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occurrence of clostridium difficile in infections of man.smith, louis ds. (montana state college, bozeman) and elizabeth o. king. occurrence of clostridium difficile in infections of man. j. bacteriol. 84:65-67. 1962-eight strains of clostridium difficile were isolated from cases of infection in man in seven different bacteriological laboratories. one of these was isolated from a case of gas gangrene, one from an abscess following a fractured femur, one from a blood culture from an infant, two from pleural fluid, two from peritoneal fluid, and one fro ...196213914327
immunological studies in ulcerative colitis. iv. origin of autoantibodies.the incidence and height of antibody titers to colon, assayed by indirect hemagglutination with a heat stable colon extract from germ free rats, is significantly higher in sera from patients with ulcerative colitis than in those from healthy controls or from patients with amebic liver abscess or dysentery. while sera from ulcerative colitis patients and controls are indistinguishable in regard to incidence and height of antibody titers to forsman antigen, staphylococcus aureus s 209, clostridium ...19684879999
autoantibodies to colon in germfree rats monocontaminated with clostridium difficile.germfree rats monocontaminated with the anaerobic microorganisms clostridium difficile or another clostridium species (strain g 62) produce auto-antibodies to colon antigen. the antigen can be extracted with phenol water from the feces of germfree rats. antibodies, demonstrable by means of passive hemagglutination of antigen sensitized sheep erythrocytes appear after monocontamination for 35 days or longer. the indirect immunofluorescence techniques, applied to sections of germfree rat colon, ga ...19694886046
effect of bacterial contamination on cecal size and cecal contents of gnotobiotic rodents.in the present investigation the effect of various bacterial contaminations of gnotobiotic mice and rats on cecal size is presented. of the species tested, bacteroides oralis and fusobacterium nucleatum did not establish in germ-free mice. streptococcus mutans, clostridium difficile, a neisseria strain and two recent cecal isolates established, but failed to exert an effect upon the cecum of mice. a group k streptococcus and b. fragilis increased the cecal size apparently by increasing the level ...19695808078
the immune response in a patient to an infection with bacteroides fragilis ss. fragilis and clostridium difficile. 19724629360
competitive effects of intestinal microflora on vibrio cholerae in gnotobiotic mice.the coexistence of vibrio cholerae and several intestinal bacteria was determined in gnotobiotic mice. the bacteria tested included a bacteroides sp, clostridium difficile, clostridium perfringens type a, 2 separate isolates of escherichia coli, 2 different lactobacilli, 2 separate isolates of proteus mirabilis, pseudomonas maltophilia, and streptococcus faecalis. each species of bacteria became established and was recovered repeatedly from the stools during the studies. no single strain or spec ...1975807775
clostridium defficiel in the urogenital tract of males and females.a study of the occurrence of clostridium difficile in the urogenital tract of males and females revealed higher isolation-rates in patients attending the special (venereal-disease) clinic than in patients attending family-planning and urological clinics. the presence of cl. difficile in patients with venereal diseases is being investigated to see if the organism is simply an opportunist infecting a urethra disturbed by some antecedent disease, or if it is perhaps a primary cuase of disease.197548610
clostridium difficile.seventy-five meconium samples were examined for the presence of cl. difficile; 3 strains were isolated. additionally 45 laboratory animal faeces specimens were tested for the same purpose, a further 2 cases were isolated. these five suspicious strains were identified as cl. difficle according to the tests mentioned in the previous paragraphs. the organisms isolated here showed the same characteristics as five of the strains received and also as the organisms isolated from the inoculated animals ...197560044
clostridium difficile: isolation and characteristics.clostridium difficile can be grown readily in reinforced clostridial medium (rcm) containing 0-1-0-4% of o-, m- or p-cresol, or phenol. we recommend 0-2% of phenol or p-cresol in rcm for the isolation of this organism. the characteristic "cornfield" growth in rcm in 25-ml universal containers is described. glucose, fructose, galactose, mannose, raffinose, aesculin and mannitol are fermented with production of acid and gas; maltose, sucrose, glycogen, soluble starch and sorbitol are fermented wit ...1976933146
clostridium difficile and the aetiology of pseudomembranous colitis.bacterial isolates from 5 patients with pseudomembranous colitis (p.m.c.) were screened for toxin production. strains of clostridium from 4 patients produced in vitro a toxin similar to that found in p.m.c. faecal suspension. these were identified as c. difficile. use of the strains from 2 patients induced a fatal enterocolitis when inoculated orally into hamsters pretreated with vancomycin. the c. difficile that produced the toxin in vitro was then re-isolated from hamster caecal contents. thes ...197877366
diarrhoea and pseudomembranous colitis after gastrointestinal operations. a prospective study.241 patients who had gastrointestinal operations were studied prospectively. postoperative diarrhoea occurred in 58 patients (24%) and was significantly more common after exposure to antibiotics. 9 patients (4%) had high titres of a neutralisable faecal toxin characteristic of pseudomembranous colitis. toxigenic clostridium difficile strains were isolated from the stools of all patients with neutralisable faecal toxin. if pseudomembranous colitis is defined as the presence of neutralisable faeca ...197882138
aetiology of antimicrobial-agent-associated colitis.clostridium difficile was isolated from the faeces of a patient with clindamycin-associated pseudomembranous colitis (p.m.c.). the presence of a preformed faecal toxin and the toxigenicity of both the faecal isolate of c. difficile and a reference strain of c. difficile were demonstrated by tissue-culture assay. the toxin of both strains of c. difficile and that in the patient's faeces were neutralised by heating and by incubation with antitoxin to c. sordellii, but not by incubation with antito ...197885818
[initiation of germination of clostridium difficile spores by lysozyme].the germination rate of spores of c. difficile which is usually lower than 10(-5) is raised to about 5.10(-3) in presence of lysozyme. all spores are initiated by lysozyme when previously treated by sodium thioglycolate. these spores are indeed lysozyme-dependent for germination.1978103645
identification of clostridium difficile as a cause of pseudomembranous colitis. 1978630301
clindamycin-induced enterocolitis in hamsters.a lethal enterocolitis was induced in hamsters by oral or parenteral administration of clindamycin in amounts comparable to those used in treatment of humans. the intestinal lesions were characterized histologically as an acute inflammatory reaction with pseudomembrane formation and resembled the lesions seen in humans with antibiotic-induced colitis. results of quantitative stool cultures showed the numbers of peptostreptococcus and corynebacterium decreased in animals with colitis after challe ...1978649990
clostridium difficile toxin and antimicrobial agent-induced diarrhea. 1978659927
clindamycin-induced enterocolitis in hamsters as a model of pseudomembranous colitis in patients.stools from a patient with antibiotic-associated colitis and cecal contents from a hamster with clindamycin-induced enterocolitis were compared in a cytotoxicity assay to determine common properties. both specimens produced actinomorphic changes in human amnion cells at 10(-7) dilutions. the toxin was acid labile, heat labile, nonether extractable, non-dialyzable, and produced maximum activity at 60% with ammonium sulfate precipitation. cytotoxicity was neutralized with clostridial antitoxin but ...1978669810
antibiotic-induced lethal enterocolitis in hamsters: studies with eleven agents and evidence to support the pathogenic role of toxin-producing clostridia.clindamycin-induced enterocolitis in hamsters was studied, using a tissue culture assay to detect clostridial toxin. it was found that animals with lethal enterocolitis had a cytopathogenic substance in cecal contents and blood that was neutralized by clostridial antitoxins. cultures of the cecal flora yielded numerous species of clostridia, but only 1 organism was detected which produced a toxin which was cytopathic in tissue culture. this organism, clostridium difficile, was consistently prese ...1978697162
role of clostridium difficile in antibiotic-associated pseudomembranous colitis.tissue cultures were performed on stools from 189 patients to detect a cytopathic toxin which is neutralized by clostridium sordellii antitoxin. specimens satisfying these criteria were considered positive in the tissue culture assay. stools from 26 of 27 patients with antibiotic-associated pseudomembranous colitis were positive and 16 of these specimens showed toxin titers of 10(-3) dilutions or greater. the tissue culture assay was positive with specimens from 9 of 63 patients with antibiotic- ...1978700321
neutralization of clostridium difficile toxin by clostridium sordellii antitoxins.neutralization of clostridium difficile toxin by clostridium sordellii antitoxin was studied by cytotoxicity assay in tissue culture. the sources of toxin were stools from two patients with pseudomembranous colitis and a culture filtrate of c. difficile isolated from one of the patients. c. sordellii antitoxin was available either in monovalent form or as gas gangrene polyvalent antitoxin. the potency of antitoxins against c. difficile determined by cytotoxicity assay did not correlate with the ...1978730363
prevention of clindamycin-induced colitis in hamsters by clostridium sordellii antitoxin.toxins produced by clostridium difficile have been implicated in the etiology of antibiotic-induced colitis. clostridium difficile antitoxin is not available, but recent studies have shown that toxins present in the feces of patients with this disease are neutralized by clostridium sordellii antitoxin. we found that c. sordellii antitoxin neutralized toxins produced in broth cultures of either c. sordellii or c. difficile and that passive immunization with c. sordellii antitoxin before challenge ...1979759263
clindamycin-induced colitis.the hamster model of enterocolitis after the administration of clindamycin was used to study various drugs used in treatment of the disease in humans. current evidence strongly suggests toxigenic, clindamycin-resistant clostridium difficile is a cause of the disease in hamster and man. this organism is susceptible to vancomycin and metronidazole, and the disease could be prevented in the hamster so long as the antibiotics were given orally. a fatal colitis almost invariably ensued once they were ...1979760500
effect of phenoxymethylpenicillin and clindamycin on the oral, throat and faecal microflora of man.phenoxymethylpenicillin in capsules was given orally in doses of 800 mg twice daily for 7 days to 10 subjects. saliva, throat and faecal specimens were taken up to 29 days for cultivation of aerobic and anaerobic bacteria. no changes in the normal flora in saliva, throat or faeces were noticed during the observation period. clindamycin was given orally in doses of 150 mg 4 times daily to 10 other subjects. no changes in the aerobic oral flora were observed, while a significant decrease in the nu ...1979118526
experimental reproduction of neonatal diarrhea in young gnotobiotic hares simultaneously associated with clostridium difficile and other clostridium strains.clostridium difficile, c. perfringens, and c. tertium are very often present simultaneously in the feces of conventional diarrheic young hares, whereas these three bacterial species are rarely encountered and never present simultaneously in the feces of healthy young hares. when a strain of each of the three bacterial species was monoassociated with axenic young hares, the appearance of pathological disorders was only observed in animals monoassociated with c. difficile, when the number of c. di ...1979222683
diarrhea and colitis associated with antimicrobial therapy in man and animals.antimicrobial agent-induced ileocecitis of laboratory animals and colitis of man share common features. the significance of a newly described toxin in these two entities, the apparent source of the toxin (clostridium difficile) and characteristics of the toxin are reviewed. methods of toxin detection, isolation and rapid identification of c. difficile, and possible modes of therapy for antimicrobial agent-associated colitis of man are discussed.1979367148
selective and differential medium for isolation of clostridium difficile.clostridium difficile is a recognized cause of pseudomembranous (antimicrobial agent-associated) colitis and may be one of the causes of antimicrobial agent-induced diarrhea. a selective and differential agar medium that contains cycloserine, cefoxitin, fructose, and egg yolk (ccfa) was developed to facilitate the isolation of c. difficile from fecal specimens. quantitative cultures of 16 stock strains of c. difficile on this medium (and on a medium containing cycloserine, fructose, and egg yolk ...1979429542
[a case of antibiotic-associated diarrhea caused by clostridium difficile and treated with vancomycin]. 1979449466
ultrastructural changes of cultured human amnion cells by clostridiu difficile toxin.the ultrastructure of the surface of primary human amnion monolayer cells undergoing cytopathology induced by clostridium difficile toxin was examined by scanning electron microscopy. our observations indicated that the type and distribution of cell surface projections were altered dramatically by this toxin. the patterns of such surface changes were specific for the two different types of cells found in this cell culture. cells with demarcated borders showed rearrangement of microvilli into glo ...1979457259
oral metronidazole in clostridium difficile colitis. 1979466143
oral metronidazole in clostridium difficile colitis. 1979476461
purification and characterization of clostridium difficile toxin.recent evidence indicates that toxigenic clostridium difficile strains are a major cause of antimicrobial-associated ileocecitis in laboratory animals and pseudomembranous colitis in humans. c. difficile atcc 9689 was cultivated in a synthetic medium to which 3% ultrafiltrated proteose peptone was added. purification of the toxin from broth filtrate was accomplished through ultrafiltration (100,000 nominal-molecular-weight-limit membrane), precipitation with 75% (nh4)2so4, and chromatographic se ...1979478634
antibiotic susceptibility of clostridium difficile. 1979479065
[antibiotic-induced pseudomembranous clostridium difficile colitis. a new etiopathogenetically definable infectious disease].pseudomembranous colitis has been recognized as a complication of antimicrobial therapy since 1952. most recently, evidence has been accumulated showing that a heat labile toxin is involved. though little is known so far about the normal ecology of c. difficile and the host factors of potential importance in the development of colitis by this anaerobe, antimicrobial agent-induced suppression of the normal gut flora seems to be a major factor leading to the intestinal proliferation of resistant t ...1979488887
cephalosporin-associated pseudomembranous colitis due to clostridium difficile. 1979501864
antibiotic-associated colitis--a review of 66 cases.we have reviewed 66 cases of antibiotic-associated colitis since march 1975, which have been associated with a 27 per cent mortality. we believe antibiotics may predispose patients to this condition which is caused by a toxin produced by clostridium difficile. although the disease is rare, it is more common than previously reported. the presentation, methods of diagnosis and treatment are discussed.1979509051
cultures for clostridium difficile in stools containing a cytotoxin neutralized by clostridium sordellii antitoxin.stools from patients with antibiotic-associated diarrhea or colitis were cultured to detect the presence of clostridium difficile. all specimens contained a cytotoxin which was neutralized by clostridium sordellii antitoxin. initial testing employed several methods with comparative merits in recovering this organism. these included the use of nonselective media, antibiotic-incorporated media, alcohol shock, and paracresol-containing broth. optimal results were achieved with primary plating of se ...1979521486
clostridium difficile-associated colitis after neomycin treated with metronidazole. 1979526821
colitis induced by clostridium difficile.clostridium difficile has been implicated as the major cause of antibiotic-associated pseudomembranous colitis. the current laboratory diagnostic test of choice is a tissue culture assay that demonstrates the presence of a cytopathic toxin neutralized by antitoxin to clostridium sordellii. this toxin was found in stools from 42 of 43 patients with antibiotic-associated pseudomembranous colitis and in stools from 12 of 78 patients with antibiotic-associated diarrhea. specimens from patients with ...1979549188
partial purification and characterization of a cytotoxin from clostridium difficile.a trypsin-sensitive, heat-labile cytotoxin was purified from the supernatant of a culture of clostridium difficile by a procedure that included ultrafiltration, precipitation with (nh4)2so4, gel filtration, and ion-exchange chromatography. the procedure resulted in recovery of 20% of the cytotoxin and an estimated 1,500-fold increase in cytotoxic activity. the minimal amount of protein required to give an actinomorphic response in wi-38 cell cultures was 1.4 ng/ml. the estimated molecular weight ...1979549189
antibiotic-associated colitis: effects of antibiotics on clostridium difficile and the disease in hamsters.fifteen isolates of clostridium difficile from hamsters and human patients were inhibited or killed by low concentrations of metronidazole, vancomycin, penicillin, and ampicillin; the isolates were often reesistant to tetracycline, cephalosporins, trimethoprim-sulfamethoxazole, clindamycin, erythromycin, and aminoglycosides. antibiotics to which c. difficile was susceptible were able to prevent or postpone the colitis caused by clindamycin in hamsters. colitis could be produced by treatment of ...1979549190
induction of colitis in hamsters by topical application of antibiotics.syrian hamsters are exquisitely sensitive to clindamycin; as little as 1 mg/kg of clindamycin given systemically causes a fatal colitis. clindamycin and erythromycin were applied topically daily to the shaved backs of syrian hamsters in a hydroalcoholic vehicle. a daily dose of 0.1 mg of clindamycin was lethal to more than half the hamsters and 1 mg to all the animals. the antibiotic-associated toxin from clostridium difficile was present in their cecal material. based on body surface areas and ...1979571698
effect of environmental stress on clostridium difficile toxin levels during continuous cultivation.a method for the continuous culture of clostridium difficile has been described. it has been shown that subjecting continuous cultures of this microorganism to environmental stress results in increased levels of toxin in culture medium. factors found to cause this release include alteration of the eh from --360 to +100 mv or increasing the temperature from 37 to 45 degrees c. the increased toxin levels were not associated with a change in viable cell density or the numbers of spores present. add ...197944176
effects of clostridium difficile toxin on tissue-cultured cells.a partially purified toxin of clostridium difficile induced similar morphologic changes in three different tissue-cultured mammalian cell lines. the morphologic changes were not associated with biochemical changes indentical to those caused by the enterotoxins of vibrio cholerae and escherichia coli. although the mechanisms responsible for the noncytotoxic morphologic effects remain to be delineated, the toxin appears to exert its effects by directly affecting membrane constituents.19806245152
[transferable tetracycline resistance in "clostridium difficile" (author's transl)].tetracycline (tc) resistance is transferable from a resistant strain of clostridium difficile to a sensitive strain and this resistance is not curable. resistances to erythromycin and clindamycin are curable but not transferable. these results suggest for these resistances a plasmid determinism. it is shown that a plasmid-mediated tc resistance (pip401) of c. perfringens is also transferable to c. difficile. tc resistance is inducible in c. perfringens and constitutively expressed in c. difficil ...19806247949
therapeutic implications of clostridium difficile toxin during relapse of chronic inflammatory bowel disease.clostridium difficile toxin was present in the stools of six patients with chronic inflammatory bowel disease during symptomatic relapse. only two of these individuals had received antibiotics known to cause pseudomembranous colitis, and on proctoscopy none had pseudomembranes. in all patients disappearance of toxin, either with vancomycin therapy (five patients) or spontaneously (one patient), was associated with symptomatic improvement. cl. difficile toxin may complicate chronic inflammatory b ...19806101841
clostridium difficile associated diarrhoea: a role in inflammatory bowel disease?56 patients with diarrhoea were screened for the presence of clostridium difficile toxin in their stool. the test was positive in 9: 5 had severe inflammatory bowel disease and were receiving systemic steroids; 2 were on steroids for other conditions; 1 had been on antibiotics; and in 1 there was no apparent predisposing factor. in each case clearance of the toxin was associated with clinical improvement. evidently cl. difficile toxin is not specific for antibiotic-associated diarrhoea, but is a ...19806101842
clostridium difficile and chronic bowel disease. 19806101850
clostridium difficile and chronic inflammatory bowel disease. 19806103129
clostridium difficile and non-antibiotic-associated colitis. 19806106775
clostridium difficile toxin as a confounding factor in enterovirus isolation.a peculiar cytotoxic effect, occasionally encountered in the course of inoculating cell cultures with fecal specimens for routine enterovirus isolation attempts, was shown to be produced by clostridium difficile toxin.19806273451
[pseudomembranous colitis due to clostridium difficile and the new therapeutic approach (author's transl)]. 19806787148
inhibition of binding of clostridium difficile toxin by steroids.no detectable inhibition of binding of clostridium difficile toxin to human erythrocyte lysate was found with alpha-d-(+)-fucose, 1-(-)-fucose, ribose, arabinose, mannose, galactose, xylose, galactosamine, glucosamine, mannosamine, n-acetyl glucosamine, n-acetyl galactosamine, n-acetyl mannosamine, n-acetyl neuraminic acid, lactose, sucrose, lactulose, neuraminidase, saponin, or amantadine. inhibition was found, however, with a number of sterols and bile acids. in general, bile acids were more a ...19806772711
mucosal damage mediated by clostridial toxin in experimental clindamycin-associated colitis.a toxin produced by clostridium difficile has been implicated in the pathogenesis of antibiotic-associated colitis in humans and experimental animals. this study was undertaken in order to define the sequential evolution of caecal mucosal lesions in the hamster and to relate those lesions directly to the clostridial toxin. sterile filtrates from a culture of c. difficile and from caecal contents of clindamycin-treated hamsters were studied with respect to their effects on the caecal mucosa and o ...19806776012
antibacterial activities of a new stabilized thienamycin, n-formimidoyl thienamycin, in comparison with other antibiotics.the in vitro activity of a new crystalline derivative of thienamycin, n-formimidoyl thienamycin (mk0787), was tested against 46 laboratory reference strains and 2,158 clinical isolates of gram-positive and -negative bacteria, including anaerobes, and compared with cefoxitin, cefaxolin, carbenicillin, and amikacin. mk0787 was significantly more active than the reference antibiotics against most bacteria tests. mk0787 was 16- to 500-fold more active than the other antibiotics against staphylococcu ...19806931548
antibiotic associated colitis and clostridium difficile. a symposium held at the swedish medical society, stockholm, sweden, august 23, 1979. 19806937943
experimental studies of antibiotic associated colitis.clostridium difficile has been implicated as the major cause of antibiotic-associated pseudomembranous colitis. the laboratory diagnostic test of choice is a tissue culture assay that demonstrates the presence of a cytopathic toxin neutralized by antitoxin to clostridium sordelli. this toxin is found in stools from patients with antibiotic-associated pseudomembranous colitis and in stools from patients with antibiotic-associated diarrhea. neutralization of toxin by antitoxin to c. sordelli appea ...19806937944
diagnosis of clostridium difficile-associated enterocolitis in sweden. laboratory and epidemiological aspects.over a 32-week period 1979, 256 fecal samples from 132 patients with antibiotic-associated enterocolitis were analyzed for the presence of c. difficile bacteria and/or toxin. the toxin test was positive in 35 patients (27%) and the bacterium was present in 14 patients (11%). seventy-three patients with enterocolitis were investigated with regard to age, sex, antibiotic therapy, and clinical symptoms by analysis of their records. a positive toxin titre had an apparent predictive value of 69% for ...19806937945
characterization of clostridium difficile and its differentiation from clostridium sporogenes by automatic head-space gas chromatography.although 47 strains of clostridium difficile and clostridium sporogenes were studied by gas chromatography. acidic and neutral volatile products, formed after 96 h of incubation in glucose-containing peptone yeast-extract medium, were chromatographed. all strains produced appreciable amounts of fatty acids, which were tentatively identified by gas chromatographic retention data. chromatograms obtained when analysing diethyl ether extracts of culture media of all 47 strains were virtually identic ...19806937946
the experimental pathogenesis of antibiotic related colitis.findings from several countries now closely associate clostridium difficile and its toxin with pmc. in fact, testing for the toxin by means of tissue culture assay is being used more and more to define the proportion of patients with clinically significant antibiotic associated colitis. reproduction of a similar entity in hamsters appears to fulfil the koch-henle postulates, establishing c. difficile as the cause of the syndrome. antibiotic treatment creates susceptibility to infection rather th ...19806937947
interaction of cytopathogenic toxin from clostridium difficile with cells in tissue culture.partially purified cytopathogenic toxin from clostridium difficile induced morphological changes in five cell lines in tissue culture. the relative sensitivity scale of the cell lines was human lung and intestinal fibroblasts greater than chinese hamster ovary cells much greater than mouse adrenal cells greater than mouse neuroblastoma cells. the cytopathogenic effect did not occur in toxin-treated lung fibroblasts incubated at 0 degree c. pre-incubation of lung fibroblasts with 2,4-dinitropheno ...19807010532
therapeutic trials of antibiotic associated colitis.since september 1977 we have seen 63 patients with clostridium difficile and a faecal toxin, but only 33 had histological evidence of pseudomembranous colitis. we have conducted separate double blind trials of an antibiotic, vancomycin and an anion-exchange resin, colestipol, in patients with post-operative diarrhoea. vancomycin was extremely effective at eradicating the organism and its faecal toxin. these changes were associated with a marked symptomatic improvement. colestipol proved ineffect ...19807010533
rapid detection of clostridium difficile toxin in human feces.fifty fecal specimens were tested by three methods, bacterial isolation, counterimmunoelectrophoresis, and tissue culture, for clostridium difficile and its toxin. ten specimens (20%) were positive by all three methods. an additional eight specimens were toxin positive only by counterimmunoelectrophoresis. although counterimmunoelectrophoresis and tissue culture are of equivalent sensitivity, the additional dilution necessary for tissue culture assay may be critical when only small concentration ...19807031079
antimicrobial agent-associated colitis and diarrhea.although antimicrobial agent-associated colitis has been recognized as a clinicopathologic entity for years, the cause of this disease has been determined only recently. virtually all cases of pseudomembranous colitis and some cases of antimicrobial agent-associated nonspecific colitis or diarrhea have been shown to be caused by a toxin of clostridium difficile. methods for cultivating c difficile from feces and for detecting the toxin have been developed. oral administration of vancomycin has p ...19807233892
clostridium difficile: a new enteric pathogen. 19807233895
bacitracin therapy in antibiotic-associated pseudomembranous colitis.two patients with antibiotic-associated pseudomembranous colitis, and stool positive for clostridium difficile cytotoxin were successfully treated with oral bacitracin. one patient had previously suffered two relapses of pseudomembranous colitis following successful treatment with vancomycin and one patient was allergic to vancomycin. bacitracin appears to be a reasonable choice to treat patients with antibiotic-associated colitis who are allergic to vancomycin. further studies comparing vancomy ...19806903494
clostridium difficile-associated cecitis in guinea pigs exposed to penicillin.penicillin treatment resulted in lethal hemorrhagic cecitis in seven of eight guinea pigs. cecal contents at necropsy from all seven animals contained a cytopathic toxin which was neutralized by clostridium sordellii and c difficile antitoxins. bacteriologic cultural examinations of these specimens yielded penicillin-sensitive strains of c difficile which produced a similar or identical cytotoxin in vitro. stools obtained before penicillin administration and cecal contents from control animals l ...19806969561
implantation of bacteria from the digestive tract of man and various animals into gnotobiotic mice.fourteen microbial strains isolated from conventional rats were inoculated into axenic rats and mice receiving identical diets. the populations of these organisms which became established in the feces of gnotobiotic adult recipient rats and mice were quite similar. the only major difference was that one strain, belonging to the genus clostridium, disappeared from the feces of gnotobiotic mice, whereas this strain became established in gnotobiotic rats. most of the strictly anaerobic strains were ...19807001883
clostridium difficile from a peri-anal abscess. 19807185937
clostridium difficile in relation to enteric bacterial pathogens.all feces samples (n = 2,390) sent to the bacteriological laboratory, göteborg, sweden over 43 days were, in addition to the standard procedure, cultivated to detect clostridium difficile by using a special selective medium. c. difficile was found in 81 of the 2,390 samples (3%). these 81 samples represented 56 patients. fifty of the 56 patients had diarrhea. in 20 of the 56 patients (36%), salmonella, campylobacter, or yersinia were also found. of the 2,390 samples 252 (11%) from 132 patients r ...19807217331
cephalosporin-associated colitis and clostridium difficile.a case of cephalosporin-associated colitis occurred in which a tissue-cultured morphologic-altering activity was demonstrated in the patient's feces during the active episode. neutralization of the tissue culture activity by antiserum directed against a partially purified toxin of clostridium difficile provided a more suggestive link between the colitis and this clostridial species.19807362397
binding of clostridium difficile cytotoxin and vancomycin by anion-exchange resins.cholestyramine and colestipol were tested for binding of clostridium difficile cytotoxin with use of batch absorption and column chromatography. the toxin was bound by both resins and could not be eluted from cholestyramine with either an ionic of a ph gradient. vancomycin bound to cholestyramine more strongly than to colestipol. cholestyramine and vancomycin were also tested for therapeutic efficacy in the hamster model of clindamycin-induced cecitis. both compounds delayed death and reduced le ...19807365273
bacitracin treatment of antibiotic-associated colitis and diarrhea caused by clostridium difficile toxin.four cases of antibiotic-associated colitis and diarrhea caused by clostridium difficile were successfully treated with oral bacitracin, 25,000 units four times daily for 7-10 days. diarrhea resolved in all of the cases, in 2 days, with disappearance of clostridium difficile toxin in the stools in 3 out of 4 patients so measured. two of the patients treated had relapses after vancomycin, while the other 2 were experiencing the first episodes. one patient relapsed after bacitracin treatment, but ...19807372074
isolation of toxin producing clostridium difficile from two children with oxacillin- and dicloxacillin-associated diarrhea.clostridium difficile was isolated from the feces of two infants who had developed watery diarrhea with blood-tinged stain. one child suffered from diarrhea after five days of parenteral oxacillin therapy; the diarrhea subsided within three days of cessation of therapy. the other infant developed diarrhea following four days of oral dicloxacillin; the diarrhea subsided within two days of cessation of therapy. c difficile was no longer detectable in the stools of the infants at that time. tissue ...19807375240
clostridium difficile in gnotobiotic mice.germfree mice associated with clostridium difficile developed intestinal disease characterized by polymorphonuclear cell infiltration of the lamina propria, diarrhea, and cecal cytotoxin concentrations positive at a 10(-6) dilution. the numbers of viable bacteria never exceeded 10(10) colony-forming units per g (dry weight). despite the high toxin levels and chronic inflammation over a 30-day period, the mortality rate was low (less than 2%). daily treatment of these animals with two oral doses ...19807380566
identification of toxigenic clostridium difficile by counterimmunoelectrophoresis.a counterimmunoelectrophoresis (cie) technique which reacted positively with culture filtrates of clostridium difficile was developed and compared with a cytotoxicity assay in human embryonic lung cell cultures. cie, employing c. sordellii antitoxin, detected 17 of 17 c. difficile strains. of those positive by cie, 13 were cytotoxic in cell culture. fourteen clostridium species other than c. difficile, c. sordellii, and c. bifermentans were negative by cie. c. sordellii and c. bifermentans gave ...19807381011
treatment of antibiotic-associated clostridium difficile diarrhea with oral vancomycin. 19807381635
clostridium difficile isolated from the stool of a patient with pseudomembranous colits following ampicillin plus flucloxacillin (magnapen) therapy.a case is reported of the isolation of clostridium difficile from the stool of a patient with antibiotic-related pseudomembranous colitis.19807383956
colitis associated with metronidazole therapy.a 46-year-old woman was treated with oral metronidazole for trichomonal vaginitis and developed diarrhea, which persisted for five weeks. tissue culture assay of stool supernatant showed a cytopathic toxin that was neutralized by clostridium sordellii antitoxin, and cultures yielded clostridium difficile, which produced a similar or identical cytotoxin in vitro. this isolate proved sensitive to metronidazole at 0.25 microgram/ml. prior reports have indicated that metronidazole may also be used t ...19807391617
relapse of antibiotic-associated colitis after vancomycin therapy.antibiotic-associated colitis, although occasionally fatal, is a disease which is considered to be self-limiting and non-recurring. recently, specific treatment with oral vancomycin directed at the trigger organism, clostridium difficile, has been shown to be effective. a case in which antibiotic-associated colitis was treated with vancomycin and subsequently recurred is described. the fact that such relapse can occur indicates that further evaluation of the efficacy of vancomycin is required.19807393060
in vitro susceptibility of clostridium difficile isolates from patients with antibiotic-associated diarrhea or colitis.in vitro susceptibility tests were performed on 84 strains of clostridium difficile to 11 antimicrobial agents. all isolates were from the stools of patients with antibiotic-associated diarrhea or colitis in which there was a cytopathic toxin that was neutralized by clostridium sordellii antitoxin. over 95% of the strains were susceptible to vancomycin, penicillin g, ampicillin, and metronidazole at concentrations of 4 microgram/ml. susceptibility to clindamycin was variable; 60% of the strains ...19807396460
production of clostridium difficile antitoxin.we have produced antitoxin to the toxin of clostridium difficile in rabbits and in goats. antitoxin dilutions of 1/8,000 and 1/5,120 were capable of neutralizing lethal doses of the toxin in mice and in tissue culture, respectively.19807399686
role of clostridium difficile in a case of nonantibiotic-associated pseudomembranous colitis.a 57-yr-old woman with chronic diarrhea, mild azotemia, and red cell casts in her urine was found to have pseudomembranous colitis. she had not received antimicrobial agents for at least 2 yr. membranoproliferative glomerulonephritis was found in kidney biopsy, and her renal function improved spontaneously. pseudomembranous colitis was diagnosed by endoscopic biopsy. her stool contained a cytophatic toxin that was neutralized by clostridium sordellii antitoxin, and clostridium difficile was cult ...19807419019
vancomycin therapy for clostridium difficile. 19807421667
vancomycin therapy clostridium difficile. 19807421668
antimicrobial susceptibilities of clostridium difficile.the antimicrobial susceptibilities of 78 strains of clostridium difficile isolated from patients with and without gastrointestinal symptoms were determined and compared. strains from patients with symptoms were more likely to show resistance to antibiotics. the antimicrobial susceptibilities of toxigenic and non-toxigenic strains were found to be similar.19807430354
clinical and laboratory observations in clostridium difficile colitis. 19807435423
studies on the epidemiology of antibiotic-associated clostridium difficile colitis.vancomycin protects hamsters from the development of clostridium difficile colitis after treatment with clindamycin, and vancomycin is useful in treatment of humans with the disease. relapses have occurred in both hamsters and humans when vancomycin is discontinued. vancomycin appears to enhance susceptibility to colonization with c. difficile by eliminating competing intestinal organisms. the nature of these organisms is not known, but various tools are now available to aid in identifying them. ...19807435424
epidemiological aspects of clostridium difficile-induced diarrhea and colitis.clostridium difficile has been shown to be a cause of antimicrobial agent-associated diarrhea and colitis. the source from which this organism gains access to the gastrointestinal tract is not known. cultures of the hospital environments of six of eight patients whose fecal cultures were positive for c. difficile yielded this organism, whereas cultures of control hospital sites were almost invariably negative. these data suggest that hospital environmental contamination may be a potential source ...19807435425
epidemiology of experimental enterocecitis due to clostridium difficile.hamsters can survive a course of clindamycin if they are held in a protected environment. inoculation of clostridium difficile regularly results in fatal enterocecitis in such animals but is without effect in untreated animals. these findings suggest that in the development of enterocecitis, clindamycin treatment and infection with c. difficile are separate events, and they imply that hamsters usually acquire c. difficile from environmental sources. environments appear to differ in the risk of e ...19807441010
[antibiotic-related colitis and clostridium difficile]. 19807445210
[pseudomembranous entercolitis after antibiotic treatment: vancomycin therapy].after reporting the case of a child suffering from pseudomembranous colitis (pmc) rapidly cured by vancomycin, the authors present current knowledge which had led to this new mode of therapy. a patient of 2 years 7 months was treated with amoxycillin per os for 8 days for otitis media. a week after this treatment, diffuse abdominal pains appeared, with 8-12 diarrhoeic stools per day containing blood and mucus and recurrent episodes of rectal prolapsus. pmc was diagnosed after rectoscopy and rect ...19807451238
[rate of isolation of "c. difficile" from stools of hospitalized patients: susceptibility of 75 strains (author's transl)].seventy-five strains of clostridium difficile were recovered from 1,276 stools from patients. fifty-six of these strains were found to be toxigenic. the rate of isolation of c. difficile was high in culture of stools from patients in surgical intensive care units and in pediatrics units. the susceptibility of these isolates to 13 antimicrobial agents was tested by agar dilution technics. vancomycin, metronidazole, penicillin and ampicillin at 4 micrograms/ml inhibited all the strains. cefoxitin, ...19807458111
toxigenicity of clostridium difficile isolates from patients and healthy adults. 19807464571
neutralizing activity against clostridium difficile toxin in the supernatants of cultured colostral cells.human colostral specimens were obtained from 60 japanese postpartum women within the first 3 days after delivery. neutralizing activity against clostridium difficile toxin was evaluated with y1 adrenal cells in miniculture. when y1 adrenal cells were exposed briefly to the toxin, they showed a rounding response in culture, resembling that effected by escherichia coli enterotoxin; however, preincubation of the toxin with aqueous phase of colostrum significantly reduced its cytopathic effect on y1 ...19807216424
arthritis in pseudomembranous colitis associated with an antibody to clostridium difficile toxin. 19807230227
pseudomembranous colitis with sparing of transplanted colon.there is strong evidence that pseudomembranous colitis (pmc) is caused by the toxin of clostridium difficile. a case of pmc which occurred in a patient who underwent colon interposition for a benign oesophageal stricture is presented, which had all the features of a florid pmc, but the changes were confined to the normally sited colon, and did not occur in the interposed loop. no similar case report could be found in the literature. this case is in accord with the view that pmc is produced by th ...19817231256
a second relapse of clostridium difficile colitis. 19817216943
clostridium difficile-associated. 19817469474
spectrum of antibiotic-associated diarrhoea.in an attempt to find the extent to which clostridium difficile could be implicated as the cause of antibiotic-associated diarrhoea, the stools of 53 patients who had diarrhoea after a course of antibiotics were investigated for the presence of c. difficile toxin. ten of the patients (19%) were found to be positive, but the stools of four out of 53 patients without diarrhoea after a course of antibiotics were also found to contain c. difficile toxin (7.5%). the titre of toxin in patients both wi ...19817461475
isolation of clostridium difficile from the environment and contacts of patients with antibiotic-associated colitis.clostridium difficile is the most important cause of antibiotic-associated colitis, but its epidemiology remains unknown. using a selective medium for the isolation of c. difficile, cultures were obtained from the environment and contacts of hospitalized patients carrying c. difficile in their stools. in areas where carriers had diarrhea, 85 (9.3%) of 910 cultures of floors and other surfaces, especially those subject to fecal contamination, were positive. in areas where there were no known carr ...19817217711
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