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characteristics of the clostridium difficile cell envelope and its importance in therapeutics.clostridium difficile infection (cdi) is a challenging threat to human health. infections occur after disruption of the normal microbiota, most commonly through the use of antibiotics. current treatment for cdi largely relies on the broad-spectrum antibiotics vancomycin and metronidazole that further disrupt the microbiota resulting in frequent recurrence, highlighting the need for c. difficile-specific antimicrobials. the cell surface of c. difficile represents a promising target for the develo ...201727311697
fecal transplantation - the new, inexpensive, safe, and rapidly effective approach in the treatment of gastrointestinal tract diseases.introduction. fecal transplantation was shown to effectively reduce the reoccurrence in patients with refractory clostridium difficile infection. new data suggest that fecal transplantation could also be efficient in other gastrointestinal diseases, for instance in inflammatory bowel disease, irritable bowel syndrome, but, there are also some data that could imply the efficacy outside the gastrointestinal tract. fecal transplantation should be considered a unique agent, capable of treating sever ...201727453747
antibiotic-induced alterations of the gut microbiota alter secondary bile acid production and allow for clostridium difficile spore germination and outgrowth in the large intestine.it is hypothesized that the depletion of microbial members responsible for converting primary bile acids into secondary bile acids reduces resistance to clostridium difficile colonization. to date, inhibition of c. difficile growth by secondary bile acids has only been shown in vitro. using targeted bile acid metabolomics, we sought to define the physiologically relevant concentrations of primary and secondary bile acids present in the murine small and large intestinal tracts and how these impac ...201727239562
clostridium difficile in libya: a neglected pathogen? 201727290694
procalcitonin-guided antibiotic treatment in critically ill patients.in critically ill patients, length of antibiotic treatment can be effectively guided by procalcitonin (pct) protocols. international sepsis guidelines and guidelines on antibiotic stewardship strategies recommend pct as helpful laboratory marker for a rational use of antibiotics. a number of studies and meta-analyses have confirmed the effectiveness of pct-protocols for shortening antibiotic treatment without compromising clinical outcome in critically ill patients. but in clinical practice, the ...201727283067
clostridium difficile infection: a review of current and emerging therapies.clostridium difficile (c. difficile) infection (cdi) is the most common cause of -healthcare-associated infections in us hospitals. the epidemic strain nap1/bi/ribotype 027 accounts for outbreaks worldwide, with increasing mortality and severity. cdi is acquired from an endogenous source or from spores in the environment, most easily acquired during the hospital stay. the use of antimicrobials disrupts the intestinal microflora enabling c. difficile to proliferate in the colon and produce toxins ...201727065726
anaerobes as sources of bioactive compounds and health promoting tools.aerobic microorganisms have been sources of medicinal agents for several decades and an impressive variety of drugs have been isolated from their cultures, studied and formulated to treat or prevent diseases. on the other hand, anaerobes, which are believed to be the oldest life forms on earth and evolved remarkably diverse physiological functions, have largely been neglected as sources of bioactive compounds. however, results obtained from the limited research done so far show that anaerobes ar ...201727432247
treatment of clostridium difficile infections. 201726960574
isolation of recombinant antibodies directed against surface proteins of clostridium difficile.clostridium difficile has emerged as an increasingly important nosocomial pathogen and the prime causative agent of antibiotic-associated diarrhoea and pseudomembranous colitis in humans. in addition to toxins a and b, immunological studies using antisera from patients infected with c. difficile have shown that a number of other bacterial factors contribute to the pathogenesis, including surface proteins, which are responsible for adhesion, motility and other interactions with the human host. in ...201726991284
evaluation of two raw diets vs a commercial cooked diet on feline growth.objectives the objective of this study was to determine if two raw feline diets were nutritionally adequate for kittens. methods twenty-four 9-week-old kittens underwent an association of american feed control officials' (aafco) 10 week growth feeding trial with two raw diet groups and one cooked diet group (eight kittens in each). morphometric measurements (weight, height and length), complete blood counts, serum chemistry, whole blood taurine and fecal cultures were evaluated. results overall, ...201726927818
identifying environmental reservoirs of clostridium difficile with a scent detection dog: preliminary evaluation.prompted by an article describing a dog trained to detect clostridium difficile in patients, our institution evaluated a dog's ability to detect c. difficile scent from equipment and surfaces to assist in strategic deployment of adjunctive cleaning measures.201728579472
compliance with clostridium difficile treatment guidelines: effect on patient outcomes.guidelines for the severity classification and treatment of clostridium difficile infection (cdi) were published by infectious diseases society of america (idsa)/society for healthcare epidemiology of america (shea) in 2010; however, compliance and efficacy of these guidelines has not been widely investigated. this present study assessed compliance with guidelines and its effect on cdi patient outcomes as compared with before these recommendations. a retrospective study included all adult inpati ...201728578710
extraintestinal clostridium difficile infection due to a ribotype different from that isolated from the feces of the patient: a case report.extraintestinal infections due to clostridium difficile are uncommon. when such infections occur, extraintestinal c. difficile isolates are usually identical to fecal isolates. we present a rare case of a large postoperative abscess caused by c. difficile infection, in which different c. difficile strains were isolated from the abscess and from feces of the patient. an 82-year-old woman with cutaneous polyarteritis nodosa developed pain, skin ulcers, and extensive necrosis of the right leg. abov ...201728578133
assessing the effect of patient screening and isolation on curtailing clostridium difficile infection in hospital settings.patient screening at the time of hospital admission is not recommended as a routine practice, but may be an important strategy for containment of clostridium difficile infection (cdi) in hospital settings. we sought to investigate the effect of patient screening in the presence of asymptomatic carriers and in the context of imperfect patient isolation.201728577357
adherence to clinical practice guidelines for the management of clostridium difficile infection in japan: a multicenter retrospective study.this study was conducted to investigate the adherence to clinical practice guidelines (cpgs) for clostridium difficile infection (cdi). a retrospective multicenter observational study was conducted via chart review at four teaching hospitals in japan from april 2012 through september 2013. cdi was diagnosed based on positive identification of cd toxin by enzyme immunoassay testing. cdi patients were divided into non-severe and severe groups according to the severity criteria of four published gu ...201728577158
safety and efficacy of antibacterial prophylaxis after craniotomy: a decision model analysis.antibiotic prophylaxis has revolutionized the safety of neurosurgical procedures in the last century. today, the clinician's drug of choice before surgery often is based on the antibiotic's resistance profile and drug-induced complications.201728576711
safety and pharmacokinetic study of fidaxomicin in children with clostridium difficile-associated diarrhea: a phase 2a multicenter clinical trial.fidaxomicin is an approved therapy for clostridium difficile-associated diarrhea (cdad) in adults. the safety of fidaxomicin in children has not been reported.201728575523
comparison of control of clostridium difficile infection in six english hospitals using whole-genome sequencing.variation in clostridium difficile infection (cdi) rates between healthcare institutions suggests overall incidence could be reduced if the lowest rates could be achieved more widely.201728575285
vancomycin taper and risk of failure of fecal microbiota transplant in patients with recurrent clostridium difficile infection.we retrospectively analyzed a cohort of 109 subjects treated for rcdi with fmt at tertiary referral center between 2011 and 2014 to determine risk factors for fmt failure.. in a multivariate analysis, failure to use an oral vancomycin taper preceding fmt was associated with a significant risk of fmt failure (odds ratio [95% ci], 0.15 [0.007-0.40]).201728575220
epidemiology, risk factors, and outcomes of infections in patients undergoing liver transplantation for hilar cholangiocarcinoma.the epidemiology of infection after liver transplantation for hilar cholangiocarcinoma has not been systematically investigated. in this study of 124 patients, 255 infections occurred in 105 patients during the median follow-up of 4.2 years. the median time to first infection was 15.1 weeks (iqr 1.6-62.6). the most common sites were the abdomen, bloodstream, and musculoskeletal system. risk factors for any post-transplant infection were pre-transplant vre colonization (hazard ratio [hr] 1.9, p=. ...201728573685
emergence of clostridium difficile tcdc variant 078 in marseille, france.the purpose of this investigation was to evaluate the epidemiology of hypervirulent clostridium difficile ribotypes from january 2013 to february 2017 in the marseille area of southern france. by using the xpert clostridium difficile epi polymerase chain reaction (pcr) assay and sequencing the tcdc gene, we characterised c. difficile isolates from symptomatic patients diagnosed with c. difficile infection (cdi) in marseille university hospitals. we first tested retrospectively 278 c. difficile s ...201728573471
functional amplification and preservation of human gut microbiota.background: the availability of fresh stool samples is a prerequisite in most gut microbiota functional studies. objective: strategies for amplification and long-term gut microbiota preservation from fecal samples would favor sample sharing, help comparisons and reproducibility over time and between laboratories, and improve the safety and ethical issues surrounding fecal microbiota transplantations. design: taking advantage of in vitro gut-simulating systems, we amplified the microbial repertoi ...201728572754
editorial: making fecal microbiota transplantation easier to swallow: freeze-dried preparation for recurrent clostridium difficile infections.fecal microbiota transplant (fmt) has emerged as an effective and increasingly popular therapy for recurrent clostridium difficile infections in patients that have failed standard antimicrobial treatment. patient access to fmt is hampered by the logistics of manufacturing, storing, and delivering the inocula. an observational study describes the development and clinical efficacy of freeze-dried fmt capsules for oral administration. while awaiting the emergence of defined bacterial therapeutics f ...201728572645
a protocol to characterize the morphological changes of clostridium difficile in response to antibiotic treatment.assessment of antibiotic action with new drug development directed towards anaerobic bacteria is difficult and technically demanding. to gain insight into possible moa, morphologic changes associated with antibiotic exposure can be visualized using scanning electron microscopy (sem). integrating sem imaging with traditional kill curves may improve our insight into drug action and advance the drug development process. to test this premise, kill curves and sem studies were conducted using drugs wi ...201728570548
how chinese clinicians face ethical and social challenges in fecal microbiota transplantation: a questionnaire study.fecal microbiota transplantation (fmt) is reportedly the most effective therapy for relapsing clostridium difficile infection (cdi) and a potential therapeutic option for many diseases. it also poses important ethical concerns. this study is an attempt to assess clinicians' perception and attitudes towards ethical and social challenges raised by fecal microbiota transplantation.201728569156
a retrospective study of patient factors that indicate provider nonadherence to an institutional clostridium difficile treatment guideline.clostridium difficile infection (cdi) is treated most often with metronidazole or vancomycin. both have been effective in treatment of mild to moderate infection. in more severe cases, vancomycin may be more effective.201728569127
therapy of the postinfectious irritable bowel syndrome: an update.after acute infectious gastroenteritis, up to thirty percent of patients present prolonged gastrointestinal symptoms and a part of those affected patients can have the diagnostic criteria for postinfectious irritable bowel syndrome. treatment is symptom directed rather than curative and includes agents prescribed for the treatment of irritable bowel syndrome in general. prophylaxis or early treatment of acute bacterial diarrhea may reduce the risk of postinfectious irritable bowel syndrome devel ...201728559695
incidence and risk factors for community and hospital acquisition of clostridium difficile infection in the tel aviv sourasky medical center.objectives to estimate the incidence and identified risk factors for community-acquired (ca) and hospital-acquired (ha) clostridium difficile infection (cdi) methods we conducted 2 parallel case-control studies at tel aviv sourasky medical center from january 1, 2011, to december 31, 2014. we identified persons with cdi, determined whether infection was community or hospital acquired, and calculated incidence rates from 2007 to 2014. we collected demographic, clinical, and epidemiological inform ...201728558856
effects of a new hospital-wide surgical consultation protocol in patients with clostridium difficile colitis.fulminant clostridium difficile colitis (fcdc) occurs in 2%-8% of patients with cdc and carries a high death rate. prompt operation may reduce death. our aim was to determine whether a standardized hospital-wide protocol for surgical referral in cdc would result in earlier surgical consultation, earlier identification of patients who could benefit from surgical therapy, and reduced deaths from fcdc.201728557651
clostridium difficile infections in finland, 2008-2015: trends, diagnostics and ribotypes.we evaluated clostridium difficile (cd) diagnostics in finnish clinical microbiology laboratories during 2006-2011, with an update in 2015, in relation to cd surveillance data of the national infectious disease register (nidr) and ribotyping data from the national reference laboratory during the years 2008-2015. in 2011, diagnostic activity varied regionally more than three-fold and the positivity rate ranged between 7 and 21%. nucleic acid amplification testing (naat) was implemented in the reg ...201728555402
trends in the use of laboratory tests for the diagnosis of clostridium difficile infection and association with incidence rates in quebec, canada, 2010-2014.several clostridium difficile infection (cdi) surveillance programs do not specify laboratory strategies to use. we investigated the evolution in testing strategies used across quebec, canada, and its association with incidence rates.201728549882
investigation of community carriage rates of clostridium difficile and hungatella hathewayi in healthy volunteers from four regions of england.faecal samples from 1365 healthy asymptomatic volunteers from four regions in england were screened for the presence of clostridium difficile between december 2013 and july 2014. the carriage rate of c. difficile in healthy patients was 0.5%, which is lower than reported previously. this study demonstrates that the true community reservoir of c. difficile in the healthy uk population is very low and is, therefore, unlikely to be a reservoir for infections diagnosed in the hospital setting.201728549779
synthesis of defined and functionalized glycans of lipoteichoic acid: a cell surface polysaccharide from clostridium difficile.two structurally defined, functionalized glycans of lipoteichoic acid (lta, also known as ps-iii) from c. difficile, which have one or two repeating units of lta linked to the core trisaccharide, were efficiently synthesized via a convergent [2 + 3] or [2 + 2 + 3] strategy. the α-linkage of both n-acetylglucosamine residues in the repeating unit were constructed with glycosyl imidates of azidosugars as donors, while the phosphodiester bridges between the oligosaccharides were fashioned using h-p ...201728548838
evidence-based approach to clostridium difficile infection. 201728546796
fecal microbiota transplantation: from clostridium difficile to inflammatory bowel disease.fecal microbiota transplantation (fmt) has evolved from a case report in the medical literature to the basis of major innovations in the treatment of clostridium difficile infection (cdi) and, potentially, inflammatory bowel disease (ibd). in the clinical setting, fmt was noted to significantly lower the risk of recurrent cdi, likely by increasing microbial diversity and altering the metabolic environment in the intestinal tract of recipients. in parallel, advances in the ability to quantify and ...201728546791
clostridium difficile toxins a and b: receptors, pores, and translocation into cells.the most potent toxins secreted by pathogenic bacteria contain enzymatic moieties that must reach the cytosol of target cells to exert their full toxicity. toxins such as anthrax, diphtheria, and botulinum toxin all use three well-defined functional domains to intoxicate cells: a receptor-binding moiety that triggers endocytosis into acidified vesicles by binding to a specific host-cell receptor, a translocation domain that forms pores across the endosomal membrane in response to acidic ph, and ...201728545305
a multicenter, retrospective, case-cohort study of the epidemiology and risk factors for clostridium difficile infection among cord blood transplant recipients.clostridium difficile infection (cdi) is the leading cause of health-care associated infectious diarrhea. the aim of this study was to evaluate the epidemiology and risk factors for cdi in the 100 days following umbilical cord blood transplantation (ucbt) at three boston hospitals.201728544102
clostridium difficile infection in solid organ transplant recipients.clostridium difficile infection (cdi) is a major healthcare-associated infection that causes significant morbidity and an economic impact in the united states. in this review, we provide an overview of clostridium difficile infection in solid organ transplant recipients with an emphasis on recent literature.201728542111
[intestinal microbiota in individualized therapies].during recent years, the analysis of the human microbiota has been receiving more and more scientific focus. deep sequencing analysis enables characterization of microbial communities in different environments without the need of culture-based methods. hereby, information about microbial communities is increasing enormously. numerous studies in humans and animal models revealed the important role of the microbiome in emergence and natural course of diseases such as autoimmune diseases and metabo ...201728540475
faecal microbiota transplantation: where did it start? what have studies taught us? where is it going?the composition and activity of microorganisms in the gut, the microbiome, is emerging as an important factor to consider with regard to the treatment of many diseases. dysbiosis of the normal community has been implicated in inflammatory bowel disease, crohn's disease, diabetes and, most notoriously, clostridium difficile infection. in canada, the leading treatment strategy for recalcitrant c. difficile infection is to receive faecal material which by nature is filled with microorganisms and th ...201728540051
bacteriophage transfer during faecal microbiota transplantation in clostridium difficile infection is associated with treatment outcome.faecal microbiota transplantation (fmt) is effective for the treatment of recurrent clostridium difficile infection (cdi). studies have shown bacterial colonisation after fmt, but data on viral alterations in cdi are scarce. we investigated enteric virome alterations in cdi and the association between viral transfer and clinical outcome in patients with cdi.201728539351
less is more? antibiotic duration and outcomes in fournier's gangrene.antibiotic management of fournier's gangrene (fg) is without evidence-based guidelines and is based on expert opinion. the effect of duration of antibiotic therapy on outcomes in fg is unknown.201728538648
norovirus and clostridium difficile outbreaks: squelching the wildfire.gastrointestinal outbreaks in the healthcare setting cause increased morbidity and mortality in an already vulnerable population. optimization of infection prevention measures can be a challenge in healthcare settings. this review describes new literature that may change the traditional infection prevention approach to such outbreaks.201728538249
erratum for hong et al., "mucosal antibodies to the c terminus of toxin a prevent colonization of clostridium difficile". 201728536258
clostridium difficile extraintestinal abscess: a rare complication.extraintestinal clostridium difficile is rare. a 74-year-old man with a history of ulcerative colitis presented after a fall. trauma work-up showed liver cirrhosis. two days later he developed abdominal pain, distension, diarrhoea and leucocytosis. stool tested positive for c. difficile ct abdomen showed pancolitis with toxic megacolon. total abdominal colectomy and ileostomy with a rectal stump was performed. he was discharged, but was readmitted with sepsis. ct abdomen showed a 10.4×7.2 cm flu ...201728536228
correction for cairns et al., "comparative genome analysis and global phylogeny of the toxin variant clostridium difficile pcr ribotype 017 reveals the evolution of two independent sublineages". 201728536162
primary human polarized small intestinal epithelial barriers respond differently to a hazardous and an innocuous protein.an experimental platform employing human derived intestinal epithelial cell (iec) line monolayers grown on permeable transwell(®) filters was previously investigated to differentiate between hazardous and innocuous proteins. this approach was effective at distinguishing these types of proteins and perturbation of monolayer integrity, particularly transepithelial electrical resistance (teer), was the most sensitive indicator. in the current report, in vitro indicators of monolayer integrity, cyto ...201728533127
clinical, immunological and microbiological predictors of poor outcome in clostridium difficile infection.clostridium difficile infection (cdi) causes increased morbidity and mortality. clinical data cannot clearly predict poor cdi outcome. data on the value of microbiological predictors is scarce.201728533000
methods and reporting studies assessing fecal microbiota transplantation: a systematic review.fecal microbiota transplantation (fmt) could be a novel treatment option for several chronic diseases associated with altered gut microbiota.201728531908
management of bacteriuria in veterans affairs hospitals.bacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (asb) and long durations of therapy for symptomatic urinary tract infections (utis), yet large-scale evaluations of bacteriuria management among inpatients are lacking.201728531289
how to: establish and run a stool bank.since 2013, several stool banks have been developed following publications reporting on clinical success of 'faecal microbiota transplantation' (fmt) for recurrent clostridium difficile infections (cdi). however, protocols for donor screening, faecal suspension preparation, and transfer of the faecal suspension differ between countries and institutions. moreover, no european consensus exists regarding the legislative aspects of the faecal suspension product. internationally standardized recommen ...201728529025
antimicrobial activity of fidaxomicin against clostridium difficile clinical isolates in aichi area in japan.we evaluated the susceptibility of 100 japanese clostridium difficile isolates to fidaxomicin, a new macrocyclic antibiotic. the minimum inhibitory concentration (mic) range of fidaxomicin was 0.03-0.5 μg/ml, with a mic for inhibition of 50% (mic50) of 0.12 μg/ml, and for inhibition of 90% (mic90) of 0.25 μg/ml. we also evaluated the susceptibilities of the same 100 c. difficile isolates to vancomycin, metronidazole, moxifloxacin, clindamycin, meropenem, and ampicillin. of all the antibiotics te ...201728527649
[clinical and demographic profile and risk factors for clostridium difficile infection].clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. the increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease.201728527248
efficacy of the world health organization-recommended handwashing technique and a modified washing technique to remove clostridium difficile from hands.the efficacy of the world health organization (who)-recommended handwashing technique against clostridium difficile is uncertain, and whether it could be improved remains unknown. also, the benefit of using a structured technique instead of an unstructured technique remains unclear.201728526314
dramatic effects of a new antimicrobial stewardship program in a rural community hospital.new joint commission antimicrobial stewardship requirements took effect on january 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and clostridium difficile infection. our objective was to measure the effects of a new antimicrobial stewardship program (asp) in a rural community hospital with no prior asp, in the context of having a new infectious disease specialist on staff.201728526311
antimicrobial stewardship for hospitalized patients with viral respiratory tract infections.the purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection.201728526309
draft genome sequences of five enterococcus species isolated from the gut of patients with suspected clostridium difficile infection.we present draft genome sequences of five enterococcus species from patients suspected of clostridium difficile infection. genome completeness was confirmed by presence of bacterial orthologs (97%). gene searches using hidden-markov models revealed that the isolates harbor between seven and 11 genes involved in antibiotic resistance to tetracyclines, beta-lactams, and vancomycin.201728522725
gut microbiota-mediated protection against diarrheal infections.the mammalian gut microbiota is a highly abundant and diverse microbial community that resides in the gastrointestinal tract. one major benefit that the gut microbiota provides to its host is colonization resistance-the ability to prevent colonization by foreign microbes, including diarrheal pathogens such as clostridium difficile , salmonella enterica serovar typhimurium and diarrheagenic escherichia coli .201728520994
effects of short- and long-course antibiotics on the lower intestinal microbiome as they relate to traveller's diarrhea.antibiotics have profound and lasting effects on the lower intestinal (gut) microbiome that can both promote resistance and increase susceptibility to colonization and infection; knowledge of these changes is important to the prevention and treatment of traveler's diarrhea.201728520993
evolving insights into the epidemiology and control of clostridium difficile in hospitals.typing studies suggest most cases of hospital-onset clostridium difficile infection are unrelated to other cases of active disease in the hospital. new cases may instead be due to transmissions from asymptomatic carriers or progression of latent c.difficile present-on-admission to active infection. direct exposure to antibiotics remains the primary risk factor for c.difficile infection but ward-level antibiotic use, antibiotic exposure of the prior room occupant, and c.difficile status of the pr ...201728520953
determination of the in vitro sporulation frequency of clostridium difficile.the anaerobic, gastrointestinal pathogen, clostridium difficile, persists within the environment and spreads from host-to-host via its infectious form, the spore. to effectively study spore formation, the physical differentiation of vegetative cells from spores is required to determine the proportion of spores within a population of c. difficile. this protocol describes a method to accurately enumerate both viable vegetative cells and spores separately and subsequently calculate a sporulation fr ...201728516125
serum-derived bovine immunoglobulin as novel adjunct in complicated clostridium difficile colitis treatment.clostridium difficile infection (cdi) is a well-known complication of antibiotic therapy. it is associated with significant morbidity, mortality, and cost in the hospital setting. the main symptoms include watery diarrhea, abdominal pain, and distension, but cdi can also present as toxic megacolon, bowel perforation with peritonitis, sepsis and renal failure. therapy includes metronidazole and oral vancomycin, with rectal vancomycin and fecal transplant reserved for more complicated cases. adjun ...201728516109
fecal microbiota transplantation outcomes in immunocompetent and immunocompromised patients: a single-center experience.clostridium difficile infection (cdi) is a major infectious disease focus for which fecal microbiota transplantation (fmt) has been used with success in various patient populations.201728513974
can procalcitonin contribute to the diagnosis of clostridium difficile colitis?it is a challenge to diagnosis clostridium difficile colitis.201728513121
intrinsic toxin-derived peptides destabilize and inactivate clostridium difficile tcdb.clostridium difficile infection (cdi) is a major cause of hospital-associated, antibiotic-induced diarrhea, which is largely mediated by the production of two large multidomain clostridial toxins, tcda and tcdb. both toxins coordinate the action of specific domains to bind receptors, enter cells, and deliver a catalytic fragment into the cytosol. this results in gtpase inactivation, actin disassembly, and cytotoxicity. tcdb in particular has been shown to encode a region covering amino acids 175 ...201728512094
emergence of microbial diversity due to cross-feeding interactions in a spatial model of gut microbial metabolism.the human gut contains approximately 10(14) bacteria, belonging to hundreds of different species. together, these microbial species form a complex food web that can break down nutrient sources that our own digestive enzymes cannot handle, including complex polysaccharides, producing short chain fatty acids and additional metabolites, e.g., vitamin k. microbial diversity is important for colonic health: changes in the composition of the microbiota have been associated with inflammatory bowel dise ...201728511646
enteric infection in relapse of inflammatory bowel disease: the utility of stool microbial pcr testing.the similar presentations in relapse of inflammatory bowel disease (ibd) and enteric infection pose substantial barriers to diagnosis and treatment. the objective of this study was to investigate the incidence, etiology, predictors, and treatment of enteric infection in patients with ibd.201728511200
identification of novel risk factors for community-acquired clostridium difficile infection using spatial statistics and geographic information system analyses.the rate of community-acquired clostridium difficile infection (ca-cdi) is increasing. while receipt of antibiotics remains an important risk factor for cdi, studies related to acquisition of c. difficile outside of hospitals are lacking. as a result, risk factors for exposure to c. difficile in community settings have been inadequately studied.201728510584
changes in microbial ecology after fecal microbiota transplantation for recurrent c. difficile infection affected by underlying inflammatory bowel disease.gut microbiota play a key role in maintaining homeostasis in the human gut. alterations in the gut microbial ecosystem predispose to clostridium difficile infection (cdi) and gut inflammatory disorders such as inflammatory bowel disease (ibd). fecal microbiota transplantation (fmt) from a healthy donor can restore gut microbial diversity and pathogen colonization resistance; consequently, it is now being investigated for its ability to improve inflammatory gut conditions such as ibd. in this stu ...201728506317
fecal microbiota transplantation in recurrent clostridium difficile infection in a patient with concomitant inflammatory bowel disease.the use of fecal microbiota transplantation in recurrent clostridium difficile infection and coexistent inflammatory bowel disease remains unclear. a 61-year-old man with ulcerative pancolitis was diagnosed with a third recurrence of clostridium difficile infection, previously treated with metronidazole, vancomycin and fidaxomicin. fecal microbiota transplantation of an unrelated healthy donor was performed by the lower route. after a twelve month follow-up, the patient remains asymptomatic with ...201728506071
comparison of the hospital-acquired clostridium difficile infection risk of using proton pump inhibitors versus histamine-2 receptor antagonists for prophylaxis and treatment of stress ulcers: a systematic review and meta-analysis.although proton pump inhibitors (ppis) have been widely used for the prevention and treatment of stress gastric ulcers in hospital settings, there are concerns that ppis increase the risk of clostridium difficile infection (cdi). however, little is known about the risk of cdi following ppi and histamine-2 receptor antagonist (h2ra) use. we evaluated the comparative hospital-acquired cdi occurrence risk associated with the concurrent use of ppis versus h2ras.201728506028
predictors of failure after single faecal microbiota transplantation in patients with recurrent clostridium difficile infection: results from a 3-year cohort study: authors' reply. 201728502839
an outbreak of clostridium difficile pcr ribotype 027 in spain: risk factors for recurrence and a novel treatment strategy.an outbreak of clostridium difficile infection (cdi) caused by ribotype 027 (b1/nap1) began in our hospital in november 2014, and produced 141 episodes in the following months. the aim of this study is to describe this outbreak, assess risk factors for recurrence of cdi-027 and to analyze the implementation of a novel treatment strategy. this is a prospective study of all patients with cdi-027, from november 2014 to november 2015. the epidemiological data were collected daily for each patient. w ...201728501926
molecular typing of clostridium difficile isolates cultured from patient stool samples and gastroenterological medical devices in a single iranian hospital.this study aimed to characterize clostridium difficile isolates cultured from stool samples of patients with c. difficile infection (cdi) and swabs from a medical environment in a gastroenterology center in tehran, iran. a total of 158 samples (105 stool samples from hospitalized patients and 53 swabs from medical devices and the environment) were collected from january 2011 to august 2011 and investigated for the presence of c. difficile by direct anaerobic culture on a selective media for c. d ...201728501554
comparative effectiveness of faecal microbiota transplant by route of administration.the optimal route of delivery for faecal microbiota transplant (fmt) is unknown. this observational single-centre study analysed the two-week cure rates for all patients who received fmt from 2013 to 2016 according to route of delivery. overall, nasogastric delivery of fmt was less effective than lower endoscopic delivery. when patients were stratified by illness severity, nasogastric delivery achieved similar cure rates in healthier individuals, whereas lower endoscopic delivery was preferred f ...201728501333
carboxyl analogue of mutacin 1140, a scaffold for lead antibacterial discovery.mutacin 1140 belongs to the epidermin group of lantibiotics. epidermin class lantibiotics are ribosomally synthesized and posttranslationally modified antibiotics with potent activity against gram-positive bacteria. in particular, this class is effective at targeting drug-resistant streptococcus pneumoniae, methicillin-resistant staphylococcus aureus (mrsa), mycobacterium tuberculosis, and clostridium difficile a c-terminal s-[(z)-2-aminovinyl]-d-cysteine (avicys) residue is derived from a decar ...201728500042
protective factors in the intestinal microbiome against clostridium difficile infection in recipients of allogeneic hematopoietic stem cell transplantation.clostridium difficile infection (cdi) is a frequent complication in recipients of allogeneic hematopoietic stem cell transplantation (allo-hsct), who receive intensive treatments that significantly disrupt the intestinal microbiota. in this study, we examined the microbiota composition of allo-hsct recipients to identify bacterial colonizers that confer protection against cdi after engraftment.201728498996
assessing the risk and disease burden of clostridium difficile infection among patients with hospital-acquired pneumonia at a university hospital in central china.hospital-acquired pneumonia (hap) remains one of the major hospital-acquired infections in china. antibiotic treatment of hap may lead to subsequent clostridium difficile infection (cdi). baseline data on the occurrence of cdi among hap patients in china are currently unavailable. this study examines the risk and disease burden of cdi among hap hospitalized patients (hap-cdi).201728497295
inhibition of clostridium difficile in mice using a mixture of potential probiotic strains enterococcus faecalis nm815, e. faecalis nm915, and e. faecium nm1015: novel candidates to control c. difficile infection (cdi).this study is aimed at the isolation, identification, and characterization of potential probiotic strains capable of inhibiting clostridium difficile in vitro and in vivo. twenty isolates were isolated from infant fecal samples and screened against c. difficile using their cell-free supernatant. only three isolates showed maximum inhibition from 56.05 to 60.60%, thus they were characterized for probiotic properties and safety. the results obtained approved their tolerance to the gastrointestinal ...201728497217
lack of association between the clinical outcome of clostridium difficile infection and current steroids use.the purpose of this study was to compare the outcome of clostridium difficile infection (cdi) in patients on systemic steroids for various indications to patients not on steroids in term of disease severity, and associated morbidity and mortality.201728496532
comparison of two environmental sampling tools for the detection of clostridium difficile spores on hard bathroom surfaces in the hospital setting. 201728495188
filmarray™ gi panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea.acute gastroenteritis is a common cause of morbidity and mortality in humans worldwide. the rapid and specific identification of infectious agents is crucial for correct patient management. however, diagnosis of acute gastroenteritis is usually performed with diagnostic panels that include only a few pathogens. in the present bicentric study, the diagnostic value of filmarray™ gi panels was assessed in unformed stool samples of patients with acute gastroenteritis and in a series of samples colle ...201728494766
rapid synthesis of bicyclic lactones via palladium-catalyzed aminocarbonylative lactonizations.a novel and efficient palladium-catalyzed aminocarbonylative lactonization of amino propargylic alcohols has been developed to provide rapid access to various bicyclic lactones especially dihydropyrrole-fused furanones, which are novel structures and have not been explored in biological and medicinal settings. this method can also be used to access β-lactone products such as 16. preliminary biological evaluations revealed that compounds 13h and 13s demonstrated promising activity against clostri ...201728492641
infections in hematopoietic cell transplant recipients: results from the organ transplant infection project, a multicenter, prospective, cohort study.infection is a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (hct). our object was to better define the epidemiology and outcomes of infections after hct.201728491889
current challenges in the treatment of severe clostridium difficile infection: early treatment potential of fecal microbiota transplantation.fecal microbiota transplantation (fmt) is a very effective treatment for recurrent clostridium difficile infection (cdi). less is known about the application of fmt as a curative treatment of severe or complicated cdi. in this review, we present and discuss evidence supporting the curative use of fmt in severe or complicated cdi. we performed a literature search in pubmed and embase for studies on the curative use of fmt in severe or complicated cdi. in addition, we describe a patient with sever ...201728491142
antimicrobial activity of natural products against clostridium difficile in vitro.to investigate the antimicrobial activity of various natural products against clostridium difficile in vitro.201728489336
a clostridium difficile alanine racemase affects spore germination and accommodates serine as a substrate.clostridium difficile has become one of the most common bacterial pathogens in hospital-acquired infections in the united states. although c. difficile is strictly anaerobic, it survives in aerobic environments and transmits between hosts via spores. c. difficile spore germination is triggered in response to certain bile acids and glycine. although glycine is the most effective co-germinant, other amino acids can substitute with varying efficiencies. of these, l-alanine is an effective co-germin ...201728487371
thirty-day readmissions after hospitalization for clostridium difficile enteritis measures and predictors: a nationwide analysis. 201728486996
optimal control of vaccination rate in an epidemiological model of clostridium difficile transmission.the spore-forming, gram-negative bacteria clostridium difficile can cause severe intestinal illness. a striking increase in the number of cases of c. difficile infection (cdi) among hospitals has highlighted the need to better understand how to prevent the spread of cdi. in our paper, we modify and update a compartmental model of nosocomial c. difficile transmission to include vaccination. we then apply optimal control theory to determine the time-varying optimal vaccination rate that minimizes ...201728484801
intraluminal administration of resiniferatoxin protects against clostridium difficile toxin a-induced colitis.clostridium difficile toxin a is a colonic inflammatory agent that acts partially by activation of trpv1 (transient receptor potential vanilloid type 1). resiniferatoxin (rtx) is an excitotoxin that activates trpv1 at low concentrations and defunctionalizes trpv1 at high concentrations. rtx at various doses was injected intraluminally into isolated ileal segments in anesthetized rats. after 3 hours, the treated segments were removed and inflammation was assessed. this acute treatment with rtx re ...201728484490
protective effect of carvacrol against gut dysbiosis and clostridium difficile associated disease in a mouse model.this study investigated the effect of carvacrol (cr), a phytophenolic compound on antibiotic-associated gut dysbiosis and c. difficile infection in a mouse model. five to six-week-old c57bl/6 mice were randomly divided into seven treatment groups (challenge and control) of eight mice each. mice were fed with irradiated feed supplemented with cr (0, 0.05, and 0.1%); the challenge groups were made susceptible to c. difficile by orally administering an antibiotic cocktail in water and an intra-peri ...201728484429
bezlotoxumab: could this be the answer for clostridium difficile recurrence?to review the pharmacology, pharmacokinetics, efficacy, safety, and place in therapy of bezlotoxumab (bez), a novel monoclonal antibody against clostridium difficile toxin b.201728480750
community environmental contamination of toxigenic clostridium difficile.clostridium difficile infection is often considered to result from recent acquisition of a c difficile isolate in a healthcare setting. however, c difficile spores can persist for long periods of time, suggesting a potentially large community environmental reservoir. the objectives of this study were to assess community environmental contamination of toxigenic c difficile and to assess strain distribution in environmental versus clinical isolates.201728480289
primary outcomes from a phase 3, randomized, double-blind, active-controlled trial of surotomycin in subjects with clostridium difficile infection.although the incidence of clostridium difficile infection (cdi) is increasing, available cdi treatment options are limited in terms of sustained response after treatment. this phase 3 trial assessed the efficacy and safety of surotomycin, a novel bactericidal cyclic lipopeptide, versus oral vancomycin in subjects with cdi.201728480267
does adjunctive tigecycline improve outcomes in severe-complicated, nonoperative clostridium difficile infection?severe clostridium difficile infection is associated with a high rate of mortality; however, the optimal treatment for severe- complicated infection remains uncertain for patients who are not candidates for surgical intervention. thus, we sought to evaluate the benefit of adjunctive tigecycline in this patient population using a retrospective cohort adjusted for propensity to receive tigecycline. we found that patients who received tigecycline had similar outcomes to those who did not, although ...201728480257
outcomes associated with antimicrobial de-escalation of treatment for pneumonia within the veterans healthcare administration.de-escalation, an antimicrobial stewardship concept, involves narrowing broad-spectrum empiric antimicrobial therapy based on clinical data. current health outcomes evidence is lacking to support de-escalation. studying veterans healthcare administration pneumonia patients, de-escalation was associated with improved length of stay without affecting 30-day readmission or 30-day clostridium difficile infection rates.201728480242
higher incidence of clostridium difficile infection among individuals with inflammatory bowel disease.studies of clostridium difficile infections (cdis) among individuals with inflammatory bowel disease (ibd) have used data from single centers or cdi administrative data codes of limited diagnostic accuracy. we determined the incidence, risk factors, and outcomes after cdi in a population-based cohort of patients with ibd and laboratory confirmation diagnoses of cdi.201728479377
promoting appropriate urine culture management to improve health care outcomes and the accuracy of catheter-associated urinary tract infections.published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and clostri ...201728476493
tracking microbial colonization in fecal microbiota transplantation experiments via genome-resolved metagenomics.fecal microbiota transplantation (fmt) is an effective treatment for recurrent clostridium difficile infection and shows promise for treating other medical conditions associated with intestinal dysbioses. however, we lack a sufficient understanding of which microbial populations successfully colonize the recipient gut, and the widely used approaches to study the microbial ecology of fmt experiments fail to provide enough resolution to identify populations that are likely responsible for fmt-deri ...201728473000
microbicidal effects of weakly acidified chlorous acid water against feline calicivirus and clostridium difficile spores under protein-rich conditions.sanitation of environmental surfaces with chlorine based-disinfectants is a principal measure to control outbreaks of norovirus or clostridium difficile. the microbicidal activity of chlorine-based disinfectants depends on the free available chlorine (fac), but their oxidative potential is rapidly eliminated by organic matter. in this study, the microbicidal activities of weakly acidified chlorous acid water (wacaw) and sodium hypochlorite solution (naclo) against feline calcivirus (fcv) and c. ...201728472060
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