Publications

clostridium difficile after antibiotic therapy.		1994	8068383
possible red-man syndrome associated with systemic absorption of oral vancomycin in a child with normal renal function.	to report possible red-man syndrome (rms) associated with oral administration of vancomycin.	1994	8068993
periprosthetic clostridium difficile hip abscess imaged with in-111 wbcs.	during a prolonged hospital stay, left hip pain developed in a woman with sickle cell disease and bilateral hip prostheses. in-111 labeled wbc scintigraphy supplemented by tc-99m sc bone marrow imaging demonstrated abnormal wbc accumulation surrounding the left greater trochanter. results of surgical exploration showed an abscess involving the pseudocapsule, trochanteric bursa, and periprosthetic cement column. cultures grew clostridium difficile, an unusual pathogen in this site.	1994	7805316
evaluation of an oligonucleotide probe and an immunological test for direct detection of toxigenic clostridium difficile in stool samples.	a 33 basepair oligonucleotide probe, designed from the sequence of the clostridium difficile toxin b gene, was evaluated for its ability to detect toxigenic clostridium difficile directly in stool samples, without culture or dna isolation. two different labelling techniques were investigated: radiolabelling and digoxigenin-labelling. one hundred ninety-six stools were tested, with a good correlation (96%) obtained between the oligonucleotide probe and the gold standard, the cytotoxicity tissue c ...	1994	7805686
application of typing by pulsed-field gel electrophoresis to the study of clostridium difficile in a neonatal intensive care unit.	pulsed-field gel electrophoresis (pfge) analysis of restriction pattern polymorphism was applied to type clostridium difficile isolated from neonates hospitalized in a neonatal intensive care unit, and the results were compared with those of immunoblot analysis. c. difficile was isolated from fecal specimens of 41 (61%) of 67 neonates during a 5-month investigation. all of these neonates were asymptomatic. fifty-five c. difficile isolates from 32 patients were analyzed by pfge after digestion wi ...	1994	7814526
intestinal microflora in colicky and noncolicky infants: bacterial cultures and gas-liquid chromatography.	to find out whether intestinal microflora in colicky infants is different from that in noncolicky controls, stool samples were collected from colicky infants during colic (n = 55) and at the age of 3 months (n = 46) and compared with samples from age-matched controls (n = 49 and n = 45, respectively). the samples were cultured on several selective and unselective aerobic and anaerobic culture agars, and gas-liquid chromatography of bacterial cellular fatty acids was used to produce fatty-acid pr ...	1994	7815263
saccharomyces boulardii enhances rat intestinal enzyme expression by endoluminal release of polyamines.	saccharomyces boulardii is a yeast widely used in humans for the prevention and treatment of infectious enteritis and clostridium difficile-associated enterocolopathies. after oral administration to human volunteers or growing rats, s. boulardii enhances markedly the expression of intestinal enzymes as well as the production of the polymeric immunoglobulin receptor by mechanisms that remain unknown. we have analyzed the role of the yeast polyamines as potential mediators in the intestinal trophi ...	1994	7816529
[antibiotics-associated colitis--clostridium difficile colitis].		1994	7736018
specific detection of clostridium difficile toxin a gene sequences in clinical isolates.	the polymerase chain reaction (pcr) was used to specifically detect toxin a gene sequences of clostridium difficile in dna isolated from human faeces. a set of oligonucleotide primers derived from the non-repetitive region of the toxin a gene was developed to amplify a 634-bp dna fragment. all 28 cytotoxic strains of c. difficile, previously characterized by a toxin b-pcr assay, were positive for the presence of toxin a gene sequences. no amplification products were obtained from dnas extracted ...	1994	7700267
pneumatosis intestinalis in a child with aids and pseudomembranous colitis.	pneumatosis intestinalis (pi) was first reported in three children and one adult with acquired immune deficiency syndrome (aids) in 1990. the microorganisms cultured from these patients included cryptosporidium, rotavirus, cytomegalovirus, and pseudomonas. we report the fourth child with aids and pi, and the first with pi to be associated with clostridium difficile colitis.	1994	7724293
clostridium sordellii cytotoxin induces phosphorylation of an 80,000 mol. wt protein in mccoy cultured cells.	the cytotoxins from clostridium difficile (toxin b) and clostridium sordellii (toxin l) induce rounding of cultured cells. the cellular effects induced by these two cytotoxins are clearly distinct, suggesting that both toxins use a similar, but not identical mechanism for cell intoxication. we have employed the technique of two-dimensional page for the separation of 32p-labelled cell lysates of mccoy cultured cells to investigate changes in the phosphorylation status of cellular proteins after t ...	1994	7725327
use of arbitrary primer pcr to type clostridium difficile and comparison of results with those by immunoblot typing.	an arbitrarily primed pcr (ap-pcr) assay was used to type clostridium difficile isolates from a hospital outbreak of antibiotic-associated diarrhea. forty-one isolates were separated into nine groups, with 66% falling into one group; no other group contained more than 10%. comparison of ap-pcr grouping with that when the immunoblot technique was used showed agreement for 33 of 34 isolates typed by both techniques, and ap-pcr grouped seven isolates that were not typeable by immunoblotting.	1994	7741841
tox-a test for clostridium difficile.		1994	7695729
rectal use of vancomycin.		1994	7696727
diarrheal disease. established pathogens, new pathogens, and progress in vaccine development.	although much progress has been made in reducing the morbidity and mortality of infectious diarrhea through the use of oral rehydration, progress in preventive measures, such as vaccine development, has been slow. despite the plethora of candidate vaccines developed, there has not been an effective vaccine ready for general use, particularly in developing countries, during the past decade, perhaps in part because of the as-yet-undefined pathophysiology of many of these pathogens, as well as the ...	1994	7698825
cp-96,345, a substance p antagonist, inhibits rat intestinal responses to clostridium difficile toxin a but not cholera toxin.	toxin a from clostridium difficile mediates acute inflammatory enterocolitis in experimental animals, while cholera toxin causes noninflammatory secretory diarrhea. the purpose of this study was to investigate whether an antagonist to the peptide substance p, a constituent of primary sensory neurons known to participate in inflammatory responses, would inhibit toxin a-mediated enteritis in the rat ileum. pretreatment of rats with cp-96,345 (2.5 mg per kg of body weight), a substance p antagonist ...	1994	7508124
[sequelae of prolonged consumption of honey in excessive amounts].	a case of a 46-year patient with honey poisoning is presented. it is worth mentioning that honey eaten for a long time may produce severe pathologies. honey in the south-eastern poland, where the patient lives, contains not only water, sugars such as sucrose, glucose and fructose, dextrins, and nitrogen compounds but also low levels of antibiotics and sulphonamides, used as prophylaxis against honey-bee diseases, heavy metals ions, and various bacteria.	1994	7675708
ten years of prospective clostridium difficile-associated disease surveillance and treatment at the minneapolis va medical center, 1982-1991.	to understand the epidemiology, risks, and management of clostridium difficile-associated disease (cdad) and to establish and evaluate reliable methods of surveillance.	1994	7632199
evaluation of a commercial latex agglutination assay for screening for clostridium difficile-associated disease.	to determine if the clostridium difficile latex agglutination assay is an effective screening procedure for the diagnosis of c. difficile-associated disease (cdad).	1994	10150387
how to identify the cause of antibiotic-associated diarrhea.	most cases of antibiotic-associated diarrhea are due to clostridium difficile or are of enigmatic etiology. the antibiotics most often implicated are clindamycin, ampicillin or amoxicillin, and the cephalosporins. clinical signs of antibiotic-associated diarrhea may be limited to watery stools; however, evidence of colitis (fever, cramps, leukocytosis, fecal leukocytes) suggests c. difficile infection. the tissue culture assay for c. difficile toxin remains the gold standard for diagnosis, but t ...	1994	10150699
improved linen handling cuts risks, ups efficiency.		1994	10131501
genotyping of clostridium difficile isolates.		1994	7533782
drug risk factors associated with a sustained outbreak of clostridium difficile diarrhea in a teaching hospital.	a case-control study was undertaken to identify and quantify antimicrobial and nonantimicrobial drug risk factors associated with a sustained outbreak of clostridium difficile diarrhea on two medical (teaching and nonteaching) units and an oncology unit. in total, 80 cases associated with an endemic clone of toxigenic c difficile were compared with controls. eighty controls were selected from a group of 290 controls randomly chosen from the outbreak period. the controls were matched to cases acc ...	1994	22346513
comparison of culture, cytotoxin assay and two eia tests with clinical diagnosis of clostridium difficile-associated diarrhea.	the most common etiology of infectious diarrhea in hospitalized patients is clostridium difficile. no single laboratory test yields a definitive diagnosis. four methods were evaluated for their sensitivity and specificity in patients who had clinically defined c difficile-associated diarrhea.	1994	22346495
gamma globulin administration in relapsing clostridium difficile-induced pseudomembranous colitis with a defective antibody response to toxin a.	a 53-year-old woman suffered six episodes of clostridium difficile-pseudomembranous colitis. the serological follow-up demonstrated the absence of a rise in igg and iga to toxin a. human pooled gamma globulin was administered during the fifth relapse and raised igg levels to toxin a. normal stools reappeared a week later. the role of the antibodies to toxin a and gamma globulin in c. difficile colitis are discussed.	1995	7537003
role of platelet activating factor in the inflammatory and secretory effects of clostridium difficile toxin a.	clostridium difficile is a major recognized cause of antibiotic-associated diarrhea, an effect mediated through its toxin a. toxin a has been reported to disrupt epithelial tight junctions, attract neutrophils, and cause striking intestinal inflammation and secretion. having demonstrated that phospholipase a2 inhibitors block the secretory effects of toxin a, we next wished to examine whether platelet activating factor (paf) was involved in either the direct epithelial or secretory effects of to ...	1995	7540097
update on diagnosis of clostridium difficile-associated diarrhea.		1995	7546376
bacteremia due to clostridium difficile: case report and review of extraintestinal c. difficile infections.	we report the case of an 85-year-old woman who developed diarrhea and bacteremia caused by clostridium difficile after a prolonged hospitalization. c. difficile is a major cause of antibiotic-associated diarrhea but only rarely has been reported to cause extraintestinal infection. isolation of c. difficile from a wide range of specimens outside the intestinal tract has been reported and is not always associated with diarrhea or intestinal pathology.	1995	7548512
diarrhea associated with parenteral vancomycin therapy.		1995	7548526
baker's yeast as adjunctive therapy for relapses of clostridium difficile diarrhea.		1995	7548528
use of fatty acid analysis (microbial identification system) for the identification of clostridium difficile.		1995	7548552
clostridial disease of the gut.	clostridia are an important cause of morbidity and mortality in humans and animals. some of the most common clostridial infections are those of the gut. the primary infections in humans are clostridium perfringens food poisoning and clostridium difficile-mediated antibiotic-associated diarrhea and colitis. less common but important infections include non-food poisoning c. perfringens nosocomial diarrhea and c. perfringens type c necrotizing jejunitis (pig-bel). c. perfringens is also the dominan ...	1995	7548565
prevalence of clostridium difficile among healthy chilean infants: evaluation by commercial enzyme immunoassay versus standard cytotoxin assay.		1995	7548568
isolation of clostridium difficile at a university hospital: a two-year study.		1995	7548569
community-acquired clostridium difficile-associated diarrhea.		1995	7548570
recurrent clostridium difficile infection in a patient with selective igg1 deficiency treated with intravenous immune globulin and saccharomyces boulardii.		1995	7548571
an international study on the unification of nomenclature for typing clostridium difficile.		1995	7548587
sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of edta-extracted cell-surface protein antigens is a simple and reproducible method for typing clostridium difficile.		1995	7548588
correlation of pyrolysis mass spectrometry and outer membrane protein profiles of clostridium difficile.		1995	7548589
[diarrhea associated with antibiotics and disease caused by clostridium difficile].		1995	7548675
toxic megacolon complicating pseudomembranous enterocolitis.	toxic megacolon is a rare complication of pseudomembranous enterocolitis. we reviewed our recent experience with this complication.	1995	7555415
escherichia coli cytotoxic necrotizing factor 1: evidence for induction of actin assembly by constitutive activation of the p21 rho gtpase.	cytotoxic necrotizing factor type 1 (cnf1) induces in hep-2 cells an increase in f-actin structures, which was detectable by fluorescence-activated cell sorter analysis 24 h after addition of this factor to the culture medium. increase in f-actin was correlated with the augmentation of both the cell volume and the total cell actin content. actin assembly-disassembly is controlled by small gtp-binding proteins of the rho family, which have been reported recently to be modified by cnf1 treatment. ...	1995	7558302
transient expression of rhoa, -b, and -c gtpases in hela cells potentiates resistance to clostridium difficile toxins a and b but not to clostridium sordellii lethal toxin.	the bacterial pathogen clostridium difficle synthesizes two high-molecular-weight toxins (a and b), which exhibit toxic effects in vivo and in vitro. here, we present evidence that the major intracellular targets of these two toxins are the rho gtpases. overexpression of rhoa, rhob, or rhoc gtpases in transfected hela cells conferred an increased resistance to toxins a and b, indicating that these toxins cause their cytopathic effects primarily by affecting rho proteins. in addition, toxin a and ...	1995	7558320
pcr ribotyping and arbitrarily primed pcr for typing strains of clostridium difficile from a polish maternity hospital.	detection of the source of clostridium difficile strains is of importance for the control of the nosocomial spread of this microorganism. for this purpose, vaginal and rectal swabs from 183 mothers, duplicate fecal samples (taken on days 1 and 4 after birth) from 183 neonates, and 94 environmental samples were cultured for c. difficile. the microorganism was never detected in the meconium obtained on day 1 after birth. on the other hand, an incidence of 17% c. difficile positivity was noted in t ...	1995	7559940
antineoplastic-associated colitis in chulalongkorn university hospital.	clostridium difficile is well known for causing pseudomembranous colitis. most cases are associated with the use of antimicrobial agents. non-antibiotic associated colitis has rarely been reported. the causes of colitis are related to dietary changes, anesthesia, uremia, and various non-antibiotics medications, especially antineoplastic agents. most responsible antineoplastics in previous reports are methotrexate and 5fu. from july 1993 to august 1994, 34 cancer patients developed acute diarrhea ...	1995	7561566
ciprofloxacin-associated clostridium difficile disease.		1995	7564771
a binding site for activation by the bacillus subtilis ahrc protein, a repressor/activator of arginine metabolism.	in bacillus subtilis, the ahrc protein represses genes encoding enzymes of arginine biosynthesis and activates those mediating its catabolism. to determine how this repressor also functions as an activator, we attempted to clone catabolic genes by searching for insertions of the tn917-lacz transposon that express ahrc-dependent, arginine-inducible beta-galactosidase activity. one such isolate was obtained. the region upstream of lacz was subcloned in escherichia coli in such a way that it could ...	1995	7565595
role of clostridium difficile in childhood diarrhea.	to investigate the etiologic role of clostridium difficile in childhood acute diarrhea, stool specimens from 618 children with diarrhea and 135 controls without enteric symptoms were examined by cell culture assay for the presence of free toxin b. this toxin was found in 4.2% of the fecal specimens examined without finding a significant difference between cases and controls, suggesting no causal relationship between diarrhea and the presence of free c. difficile toxin b. c. difficile strains iso ...	1995	7567289
[presence of campylobacter spp., clostridium difficile, c. perfringens and salmonellae in litters of puppies and in adult dogs in a shelter].	in order to ascertain the importance of campylobacter spp., c.difficile, c.perfringens and salmonella as agents of bacterial gastroenteritis in dogs, two groups of animals were studied prospectively. the first group consisted of 77 puppies in 14 litters, with fecal cultures performed weekly for 10 weeks, starting at birth. the second group consisted of a kennel population with every dog cultured at entry, and at two-month intervals thereafter. incidence of campylobacter spp. was 32 and 31 per 10 ...	1995	7569838
apparent outbreaks of clostridium difficile-associated diarrhea in horses in a veterinary medical teaching hospital.	intestinal colonization with toxigenic strains of clostridium difficile was documented in 9 of 10 horses with acute onset diarrhea in a veterinary medical teaching hospital, whereas a similar isolate was detected in only 1 of 23 other horses without diarrhea in the hospital. one horse with diarrhea was infected simultaneously with both c. difficile and salmonella krefeld. clostridium difficile was detected by fecal culture on selective medium, confirmed with a latex particle agglutination test, ...	1995	7578449
antibiotic-induced diarrhoea.		1995	7587988
chronic septic arthritis and osteomyelitis in a prosthetic knee joint due to clostridium difficile.	a case of chronic septic arthritis and osteomyelitis in a prosthetic knee joint due to clostridium difficile is reported. a knee prosthesis was installed in a 16-year-old boy for surgical treatment of an osteosarcoma of the femur. later, the patient suffered a traumatic closed fracture of his patella, and a sterile fluid was aspirated. one month later, the joint displayed inflammation. culture of the articular fluid yielded a nontoxigenic clostridium difficile strain. despite several attempts us ...	1995	7588845
[pseudomembranous colitis probably caused by clostridium difficile: first case appeared during preventive treatment of infection of ascitic fluid with norfloxacin].		1995	7590012
evaluation of formalin-inactivated clostridium difficile vaccines administered by parenteral and mucosal routes of immunization in hamsters.	clostridium difficile produces toxins that cause inflammation, necrosis, and fluid in the intestine and is the most important cause of nosocomial antibiotic-associated diarrhea and colitis. we evaluated c. difficile antigens as vaccines to protect against systemic and intestinal disease in a hamster model of clindamycin colitis. formalin-inactivated culture filtrates from a highly toxigenic strain were administered by mucosal routes (intranasal, intragastric, and rectal) with cholera toxin as a ...	1995	7591115
clostridium difficile-associated diarrhea and colitis.	objectives: to review and summarize the status of diagnosis, epidemiology, infection control, and treatment of clostridium difficile-associated disease (cdad). diagnosis: a case definition of cdad should include the presence of symptoms (usually diarrhea) and at least one of the following positive tests: endoscopy revealing pseudomembranes, stool cytotoxicity test for toxin b, stool enzyme immunoassay for toxin a or b, or stool culture for c difficile (preferably with confirmation of organism to ...	1995	7594392
treatment of clostridium difficile colitis. summary of a round table held in brussels on march, 3rd, 1994.	due to the growing incidence and the severity of infections due to vancomycin resistant enterococci, it is now recommended to treat mild to moderate cases of clostridium difficile-associated diarrhoea with metronidazole while maintaining the use of oral vancomycin in serious or life-threatening colitis. clostridium difficile is a common cause of diarrhoea after antibiotic therapy and induces a spectrum of diseases ranging from mild diarrhoea to pseudomembranous colitis (pmc). it is considered to ...	1995	7597874
evaluation of gas-liquid chromatography (glc) for rapid detection of clostridium difficile in fecal specimens.	clostridium difficile intestinal infection is a major nosocomial hazard in patients receiving antimicrobial therapy. rationale for rapid diagnosis include lifesaving antimicrobial therapy in patients with severe colitis and early isolation measures for transmission control. we have therefore analysed the sensitivity, specificity and predictive value of glc identification of isocaproic acid in diarrheic stools from adult hospitalized patients in comparison with selective fecal culture on cycloser ...	1995	7597879
[5 cases of clostridium difficile enteritis in infants].	we encountered 5 cases of clostridium difficile enteritis that is rate in infancy. its clinical symptoms consisted mainly of diarrhea, fever and vomiting. also progressive abdominal enlargement was characteristically noted. hematological examination revealed an increase in the number of leukocytes predominant with granulocytes in addition to accelerated erythrocyte sedimentation rate, an increase in alpha 2 globulin value and high ldh. on the bacteriological examination, detecting bacteria was d ...	1995	7602196
clostridium difficile infection in hamsters fed an atherogenic diet.	diarrhea and unexpected death were encountered in a group of young syrian hamsters (mesocricetus auratus) used for hyperlipoproteinemia and atherosclerosis research. the animals were fed an atherogenic diet containing 18% saturated fat and 0.366% cholesterol. mortality began 45 days after hamsters were placed on this atherogenic diet. the atherogenic studies were aborted at 74 days because of high mortality. toxigenic clostridium difficile was isolated from animals found dead or euthanatized bec ...	1995	7604493
usefulness of culture in the diagnosis of clostridium difficile infection.	between january and april 1993, culture for clostridium difficile and a faecal cytotoxin assay were performed on 500 selected specimens. isolates from culture-positive patients from whom faecal samples were cytotoxin negative were also examined in vitro for cytotoxin production. the significance of a positive culture result in the absence of faecal cytotoxin was assessed. forty-one of the 500 specimens were toxin positive. in only 25 of these was clostridium difficile examination specifically re ...	1995	7614964
effects of purified clostridium difficile toxin a on rabbit distal colon.	antibiotic-associated pseudomembranous colitis in humans is caused by proliferation of clostridium difficile, which elaborates an enterotoxin toxin a that causes epithelial damage and altered motility in rabbit small intestine. the aim of this study was to assess the effects of toxin a on rabbit distal colonic motility and to relate this to histological damage and inflammatory mediator production.	1995	7615182
trefoil peptide protection of intestinal epithelial barrier function: cooperative interaction with mucin glycoprotein.	goblet cells secrete a combination of trefoil peptides and mucin glycoproteins to form a continuous gel on the mucosal surface. the functional effects of these products remain uncertain.	1995	7615201
sequencing and analysis of the gene encoding the alpha-toxin of clostridium novyi proves its homology to toxins a and b of clostridium difficile.	a library of total clostridium novyi dna was established and screened for the alpha-toxin gene (tcn alpha) by hybridization with oligonucleotides derived from a partial n-terminal sequence and by using specific antisera. overlapping subgenic tcn alpha fragments were isolated and subsequently the total sequence of tcn alpha was determined. the 6534 nucleotide open reading frame encodes a polypeptide of m(r) 250,166 and pi 5.9. the n-terminal alpha-toxin (tcn alpha) sequence mlitreqlmkiasip determ ...	1995	7616958
treatment of clostridium difficile infection.		1995	7616972
photo quiz. fulminant clostridium difficile colitis with intramural gas.		1995	7619993
selective neutralization of a bacterial enterotoxin by serum immunoglobulin a in response to mucosal disease.	one-third of convalescent-phase serum samples (6 of 18) from patients with clostridium difficle-associated diarrhea demonstrated neutralization of the clostridial enterotoxin, toxin a. although appreciable amounts of toxin a-specific immunoglobulin g (igg) and iga were present in these sera, the ability to neutralize the cytotoxic activity of toxin a on otf9-63 cells in vitro was confined to the iga fraction and the iga1 subclass in serum samples from all six patients. in contrast to the patient ...	1995	7622244
[fecal flora in infants at the beginning and the end of hospitalization].	the feces of 52 children without diarrhea, aged from 5 days to 22 months, treated in the department for various causes was investigated for the presence of that might be the cause of infectious diarrhea. samples were taken at the beginning and the end of hospitalization. the results were analyzed with reference to 5 age subgroups (1 month, 2-3 months, 4-6 months, 7-12 months, 12-22 months) and duration of hospitalization (3-42 days). the presence of potentially pathogenic bacteria in the feces w ...	1995	7624168
fibronectin and laminin binding of eighteen clostridium species.	the ability of clostridium difficile, clostridium perfringens, clostridium sporogenes and fifteen other clostridium species to bind to human serum fibronectin or laminin was tested by using protein-coated latex particles. three groups of clostridium species were formed, namely the pseudomembranous colitis-causing species clostridium difficile, the gas gangrene-causing clostridium species and other clostridium species, which are infrequently found in human infections. significantly more strains o ...	1995	9810669
cloning and characterization of the cytotoxin l-encoding gene of clostridium sordellii: homology with clostridium difficile cytotoxin b.	hybridization of an oligodeoxyribonucleotide (oligo) probe, designed from a repeated sequence ('oligo rep') at the c terminus of the clostridium difficile (cd) cytotoxin (cyt), revealed that homologies exist between the cd cyt gene and the genomes of several other clostridia, including clostridium sordellii (cs), suggesting a common ancestral cyt amongst the clostridium genus. this cd 'oligo rep' probe was used to clone the cs (strain 6018) cyt. the sequenced (7095 bp) region encodes 2364 amino ...	1995	7642137
value of routine stool cultures in hospitalized patients with diarrhea.	in a prospective study conducted over a six-month period, the relative yield of 721 routine cultures of stool from adult inpatients as a function of the time after hospital admission was assessed. salmonella, campylobacter, shigella or yersinia spp. were recovered from 10.9% (41/377) of patients within three days of hospitalization and from only 1.5% (5/344) after three days. however, a review of these patients' charts did not suggest nosocomial transmission but rather a delay in stool collectio ...	1995	7649200
differentiation of clostridium difficile, clostridium bifermentans, clostridium sordellii, and clostridium perfringens from diarrheal stool by api zym and api lra oxidase test.	a simple, rapid and reliable outline for identification of clostridia isolates from human infections was developed. it consists of a combination of api zym and api lra oxidase tests. the enzymatic activities were performed with strains sub-cultured onto carbohydrate-free medium (columbia blood agar). fifty-five strains of clostridium difficile, c. bifermentans, c. sordellii, and c. perfringens from clinical specimens and eight reference standard strains representing different species of the same ...	1995	7651236
atypical clostridium difficile colitis in a heart transplant recipient.		1995	7654746
computed tomographic findings in pseudomembranous colitis: an important clue to the diagnosis.	computed tomography (ct) is increasingly used to evaluate abdominal diseases, including those of the colon. recent ct studies have documented colonic abnormalities in patients with pseudomembranous colitis; however, these findings are not widely appreciated by primary care physicians. over a 25-month period, we prospectively identified 13 patients who had proven pseudomembranous colitis evaluated by abdominal ct. the primary indications for ct were abdominal pain with or without fever in 9 patie ...	1995	7660210
is cardiorespiratory failure induced by bacterial toxins the cause of sudden infant death syndrome? studies with an animal model (the rabbit).	recent studies have implicated various toxigenic bacteria and their toxins in the aetiology of sudden infant death syndrome (sids). therefore the effect of six bacterial toxins on the cardiorespiratory system of the rabbit was studied as a model for sids. the toxins' effect on the heart rate, arterial blood pressure, and breathing of anaesthetized rabbits was determined and their action compared to that of endotoxin. intravenous injection of clostridium perfringens enterotoxin and alpha-toxin, s ...	1995	7660368
toxigenicity of clostridium difficile strains isolated in the surgical ward.	we report the use of the polymerase chain reaction (pcr) for the detection of toxigenic clostridium difficile strains. pcr was performed as described (mcmillin et al., 1991). the results obtained by pcr were compared with those of cytotoxicity assays and of the latex agglutination test. twenty seven strains cultured from stool specimens of patients and five strains isolated from hospital environment in a surgical ward were investigated. twenty five of 32 strains produced cytotoxin as shown on th ...	1995	7660857
surgical antibiotic prophylaxis and clostridium difficile toxin positivity.	to examine a possible relationship between prophylactic antibiotic therapy (pat) and the development of clostridium difficile toxin (cdt) positivity.	1995	7661686
concurrence of clostridium difficile toxin a enzyme-linked immunosorbent assay, fecal lactoferrin assay, and clinical criteria with c. difficile cytotoxin titer in two patient cohorts.	the accurate and sensitive diagnosis of clostridium difficile-related diarrhea, normally treated with vancomycin, has become increasingly important in light of the emergence of dangerous new strains of vancomycin-resistant enterococci. in order to improve the threshold for c. difficile diagnosis and treatment, a number of commonly used assays for the diagnosis of c. difficile diarrhea were examined. these included an enzyme-linked immunosorbent assay for c. difficile toxin a (toxa), a cho cell c ...	1995	7665642
acute gastroenteritis in three community-based nursing homes.	acute gastroenteritis is a cause of considerable morbidity and mortality in the elderly population. a prospective assessment of acute diarrhea in three community-based long-stay homes is described.	1995	7671026
the challenge of vancomycin-resistant enterococci: a clinical and epidemiologic study.	vancomycin-resistant enterococci have been recovered with increasing frequency from hospitalized patients. risk factors, mode of nosocomial transmission, extent of colonization in hospitalized patients, and treatment options for these organisms have not been completely delineated.	1995	7677262
pcr amplification of rrna intergenic spacer regions as a method for epidemiologic typing of clostridium difficile.	from january to march 1993, a suspected outbreak of antibiotic-associated diarrhea occurred on a pediatric oncology ward of the clinical center hospital at the national institutes of health. isolates of clostridium difficile obtained from six patients implicated in this outbreak were typed by both pcr amplification of rrna intergenic spacer regions (pcr ribotyping) and restriction endonuclease analysis of genomic dna. comparable results were obtained with both methods; five of the six patients w ...	1995	7699038
neurogenic inflammation in the intestine.		1995	7528698
treatment of recurrent clostridium difficile colitis with lactobacillus gg.		1995	7472911
[effects of azithromycin on fecal flora of healthy adult volunteers].	new macrolide antibiotic, azithromycin (azm), was administered to six healthy male volunteers and its effects on their intestinal microflora were investigated. each volunteer was given 500 mg of azm orally, once a day for 3 consecutive days. stool samples were obtained from them prior to the medication and 1, 7, 14 and 28 days after the third day the medication. a slight decrease in the total aerobic bacterial count was observed. also, several species of anaerobic bacteria showed slight decrease ...	1995	7474332
detection of clostridium difficile toxins from the small intestine and cecum of rabbits with naturally acquired enterotoxemia.	four specific-pathogen-free rabbits with anorexia died peracutely; decreased fecal output, nasal exudate, and labored breathing were the only other clinical abnormalities observed in two of the rabbits before death. the animals, three juveniles and one adult, were on a standard polyclonal antibody production regimen and had received immunizations approximately 2 weeks before presentation. external examination revealed distended abdomen and perineal fecal staining. at necropsy the small intestine ...	1995	7474876
wound botulism--california, 1995.	during january-november 1995, a total of 19 laboratory-confirmed cases of wound botulism were reported to the california department of health services (cdhs); of these, 13 had occurred since august. since 1990, the number of wound botulism cases reported annually in california has increased steadily (one case in 1990, two in 1991, three in 1992, four in 1993, and 11 in 1994). all cases except one since 1991 have occurred in injecting-drug users, and many involved subcutaneous injection or "skin ...	1995	7476845
[pseudomembranous colitis. personal experience].	the author summarizes experience with the treatment of five patients with pseudomembranous colitis. the diagnosis of this disease was outdated and only in the last two cases it was possible to use the latex agglutination test to assess the presence of clostridium difficile toxins. the patients were admitted to the clinic in a serious septic toxic condition and thus it proved possible to cure conservatively (using vancomycin) only one female patient. four patients were operated in a critical cond ...	1995	7482057
clostridium difficile colitis: an efficient clinical approach to diagnosis.	to define clinical and laboratory variables that suggest the presence of clostridium difficile colitis and to establish the number of stool specimens needed to reasonably exclude the diagnosis of c. difficile colitis.	1995	7486465
clostridium difficile colitis: recent therapeutical and immunological considerations.	clostridium difficile is the main etiological agent of antibiotic associated diarrhoea and pseudomembranous colitis (pmc). it is considered as the most frequent agent of infectious diarrhoea occurring in hospitalized patients, in whom it is responsible for a high morbidity and occasional mortality even when the diagnosis and the treatment are pursued aggressively (1). the pathology is due to the production of at least two toxins: toxin a is an enterotoxin which induces intestinal tissue damage a ...	1995	7491844
closing in on the toxic domain through analysis of a variant clostridium difficile cytotoxin b.	strain 1470 is the standard typing strain for serogroup f of clostridium difficile containing both toxin genes, toxa-1470 and toxb-1470. a polymerase chain reaction (pcr)-based approach to the sequencing of the total toxb-1470 gene identified an open reading frame (orf) of 7104 nucleotides. in comparison with the previously sequenced toxb of c. difficile vp10463, the toxb-1470 gene has 16 additional nucleotides, 13 within the 5'-untranslated region and three within the coding region. the m(r) of ...	1995	7494480
increased risk of diarrhoea caused by clostridium difficile in elderly patients receiving cefotaxime.		1995	7496287
clostridium difficile-associated diarrhoea in patients with human immunodeficiency virus infection: a case-control study.	to evaluate the prevalence of, risk factors for, treatment and outcome of clostridium difficile-associated diarrhoea (cdad) in patients with human immunodeficiency virus (hiv) infection.	1995	7743309
pseudomembranous colitis following clarithromycin therapy.	to describe the association of clarithromycin, used to treat helicobacter pylori infection and duodenal ulceration, with pseudomembranous colitis in two patients.	1995	7743311
clostridium difficile colitis: an increasing hospital-acquired illness.	colitis caused by clostridium difficile is receiving increased attention as a nosocomial hospital-acquired infection.	1995	7747823
the effect of du-6859a, a new potent fluoroquinolone, on fecal microflora in human volunteers.	following the oral administration of du-6859a to six healthy male volunteers at 100 mg per dose three times a day for seven consecutive days, the degree of disturbances of fecal microflora and fecal drug concentrations were examined. the total viable count decreased transiently during the administration due to changes in the number of members of the family bacteroidaceae, the most predominant organisms. the other obligate anaerobes and most aerobes including facultative anaerobes were suppressed ...	1995	7752450
in vivo and in vitro studies of clostridium difficile-induced disease in hamsters fed an atherogenic, high-fat diet.	after previous observation of increased susceptibility to clostridium difficile enterocolitis in hamsters fed an atherogenic, high-fat diet, a study was undertaken to examine experimental reproducibility of this disease. hamsters were fed either the high-fat diet or a control diet, then orally challenged with a toxigenic strain of c. difficile. hamsters fed the high-fat diet suffered 80% morbidity, which was statistically significant from the 11% morbidity of the control diet group (p < or = 0.0 ...	1995	7752614
clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis.		1995	7752793
severity and treatability of clostridium difficile infection in aids patients.		1995	7755799
transfer of macrolide-lincosamide-streptogramin b (mls) resistance in clostridium difficile is linked to a gene homologous with toxin a and is mediated by a conjugative transposon, tn5398.	an mls resistance gene designated ermbz, from a toxigenic clostridium difficile strain (630) could be transferred between c. difficile strains, and to and from bacillus subtilis. the intergeneric transfer occurred in the absence of any detectable plasmid dna and the element responsible for gene transfer entered the recipient's chromosome, behaviour which is characteristic of a conjugative transposon. the element was designated tn5398 and was found in six c. difficile strains. tn5398 could be tra ...	1995	7759394
cdad rates.		1995	7759818
antibiotic-induced diarrhea.	diarrhea is a common complication of antibiotic therapy and can range from mild soiling of a cast to severe and life-threatening pseudomembranous colitis. although clindamycin is the most notorious, almost all antibiotics, particularly penicillins and cephalosporins, may also be responsible (bartlett, 1992; kelly, pothoulakis, & lamont, 1994). because of the frequent use of these antibiotics in orthopaedic patients, antibiotic-associated enteric disease is a common problem in this population. ab ...	1995	7761131