of pathogen clearance and pathological inflammation. the mechanisms that result in enhanced inflammation in obese individuals are poorly understood. clostridium difficile is a major c ... | 2015 | 25638400 |
| how to eradicate clostridium difficile from the environment. | during the last decade, clostridium difficile has emerged as a major cause of healthcare-associated diarrhoea and death. transmission of this spore-forming bacterium is thought to occur via the hands of healthcare providers or via the contaminated environment. therefore, enhanced environmental cleaning/disinfection of the rooms housing c. difficile-infected patients is warranted. guidelines from various scientific bodies have been published. they recommend performing environmental decontaminatio ... | 2015 | 25638358 |
| [acute diarrhea after kidney or kidney-pancreas transplantation]. | diarrhea is a frequent and potentially severe complication of kidney transplantation. we describe here, in a cross-sectional study, the epidemiological and microbiological characteristics of acute and persistent diarrhea in 52 inpatients with kidney and kidney-pancreas transplant in a hospital in buenos aires, 42 (80.8%) of whom had received a kidney and 10 (19.2%) a kidney-pancreas transplant. diarrhea was the reason of admission of 34 cases (65.4%). the etiology could be studied in 50 patients ... | 2015 | 25637897 |
| comparing the economic and health benefits of different approaches to diagnosing clostridium difficile infection. | accurate diagnosis of clostridium difficile infection (cdi) is essential to effectively managing patients and preventing transmission. despite the availability of several diagnostic tests, the optimal strategy is debatable and their economic values are unknown. we modified our previously existing c. difficile simulation model to determine the economic value of different cdi diagnostic approaches from the hospital perspective. we evaluated four diagnostic methods for a patient suspected of having ... | 2015 | 25636938 |
| rectal bacteriotherapy for recurrent clostridium difficile-associated diarrhoea: results from a case series of 55 patients in denmark 2000-2012. | clostridium difficile infection is one of the most common nosocomial infections. among other alternatives to standard treatment with vancomycin for recurrent infection are faecal microbiota transplantation and rectal bacteriotherapy with a fixed mixture of intestinal bacterial strains isolated from faeces of healthy persons to mimic a theoretical normal microflora. developed by dr. tvede and dr. rask-madsen, the latter method has been in use for selected patients during the last 25 years in denm ... | 2015 | 25636927 |
| bloodstream infections among carriers of carbapenem-resistant klebsiella pneumoniae: etiology, incidence and predictors. | carriers of carbapenem-resistant klebsiella pneumoniae (crkp) are increasingly recognised through active surveillance in much of the world. we studied incidence, aetiology and predictors of bloodstream infections (bsi) among such carriers. via a retrospective cohort study conducted in a tertiary care teaching hospital, we examined occurrence of bsi within 45 days of crkp carrier detection. three nested case-control studies were conducted to analyse parameters associated with all-cause (all), gra ... | 2015 | 25636924 |
| complete genome sequence of the clostridium difficile laboratory strain 630δerm reveals differences from strain 630, including translocation of the mobile element ctn5. | clostridium difficile strain 630δerm is a spontaneous erythromycin sensitive derivative of the reference strain 630 obtained by serial passaging in antibiotic-free media. it is widely used as a defined and tractable c. difficile strain. though largely similar to the ancestral strain, it demonstrates phenotypic differences that might be the result of underlying genetic changes. here, we performed a de novo assembly based on single-molecule real-time sequencing and an analysis of major methylation ... | 2015 | 25636331 |
| gut check: clostridium difficile testing and treatment in the molecular testing era. | we evaluated the impact of nursing education and stewardship interventions on clostridium difficile testing and treatment appropriateness. diarrhea documentation increased for those with positive tests (45% to 70%); pretreatment laxative use decreased (50% to 19%). appropriate treatment increased for severe infection (57% to 93%), but all asymptomatically colonized patients were treated. | 2015 | 25633006 |
| evaluation of a pulsed xenon ultraviolet disinfection system for reduction of healthcare-associated pathogens in hospital rooms. | objective to determine the effectiveness of a pulsed xenon ultraviolet (px-uv) disinfection device for reduction in recovery of healthcare-associated pathogens. setting two acute-care hospitals. methods we examined the effectiveness of px-uv for killing of clostridium difficile spores, methicillin-resistant staphylococcus aureus (mrsa), and vancomycin-resistant enterococcus (vre) on glass carriers and evaluated the impact of pathogen concentration, distance from the device, organic load, and sha ... | 2015 | 25633002 |
| comorbidities, exposure to medications, and the risk of community-acquired clostridium difficile infection: a systematic review and meta-analysis. | clostridium difficile infection (cdi) has been extensively described in healthcare settings; however, risk factors associated with community-acquired (ca) cdi remain uncertain. this study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with ca-cdi. | 2015 | 25632995 |
| a comparison between national healthcare safety network laboratory-identified event reporting versus traditional surveillance for clostridium difficile infection. | objective hospitals in the national healthcare safety network began reporting laboratory-identified (labid) clostridium difficile infection (cdi) events in january 2013. our study quantified the differences between the labid and traditional surveillance methods. design cohort study. setting a cohort of 29 community hospitals in the southeastern united states. methods a period of 6 months (january 1, 2013, to june 30, 2013) of prospectively collected data using both labid and traditional surveill ... | 2015 | 25632994 |
| evaluation of portability and cost of a fluorescent pcr ribotyping protocol for clostridium difficile epidemiology. | clostridium difficile is the most commonly identified pathogen among health care-associated infections in the united states. there is a need for accurate and low-cost typing tools that produce comparable data across studies (i.e., portable data) to help characterize isolates during epidemiologic investigations of c. difficile outbreaks and sporadic cases of disease. the most popular c. difficile-typing technique is pcr ribotyping, and we previously developed methods using fluorescent pcr primers ... | 2015 | 25631804 |
| surveillance snapshot of clostridium difficile infection in hospitals across queensland detects binary toxin producing ribotype uk 244. | in north america and europe, the binary toxin positive clostridium difficile strains of the ribotypes 027 and 078 have been associated with death, toxic megacolon and other adverse outcomes. following an increase in c. difficile infections (cdis) in queensland, a prevalence study involving 175 hospitals was undertaken in early 2012, identifying 168 cases of cdi over a 2 month period. patient demographics and clinical characteristics were recorded, and c. difficile isolates were ribotyped and tes ... | 2014 | 25631588 |
| antibiotic therapy for acute uncomplicated pyelonephritis in women. take resistance into account. | acute uncomplicated pyelonephritis is a bacterial infection of the renal parenchyma, common in women. the bacterium responsible is usually escherichia coli. empirical antibiotic therapy should be initiated promptly to prevent serious complications. as of 2014, which empirical antibiotic regimen should be offered to non-pregnant adult women with acute uncomplicated pyelonephritis, while awaiting the results of antimicrobial susceptibility testing? we reviewed the available evidence using the stan ... | 2014 | 25629148 |
| low colonization rates of clostridium difficile among patients and healthcare workers at örebro university hospital in sweden. | the aim of this study was to investigate the rate of asymptomatic colonization rate of clostridium difficile among both healthcare workers (hcws) and patients in a hospital ward in sweden. in a prospective observational study, asymptomatic hcws (n = 22) (22/60; 37%) attending patients in an infectious disease ward in sweden participated and were screened once for c. difficile. at the same time, 58 consecutive patients (58/227; 26%) admitted to the same ward were screened for c. difficile, first ... | 2015 | 25627981 |
| low incidence of clostridium difficile infection (cdi) in patients treated with outpatient parenteral antimicrobial therapy (opat). | 2015 | 25627769 | |
| postoperative burden of hospital-acquired clostridium difficile infection. | objective clostridium difficile infection (cdi) is a common hospital-acquired infection. previous reports on the incidence, risk factors, and impact of cdi on resources in the surgical population are limited. in this context, we study cdi across diverse surgical settings. methods we prospectively identified patients with laboratory-confirmed postoperative cdi after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between july 2012 and september 2013 ... | 2015 | 25627760 |
| clostridium difficile the hospital plague. | clostridium difficile infection (cdi) has become one of the major public health threats in the last two decades. an increase has been observed not only in the rate of cdi, but also in its severity and mortality. symptoms caused by this pathogen are accompanied by intense local and systemic inflammation. we confirmed that raman microspectroscopy can help us in understanding cdi pathogenesis. a single erythrocyte of patients with cdi shows a difference, approximately 10 times, in the intensity of ... | 2015 | 25627751 |
| non-inferiority of pulsed xenon uv light versus bleach for reducing environmental clostridium difficile contamination on high-touch surfaces in clostridium difficile infection isolation rooms. | the standard for clostridium difficile surface decontamination is bleach solution at a concentration of 10 % of sodium hypochlorite. pulsed xenon uv light (px-uv) is a means of quickly producing germicidal uv that has been shown to be effective in reducing environmental contamination by c. difficile spores. the purpose of this study was to investigate whether px-uv was equivalent to bleach for decontamination of surfaces in c. difficile infection isolation rooms. high-touch surfaces in rooms pre ... | 2015 | 25627208 |
| acute gastroenteritis due to co-infection by salmonella and clostridium difficile. | 2015 | 25626957 | |
| inflammasome activation contributes to interleukin-23 production in response to clostridium difficile. | clostridium difficile is the most common hospital-acquired pathogen, causing antibiotic-associated diarrhea in over 250,000 patients annually in the united states. disease is primarily mediated by toxins a and b, which induce potent proinflammatory signaling in host cells and can activate an asc-containing inflammasome. recent findings suggest that the intensity of the host response to infection correlates with disease severity. our lab has identified the proinflammatory cytokine interleukin-23 ... | 2015 | 25626905 |
| risk factors for recurrent clostridium difficile infection: a systematic review and meta-analysis. | an estimated 20-30% of patients with primary clostridium difficile infection (cdi) develop recurrent cdi (rcdi) within 2 weeks of completion of therapy. while the actual mechanism of recurrence remains unknown, a variety of risk factors have been suggested and studied. the aim of this systematic review and meta-analysis was to evaluate current evidence on the risk factors for rcdi. | 2015 | 25626326 |
| diagnosis and treatment of clostridium difficile in adults: a systematic review. | since 2000, the incidence and severity of clostridium difficile infection (cdi) have increased. | 2015 | 25626036 |
| tigecycline exhibits inhibitory activity against clostridium difficile in the intestinal tract of hospitalised patients. | no new acquisition of clostridium difficile occurred among 12 hospitalised patients receiving tigecycline, and pre-existing colonisation was reduced to undetectable levels in 2 patients. moreover, 91% of stool suspensions obtained during tigecycline therapy exhibited inhibitory activity against c. difficile. these results suggest that tigecycline achieves sufficient concentrations to inhibit intestinal colonisation by c. difficile. | 2015 | 25623897 |
| meropenem versus piperacillin-tazobactam for definitive treatment of bloodstream infections due to ceftriaxone non-susceptible escherichia coli and klebsiella spp (the merino trial): study protocol for a randomised controlled trial. | gram-negative bacteria such as escherichia coli or klebsiella spp. frequently cause bloodstream infections. there has been a worldwide increase in resistance in these species to antibiotics such as third generation cephalosporins, largely driven by the acquisition of extended-spectrum beta-lactamase or plasmid-mediated ampc enzymes. carbapenems have been considered the most effective therapy for serious infections caused by such resistant bacteria; however, increased use creates selection pressu ... | 2015 | 25623485 |
| prolonged clostridium difficile infection may be associated with vitamin d deficiency. | clostridium difficile infection (cdi) is one of the leading causes of hospital-acquired infections, creating a financial burden for the u.s. healthcare system. reports suggest that vitamin d-deficient cdi patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. the objective here was to evaluate the relationship between vitamin d level and cdi recurrence. | 2016 | 25623479 |
| faecal microbiota transplantation in clostridium difficile infections. | 2015 | 25623242 | |
| risk of clostridium difficile infection in intensive care unit patients with sepsis exposed to metronidazole. | antimicrobial agents used to treat clostridium difficile infection (cdi), such as metronidazole and vancomycin, have been used during antibiotic treatment of other infections to try to prevent the development of cdi. we evaluated the hypothesis that intensive care unit (icu) patients who receive metronidazole as part of an antibiotic treatment regimen for sepsis have a lower risk of subsequently developing cdi. | 2015 | 25622943 |
| novel multiplex format of an extended multilocus variable-number-tandem-repeat analysis of clostridium difficile correlates with tandem repeat sequence typing. | subtyping of clostridium difficile is crucial for outbreak investigations. an extended multilocus variable-number tandem-repeat analysis (emlva) of 14 variable number tandem repeat (vntr) loci was validated in multiplex format compatible with a routine typing laboratory and showed excellent concordance with tandem repeat sequence typing (trst) and high discriminatory power. | 2015 | 25620018 |
| small molecule inhibitors of clostridium difficile toxin b-induced cellular damage. | clostridium difficile causes life-threatening diarrhea through the actions of its homologous toxins tcda and tcdb on human colonocytes. therapeutic agents that block toxin-induced damage are urgently needed to prevent the harmful consequences of toxin action that are not addressed with current antibiotic-based treatments. here, we developed an imaging-based phenotypic screen to identify small molecules that protected human cells from tcdb-induced cell rounding. a series of structurally diverse c ... | 2015 | 25619932 |
| in vivo bacterial imaging without engineering; a novel probe-based strategy facilitated by endogenous nitroreductase enzymes. | the feasibility of utilising bacteria as vectors for gene therapy is becoming increasingly recognised. this is primarily due to a number of intrinsic properties of bacteria such as their tumour targeting capabilities, their ability to carry large genetic or protein loads and the availability of well-established genetic engineering tools for a range of common lab strains. however, a number of issues relating to the use of bacteria as vectors for gene therapy need to be addressed in order for the ... | 2015 | 25619884 |
| adverse drug reactions in special populations - the elderly. | the international conference on harmonization considers older people a 'special population', as they differ from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics and greater vulnerability to adverse drug reactions (adrs). medical practice is often based on single disease guidelines derived from clinical trials that have not included frail older people or those with multiple morbidities. this presents a challenge caring for older people, as drug doses in trials may not be ac ... | 2015 | 25619317 |
| use of tigecycline in elderly patients for clostridium difficile infection. | 2015 | 25619268 | |
| comparison of antibiotic prophylaxis with cotrimoxazole/colistin (cot/col) versus ciprofloxacin (cip) in patients with acute myeloid leukemia. | recent meta-analyses showed that antibiotic prophylaxis in patients with neutropenia after chemotherapy reduced the incidence of fever and mortality rate. fluoroquinolones appear to be most effective and well tolerated. thus, in april 2008, we changed our antibiotic prophylaxis regimen from cotrimoxazole/colistin (cot/col) to the fluoroquinolone ciprofloxacin (cip) in patients with acute myeloid leukemia (aml). the aim of this retrospective study was to compare efficacy and development of bacter ... | 2015 | 25617073 |
| comparison of bd max cdiff and genomera c. difficile molecular assays for detection of toxigenic clostridium difficile from stools in conventional sample containers and in fecalswabs. | in this study, the usability and performance of genomera™ c. difficile and bd max™ cdiff nucleic acid amplification tests (naats) for the detection of toxigenic clostridium difficile were investigated in comparison with toxigenic culture and c. difficile toxin a- and toxin b-detecting immunochromatographic antigen (ia) test, the tox a/b quikchek®. in total, 302 faecal specimens were collected, 113 of which were in parallel to conventional sample containers and fecalswab liquid-based microbiology ... | 2015 | 25616552 |
| exposure of neutralizing epitopes in the carboxyl-terminal domain of tcdb is altered by a proximal hypervariable region. | the sequence, activity, and antigenicity of tcdb varies between different strains of clostridium difficile. as a result, ribotype-specific forms of tcdb exhibit different toxicities and are not strongly cross-neutralized. using a combination of biochemical and immunological approaches, we compared two important variants of tcdb (tcdb012 and tcdb027) to identify the mechanisms through which sequence differences alter epitopes and activity of the toxin. these analyses led to the discovery of a cri ... | 2015 | 25614625 |
| luminal toxin-binding agents for clostridium difficile infection. | to systematically search the literature for trials evaluating luminal toxin-binding agents (ltbas) for clostridium difficile infection (cdi). | 2016 | 25613056 |
| the preventive antibiotics in stroke study (pass): a pragmatic randomised open-label masked endpoint clinical trial. | in adults with acute stroke, infections occur commonly and are associated with an unfavourable functional outcome. in the preventive antibiotics in stroke study (pass) we aimed to establish whether or not preventive antimicrobial therapy with a third-generation cephalosporin, ceftriaxone, improves functional outcome in patients with acute stroke. | 2015 | 25612858 |
| clostridium difficile ileitis in pediatric inflammatory bowel disease: a case report and literature review. | 2015 | 25611030 | |
| supervised self-administration of outpatient parenteral antibiotic therapy: a report from a large tertiary hospital in australia. | outpatient parenteral antibiotic therapy (opat) has become established as a standard of care in most australian hospitals to treat a variety of infections. since 1998, the alternate site infusion service (asis) has provided an opat service to five hospitals in southern brisbane, queensland, using predominantly a patient or carer administration model (self-administered, s-opat). the aim of this study was to evaluate outcomes of our s-opat programme. | 2015 | 25603999 |
| risk factors for clostridium difficile diarrhea in patients with inflammatory bowel disease. | despite the growing incidence of clostridium difficile diarrhea (ccd) in patients with inflammatory bowel disease (ibd), little is known about the associated risk factors. | 2015 | 25603325 |
| clostridium difficile infection in inflammatory bowel disease. | 2015 | 25603324 | |
| chlorhexidine bathing and health care-associated infections: a randomized clinical trial. | daily bathing of critically ill patients with the broad-spectrum, topical antimicrobial agent chlorhexidine is widely performed and may reduce health care-associated infections. | 2015 | 25602496 |
| targeted localized use of therapeutic antibodies: a review of non-systemic, topical and oral applications. | therapeutic antibodies provide important tools in the "medicine chest" of today's clinician for the treatment of a range of disorders. typically monoclonal or polyclonal antibodies are administered in large doses, either directly or indirectly into the circulation, via a systemic route which is well suited for disseminated ailments. diseases confined within a specific localized tissue, however, may be treated more effectively and at reduced cost by a delivery system which targets directly the af ... | 2016 | 25600465 |
| how well does physician selection of microbiologic tests identify clostridium difficile and other pathogens in paediatric diarrhoea? insights using multiplex pcr-based detection. | the objective of this study was to compare the aetiologic yield of standard-of-care microbiologic testing ordered by physicians with that of a multiplex pcr platform. stool specimens obtained from children and young adults with gastrointestinal illness were evaluated by standard laboratory methods and a developmental version of the filmarray gastrointestinal (gi) diagnostic system (filmarray gi panel), a rapid multiplex pcr platform that detects 23 bacterial, viral and protozoal agents. results ... | 2014 | 25599941 |
| the role of bifidobacterium lactis b94 plus inulin in the treatment of acute infectious diarrhea in children. | in contrast to many other studies of probiotic species, the number of publications evaluating bifidobacterium lactis and its combinations with prebiotics as treatments for acute infectious diarrhea is limited. we investigated the synbiotic effects of b. lactis b94 plus inulin on acute infectious diarrhea. | 2014 | 25599772 |
| clostridium difficile infection and inflammatory bowel disease. | over the past 15 years, clostridium difficile infection (cdi) in patients with inflammatory bowel disease (ibd) has increased both in incidence and severity. traditional risk factors for cdi are similar in ibd and non-ibd populations, but there is a significant proportion of ibd patients which have distinctive characteristics. patients with ulcerative colitis (uc) are more susceptible to cdi and have more severe outcomes than those with crohn's disease (cd). cdi may be difficult to distinguish f ... | 2014 | 25599768 |
| structural and evolutionary analyses show unique stabilization strategies in the type iv pili of clostridium difficile. | type iv pili are produced by many pathogenic gram-negative bacteria and are important for processes as diverse as twitching motility, biofilm formation, cellular adhesion, and horizontal gene transfer. however, many gram-positive species, including clostridium difficile, also produce type iv pili. here, we identify the major subunit of the type iv pili of c. difficile, pila1, and describe multiple 3d structures of pila1, demonstrating the diversity found in three strains of c. difficile. we also ... | 2015 | 25599642 |
| a possible route for foodborne transmission of clostridium difficile? | spores of toxigenic clostridium difficile and spores of food-poisoning strains of clostridium perfringens show a similar prevalence in meats. spores of both species are heat resistant and can survive cooking of foods. c. perfringens is a major cause of foodborne illness; studies are needed to determine whether c. difficile transmission by a similar route is a cause of infection. | 2015 | 25599421 |
| fecal microbiota transplantation for clostridium difficile infection: the ochsner experience. | clostridium difficile infection (cdi) accounts for 20%-30% of cases of antibiotic-associated diarrhea and is the most commonly recognized cause of infectious diarrhea in healthcare settings. the incidence of cdi is rising, while the effectiveness of antibiotics for treatment decreases with recurrent episodes. the use of fecal microbiota transplantation (fmt) for cure of cdi has been reported since 1958, and the worldwide cure rate is reported to be 93%. we report our experience with fmt for the ... | 2014 | 25598718 |
| emergence of toxin a-negative, toxin b-positive clostridium difficile strains: epidemiological and clinical considerations. | 2015 | 25598331 | |
| selection of nanobodies that block the enzymatic and cytotoxic activities of the binary clostridium difficile toxin cdt. | the spore-forming gut bacterium clostridium difficile is the leading cause of antibiotic-associated diarrhea in hospitalized patients. the major virulence factors are two large glucosylating cytotoxins. hypervirulent strains (e.g. ribotype 027) with higher morbidity and mortality additionally produce the binary cdt toxin (clostridium difficile transferase) that adp-ribosylates actin and induces microtubule-based cell protrusions. nanobodies are robust single domain antibodies derived from cameli ... | 2015 | 25597743 |
| metronidazole-induced encephalopathy after prolonged metronidazole course for treatment of c. difficile colitis. | a 65-year-old woman with a diagnosis of clostridium difficile colitis undergoing prolonged treatment with metronidazole was admitted to hospital for altered mentation, slurred speech and weakness. she was diagnosed with metronidazole-induced encephalopathy, confirmed with brain mri and improved when the offending agent was removed. this case report highlights encephalopathy as a complication of prolonged metronidazole treatment, which has become more common in clinical practice for the treatment ... | 2015 | 25596288 |
| risk factors, outcomes and epidemiology associated with clostridium difficile infection in patients with haematological malignancies in a tertiary care hospital in china. | the purpose of this study was to evaluate the risk factors, outcomes and epidemiology associated with clostridium difficile infection (cdi) in patients with haematological malignancies in a tertiary care hospital in china. c. difficile screening was performed on patients admitted for chemotherapy or haematopoietic stem cell transplantation between 2009 and 2013. c. difficile isolates were analysed by multilocus sequence typing, and a retrospective chart review was performed on all patients with ... | 2015 | 25596117 |
| management of severe ulcerative colitis. | acute severe steroid-refractory ulcerative colitis (asuc) provides challenges for physicians and surgeons who manage these patients. when a patient is diagnosed with asuc, they should be admitted for inpatient management including intravenous corticosteroids, venous thromboembolism prophylaxis, oral or enteral feeding if tolerated, and exclusion of infection including clostridium difficile. failure to improve by day 3 of corticosteroids requires escalation to medical rescue therapies such as inf ... | 2015 | 25595929 |
| colonization versus carriage of clostridium difficile. | asymptomatic carriage of toxigenic strains of clostridium difficile is common in health care facilities and the community. however, infection control efforts have traditionally focused almost entirely on symptomatic patients. there is now growing concern that asymptomatic carriers may be an underappreciated source of transmission. this article provides an overview of the pathogenesis and epidemiology of c difficile colonization, reviews the evidence that asymptomatic carriers shed spores and con ... | 2015 | 25595843 |
| diagnostic pitfalls in clostridium difficile infection. | accurate diagnosis of clostridium difficile infection (cdi) is important not only for patient care but also for epidemiology and disease research. as it is not possible clinically to reliably differentiate cdi from other causes of health care-associated diarrhea, the laboratory confirmation of cdi is essential. rapid commercial assays, including nucleic acid amplification tests and immunoassays for c difficile toxin and glutamate dehydrogenase, have largely superseded the use of older assays. al ... | 2015 | 25595842 |
| phosphatidylcholine and the intestinal mucus layer: in vitro efficacy against clostridium difficile-associated polymorphonuclear neutrophil activation. | phosphatidylcholine (pc), an important component of intestinal mucus, protects against clostridium difficile toxin-induced intestinal barrier injury in vitro. polymorphonuclear neutrophil (pmn) activation may contribute to intestinal injury and systemic toxicity in patients with c. difficile-associated disease. we therefore hypothesized that the intestinal barrier function against c. difficile toxin by exogenous pc would ameliorate pmn activation. | 2015 | 25595713 |
| media discourse on the social acceptability of fecal transplants. | advances in human microbiome research have generated considerable interest in elucidating the role of bacteria in health and the application of microbial ecosystem therapies and probiotics. fecal transplants involve the introduction of gut microbes from a healthy donor's stool to the patient and have been documented as effective for treating clostridium difficile infections (cdis) and some other gastrointestinal disorders. however, the treatment has encountered regulatory hurdles preventing wide ... | 2015 | 25595150 |