Publications

TitleAbstractYear(sorted ascending)
Filter
PMID
Filter
the burden of healthcare-associated clostridium difficile infection in a non-metropolitan setting.healthcare-associated clostridium difficile infection (hca-cdi) remains a major cause of morbidity and mortality in industrialized countries. however, few data exist on the burden of hca-cdi in multi-site non-metropolitan settings. this study examined the introduction of an antimicrobial stewardship programme (asp) in relation to hca-cdi rates, and the effect of hca-cdi on length of stay (los) and hospital costs.201728131640
clostridium difficile colitis: a clinical review.clostridium difficile colitis is an important cause of morbidity and mortality in the surgical patient. in recent years, clostridium difficile infections have shown marked increases in frequency, severity, and resistance to standard treatment. with urgent operative interventions and novel endoscopic approaches, pseudomembranous colitis is being seen more commonly in surgical practices.201728131326
key advantages of a targeted incident reporting system for severe and critical clostridium difficile infection incidents.there is little guidance on how to design and implement an incident reporting system (irs) targeted at one of the most common types of adverse events in hospitals: hospital-associated infections. in this article, we describe an irs for severe and critical clostridium difficile infection incidents and highlight its key advantages.201728130951
clinical implications of emerging data on the safety of proton pump inhibitors.proton pump inhibitors (ppi) are among the safest class of drugs used by all care providers, including gastroenterologists. they are the mainstay in treatment of acid-related disease, in particular, gastroesophageal reflux disease. without them, many patients would experience a major decrement in their quality of life. however, no drug is without side effects or adverse events. in the past decade, numerous reports, principally case control studies and meta-analyses, have raised questions about i ...201728130652
effects of control interventions on clostridium difficile infection in england: an observational study.the control of clostridium difficile infections is an international clinical challenge. the incidence of c difficile in england declined by roughly 80% after 2006, following the implementation of national control policies; we tested two hypotheses to investigate their role in this decline. first, if c difficile infection declines in england were driven by reductions in use of particular antibiotics, then incidence of c difficile infections caused by resistant isolates should decline faster than ...201728130063
fluoroquinolone restriction to control fluoroquinolone-resistant clostridium difficile. 201728130062
[reactive arthritis due to clostridium difficile: report of two cases and literature review].reactive arthritis due to clostridium difficile infection is uncommon.201728129954
challenges in fecal donor selection and screening for fecal microbiota transplantation: a review.fecal microbiota transplantation is best understood as an effective and inexpensive therapy for recurrent clostridium difficile infection but fecal donor selection and screening should be periodically revised. here, we review current recommendations for selection and screening of fecal donors for fecal microbiota transplantation. we recommend considering diabetes mellitus, prior cardiovascular events, and clinical healthcare exposure as fecal donor exclusion criteria until more is known about th ...201728129018
lactulose is associated with decreased risk of clostridium difficile infection in decompensated cirrhosis. 201728126426
[breaking paradigms. intestinal microbiota transplantation: preliminar report].in the fourth century, during the chinese dong jin dynasty, the doctor ge hong described good results after the oral administration of a suspension prepared from human faeces in patients with severe diarrhoea or food poisoning. faecal microbiota transplantation has been used for five years in order to treat different diseases in addition to the severe diarrhoea caused by clostridium difficile(1). this paper aims to confirm that intestinal microbiota transplantation succeeds in reducing the negat ...201728126184
profiling living bacteria informs preparation of fecal microbiota transplantations.fecal microbiota transplantation is a compelling treatment for recurrent clostridium difficile infections, with potential applications against other diseases associated with changes in gut microbiota. but variability in fecal bacterial communities-believed to be the therapeutic agent-can complicate or undermine treatment efficacy. to understand the effects of transplant preparation methods on living fecal microbial communities, we applied a dna-sequencing method (pma-seq) that uses propidium mon ...201728125667
development of a novel vaccine containing binary toxin for the prevention of clostridium difficile disease with enhanced efficacy against nap1 strains.clostridium difficile infections (cdi) are a leading cause of nosocomial diarrhea in the developed world. the main virulence factors of the bacterium are the large clostridial toxins (lcts), tcda and tcdb, which are largely responsible for the symptoms of the disease. recent outbreaks of cdi have been associated with the emergence of hypervirulent strains, such as nap1/bi/027, many strains of which also produce a third toxin, binary toxin (cdta and cdtb). these hypervirulent strains have been as ...201728125650
impact of humic acids on the colonic microbiome in healthy volunteers.to test the effects of humic acids on innate microbial communities of the colon.201728223733
role of the leukocyte response in normal and immunocompromised host after clostridium difficile infection.clostridium difficile is the leading cause of healthcare-associated infections in the united states. clinically, c. difficile-associated disease can present as asymptomatic colonization, self-limited diarrheal illness or severe colitis (that may result in death). this variability in disease course and outcomes suggests that host factors play an important role as key determinants of disease severity. currently, there are several scoring indices to estimate severity of c. difficile-associated dise ...201728223256
comparative performance study of six commercial molecular assays for rapid detection of toxigenic clostridium difficile.rapid and accurate detection of clostridium difficile in stool affects patient treatment and containment efforts. detection of c. difficile toxin genes using nucleic acid amplification techniques (naat) is part of a multistep algorithm. our objective was to directly compare the diagnostic accuracy and applicability of six commercial c. difficile naat.201728223147
evaluation of risk factors for clostridium difficile infection in hematopoietic stem cell transplant recipients.the primary objective was to determine the impact of hematologic malignancies and/or conditioning regimens on the risk of developing clostridium difficile infection (cdi) in patients undergoing hematopoietic stem cell transplantation (hsct). secondary objectives were to determine if traditional cdi risk factors applied to patients undergoing hsct and to determine the presence of cdi markers of severity of illness among this patient population.201728226419
consensus report: faecal microbiota transfer - clinical applications and procedures.faecal microbiota transplantation or transfer (fmt) aims at replacing or reinforcing the gut microbiota of a patient with the microbiota from a healthy donor. not many controlled or randomised studies have been published evaluating the use of fmt for other diseases than clostridium difficile infection, making it difficult for clinicians to decide on a suitable indication.201727891639
enteric glial cells are susceptible to clostridium difficile toxin b.clostridium difficile causes nosocomial/antibiotic-associated diarrhoea and pseudomembranous colitis. the major virulence factors are toxin a and toxin b (tcdb), which inactivate gtpases by monoglucosylation, leading to cytopathic (cytoskeleton alteration, cell rounding) and cytotoxic effects (cell-cycle arrest, apoptosis). c. difficile toxins breaching the intestinal epithelial barrier can act on underlying cells, enterocytes, colonocytes, and enteric neurons, as described in vitro and in vivo, ...201727891552
interaction of gut microbiota with bile acid metabolism and its influence on disease states.primary bile acids serve important roles in cholesterol metabolism, lipid digestion, host-microbe interactions, and regulatory pathways in the human host. while most bile acids are reabsorbed and recycled via enterohepatic cycling, ∼5% serve as substrates for bacterial biotransformation in the colon. enzymes involved in various transformations have been characterized from cultured gut bacteria and reveal taxa-specific distribution. more recently, bioinformatic approaches have revealed greater di ...201727888332
multicenter observational study of ceftaroline fosamil for methicillin-resistant staphylococcus aureus bloodstream infections.novel therapies for methicillin-resistant staphylococcus aureus (mrsa) bloodstream infection (bsi) are needed in the setting of reduced antibiotic susceptibilities and therapeutic failure. ceftaroline is a cephalosporin antibiotic with mrsa activity. although not fda approved for mrsa bsi, ceftaroline has generated much interest as a potential treatment option. however, detailed descriptions of its use in this setting remain limited. to address this, we conducted a retrospective, multicenter, ob ...201727895012
a review of experimental and off-label therapies for clostridium difficile infection.in spite of increased awareness and the efforts taken to optimize clostridium difficile infection (cdi) management, with the limited number of currently available antibiotics for c. difficile the halt of this increasing epidemic remains out of reach. there are, however, close to 80 alternative treatment methods with controversial anti-clostridial efficacy or in experimental phase today. indeed, some of these therapies are expected to become acknowledged members of the recommended anti-cdi arsena ...201727910000
clostridium difficile carriage in adult cystic fibrosis (cf); implications for patients with cf and the potential for transmission of nosocomial infection.clostridium difficile is an anaerobic gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal-oral route. despite increasing carriage rates and the presence of c. difficile toxin in stool, patients with cf rarely appear to develop typical manifestations of c. difficile infection (cdi). in this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of c. difficile in a cohort of 60 adult patients with cf wh ...201727908697
re-evaluating the inhibition of stress erosions (revise): a protocol for pilot randomized controlled trial.clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (icu), most commonly prescribing proton pump inhibitors (ppis). however, the incidence of gastrointestinal (gi) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. therefore, a large randomized clinical trial (rct) is needed to inform modern practice. the aim of this multicenter pilot trial is to determine the fe ...201727920416
hiv-associated changes in the enteric microbial community: potential role in loss of homeostasis and development of systemic inflammation.despite hiv therapy advances, average life expectancy in hiv-infected individuals on effective treatment is significantly decreased relative to uninfected persons, largely because of increased incidence of inflammation-related diseases, such as cardiovascular disease and renal dysfunction. the enteric microbial community could potentially cause this inflammation, as hiv-driven destruction of gastrointestinal cd4 t cells may disturb the microbiota-mucosal immune system balance, disrupting the sta ...201727922852
genomic study of the type ivc secretion system in clostridium difficile: understanding c. difficile evolution via horizontal gene transfer.clostridium difficile, the etiological agent of clostridium difficile infection (cdi), is a gram-positive, spore-forming bacillus that is responsible for ∼20% of antibiotic-related cases of diarrhea and nearly all cases of pseudomembranous colitis. previous data have shown that a substantial proportion (11%) of the c. difficile genome consists of mobile genetic elements, including seven conjugative transposons. however, the mechanism underlying the formation of a mosaic genome in c. difficile is ...201727922269
evaluation of correlation between pretest probability for clostridium difficile infection and clostridium difficile enzyme immunoassay results.the objective of this study was to evaluate the clinical characteristics and outcomes of hospitalized patients tested for clostridium difficile and determine the correlation between pretest probability for c. difficile infection (cdi) and assay results. patients with testing ordered for c. difficile were enrolled and assigned a high, medium, or low pretest probability of cdi based on clinical evaluation, laboratory, and imaging results. stool was tested for c. difficile by toxin enzyme immunoass ...201727927930
expert consensus on metrics to assess the impact of patient-level antimicrobial stewardship interventions in acute-care settings.antimicrobial stewardship programs (asps) positively impact patient care, but metrics to assess asp impact are poorly defined. we used a modified delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. an expert panel rated 90 candidate metrics on a 9-point likert scale for association with 4 criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardshi ...201727927866
fecal microbiota transplantation for recurrent clostridium difficile infection in patients with inflammatory bowel disease: a single-center experience. 201727923723
in vitro inhibition of clostridium difficile by commercial probiotics: a microcalorimetric study.the aim of the study was to investigate the influence of some commercial probiotics on the growth of clostridium difficile using isothermal microcalorimetry, a technique which can monitor the real time growth of bacteria. commercial probiotic strains and products, lactobacillus acidophilus la-5(®), bifidobacterium lactis bb-12(®), probio 7(®) and symprove™ were co-cultured with c. difficile in brain heart infusion (bhi) broth supplemented with 0.1% (w/v) l-cysteine hydrochloride and 0.1% (w/v) s ...201727923699
clostridium difficile in an urban, university-affiliated long-term acute-care hospital.objectives to describe the characteristics and impact of clostridium difficile infection (cdi) in a long-term acute-care hospital (ltach). design retrospective matched cohort study. setting a 38-bed, urban, university-affiliated ltach. methods the characteristics of ltach-onset cdi were assessed among patients hospitalized between july 2008 and october 2015. patients with cdi were matched to concurrently hospitalized patients without a diagnosis of cdi. severe cdi was defined as cdi with 2 or mo ...201727923419
reduction in hospital-associated methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococcus with daily chlorhexidine gluconate bathing for medical inpatients.daily bathing with chlorhexidine gluconate (chg) is increasingly used in intensive care units to prevent hospital-associated infections, but limited evidence exists for noncritical care settings.201727938986
isolation of clostridium difficile from dogs with digestive disorders, including stable metronidazole-resistant strains.the prevalence of clostridium difficile in 107 dogs with diverse digestive disorders attended in a spanish veterinary teaching hospital was assessed. the microorganism was isolated from 13 dogs (12.1%) of different disease groups. isolates belonged to pcr ribotypes 078, 106, 154 and 430 (all of them toxigenic) and 110 (non-toxigenic), and were resistant to several antimicrobial drugs. notably, seven isolates obtained from different dogs displayed stable resistance to metronidazole. the results o ...201727965048
an institutional comparison of total abdominal colectomy and diverting loop ileostomy and colonic lavage in the treatment of severe, complicated clostridium difficile infections.total abdominal colectomy (tac) is the standard surgical treatment of clostridium difficile infection (cdi). an alternative therapy, loop ileostomy and colonic lavage (il), was described in 2011, but the results have never been validated.201727964924
evaluation of the biofire filmarray® gastrointestinalpanel in a midwestern academic hospital.the biofire filmarray® gastrointestinal panel (gip) was implemented to replace traditional stool culture and enzyme immunoassay (eia) testing for stool pathogens. the purpose of this study was to evaluate the detection rate, incidence of coinfection, and culture recovery rate of gastrointestinal (gi) pathogens detected by the gip over a 1-year period. a total of 2257 stools collected from january to december 2015 were tested using the gip. clostridium difficile colonization was also evaluated by ...201727957599
risk factors and epidemiology of clostridium difficile infection in hematopoietic stem cell transplant recipients during the peritransplant period.hematopoietic stem cell transplant (hsct) recipients represent a high-risk group for developing clostridium difficile (cd) infection (cdi). we aimed to identify specific risk factors for cdi in an hsct patient population during the peritransplant period.201727943501
risk factors for the development of clostridium difficile infection in adult allogeneic hematopoietic stem cell transplant recipients: a single-center study in québec, canada.clostridium difficile infection (cdi) is a significant complication of allogeneic hematopoietic stem cell transplantation (allo-hsct). our primary objective was to determine risk factors for the development of cdi during the first year following allo-hsct.201727943498
successful therapy of severe pseudomembranous clostridium difficile colitis using a combination of fecal microbiota therapy and fidaxomicin.the aim of this work was to describe the use of a combination of fidaxomicin and fecal microbiota therapy (fmt) in clostridium difficile infection (cdi).201727978522
recurrent clostridium difficile infection in children: patient risk factors and markers of intestinal inflammation.the management of clostridium difficile infection (cdi) in children is complicated by recurrence rates of 20%-30%. the identification of risk factors associated with recurrent disease might allow early recognition of those children at highest risk.201727977555
molecular epidemiology of clostridium difficile infection in hospitalized patients in eastern china.few studies on risk factors for and transmission of clostridium difficile infection (cdi) in china have been reported. a cross-sectional study was conducted for 3 years in eastern china. consecutive stool specimens from hospitalized patients with diarrhea were cultured for c. difficile. c. difficile isolates from these patients then were analyzed for toxin genes, genotypes, and antimicrobial resistance. a severity score for the cdi in each patient was determined by a blinded review of the medica ...201727974547
prospective randomized controlled study on the effects of saccharomyces boulardii cncm i-745 and amoxicillin-clavulanate or the combination on the gut microbiota of healthy volunteers.probiotics are believed to be beneficial in maintaining a healthy gut microbiota whereas antibiotics are known to induce dysbiosis. this study aimed to examine the effects of the probiotic saccharomyces boulardii cncm i-745 (sb), the antibiotic amoxicillin-clavulanate (ac) and the combination on the microbiota and symptoms of healthy humans. healthy subjects were randomized to one of 4 study groups: sb for 14 days, ac for 7 days, sb plus ac, control (no treatment). participants gave stool sample ...201727973989
clinical and microbiological characteristics of clostridium difficile infection among hospitalized children in the netherlands.little is known about pediatric clostridium difficile infection (cdi) epidemiology. we describe the clinical and microbiological characteristics of cdi among hospitalized children in the netherlands.201727986664
diagnostic testing methods for clostridium difficile infection: a statewide survey of ohio acute care hospitals.we surveyed ohio acute care hospitals on laboratory testing used for diagnosis of clostridium difficile infection (cdi). of 146 hospitals surveyed, 109 (84%) used nucleic acid amplification tests (naats) as stand-alone diagnostic assays. only 53 (42.4%) hospitals using naats had a mechanism in place to prevent repeat cdi testing.201728029400
predictors of severe outcomes in patients with clostridium difficile infection from a hispanic population.factors associated with complicated clostridium difficile infection (cdi) may vary among populations, and predictors of severe outcomes in cdi have not been studied in hispanic patients. the aim of this study was to identify factors associated with a higher risk of colectomy, all-cause mortality, and cdi-associated mortality in a hispanic population.201727987135
role of interferon-γ and inflammatory monocytes in driving colonic inflammation during acute clostridium difficile infection in mice.the inflammatory response to the colonic pathogen clostridium difficile is characterized by the induction of inflammatory cytokines including interleukin-23 (il-23) and interferon-γ (ifn-γ) and the recruitment of myeloid cells including ly6c(h)(igh) monocytes. il-23 knockout mice showed reduced expression of the monocyte chemokines ccl4 and ccl7, but not ccl2, as well as reduced ly6c(h)(igh) ly6g(m)(id) monocyte recruitment to the colon in response to c. difficile colitis. clostridium difficile- ...201727995603
clostridium difficile infection: updates in management.clostridium difficile was first identified in 1978 as a diarrhea-causing bacterium in humans. in the last three decades, c. difficile infection (cdi) has reached an epidemic state, both in health care and community settings worldwide. there has been substantial progress in the field of cdi, including identification of novel risk factors, presence of cdi in individuals not considered at risk previously, and treatment options including new drugs, monoclonal antibodies, and fecal microbiota transpl ...201727995486
in vitro activities of mcb3681 and eight comparators against clostridium difficile isolates with known ribotypes and diverse geographical spread.treatments for clostridium difficile infection remain limited, despite the introduction of fidaxomicin, and development of new agents is necessary. we determined the in vitro susceptibilities of 199 prevalent or emerging clostridium difficile pcr ribotypes to mcb3681, a novel investigational quinolonyl-oxazolidinone, and 8 comparators (metronidazole, vancomycin, fidaxomicin, moxifloxacin, ciprofloxacin, clindamycin, tigecycline, and linezolid). mcb3681 showed good activity against c. difficile w ...201727993853
presence of clostridium difficile in pig faecal samples and wild animal species associated with pig farms.to determine the presence of clostridium difficile on fattening pig farms in north-eastern spain.201727990723
electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 uk infection specialists.the implementation of electronic prescribing and medication administration (epma) systems is a priority for hospitals and a potential component of antimicrobial stewardship (ams).201727999065
cumulative and temporal associations between antimicrobial prescribing and community-associated clostridium difficile infection: population-based case-control study using administrative data.community-associated clostridium difficile infection (ca-cdi; defined as cases without prior hospitalization in the previous 12 weeks who were either tested outside of hospital or tested within 2 days of admission to hospital) is a major public health problem. this study estimates the magnitude of the association between temporal and cumulative prescribing of antimicrobials in primary care and ca-cdi.201727999064
gut-sparing treatment of urinary tract infection in patients at high risk of clostridium difficile infection.recipients of faecal microbiota transplantation (fmt) in treatment of recurrent clostridium difficile infection (rcdi) remain at markedly increased risk of re-infection with c. difficile with new antibiotic provocations. urinary tract infections (utis) are common indications for antibiotics in these patients, often resulting in c. difficile re-infection.201727999027
lactobacillus probiotics in the prevention of diarrhea associated with clostridium difficile: a systematic review and bayesian hierarchical meta-analysis.recent meta-analyses of the efficacy of probiotics for preventing diarrhea associated with clostridium difficile have concluded there is a large effect favouring probiotics. we reexamined this evidence, which contradicts the results of a more recent large randomized controlled trial that found no benefit of lactobacillus probiotics for preventing c. difficile-associated diarrhea.201728018885
clostridium difficile infection: evolution, phylogeny and molecular epidemiology.over the recent decades, clostridium difficile infection (cdi) has emerged as a global public health threat. despite growing attention, c. difficile remains a poorly understood pathogen, however, the exquisite sensitivity offered by next generation sequencing (ngs) technology has enabled analysis of the genome of c. difficile, giving us access to massive genomic data on factors such as virulence, evolution, and genetic relatedness within c. difficile groups. ngs has also demonstrated excellence ...201728012982
oral vancomycin followed by fecal transplantation versus tapering oral vancomycin treatment for recurrent clostridium difficile infection: an open-label, randomized controlled trial.fecal transplantation (ft) is a promising treatment for recurrent clostridium difficile infection (cdi), but its true effectiveness remains unknown. we compared 14 days of oral vancomycin followed by a single ft by enema with oral vancomycin taper (standard of care) in adult patients experiencing acute recurrence of cdi.201728011612
fecal fixation: fecal microbiota transplantation for clostridium difficile infection. 201728011611
risk factors for hospital-acquired clostridium difficile infection among pediatric patients with cancer.hospital-acquired clostridium difficile infection (cdi) may cause life-threatening colitis for children with cancer, making identification of risk factors important. we described characteristics of pediatric cancer patients with primary and recurring cdi, and evaluated potential risk factors. among 189 cancer patients, 51 cases (27%) of cdi and 94 matched controls of cancer patients without cdi were analyzed. multivariable logistic regression was used to evaluate the association between cdi and ...201728002256
rasch analysis of the antimicrobial self-assessment toolkit for national health service (nhs) trusts (asat v17).the antimicrobial self-assessment toolkit for national health service (nhs) trusts (asat) was developed to evaluate hospital-based antimicrobial stewardship programmes. iterative validity investigations of the asat were used to produce a 91-item asat v17 utilizing qualitative methodology. rasch analysis was used to generate question (item) behaviour estimates and to investigate the validity of asat v17.201727798214
influence of antibiotics and case exposure on hospital-acquired clostridium difficile infection independent of illness severity.previous studies of the association between antibiotic exposure and risk of hospital-acquired clostridium difficile-associated infection (cdi) have not fully accounted for patient severity of illness, and competing risks.201727825674
clostridium difficile infection: stewardship's lowest hanging fruit? 201727825596
effect of a national 4c antibiotic stewardship intervention on the clinical and molecular epidemiology of clostridium difficile infections in a region of scotland: a non-linear time-series analysis.whereas many antibiotics increase risk of clostridium difficile infection through dysbiosis, epidemic c difficile ribotypes characterised by multidrug resistance might depend on antibiotic selection pressures arising from population use of specific drugs. we examined the effect of a national antibiotic stewardship intervention limiting the use of 4c antibiotics (fluoroquinolones, clindamycin, co-amoxiclav, and cephalosporins) and other infection prevention and control strategies on the clinical ...201727825595
antimicrobial stewardship and environmental decontamination for the control of clostridium difficile transmission in healthcare settings.we implement an agent-based model for clostridium difficile transmission in hospitals that accounts for several processes and individual factors including environmental and antibiotic heterogeneity in order to evaluate the efficacy of various control measures aimed at reducing environmental contamination and mitigating the effects of antibiotic use on transmission. in particular, we account for local contamination levels that contribute to the probability of colonization and we account for both ...201727826877
are proton pump inhibitors associated with an increased risk of clostridium difficile infection after considering confounding variables? 201727847127
cost-effectiveness of histamine2 receptor antagonists versus proton pump inhibitors for stress ulcer prophylaxis in critically ill patients.to determine the cost-effectiveness of stress ulcer prophylaxis with histamine2 receptor antagonists (h2ras) versus proton pump inhibitors (ppis) in critically ill and mechanically ventilated adults.201727809338
nutrition and the gut microbiome in the elderly.the gut microbiota is the assembly of microorganisms living in our intestine and their genomes are known as the microbiome. the correct composition and functionality of this microbiome is essential for maintaining a "healthy status." aging is related to changes in the gut microbiota which are frequently associated with physiological modifications of the gastrointestinal tract, as well as, to changes in dietary patterns, together with a concomitant decline in cognitive and immune function, all to ...201727808595
comparison of clostridium difficile ribotypes circulating in australian hospitals and communities.clostridium difficile infection (cdi) is becoming less exclusively a health care-associated cdi (ha-cdi). the incidence of community-associated cdi (ca-cdi) has increased over the past few decades. it has been postulated that asymptomatic toxigenic c. difficile (tcd)-colonized patients may play a role in the transfer of c. difficile between the hospital setting and the community. thus, to investigate the relatedness of c. difficile across the hospital and community settings, we compared the char ...201727807147
toxin a of the nosocomial pathogen clostridium difficile induces primary effects in the proteome of hep-2 cells.this study was carried out to investigate the impact of high concentrations of clostridium difficile toxin a (tcda) on the proteome of human cells. it should also be examined whether a catalytically deficient mutant (tcdanxn ) has an effect on target cells.201727860399
variability in antibiotic use across ontario acute care hospitals.antibiotic stewardship is a required organizational practice for canadian acute care hospitals, yet data are scarce regarding the quantity and composition of antibiotic use across facilities. we sought to examine the variability, and risk-adjusted variability, in antibiotic use across acute care hospitals in ontario, canada's most populous province.201727856724
duodenitis-proximal jejunitis in horses after experimental administration of clostridium difficile toxins.duodenitis-proximal jejunitis (dpj) is an acute sporadic gastrointestinal disorder of horses of unknown cause.201727906466
patients' views on fecal microbiota transplantation: an acceptable therapeutic option in inflammatory bowel disease?fecal microbiota transplantation (fmt) represents a new therapeutic option that has been studied in two randomized-controlled trials in ulcerative colitis patients. our study aimed to identify patients' views on the use of this novel therapeutic approach.201727879485
gleaning insights from fecal microbiota transplantation and probiotic studies for the rational design of combination microbial therapies.beneficial microorganisms hold promise for the treatment of numerous gastrointestinal diseases. the transfer of whole microbiota via fecal transplantation has already been shown to ameliorate the severity of diseases such as clostridium difficile infection, inflammatory bowel disease, and others. however, the exact mechanisms of fecal microbiota transplant efficacy and the particular strains conferring this benefit are still unclear. rationally designed combinations of microbial preparations may ...201727856521
national survey of practice of faecal microbiota transplantation for clostridium difficile infection in the uk. 201727876399
diagnosis and treatment of clostridium difficile (c. diff) colitis: review of the literature and a perspective in gynecologic oncology.clostridium difficile infection (cdi) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. although patients with a gynecologic malignancy may be at a higher risk of developing cdi due to an increased likelihood of having one or more risk factors, data do not consistently support the i ...201727876339
survival and prevalence of clostridium difficile in manure compost derived from pigs.pigs, particularly piglets, have been identified as reservoir hosts of clostridium difficile. to examine the survival ability of this pathogen in pig feces-based manure compost, c. difficile spores, which were prepared to contain as few vegetative cells as possible, were artificially inoculated into pig feces and incubated at different temperatures. while c. difficile survived in the feces incubated at temperatures below 37 °c for over 30 days, cell numbers gradually decreased at thermophilic te ...201727871997
prevalence and molecular characterization of clostridium difficile isolates from a pig slaughterhouse, pork, and humans in taiwan.clostridium difficile causes antibiotic-associated diarrhea in both humans and animals. the ribotype 078, predominant in food animals, is associated with community-acquired c. difficile infection, and c. difficile is suggested to be a foodborne pathogen. recently, the c. difficile ribotype 078 lineage emerged in patients and pigs in taiwan. this study aimed to investigate the prevalence and molecular characterization of c. difficile isolated from a pig slaughterhouse, retail meat, ready-to-eat m ...201727870984
efficacy of sterile fecal filtrate transfer for treating patients with clostridium difficile infection.fecal microbiota transplantation (fmt) is a highly effective therapy for recurrent clostridium difficile infection (cdi). however, transferring undefined living bacteria entails uncontrollable risks for infectious and metabolic or malignant diseases, particularly in immunocompromised patients. we investigated whether sterile fecal filtrates (containing bacterial debris, proteins, antimicrobial compounds, metabolic products, and oligonucleotides/dna), rather than intact microorganisms, are effect ...201727866880
evaluation of an automated room decontamination device using aerosolized peracetic acid.because manual cleaning is often suboptimal, there is increasing interest in use of automated devices for room decontamination. we demonstrated that an ultrasonic room fogging system that generates submicron droplets of peracetic acid and hydrogen peroxide eliminated clostridium difficile spores and vegetative pathogens from exposed carriers in hospital rooms and adjacent bathrooms.201727866755
an increase in healthcare-associated clostridium difficile infection associated with use of a defective peracetic acid-based surface disinfectant.background we investigated an increase in the incidence of healthcare-associated clostridium difficile infection (cdi) that occurred following a change from a bleach disinfectant to a peracetic acid-based disinfectant. objective to evaluate the efficacy of the peracetic acid-based disinfectant. design laboratory-based product evaluation. methods the commercial peracetic acid-based product is activated on site by mixing a small volume of concentrated hydrogen peroxide and peracetic acid present i ...201727866475
detection of clostridium difficile in feces of asymptomatic patients admitted to the hospital.recent evidence shows that patients asymptomatically colonized with clostridium difficile may contribute to the transmission of c. difficile in health care facilities. additionally, these patients may have a higher risk of developing c. difficile infection. the aim of this study was to compare a commercially available pcr directed to both toxin a and b (artus c. difficile qs-rgq kit ce; qiagen), an enzyme-linked fluorescent assay to glutamate dehydrogenase (gdh elfa) (vidas, biomérieux), and an ...201727852676
fecal calprotectin level reflects the severity of clostridium difficile infection.clostridium difficile is a significant nosocomial and community-acquired pathogen, and is the leading cause of antibiotic-induced diarrhea associated with high morbidity and mortality. given that the treatment outcome depends on the severity of c. difficile infection (cdi), we aimed to establish an efficient method of assessing severity, and focused on the stool biomarker fecal calprotectin (fc). fc directly reflects the intestinal inflammation status of a patient, and can aid in interpreting th ...201727834066
evaluation of the xtag gastrointestinal pathogen panel assay for the detection of enteric pathogens in kuwait.to evaluate the utility of the luminex xtag gastrointestinal pathogen panel (gpp) assay in the detection of enteric pathogens from diarrheal stool samples in kuwait.201727322647
clinical characteristics of clostridium difficile-associated diarrhea among patients in a tertiary care center in china.this study investigated the incidence, risk factors, and clinical characteristics of clostridium difficile-associated diarrhea (cdad) in chinese patients.201727375724
extended-spectrum β-lactam resistance in the enteric flora of patients at a tertiary care medical centre.the dissemination of enterobacteriaceae expressing resistance to extended-spectrum cephalosporins, which are therapeutically used in both human and veterinary medicine, is of critical concern. the normal commensal flora of food animals may serve as an important reservoir for the zoonotic food-borne transmission of enterobacteriaceae harbouring β-lactam resistance. we hypothesized that the predominant ampc and esbl genes reported in us livestock and fresh retail meat products, blacmy-2 and blactx ...201727486061
towards an automated analysis of bacterial peptidoglycan structure.peptidoglycan (pg) is an essential component of the bacterial cell envelope. this macromolecule consists of glycan chains alternating n-acetylglucosamine and n-acetylmuramic acid, cross-linked by short peptides containing nonstandard amino acids. structural analysis of pg usually involves enzymatic digestion of glycan strands and separation of disaccharide peptides by reversed-phase hplc followed by collection of individual peaks for maldi-tof and/or tandem mass spectrometry. here, we report a n ...201727520322
analysis of risk factors and clinical manifestations associated with clostridium difficile disease in serbian hospitalized patients.clostridium difficile is the leading cause of infectious diarrhoea in hospitalized patients. the aim of this study was to determine the risk factors important for the development of hospital-acquired clostridium difficile-associated disease and clinical manifestations of clostridium difficile-associated disease. the clinical trial group included 37 hospitalized patients who were selected according to the inclusion criteria. a control group of 74 hospitalized patients was individually matched wit ...201727528082
a phenotypically silent vanb2 operon carried on a tn1549-like element in clostridium difficile.in the last decade, clostridium difficile infection (cdi) has reached an epidemic state with increasing incidence and severity in both health care and community settings. vancomycin is an important first-line therapy for cdi, and the emergence of resistance would have significant clinical consequences. in this study, we describe for the first time a vanb2 vancomycin resistance operon in c. difficile, isolated from an australian veal calf at slaughter. the operon was carried on an ~42-kb element ...201727536735
antimicrobial susceptibility of brazilian clostridium difficile strains determined by agar dilution and disk diffusion.clostridium difficile is a leading cause of diarrhea in hospitalized patients worldwide. while metronidazole and vancomycin are the most prescribed antibiotics for the treatment of this infection, teicoplanin, tigecycline and nitazoxanide are alternatives drugs. knowledge on the antibiotic susceptibility profiles is a basic step to differentiate recurrence from treatment failure due to antimicrobial resistance. because c. difficile antimicrobial susceptibility is largely unknown in brazil, we ai ...201727542867
diagnosis and outcome of clostridium difficile infection by toxin enzyme immunoassay and polymerase chain reaction in an island population.clostridium difficile infection (cdi) is a potentially life-threatening cause of diarrhea. correct laboratory diagnosis is essential to differentiate cdi from other causes of diarrhea. a positive fecal c. difficile toxin (cdt) is the best indicator of cdi, but the significance of a positive fecal nucleic acid amplification test (naat) remains unclear. our aim was to elucidate the significance of cdi diagnostics in patients in jersey.201727505006
mathematical modeling of the transmission dynamics of clostridium difficile infection and colonization in healthcare settings: a systematic review.we conducted a systematic review of mathematical models of transmission dynamic of clostridium difficile infection (cdi) in healthcare settings, to provide an overview of existing models and their assessment of different cdi control strategies.201727690247
short- and long-term effects of oral vancomycin on the human intestinal microbiota.oral vancomycin remains the mainstay of therapy for severe infections produced by clostridium difficile, the most prevalent cause of healthcare-associated infectious diarrhoea in developed countries. however, its short- and long-term effects on the human intestinal microbiota remain largely unknown.201727707993
impact of ultraviolet germicidal irradiation for no-touch terminal room disinfection on clostridium difficile infection incidence among hematology-oncology patients.objective to evaluate the impact of no-touch terminal room no-touch disinfection using ultraviolet wavelength c germicidal irradiation (uvgi) on c. difficile infection (cdi) rates on inpatient units with persistently high rates of cdi despite infection control measures. design interrupted time-series analysis with a comparison arm. setting 3 adult hematology-oncology units in a large, tertiary-care hospital. methods we conducted a 12-month prospective valuation of uvgi. rooms of patients with cd ...201727707423
the efficacy of fidaxomicin in the treatment of clostridium difficile infection in a real-world clinical setting: a spanish multi-centre retrospective cohort.the objective of this study was to evaluate the efficacy and safety of fidaxomicin in the real-life clinical setting. this was a retrospective cohort of patients with clostridium difficile infection (cdi) treated with fidaxomicin in 20 spanish hospitals between july 2013 and july 2014. clinical cure, 30-day recurrence, 30-day mortality, sustained cure, and factors associated with the failure to achieve sustained cure were analyzed. of the 72 patients in the cohort 41 (56.9 %) had a fatal underly ...201727718071
clostridium difficile infection in dialysis patients.clostridium difficile infection (cdi) is the most common cause of nosocomial diarrhea. patients with end-stage renal disease (esrd) may be at increased risk for cdi. patients with esrd with cdi have increased mortality, longer length of stay, and higher costs. the present studies extend these observations and address associated comorbidities, incidence of recurrence, and risk factors for mortality. we queried the united states renal data system (usrds) for patients with esrd diagnosed with cdi, ...201727737913
utilization of health services among adults with recurrent clostridium difficile infection: a 12-year population-based study.background considerable efforts have been dedicated to developing strategies to prevent and treat recurrent clostridium difficile infection (rcdi); however, evidence of the impact of rcdi on patient healthcare utilization and outcomes is limited. objective to compare healthcare utilization and 1-year mortality among adults who had rcdi, nonrecurrent cdi, or no cdi. methods we performed a nested case-control study among adult kaiser foundation health plan members from september 1, 2001, through d ...201727760583
an antimicrobial stewardship program based on systematic infectious disease consultation in a rehabilitation facility.objective to assess the impact of an antimicrobial stewardship program (asp) on antibiotic consumption, clostridium difficile infections (cdi), and antimicrobial resistance patterns in a rehabilitation hospital. design quasi-experimental study of the periods before (from january 2011 to june 2012) and after (from july 2012 to december 2014) asp implementation. setting 150-bed rehabilitation hospital dedicated to patients with spinal-cord injuries. intervention beginning in july 2012, an asp was ...201727745559
failure of risk-adjustment by test method for c. difficile laboratory-identified event reporting.using an algorithm including both enzyme immunoassay (eia) and nucleic acid amplification (naat) for clostridium difficile infection (cdi) diagnosis, we found that the use of naat versus eia almost doubled our hospital-onset cdi laboratory-identified (labid) event standardized infection ratio (sir). we recommend that the current risk adjustment approach be modified. infect control hosp epidemiol 2016:1-3.201727745553
fear of failure: engaging patients in antimicrobial stewardship after fecal transplantation for recurrent clostridium difficile infection. 201727766987
determining the cause of recurrent clostridium difficile infection using whole genome sequencing.understanding the contribution of relapse and reinfection to recurrent clostridium difficile infection (cdi) has implications for therapy and infection prevention, respectively. we used whole genome sequencing to determine the relation of c. difficile strains isolated from patients with recurrent cdi at an academic medical center in the united states. thirty-five toxigenic c. difficile isolates from 16 patients with 19 recurrent cdi episodes with median time of 53.5days (range, 13-362) between e ...201727771207
asymptomatic clostridium difficile colonization in two australian tertiary hospitals, 2012-2014: prospective, repeated cross-sectional study.to investigate the prevalence and risk factors for asymptomatic toxigenic (tcd) and nontoxigenic clostridium difficile (ntcd) colonization in a broad cross section of the general hospital population over a 3-year period.201727615716
a descriptive case study of the changing nature of nurses' work: the impact of managing infectious diseases requiring isolation.methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococci, and clostridium difficile have increased in health care facilities worldwide. the complexity of caring for patients with infectious comorbidities has impacted nurses' daily work. a mixed-methods study at 1 community hospital in ontario, canada, demonstrated the cumulative effect of additional time spent on infection prevention and control measures resulted in trade-offs, cutting corners, and raised concerns about the ...201727776824
clostridium difficile infection due to pneumonia treatment: mortality risk models.one of the most common gastrointestinal infection after the antibiotic treatment of community or nosocomial pneumonia is caused by the anaerobic spore clostridium difficile (c. difficile). the aim of this study was to retrospectively assess mortality due to c. difficile infection (cdi) in patients treated for pneumonia. we identified 94 cases of post-pneumonia cdi out of the 217 patients with cdi. the mortality issue was addressed by creating a mortality risk models using logistic regression and ...201727815923
dissemination of clostridium difficile in food and the environment: significant sources of c. difficile community-acquired infection?clostridium difficile is a significant pathogen with over 300 000 cases reported in north america annually. previously, it was thought that c. difficile was primarily a clinically associated infection. however, through the use of whole genome sequencing it has been revealed that the majority of cases are community acquired. the source of community-acquired c. difficile infections (cdi) is open to debate with foodborne being one route considered. clostridium difficile fits the criteria of a foodb ...201727813268
Refresh
firstprev
...121122
nextlast
Displaying items 12001 - 12100 of 12134