Publications

direct e-test (ab biodisk) of respiratory samples improves antimicrobial use in ventilator-associated pneumonia.	ventilator-associated pneumonia is the most frequently observed nosocomial infection in intensive care units, and it is associated with high morbidity and mortality. early microbiological diagnosis and the initial administration of appropriate antimicrobial therapy are associated with decreased mortality and potentially reduced costs. our study evaluates the clinical and financial impact of performing rapid antimicrobial susceptibility tests directly on samples obtained from the lower respirator ...	2007	17205445
antibiotics and clostridium difficile: cause and cure.		2007	17198057
[clinical case of the month: clostridium difficile colitis].	a 55-year-old patient with mant e cels underwent a cytotoxic chemotherapy (d.h.a.p. + rituximab). during the medullar aplasia related to the third cycle, diarrhoea due to clostridium difficile arised and relapsed 15 days later despite normal blood counts. this colitis was very severe with pluribacterial peritonitis, but resolved with intensive medical treatment. the incidence, the patient's risk factors, the iatrogenic and nosocomial characters of cl. difficile colitis are discussed.	2006	17191741
old bugs learn some new tricks.		2006	17186890
ertapenem versus cefotetan prophylaxis in elective colorectal surgery.	ertapenem, a long-acting carbapenem, may be an alternative to the recommended prophylactic antibiotic cefotetan.	2006	17182989
prophylactic antibiotics in obstetrics-gynecology: a current asset, a future liability?	currently, prophylactic antibiotics have proven effective in lowering the postoperative and postprocedure infection rate following vaginal hysterectomy, emergency cesarean section for the patient in labor, radical hysterectomy, abdominal hysterectomy, pregnancy termination, hysterosalpingogram and intrauterine device insertion. guidelines for the most effective and safe use are presented. concerns are raised regarding the widespread prolonged use of prophylactic antibiotics on women in labor to ...	2006	17181412
ramoplanin: a topical lipoglycodepsipeptide antibacterial agent.	ramoplanin, a novel antibiotic with activity against aerobic and anaerobic gram-positive bacteria, acts to prevent cell wall peptidoglycan formation by binding to a key intermediate moiety, lipid ii. it has been fast-tracked by the us fda for the prevention of enterococcal infections and the treatment of clostridium difficile. the minimum inhibitory concentration(90s) have been < or = 1.0 microg/ml against gram-positive organisms examined. in carriers of vancomycin-resistant enterococci, a doubl ...	2006	17181409
icd-9 codes and surveillance for clostridium difficile-associated disease.	we conducted a retrospective cohort study to compare clostridium difficile-associated disease rates determined by c. difficile-toxin assays and international classification of diseases, 9th revision (icd-9) codes. the correlation between toxin assay results and icd-9 codes was good (k = 0.72, p<0.01). the sensitivity of the icd-9 codes was 78% and the specificity was 99.7%.	2006	17176576
a portrait of the geographic dissemination of the clostridium difficile north american pulsed-field type 1 strain and the epidemiology of c. difficile-associated disease in québec.	an increase in the incidence and severity of clostridium difficile-associated disease in québec and the united states has been associated with a hypervirulent strain referred to as north american pulsed-field type 1 (nap1)/027.	2007	17173224
evaluation of real-time pcr and conventional diagnostic methods for the detection of clostridium difficile-associated diarrhoea in a prospective multicentre study.	in this prospective multicentre study, an enzyme-linked fluorescent assay (vidas cda2; biomérieux), an enzyme-linked assay [premier toxins a and b (ptab); meridian] and an in-house real-time pcr amplifying the tcdb gene were compared with the cell cytotoxicity assay used as the 'gold standard' for diagnosis of clostridium difficile-associated diarrhoea (cdad). faecal samples from patients with a request for c. difficile diagnosis and samples from patients with diarrhoea hospitalized for at least ...	2007	17172514
typing and subtyping of clostridium difficile isolates by using multiple-locus variable-number tandem-repeat analysis.	using the genomic sequence of clostridium difficile strain 630, we developed multiple-locus variable-number tandem-repeat analysis (mlva) with automated fragment analysis and multicolored capillary electrophoresis as a typing method for c. difficile. all reference strains, representing 31 serogroups, 25 toxinotypes, and 7 known subtypes of pcr ribotype 001, could be discriminated from each other. application of mlva to 28 isolates from 7 outbreaks due to the emerging hypervirulent pcr ribotype 0 ...	2007	17166961
cholesterol, it's not just for heart disease anymore.	recent studies have shown that cholesterol plays a significant role in the ability of toxin a from clostridium difficile to enter eukaryotic cells. the translocation process is one of three major steps during intoxication that could be targeted for intervention against the severe antibiotic-associated diarrhea caused by c. difficile.	2006	17163660
a hospital outbreak of diarrhea due to an emerging epidemic strain of clostridium difficile.	increased clostridium difficile-associated disease (cdad) in a hospital and an affiliated long-term care facility continued despite infection control measures. we investigated this outbreak to determine risk factors and transmission settings.	2006	17159019
antiparasitic drug nitazoxanide inhibits the pyruvate oxidoreductases of helicobacter pylori, selected anaerobic bacteria and parasites, and campylobacter jejuni.	nitazoxanide (ntz) exhibits broad-spectrum activity against anaerobic bacteria and parasites and the ulcer-causing pathogen helicobacter pylori. here we show that ntz is a noncompetitive inhibitor (k(i), 2 to 10 microm) of the pyruvate:ferredoxin/flavodoxin oxidoreductases (pfors) of trichomonas vaginalis, entamoeba histolytica, giardia intestinalis, clostridium difficile, clostridium perfringens, h. pylori, and campylobacter jejuni and is weakly active against the pyruvate dehydrogenase of esch ...	2007	17158936
accuracy of icd-9 coding for clostridium difficile infections: a retrospective cohort.	clostridium difficile (c. diff) is a major nosocomial problem. epidemiological surveillance of the disease can be accomplished by microbiological or administrative data. microbiological tracking is problematic since it does not always translate into clinical disease, and it is not always available. tracking by administrative data is attractive, but icd-9 code accuracy for c. diff is unknown. by using a large administrative database of hospitalized patients with c. diff (by icd-9 code or cytotoxi ...	2007	17156501
[feces culture successful therapy in clostridium difficile diarrhea].		2006	17153868
klebsiella oxytoca as a causative organism of antibiotic-associated hemorrhagic colitis.	antibiotic-associated hemorrhagic colitis is a distinct form of antibiotic-associated colitis in which clostridium difficile is absent. although the cause is not known, previous reports have suggested a role of klebsiella oxytoca.	2006	17151365
past, present, and future therapies for clostridium difficile-associated disease.	to describe and examine the past, present, and potential future treatment options for clostridium difficile-associated disease (cdad).	2006	17148650
difference in the cytotoxic effects of toxin b from clostridium difficile strain vpi 10463 and toxin b from variant clostridium difficile strain 1470.	glucosylation of rhoa, rac1, and cdc42 by clostridium difficile toxin b from strain vpi 10463 (tcdb) results in actin reorganization (cytopathic effect) and apoptosis (cytotoxic effect). toxin b from variant c. difficile strain 1470 serotype f (tcdbf) differs from tcdb with regard to substrate proteins, as it glucosylates rac1 and r-ras but not rhoa and cdc42. in this study, we addressed the question of whether the cellular effects of the toxins depend on their protein substrate specificity. rat ...	2007	17145947
epidemiology and incidence of clostridium difficile-associated diarrhoea diagnosed upon admission to a university hospital.	patients with clostridium difficile-associated diarrhoea (cdad) may initially develop symptoms in the community and be subsequently diagnosed at hospital admission. at the present time there is no national surveillance system and no standardized case definition of cdad in the usa, and baseline data on the incidence and epidemiology of cdad are scarce. the objective of this study was to report the incidence of cdad at a tertiary care hospital, and to determine the epidemiology of cases diagnosed ...	2007	17145108
nitazoxanide versus metronidazole for clostridium difficile-associated colitis.		2007	17143841
treatment of a radiation-induced rectal ulcer with hyperbaric oxygen therapy in a man with prostate cancer.	late radiation proctopathy is a painful and vexing complication of prostate radiation. we report a case of a 55-year-old man with prostate cancer, and complaints of tenesmus and severe rectal pain after radiation therapy. the patient was diagnosed with a locally advanced gleason score 8 prostate cancer and an increased prostate-specific antigen of 42.3 ng/ml. his past medical history was notable for a history of bilateral lymph node dissection complicated by clostridium difficile colitis. he sub ...	2006	17138131
[influence of selected lactobacillus sp. on clostridium difficile strains with different toxigenicity profile].	this study was performed for determination of antagonistic activity of lactobacillus spp. (l. plantarum 2017405, l. rhamnosus gg, l. acidophilus dsm 21007 and l. fernmentumn 353) on clostridiunl difficile strains belonging to different toxigenicity profiles. forty strains c. difficile isolated from patients suffering from antibiotic associated diarrhea (aad) were used. among c. difficile strains 13 produced toxin a and b (a+b+cdt-), 14 produced only toxin b (ab'cdt), 9 produced toxins a and b an ...	2006	17133906
update on clostridium difficile associated disease.	the aim of this article is to report recent changes in the epidemiology of clostridium difficile associated disease.	2007	17133077
gut microbes, the innate immune system and inflammatory bowel disease: location, location, location.		2007	17133076
colonic irritation.		2006	17120341
emerging therapies in the treatment of clostridium difficile-associated disease.	to describe emergent therapies, such as rifaximin, nitazoxanide, intravenous immunoglobulin (ivig), tinidazole, tolevamer, and the possible use of a vaccine, in clostridium difficile-associated disease (cdad), one of the most common causes of diarrhea in hospitalized adults in north america.	2006	17119105
narrative review: the new epidemic of clostridium difficile-associated enteric disease.	antibiotic-associated diarrhea and colitis were well established soon after antibiotics became available. early work implicated staphylococcus aureus, but in 1978 clostridium difficile became the established pathogen in the vast majority of cases. in the first 5 years (1978 through 1983), the most common cause was clindamycin, the standard diagnostic test was the cytotoxin assay, and standard management was to withdraw the implicated antibiotic and treat with oral vancomycin. most patients respo ...	2006	17116920
antimicrobial therapy of clostridium difficile-associated diarrhea.	clostridium difficile-associated diarrhea (cdad) is the most common etiologically-defined cause of hospital-acquired diarrhea. caused by the toxins of certain strains of c difficile, cdad represents a growing concern, with epidemic outbreaks in some hospitals where very aggressive and difficult-to-treat strains have recently been found. incidence of cdad varies ordinarily between 1 to 10 in every 1,000 admissions. evidence shows that cdad increases morbidity, length of stay, and costs. this arti ...	2006	17116441
molecular analysis of clostridium difficile isolates recovered from horses with diarrhea.	clostridium difficile is an important cause of diarrhea in horses, causing sporadic and epidemic disease of varying severity. this study evaluated the molecular characteristics of 48 c. difficile isolates recovered from diarrheic horses admitted to a veterinary hospital by using pcr-ribotyping and toxin gene profile. additionally, feces were tested for the presence of c. difficile toxin a/b via enzyme immunosorbant assay (eia) in 38 horses. the toxin genes tcda, tcdb and cdtb were present in 27 ...	2007	17112686
a probiotic treatment containing lactobacillus, bifidobacterium and enterococcus improves ibs symptoms in an open label trial.	to evaluate the efficacy and safety of live combined bifidobacterium, lactobacillus and enterococcus capsules in treatment of irritable bowel syndrome.	2006	17111468
clostridium difficile-associated pouchitis.	pouchitis is the most common long-term sequela of ileal pouch-anal anastomosis (ipaa) following total proctocolectomy. no single pathogen is identified as being solely responsible for the pathogenesis of the disease. here we describe a case of clostridium difficile-associated pouchitis that was successfully treated with ciprofloxacin and tinidazole. diagnosis and management of a patient with medically refractory pouchitis associated with clostridium difficile infection is described. a 63-year-ol ...	2006	17103037
high unmet-need infectious disease opportunities.	despite advances in pharmaceutical science, considerable unmet medical needs exist in the field of anti-infective therapies. while pharmaceutical companies have focused research efforts on a few selected areas of the field, new microbial diseases have steadily increased in prevalence. three emerging areas in the field of anti-infectives now represent large commercial opportunities: gram-negative infections, community-acquired methicillin-resistant staphylococcus aureus, and clostridium difficile ...	2006	17096298
enhancing patient safety through the management of clostridium difficile at toronto east general hospital.	in 2005 toronto east general hospital experienced a steady increase in the number of c. difficile cases diagnosed within the hospital. this was identified as a patient safety issue, and several areas of the hospital came together to address the problem. pharmacy immediately started a medication review of past cases. environmental services took the lead on the environmental cleaning, and a process was put into place with infection control so that housekeeping knew of every room that contained a p ...	2006	17087168
treatment of clostridium difficile-associated disease (cdad).		2006	17082738
the potential role of computerized decision support systems to improve empirical antibiotic prescribing.	prudent antibiotic prescribing is a cornerstone of efforts to control the emergence and spread of antimicrobial resistance and to reduce the occurrence of clostridium difficile associated diarrhoea, and is also currently the subject of a joint working party of the british society for antimicrobial chemotherapy and the hospital infection society. an article in this issue of the journal describes a cluster randomized trial of an intervention to improve antibiotic prescribing using treat, a compute ...	2006	17082202
management of an outbreak of clostridium difficile-associated disease among geriatric patients.	to describe a nosocomial outbreak of clostridium difficile-associated disease (cdad).	2006	17080377
experimental evaluation of an automated endoscope reprocessor with in situ generation of peracetic acid for disinfection of semicritical devices.	to evaluate the effectiveness of a high-level disinfection solution generated inside an endoscope processing system for decontaminating external and internal surfaces of experimentally contaminated heat-sensitive medical devices.	2006	17080376
production of xylitol by metabolically engineered strains of bacillus subtilis.	xylitol-phosphate dehydrogenase (xpdh) genes from several gram-positive bacteria were isolated and expressed in bacillus subtilis. the substrate specificities of the recombinant xpdh enzymes were compared and it was found that the xpdh enzymes of lactobacillus rhamnosus and clostridium difficile had the highest selectivity towards d-xylulose 5-phosphate. expression of these two xpdh enzymes in d-ribulose and d-xylulose producing b. subtilis strain resulted in strains of b. subtilis capable of co ...	2007	17079043
helicobacter pylori and clostridium difficile in cystic fibrosis patients.	we describe the prevalence of h. pylori and toxigenic clostridium difficile (cd) infection and its relationship with gastrointestinal symptoms and pancreatic sufficiency (ps) or insufficiency (pi) in cystic fibrosis (cf) patients. stool specimens from 30 consecutive patients with cf, aged 1-44, and from 30 healthy similarly aged subjects were tested for the h. pylori antigen by specific monoclonal antibodies and for cd toxins by tox a/b assay and tox a assay. cf patients were assessed clinically ...	2006	17078007
lessons from stoke mandeville.		2006	17077764
final report and recommendations from the national notifiable diseases working group.	the national notifiable diseases working group performed a ranking of 48 communicable diseases to assist with determining priorities for national surveillance. the wg offers six specific recommendations relating to the addition or deletion of communicable diseases from the list of nationally notifiable diseases. key recommendations: 1. clostridium difficile-associated diarrhea, paralytic shellfish poisoning, and invasive listeriosis are recommended for addition to the nationally notifiable disea ...	2006	17076030
first isolation of clostridium difficile pcr ribotype 027 in austria.		2006	17075148
epidemiology of clostridium difficile toxinotype iii, pcr-ribotype 027 associated disease in belgium, 2006.		2006	17075147
emergence of clostridium difficile toxinotype iii, pcr-ribotype 027-associated disease, france, 2006.		2006	17075146
nosocomial infections in neurocritical care.	development of nosocomial infections is a commonly encountered problem for critically ill patients. approximately half of all nosocomial pneumonias in the neurointensive care unit (nicu) are associated with ventilator-associated pneumonia. prompt diagnosis with appropriate specimen analysis is required in order to prevent increased morbidity. catheter-related blood stream infection imposes financial as well as medical implications. multifaceted interventions are helpful to ensure adherence with ...	2006	17074289
fluoroquinolones and risk for methicillin-resistant staphylococcus aureus, canada.	receipt of fluoroquinolones was the predominant risk factor for clostridium difficile-associated disease (cdad) during an epidemic in quebec, canada. to determine the role of antimicrobial drugs in facilitating healthcare-associated methicillin-resistant staphylococcus aureus (mrsa) colonization and infection and to compare this role with their effects on methicillin-susceptible s. aureus infection and cdad, we conducted a retrospective cohort study of patients in a quebec hospital. for 7371 epi ...	2006	17073089
risk factors for clostridium difficile-associated diarrhea on an adult hematology-oncology ward.	nosocomial diarrhea caused by clostridium difficile causes significant morbidity and mortality in an increasing proportion of hospitalized patients annually. this case-control study of patients admitted to the hematology-oncology ward of a tertiary academic medical center over a 2-year period demonstrates that patients with clostridium difficile-associated diarrhea (cdad) were 22 times more likely than ward-matched controls with diarrhea to have received any antibiotic either during hospitalizat ...	2006	17072575
are probiotics effective for treating clostridium difficile disease and antibiotic-associated diarrhea?		2006	17068492
in vitro killing of nosocomial pathogens by acid and acidified nitrite.	exposure to ph 1 or 2 buffers or acidic gastric contents resulted in the killing of vancomycin-resistant enterococcus sp., klebsiella pneumoniae, staphylococcus aureus, and candida glabrata but not clostridium difficile spores. nitrite enhanced killing under acidic conditions, but significant killing of c. difficile spores required nitrite concentrations above usual physiological levels.	2006	17065628
ehrho1, a rhoa-like gtpase of entamoeba histolytica, is modified by clostridial glucosylating cytotoxins.	clostridial glucosylating cytotoxins inactivate mammalian rho gtpases by mono-o glucosylation of a conserved threonine residue located in the switch 1 region of the target protein. here we report that ehrho1, a rhoa-like gtpase from the protozoan parasite entamoeba histolytica, is glucosylated by clostridial cytotoxins. recombinant glutathione s-transferase-ehrho1 and ehrho1 from cell lysate of entamoeba histolytica were glucosylated by clostridium difficile toxin b and clostridium novyi alpha-t ...	2006	17056697
has the severity of clostridium difficile infections increased?		2007	17055114
proton pump inhibitors and hospitalization for clostridium difficile-associated disease: a population-based study.	previous studies have examined the association between proton pump inhibitor (ppi) use and the risk of clostridium difficile-associated disease (cdad), with conflicting results. whether outpatient ppi use influences the risk of hospital admission for cdad among older patients who have recently been treated with antibiotics is unknown.	2006	17051491
gut microbiota composition and development of atopic manifestations in infancy: the koala birth cohort study.	perturbations in intestinal microbiota composition due to lifestyle changes may be involved in the development of atopic diseases. we examined gut microbiota composition in early infancy and the subsequent development of atopic manifestations and sensitisation.	2007	17047098
analysis of proline reduction in the nosocomial pathogen clostridium difficile.	clostridium difficile, a proteolytic strict anaerobe, has emerged as a clinically significant nosocomial pathogen in recent years. pathogenesis is due to the production of lethal toxins, a and b, members of the large clostridial cytotoxin family. although it has been established that alterations in the amino acid content of the growth medium affect toxin production, the molecular mechanism for this observed effect is not yet known. since there is a paucity of information on the amino acid fermen ...	2006	17041035
larry's story.		2006	17038849
nosocomial diarrhoea.	toroviruses have been reported as a new cause of nosocomial viral diarrhoea, and the role of astroviruses has been further elucidated. polymerase chain reaction methods promise to improve the diagnosis and understanding of the aetiology and control of hospital-acquired viral gastroenteritis. a clearer picture of the impact and extent of clostridium difficile diarrhoea has emerged, and several control measures have been described. an epidemic clostridium difficile strain and toxin a-deficient str ...	1999	17035796
tcdc genotypes associated with severe tcdc truncation in an epidemic clone and other strains of clostridium difficile.	severe clostridium difficile associated disease is associated with outbreaks of the recently described bi/nap1 epidemic clone. this clone is characterized by an 18-bp deletion in the tcdc gene and increased production of toxins a and b in vitro. tcdc is a putative negative regulator of toxin a&b production. we characterized tcdc genotypes from a collection of c. difficile isolates from a hospital that experienced an outbreak caused by the bi/nap1 epidemic clone. sequence analysis of tcdc was per ...	2007	17035492
bacterial infections of the gut (excluding enteric fever).	bacterial enteric infections are still a major cause of morbidity and mortality, and many challenges lie ahead in understanding and managing these conditions. clostridium difficile remains the most important nosocomial infection. antibiotic resistance makes the treatment of shigella infections increasingly difficult. molecular and cellular techniques are, however, rapidly expanding our understanding of the complexity of the pathogenesis of established and newly recognized pathogens.	1998	17033424
probiotics in gastroenterology.	recent evidence has suggested the potential therapeutic role for probiotics in the prevention or treatment of gastrointestinal diseases. several studies have shown that probiotics are of benefit in gastrointestinal infections, including viral diarrhea, clostridium difficile-associated diarrhea, traveler's diarrhea, and antibiotic-associated diarrhea. recent data support the potential beneficial therapeutic effect in inflammatory bowel disease as well. other possible indications for probiotic tre ...	2002	17033293
induction of mucosal immune responses by bacteria and bacterial components.	bacteria have well documented abilities to induce protective as well as pathogenic mucosal immune responses, with the type of response dependent on the genetically programmed balance of pro- and anti-inflammatory cytokines and t-lymphocyte subsets. inflammatory bowel disease, especially crohn disease and periodontal disease, appear to be overly aggressive cellular immune responses to some, but not all, normal resident bacteria. recent evidence suggests that the balance of protective (probiotic) ...	2001	17031218
the role of probiotics in the treatment of intestinal infections and inflammation.	clinical studies have established that certain probiotics are useful in a variety of intestinal disorders, including viral diarrhea, antibiotic-associated diarrhea, clostridium difficile-associated diarrhea, and traveler's diarrhea. evolving data suggest that probiotics might be useful in the control of inflammatory diseases, treatment and prevention of allergic diseases, cancer prevention, and stimulation of the immune system, which may result in the reduction in respiratory disease. a review o ...	2001	17031151
tigecycline does not induce proliferation or cytotoxin production by epidemic clostridium difficile strains in a human gut model.	data on the risk of clostridium difficile infection (cdi) associated with specific antibiotics are difficult to obtain because of confounding clinical factors. it is particularly important to evaluate the propensity of new antibiotics to induce cdi. we have examined the propensity of tigecycline to induce cdi using a human gut model.	2006	17030519
bacterial aetiology of diarrhoea in young children: high prevalence of enteropathogenic escherichia coli (epec) not belonging to the classical epec serogroups.	diarrhoeal disease continues to be one of the most common causes of admittance in children hospital emergency. the aim of the present study was to investigate the relative contribution of enteropathogenic and enterohemorrhagic escherichia coli (epec and ehec, respectively) as a cause of infectious bacterial diarrhoea in children from the region of toulouse. we analysed 280 samples of stools from 280 children (<2 years) with diarrhoea admitted in the "hopital des enfants" from january to august 2 ...	2006	17030460
who are susceptible to pseudomembranous colitis among patients with presumed antibiotic-associated diarrhea?	pseudomembranous colitis is a severe form of antibiotic-associated diarrhea. however, there have been no reports about the factors that make patients with presumed antibiotic-associated diarrhea susceptible to pseudomembranous colitis. this study was designed to determine the clinical risk factors for pseudomembranous colitis among the patients with presumed antibiotic-associated diarrhea.	2006	17028914
[evaluation of four immunoenzymatic tests for detecting clostridium difficile toxins a and b].	four immunoenzymatic tests for detecting clostridium difficile toxins a and b were studied: two rapid tests (tox a/b quik chek-techlab and noviview toxine-a-hiss diagnostics) and two elisa tests (c. difficile tox a/b ii -techlab and toxin a+b elisa test, novitec-hiss diagnostics). the results were compared to those obtained with immunocard tox a+b -ictab (meridian), c. difficile toxine a (oxoid) for rapid test and elisa premier a+b meridian for elisa. a total of 41 stools and 16 isolates were st ...	2006	17027189
treatment of gastrointestinal infections.	treatment of gastrointestinal infections continues to be complicated by expanding resistance to antibiotics. this has led to both new antibiotic treatments and to research on alternative therapies. in the case of clostridium difficile colitis, interesting preliminary results have been obtained with both probiotic therapy and passive immunization strategies. the newer macrolides were found to be effective for multidrug-resistant salmonella typhi and safe in the pediatric population. the efficacy ...	2000	17024016
gastrointestinal infections in children.	new pathogens that cause gastroenteritis in children are being recognized. even well-recognized pathogens, such as clostridium difficile, may require more extensive testing than was previously thought necessary. several new tests have emerged that allow for faster identification of these pathogens so that same-day results may be possible. probiotic therapy has emerged as a novel strategy for the treatment of gastroenteritis. new vaccines against both viral and bacterial causes of gastroenteritis ...	2000	17024014
small intestinal pathology.	during the past year, important studies on various mechanisms of small bowel disease have been reported. the section on enterocyte function evaluates studies on hypoxia and apoptosis. many of the studies of small intestinal epithelia use as models t84 cells. when these cells are referred to as intestinal cells, it may be in a general sense. this may be of relevance in permeability studies because the transepithelial resistance of t84 cells is on the order of 1000 to 2000 ohm.cm, much higher than ...	1999	17023934
major issues still to be addressed.		2006	17019902
[clostridium difficile:an epidemic event in service of public health].		2006	17019844
high-level resistance to moxifloxacin and gatifloxacin associated with a novel mutation in gyrb in toxin-a-negative, toxin-b-positive clostridium difficile.	to determine the mechanism of high-level resistance to fluoroquinolone antimicrobials in toxin-a-negative, toxin-b-positive (a- b+) clostridium difficile isolates.	2006	17018563
involvement of rho gtpases and erk in synuclein-gamma enhanced cancer cell motility.	synuclein-gamma is aberrantly expressed in more than 70% of stage iii/iv breast and ovarian carcinomas. ectopic overexpression of synuclein-gamma enhanced mda-mb-435 cell migration in vitro and metastasis in a nude mouse model. however, the mechanism of how synuclein-gamma promotes cell motility is not clear. in our previous studies, we showed that synuclein-gamma overexpression activates erk. in the present study, we overexpressed synuclein-gamma in several breast and ovarian cancer cell lines ...	2006	17016652
comparative phylogenomics of clostridium difficile reveals clade specificity and microevolution of hypervirulent strains.	clostridium difficile is the most frequent cause of nosocomial diarrhea worldwide, and recent reports suggested the emergence of a hypervirulent strain in north america and europe. in this study, we applied comparative phylogenomics (whole-genome comparisons using dna microarrays combined with bayesian phylogenies) to model the phylogeny of c. difficile, including 75 diverse isolates comprising hypervirulent, toxin-variable, and animal strains. the analysis identified four distinct statistically ...	2006	17015669
surveillance for vancomycin-resistant enterococci: type, rates, costs, and implications.	to evaluate 2 active surveillance strategies for detection of enteric vancomycin-resistant enterococci (vre) in an intensive care unit (icu).	2006	17006814
in vitro susceptibility of clostridium difficile clinical isolates from a multi-institutional outbreak in southern québec, canada.	clostridium difficile isolates from a 2004 outbreak in québec, canada, were all found to be susceptible to metronidazole, vancomycin, rifampin, and meropenem but resistant to bacitracin, cefotaxime, ciprofloxacin, and levofloxacin, and most (>80%) were resistant to ceftriaxone, clarithromycin, gatifloxacin, and moxifloxacin. the predominant nap1 isolates were susceptible to clindamycin, while the nap2 isolates were resistant.	2006	17005836
effect of tigecycline on normal oropharyngeal and intestinal microflora.	antibacterial agents disrupt the ecological balance of the normal human microflora. tigecycline, a member of a new class of antibiotics (glycylcyclines), has been shown to have a potent broad-spectrum activity against most gram-positive and gram-negative aerobic and anaerobic bacteria. the aim of the study was to investigate the ecological effects of tigecycline on the normal oropharyngeal and intestinal microflora of healthy subjects. thirteen healthy white subjects (six females and seven males ...	2006	17005820
rhoa-gtpase facilitates entry of kaposi's sarcoma-associated herpesvirus into adherent target cells in a src-dependent manner.	kaposi's sarcoma-associated herpesvirus (kshv) (human herpesvirus 8) binds to adherent target cell surface heparan sulfate molecules via its envelope glycoproteins gb and gpk8.1a, to integrins via gb, to the transporter cd98/xct complex, and possibly to another molecule(s). this is followed by virus entry overlapping with the induction of preexisting host cell signal pathways, such as focal adhesion kinase, src, phosphatidylinositol 3-kinase (pi3-k), rho-gtpases, protein kinase c-zeta, and extra ...	2006	17005646
proton pump inhibitors and the risk of clostridium difficile-associated disease: further evidence from the community.		2006	17001056
proton pump inhibitor use and risk of community-acquired clostridium difficile-associated disease defined by prescription for oral vancomycin therapy.	the association between the use of proton pump inhibitors and the risk of clostridium difficile-associated disease (cdad) is controversial. in this study we re-examined a previously reported association between the use of proton pump inhibitors and the development of community-acquired cdad, this time using an alternative case definition of the disease.	2006	17001054
[therapeutic possibilities of probiotics in antibiotic-related diarrhea].	one of the major problems associated with the use of antibiotics is the occurrence of antibiotic-related diarrhea. although most such cases of diarrhea are harmless, in individual cases it may lead on to fulminant colitis. in 10-20% of the patients, the causal factor is infection with clostridium difficile, which multiplies unhindered in patients on antibiotics. in the meantime, controlled, randomized studies have shown that probiotics can exercise a preventive effect in antibiotic-related diarr ...	2006	16995359
positive clostridium difficile stool assay in a patient with fatal c. sordellii infection.		2006	16990397
application of mutated clostridium difficile toxin a for determination of glucosyltransferase-dependent effects.	mutation of tryptophan-101 in clostridium difficile toxin a, a 308-kda glucosyltransferase, resulted in a 50-fold-reduced cytopathic activity in cell culture experiments. the mutant toxin a was characterized and applied to distinguish between glucosyltransferase-dependent and -independent effects with respect to rhob up-regulation as a cellular stress response.	2006	16988280
there are lessons to be learnt in the aftermath of a scandal.		2006	16986585
the mosaic nature of intergenic 16s-23s rrna spacer regions suggests rrna operon copy number variation in clostridium difficile strains.	clostridium difficile is a major spore-forming environmental pathogen that causes serious health problems in patients undergoing antibiotic therapy. consequently, reliable and sensitive methods for typing individual strains are required for epidemiological and environmental studies. ribotyping is generally considered the best method, but it fails to account for sequence diversity which might exist in intergenic 16s-23s rrna spacer regions (isrs) within and among strains of this organism. therefo ...	2006	16980415
ultrasound diagnosis of clinically undetected clostridium difficile toxin colitis.		2006	16978990
antibiotic prophylaxis in neutropenic patients: new evidence, practical decisions.	new evidence shows that antibiotic prophylaxis in neutropenic patients reduces mortality, febrile episodes, and bacterial infections. for patients with acute leukemia or those who undergo bone marrow transplantation, prophylaxis with fluoroquinolones diminished the risk of death from any cause by 33% (95% confidence interval [95% ci], 2-54%). thus, 55 patients who have acute leukemia or who undergo bone marrow transplantation must receive prophylaxis to prevent 1 death. in 4 studies that include ...	2006	16977651
curtailing the spread of disease.		2006	16972462
clostridium difficile: more and meaner.		2006	16972351
identification of clostridium difficile toxin b cardiotoxicity using a zebrafish embryo model of intoxication.	clostridium difficile toxin b (tcdb) has been studied extensively by using cell-free systems and tissue culture, but, like many bacterial toxins, the in vivo targets of tcdb are unknown and have been difficult to elucidate with traditional animal models. in the current study, the transparent danio rerio (zebrafish) embryo was used as a model for imaging of in vivo tcdb localization and organ-specific damage in real time. at 24 h after treatment, tcdb was found to localize at the pericardial regi ...	2006	16966605
human monoclonal antibodies directed against toxins a and b prevent clostridium difficile-induced mortality in hamsters.	clostridium difficile is the leading cause of nosocomial antibiotic-associated diarrhea, and recent outbreaks of strains with increased virulence underscore the importance of identifying novel approaches to treat and prevent relapse of clostridium difficile-associated diarrhea (cdad). cdad pathology is induced by two exotoxins, toxin a and toxin b, which have been shown to be cytotoxic and, in the case of toxin a, enterotoxic. in this report we describe fully human monoclonal antibodies (humabs) ...	2006	16966409
emergence of clostridium difficile-associated disease in north america and europe.	the clinical spectrum of clostridium difficile-associated disease (cdad) ranges from diarrhoea to severe life-threatening pseudomembranous colitis. although not always associated with previous antibiotic exposure, it is in the majority of cases. cdad is recognised increasingly in a variety of animal species and in individuals previously not considered to be predisposed. c. difficile can be transmitted via personal contact or environmentally. the role of patients and healthcare workers who are sy ...	2006	16965399
effect of tea phenolics and their aromatic fecal bacterial metabolites on intestinal microbiota.	tea is rich in polyphenols and other phenolics that have been widely reported to have beneficial health effects. however, dietary polyphenols are not completely absorbed from the gastrointestinal tract and are metabolized by the gut microflora so that they and their metabolites may accumulate to exert physiological effects. in this study, we investigated the influence of the phenolic components of a tea extract and their aromatic metabolites upon bacterial growth. fecal homogenates containing ba ...	2006	16962743
characterization of (r)-2-hydroxyisocaproate dehydrogenase and a family iii coenzyme a transferase involved in reduction of l-leucine to isocaproate by clostridium difficile.	the strictly anaerobic pathogenic bacterium clostridium difficile occurs in the human gut and is able to thrive from fermentation of leucine. thereby the amino acid is both oxidized to isovalerate plus co(2) and reduced to isocaproate. in the reductive branch of this pathway, the dehydration of (r)-2-hydroxyisocaproyl-coenzyme a (coa) to (e)-2-isocaprenoyl-coa is probably catalyzed via radical intermediates. the dehydratase requires activation by an atp-dependent one-electron transfer (j. kim, d ...	2006	16957230
glycopeptides and glycodepsipeptides in clinical development: a comparative review of their antibacterial spectrum, pharmacokinetics and clinical efficacy.	hemi-synthetic derivatives of glycopeptides have demonstrated bactericidal activity towards gram-positive bacteria, including vancomycin-resistant strains (oritavancin and telavancin), and a prolonged half-life, allowing for once-daily (oritavancin and telavancin) or once-weekly (dalbavancin) administration. these compounds have proved effective for the treatment of infections caused by multidrug-resistant gram-positive bacteria, including complicated skin and skin structure infections (oritavan ...	2006	16955686
multihospital surveillance of nosocomial methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococcus, and clostridium difficile: analysis of a 4-year data-sharing project, 1999-2002.	this study sought to establish a benchmark of resistant organism rates among a cohort of regional hospitals.	2006	16945694
review: probiotics are effective for prevention of antibiotic-associated diarrhea and treatment of clostridium difficile disease.		2006	16944866
clostridium difficile and childhood diarrhea: cause, consequence, or confounder.		2006	16941359
diarrhea etiology in a children's hospital emergency department: a prospective cohort study.	we evaluated the frequency of recovery of pathogens from children with diarrhea who presented to a pediatric emergency department and characterized the associated illnesses, to develop guidelines for performing a bacterial enteric culture.	2006	16941358
are broad-spectrum fluoroquinolones more likely to cause clostridium difficile-associated disease?	limited evidence suggests that broad-spectrum fluoroquinolones such as gatifloxacin and moxifloxacin are more likely to cause clostridium difficile-associated disease than levofloxacin. in a population-based case-control study of outpatients prescribed fluoroquinolones, we found no increased risk of c. difficile-associated disease requiring hospitalization among patients prescribed gatifloxacin or moxifloxacin compared to levofloxacin.	2006	16940135