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clostridium difficile infection is associated with increased risk of death and prolonged hospitalization in children.clostridium difficile infection (cdi) is associated with significant morbidity and mortality among adults. however, outcomes are poorly defined among children.201323532470
validation of the chronic disease score-infectious disease (cds-id) for the prediction of hospital-associated clostridium difficile infection (cdi) within a retrospective cohort.aggregate comorbidity scores are useful for summarizing risk and confounder control in studies of hospital-associated infections. the chronic disease score - infectious diseases (cds-id) was developed for this purpose, but it has not been validated for use in studies of clostridium difficile infection (cdi). the aim of this study was to assess the discrimination, calibration and potential for confounder control of cds-id compared to age alone or individual comorbid conditions.201323530876
derivation and validation of a simple clinical bedside score (atlas) for clostridium difficile infection which predicts response to therapy.clostridium difficile infection (cdi) continues to be a frequent and potentially severe infection. there is currently no validated clinical tool for use at the time of cdi diagnosis to categorize patients in order to predict response to therapy.201323530807
counterpoint: is clostridium difficile a food-borne disease?the increase in community associated clostridium difficile disease paired with recent data on c. difficile in retail foods has led to speculation that c. difficile is a food-borne pathogen. however, there is no current epidemiologic evidence (i.e. restaurant or food-associated outbreaks) to support this hypothesis. rates of c. difficile recovery from food vary widely across laboratories and may be due to a number of confounding factors. this commentary discusses the results of two published inve ...201323528985
confocal laser endomicroscopy for in vivo diagnosis of clostridium difficile associated colitis - a pilot study.clostridium difficile infection (cdi) is one of the most dreaded causes of hospital-acquired diarrhea. main objective was to investigate whether confocal laser endomicroscopy (cle) has the capability for in vivo diagnosis of c. difficile associated histological changes. second objective was to prove the presence of intramucosal bacteria using cle.201323527018
clostridium difficile as a cause of acute diarrhea: a prospective study in a tertiary care center.clostridium difficile-associated diarrhea (cdad) is an increasing problem. recent reports suggest presence of community acquired cdad (ca cdad). studies in india have shown varied results.201323526401
similar outcomes of ibd inpatients with clostridium difficile infection detected by elisa or pcr assay.clostridium difficile infection (cdi) is known as a risk factor for exacerbation of inflammatory bowel disease (ibd). cdi has been most commonly tested with enzyme-linked immunosorbent assay for toxins, but with a suboptimal sensitivity. compared with conventional elisa, the polymerase chain reaction-based assay (pcr) is a highly sensitive detection technique for c. difficile. however, its pure detection of only the dna of toxin b may lead to over-treatment.201323525735
molecular epidemiology and resistance profiles of clostridium difficile in a tertiary care hospital in spain.epidemiological surveillance of clostridium difficile infection has gained importance in recent years as a result of the rapid spread of epidemic strains, including hypervirulent strains and strains with reduced susceptibility to antimicrobials. the molecular epidemiology and antimicrobial susceptibility of c. difficile in the reference hospital of the balearic islands (spain) is reported in this study. one hundred isolates of toxigenic c. difficile from different patients were selected using ra ...201323523477
clostridium difficile infection in italian urban hospitals: data from 2006 through 2011.in developed countries, clostridium difficile infection (cdi) represents an emerging threat in terms of morbidity and mortality rates. in our country limited cdi epidemiological data can be found.201323522431
comparison of testing approaches for clostridium difficile infection at a large community hospital.multiple diagnostic approaches are available for clostridium difficile infection (cdi); current guidelines support two-step testing (2st) as the preferred approach. we retrospectively evaluated the impact of switching from toxin enzyme immunoassay (eia) to 2st, and then to polymerase chain reaction (pcr), on cdi rates, test utilization and cdi treatment at a 900-bed tertiary care community teaching hospital. all inpatients tested for cdi between december 2008 and february 2011 were included. a p ...201423521523
systemic antibody responses induced by a two-component clostridium difficile toxoid vaccine protect against c. difficile-associated disease in hamsters.clostridium difficile infection (cdi) has been identified as the leading cause of nosocomial diarrhoea and pseudomembranous colitis associated with antibiotic therapy. recent epidemiological changes as well as increases in the number of outbreaks of strains associated with increased virulence and higher mortality rates underscore the importance of identifying alternatives to antibiotics to manage this important disease. animal studies have clearly demonstrated the roles that toxins a and b play ...201323518659
surface-layer (s-layer) of human and animal clostridium difficile strains and their behaviour in adherence to epithelial cells and intestinal colonization.clostridium difficile is a frequent cause of severe, recurrent post-antibiotic diarrhoea and pseudomembranous colitis. the surface layer (s-layer) is the predominant outer surface component of c. difficile which is involved in pathogen-host interactions critical to pathogenesis. in this study, we characterized the s-layer protein a (slpa) of animal and human strains belonging to different pcr-ribotypes (pr) and compared the in vitro adherence and in vivo colonization properties of strains showin ...201323518658
germination efficiency of clinical clostridium difficile spores and correlation with ribotype, disease severity and therapy failure.spore germination is an important part of the pathogenesis of clostridium difficile infection (cdi). spores are resistant to antibiotics, including those therapeutically administered for cdi and strains with a high germination rate are significantly more likely to be implicated in recurrent cdi. the role of germination efficiency in cases of refractory cdi where first-line therapy fails remains unclear. we investigated spore germination efficiencies of clinical c. difficile isolates by measuring ...201323518657
cbpa: a novel surface exposed adhesin of clostridium difficile targeting human collagen.clostridium difficile is the leading cause of antibiotic-associated diarrhoea and pseudomembranous colitis. while the role of toxins in pathogenesis has been extensively described, the contribution of surface determinants to intestinal colonization is still poorly understood. we focused our study on a novel member of the mscramm family, named cbpa (collagen binding protein a), for its adhesive properties towards collagen. we demonstrate that cbpa, which carries an lpxtg-like cell wall anchoring ...201323517059
evaluation of the fully automated bd max cdiff and xpert c. difficile assays for direct detection of clostridium difficile in stool specimens.we evaluated the fully automated molecular bd max cdiff assay (bd diagnostics) and the xpert c. difficile test (cepheid) for rapid detection of clostridium difficile infection. culture was done on chromogenic agar followed by matrix-assisted laser desorption ionization-time of flight (maldi-tof) mass spectrometry identification and toxin detection. repeat testing was required for 1.8% and 6.0% of the bd max and xpert tests, respectively. sensitivities, specificities, positive predictive values ( ...201323515539
decreasing clostridium difficile infections in surgery: impact of a practice bundle incorporating a resident rounding protocol.clostridium difficile (cd) infection is a significant health problem. a new systems approach was introduced to reduce the risk of hospital-acquired cd infection (ha-cd) at our institution. we hypothesized that a practice bundle, including a protocol to limit patient exposures during house staff rounding, would decrease ha-cd infections.201323513633
chlorhexidine to maintain cleanliness of laryngoscope handles: an audit and laboratory study.laryngoscope handles are a potential vector for infection transmission and require adequate decontamination.201323511956
fecal microbiota transplantation for clostridium difficile infection: systematic review and meta-analysis.the clinical and economic burden of clostridium difficile infection (cdi) is significant. recurrent cdi management has emerged as a major challenge with suboptimal response to standard therapy. fecal microbiota transplantation (fmt) has been used as a treatment to reconstitute the normal microbial homeostasis and break the cycle of antibiotic agents that may further disrupt the microbiome. given the lack of randomized-controlled trials (rcts) and limitations in previous systematic reviews, we ai ...201323511459
effect of host defenses on clostridium difficile toxin-induced intestinal barrier injury.the severity of clostridium difficile-associated infection depends on the virulence factors of the organism and host factors, including intestinal barrier function. the intestinal mucus layer has recently been recognized as the first line of defense against enteric pathogens. its interaction with mucosal humoral immunity provided by secretory immunoglobulin a (siga) is unknown as it relates to c. difficile disease severity. this was studied in vitro.201323511135
rifaximin therapy and clostridium difficile infection: a note of caution. 201323507769
clostridium difficile infection and inflammatory bowel disease.the prevalence of clostridium difficile infection (cdi) in inflammatory bowel disease (ibd) has become a focus of increased attention, as the c. difficile epidemic continues to grow. although first documented more than 20 years ago, only in recent years has the relationship between these 2 entities been better clarified, and recent epidemiologic studies have shown that ibd patients are at increased susceptibility for cdi compared with the general population. despite this increased attention, muc ...201323507767
opioid use and clostridium difficile infection. 201323507210
procalcitonin levels associate with severity of clostridium difficile infection.clostridium difficile infection (cdi) is a major cause of morbidity and biomarkers that predict severity of illness are needed. procalcitonin (pct), a serum biomarker with specificity for bacterial infections, has been little studied in cdi. we hypothesized that pct associated with cdi severity.201323505476
clostridium difficile contamination of public tap water distribution system during a waterborne outbreak in finland.in november through december 2007, the drinking water distribution system in the town of nokia, finland, was contaminated with treated sewage effluent that resulted in a large gastroenteritis outbreak in the community. the aim of the present study was to investigate if the contaminated water in this outbreak was also a potential source of clostridium difficile infections.201323503193
effects of nisin and reutericyclin on resistance of endospores of clostridium spp. to heat and high pressure.the effects of high pressure, temperature, and antimicrobial compounds on endospores of clostridium spp. were examined. minimal inhibitory concentrations (mic) of nisin and reutericyclin were determined for vegetative cells and endospores of clostridium sporogenes atcc 7955, clostridium beijerinckii atcc 8260, and clostridium difficile 3195. endospores of c. sporogenes atcc 7955 and c. beijerinckii atcc 8260 were exposed to 90 °c and 90 °c/600 mpa in the presence of 16 mg l(-1) nisin or 6.4 mg l ...201223498177
clinical and microbiological features of clostridium difficile infections in france: the icd-raisin 2009 national survey.the surveillance of clostridium difficile infections (cdi) in france was reinforced after the emergence of the pcr-ribotype 027 epidemic clone in 2006; notification of case clusters or severe cases by healthcare facilities (hcf) became mandatory. the french public health surveillance institute (invs) and the c. difficile national reference center (nrc) launched a national, prospective, multicentric survey to complete available data, in 2009. the survey had for objectives to assess cdi incidence ...201323498135
clostridium difficile in faeces from healthy dogs and dogs with diarrhea.this study was conducted to evaluate the faecal occurrence and characterization of clostridium difficile in clinically healthy dogs (n = 50) and in dogs with diarrhea (n = 20) in the stockholm-uppsala region of sweden.201323497714
current role of surgery for the treatment of fulminant clostridium difficile colitis.this review discusses the current status and progress in studies on fulminant clostridium difficile colitis (fcdc), including the definition, risk factor, diagnostic role of ct, surgical treatment, postoperative mortality, and new therapeutic strategy.201323489808
understanding factors that impact on health care professionals' risk perceptions and responses toward clostridium difficile and meticillin-resistant staphylococcus aureus: a structured literature review.clostridium difficile is the most common health care-associated infection. despite considerable efforts to prevent and manage c difficile, poor clinical practice and nonadherence to policy continues to compromise patient safety. risk perception research is essential in gaining understanding about how health care professionals respond.201323489738
the role of gut inflammation in recurrent clostridium difficile-associated disease. 201323487370
markers of intestinal inflammation, not bacterial burden, correlate with clinical outcomes in clostridium difficile infection.clostridium difficile is a leading hospital-acquired infection. many patients remain symptomatic for several days on appropriate antibiotic therapy. to assess the contribution of ongoing infection vs persistent inflammation, we examined the correlation between fecal cytokine levels, fecal c. difficile burden, and disease outcomes in c. difficile infection (cdi).201323487367
portal vein thrombosis following laparoscopic sleeve gastrectomy for morbid obesity.portal vein thrombosis has been documented after laparoscopic general surgery and has been uncommonly observed after laparoscopic bariatric surgery. among bariatric operations, the sleeve gastrectomy is being performed with ever-increasing frequency. here we report the case of a man who presented with portal vein thrombosis after laparoscopic sleeve gastrectomy.201223484577
glutamine and alanyl-glutamine increase rhoa expression and reduce clostridium difficile toxin-a-induced intestinal epithelial cell damage.clostridium difficile is a major cause of antibiotic-associated colitis and is associated with significant morbidity and mortality. glutamine (gln) is a major fuel for the intestinal cell population. alanyl-glutamine (ala-gln) is a dipeptide that is highly soluble and well tolerated. iec-6 cells were used in the in vitro experiments. cell morphology was evaluated by atomic force microscopy (afm) and scanning electron microscopy (sem). cell proliferation was assessed by wst-1 and ki-67 and apopto ...201223484083
a segment of 97 amino acids within the translocation domain of clostridium difficile toxin b is essential for toxicity.clostridium difficile toxin b (tcdb) intoxicates target cells by glucosylating rho gtpases. tcdb (269 kda) consists of at least 4 functional domains including a glucosyltransferase domain (gtd), a cysteine protease domain (cpd), a translocation domain (td), and a receptor binding domain (rbd). the function and molecular mode of action of the td, which is the largest segment of tcdb and comprises nearly 50% of the protein, remain largely unknown. here we show that a 97-amino-acid segment (aa1756 ...201323484044
clostridium difficile infection in patients with inflammatory bowel disease. 201223483861
[infusion of donor feces in recurrent clostridium difficile infection? - infusion of donor feces: promising intervention with several question marks]. 201323483414
clostridium difficile colitis in patients undergoing lower-extremity arthroplasty: rare infection with major impact.the prevalence of clostridium difficile colitis is reportedly increasing in surgical patients and can negatively impact their outcome. however, as yet there are no clear estimates of the c difficile infection colitis rate and its consequences among patients undergoing total joint arthroplasty (tja).201323479237
meta-analysis of antibiotics and the risk of community-associated clostridium difficile infection.the rising incidence of clostridium difficile infection (cdi) could be reduced by lowering exposure to high-risk antibiotics. the objective of this study was to determine the association between antibiotic class and the risk of cdi in the community setting. the embase and pubmed databases were queried without restriction to time period or language. comparative observational studies and randomized controlled trials (rcts) considering the impact of exposure to antibiotics on cdi risk among nonhosp ...201323478961
health care burden of clostridium difficile infection in hospitalized children with inflammatory bowel disease.children with inflammatory bowel disease (ibd), similar to adults, are at increased risk of acquiring a clostridium difficile infection (cdi). our objective was to characterize the health care burden associated with cdi in hospitalized pediatric patients with ibd.201323478808
trends in clostridium difficile infection and risk factors for hospital acquisition of clostridium difficile among children with cancer.to study the trend of clostridium difficile infection (cdi) and risk factors for hospital acquired cdi (ha-cdi) among children with cancer.201323477996
expression and display of clostridium difficile protein flid on the surface of bacillus subtilis spores.the endospores of bacillus subtilis can serve as a tool for surface presentation of heterologous proteins. the unique properties of the spore protective layers make them perfect vehicles for orally administered vaccines. in this study, we successfully displayed a fragment of clostridium difficile flid protein on the surface of b. subtilis spores using the cotb, cotc, cotg and cotz spore coat proteins. the presence of the fusion proteins in the spore coat was verified by western blotting and immu ...201323475909
the clostridium difficile problem: a south african tertiary institution's prospective perspective.the aim of this study is to report the incidence of clostridium difficile-associated disease (cdad) in a tertiary-care hospital in south africa and to identify risk factors, assess patient outcomes and determine the impact of the hypervirulent strain of the organism referred to as north american pulsed-field type 1 (nap1).201323472693
analysis of nosocomial acquired clostridium difficile infection in an italian research and teaching hospital.clostridium difficile (cd) infection is a nosocomial plague which is correlated with several clinical and medical factors such as antibiotics intake. it is known that prevention is possible through infection control measures both clinical and epidemiological.201323471449
effectiveness of supportive care measures to reduce infections in pediatric aml: a report from the children's oncology group.objective was to describe the effect of antibiotic and granulocyte colony-stimulating factor (g-csf) prophylaxis and discharge policy on infection risk and nonrelapse-related mortality (nrm) during chemotherapy for children with acute myeloid leukemia. patients were non-down syndrome children enrolled on children's oncology group (cog) trial aaml0531. we surveyed sites to determine institutional standards for systemic antibacterial, antifungal, and g-csf prophylaxis, and mandatory hospitalizatio ...201323471307
in vitro inhibition of clostridium difficile and clostridium perfringens by commercial probiotic strains.probiotics have gained importance in human and veterinary medicine to prevent and control clostridial enteric disease. limited information is available on the ability of different probiotic bacteria used in food products to inhibit clostridium difficile and clostridium perfringens. the objective of this study was to examine the in vitro inhibitory effects of selected commercial bacterial strains on pathogenic clostridia and their growth characteristics under simulated gastrointestinal conditions ...201323471038
predictors of mortality after emergency colectomy for clostridium difficile colitis: an analysis of acs-nsqip.to evaluate clinical factors associated with mortality in emergency colectomies performed for clostridium difficile colitis.201423470584
deadly diarrhea: clostridium difficile infection.diarrhea is often only a minor inconvenience, but sometimes it can be deadly--especially if it results from a clostridium difficile infection. clostridium difficile colitis is becoming increasingly common and more virulent, and patients with kidney failure are at increased risk for development of a clostridium disfficile infection. this article provides information about clostridium difficile infection, its incidence, diagnosis, and treatment. in addition, the article discusses how to combat the ...201223469412
the association between histamine 2 receptor antagonist use and clostridium difficile infection: a systematic review and meta-analysis.clostridium difficile infection (cdi) is a major health problem. epidemiological evidence suggests that there is an association between acid suppression therapy and development of cdi.201323469173
gut microbiota patterns associated with colonization of different clostridium difficile ribotypes.c. difficile infection is associated with disturbed gut microbiota and changes in relative frequencies and abundance of individual bacterial taxons have been described. in this study we have analysed bacterial, fungal and archaeal microbiota by denaturing high pressure liquid chromatography (dhplc) and with machine learning methods in 208 faecal samples from healthy volunteers and in routine samples with requested c. difficile testing. the latter were further divided according to stool consisten ...201323469128
fecal transplant in refractory clostridium difficile colitis.clostridium difficile infections are becoming more common, more severe, and more likely to recur. conventional treatment with antibiotics often fails to eradicate the infection; even when it succeeds, recurrent infection is common. complementary treatment with probiotic agents to reconstitute the physiological intestinal flora does not yield any consistent benefit. in recent years, fecal transplantation has been used in the english-speaking countries with cure rates of about 87%, but the availab ...201323468820
clostridium difficile-associated diarrhea in an ocelot (leopardus pardalis).the aim of this study is to report a case of clostridium difficile-associated diarrhea in an ocelot (leopardus pardalis) in the state of mato grosso do sul, brazil. the animal, a 24-month-old male, was referred to the centro de reabilitação de animais silvestres (cras) with a history of having been run over and tibia and fibula fractures. after a surgery to repair the fractures, the ocelot underwent antibiotic therapy with two doses of sodium cefovecin, during which he presented with diarrhea. a ...201323467074
clostridium difficile infection: it's a family affair. 201323466923
transfer of clostridium difficile spores by nonsporicidal wipes and improperly used hypochlorite wipes: practice + product = perfection. 201323466922
electronic health record-based detection of risk factors for clostridium difficile infection relapse.a major challenge in treating clostridium difficile infection (cdi) is relapse. many new therapies are being developed to help prevent this outcome. we sought to establish risk factors for relapse and determine whether fields available in an electronic health record (ehr) could be used to identify high-risk patients for targeted relapse prevention strategies.201323466915
antibacterial and cytotoxic activity of isoprenylated coumarin mammea a/aa isolated from mammea africana.the stem bark of mammea africana is widely distributed in tropical africa and commonly used in traditional medicine. this study aims to identify the active compound in mammea africana and to evaluate its antimicrobial and antiproliferative activity.201323466248
environmental prevention of infection in stem cell transplant recipients: a survey of the infectious diseases working party of the european group for blood and marrow transplantation.the developments of peripheral blood stem cells in autologous hematopoietic stem cell transplantation (auto-hct), and of reduced-intensity conditioning (ric) regimens in allogeneic hct (allo-hct), have considerably changed the transplant approach. prolonged neutropenia combined with severe mucosal damage and organ dysfunction is no longer the rule in the early post-hct pancytopenic phase. although strict isolation during pancytopenia was followed by most hct units in the past, this may not be th ...201323465046
clostridium difficile infections in solid organ transplantation. 201323464997
does infection with specific clostridium difficile strains or clades influence clinical outcome? 201323463642
relationship between bacterial strain type, host biomarkers, and mortality in clostridium difficile infection.despite substantial interest in biomarkers, their impact on clinical outcomes and variation with bacterial strain has rarely been explored using integrated databases.201323463640
successful use of fidaxomicin in recurrent clostridium difficile infection in a child. 201323463209
clostridium difficile infection in children.clostridium difficile is the most common cause of health care-associated diarrhea among adults in the united states and is associated with significant morbidity and mortality. during the past decade, the epidemiology of c difficile infection (cdi) has changed, including a rise in the rate and severity of infection related to the emergence of a hypervirulent strain as well as an increase in disease among outpatients in community settings. although less is known about cdi among pediatric patients, ...201323460123
in vitro activity of cadazolid against clostridium difficile strains isolated from primary and recurrent infections in stockholm, sweden.one hundred thirty-three clostridium difficile strains were collected from 71 patients and analyzed for the presence of c. difficile toxin b by the cell cytotoxicity neutralization assay, genes for toxin a, toxin b, binary toxin and tcdc deletion by pcr. all strains were also pcr-ribotyped and analyzed for sporulation frequency. the mics of the isolates were determined against cadazolid and seven other antimicrobial agents by the agar dilution method. all isolates were positive for toxin b by th ...201323454525
statewide costs of health care-associated infections: estimates for acute care hospitals in north carolina.state-specific, health care-associated infection (hai) cost estimates have not been calculated to guide department of public health efforts and investments.201323453162
in vitro biological effects of two anti-diabetic medicinal plants used in benin as folk medicine.extracts from polygonum senegalensis (polygonaceae) and pseudocedrela kotschyi (meliaceae) are two important traditionally used medicinal plants in rural benin to treat many diseases and notably type 2 diabetes. the aim of the study was to investigate the α-glucosidase inhibition, antioxidant and antibacterial activities of those plants extract: polygonum senegalensis leaves, and pseudocedrela kotschyi root.201323452899
detection of a/b toxin and isolation of clostridium difficile and clostridium perfringens from foals.toxin detection and screening could contribute to knowledge of the transmission patterns, risk factors and epidemiology of clostridium difficile and clostridium perfringens.201323452044
clostridium difficile infection of a prosthetic knee joint requiring amputation. 201323451730
[clostridium difficile infection as interdisciplinary challenge. current discussions in respect to epidemiology, diagnostic methods, risk classification as well as treatment options].within the last decade, the incidence ofclostridium difficile infection (cdi) has increased in many regions all over the world including the highly virulent b1/nap1/027 strain. meanwhile, the value of predisposing risk factors and diagnostic measures as well as the spectrum of therapeutic options has been elucidated in more detail. most commonly applied antiinfective agents include metronidazole, vancomycin and fidaxomicin, however, several questions remain unanswered in respect to their optimiz ...201323451705
detection of clostridium difficile in retail ground meat products in manitoba.the aim of the present study was to determine whether clostridium difficile was present in uncooked retail ground beef and ground pork products sold in winnipeg, manitoba. using an alcohol treatment protocol and inoculation of cultures on c difficile moxalactam norfloxacin (cdmn), toxigenic c difficile was found in 6.3% of 48 meat samples. the c difficile isolates belonged to different pulsotypes, all of which had been previously isolated from the stool of manitoba patients with c difficile dise ...201223450202
contamination of ready-to-eat raw vegetables with clostridium difficile in france.the presence of clostridium difficile in food like shellfish, vegetables and meat has been reported in several publications during the past few years. the objective of this study was to assess the prevalence of ready-to-eat raw vegetables contaminated with c. difficile in france. one hundred and four ready-to-eat salads and vegetables were studied. toxigenic c. difficile strains were isolated in three samples (2.9 %): two ready-to-eat salads (one heart of lettuce and one lamb's lettuce salad) an ...201323449876
epidemiology of clostridium difficile infection and risk factors for unfavorable clinical outcomes: results of a hospital-based study in barcelona, spain.prospective hospital-based surveillance for clostridium difficile-associated disease (cdad) was conducted in barcelona (spain) to describe the epidemiology of this condition and investigate the risk factors for an unfavorable outcome. all patients diagnosed with cdad during 2009 were included. using logistic regression modeling, we analyzed the potential risk factors associated with recurrent and complicated cdad, defined as a need for colectomy or death within 30 days. there were 365 episodes o ...201323447638
emergence of clostridium difficile infection in tuberculosis patients due to a highly rifampicin-resistant pcr ribotype 046 clone in poland.clostridium difficile infection (cdi) is a major cause of nosocomial diarrhea. cdi is known to develop after antibiotic administration, but anti-tuberculosis agents have rarely been implicated. we documented an outbreak caused by a highly rifampicin-resistant c. difficile strain of polymerase chain reaction (pcr) ribotype 046 in patients with active tuberculosis.201323443474
diverticular disease of the colon does not increase risk of repeat c. difficile infection.studies have suggested that colonic diverticulosis might increase the likelihood of repeat clostridium difficile infection (cdi). our study was designed to compare rates of repeat infection in patients with and without colon diverticula.201623442832
risk factors for clostridium difficile acquisition in infants: importance of study design. 201323442761
mortality in clostridium difficile infection: a prospective analysis of risk predictors.to date, the vast majority of studies investigating risk factors for mortality in clostridium difficile infection (cdi) have been based on retrospective, routinely collected data, and have not specifically tested the capacity of risk factors to predict outcome. we aimed to prospectively evaluate predictors of mortality in patients with cdi, utilizing established metrics of risk prediction to assess their ability to prognosticate.201323442414
guidelines for diagnosis, treatment, and prevention of clostridium difficile infections.clostridium difficile infection (cdi) is a leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system. patients with cdi typically have extended lengths-of-stay in hospitals, and cdi is a frequent cause of large hospital outbreaks of disease. this guideline provides recommendations for the diagnosis and management of patients with cdi as well as for the prevention and control of outbreaks while supplementing previously published guidelines. n ...201323439232
using phenotype microarrays to determine culture conditions that induce or repress toxin production by clostridium difficile and other microorganisms.toxin production is a central issue in the pathogenesis of clostridium difficile and many other pathogenic microorganisms. toxin synthesis is influenced by a variety of known and unknown factors of genetics, physiology, and environment. to facilitate the study of toxin production by c. difficile, we have developed a new, reliable, quantitative, and robust cell-based cytotoxicity assay. then we combined this new assay with phenotype microarrays (pm) technology which provides high throughput testi ...201323437164
comparative analysis of different methods to detect clostridium difficile infection.the increased incidence and severity of clostridium difficile infection, particularly in north america and europe, have brought renewed focus on the most appropriate method to detect c. difficile and/or its toxins in stools. this prospective study evaluated the usefulness of the illumigene tm c. difficile assay in diagnostic practice for the detection of toxigenic c. difficile dna in clinical samples. a total of 88 out of 306 stool samples analysed were positive both by illumigene and the combin ...201323435816
hyperimmune bovine colostrum for treatment of gi infections: a review and update on clostridium difficile.hyperimmune bovine colostrum (hbc), produced by vaccination of a cow during gestation, is rich in targeted immunoglobulins, and can be used to treat a variety of diseases. the published history of hbc use for treating gastrointestinal infections in humans has developed over the past several decades and demonstrates the promise of this type of therapeutic for gi infectious disease. hbc, or purified derivative products, have been used successfully for treatment or prevention of cryptosporidiosis, ...201323435084
probiotics in clostridium difficile infection: reviewing the need for a multistrain probiotic.in the past two years an enormous amount of molecular, genetic, metabolomic and mechanistic data on the host-bacterium interaction, a healthy gut microbiota and a possible role for probiotics in clostridium difficile infection (cdi) has been accumulated. also, new hypervirulent strains of c. difficile have emerged. yet, clinical trials in cdi have been less promising than in antibiotic associated diarrhoea in general, with more meta-analysis than primary papers on cdi-clinical-trials. the fact t ...201323434948
defining acute renal dysfunction as a criterion for the severity of clostridium difficile infection in patients with community-onset vs hospital-onset infection.acute renal dysfunction can be used to define severe clostridium difficile infection (cdi). the society for healthcare epidemiology of america (shea) and infectious disease society of america (idsa) guidelines define acute renal dysfunction as serum creatinine (srcr) ≥1.5 times the premorbid level.201323433867
isolation of a toxigenic and clinical genotype of clostridium difficile in retail meats in costa rica.we isolated a regional toxigenic genotype of clostridium difficile, previously found in human infection in 4 of 200 (2%) samples of retail meats for human consumption: 1 of 67 samples of beef, 2 of 66 of pork, and 1 of 67 of poultry meat. these four isolates were positive for the tcda and tcdb genes but negative for deletion of the tcdc and cdtb genes. all strains induced cytopathic effects in hela cells. however, they were susceptible to some antibiotics to which clinical isolates are often res ...201323433387
isolation and characterization of clostridium difficile associated with beef cattle and commercially produced ground beef.the incidence of clostridium difficile infection has recently increased in north american and european countries. this pathogen has been isolated from retail pork, turkey, and beef products and reported associated with human illness. this increase in infections has been attributed to the emergence of a toxigenic strain designated north america pulsed-field gel electrophoresis type 1 (nap1). the nap1 strain has been isolated from calves as well as ground meat products, leading to speculation of i ...201323433373
concurrent outbreaks with co-infection of norovirus and clostridium difficile in a long-term-care facility.we describe an outbreak of simultaneous clostridium difficile and norovirus infections in a long-term-care facility. thirty patients experienced acute gastroenteritis, and four had co-infection with identical c. difficile 027 and genotype ii.4 new orleans norovirus strains. co-occurring infection requires improved understanding of risk factors, clinical impact, and testing strategies.201323433360
clostridium difficile outcomes difficult to generalize. 201323433315
effects of ciprofloxacin on the expression and production of exotoxins by clostridium difficile.hypervirulent bi/nap1/027 strains of clostridium difficile have been associated with increased mortality of c. difficile infection (cdi). the emergence of highly fluoroquinolone (flq)-resistant bi/nap1/027 strains suggests that flq exposure may be a risk factor for cdi development. however, the mechanism for this is not clear. we compared the effects of subinhibitory concentrations of ciprofloxacin on toxin a and b gene expression and protein production in recent (strain 039) and historical (str ...201323429695
[risk factors for relapsing and severe colitis caused by clostridium difficile infection].describe risk factors for relapsing and severe clostridium difficile infection (cdi) in a set of patients hospitalized at the clinic of infectious diseases the university hospital brno.201323427999
novel avenues for clostridium difficile infection drug discovery.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 agents able to neutralize the bacterium without affecting the gut microbiota are badly needed.201323427910
a new strategy for the prevention of clostridium difficile infection.clostridium difficile infection (cdi) is a leading cause of antibiotic-associated diarrhea. the infective form of c. difficile is the spore, but the vegetative bacterium causes the disease. because c. difficile spore germination is required for symptomatic infection, antigermination approaches could lead to the prevention of cdi. we recently reported that camsa, a bile salt analog, inhibits c. difficile spore germination in vitro.201323420906
a potential new tool for managing clostridium difficile infection. 201323420904
antimicrobial activity of lff571 and three treatment agents against clostridium difficile isolates collected for a pan-european survey in 2008: clinical and therapeutic implications.in november 2008, a study was performed with support from the european centre for disease prevention and control (ecdc) to obtain an overview of clostridium difficile infections (cdis) in european hospitals. a collection of 398 c. difficile isolates obtained from this hospital-based survey was utilized to identify antimicrobial susceptibility patterns of common c. difficile pcr ribotypes across europe.201323420839
regarding "clostridium difficile ribotype does not predict severe infection". 201323420817
secular trends in the epidemiology of clostridium difficile infection (cdi): relationship with alcohol gel and antimicrobial usage in a hospital.clostridium difficile-associated diarrhea (cdad) has shown increasing incidence, morbidity, and mortality in recent years. we assessed the number of cdad tests requested, cdad positivity rates, the use of alcohol-based hand rubs, and antimicrobial utilization.201323419978
improved detection of clostridium difficile in animals by using enrichment culture followed by lightcycler real-time pcr.the performance of our previously published taqman real-time pcr (tmrtpcr) for the detection of clostridium difficile directly from animal faeces was found to be inadequate due to tmrtpcr false negative results. therefore, we developed a new internally controlled lightcycler real-time pcr (lc rtpcr) capable of detecting variant strains in diarrhoeic and subclinical animals by using two hybridisation probes instead of one hydrolysis probe used in tmrtpcr. while lc rtpcr did not provide better res ...201323419821
[probiotics in gastroenterology -- from a different angle].after a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. the indications of probiotic administration have been defined and extended in recent years. the author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. probiotics are useful in preventing and treating diarrhoea caused by antibi ...201323419530
clostridium-dt(db): a comprehensive database for potential drug targets of clostridium difficile.clostridium difficile is considered to be one of the most important causes of health care-associated infections currently. the prevalence and severity of c. difficile infection have increased significantly worldwide in the past decade which has led to the increased research interest. here, using comparative genomics strategy coupled with bioinformatics tools we have identified potential drug targets in c. difficile and determined their three-dimensional structures in order to develop a database, ...201323415847
prospective comparison of a commercial multiplex real-time polymerase chain reaction and an enzyme immunoassay with toxigenic culture in the diagnosis of clostridium difficile-associated infections.clostridium difficile infections (cdi) is a leading cause of nosocomial infections worldwide. the changes in the epidemiology of cdi during the past years, including the appearance of new epidemic strains of c. difficile that cause cdi episodes with increased severity, have led to the development of molecular methods with improved sensitivity and specificity. this study was designed to compare the performances of one antigen assay (vidas, biomérieux) and one molecular assay (genexpert, cepheid). ...201323415540
[infections caused by clostridium difficile].the epidemiology of clostridium difficile infections (cdis) has dramatically changed over the last decade in both north america and europe, and it has become more frequent, more severe, more refractory to standard therapy, and more likely to relapse. these changes have been associated with the emergence of a "hypervirulent" strain known as bi/nap1/027 which has become endemic in some areas, although, other hypervirulent genotypes (e.g. pcr ribotype 078) have also been described. to reduce the in ...201323411363
structural and functional analysis of the cspb protease required for clostridium spore germination.spores are the major transmissive form of the nosocomial pathogen clostridium difficile, a leading cause of healthcare-associated diarrhea worldwide. successful transmission of c. difficile requires that its hardy, resistant spores germinate into vegetative cells in the gastrointestinal tract. a critical step during this process is the degradation of the spore cortex, a thick layer of peptidoglycan surrounding the spore core. in clostridium sp., cortex degradation depends on the proteolytic acti ...201323408892
the epidemiology of clostridium difficile infection in children: a population-based study.the incidence of clostridium difficile infection (cdi) is increasing, even in populations previously thought to be at low risk, including children. most incidence studies have included only hospitalized patients and are thus potentially influenced by referral or hospitalization biases.201323408679
correlation between coinfection with parasites, cytomegalovirus, and clostridium difficile and disease severity in patients with ulcerative colitis.a cross-sectional study was undertaken to determine whether there was any association between intestinal infection (with parasites, cytomegalovirus, or clostridium difficile) and clinical disease severity in patients with ulcerative colitis (uc). consecutive cases of uc were enrolled after history and clinical examination, evaluated for presence of stool parasites (routine/special stains) and c. difficile toxins a and b (cdt) in stools. segmental biopsies at colonoscopy were assessed for cytopat ...201323408260
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