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outcomes with fidaxomicin therapy in clostridium difficile infection.fidaxomicin is a new antibiotic used to treat clostridium difficile infection (cdi). given limited clinical experience with fidaxomicin, we assessed outcomes in a diverse cohort of patients with cdi treated with fidaxomicin.201628009682
[fecal microbiota transplantation: indications and perspectives].fecal transplantation demonstrated in a randomized trial its superiority compared to antibiotics in recurrent clostridium difficile (cd) infections. used in first-line treatment, it has reduced the mortality of patients suffering of cd infections caused by ribotype 027 and made it possible to cure patients with severe manifestations of cd infections caused by other ribotypes. the use of frozen microbiota, now validated, facilitates fecal microbiota transplantation. in addition, the frozen microb ...201628008840
a review of dose-responses of probiotics in human studies.the probiotic definition requires the administration of an 'adequate amount' in order to obtain a health benefit. what that amount should be is not indicated. here, an overview is given of studies that investigated the dose-response relation of probiotics in human interventions. studies were divided in; meta-analyses, meta-analyses on specific probiotic strains, and studies testing two or more doses of a probiotic (combination) in the same study. meta-analyses on the effect of probiotics on anti ...201628008787
therapeutic interventions for gut dysbiosis and related disorders in the elderly: antibiotics, probiotics or faecal microbiota transplantation?ageing and physiological functions of the human body are inversely proportional to each other. the gut microbiota and host immune system co-evolve from infants to the elderly. ageing is accompanied by a decline in gut microbial diversity, immunity and metabolism, which increases susceptibility to infections. any compositional change in the gut is directly linked to gastrointestinal disorders, obesity and metabolic diseases. increase in opportunistic pathogen invasion in the gut like clostridium ...201628008784
response to comment on "a small-molecule antivirulence agent for treating clostridium difficile infection".ebselen's antivirulence activity in clostridium difficile infection is likely due to multiple modes of action, but the contribution of each to its efficacy remains unclear.201628003551
comment on "a small-molecule antivirulence agent for treating clostridium difficile infection".new insights into the mechanism of action of ebselen, a small-molecule antivirulence agent that reduces disease pathology in a mouse model of clostridium difficile infection, suggest a different molecular target may be responsible for its efficacy.201628003550
clinical characteristics and treatment outcomes of clostridium difficile infections by pcr ribotype 017 and 018 strains.the objective of this study was to identify the clinical characteristics of clostridium difficile infections (cdis) caused by toxin a-negative/toxin b-positive (a-b+) pcr ribotype 017 (r017) and a+b+ ribotype 018 (r018) strains, prevalent in asian countries. from february 2010 through january 2013, all cdi patients in our hospital were enrolled; their medical records were retrospectively reviewed, and the isolates were characterized by toxigenic culture and pcr ribotyping. based on the ribotypes ...201628002482
role of p38alpha/beta map kinase in cell susceptibility to clostridium sordellii lethal toxin and clostridium difficile toxin b.lethal toxin from clostridium sordellii (tcsl), which is casually involved in the toxic shock syndrome and in gas gangrene, enters its target cells by receptor-mediated endocytosis. inside the cell, tcsl mono-o-glucosylates and thereby inactivates rac/cdc42 and ras subtype gtpases, resulting in actin reorganization and an activation of p38 map kinase. while a role of p38 map kinase in tcsl-induced cell death is well established, data on a role of p38 map kinase in tcsl-induced actin reorganizati ...201628025502
costs of clostridium difficile infection in pediatric operations: a propensity score-matching analysis.the purpose of this analysis was to assess the burden of clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care.201628024858
fecal microbiota transplant in severe and severe-complicated clostridium difficile: a promising treatment approach.severe and severe-complicated clostridium difficile infection (cdi) is associated with high morbidity and mortality. colectomy is standard of care; however, post-surgical mortality rates approach 50%. case reports suggest fecal microbiota transplant (fmt) is a promising treatment of severe and severe-complicated disease but there is a paucity of data. here, we present a single center experience with a novel sequential fmt protocol for patients refractory to maximal medical therapy. this approach ...201628001467
traditional chinese medicine qpyf as preventive treatment for clostridium difficile associated diarrhea in a mouse model.traditional chinese medicine qpyf has a good effect for treating antibiotic-associated diarrhea in clinical practice. the aim of this study is to test its efficacy to prevent clostridium difficile associated diarrhea (cdad) in a mouse model. c57bl/6 mice were infected with clostridium difficile vpi 10463 after exposure to antimicrobial mixture. qpyf was administered from 7 days prior to clostridium difficile infection to 20 days after infection, and its effect was compared with no treatment and ...201627999606
detection, ribotyping and antimicrobial resistance properties of clostridium difficile strains isolated from the cases of diarrhea.clostridium difficile is the most prevalent cause of antibiotic-associated infectious diarrhea al-around the world. prevalence of virulent and resistant strains of clostridium difficile is increasing now a day. the present investigation was carried out to study the prevalence, ribotyping and antibiotic resistance pattern of c. difficile isolated from diarrheic and non-diarrheic pediatrics.201627999477
complete microbiota engraftment is not essential for recovery from recurrent clostridium difficile infection following fecal microbiota transplantation.bacterial communities from subjects treated for recurrent clostridium difficile infection (rcdi) by fecal microbiota transplantation (fmt), using either heterologous donor stool samples or autologous stool samples, were characterized by illumina next-generation sequencing. as previously reported, the success of heterologous fmt (90%) was superior to that of autologous fmt (43%) (p = 0.019), and post-fmt intestinal bacterial communities differed significantly between treatment arms (p < 0.001). s ...201627999162
the microbiome: what will the future hold?current research on the human microbiome has opened our eyes to the intimate relationship that we have with the bacteria that populate our gastrointestinal tract and its potential relationship to health and disease. to date, clinical research on the microbiome has identified intriguing associations between an altered microbiome and disease states, but proven therapeutic applications have been very limited. the ingestion of prebiotics, probiotics, and/or synbiotics is appealing to the general pub ...201627997976
the emerging metabolic view of clostridium difficile pathogenesis.it is widely accepted that clostridium difficile exploits dysbiosis and leverages inflammation to thrive in the gut environment, where it can asymptomatically colonize humans or cause a toxin-mediated disease ranging in severity from frequent watery diarrhea to pseudomembranous colitis or toxic megacolon. here, we synthesize recent findings from the gut microbiota and enteric pathogenesis fields to inform the next steps toward a better understanding of c. difficile infection (cdi). in this revie ...201627997854
homogeneous and digital proximity ligation assays for the detection of clostridium difficile toxins a and b.the proximity ligation assay (pla) detects proteins via their interaction with pairs of proximity probes, which are antibodies coupled to noncomplementary dna oligonucleotides. the binding of both proximity probes to their epitopes on the target protein brings the oligonucleotides together, allowing them to be bridged by a third oligonucleotide with complementarity to the other two. this enables their ligation and the detection of the resulting amplicon by real-time quantitative pcr (qpcr), whic ...201627990343
novel portable platform for molecular detection of toxigenic clostridium difficile in faeces: a diagnostic accuracy study.a novel portable platform for nucleic acid amplification enables rapid detection of diarrhoea causing toxigenic clostridium difficile directly from faeces, even in resource-limited settings. we evaluated the accuracy and precision of the new commercial molecular test system.201627988815
probiotics and prevention of clostridium difficile infection.the role of probiotics as adjunctive measures in the prevention of clostridium difficile infection (cdi) has been controversial. however, a growing body of evidence has suggested that they have a role in primary prevention of cdi. elements of this controversy are reviewed and the proposed mechanisms of action, the value and cost effectiveness of probiotics are addressed with a focus on three agents, saccharomyces boulardii, lactobacillus rhamnosus gg and the combination of lactobacillus acidophi ...201627988389
clostridium difficile-associated clinical burden from lack of diagnostic testing in a chinese tertiary hospital.despite clostridium difficile infection (cdi) being a common cause of diarrhoea in hospitals worldwide, diagnostic testing or management guidelines are not available in most hospitals in china. in this prospective two-year study, the incidence of cdi among 276 patients with watery diarrhoea was 23.1%. lack of diagnostic testing for cdi was associated with improper management in 26.4% of patients, risk of nosocomial transmission from lack of isolation precautions, and risk of community transmissi ...201628029470
evaluation of the novel artus c. difficile qs-rgq, vanr qs-rgq and mrsa/sa qs-rgq assays for the laboratory diagnosis of clostridium difficile infection (cdi), and for vancomycin-resistant enterococci (vre) and methicillin-resistant staphylococcus aureus (mrsa) screening.clostridium difficile, methicillin-resistant staphylococcus aureus (mrsa) and vancomycin-resistant enterococci (vre) are worldwide prevalent healthcare-associated pathogens. we have evaluated three qiagen artus qs-rgq assays for the detection of these pathogens. we examined 200 stool samples previously tested for c. difficile infection (cdi), 94 rectal swabs previously screened for vre and 200 mrsa screening nasal swabs. with the routine diagnostic laboratory results being adopted as the gold st ...201627987047
donor screening experience for fecal microbiota transplantation in patients with recurrent c. difficile infection.to evaluate our experience with stool donor recruitment, screening, retention, and donor perception for fecal microbiota transplantation (fmt).201627984397
clostridium difficile colonization and antibiotics response in polyferms continuous model mimicking elderly intestinal fermentation.clostridium difficile (cd), a spore-forming and toxin-producing bacterium, is the main cause for antibiotic-associated diarrhea in the elderly. here we investigated cd colonization in novel in vitro fermentation models inoculated with immobilized elderly fecal microbiota and the effects of antibiotic treatments.201627980686
repeat clostridium difficile testing. 201627959982
clostridium difficile infection and fecal microbiota transplant.clostridium difficile infection (cdi) is a major source of morbidity and mortality for hospitalized patients. although most patients have a clinical response to existing antimicrobial therapies, recurrent infection develops in up to 30% of patients. fecal microbiota transplant is a novel approach to this complex problem, with an efficacy rate of nearly 90% in the setting of multiple recurrent cdi. this review covers the current epidemiology of cdi (including toxigenic and nontoxigenic strains, r ...201627959316
antibiotic treatment of hospitalized patients with pneumonia complicated by clostridium difficile infection.clostridium difficile infection (cdi) is one of the most common gastrointestinal complication after antimicrobial treatment. it is estimated that cdi after pneumonia treatment is connected with a higher mortality than other causes of hospitalization. the aim of the study was to assess the relationship between the kind of antibiotic used for pneumonia treatment and mortality from post-pneumonia cdi. we addressed the issue by examining retrospectively the records of 217 patients who met the diagno ...201627966110
efficacy of computed tomography for the prediction of colectomy and mortality in patients with clostridium difficile infection.to develop a ct predictor scale for the need for colectomy and to evaluate predictors of all-cause mortality within 30 days after diagnosis ofc. difficile infection (cdi).201627942384
clostridium difficile toxin a undergoes clathrin-independent, pacsin2-dependent endocytosis.clostridium difficile infection affects a significant number of hospitalized patients in the united states. two homologous exotoxins, tcda and tcdb, are the major virulence factors in c. difficile pathogenesis. the toxins are glucosyltransferases that inactivate rho family-gtpases to disrupt host cellular function and cause fluid secretion, inflammation, and cell death. toxicity depends on receptor binding and subsequent endocytosis. tcdb has been shown to enter cells by clathrin-dependent endoc ...201627942025
stable core virome despite variable microbiome after fecal transfer.we recently described the 4.5-year time course of the enteric bacterial microbiota and virome of a patient cured from recurrent clostridium difficile infection (rcdi) by fecal microbiota transplantation (fmt). here, we extended the virome analyses and found the patient's phage population to exhibit highly donor-similar characteristics following fmt, which remained stable for the whole period tested (up to 7 months). moreover, the detected viral populations of donor and patient exhibited comparab ...201627935413
development and validation of a liquid chromatography tandem mass spectrometry assay for the measurement of faecal metronidazole.metronidazole is an oral antibiotic which is widely used in the treatment of patients with clostridium difficile associated disease.201627932283
acute bronchitis.cough is the most common illness-related reason for ambulatory care visits in the united states. acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. pertussis should be suspected in patients with cough persisting for more than two weeks that is a ...201627929206
erratum: dietary zinc alters the microbiota and decreases resistance to clostridium difficile infection. 201627923021
structural insights into substrate recognition by clostridium difficile sortase.sortases function as cysteine transpeptidases that catalyze the covalent attachment of virulence-associated surface proteins into the cell wall peptidoglycan in gram-positive bacteria. the substrate proteins targeted by sortase enzymes have a cell wall sorting signal (cwss) located at the c-terminus. up to date, it is still not well understood how sortases with structural resemblance among different classes and diverse species of bacteria achieve substrate specificity. in this study, we focus on ...201627921010
correction: chen, s., et al. identification of an essential region for translocation of clostridium difficile toxin b. toxins 2016, 8, 241.n/a.201627918428
management of clostridium difficile infection.since the discovery of clostridium difficile infection (cdi) in the 1970s, there has been an increase in the incidence, severity, and recurrence rate of the disease. we reviewed the recent cdi literature in pubmed published before february 28, 2016 that focused on advances in therapy. despite a large number of studies describing methods for diagnosing the disease, there is currently no definitive test that identifies this infection with certainty, which complicates therapy. recommended therapy f ...201627917075
familial mediterranean fever mutations lift the obligatory requirement for microtubules in pyrin inflammasome activation.familial mediterranean fever (fmf) is the most common monogenic autoinflammatory disease worldwide. it is caused by mutations in the inflammasome adaptor pyrin, but how fmf mutations alter signaling in fmf patients is unknown. herein, we establish clostridium difficile and its enterotoxin a (tcda) as pyrin-activating agents and show that wild-type and fmf pyrin are differentially controlled by microtubules. diverse microtubule assembly inhibitors prevented pyrin-mediated caspase-1 activation and ...201627911804
bezlotoxumab: first global approval.bezlotoxumab (zinplava™) is a human monoclonal antibody against clostridium difficile toxin b developed by merck & co. in october 2016 it was approved in the usa for reducing the recurrence of c. difficile infection. this article summarizes the milestones in the development of bezlotoxumab leading to this first approval for use in patients receiving antibacterial drug treatment for c. difficile infection who are at high risk for recurrence of c. difficile infection.201627905086
the incidence and drug resistance of clostridium difficile infection in mainland china: a systematic review and meta-analysis.it has been widely reported that the incidence and severity of clostridium difficile infection (cdi) have increased dramatically in north america and europe. however, little is known about cdi in mainland china. in this study, we aimed to investigate the incidence of cdi and the main epidemic and drug-resistant strains of c. difficile in mainland china through meta-analysis of related studies published after the year 2010. a total of 51 eligible studies were included. the pooled incidence of tox ...201627897206
dysbiosis of fecal microbiota and high frequency of citrobacter, klebsiella spp., and actinomycetes in patients with irritable bowel syndrome and gastroenteritis.this study was aimed to characterize putative differences of fecal microbiota between irritable bowel syndrome (ibs) and gastroenteritis patients and healthy controls.201627895859
clostridium difficile: a healthcare-associated infection of unknown significance in adults in sub-saharan africa.clostridium difficile infection (cdi) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality, and financial implications. cdi is a healthcare-associated infection for which the primary risk factor is antibiotic usage, and it is the leading cause of bacterial diarrhoea in hiv-infected patients in the united states. little is known about the disease burden of cdi in sub-saharan africa, where hiv and healthcare-associated infections are more preva ...201627895832
detection of a cfr(b) variant in german enterococcus faecium clinical isolates and the impact on linezolid resistance in enterococcus spp.the national reference centre for staphylococci and enterococci in germany has received an increasing number of clinical linezolid-resistant e. faecium isolates in recent years. five isolates harbored a cfr(b) variant gene locus the product of which is capable of conferring linezolid resistance. the cfr(b)-like methyltransferase gene was also detected in clostridium difficile. antimicrobial susceptibility was determined for cfr(b)-positive and linezolid-resistant e. faecium isolates and two isog ...201627893790
enteropathogen infections in canine puppies: (co-)occurrence, clinical relevance and risk factors.laboratory confirmation of the causative agent(s) of diarrhoea in puppies may allow for appropriate treatment. the presence of potential pathogens however, does not prove a causal relationship with diarrhoea. the aim of this study was to identify specific enteropathogens in ≤12 month old puppies with and without acute diarrhoea and to assess their associations with clinical signs, putative risk factors and pathogen co-occurrence. faecal samples from puppies with (n=113) and without (n=56) acute ...201627771056
[liver disease, gastrointestinal complications, nutritional management and feeding disorders in pediatric cystic fibrosis].in cystic fibrosis (cf), approximately 5-8% of the patients develop multilobular cirrhosis during the first decade of life. annual screening (clinical examination, liver biochemistry, ultrasonography) is recommended in order to identify early signs of liver involvement, initiate ursodeoxycholic acid therapy and detect complications (portal hypertension and liver failure). management should focus on nutrition and prevention of variceal bleeding. the gut may also be involved in children with cf. g ...201628231889
isolation of clostridium difficile and molecular detection of binary and a/b toxins in faeces of dogs.the aim of this study was to isolate clostridium difficile from dogs' faeces, and to study the frequency of its virulence genes. a total of 151 samples of dogs' faeces were collected. the isolation of c. difficile was performed by using the bacterial culture methods followed by dna extraction using boiling method. multiplex pcr method was performed for identification of tcda, tcdb, cdta and cdtb genes and single method was carried out for detection of tcdc. twelve samples (7.9%) were positive in ...201628224013
[a case of advanced rectal cancer resulting in a pathologically complete response after neoadjuvant chemotherapy].a 61-years-old man was admitted to our hospital because of abdominal pain. colonoscopy revealed a type 2 tumor in the rectum, which was diagnosed as low differentiated adenocarcinoma. at least 8 abdominal lymph adenopathies were enhanced on contrast-enhanced ct. we diagnosed stage ct3n2h0m0p0, cstage iii b. because of the risk of a poor prognosis, we tried neoadjuvant chemotherapy for the purpose of down staging. a crt was prevented by clostridium difficile enteritis, but we completed 80% of the ...201628133313
detection of clostridium difficile in fecal specimens: a comparative evaluation of nucleic acid amplification test and toxigenic culture.the available data regarding clostridium difficile infections (cdis) in developing countries are scarce. this may be related in part to the complexity of anaerobic bacterial culture and/or cytotoxicity assays of c. difficile. here, we evaluated the diagnostic efficacy of pcr in comparison with toxigenic culture for direct detection of conserved genes as well as toxin genes of c. difficile in fecal specimens of patients with clinical symptoms of cdi.201628164522
thermal resistance of clostridium difficile spores in peptone water and pork meat.the thermal resistance of four strains of clostridium difficile spores (three hypervirulent and one nonhypervirulent) in peptone water (pw) and pork meat was evaluated individually at 70, 75, 80, 85, and 90°c using two recovery methods (taurocholate and lysozyme). pw or meat was inoculated with c. difficile spores and mixed to obtain ca. 5.0 log cfu/ml or 4.0 log cfu/g, respectively. the d-values of c. difficile spores in pw ranged from 7.07 to 22.14 h, 1.42 to 3.82 h, 0.35 to 0.59 h, 4.93 to 5. ...201628221931
successful therapy of clostridium difficile infection with fecal microbiota transplantation.clostridium difficile infection (cdi) is the most common cause of infectious diarrhea and represents an important burden for healthcare worldwide. symptoms of severe cdi include watery, foul-smelling diarrhea, peripheral leucocytosis, increased c-reactive protein (crp), acute renal failure, hypotension and pseudomembranous colitis. recent studies indicate that the main cause of cdi is dysbiosis, an imbalance in the normal gut microbiota. the restoration of a healthy gut microbiota composition vi ...201628195066
pseudomembranous collagenous colitis: a case of not-so-microscopic colitis.we present a 72-year-old male who developed progressive, watery diarrhea despite anti-motility agents. on colonoscopy, the mucosa was inflamed and covered with an exudate. stool studies for clostridium difficile and escherichia coli were negative. biopsies revealed pseudomembranous collagenous colitis, a rare form of microscopic colitis. his symptoms improved dramatically with budesonide therapy.201628119938
community-onset clostridium difficile infection at a tertiary medical center in southern taiwan, 2007-2015.clostridium difficile infection (cdi) is well-known as the major cause of infectious diarrhea in hospitalized patients. community-onset cdi (co-cdi) is an emerging threat. however, clinical information of co-cdi in taiwan remains scarce.201628089100
genome analysis of clostridium difficile pcr ribotype 014 lineage in australian pigs and humans reveals a diverse genetic repertoire and signatures of long-range interspecies transmission.clostridium difficile pcr ribotype (rt) 014 is well-established in both human and porcine populations in australia, raising the possibility that c. difficile infection (cdi) may have a zoonotic or foodborne etiology. here, whole genome sequencing and high-resolution core genome phylogenetics were performed on a contemporaneous collection of 40 australian rt014 isolates of human and porcine origin. phylogenies based on mlst (7 loci, sts 2, 13, and 49) and core orthologous genes (1260 loci) showed ...201628123380
blowhole colostomy for clostridium difficile-associated toxic megacolon.we present the case of a 58-year-old man who underwent urgent blowhole colostomy for toxic megacolon (tm) secondary to clostridium difficile infection (cdi). this infection occurred under antibiotic coverage with amoxicillin-clavulanic acid, four days after laparoscopic sigmoidectomy in our hospital. although prospective clinical research regarding the surgical management of tm is lacking, decompressive procedures like blowhole colostomy are reported to carry a high risk of postoperative morbidi ...201628097034
a quaternary ammonium disinfectant containing germinants reduces clostridium difficile spores on surfaces by inducing susceptibility to environmental stressors.exposing clostridium difficile spores to germinants in a quaternary ammonium matrix was an effective method to reduce environmental contamination by sensitizing the spores, leaving them susceptible to ambient conditions and enhancing killing by acid, high-intensity visible light, and radiation.201628066792
functional intestinal bile acid 7α-dehydroxylation by clostridium scindens associated with protection from clostridium difficile infection in a gnotobiotic mouse model.bile acids, important mediators of lipid absorption, also act as hormone-like regulators and as antimicrobial molecules. in all these functions their potency is modulated by a variety of chemical modifications catalyzed by bacteria of the healthy gut microbiota, generating a complex variety of secondary bile acids. intestinal commensal organisms are well-adapted to normal concentrations of bile acids in the gut. in contrast, physiological concentrations of the various intestinal bile acid specie ...201628066726
the power of poop: fecal microbiota transplantation for clostridium difficile infection.the human gut is colonized with 200 to 1,000 bacterial species. administration of antibiotics reduces the diversity of the intestinal microbiota, reduces colonization resistance, and can lead to infection with clostridium difficile. these infections have become more prevalent and increasingly patients are experiencing multiple recurrences that are incurable with standard treatment. although fecal microbiota transplantation (fmt) has been used for centuries in human and veterinary medicine, only ...201628066039
fecal microbiota transplantation to fight clostridium difficile infections and other intestinal diseases.we have analyzed fecal bacterial and viral communities of a patient with recurrent c. difficile infection (rcdi) who was cured by fecal microbiota transplantation (fmt). the "zürich patient" experienced immediate cure and has remained free of symptoms for now over 5 y. donor-similar bacterial compositions after 4.5 y post-fmt demonstrated sustainable engraftment of donor microbiota predominated by bacteroidetes and firmicutes bacteria. appearance of beneficial species faecalibacterium prausnitzi ...201628090385
cefoperazone-treated mouse model of clinically-relevant clostridium difficile strain r20291.clostridium difficile is an anaerobic, gram-positive, spore-forming enteric pathogen that is associated with increasing morbidity and mortality and consequently poses an urgent threat to public health. recurrence of a c. difficile infection (cdi) after successful treatment with antibiotics is high, occurring in 20-30% of patients, thus necessitating the discovery of novel therapeutics against this pathogen. current animal models of cdi result in high mortality rates and thus do not approximate t ...201628060346
production, crystallization and structure determination of c. difficile ppep-1 via microseeding and zinc-sad.new therapies are needed to treat clostridium difficile infections that are a major threat to human health. the c. difficile metalloprotease ppep-1 is a target for future development of inhibitors to decrease the virulence of the pathogen. to perform biophysical and structural characterization as well as inhibitor screening, large amounts of pure and active protein will be needed. we have developed a protocol for efficient production and purification of ppep-1 by the use of e. coli as the expres ...201628060332
fecal microbial transplant for the treatment of pediatric inflammatory bowel disease.the role of fecal microbial transplant (fmt) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. the success of fmt for the treatment of recurrent clostridium difficile infection (rcdi) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease (ibd). fmt has particular interest in pediatrics, given the concerns of patients and parents about rates of adver ...201628058011
impact of targeted educational interventions on clostridium difficile infection treatment in critically ill adults.background: clostridium difficile infection (cdi) is a growing clinical and economic burden throughout the world. pharmacists often are members of the primary care team in the intensive care unit (icu) setting; however, the impact of pharmacists educating other health care providers on appropriateness of cdi treatment has not been previously examined. objective: this study was performed to determine the impact of structured educational interventions on cdi treatment on appropriateness of cdi tre ...201628057949
fatal community-acquired ribotype 002 clostridium difficile bacteremia.extra-colonic infections, and especially bacteremia, are infrequent manifestations of clostridium difficile infection. c. difficile bacteremia is generally health-care associated and polymicrobial. we report the case of a patient on hunger strike that presented a c. difficile colitis and mono-microbial bacteremia on its admission to the hospital. multilocus variable number tandem repeat analysis of stool and blood isolates indicated clonality. the strain was characterized as a ribotype 002, an e ...201628043925
the potential impact of gut microbiota on your health:current status and future challenges.our health and probably also our behaviors and mood depend not only on what we eat or what we do (lifestyle behaviors), but also on what we host. it is well established for decades that all vertebrates including humans are colonized by a wide array of bacteria, fungi, eukaryotic parasites and viruses, and that, at steady state (homeostasis), this community of microbes establishes a friendly mutual relationship with the host. the term microbiota was originally meant to represent an ecological com ...201628042926
probiotics for trauma patients: should we be taking a precautionary approach?the use of probiotics in the hospital setting is largely understudied and highly controversial. probiotics are living organisms that, when taken internally, can produce an immunomodulating effect and improve the gastrointestinal (gi) mucosal barrier. although used for centuries by healthy individuals for gi health, their use in the hospital setting is now gaining wide attention for the prevention of infectious complications such as antibiotic-associated diarrhea, clostridium difficile infections ...201628033143
infection prevention and control of clostridium difficile: a global review of guidelines, strategies, and recommendations.clostridium difficile is the leading cause of health care-associated infections. given the high incidence of c. difficile infection (cdi) and the lack of primary prevention through immunization, health care professionals should be aware of the most current guidance, as well as strengths and limitations of the evidence base underpinning this guidance.201628028434
can probiotics benefit children with autism spectrum disorders?children with autism are commonly affected by gastrointestinal problems such as abdominal pain, constipation and diarrhea. in recent years, there has been a growing interest in the use of probiotics in this population, as it hypothetically may help to improve bowel habits and the behavioral and social functioning of these individuals. the gut microbiome plays an important role in the pathophysiology of organic as well as functional gastrointestinal disorders. microbial modification with the use ...201628028357
clostridium difficile infection and takotsubo cardiomyopathy: is there a relation?takotsubo cardiomyopathy (tcm) mimics acute coronary syndrome and is accompanied by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. it is a transient condition that typically precedes physical or emotional triggers.201627583241
comparison of pediatric and adult antibiotic-associated diarrhea and clostridium difficile infections.antibiotic-associated diarrhea (aad) and clostridium difficile infections (cdi) have been well studied for adult cases, but not as well in the pediatric population. whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. a systematic review of the literature using databases pubmed (june 3, 1978-2015) was conducted to compare aad and cdi in pediatric and ad ...201627003987
in vitro antibacterial activity of rhodanine derivatives against pathogenic clinical isolates.bacterial infections present a serious challenge to healthcare practitioners due to the emergence of resistance to numerous conventional antibacterial drugs. therefore, new bacterial targets and new antimicrobials are unmet medical needs. rhodanine derivatives have been shown to possess potent antimicrobial activity via a novel mechanism. however, their potential use as antibacterials has not been fully examined. in this study, we determined the spectrum of activity of seven rhodanine derivative ...201627711156
assessment of the overall and multidrug-resistant organism bioburden on environmental surfaces in healthcare facilities.objective to determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [mdros]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. design prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). setting mdro contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. participants samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). methods usi ...201627619507
vaccines for healthcare-associated infections: promise and challenge.as antibiotic resistance increases and the rate of antibiotic development slows, it is becoming more urgent to develop novel approaches to prevent and mitigate serious bacterial and fungal infections. healthcare-associated infections (hais), including those caused by clostridium difficile, staphylococcus aureus, pseudomonas aeruginosa, acinetobacter baumannii, carbapenem-resistant enterobacteriaceae, and candida species, are a major cause of morbidity, mortality, and healthcare costs. hais are a ...201627208045
discovery and development of kibdelomycin, a new class of broad-spectrum antibiotics targeting the clinically proven bacterial type ii topoisomerase.kibdelomycin is a complex novel antibiotic, discovered by applying a highly sophisticated chemical-genetic staphylococcus aureus fitness test (saft) approach, that inhibits the clinically established bacterial targets, gyrase and topoisomerase iv. it exhibits broad-spectrum antibacterial activity against aerobic bacteria including mrsa and acinetobacter baumannii. it is slowly bactericidal and has a low frequency of resistance. in an anaerobic environment, it exhibits narrow-spectrum activity an ...201627143131
point-prevalence survey of healthcare-associated infections in beijing, china: a survey and analysis in 2014.point-prevalence studies can identify priorities for infection control.201627140419
drug and vaccine development for the treatment and prevention of urinary tract infections.urinary tract infections (uti) are among the most common bacterial infections in humans, affecting millions of people every year. uti cause significant morbidity in women throughout their lifespan, in infant boys, in older men, in individuals with underlying urinary tract abnormalities, and in those that require long-term urethral catheterization, such as patients with spinal cord injuries or incapacitated individuals living in nursing homes. serious sequelae include frequent recurrences, pyelon ...201626999391
semicarbazone ega inhibits uptake of diphtheria toxin into human cells and protects cells from intoxication.diphtheria toxin is a single-chain protein toxin that invades human cells by receptor-mediated endocytosis. in acidic endosomes, its translocation domain inserts into endosomal membranes and facilitates the transport of the catalytic domain (dta) from endosomal lumen into the host cell cytosol. here, dta adp-ribosylates elongation factor 2 inhibits protein synthesis and leads to cell death. the compound 4-bromobenzaldehyde n-(2,6-dimethylphenyl)semicarbazone (ega) has been previously shown to pr ...201627729638
surviving between hosts: sporulation and transmission.to survive adverse conditions, some bacterial species are capable of developing into a cell type, the "spore," which exhibits minimal metabolic activity and remains viable in the presence of multiple environmental challenges. for some pathogenic bacteria, this developmental state serves as a means of survival during transmission from one host to another. spores are the highly infectious form of these bacteria. upon entrance into a host, specific signals facilitate germination into metabolically ...201627726794
generic aspects of the airborne spread of human pathogens indoors and emerging air decontamination technologies.indoor air can be an important vehicle for a variety of human pathogens. this review provides examples of airborne transmission of infectious agents from experimental and field studies and discusses how airborne pathogens can contaminate other parts of the environment to give rise to secondary vehicles leading air-surface-air nexus with possible transmission to susceptible hosts. the following groups of human pathogens are covered because of their known or potential airborne spread: vegetative b ...201627590695
semicarbazone ega inhibits uptake of diphtheria toxin into human cells and protects cells from intoxication.diphtheria toxin is a single-chain protein toxin that invades human cells by receptor-mediated endocytosis. in acidic endosomes, its translocation domain inserts into endosomal membranes and facilitates the transport of the catalytic domain (dta) from endosomal lumen into the host cell cytosol. here, dta adp-ribosylates elongation factor 2 inhibits protein synthesis and leads to cell death. the compound 4-bromobenzaldehyde n-(2,6-dimethylphenyl)semicarbazone (ega) has been previously shown to pr ...201627428999
crystal structures of the spoiid lytic transglycosylases essential for bacterial sporulation.bacterial spores are the most resistant form of life known on earth and represent a serious problem for (i) bioterrorism attack, (ii) horizontal transmission of microbial pathogens in the community, and (iii) persistence in patients and in a nosocomial environment. stage ii sporulation protein d (spoiid) is a lytic transglycosylase (lt) essential for sporulation. the lt superfamily is a potential drug target because it is active in essential bacterial processes involving the peptidoglycan, which ...201627226615
a cumulative spore killing approach: synergistic sporicidal activity of dilute peracetic acid and ethanol at low ph against clostridium difficile and bacillus subtilis spores.background.  alcohol-based hand sanitizers are the primary method of hand hygiene in healthcare settings, but they lack activity against bacterial spores produced by pathogens such as clostridium difficile and bacillus anthracis. we previously demonstrated that acidification of ethanol induced rapid sporicidal activity, resulting in ethanol formulations with ph 1.5-2 that were as effective as soap and water washing in reducing levels of c difficile spores on hands. we hypothesized that the addit ...201626885539
structural characterization of zinc-bound zmp1, a zinc-dependent metalloprotease secreted by clostridium difficile.proteases are commonly secreted by microorganisms. in some pathogens, they can play a series of functional roles during infection, including maturation of cell surface or extracellular virulence factors, interference with host cell signaling, massive host tissue destruction, and dissolution of infection-limiting clots through degradation of the host proteins devoted to the coagulation cascade. we previously reported the identification and characterization of zmp1, a zinc-dependent metalloproteas ...201626711661
anti-infectious human vaccination in historical perspective.a brief history of vaccination is presented since the jenner's observation, through the first golden age of vaccinology (from pasteur's era to 1938), the second golden age (from 1940 to 1970), until the current period. in the first golden age, live, such as bacille calmette guérin (bcg), and yellow fever, inactivated, such as typhoid, cholera, plague, and influenza, and subunit vaccines, such as tetanus and diphtheria toxoids, have been developed. in the second golden age, the cell culture techn ...201626606466
pore-forming activity of clostridial binary toxins.clostridial binary toxins (clostridium perfringens iota toxin, clostridium difficile transferase, clostridium spiroforme toxin, clostridium botulinum c2 toxin) as bacillus binary toxins, including bacillus anthracis toxins consist of two independent proteins, one being the binding component which mediates the internalization into cell of the intracellularly active component. clostridial binary toxins induce actin cytoskeleton disorganization through mono-adp-ribosylation of globular actin and ar ...201626278641
development of syn-004, an oral beta-lactamase treatment to protect the gut microbiome from antibiotic-mediated damage and prevent clostridium difficile infection.the gut microbiome, composed of the microflora that inhabit the gastrointestinal tract and their genomes, make up a complex ecosystem that can be disrupted by antibiotic use. the ensuing dysbiosis is conducive to the emergence of opportunistic pathogens such as clostridium difficile. a novel approach to protect the microbiome from antibiotic-mediated dysbiosis is the use of beta-lactamase enzymes to degrade residual antibiotics in the gastrointestinal tract before the microflora are harmed. here ...201627262694
secreted compounds of the probiotic bacillus clausii strain o/c inhibit the cytotoxic effects induced by clostridium difficile and bacillus cereus toxins.although the use of probiotics based on bacillus strains to fight off intestinal pathogens and antibiotic-associated diarrhea is widespread, the mechanisms involved in producing their beneficial effects remain unclear. here, we studied the ability of compounds secreted by the probiotic bacillus clausii strain o/c to counteract the cytotoxic effects induced by toxins of two pathogens, clostridium difficile and bacillus cereus, by evaluating eukaryotic cell viability and expression of selected gen ...201627001810
uptake and levels of the antibiotic berberine in individual dormant and germinating clostridium difficile and bacillus cereus spores as measured by laser tweezers raman spectroscopy.spores of clostridium difficile and bacillus cereus are major causes of nosocomial diarrhoea and foodborne disease. our aim was to measure the dynamics of the uptake of the antibiotic berberine by individual germinating spores and the levels of berberine accumulated in germinated spores.201626861569
contamination of healthcare workers' hands with bacterial spores.clostridium species and bacillus spp. are spore-forming bacteria that cause hospital infections. the spores from these bacteria are transmitted from patient to patient via healthcare workers' hands. although alcohol-based hand rubbing is an important hand hygiene practice, it is ineffective against bacterial spores. therefore, healthcare workers should wash their hands with soap when they are contaminated with spores. however, the extent of health care worker hand contamination remains unclear. ...201627236515
intestinal microbiota and allergic diseases: a systematic review.evidence suggests that possible imbalances in intestinal microbiota composition may be implicated in the occurrence of allergic diseases. although several studies published until 2006 indicated a correlation between microbiota composition and allergic symptoms, it has not been possible to distinguish protective microorganisms from those associated with increased risk of allergic diseases. therefore, the objective of this study was to review the studies published since 2007 that address the intes ...201625985709
[design of artificial foetor flatus based on bacterial volatile compounds].excessive flatulence can be a huge social problem. the purpose of this study was to design artificial flatus from bacterial volatile compounds to stimulate research into neutralizing measures.201627966414
effect of oligosaccharides on the adhesion of gut bacteria to human ht-29 cells.the influence of five oligosaccharides (cellobiose, stachyose, raffinose, lactulose and chito-oligosaccharides) on the adhesion of eight gut bacteria (bifidobacterium bifidum atcc 29521, bacteroides thetaiotaomicron atcc 29148d-5, clostridium leptum atcc 29065, blautia coccoides atcc 29236, faecalibacterium prausnitzii atcc 27766, bacteroides fragilis atcc 23745, clostridium difficile atcc 43255 and lactobacillus casei atcc 393) to mucous secreting and non-mucous secreting ht-29 human epithelial ...201627018325
alterations in the mucosa-associated bacterial composition in crohn's disease: a pilot study.changes in the intestinal bacterial composition seem to play a major role in the pathogenesis and in the clinical course of inflammatory bowel diseases (ibd), which consist of crohn's disease (cd), and ulcerative colitis (uc). mutations in the nod2 gene are the most important genetic risk factors for the development of cd. in this study, the association between mucosal biopsies and the mucosa-associated bacterial composition from cd and uc patients regarding their genetic risk factors (mutations ...201626951181
efficacy of vancomycin extended-dosing regimens for treatment of simulated clostridium difficile infection within an in vitro human gut model.effects of two vancomycin extended-dosing regimens on microbiota populations within an in vitro gut model of simulated clostridium difficile infection (cdi) were evaluated.201626755495
high occurrence of fusobacterium nucleatum and clostridium difficile in the intestinal microbiota of colorectal carcinoma patients.colorectal carcinoma is considered the fourth leading cause of cancer deaths worldwide. several microorganisms have been associated with carcinogenesis, including enterococcus spp., helicobacter pylori, enterotoxigenic bacteroides fragilis, pathogenic e. coli strains and oral fusobacterium. here we qualitatively and quantitatively evaluated the presence of oral and intestinal microorganisms in the fecal microbiota of colorectal cancer patients and healthy controls. seventeen patients (between 49 ...201626691472
a recombination directionality factor controls the cell type-specific activation of σk and the fidelity of spore development in clostridium difficile.the strict anaerobe clostridium difficile is the most common cause of nosocomial diarrhea, and the oxygen-resistant spores that it forms have a central role in the infectious cycle. the late stages of sporulation require the mother cell regulatory protein σk. in bacillus subtilis, the onset of σk activity requires both excision of a prophage-like element (skinbs) inserted in the sigk gene and proteolytical removal of an inhibitory pro-sequence. importantly, the rearrangement is restricted to the ...201627631621
germinants and their receptors in clostridia.many anaerobic spore-forming clostridial species are pathogenic, and some are industrially useful. although many are strict anaerobes, the bacteria persist under aerobic and growth-limiting conditions as multilayered metabolically dormant spores. for many pathogens, the spore form is what most commonly transmits the organism between hosts. after the spores are introduced into the host, certain proteins (germinant receptors) recognize specific signals (germinants), inducing spores to germinate an ...201627432831
detecting cortex fragments during bacterial spore germination.the process of endospore germination in clostridium difficile, and other clostridia, increasingly is being found to differ from the model spore-forming bacterium, bacillus subtilis. germination is triggered by small molecule germinants and occurs without the need for macromolecular synthesis. though differences exist between the mechanisms of spore germination in species of bacillus and clostridium, a common requirement is the hydrolysis of the peptidoglycan-like cortex which allows the spore co ...201627403726
impact of standard test protocols on sporicidal efficacy.there has been an increase in the availability of commercial sporicidal formulations. any comparison of sporicidal data from the literature is hampered by the number of different standard tests available and the use of diverse test conditions including bacterial strains and endospore preparation.201627133281
characterization of clostridium difficile spores lacking either spovac or dipicolinic acid synthetase.the spore-forming obligate anaerobe clostridium difficile is a leading cause of antibiotic-associated diarrhea around the world. in order for c. difficile to cause infection, its metabolically dormant spores must germinate in the gastrointestinal tract. during germination, spores degrade their protective cortex peptidoglycan layers, release dipicolinic acid (dpa), and hydrate their cores. in c. difficile, cortex hydrolysis is necessary for dpa release, whereas in bacillus subtilis, dpa release i ...201627044622
the spoiiq-spoiiiah complex of clostridium difficile controls forespore engulfment and late stages of gene expression and spore morphogenesis.engulfment of the forespore by the mother cell is a universal feature of endosporulation. in bacillus subtilis, the forespore protein spoiiq and the mother cell protein spoiiiah form a channel, essential for endosporulation, through which the developing spore is nurtured. the two proteins also form a backup system for engulfment. unlike in b. subtilis, spoiiq of clostridium difficile has intact lytm zinc-binding motifs. we show that spoiiq or spoiiiah deletion mutants of c. difficile result in a ...201626690930
effect of bifidobacterium upon clostridium difficile growth and toxicity when co-cultured in different prebiotic substrates.the intestinal overgrowth of clostridium difficile, often after disturbance of the gut microbiota by antibiotic treatment, leads to c. difficile infection (cdi) which manifestation ranges from mild diarrhea to life-threatening conditions. the increasing cdi incidence, not only in compromised subjects but also in traditionally considered low-risk populations, together with the frequent relapses of the disease, has attracted the interest for prevention/therapeutic options. among these, probiotics, ...201627242753
bacteria-mediated hypoxia-specific delivery of nanoparticles for tumors imaging and therapy.the hypoxia region in a solid tumor has been recognized as a complex microenvironment revealing very low oxygen concentration and deficient nutrients. the hypoxic environment reduces the susceptibility of the cancer cells to anticancer drugs, low response of free radicals, and less proliferation of cancer cells in the center of the solid tumors. however, the reduced oxygen surroundings provide an appreciable habitat for anaerobic bacteria to colonize. here, we present the bacteria-mediated targe ...201627148804
intestinal microbiota in pediatric surgical cases administered bifidobacterium breve: a randomized controlled trial.the efficacy of perioperative probiotic administration has been reported in adults. we examined the effects of orally administered bifidobacterium breve strain yakult (bbg-01) on outcomes in pediatric surgical cases by assessing intestinal and blood microbiota. bbg-01 was well tolerated without adverse effects, and postoperative infectious complications were significantly decreased. fecal analysis showed increased bifidobacterium and decreased enterobacteriaceae, clostridium difficile, and pseud ...201626859092
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