Publications
Title | Abstract | Year Filter | PMID(sorted descending) Filter |
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antimicrobial susceptibility of animal and human isolates of clostridium difficile by broth microdilution. | a total of 188 human (n = 92) and animal (n = 96) isolates of clostridium difficile of different pcr ribotypes were screened for susceptibility to 30 antimicrobials using broth microdilution. when comparing the prevalence of antimicrobial resistance, the isolates of animal origin were significantly more often resistant to oxacillin, gentamicin and trimethoprim/sulfamethoxazole (p<0.01). the most significant difference between the animal and human populations (p = 0.0006) was found in the level o ... | 2013 | 23861298 |
antimicrobial stewardship in pediatrics: how every pediatrician can be a steward. | antimicrobial stewardship (as) programs are effective in improving clinical outcomes associated with antimicrobial therapies while improving patient safety by reducing adverse events and development of bacterial resistance. understanding the basic principles of as is essential to the successful development and implementation of as strategies. identifying and developing strategies to address barriers and challenges to as can facilitate the establishment of financial, administrative, and organizat ... | 2013 | 23857121 |
major infection events over 5 years: how is media coverage influencing online information needs of health care professionals and the public? | the last decade witnessed turbulent events in public health. emerging infections, increase of antimicrobial resistance, deliberately released threats and ongoing battles with common illnesses were amplified by the spread of disease through increased international travel. the internet has dramatically changed the availability of information about outbreaks; however, little research has been done in comparing the online behavior of public and professionals around the same events and the effect of ... | 2013 | 23856364 |
fecal microbiota transplantation: indications, methods, evidence, and future directions. | fecal microbiota transplantation (fmt) has attracted great interest in recent years, largely due to the global clostridium difficile infection (cdi) epidemic and major advances in metagenomic sequencing of the gastrointestinal (gi) microbiota, with growing understanding of its structure and function. fmt is now recommended as the most effective therapy for relapsing cdi and, with further refinement, may even be used in "first-time" cdi. there is interest also in other conditions related to gi dy ... | 2013 | 23852569 |
potent monoclonal antibodies against clostridium difficile toxin a elicited by dna immunization. | recent studies have demonstrated that dna immunization is effective in eliciting antigen-specific antibody responses against a wide range of infectious disease targets. the polyclonal antibodies elicited by dna vaccination exhibit high sensitivity to conformational epitopes and high avidity. however, there have been limited reports in literature on the production of monoclonal antibodies (mab) by dna immunization. here, by using clostridium difficile (c. diff) toxin a as a model antigen, we demo ... | 2013 | 23851482 |
prevalence of gastrointestinal clostridium difficile carriage in australian sheep and lambs. | recently, clostridium difficile has been isolated from a wide variety of animals, particularly production animals, mainly cattle and pigs. concurrently, the incidence of c. difficile infection (cdi) in humans has increased in the community, with some suggestions that food-borne transmission of c. difficile is occurring. interestingly, sheep and lambs appear not to have been investigated for carriage/colonization with c. difficile. the aim of this project was to determine the prevalence of carria ... | 2013 | 23851101 |
evaluation of luminex xtag gastrointestinal pathogen analyte-specific reagents for high-throughput, simultaneous detection of bacteria, viruses, and parasites of clinical and public health importance. | acute diarrheal disease (add) can be caused by a range of pathogens, including bacteria, viruses, and parasites. conventional diagnostic methods, such as culture, microscopy, biochemical assays, and enzyme-linked immunosorbent assays (elisa), are laborious and time-consuming and lack sensitivity. combined, the array of tests performed on a single specimen can increase the turnaround time (tat) significantly. we validated a 19plex laboratory-developed gastrointestinal pathogen panel (gpp) using l ... | 2013 | 23850948 |
efficacy and safety of paromomycin for treating amebiasis in japan. | the clinical management of amebiasis is a growing concern, particularly among human immunodeficiency virus (hiv)-infected individuals who are predisposed to severe illness. treatment with a luminal amebicide is strongly recommended following acute-stage treatment with a nitroimidazole. in 2004, the japanese research group on chemotherapy of tropical diseases introduced paromomycin, which was not nationally licensed, and offered it to a number of patients. from 2004 to 2011, 143 case records of a ... | 2013 | 23850836 |
epidemiology of adverse events and clostridium difficile-associated diarrhea during long-term antibiotic therapy for osteoarticular infections. | osteoarticular infections require several weeks of antibiotic therapy, but little is known about the epidemiology of adverse events (ae) including symptomatic clostridium difficile-associated diarrhea during treatment in these patients. | 2013 | 23850617 |
derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with clostridium difficile infection. | clostridium difficile infection poses a significant healthcare burden. however, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described. | 2013 | 23849267 |
genetic risk factors for clostridium difficile infection in ulcerative colitis. | patients with inflammatory bowel disease (ibd) are at higher risk for clostridium difficile infection (cdi). disruption of gut microbiome and interaction with the intestinal immune system are essential mechanisms for pathogenesis of both cdi and ibd. whether genetic polymorphisms associated with susceptibility to ibd are also associated with risk of cdi is unknown. | 2013 | 23848254 |
clostridium difficile associated disease in a neurointensive care unit. | critically ill patients are at high risk for acquiring clostridium difficile infection. the aim of this study was to investigate the prevalence, severity, and outcome of neurointensive care unit (nicu) acquired clostridium difficile associated disease (cdad). | 2013 | 23847584 |
comparison of chromid c. difficile agar and cycloserine-cefoxitin-fructose agar for the recovery of clostridium difficile. | the rapidly changing epidemiology of clostridium difficile infection highlights the need for improved and continuing surveillance involving stool culturing to enable molecular tracking. culture of c. difficile can be difficult and time consuming. in this report chromid c. difficile agar (cdif) was compared to cycloserine-cefoxitin-fructose-egg-yolk agar which contained 0.1% sodium taurocholate (tccfa) as a germinant. | 2013 | 23846295 |
the adoptive transfer of behavioral phenotype via the intestinal microbiota: experimental evidence and clinical implications. | there is growing interest in the ability of the intestinal microbiome to influence host function within and beyond the gastrointestinal tract. here we review evidence of microbiome-brain interactions in mice and focus on the ability to transfer behavioral traits between mouse strains using fecal microbiota transplantation (fmt). transplantation alters brain chemistry and behavior in recipient ex-germ free mice, raising the possibility of using fmt for disorders of the central nervous system, and ... | 2013 | 23845749 |
[harnessing nature for treating infectious and autoimmune diseases: good and bad bacteria]. | clostridium difficile is the etiologic agent of nosocomial and community-acquired diarrhea associated with exposure to antibiotics that disrupt the normal colonic flora. as antibacterials currently used for primary c. difficile infections favor recurrences, new methods able to neutralize the bacterium without affecting the gut microbiota are badly needed. complementary treatment with probiotic agents to reconstitute the physiological intestinal flora does not yield any consistent benefit. in rec ... | 2013 | 23844515 |
novel strategies for enhanced removal of persistent bacillus anthracis surrogates and clostridium difficile spores from skin. | removing spores of clostridium difficile and bacillus anthracis from skin is challenging because they are resistant to commonly used antimicrobials and soap and water washing provides only modest efficacy. we hypothesized that hygiene interventions incorporating a sporicidal electrochemically generated hypochlorous acid solution (vashe(®)) would reduce the burden of spores on skin. | 2013 | 23844234 |
emerging therapies for clostridium difficile infection - focus on fidaxomicin. | the epidemiology of clostridium difficile infections (cdi) has evolved during the last decades, with an increase in the reported incidence, severity of cases, and rate of mortality and relapses. these increases have primarily affected some special populations including the elderly, patients requiring concomitant antibiotic therapy, patients with renal failure, and patients with cancer. until recently, the treatment of cdi was limited to either metronidazole or vancomycin. new therapeutic options ... | 2013 | 23843696 |
clostridium difficile in a hiv-infected cohort: incidence, risk factors, and clinical outcomes. | clostridium difficile is the most commonly reported infectious diarrhoea in hiv-infected patients in the united states. we set out to determine the incidence, risk factors and clinical presentation of c. difficile infections (cdis) in a cohort of hiv-infected individuals. | 2013 | 23842125 |
fecal microbiota transplantation for treating recurrent clostridium difficile infection. | 2013 | 23841136 | |
excess risk of clostridium difficile infection in ovarian cancer is related to exposure to broad-spectrum antibiotics. | the purpose of the study was to determine if a diagnosis of ovarian cancer is independently associated with an increased risk of clostridium difficile infection (cdi). | 2013 | 23839499 |
treatment of recurrent clostridium difficile infection: a systematic review. | clostridium difficile infection (cdi) recurs in nearly one-third of patients who develop an initial infection. recurrent cdi (rcdi) is associated with considerable morbidity, mortality, and cost. treatment for rcdi has not been not well examined. | 2014 | 23839210 |
viral co-infections are common and are associated with higher bacterial burden in children with clostridium difficile infection. | clostridium difficile infections in children are increasing. in this cohort study, we enrolled 62 children with diarrhea and c difficile. we performed polymerase chain reaction assays to detect viral agents of gastroenteritis and quantify c difficile burden. fifteen (24%) children diagnosed as having c difficile infection had a concomitant viral co-infection. these patients tended to be younger and had a higher c difficile bacterial burden than children with no viral co-infections (median differ ... | 2013 | 23838821 |
clostridium difficile infection in pediatric acute myeloid leukemia: from the canadian infections in acute myeloid leukemia research group. | the prevalence and severity of clostridium difficile infection (cdi) has increased over time in adult patients, but little is known about cdi in pediatric cancer. the primary objectives were to describe the incidence and characteristics of cdi in children with de novo acute myeloid leukemia (aml). the secondary objective was to describe factors associated with cdi. | 2013 | 23838731 |
utility of an adenosine triphosphate bioluminescence assay to evaluate disinfection of clostridium difficile isolation rooms. | 2013 | 23838235 | |
discontinuation of reflex testing of stool samples for vancomycin-resistant enterococci resulted in increased prevalence. | discontinuation of reflex testing of stool submitted for clostridium difficile testing for vancomycin-resistant enterococci (vre) led to an increase in the number of patients with healthcare-associated vre bacteremia and bacteriuria (0.21 vs 0.36 cases per 1,000 patient-days; p<.01). cost-benefit analysis showed reflex screening and isolation of vre reduced hospital costs. | 2013 | 23838226 |
[reply to «infections caused by clostridium difficile. addendum»]. | 2013 | 23838212 | |
antimicrobial regime for cardiac surgery: the safety and effectiveness of short-course flucloxacillin (or teicoplanin) and gentamicin-based prophylaxis. | to determine if changing from multidose cefuroxime-based to flucloxacillin (or teicoplanin) and gentamicin-based antibiotic prophylaxis for cardiac surgery was as effective at preventing infections without increasing postoperative renal impairment. | 2013 | 23837413 |
fidaxomicin versus conventional antimicrobial therapy in 59 recipients of solid organ and hematopoietic stem cell transplantation with clostridium difficile-associated diarrhea. | the feasibility of fidaxomicin versus vancomycin and metronidazole (conventional therapy) was assessed in 59 transplant recipients with 61 episodes of clostridium difficile-associated diarrhea (cdad). overall clinical cure was achieved in 86% of episodes, and in 7% of episodes, infection recurred. fidaxomicin was well tolerated. clinical cures were not significantly different compared with conventional therapy (67% versus 89%, respectively; p = 0.06). univariate analysis of predictors for lack o ... | 2013 | 23836168 |
glycan arrays containing synthetic clostridium difficile lipoteichoic acid oligomers as tools toward a carbohydrate vaccine. | clostridium difficile is a leading cause of severe nosocomial infections. cell-surface carbohydrate antigens are promising vaccine candidates. here we report the first total synthesis of oligomers of the lipoteichoic acid antigen repeating unit. synthetic glycan microarrays revealed anti-glycan antibodies in the blood of patients that help to define epitopes for vaccine development. | 2013 | 23836132 |
assessment of treatment patterns and patient outcomes before vs after implementation of a severity-based clostridium difficile infection treatment policy. | national guidelines recommend oral vancomycin for severe clostridium difficile infection (cdi) based on results from recent clinical trials demonstrating improved clinical outcomes. however, real-world data to support these clinical trials are scant. | 2013 | 23834988 |
a genomic update on clostridial phylogeny: gram-negative spore formers and other misplaced clostridia. | the class clostridia in the phylum firmicutes (formerly low-g+c gram-positive bacteria) includes diverse bacteria of medical, environmental and biotechnological importance. the selenomonas-megasphaera-sporomusa branch, which unifies members of the firmicutes with gram-negative-type cell envelopes, was recently moved from clostridia to a separate class negativicutes. however, draft genome sequences of the spore-forming members of the negativicutes revealed typically clostridial sets of sporulatio ... | 2013 | 23834245 |
clinical relevance of a positive molecular test in the diagnosis of clostridium difficile infection. | in 2011, the department of health advised that a two-stage test approach should be used to improve accuracy of clostridium difficile infection (cdi) diagnosis. no specific test protocol was established at that time. | 2013 | 23831282 |
[case report. leukocytosis in the course of clostridium difficile infection]. | clostridium difficile infections (cdi) are increasing in incidence and severity, amongst other reasons because of the increasing spread of hypervirulent strains. leukocytosis is a sign of severe cdi and is predictive for a complicated course. in this case report, we describe 2 patients with cdi who developed leukocytosis within a leukemoid range. in both cases high white blood cell counts returned totally to normal range under cdi therapy according to guidelines. leukemia-related therapy pattern ... | 2013 | 23828079 |
[clostridium difficile--an increasing problem]. | 2013 | 23828075 | |
community-associated clostridium difficile infection among older people in tayside, scotland, is associated with antibiotic exposure and care home residence: cohort study with nested case-control. | to estimate the risks of community-associated clostridium difficile infection (ca-cdi) among the population aged ≥ 65 years associated with antibiotic exposure and care home residence. | 2013 | 23825381 |
caspase activation as a versatile assay platform for detection of cytotoxic bacterial toxins. | pathogenic bacteria produce several virulence factors that help them establish infection in permissive hosts. bacterial toxins are a major class of virulence factors and hence are attractive therapeutic targets for vaccine development. here, we describe the development of a rapid, sensitive, and high-throughput assay that can be used as a versatile platform to measure the activities of bacterial toxins. we have exploited the ability of these toxins to cause cell death via apoptosis of sensitive ... | 2013 | 23824772 |
[multiresistant organisms]. | infections caused by multidrug resistant (mdr) organisms are becoming more frequently in daily practice and are associated with an increase in duration of treatment and mortality. during the past decades, particular attention in the field of mdr pathogens was paid to methicillin-resistant staphylococcus aureus (mrsa). for the last years, mdr gram-negative organisms, with e.g., "extended-spectrum beta-lactamases" (esbl), have been gaining a growing significance. currently, treatment of infections ... | 2015 | 23824619 |
diagnosis of clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. | clostridium difficile is a formidable nosocomial and community-acquired pathogen, causing clinical presentations ranging from asymptomatic colonization to self-limiting diarrhea to toxic megacolon and fulminant colitis. since the early 2000s, the incidence of c. difficile disease has increased dramatically, and this is thought to be due to the emergence of new strain types. for many years, the mainstay of c. difficile disease diagnosis was enzyme immunoassays for detection of the c. difficile to ... | 2013 | 23824374 |
clinical features and treatment responses in pediatric lymphocytic and collagenous colitis. | microscopic colitis (mc) is prevalent in adults investigated for chronic watery diarrhea, yet characterization of pediatric mc is limited. | 2013 | 23820404 |
epidemiology of clostridium difficile infection in asia. | while clostridium difficile infection (cdi) has come to prominence as major epidemics have occurred in north america and europe over the recent decade, awareness and surveillance of cdi in asia have remained poor. limited studies performed throughout asia indicate that cdi is also a significant nosocomial pathogen in this region, but the true prevalence of cdi remains unknown. a lack of regulated antibiotic use in many asian countries suggests that the prevalence of cdi may be comparatively high ... | 2013 | 23816346 |
a unique strain of community-acquired clostridium difficile in severe complicated infection and death of a young adult. | clostridium difficile is the major cause of nosocomial antibiotic-associated diarrhoea with the potential risk of progressing to severe clinical outcomes including death. it is not unusual for clostridium difficile infection to progress to complications of toxic megacolon, bowel perforation and even gram-negative sepsis following pathological changes in the intestinal mucosa. these complications are however less commonly seen in community-acquired clostridium difficile infection than in hospital ... | 2013 | 23815405 |
community-acquired clostridium difficile infection: awareness and clinical implications. | the epidemiology of clostridium difficile infection (cdi) is changing. cdi, usually depicted as a nosocomial infection in the elderly, is now occurring in community-dwelling persons who are younger and otherwise dissimilar. a more virulent isolate (north american pulsed field type 1 (nap1) associated with increased morbidity and mortality, has been identified. in 2005, similar strains were associated with severe disease in community-dwelling patients at a rate of 7.6/100,000. screening patients ... | 2013 | 23814528 |
an investigation into the association between cpb2-encoding clostridium perfringens type a and diarrhea in neonatal piglets. | to investigate the possible role of cpb2-positive type a clostridium perfringens in neonatal diarrheal illness in pigs, the jejunum and colon of matched normal and diarrheic piglets from 10 farms with a history of neonatal diarrhea were examined grossly and by histopathology, and tested for c. perfringens, for c. perfringens beta2 (cpb2) toxin, as well as for clostridium difficile toxins, salmonella, enterotoxigenic escherichia coli, rotavirus, transmissible gastroenteritis (tge) virus, and cocc ... | 2013 | 23814355 |
nutritional and microbial analysis of bully sticks and survey of opinions about pet treats. | the objectives of this study were to measure the caloric density of bully sticks, to analyze the bully sticks for bacterial contamination, and to assess owner opinions about these and other pet treat products. mean caloric density was 15 kcal/inch (38 kcal/cm) [range: 9 to 22 kcal/inch (23 to 56 kcal/cm), 2.96 to 3.07 kcal/g]. of 26 bully sticks that were tested for bacterial contamination 1 (4%) was contaminated with clostridium difficile, 1 was contaminated with methicillin-resistant staphyloc ... | 2013 | 23814301 |
pre-emptive broad-spectrum treatment for ventilator-associated pneumonia in high-risk patients. | patients requiring mechanical ventilation (mv) for >48 h after major heart surgery (mhs) are at a high risk of acquiring ventilator-associated pneumonia (vap) and tracheobronchitis (vat). most non-pharmacological interventions to prevent vap in such patients are usually already implemented. the objective of this study was to evaluate the efficacy in preventing lower respiratory infections of antibiotics active against multidrug-resistant pathogens in this very high-risk population. | 2013 | 23812339 |
clostridium difficile infection associated with antituberculous agents in a patient with tuberculous pericarditis. | clostridium difficile can cause pseudomembranous colitis (pmc). antimicrobial agent exposure is a risk factor for clostridium difficile-associated disease, whereas the use of antituberculous (anti-tb) agents is not. we herein report a case of pmc-associated with antituberculous therapy. a 63-year-old woman with tuberculous pericarditis treated with anti-tb agents was admitted for abdominal pain and diarrhea. on colonoscopy, mucoid exudate and yellowish plaque lesions were observed. the anti-tb a ... | 2013 | 23812197 |
unusual case of prosthetic shoulder joint infection due to clostridium difficile. | extraintestinal manifestatation such as prosthetic joint infection due to clostridium difficile is a rare diagnosis. a 47-year-old female patient presented with chronic pain in left shoulder prosthetic joint. plain roentgenogram of left shoulder prosthetic joint revealed anterior dislocation and loosening of prosthesis. the synovial fluid cultures and intraoperative deep joint cultures repeatedly grew clostridium difficile. patient was treated with antimicrobial therapy and surgical debridement ... | 2013 | 23811577 |
clostridium difficile infection. | clostridium difficile is emerging as a common cause of infectious diarrhea. incidence has increased dramatically since 2000, associated with a new strain that features both increased toxin production and increased resistance to antibiotics. for patients with mild to moderate disease, oral metronidazole is usually the first choice of treatment, and those with severe disease should be treated with vancomycin, with additional intravenous metronidazole in some cases. fecal microbiota transplantation ... | 2013 | 23809712 |
clostridium difficile infection among hematopoietic stem cell transplant recipients: beyond colitis. | to review the most recent data regarding the epidemiology, risks factors, and outcomes among hematopoietic stem cell transplant recipients with clostridium difficile infection (cdi). | 2013 | 23806895 |
a retrospective review of metronidazole and vancomycin in the management of clostridium difficile infection in patients with hematologic malignancies. | the incidence and severity of clostridium difficile infection has significantly increased over the past decade. although the epidemiology and treatment of c. difficile infection is well elucidated in the non-oncology population, it is poorly understood among cancer patients. this illustrates great concern as the majority of these patients are immunosuppressed, which puts them at higher risk for developing severe disease. furthermore, suboptimal treatment of c. difficile infection can compromise ... | 2014 | 23804627 |
evaluation of cycloserine-cefoxitin fructose agar (ccfa), ccfa with horse blood and taurocholate, and cycloserine-cefoxitin mannitol broth with taurocholate and lysozyme for recovery of clostridium difficile isolates from fecal samples. | cycloserine-cefoxitin fructose agar (ccfa), ccfa with horse blood and taurocholate (ccfa-ht), and cycloserine-cefoxitin mannitol broth with taurocholate and lysozyme (ccmb-tal) were compared for recovery of clostridium difficile from 120 stool specimens. compared to ccfa, ccfa-ht enhanced c. difficile growth and improved recovery by 4%. in a separate study, 9% (8/91) of stool samples previously c. difficile negative on plate medium were c. difficile positive when cultured in ccmb-tal. | 2013 | 23804392 |
evaluation of a new automated homogeneous pcr assay, genomera c. difficile, for rapid detection of toxigenic clostridium difficile in fecal specimens. | we evaluated a new automated homogeneous pcr assay to detect toxigenic clostridium difficile, the genomera c. difficile assay (abacus diagnostica, finland), with 310 diarrheal stool specimens and with a collection of 33 known clostridial and nonclostridial isolates. results were compared with toxigenic culture results, with discrepancies being resolved by the genexpert c. difficile pcr assay (cepheid). among the 80 toxigenic culture-positive or genexpert c. difficile assay-positive fecal specime ... | 2013 | 23804386 |
intestinal dysbiosis and depletion of butyrogenic bacteria in clostridium difficile infection and nosocomial diarrhea. | clostridium difficile infection (cdi) causes nearly half a million cases of diarrhea and colitis in the united states each year. although the importance of the gut microbiota in c. difficile pathogenesis is well recognized, components of the human gut flora critical for colonization resistance are not known. culture-independent high-density roche 454 pyrosequencing was used to survey the distal gut microbiota for 39 individuals with cdi, 36 subjects with c. difficile-negative nosocomial diarrhea ... | 2013 | 23804381 |
ceftaroline fosamil: a review of its use in the treatment of complicated skin and soft tissue infections and community-acquired pneumonia. | ceftaroline, the active metabolite of the prodrug ceftaroline fosamil (zinforo, teflaro), is an advanced-generation, parenteral cephalosporin with broad-spectrum antibacterial activity in vitro against gram-positive bacteria, including methicillin-resistant staphylococcus aureus (mrsa) and multidrug resistant streptococcus pneumoniae and gram-negative bacteria, including haemophilus influenzae and moraxella catarrhalis, but not pseudomonas aeruginosa. ceftaroline has demonstrated a low potential ... | 2013 | 23801418 |
correlation between virulence gene expression and proton pump inhibitors and ambient ph in clostridium difficile: results of an in vitro study. | proton pump inhibitors (ppis) are associated with the development of clostridium difficile infection in humans. though it is assumed that ppis mediate this effect through gastric acid suppression, there has been little investigation into whether ppis, or ambient ph, might directly affect the expression of c. difficile toxin genes. in the present study, c. difficile ribotypes 001, 027 and 078 obtained from human subjects were grown under anaerobic conditions prepared at phs of 5, 7.3 and 9. match ... | 2013 | 23800596 |
quinolone prophylaxis for the prevention of bk virus infection in kidney transplantation: study protocol for a randomized controlled trial. | bk virus infection has emerged as a major complication in kidney transplantation leading to a significant reduction in graft survival. there are currently no proven strategies to prevent or treat bk virus infection. quinolone antibiotics, such as levofloxacin, have demonstrated activity against bk virus. we hypothesize that administration of a quinolone antibiotic, when given early post-transplantation, will prevent the establishment of bk viral replication in the urine and thus prevent systemic ... | 2013 | 23800312 |
imipenem versus piperacillin/tazobactam for empiric treatment of neutropenic fever in adults. | australian guidelines for neutropenic fever recommend piperacillin/tazobactam (pip-taz) or cefepime for first-line empiric treatment of neutropenic fever. we compared outcomes among haematology patients before and after changing our first-line neutropenic fever treatment from imipenem to pip-taz. forty-five patients received imipenem and 60 pip-taz. despite a higher rate of antibiotic modification in the pip-taz cohort, treatment success and time to defervescence were similar, with a trend towar ... | 2013 | 23800137 |
increased hospital length of stay attributable to clostridium difficile infection in patients with four co-morbidities: an analysis of hospital episode statistics in four european countries. | hospital-onset clostridium difficile infection (cdi) places a significant burden on health care systems throughout europe, estimated at around €3 billion per annum. this burden is shared between national payers and hospitals that support additional bed days for patients diagnosed with cdi while in hospital or patients re-admitted from a previous hospitalisation. this study was performed to quantify additional hospital stay attributable to cdi in four countries, england, germany, spain, and the n ... | 2013 | 23797490 |
vancomycin use for pediatric clostridium difficile infection is increasing and associated with specific patient characteristics. | in adults with clostridium difficile infection (cdi), enteral vancomycin is considered the preferred initial regimen for severe disease; however, patterns of antimicrobial use for children with cdi are unknown. we sought to describe trends in and predictors of vancomycin use for the treatment of children with cdi admitted to tertiary-care children's hospitals in the united states. we used a database of freestanding children's hospitals to identify patients 1 to 18 years old with cdi between janu ... | 2013 | 23796942 |
renal impairment and clinical outcomes of clostridium difficile infection in two randomized trials. | patients with chronic kidney disease (ckd) have increased risk for clostridium difficile infection (cdi) and for subsequent mortality. we determined the effect of ckd on response to treatment for cdi. | 2013 | 23796582 |
immunological evaluation of a synthetic clostridium difficile oligosaccharide conjugate vaccine candidate and identification of a minimal epitope. | clostridium difficile is the cause of emerging nosocomial infections that result in abundant morbidity and mortality worldwide. thus, the development of a vaccine to kill the bacteria to prevent this disease is highly desirable. several recently identified bacterial surface glycans, such as ps-i and ps-ii, are promising vaccine candidates to preclude c. difficile infection. to circumvent difficulties with the generation of natural ps-i due to its low expression levels in bacterial cultures, impr ... | 2013 | 23795894 |
the clostridium difficile exosporium cysteine (cdec)-rich protein is required for exosporium morphogenesis and coat assembly. | clostridium difficile is an important nosocomial pathogen that has become a major cause of antibiotic-associated diarrhea. there is a general consensus that c. difficile spores play an important role in c. difficile pathogenesis, contributing to infection, persistence, and transmission. evidence has demonstrated that c. difficile spores have an outermost layer, termed the exosporium, that plays some role in adherence to intestinal epithelial cells. recently, the protein encoded by cd1067 was sho ... | 2013 | 23794627 |
national variability in surveillance, testing, and infection prevention for clostridium difficile infection in pediatric populations. | to assess national variability in methods of identifying and preventing clostridium difficile infection (cdi) in pediatric populations, an anonymous survey was sent to hospital epidemiologists at us children's hospitals. data from 30 hospitals indicate substantial variability in surveillance, testing, and infection control strategies, which may limit reliable interfacility comparison of cdi rates. in addition, only 60% of respondents perform surveillance for community-associated cdi. | 2013 | 23790613 |
rapid detection of clostridium difficile toxins from stool samples using real-time multiplex pcr. | in this study, a total of 650 stool samples were tested to show that our method is capable of detecting four clostridium difficile genes; tcda, tcdb, encoding toxin a (tcda) and toxin b (tcdb), and the binary toxin c. difficile transferase genes (cdta and/or cdtb) encoding cdt toxin. besides detecting the targeted c. difficile genes, our method can be used to detect the presence of any inhibitory components in the pcr. this assay, combined with a selective culture medium, such as the chromid™ c. ... | 2013 | 23788597 |
clostridium difficile infections in south east scotland: mortality and recurrence in a region without pcr ribotype 027. | three hundred and thirty-five patients with laboratory-confirmed clostridium difficile infections (cdis) were studied for epidemiological features, clinical presentation and laboratory markers. they were followed up for 1 year to determine recurrence and mortality. four hundred and thirty-two episodes were recorded. one year mortality was 41.8 % of which cdi was listed on 20 % of the death certificates. one year recurrence rate was 22.9 %. pcr ribotype 001 was the commonest epidemiological type ... | 2013 | 23788595 |
laboratory diagnosis of clostridium difficile infections: there is light at the end of the colon. | single molecular or multistep assays (glutamate dehydrogenase, toxin a/b, ± molecular) are recommended for the diagnosis of cdi in patients with clinically significant diarrhea. rapid and accurate tests can improve resource allocations and improve patient care. enzyme immunoassay (eia) for toxins a/b is too insensitive for use as a stand-alone assay. this guideline will examine the use of molecular tests and multitest algorithms for the diagnosis of clostridium difficile infection (cdi). these n ... | 2013 | 23788237 |
impact of cleaning and other interventions on the reduction of hospital-acquired clostridium difficile infections in two hospitals in england assessed using a breakpoint model. | clostridium difficile infection remains a major challenge for hospitals. although targeted infection control initiatives have been shown to be effective in reducing the incidence of hospital-acquired c. difficile infection, there is little evidence available to assess the effectiveness of specific interventions. | 2013 | 23787167 |
challenges for standardization of clostridium difficile typing methods. | typing of clostridium difficile facilitates understanding of the epidemiology of the infection. some evaluations have shown that certain strain types (for example, ribotype 027) are more virulent than others and are associated with worse clinical outcomes. although restriction endonuclease analysis (rea) and pulsed-field gel electrophoresis have been widely used in the past, pcr ribotyping is the current method of choice for typing of c. difficile. however, global standardization of ribotyping r ... | 2013 | 23784128 |
clostridium difficile infection in newly diagnosed pediatric inflammatory bowel disease in the mid-southern united states. | clostridium difficile is an emerging opportunistic pathogen that infects patients with underlying chronic disorders such as inflammatory bowel diseases (ibd) at high rates. an extremely high prevalence of clostridium difficile infection (cdi) was noted recently in new-onset pediatric ibd from eastern europe (poland). we examined the rate of cdi in our new pediatric ibd patients (123 tested) from 2010 to 2012. the overall prevalence of cdi at disease onset was 8.1%, significantly (p < 0.0001) low ... | 2013 | 23783013 |
the functional vangcd cluster of clostridium difficile does not confer vancomycin resistance. | vangcd, a cryptic gene cluster highly homologous to the vang gene cluster of enterococcus faecalis is largely spread in clostridium difficile. since emergence of vancomycin resistance would have dramatic clinical consequences, we have evaluated the capacity of the vangcd cluster to confer resistance. we showed that expression of vangcd is inducible by vancomycin and that vangcd , vanxycd and vantcd are functional, exhibiting d-ala : d-ser ligase, d,d-dipeptidase and d-ser racemase activities res ... | 2013 | 23782343 |
clostridium difficile colitis acquired in the intensive care unit: outcome and prognostic factors. | we assessed factors associated with mortality and complicated course in the case of clostridium difficile infection (cdi) acquired in the intensive care unit (icu). | 2014 | 23780568 |
epidemiology of community-associated clostridium difficile infection, 2009 through 2011. | clostridium difficile infection (cdi) has been increasingly reported among healthy individuals in the community. recent data suggest that community-associated cdi represents one-third of all c difficile cases. the epidemiology and potential sources of c difficile in the community are not fully understood. | 2013 | 23780507 |
clostridium difficile leaves the hospital--what's next? | 2013 | 23778358 | |
clinical utility of retrograde terminal ileum intubation in the evaluation of chronic non-bloody diarrhea. | the aims of this study were to investigate the frequency and factors involved in the terminal ileum intubation of patients with chronic, non-bloody diarrhea and to compare diagnostic yields of colonoscopy and ileocolonoscopy. | 2013 | 23777610 |
recent advances in antibacterial drugs. | the incidence of antimicrobial resistance is on continued rise with a threat to return to the "pre-antibiotic" era. this has led to emergence of such bacterial infections which are essentially untreatable by the current armamentarium of available treatment options. various efforts have been made to develop the newer antimicrobials with novel modes of action which can act against these multi-drug resistant strains. this review aims to focus on these newly available and investigational antibacteri ... | 2013 | 23776832 |
role of interleukin 23 signaling in clostridium difficile colitis. | clostridium difficile is currently the leading cause of hospital-acquired infections in the united states. here, we observed increased interleukin 23 (il-23) protein levels in human colon biopsy specimens positive for c. difficile toxins, compared with levels in negative controls (p = .008) we also investigated the role of il-23 during c. difficile infection, using 2 distinct murine models. mice lacking il-23 signaling had a significant increase in survival (100% [12 mice]), compared with contro ... | 2013 | 23776194 |
clostridium difficile infection in the elderly. | the incidence of c. difficile infections (cdi) in the elderly continues to rise and infection is associated with increased morbidity and mortality when compared to those affected in younger age-groups. immunosenescence may be a contributory factor yet the exact immune responses that may protect against cdi are incompletely understood. increased exposure to antibiotics, frequent and/or prolonged hospital admissions and residing in long-term care facilities provide multiple opportunities for host ... | 2013 | 23774972 |
clostridium difficile: restoring the balance--microbes for the management of clostridium difficile infection? | 2013 | 23774772 | |
infectious agents associated with diarrhoea in neonatal foals in central kentucky: a comprehensive molecular study. | diarrhoea caused by infectious agents is common in foals but there is no comprehensive molecular work-up of the relative prevalence of common agents and appearance of coinfections. | 2014 | 23773143 |
effect of an oxygen-tolerant bifurcating butyryl coenzyme a dehydrogenase/electron-transferring flavoprotein complex from clostridium difficile on butyrate production in escherichia coli. | the butyrogenic genes from clostridium difficile dsm 1296(t) have been cloned and expressed in escherichia coli. the enzymes acetyl-coenzyme a (coa) c-acetyltransferase, 3-hydroxybutyryl-coa dehydrogenase, crotonase, phosphate butyryltransferase, and butyrate kinase and the butyryl-coa dehydrogenase complex composed of the dehydrogenase and two electron-transferring flavoprotein subunits were individually produced in e. coli and kinetically characterized in vitro. while most of these enzymes wer ... | 2013 | 23772070 |
the agr locus regulates virulence and colonization genes in clostridium difficile 027. | the transcriptional regulator agra, a member of the lyttr family of proteins, plays a key role in controlling gene expression in some gram-positive pathogens, including staphylococcus aureus and enterococcus faecalis. agra is encoded by the agracdb global regulatory locus, and orthologues are found within the genome of most clostridium difficile isolates, including the epidemic lineage 027/bi/nap1. comparative rna sequencing of the wild type and otherwise isogenic agra null mutant derivatives of ... | 2013 | 23772065 |
extraintestinal clostridium difficile infections. | clostridium difficile causes diarrhea that ranges from a benign, self-limiting antibiotic use-associated disease to a life-threatening pseudomembranous colitis. clostridium difficile has rarely been isolated in extraintestinal infections. our objective was to characterize clinical features and risk factors of these infections. methods extraintestinal c. difficile infections (cdis) were searched for in an electronic database of all c. difficile-positive isolates found during a 10-year period. the ... | 2013 | 23771984 |
elevated lactoferrin is associated with moderate to severe clostridium difficile disease, stool toxin, and 027 infection. | we evaluated blood and fecal biomarkers as indicators of severity in symptomatic patients with confirmed clostridium difficile infection (cdi). recruitment included patients with cdi based on clinical symptoms and supporting laboratory findings. disease severity was defined by physician's assessment and blood and fecal biomarkers were measured. toxigenic culture done using spore enrichment and toxin b detected by tissue culture were done as confirmatory tests. polymerase chain reaction (pcr) rib ... | 2013 | 23771554 |
clostridium difficile infection in hospitalized cancer patients in beijing, china is facilitated by receipt of cancer chemotherapy. | the purpose of this study was to determine the presence of clostridium difficile infection (cdi) and risk factors for infection in hospitalized patients with diarrhea in a cancer hospital in beijing, china. a total of 277 patients with hospital-associated diarrhea (had) were studied of which 41 (15%) were positive for fecal c. difficile toxin a/b. for each cdi case identified, a control with had but negative c. difficile specimen was enrolled to look for cdi risk factors. receipt of cancer chemo ... | 2013 | 23770543 |
in vitro selective inhibitory effect of 8-hydroxyquinoline against bifidobacteria and clostridia. | 8-hydroxyquinoline (8hq) inhibited clostridium tertium, clostridium clostridioforme, clostridium difficile and clostridium perfringens in vitro with mics of 8, 16, 32 and 32 μg/ml, respectively. in contrast, mics of most bifidobacteria (84%) were 512 μg/ml or higher. thus, 8hq could be used as anti-clostridial agent or in selective media for bifidobacteria isolation. | 2013 | 23770542 |
clostridium difficile in the icu: study of the incidence, recurrence, clinical characteristics and complications in a university hospital. | although several studies have established the association between antibiotics and clostridium difficile infection (cdi), there is a lack of epidemiological studies on the incidence of cdi in european intensive care units outside the context of infection outbreaks. the present study describes the incidence, patient characteristics, complications, and recurrence rates of cdi in a spanish icu. | 2014 | 23769945 |
diarrhea-associated pathogens, lactobacilli and cellulolytic bacteria in equine feces: responses to antibiotic challenge. | antibiotics are important to equine medicine, but antibiotic-associated diarrhea (aad) can lead to poor performance and even mortality. aad is attributed to disruption of the hindgut microbiota, which permits proliferation of pathogenic microbes. the goal of this study was to evaluate the effects of common antibiotics on cellulolytic bacteria, lactobacilli, and aad-associated pathogens in the feces of healthy horses. fifteen horses were assigned to three treatment groups (blocked by age and sex) ... | 2013 | 23769300 |
incidence of clostridium difficile associated diarrhoea in a tertiary care hospital. | rampant and injudicious use of broad spectrum antibiotics in hospitalized patients has increased the incidence of clostridium difficile associated diarrhoea (cdad). though antibiotic use is the best known risk factor for cdad, the occurrence of community acquired c. difficile suggests the presence of other risk factors too. however cdad is still under-recognized in india and asia. therefore we undertook a prospective study to determine the incidence of clostridium difficile associated diarrhoea ... | 2012 | 23767199 |
clostridium difficile infection--is it coming at us? | 2012 | 23767195 | |
declining cephalosporin and fluoroquinolone non-susceptibility among bloodstream enterobacteriaceae from the uk: links to prescribing change? | the uk saw major increases in cephalosporin and quinolone resistance amongst enterobacteriaceae from 2001 to 2006, with cephalosporin resistance largely reflecting dissemination of ctx-m extended-spectrum β-lactamases (esbls). we review subsequent trends. | 2013 | 23766490 |
clostridium difficile infection. | 2013 | 23764494 | |
characterization of swine isolates of clostridium difficile in spain: a potential source of epidemic multidrug resistant strains? | clostridium difficile is an emerging pathogen for humans and animals and there is concern about the possibility that livestock might serve as a reservoir of epidemic strains. in spain, ribotype 078 is one of the most prevalent in human episodes of c. difficile infection, but the distribution of this and other ribotypes in animals is yet unknown. we present the first report on the ribotype distribution and antimicrobial susceptibility of c. difficile in swine in spain. a total of 144 isolates wer ... | 2013 | 23764416 |
clostridium difficile infection: the importance of accurate diagnosis. | 2013 | 23763047 | |
effect of ribotype on all-cause mortality following clostridium difficile infection. | clostridium difficile infection (cdi) is significantly associated with subsequent all-cause mortality. although a number of studies have investigated mortality associated with cdi, few have compared all-cause mortality between ribotypes. | 2013 | 23759667 |
evaluation of the effect of oritavancin on clostridium difficile spore germination, outgrowth and recovery. | previous work suggests oritavancin may be inhibitory to clostridium difficile spores. we have evaluated the effects of oritavancin exposure on c. difficile spore germination, outgrowth and recovery. | 2013 | 23759507 |
acid suppression and the risk of clostridium difficile infection. | 2013 | 23759424 | |
evaluation of the rapid loop-mediated isothermal amplification assay illumigene for diagnosis of clostridium difficile in an outbreak situation. | an outbreak of clostridium difficile infection (cdi) at höglandet hospital eksjö in southern sweden in 2011 was mainly due to a multidrug-resistant pcr ribotype 046 (30% of all samples). diagnostics used routinely was the vidas cdab assay, but to control the outbreak the rapid loop-mediated isothermal amplification (lamp) assay illumigene was introduced and both techniques were compared to toxigenic culture (tc) prospectively. the lamp assay had a superior sensitivity, that is, 98% compared to 7 ... | 2014 | 23758095 |
modern trends in infection control practices in intensive care units. | hospital-acquired infections (hais) are common in intensive care unit (icu) patients and are associated with increased morbidity and mortality. there has been an increasing effort to prevent hais, and infection control practices are paramount in avoiding these complications. in the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. this article reviews the modern trends in infection control practices to prevent hais in ... | 2014 | 23753240 |
new drugs and strategies for management of clostridium difficile colitis. | approaches for management of clostridium difficile infection continually evolve as research reveals shifts in epidemiology, microbial pathogenesis, disease severity states, and response to therapy. these new discoveries significantly impact diagnostic and therapeutic strategies, given the high morbidity associated with this common nosocomial infectious diarrhea. critically ill patients are at an increased risk of developing diarrheal illness like c. difficile and succumbing to potentially fatal ... | 2015 | 23753229 |
fecal transplant for clostridium difficile-reply. | 2012 | 23752359 |