Publications
| Title | Abstract | Year(sorted ascending) Filter | PMID Filter |
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| clostridium difficile toxins a and b: insights into pathogenic properties and extraintestinal effects. | clostridium difficile infection (cdi) has significant clinical impact especially on the elderly and/or immunocompromised patients. the pathogenicity of clostridium difficile is mainly mediated by two exotoxins: toxin a (tcda) and toxin b (tcdb). these toxins primarily disrupt the cytoskeletal structure and the tight junctions of target cells causing cell rounding and ultimately cell death. detectable c. difficile toxemia is strongly associated with fulminant disease. however, besides the well-kn ... | 2016 | 27153087 |
| fecal transplantation: any real hope for inflammatory bowel disease? | fecal microbiota transplant (fmt) has emerged as an important treatment for antibiotic resistant or recurrent clostridium difficile infection. there has been a great deal of media coverage of the efficacy of fmt, and patients with inflammatory bowel disease (ibd) understandably wonder if this approach would also work for them. there are also instructions on 'do it yourself' fmt therapy on the web. it is important to understand whether there is evidence that this approach is effective in ibd so t ... | 2016 | 27152872 |
| high mobility group box1 protein is involved in acute inflammation induced by clostridium difficile toxin a. | high mobility group box1 (hmgb1), as a damage-associated inflammatory factor, contributes to the pathogenesis of numerous chronic inflammatory and autoimmune diseases. in this study, we explored the role of hmgb1 in cdi (clostridium difficile infection) by in vivo and in vitro experiments. our results showed that hmgb1 might play an important role in the acute inflammatory responses to c. difficile toxin a (tcda), affect early inflammatory factors, and induce inflammation via the hmgb1-tlr4 path ... | 2016 | 27151296 |
| production of the ramoplanin activity analogue by double gene inactivation. | glycopeptides such as vancomycin and telavancin are essential for treating infections caused by gram-positive bacteria. but the dwindling availability of new antibiotics and the emergence of resistant bacteria are making effective antibiotic treatment increasingly difficult. ramoplanin, an inhibitor of bacterial cell wall biosynthesis, is a highly effective antibiotic against a wide range of gram-positive bacteria, including methicillin-resistant staphylococcus aureus, vancomycin-intermediate re ... | 2016 | 27149627 |
| rifaximin for the treatment of irritable bowel syndrome - a drug safety evaluation. | irritable bowel syndrome is a functional gastrointestinal disorder with a multifactorial etiology. alterations of intestinal motility and immunity, gut-brain interactions, as well as gut microbiota dysbiosis contribute to the development of irritable bowel syndrome. therefore, gut microbiota modulation by non-absorbable antibiotics is a therapeutic option in patients with ibs. | 2016 | 27149541 |
| extended perioperative antibiotic coverage in conjunction with intraoperative bile cultures decreases infectious complications after pancreaticoduodenectomy. | background. bile contamination from the digestive tract is a well-known risk factor for postoperative complications. despite the literature concerning prevalence of bacterobilia and fungobilia in patients with biliary pathologies, there are no specific recommendations for perioperative antimicrobial coverage for biliary/pancreatic procedures. we evaluated the effect of at least 72 hours of perioperative broad spectrum antibiotic coverage on outcomes of pancreaticoduodenectomy (pd). materials and ... | 2016 | 27147813 |
| detection of 23 gastrointestinal pathogens among children who present with diarrhea. | in the era of widespread rotavirus vaccine use, toxigenic clostridium difficile, diarrheagenic escherichia coli, and viruses (particularly norovirus) are commonly detected among children with infectious gastroenteritis in the united states by using a multipathogen molecular panel. | 2016 | 27147712 |
| risk factors for recurrent clostridium difficile infection in pediatric inpatients. | the purpose of this study was to identify the risk factors during the incident clostridium difficile infection (cdi) episode, associated with developing recurrent cdi within 60 days, among hospitalized children that may be amenable to intervention. | 2016 | 27146969 |
| transplanting a microbial organ: the good, the bad, and the unknown. | fecal microbiota transplantation (fmt) has received increased attention as a therapy for correcting intestinal dysbiosis and restoring a state of health in patients suffering from either recalcitrant infection by clostridium difficile or more complex disease states, such as inflammatory bowel disease (ibd). the "gut microbial organ" from the donor that is used in these transplants may serve to transfer genetic material between donor and recipient via virus-like particles, specifically bacterioph ... | 2016 | 27143392 |
| efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials. | the relative efficacy and safety of proton pump inhibitors (ppis) compared to histamine-2-receptor antagonists (h2ras) should guide their use in reducing bleeding risk in the critically ill. | 2016 | 27142116 |
| effect of passive immunotherapy against clostridium difficile infection: a systematic review and meta-analysis. | this systematic review aimed to determine the effect of antibody therapy against clostridium difficile infection (cdi) using meta-analysis. in total, 28 studies (animals - 12; human - 17) were identified from the database on the basis of inclusion criteria; then selected studies were systematically reviewed and statistically analyzed. in animal experiments, the pooled relative risk of eight potential studies suggested that the antibody treatment could reduce the risk of cdi. however, the methodo ... | 2016 | 27140414 |
| clostridium difficile infection in patients with inflammatory bowel disease. | clostridium difficile infection (cdi) is now the leading cause of nosocomial infection. there has been an upsurge of cdi in patients with inflammatory bowel disease (ibd). ibd patients with cdi have increased morbidity and mortality. the establishment, proliferation, and recurrence of cdi in ibd patients form a complex interplay of microbial, environmental, and host-susceptibility factors. different risk factors have been found predisposing ibd patients to cdi. vancomycin performs better than me ... | 2016 | 27137789 |
| fecal microbiota transplant for clostridium difficile infection in older adults. | the objective of this study was to describe the safety of fecal microbiota transplant (fmt) for clostridium difficile infection (cdi) among older adults. | 2016 | 27134658 |
| occupational health risks associated with the use of germicides in health care. | environmental surfaces have been clearly linked to transmission of key pathogens in health care facilities, including methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococcus, clostridium difficile, norovirus, and multidrug-resistant gram-negative bacilli. for this reason, routine disinfection of environmental surfaces in patient rooms is recommended. in addition, decontamination of shared medical devices between use by different patients is also recommended. environmental ... | 2016 | 27131141 |
| effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: focus on clinical trials. | over the last decade, substantial scientific evidence has accumulated that indicates contamination of environmental surfaces in hospital rooms plays an important role in the transmission of key health care-associated pathogens (eg, methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococci, clostridium difficile, acinetobacter spp). for example, a patient admitted to a room previously occupied by a patient colonized or infected with one of these pathogens has a higher risk for ... | 2016 | 27131140 |
| reducing health care-associated infections by implementing a novel all hands on deck approach for hand hygiene compliance. | hand hygiene is a key intervention for preventing health care-associated infections; however, maintaining high compliance is a challenge, and accurate measurement of compliance can be difficult. a novel program that engaged all health care personnel to measure compliance and provide real-time interventions overcame many barriers for compliance measurement and proved effective for sustaining high compliance and reducing health care-associated infections. | 2016 | 27131129 |
| clostridium difficile clade 5 in australia: antimicrobial susceptibility profiling of pcr ribotypes of human and animal origin. | increasing reports of genetic overlap between animal and human sources of clostridium difficile necessitate an understanding of antimicrobial susceptibility and resistance in these populations. in this study, we sought to investigate the in vitro activities of 13 antimicrobials against a unique collection of clade 5 c. difficile isolates of australian animal and human origin. | 2016 | 27130808 |
| impact of microbiology cascade reporting on antibiotic de-escalation in cefazolin-susceptible gram-negative bacteremia. | cascade reporting (cr) involves reporting the susceptibilities of broad-spectrum agents only when the organism is resistant to more narrow-spectrum agents. the purpose of this study is to evaluate the impact of cr on antibiotic de-escalation practices and to characterize the impact of cr on clinical outcomes. cr rules were implemented in the microbiology laboratory at atlantic health system (ahs) in june 2013. a retrospective chart review was conducted at two community teaching hospitals in adul ... | 2016 | 27130036 |
| fecal microbiota transplantation using upper gastrointestinal tract for the treatment of refractory or severe complicated clostridium difficile infection in elderly patients in poor medical condition: the first study in an asian country. | background and aims. fecal microbiota transplantation (fmt) is a highly effective treatment option for refractory clostridium difficile infection (cdi). fmt may be challenging in patients with a low performance status, because of their poor medical condition. the aims of this study were to describe our experience treating patients in poor medical condition with refractory or severe complicated cdi using fmt via the upper gi tract route. methods. this study was a retrospective review of seven eld ... | 2016 | 27127501 |
| getting to a man's heart through his colon. | a 69-year-old man presented with a progressively enlarging pulsatile mass in the left side of his chest. because of a history of an ischemic cardiomyopathy, he had been randomized in 2003 to undergo coronary artery bypass grafting with a dor procedure, as part of the surgical treatment for ischemic heart failure (stich) trial. our patient's imaging studies, including a thoracic computed tomogram and transthoracic echocardiogram, were now of concern for left ventricular pseudoaneurysm. he was tak ... | 2016 | 27127437 |
| durable coexistence of donor and recipient strains after fecal microbiota transplantation. | fecal microbiota transplantation (fmt) has shown efficacy in treating recurrent clostridium difficile infection and is increasingly being applied to other gastrointestinal disorders, yet the fate of native and introduced microbial strains remains largely unknown. to quantify the extent of donor microbiota colonization, we monitored strain populations in fecal samples from a recent fmt study on metabolic syndrome patients using single-nucleotide variants in metagenomes. we found extensive coexist ... | 2016 | 27126044 |
| [chronic salmonella typhimurium diarrhea in an immunocompetent patient]. | chronic diarrhea caused by infection in immunocompetent patients is an infrequent condition in developed countries, although certain pathogens,generally parasites (giardia lamblia, isospora belli,cryptosporidium, cyclospora, strongyloides, ameba,trichuris and schistosoma) and some bacteria (aeromonas,plesiomonas, campylobacter, clostridium difficile, salmonella or mycobacterium tuberculosis)can cause persistent diarrhea.we present the case of a patient who showed salmonella typhimurium in his st ... | 2016 | 27125610 |
| repeat clostridium difficile pcr testing after a negative result. | 2016 | 27124907 | |
| developing a clinical prediction rule for first hospital-onset clostridium difficile infections: a retrospective observational study. | background the healthcare burden of hospital-acquired clostridium difficile infection (cdi) demands attention and calls for a solution. identifying patients' risk of developing a primary nosocomial cdi is a critical first step in reducing the development of new cases of cdi. objective to derive a clinical prediction rule that can predict a patient's risk of acquiring a primary cdi. design retrospective cohort study. setting large tertiary healthcare center. patients total of 61,482 subjects aged ... | 2016 | 27123975 |
| dynamics of the fecal microbiome in patients with recurrent and nonrecurrent clostridium difficile infection. | recurrent clostridium difficile infection (cdi) remains problematic, with up to 30 % of individuals diagnosed with primary cdi experiencing at least one episode of recurrence. the success of microbial-based therapeutics, such as fecal microbiota transplantation, for the treatment of recurrent cdi underscores the importance of restoring the microbiota. however, few studies have looked at the microbial factors that contribute to the development of recurrent disease. here we compare microbial chang ... | 2016 | 27121861 |
| epidemiology, diagnosis, and management of clostridium difficile infection in patients with inflammatory bowel disease. | clostridium difficile infection (cdi) is a major source of morbidity and mortality for the u.s. health care system and frequently complicates the course of inflammatory bowel disease (ibd). patients with ibd are more likely to be colonized with c. difficile and develop active infection than the general population. they are also more likely to have severe cdi and develop subsequent complications such as ibd flare, colectomy, or death. even after successful initial treatment and recovery, recurren ... | 2016 | 27120571 |
| nqo1-knockout mice are highly sensitive to clostridium difficile toxin a-induced enteritis. | clostridium difficile toxin a causes acute gut inflammation in animals and humans. it is known to downregulate the tight junctions between colonic epithelial cells, allowing luminal contents to access body tissues and trigger acute immune responses. however, it is not yet known whether this loss of the barrier function is a critical factor in the progression of toxin a-induced pseudomembranous colitis. we previously showed that nadh:quinone oxidoreductase 1 (nqo1) ko (knockout) mice spontaneousl ... | 2016 | 27116994 |
| uk renal registry 18th annual report: chapter 12 epidemiology of reported infections amongst patients receiving dialysis for established renal failure in england 2013 to 2014: a joint report from public health england and the uk renal registry. | from 1st may 2013 to 30th april 2014 there were 35 episodes of methicillin resistant staphylococcus aureus (mrsa) bacteraemia in established renal failure patients on dialysis. this is now fairly stable year-on-year equating to a rate of 0.15 episodes per 100 dialysis patient years, following an initial decline in rates from 4.0 episodes per 100 dialysis patient years in 2005 when reporting began. methicillin sensitive staphylococcus aureus (mssa) bacteraemia rates were slightly higher this year ... | 2016 | 27116291 |
| effect of detecting and isolating clostridium difficile carriers at hospital admission on the incidence of c difficile infections: a quasi-experimental controlled study. | clostridium difficile infection (cdi) is a major cause of health care-associated infection worldwide, and new preventive strategies are urgently needed. current control measures do not target asymptomatic carriers, despite evidence that they can contaminate the hospital environment and health care workers' hands and potentially transmit c difficile to other patients. | 2016 | 27111806 |
| active surveillance and isolation of asymptomatic carriers of clostridium difficile at hospital admission: containing what lies under the waterline. | 2016 | 27111468 | |
| efficacy and mechanisms of action of fecal microbiota transplantation in ulcerative colitis: pitfalls and promises from a first meta-analysis. | inflammatory bowel disease (ibd) is the results of a chronic inflammatory process deriving from disequilibrium between self-microbiota composition and immune response. | 2016 | 27109966 |
| determination of the extent of clostridium difficile colonisation and toxin accumulation in sows and neonatal piglets. | clostridium difficile is an important spore-forming, opportunistic pathogen in animal husbandry and health care. in pig farming, only neonatal piglets are affected, and diarrhoea and necrotising lesions are common symptoms leading to dehydration and in some cases death. this study aimed at the assessment of the quantitative development of c. difficile colonisation in neonatal piglets by determining the shedding of spores and c. difficile toxins a (tcda) and b (tcdb) concentrations in sow (n = 5- ... | 2016 | 27108595 |
| a novel method for imaging the pharmacological effects of antibiotic treatment on clostridium difficile. | clostridium difficile is a significant cause of nosocomial-acquired infection that results in severe diarrhea and can lead to mortality. treatment options for c. difficile infection (cdi) are limited, however, new antibiotics are being developed. current methods for determining efficacy of experimental antibiotics on c. difficile involve antibiotic killing rates and do not give insight into the drug's pharmacologic effects. considering this, we hypothesized that by using scanning electron micros ... | 2016 | 27108094 |
| immune responses induced by clostridium difficile. | the spectrum of clostridium difficile infections is highly variable, ranging from asymptomatic carriage to fatal colitis depending on the strain virulence and on the host, its gut microbiota and its immune response. after disruption of the gut microbiota, c. difficile pathogenesis can be divided into three steps: 1) contamination by spores and their germination; 2) multiplication of vegetative cells and intestinal colonization using colonization factors; 3) production of the toxins tcda and tcdb ... | 2016 | 27108093 |
| the role of clostridium difficile in the paediatric and neonatal gut - a narrative review. | clostridium difficile is an important nosocomial pathogen in adults. its significance in children is less well defined, but cases of c. difficile infection (cdi) appear to be increasingly prevalent in paediatric patients. this review aims to summarize reported clostridium difficile carriage rates across children of different age groups, appraise the relationship between cdi and factors such as method of delivery, type of infant feed, antibiotic use, and co-morbidities, and review factors affecti ... | 2016 | 27107991 |
| epidemiology of clostridium difficile infections in australia: enhanced surveillance to evaluate time trends and severity of illness in victoria, 2010-2014. | with epidemic strains of clostridium difficile posing a substantial healthcare burden internationally, there is a need for longitudinal evaluation of clostridium difficile infection (cdi) events in australia. | 2016 | 27107622 |
| corrigendum to "length of stay and mortality due to clostridium difficile infection acquired in the intensive care unit" journal of critical care (2013) 28, 335-340. | 2016 | 27107495 | |
| risk factors for clostridium difficile infection in hospitalized patients with community-acquired pneumonia. | clostridium difficile infection (cdi) is strongly associated with anti-biotic treatment, and community-acquired pneumonia (cap) is the leading indication for anti-biotic prescription in hospitals. this study assessed the incidence of and risk factors for cdi in a cohort of patients hospitalized with cap. | 2016 | 27105657 |
| bacterial intestinal superinfections in inflammatory bowel diseases beyond clostridum difficile. | besides genetics and environmental factors, intestinal microbiota seem to play a major role in the pathogenesis of inflammatory bowel diseases. for many decades, it has been said that some enteropathogens may even trigger both inflammatory bowel disease development and disease flares. for this reason, stool testing had been performed in inflammatory bowel disease flares but current guidelines only recommend to rule out clostridium difficile infection and there is no clear advice for other entero ... | 2016 | 27104824 |
| recurrence and death after clostridium difficile infection: gender-dependant influence of proton pump inhibitor therapy. | to determine whether patients with a pre-existing ppi treatment had a higher risk of poor evolution (recurrence or death) when diagnosed with a toxicogenic clostridium difficile digestive infection. | 2016 | 27104118 |
| fecal transplantation using a nasoenteric tube during an initial episode of severe clostridium difficile infection. | the incidence of clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise. metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains. furthermore, antibiotic therapy results in recurrence rates of at least 20%. fecal transplantation may be a feasible treatment option for recurrent c. difficile infection; moreover, it may be an early treatme ... | 2016 | 27104013 |
| the burden of clostridium difficile infection: estimates of the incidence of cdi from u.s. administrative databases. | many administrative data sources are available to study the epidemiology of infectious diseases, including clostridium difficile infection (cdi), but few publications have compared cdi event rates across databases using similar methodology. we used comparable methods with multiple administrative databases to compare the incidence of cdi in older and younger persons in the united states. | 2016 | 27102582 |
| sporulation properties and antimicrobial susceptibility in endemic and rare clostridium difficile pcr ribotypes. | increased sporulation and antibiotic resistance have been proposed to be associated with certain clostridium difficile epidemic strains such as pcr ribotype 027. in this study we examined these properties in another widespread pcr ribotype, 014/020, in comparison to prevalent pcr ribotype 002 and a group of rarely represented pcr ribotypes. highest sporulation was observed in 014/020 strains at 24 h, while after 72 h pcr ribotype 002 and rare pcr ribotypes formed higher total number of spores. p ... | 2016 | 27095618 |
| diarrhoea in the critically ill is common, associated with poor outcome, and rarely due to clostridium difficile. | diarrhoea is common in intensive care unit (icu) patients, with a reported prevalence of 15-38%. many factors may cause diarrhoea, including clostridium difficile, drugs (e.g. laxatives, antibiotics) and enteral feeds. diarrhoea impacts on patient dignity, increases nursing workload and healthcare costs, and exacerbates morbidity through dermal injury, impaired enteral uptake and subsequent fluid imbalance. we analysed a cohort of 9331 consecutive patients admitted to a mixed general intensive c ... | 2016 | 27094447 |
| stress ulcer prophylaxis with a proton pump inhibitor versus placebo in critically ill patients (sup-icu trial): study protocol for a randomised controlled trial. | critically ill patients in the intensive care unit (icu) are at risk of clinically important gastrointestinal bleeding, and acid suppressants are frequently used prophylactically. however, stress ulcer prophylaxis may increase the risk of serious adverse events and, additionally, the quantity and quality of evidence supporting the use of stress ulcer prophylaxis is low. the aim of the sup-icu trial is to assess the benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in ad ... | 2016 | 27093939 |
| clinical outcomes of acid suppressive therapy use in hematology/oncology patients at an academic medical center. | acid suppressive therapy (ast)-namely, proton pump inhibitors (ppis) and histamine-2 receptor antagonists (h2ras)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (sup). | 2016 | 27091869 |
| ulcerative colitis patients with clostridium difficile are at increased risk of death, colectomy, and postoperative complications: a population-based inception cohort study. | clostridium difficile (c. difficile) may worsen the prognosis of ulcerative colitis (uc). the objectives of this study were to: (i) validate the international classification of diseases-10 (icd-10) code for c. difficile; (ii) determine the risk of c. difficile infection after diagnosis of uc; (iii) evaluate the effect of c. difficile infection on the risk of colectomy; and (iv) assess the association between c. difficile and postoperative complications. | 2016 | 27091322 |
| do piperacillin/tazobactam and other antibiotics with inhibitory activity against clostridium difficile reduce the risk for acquisition of c. difficile colonization? | systemic antibiotics vary widely in in vitro activity against clostridium difficile. some agents with activity against c. difficile (e.g., piperacillin/tazobactam) inhibit establishment of colonization in mice. we tested the hypothesis that piperacillin/tazobactam and other agents with activity against c. difficile achieve sufficient concentrations in the intestinal tract to inhibit colonization in patients. | 2016 | 27091232 |
| postoperative antimicrobials after lung transplantation and the development of multidrug-resistant bacterial and clostridium difficile infections: an analysis of 500 non-cystic fibrosis lung transplant patients. | broad-spectrum antimicrobials are given prophylactically post-transplant, although these agents are a risk factor for multidrug-resistant (mdr) infections and clostridium difficile infection (cdi). this study aimed to determine whether an association exists between the duration of antimicrobials given early post-transplant and the development of mdr infections or cdi. | 2016 | 27091109 |
| molecular and epidemiologic study of clostridium difficile reveals unusual heterogeneity in clinical strains circulating in different regions in portugal. | clostridium difficile infection (cdi) represents a great healthcare burden in developed countries. the emergence of the epidemic pcr ribotype (rt) 027 and its acquired fluoroquinolones resistance have accentuated the need for an active surveillance of cdi. here we report the first countrywide study of cdi in portugal with the characterization of 498 c. difficile clinical isolates from 20 hospitals in four regions in portugal regarding rt, virulence factors and antimicrobial susceptibility. we id ... | 2016 | 27091093 |
| microbiome mediation of infections in the cancer setting. | infections encountered in the cancer setting may arise from intensive cancer treatments or may result from the cancer itself, leading to risk of infections through immune compromise, disruption of anatomic barriers, and exposure to nosocomial (hospital-acquired) pathogens. consequently, cancer-related infections are unique and epidemiologically distinct from those in other patient populations and may be particularly challenging for clinicians to treat. there is increasing evidence that the micro ... | 2016 | 27090860 |
| effect of fidaxomicin versus vancomycin on susceptibility to intestinal colonization with vancomycin-resistant enterococci and klebsiella pneumoniae in mice. | the use of oral vancomycin or metronidazole for treatment of clostridium difficile infection (cdi) may promote colonization by health care-associated pathogens due to disruption of the intestinal microbiota. because the macrocyclic antibiotic fidaxomicin causes less alteration of the intestinal microbiota than vancomycin, we hypothesized that it would not lead to a loss of colonization resistance to vancomycin-resistant enterococci (vre) and extended-spectrum-β-lactamase-producing klebsiella pne ... | 2016 | 27090175 |
| metal ion activation of clostridium sordellii lethal toxin and clostridium difficile toxin b. | lethal toxin from clostridium sordellii (tcsl) and toxin b from clostridium difficile (tcdb) belong to the family of the "large clostridial glycosylating toxins." these toxins mono-o-glucosylate low molecular weight gtpases of the rho and ras families by exploiting udp-glucose as a hexose donor. tcsl is casually involved in the toxic shock syndrome and the gas gangrene. tcdb-together with toxin a (tcda)-is causative for the pseudomembranous colitis (pmc). here, we present evidence for the in vit ... | 2016 | 27089365 |
| national variability and appropriateness of surgical antibiotic prophylaxis in us children's hospitals. | appropriate use of surgical antibiotic prophylaxis (ap) reduces surgical site infection rates, but prior data suggest variability in use patterns. | 2016 | 27088649 |
| importation, antibiotics, and clostridium difficile infection in veteran long-term care: a multilevel case-control study. | although clinical factors affecting a person's susceptibility to clostridium difficile infection are well-understood, little is known about what drives differences in incidence across long-term care settings. | 2016 | 27088642 |
| should asymptomatic bacteriuria be systematically treated in kidney transplant recipients? results from a randomized controlled trial. | the indication of antimicrobial treatment for asymptomatic bacteriuria (ab) after kidney transplantation (kt) remains controversial. between january 2011 and december 2013 112 kt recipients that developed ≥1 episode of ab beyond the second month post-transplantation were included in this open-label trial. participants were randomized (1:1 ratio) to the treatment group (systematic antimicrobial therapy for all episodes of ab occurring up to 24 months post-transplantation [53 patients]) or control ... | 2016 | 27088545 |
| successful fecal microbiota transplantation as an initial therapy for clostridium difficile infection on an outpatient basis. | a 64-year-old woman developed diarrhea after taking clindamycin for a dental infection. we diagnosed her with clostridium difficile infection (cdi) and performed fecal microbiota transplantation (fmt) as the initial therapy using colonoscopy on an outpatient basis. the frequency of her bowel movements decreased from 10 times per day to two times per day three days after the procedure. the key component of fmt is to restructure the protective microbiome of the natural intestinal flora. we conside ... | 2016 | 27086820 |
| recurrent clostridium difficile infection associates with distinct bile acid and microbiome profiles. | the healthy microbiome protects against the development of clostridium difficile infection (cdi), which typically develops following antibiotics. the microbiome metabolises primary to secondary bile acids, a process if disrupted by antibiotics, may be critical for the initiation of cdi. | 2016 | 27086647 |
| outcomes in children with clostridium difficile infection: results from a nationwide survey. | hospital- and population-based studies demonstrate an increasing incidence of clostridium difficile infection (cdi) in adults and children; although pediatric cdi outcomes are incompletely understood. we analysed united states national hospital discharge survey (nhds) data to study cdi in hospitalized children. | 2016 | 27081152 |
| "clostridium difficile associated pseudomembranous colitis: an under-recognized threat" - scenario from a tertiary care hospital. | 2016 | 27080803 | |
| evaluation of a new molecular method illumigene for detection of clostridium difficile associated diarrhoea. | 2016 | 27080791 | |
| safety, immunogenicity and dose response of vla84, a new vaccine candidate against clostridium difficile, in healthy volunteers. | clostridium difficile infection (cdi) is the leading cause of antibiotic-associated diarrhoea and colitis and the most common pathogen of health care-associated infections. in the us, cdi causes approximately half a million infections and close to 30,000 deaths. despite antibiotic treatment of c. difficile associated diarrhoea, the disease is complicated by its recurrence in up to 30% of patients. | 2016 | 27079932 |
| a novel fic (filamentation induced by camp) protein from clostridium difficile reveals an inhibitory motif-independent adenylylation/ampylation mechanism. | filamentation induced by camp (fic) domain proteins have been shown to catalyze the transfer of the amp moiety from atp onto a protein target. this type of post-translational modification was recently shown to play a crucial role in pathogenicity mediated by two bacterial virulence factors. herein we characterize a novel fic domain protein that we identified from the human pathogen clostridium difficile the crystal structure shows that the protein adopts a classical all-helical fic fold, which b ... | 2016 | 27076635 |
| the design of a clostridium difficile carbohydrate-based vaccine. | clostridium difficile vaccines composed of surface polysaccharides (pss) have the potential to simultaneously control infection and colonization levels in humans. hot water-phenol treatment of c. difficile biomass can extricate water-soluble ps-i and ps-ii; and water- and phenol-soluble ps-iii. c. difficile vaccines based on ps-ii have attracted the most attention due its facile purification and ubiquitous expression by c. difficile ribotypes. anti ps-ii antibodies recognize both c. difficile ve ... | 2016 | 27076143 |
| design and purification of subunit vaccines for prevention of clostridium difficile infection. | clostridium difficile is a gram-positive bacterium responsible for a large proportion of nosocomial infections in the developed world. c. difficile secretes toxins a and b (tcda and tcdb) and both toxins act synergistically to induce a spectrum of pathological responses in infected individuals ranging from pseudomembranous colitis to c. difficile-associated diarrhea. toxins a and b have been actively investigated as components of prophylactic vaccine as well as targets for therapeutic interventi ... | 2016 | 27076142 |
| possible interplay between hospital and community transmission of a novel clostridium difficile sequence type 295 recognized by next-generation sequencing. | objective to use next-generation sequencing (ngs) analysis to enhance epidemiological information to identify and resolve a clostridium difficile outbreak and to evaluate its effectiveness beyond the capacity of current standard pcr ribotyping. methods ngs analysis was performed as part of prospective surveillance of all detected c. difficile isolates at a university hospital. an outbreak of a novel c. difficile sequence type (st)-295 was identified in a hospital and a community hostel for homel ... | 2016 | 27074865 |
| the effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. | the widespread use of antibiotics in the past 80 years has saved millions of human lives, facilitated technological progress and killed incalculable numbers of microbes, both pathogenic and commensal. human-associated microbes perform an array of important functions, and we are now just beginning to understand the ways in which antibiotics have reshaped their ecology and the functional consequences of these changes. mounting evidence shows that antibiotics influence the function of the immune sy ... | 2016 | 27074706 |
| a pilot study to assess bacterial and toxin reduction in patients with clostridium difficile infection given fidaxomicin or vancomycin. | to assess the effect of fidaxomicin and vancomycin on clostridium difficile toxins and correlation with clinical and microbiologic outcomes. | 2016 | 27071986 |
| efficacy of secondary prophylaxis with vancomycin for preventing recurrent clostridium difficile infections. | patients with clostridium difficile infection (cdi) who are re-exposed to antibiotics have a high likelihood of recurrence. we aimed to determine whether oral vancomycin as secondary prophylaxis reduces the risk of recurrence in patients recently diagnosed with cdi who undergo subsequent antibiotic exposure (cdi-ae). | 2016 | 27619835 |
| why rifampin (rifampicin) is a key component in the antibiotic treatment of hidradenitis suppurativa: a review of rifampin's effects on bacteria, bacterial biofilms, and the human immune system. | combinations of rifampin and clindamycin or rifampin, metronidazole, and moxifloxcin have been reported as effective treatments for hidradenitis suppurativa (hs) hurley stage 1 and hurley stage 2. clinical trials suggest that for stage 1 and mild stage 2 hs, clindamycin 300 mg twice daily and rifampin 300 mg twice daily for 10 weeks can substantially abate hs in ~80% of cases and remit hs in ~50% of cases. another study notes use of rifampin-moxifloxacin-metronidazole given for 6 weeks, dosed ... | 2016 | 27617596 |
| antibiotic resistance. | antimicrobial resistance in bacterial pathogens is a challenge that is associated with high morbidity and mortality. multidrug resistance patterns in gram-positive and -negative bacteria are difficult to treat and may even be untreatable with conventional antibiotics. there is currently a shortage of effective therapies, lack of successful prevention measures, and only a few new antibiotics, which require development of novel treatment options and alternative antimicrobial therapies. biofilms ar ... | 2016 | 27616769 |
| cost of hospital management of clostridium difficile infection in united states-a meta-analysis and modelling study. | clostridium difficile infection (cdi) is the leading cause of infectious nosocomial diarrhoea but the economic costs of cdi on healthcare systems in the us remain uncertain. | 2016 | 27562241 |
| coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection. | clostridium difficile (peptoclostridium difficile) is a common health care-associated infection with a disproportionately high incidence in elderly patients. disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. around 20% of patients may suffer recurrent disease, which often requires rehospitalization of patients. c. difficile was isolated from stool samples from a patient with two recurrent c. difficile infections. pcr ribotyping, whole-genome sequencing, and ... | 2016 | 27558181 |
| crispr diversity and microevolution in clostridium difficile. | virulent strains of clostridium difficile have become a global health problem associated with morbidity and mortality. traditional typing methods do not provide ideal resolution to track outbreak strains, ascertain genetic diversity between isolates, or monitor the phylogeny of this species on a global basis. here, we investigate the occurrence and diversity of clustered regularly interspaced short palindromic repeats (crispr) and crispr-associated genes (cas) in c. difficile to assess the poten ... | 2016 | 27576538 |
| clostridium difficile colitis: pathogenesis and host defence. | clostridium difficile is a major cause of intestinal infection and diarrhoea in individuals following antibiotic treatment. recent studies have begun to elucidate the mechanisms that induce spore formation and germination and have determined the roles of c. difficile toxins in disease pathogenesis. exciting progress has also been made in defining the role of the microbiome, specific commensal bacterial species and host immunity in defence against infection with c. difficile. this review will sum ... | 2016 | 27573580 |
| evaluation of gastrointestinal leakage using serum (1→3)-β-d-glucan in a clostridium difficile murine model. | gastrointestinal (gi) leakage in clostridium difficile-associated diarrhea (cdad) is well known but is not routinely assessed in clinical practice. serum (1→3)-β-d-glucan (bg), a fungal cell wall component used as a biomarker for invasive fungal disease, was tested in a cdad mouse model with and without probiotics. higher serum fluorescein isothiocyanate-dextran (fitc-dextran) and spontaneous gram-negative bacteremia, gi leakage indicators, were frequently found in cdad mice, which died compared ... | 2016 | 27573235 |
| the binary toxin cdt enhances clostridium difficile virulence by suppressing protective colonic eosinophilia. | clostridium difficile is the most common hospital acquired pathogen in the usa, and infection is, in many cases, fatal. toxins a and b are its major virulence factors, but expression of a third toxin, known as c. difficile transferase (cdt), is increasingly common. an adenosine diphosphate (adp)-ribosyltransferase that causes actin cytoskeletal disruption, cdt is typically produced by the major, hypervirulent strains and has been associated with more severe disease. here, we show that cdt enhanc ... | 2016 | 27573114 |
| role of coinfecting strains in recurrent clostridium difficile infection. | the contribution of mixed infection in recurrent clostridium difficile infection (cdi) episodes is not known. among paired isolates from 52 patients, mixed infection due to >1 toxigenic strain of c. difficile was identified in 8% of first episodes. among recurrences, relapse from 1 or both co-infecting strains was uncommon; it was detected in a single case each. infect control hosp epidemiol 2016;1481-1484. | 2016 | 27572118 |
| crystal structure of clostridium difficile toxin a. | clostridium difficile infection is the leading cause of hospital-acquired diarrhoea and pseudomembranous colitis. disease is mediated by the actions of two toxins, tcda and tcdb, which cause the diarrhoea, as well as inflammation and necrosis within the colon. the toxins are large (308 and 270 kda, respectively), homologous (47% amino acid identity) glucosyltransferases that target small gtpases within the host. the multidomain toxins enter cells by receptor-mediated endocytosis and, upon exposu ... | 2016 | 27571750 |
| clostridium difficile infection health disparities by race among hospitalized adults in the united states, 2001 to 2010. | recognition of health disparities in clostridium difficile infection (cdi) is an initial step toward improved resource utilization and patient health. the purpose of this study was to identify health disparities by black vs. white race among hospitalized adults with cdi in the united states (u.s.) over 10 years. | 2016 | 27568176 |
| oral, frozen fecal microbiota transplant (fmt) capsules for recurrent clostridium difficile infection. | fecal microbiota transplantation (fmt) has been shown to be safe and effective in treating refractory or relapsing c. difficile infection (cdi), but its use has been limited by practical barriers. we recently reported a small preliminary feasibility study using orally administered frozen fecal capsules. following these early results, we now report our clinical experience in a large cohort with structured follow-up. | 2016 | 27609178 |
| the epidemiology of clostridium difficile infection in patients with cancer. | clostridium difficile infection (cdi) is a significant cause of healthcare-associated diarrhoea, and the emergence of endemic strains resulting in poorer outcomes is recognised worldwide. patients with cancer are a specific high-risk group for development of infection. areas covered: in this review, modifiable and non-modifiable risk factors for cdi in adult patients with haematological malignancy or solid tumours are evaluated. in particular, the contribution of antimicrobial exposure, hospital ... | 2016 | 27606976 |
| clostridium difficile infection in production animals and avian species: a review. | clostridium difficile is the leading cause of antibiotic-associated diarrhea and colitis in hospitalized humans. recently, c. difficile infection (cdi) has been increasingly recognized as a cause of neonatal enteritis in food animals such as pigs, resulting in stunted growth, delays in weaning, and mortality, as well as colitis in large birds such as ostriches. c. difficile is a strictly anaerobic spore-forming bacterium, which produces two toxins a (tcda) and b (tcdb) as its main virulence fact ... | 2016 | 27602596 |
| bed utilisation and increased risk of clostridium difficile infections in acute hospitals in england in 2013/2014. | the study aimed to identify thresholds for hospital bed utilisation which are independently associated with significantly higher risks for clostridium difficile infections (cdi) in acute hospitals in england. | 2016 | 27601687 |
| [a scoring system for prescribing fidaxomicin in clostridium diffícile infection]. | recurrences of clostridium difficile infections lead to hospital readmissions and high costs, in addition to the suffering and frustration for the patients. fidaxomicin has recently been introduced as a new antibiotic that has been shown to significantly reduce the recurrence of this infection. despite this superiority, its high cost has led to very restrictive policies in its use, as such that many institutions only use it in patients with multiple recurrences. while waiting for new predictive ... | 2016 | 27601193 |
| rapid detection of clostridium difficile toxins and laboratory diagnosis of clostridium difficile infections. | clostridium difficile is an anaerobic, spore-forming and gram-positive bacillus. it is the major cause of antibiotic-associated diarrhea prevailing in hospital settings. the morbidity and mortality of c. difficile infection (cdi) has increased significantly due to the emergence of hypervirulent strains. because of the poor clinical different between cdi and other causes of hospital-acquired diarrhea, laboratory test for c. difficile is an important intervention for diagnosis of cdi. | 2016 | 27601055 |
| use of intravenous tigecycline in patients with severe clostridium difficile infection: a retrospective observational cohort study. | there are only a limited number of antimicrobials for treating severe clostridium difficile infection (scdi). tigecycline shows significant in vitro effect against c. difficile and is approved for management of complicated intra-abdominal infections. our aim was to analyse the efficacy of tigecycline compared with standard therapy (oral vancomycin plus intravenous metronidazole) in adults treated for scdi. a retrospective cohort study of such patients hospitalized at our department from january ... | 2016 | 27599690 |
| growth patterns of clostridium difficile - correlations with strains, binary toxin and disease severity: a prospective cohort study. | a broad spectrum of symptoms has been associated with c. difficile infection (cdi). several studies indicate that toxin-production correlates with growth rates of c. difficile. this study aimed to correlate growth rates of c. difficile with disease severity and strain characteristics. from 01/2003 to 10/2011, strains from a prospective cohort of all inpatients with cdi at the university hospital basel, switzerland were analyzed regarding binary toxin, presence of the tcdc deletion and ribotype. ... | 2016 | 27598309 |
| comparison of agar dilution and broth microdilution methods for clostridium difficile antimicrobial susceptibility testing. | in this study, the performance of the broth microdilution (bmd) method for testing the antimicrobial susceptibility of clostridium difficile in comparison with the agar dilution (ad) method used by the clinical and laboratory standards institute (clsi) was evaluated. in total, 70 non-duplicate c. difficile clinical isolates were used in this study. the minimum inhibitory concentrations (mics) of clindamycin, moxifloxacin, metronidazole and vancomycin were examined using ad and bmd. the results s ... | 2016 | 27598055 |
| effect of an antimicrobial stewardship intervention on outcomes for patients with clostridium difficile infection. | although antimicrobial stewardship programs (asps) are uniquely positioned to improve treatment of clostridium difficile infection (cdi) through targeted interventions, studies to date have not rigorously evaluated the influence of asp involvement on clinical outcomes attributed to cdi. | 2016 | 27592160 |
| epidemiology of multidrug resistant bacterial organisms and clostridium difficile in german hospitals in 2014: results from a nationwide one-day point prevalence of 329 german hospitals. | one important aspect in combatting resistance to antibiotics is to increase the awareness and knowledge by epidemiological studies. we therefore conducted a german-wide point-prevalence survey for multidrug resistant bacterial organisms (mdros) and clostridium difficile (cd) to assess the epidemiology and structure quality of infection control in german hospitals. | 2016 | 27590879 |
| variability in testing policies and impact on reported clostridium difficile infection rates: results from the pilot longitudinal european clostridium difficile infection diagnosis surveillance study (lucid). | lack of standardised clostridium difficile testing is a potential confounder when comparing infection rates. we used an observational, systematic, prospective large-scale sampling approach to investigate variability in c. difficile sampling to understand c. difficile infection (cdi) incidence rates. in-patient and institutional data were gathered from 60 european hospitals (across three countries). testing methodology, testing/cdi rates and case profiles were compared between countries and insti ... | 2016 | 27590621 |
| draft genome sequence of clostridium difficile belonging to ribotype 018 and sequence type 17. | clostridium difficile, belonging to ribotype 018 (rt018), is one of the most prevalent genotypes circulating in hospital settings in italy. here, we report the draft genome of c. difficile cd8-15 belonging to rt018, isolated from a patient with fatal c. difficile-associated infection. | 2016 | 27587821 |
| vaccines against major icu pathogens: where do we stand? | multidrug resistance of bacterial pathogens has confronted physicians around the world with the threat of inefficacy of the antibiotic regime, which is particularly important for patients with sepsis. antibiotic resistance has revived search for alternative nonantibiotic strategies. among them, prophylaxis by vaccination is an appealing concept. | 2016 | 27583587 |
| a quantitative analysis of fda adverse event reports with oral bisphosphonates and clostridium difficile. | studies have shown associations between clostridium difficile infection (cdi) and non-antimicrobial medications including proton pump inhibitors, osteoporosis medications, and antidepressants. | 2016 | 27582058 |
| fecal microbiota transplantation is safe and efficacious for recurrent or refractory clostridium difficile infection in patients with inflammatory bowel disease. | new treatments are needed as clostridium difficile infection (cdi) is becoming increasingly formidable. fecal microbiota transplantation (fmt) has a 90% success rate in the treatment of recurrent cdi. however, evidence regarding its safety, efficacy, and effect on disease activity in patients with inflammatory bowel disease (ibd) is lacking. | 2016 | 27580384 |
| cost-effectiveness analysis of the use of probiotics for the prevention of clostridium difficile-associated diarrhea in a provincial healthcare system - erratum. | 2016 | 27580173 | |
| high mobility group box1 protein is involved in endoplasmic reticulum stress induced by clostridium difficile toxin a. | high mobility group box1 (hmgb1), a damage-associated inflammatory factor, plays an important role in the pathogenesis of numerous chronic inflammatory and autoimmune diseases. in this study, the role of the hmgb1 in tcda-induced er stress was identified. clostridium difficile toxin a is one of the major virulence factors of c. difficile infection (cdi) and has been proved to induce apoptotic cell death through er stress. our results showed that hmgb1 might play an important role in the tcda-ind ... | 2016 | 27579314 |
| epidemiology of diarrheal illness in pediatric oncology patients. | diarrhea is common in children with cancer, but this has not been systematically studied to date. | 2016 | 27578209 |
| fecal microbiota transplant in patients with recurrent clostridium difficile infection. | the clinical effectiveness of fecal microbiota transplant (fmt) for the treatment of recurrent clostridium difficile infections (rcdi) has been demonstrated in randomized controlled trials. to assess the current status of fmt in germany with respect to active centers, local standards, clinical effectiveness and safety, the microtrans registry (nct02681068) was established. | 2016 | 27658471 |