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[clostridium difficile infection. the nosocomial aspect].clostridium difficile infection is discussed relatively rarely as a nosocomial problem in norway. epidemiological studies have shown clostridium difficile diarrhoea to be frequently an antibiotica-associated nosocomial disease. we describe a material consisting of 22 patients with clostridium difficile infection from a county hospital in norway. the inclusion criteria were a clinical disease with diarrhoea and a positive test for clostridium difficile toxin a and/or b in the faeces. 11 patients ...19957770832
clostridium difficile causing sepsis and an acute abdomen in critically ill patients. 19957774230
the enterotoxin from clostridium difficile (toxa) monoglucosylates the rho proteins.the enterotoxin from clostridium difficile (toxa) is one of the causative agents of the antibiotic-associated pseudomembranous colitis. in cultured monolayer cells toxa exhibits cytotoxic activity to induce disassembly of the actin cytoskeleton, which is accompanied by morphological changes. toxa-induced depolymerization of actin filaments is correlated with a decrease in the adp-ribosylation of the low molecular mass gtp-binding rho proteins (just, i., selzer, j., von eichel-streiber, c., and a ...19957775453
teicoplanin or vancomycin in the treatment of gram-positive infections?the glycopeptide antibiotics vancomycin and teicoplanin have similar mechanisms of action on bacterial cell wall synthesis. their spectra of activity are limited to gram-positive bacteria, with the degree of bactericidal activity depending on the species of micro-organism. staphylococcus aureus, staphylococcus epidermis, enterococci and clostridium difficile are generally sensitive, including methicillin-resistant strains of s. aureus and s. epidermidis. glycopeptide resistance has recently emer ...19957775615
antibiotic-associated hemorrhagic colitis without clostridium difficile toxin in children.we describe nine children with antibiotic-associated hemorrhagic colitis without clostridium difficile toxin. the onset was usually sudden, with severe hematochezia and abdominal cramps. the illness quickly resolved and required no specific treatment except discontinuation of the implicated antibiotic. early proctosigmoidoscopy was a useful diagnostic adjunct. it appears that antibiotic-associated hemorrhagic colitis is a distinct entity rather than a variant of antibiotic-associated colitis in ...19957776076
glucosylation of rho proteins by clostridium difficile toxin b.toxin a and b, the major virulence factors of clostridium difficile, are the causative agents of antibiotic-associated pseudomembranous colitis. in cultured cell lines their potent cytotoxicity results from their ability to induce disaggregation of the microfilament cytoskeleton. toxin b acts on the low-molecular-mass gtpase rhoa, which is involved in the regulation of the actin cytoskeleton. we report here that toxin b catalyses the incorporation of up to one mole of glucose per mole of rhoa at ...19957777059
diagnosis and management of clostridium difficile infection. 19957787544
diarrhea in the intensive care patient.approximately one third of patients admitted to the icu develop diarrhea during their hospitalization. diarrhea can lead to further complications, such as volume depletion and wound infection, and can significantly increase medical costs. the most common causative factors are medications, enteral feedings, and c. difficile infections. these may be implicated alone or in combination. further investigations of the pathophysiology of icu diarrhea as well as potential therapies are needed to clarify ...19957788541
diagnosis of cryptantigen exposure and polyagglutinability: management of transfusion therapy in a patient with sepsis and colitis. 19957793597
enhanced fermentation of mannitol and release of cytotoxin by clostridium difficile in alkaline culture media.clostridium difficile atcc 43255 fermented less than 10% of the mannitol in a medium at ph 7; however, when the initial ph of the medium was adjusted to 8.5 or 9, about 80% of the mannitol was fermented. cell extracts of c. difficile phosphorylated mannitol with phosphoenolpyruvate, not atp, indicating a phosphoenolpyruvate phosphotransferase system transport phosphorylation of mannitol. the phosphorylation product was dehydrogenated by d-mannitol-1-phosphate:nad oxidoreductase. growth at an ini ...19957793964
everninomicin, a new oligosaccharide antibiotic: its antimicrobial activity, post-antibiotic effect and synergistic bactericidal activity.antimicrobial activity of everninomicin (sch) 27899) in comparison with two glycopeptides (vancomycin, teicoplanin) and six beta-lactam agents was evaluated against recent clinical isolates of gram-positive bacteria. everninomicin showed the highest activity against the species tested and mics90% of everninomicin against streptococcus pneumoniae, streptococcus pyogenes, enterococcus faecalis, enterococcus faecium and clostridium difficile were 0.1, 0.1, 0.2, 0.39, 0.1 microgram/ml, respectively. ...19957796712
hexamethonium and secretory diarrhea. 19957797038
monotherapy for fever and neutropenia in cancer patients: a randomized comparison of ceftazidime versus imipenem.to compare the efficacy of ceftazidime and imipenem monotherapy for fever and neutropenia, and to determine whether fewer antimicrobial modifications (additions or changes) are required by the broader-spectrum agent, imipenem.19957799016
ciprofloxacin versus trimethoprim/sulfamethoxazole for prophylaxis of bacterial infections in bone marrow transplant recipients: a randomized, controlled trial.to compare the efficacy and safety of ciprofloxacin (cip) and trimethoprim/sulfamethoxazole (tms) for the prevention of bacterial infections in patients who received bone marrow transplantation (bmt) for the treatment of solid and hematopoietic neoplasms.19957799026
in vitro activity of bms-181139, a new carbapenem with potent antipseudomonal activity.the in vitro activities of the carbapenem bms-181139 were determined in comparison with those of imipenem, meropenem, ciprofloxacin, ceftriaxone, and vancomycin. bms-181139 was the most active against species of pseudomonas and related genera alteromonas and burkholderia, with mics for 147 of 149 isolates of < 4 micrograms/ml. of 22 imipenem-resistant (mic > 8 micrograms/ml) p. aeruginosa strains, only 1 required an mic of bms-181139 of > 4 micrograms/ml, compared with 14 requiring the same mero ...19957726502
elevated serum antibody response to toxin a following splenic abscess due to clostridium difficile.splenic abscess and segmental small-bowel infarction were documented in a patient from whose splenic culture clostridium difficile was isolated. a week and a half after splenectomy and partial bowel resection, diarrhea developed and stool cultures yielded an isolate of c. difficile that was identical to the abscess isolate when subjected to restriction endonuclease analysis. the level of igg antibody to toxin a was markedly higher in serum from this patient than in sera from patients with c. dif ...19957727643
diagnosis of clostridium difficile associated diarrhea: comparison of three rapid methods employing different markers for detection.latex agglutination and the enzyme immunoassays cytoclone (eia-c) and vidas (eia-v) were compared with a cytotoxicity assay for the diagnosis of clostridium difficile associated diarrhea. among patients with discrepant results, the cytotoxicity assay and clinical assessment were used to evaluate the performance of the latex agglutination and eia tests. clostridium difficile associated diarrhea was documented in 30/149 samples (20.1%) from 130 patients. all test results matched in 113 instances. ...19957728658
a defined growth medium for clostridium difficile.minimal requirements of amino acids and vitamins were determined in chemically defined medium for five strains of clostridium difficile. cysteine, isoleucine, leucine, proline, tryptophan and valine were essential amino acids for growth of c. difficile. arginine, glycine, histidine, methionine and threonine enhanced growth. biotin, pantothenate and pyridoxine were essential vitamins. a defined medium containing the minimal requirements of amino acids and vitamins produced a rapid and heavy growt ...19957704267
rectal prolapse in children associated with clostridium difficile infection. 19957716002
evaluation of the effects of a new water-jel system on specific bacterial and yeast strains in laboratory conditions.in three previous studies the water-jel (wj) system was found to protect burn wounds from microbial contamination, to have excellent analgesic and cooling effects when used as a first-aid dressing and to be bactericidal to 15 microorganisms including yeasts tested from the ostrava burn unit. now a new wj system has been introduced without povidone iodine. an extensive bacteriological laboratory evaluation of the new wj system showed quite clearly its excellent antimicrobial and antimycotic prope ...19957718119
colonic localization of labeled leukocytes in critically ill patients. scintigraphic detection of pseudomembranous colitis.this study assesses the causes of colonic localization of labeled white blood cells (wbcs) in critically ill patients who had undergone leukocyte scintigraphy for suspected infection. forty-two patients showed abdominal or pelvic wbc localization; 20 of these had a pattern of colonic localization, and some also showed a pattern of small bowel activity. eight of the 20 patients had documented gastrointestinal bleeding. white blood cell scintigraphy in these eight patients showed a pattern of mult ...19957720321
severe clostridium difficile colitis.reports of fatality related to clostridium difficile colitis and a sharp increase in prevalence of this infection prompted a study of patients who develop a more aggressive form of this disease.19957720439
clostridium difficile toxin b is more potent than toxin a in damaging human colonic epithelium in vitro.toxin a but not toxin b, appears to mediate intestinal damage in animal models of clostridium difficile enteritis. the purpose of this study was to investigate the electrophysiologic and morphologic effects of purified c. difficile toxins a and b on human colonic mucosa in ussing chambers. luminal exposure of tissues to 16-65 nm of toxin a and 0.2-29 nm of toxin b for 5 h caused dose-dependent epithelial damage. potential difference, short-circuit current and resistance decreased by 76, 58, and ...19957738167
clostridium difficile diarrhoea. 19957738343
immunoglobulin and non-immunoglobulin components of human milk inhibit clostridium difficile toxin a-receptor binding.clostridium difficile is isolated from the intestinal tracts of > 50% of healthy infants. the mechanism by which intestinal colonisation of infants by toxigenic c. difficile is generally asymptomatic is unknown but may reflect the presence in human milk of neutralising activity against c. difficile toxin a. on this basis, the ability of human milk to inhibit the binding of toxin a to a purified hamster brush border membrane receptor was determined. ten milk samples from healthy volunteers in var ...19957739018
investigation and management of clostridium difficile colonisation in a paediatric oncology unit.little is known about clostridium difficile infection in children with cancer but a presumed outbreak has previously been described. the carriage rate before admission to hospital and morbidity is reported to be high, especially in younger children. the prevalence of c difficile infection on a paediatric oncology ward was monitored from june 1991 to may 1992. twenty eight (13%) of 214 children were found to be infected. though the temporal distribution suggested an outbreak, polyacrylamide gel e ...19957741567
laboratory detection of clostridium difficile. a comparison of media and incubation systems.parallel testing for culture recovery of clostridium difficile was performed using three selective media in each of four anaerobic incubation environmental systems. testing was completed on 67 stool samples from 60 hospitalized patients in whom c difficile-associated diarrhea was suspected. three different media were evaluated: ccfa (modified cycloserine-cefoxitin-fructose agar), ccfa-pras (ccfa, prereduced-anaerobically-sterilized) and cmba (modified cycloserine-mannitol-blood agar). the incuba ...19957817945
the low molecular mass gtp-binding protein rho is affected by toxin a from clostridium difficile.enterotoxin a is one of the major virulence factors of clostridium difficile, and the causative agent of antibiotic-associated pseudomembranous colitis. in cell culture (nih-3t3, rat basophilic leukemia cells) toxin a inhibits clostridium botulinum adp-ribosyltransferase c3 (c3)-catalyzed adp-ribosylation of the low molecular mass gtp-binding rho proteins. rho participates in the regulation of the microfilament cytoskeleton. decrease in adp-ribosylation of rho occurs in a time- and concentration ...19957883950
reactive arthritis following clostridium difficile colitis. 19957863666
tracking the evolution of the bacterial choline-binding domain: molecular characterization of the clostridium acetobutylicum ncib 8052 cspa gene.the major secreted protein of clostridium acetobutylicum ncib 8052, a choline-containing strain, is cspa (clostridial secreted protein). it appears to be a 115,000-m(r) glycoprotein that specifically recognizes the choline residues of the cell wall. polyclonal antibodies raised against cspa detected the presence of the protein in the cell envelope and in the culture medium. the soluble cspa protein has been purified, and an oligonucleotide probe, prepared from the determined n-terminal sequence, ...19957860591
increased length of hospital stay due to clostridium difficile associated diarrhoea. 19957853976
[digestive involvements in human immunodeficiency virus infection].dysphagia or odynophagia occurs in an estimated 21% of patients with human immunodeficiency virus infection. a causal agent can be identified in 60-90% of the cases and generally can be successfully eradicated. oesophageal candidosis, the predominant disorder, usually responds to nitrate derivatives and amphotericine b after a 10 to 15 day cure. ulcerations of the oesophagus is the second major cause of dysphagia in these patients and result from cytomegalovirus and herpes simplex infections or ...19957899394
clostridium difficile toxin b activates calcium influx required for actin disassembly during cytotoxicity.the principal cellular response to clostridium difficile toxin b, a protein toxin associated with antibiotic-associated colitis, is the disassembly of actin microfilaments. although receptor-activated signal transduction mechanisms have been proposed to mediate these effects, the intracellular events that precede actin breakdown are unknown. in nih-3t3 fibroblasts, toxin b induced an elevation of intracellular calcium possessing either a slow (minutes) or fast (seconds) rise time, followed by a ...19957900810
clostridium difficile colitis: correlation of ct findings with severity of clinical disease.clinical records and abdominal ct scans from 64 patients with documented clostridium difficile disease were reviewed to determine if any correlation existed between ct findings of colitis and severity of clinical disease. clostridium difficile disease was documented with stool toxin titre levels and ct scans were performed within 3 days of stool sample. clinical disease severity was estimated by tabulating the degree of fever, wbc count, frequency and duration of diarrhoea. thirty-nine of 64 pat ...19957889703
involvement of ras-related rho proteins in the mechanisms of action of clostridium difficile toxin a and toxin b.toxins a and b of clostridium difficile are responsible for pseudomembranous colitis, a disease that afflicts a substantial number of hospitalized patients treated with antibiotics. a major effect of these proteins is the disruption of the actin cytoskeleton. recently, i. just, g. fritz, k. aktories, m. giry, m. r. popoff, p. boquet, s. hegenbarth, and c. von eichel-streiber (j. biol. chem. 269:10706-10712, 1994) implicated rho proteins as cellular targets of c. difficile toxin b, since pretreat ...19957890404
[clostridium difficile-associated diarrhea in patients with hiv infection]. 19957891475
prevention of beta-lactam-associated diarrhea by saccharomyces boulardii compared with placebo.to determine the safety and efficacy of a new preventive agent for antibiotic-associated diarrhea (aad) in patients receiving at least one beta-lactam antibiotic.19957872284
[nosocomial infections caused by anaerobes]. 19958519821
have enteric infections a role in 5-fluorouracil-associated diarrhea?in 16 advanced colorectal cancer patients with 5-fluorouracil-associated diarrhea, we evaluated the role of bacterial pathogens in the development of this adverse effect. neither clostridium difficile nor other pathogens were cultured from fecal specimens. these data seem to suggest that it is unlikely that intestinal infections have a role in the pathogenesis of 5fu-associated diarrhea.19958520881
[diagnostic and therapeutic strategy in severe acute colitis in adults]. 19958522096
diagnostic value of clostridium difficile cytotoxin assay. 19958522782
clostridium difficile--associated diarrhoeal diseases: an overview. 19958522806
[diarrhea associated with clostridium difficile and salmonella enteritidis in a patient with hiv infection]. 19958523960
shigellosis in children from north india: a clinicopathological study.stool samples of 1488 children suffering from acute diarrhoea were studied for bacterial culture and sensitivity. shigella culture was positive in 143 (10 per cent) children and 53 hospitalized children could be studied in detail. thirty-six (68 per cent) children were under 2 years of age and peak prevalence was observed in summer months. fever and diarrhoea were universal features; 96 per cent had blood and mucus in the stools, but 32 per cent started with watery diarrhoea lasting 1-3 days fol ...19958531265
[occurrence and clinical picture of clostridium difficile infections after antibiotic therapy].39 patients with colon bowel inflammatory by c. difficile infection after antibioticotherapy were treated. the causes of antibioticotherapy most frequently former infection of the upper respiratory tract. the c. difficile infection were most frequently before therapy: poliantibiotics, cephalosporins ii generations and linkomycin. in diagnosis of c. difficile infection the enzyme immuno-fluorescence test were practical utility confirmed. the symphtomaticotherapy patients with slight course of ill ...19958868193
exchange of domains of glutamate dehydrogenase from the hyperthermophilic archaeon pyrococcus furiosus and the mesophilic bacterium clostridium difficile: effects on catalysis, thermoactivity and stability.the glutamate dehydrogenase gene from the hyperthermophilic archaeon pyrococcus furiosus has been functionally expressed in escherichia coli under the control of the lambda pl promoter. the p. furiosus glutamate dehydrogenase amounted to 20% of the total e. coli cell protein, and the vast majority consisted of hexamers. following activation by heat treatment, an enzyme could be purified from e. coli that was indistinguishable from the glutamate dehydrogenase purified from p. furiosus. hybrid gen ...19958869641
[a case of slowly resolving enteritis caused by clostridium difficile].clostridium difficile is considered as the most important cause of severe antibiotic-associated diarrhea and pseudomembranous colitis. we describe the case of an one year old boy presenting c. difficile chronic diarrhea without previous antibiotic treatments.19958685005
the toxigenic element of clostridium difficile strain vpi 10463.the toxigenic element of clostridium difficile strain vpi 10463 is identified by establishing boundaries between toxigenic sequences and those sequences shared by nontoxigenic and toxigenic strains. the toxigenic element is chromosomal, 19.6 kb in length, and comprised of five open reading frames which include the toxin a and b genes. four of the open reading frames are contiguous and are transcribed in the same direction. the fifth is downstream from the others and oriented in the opposite dire ...19958825908
[study of the thermoresistance of clostridium difficile spores].thermoresistance of c. difficile spores was investigated. c. difficile strains were isolated from different sources. as control, toxigenic vpi 10463 and nontoxigenic nih briggs 8050 c. difficile strains were used. the inhibition of growth majority of c. difficile after heating at 85 degrees c was shown. no correlation between thermoresistance of c. difficile spores, toxigenicity and source of the strains was observed.19958833929
a risk-benefit assessment of teicoplanin in the treatment of infections.teicoplanin is a glycopeptide antibiotic whose activity is selectively oriented against gram-positive aerobic and anaerobic bacteria, including staphylococcus aureus, coagulase-negative staphylococci, clostridium difficile, peptostreptococcus spp. and corynebacterium jeikeium; such activity is affected by neither methicillin resistance nor beta-lactamase production. teicoplanin is not significantly absorbed from the gastrointestinal tract; consequently, it has to be administered intravenously (e ...19958785019
granulocyte-macrophage colony-stimulating factor therapy in patients with chemotherapy-induced aplasia and clostridium difficile enterocolitis. 19958652281
use of pulsed-field gel electrophoresis for investigation of an outbreak of clostridium difficile infection among geriatric patients.a six-month outbreak of clostridium difficile infection among elderly residents of a middle-term-care facility was investigated. pulsed-field gel electrophoresis was used to genotype 22 outbreak strains and 30 epidemiologically unrelated strains. a prospective case-control study was conducted to identify risk factors for epidemic clostridium difficile-associated diarrhea. all epidemiologically unrelated clostridium difficile strains of the same serogroup could be differentiated by their dna patt ...19958654450
the interplay between enteric pathogens and gastrointestinal mucins. 19958576804
pseudomembranous colitis: ct findings in children.a spectrum of nodular haustral thickening and an accordion pattern have been reported as specific features of pseudomembranous colitis (pmc) in adults. a retrospective review of nine patients with pmc was performed to assess whether this spectrum of ct findings also occurred in children. in four girls and five boys, ct scans were performed within 3 days of a positive stool toxin assay for clostridium difficile. documented ct abnormalities included nodular haustral thickening, the accordion patte ...19958577512
[antibiotic-associated diarrhea in light of personal observations].examination was performed in a group of 539 adult patients with diarrhea admitted to the department of infectious diseases in gdańsk from 1991 to 1994. the group of 17 patients with antibiotic-associated colitis (aac) was analysed. the antibiotics responsible for aac were lincosamides, cephalosporins and penicillins. aac was diagnosed by anamnesis, medical examination and detection of toxin a clostridium difficile in stool samples. the contrast enema, colonoscopy and histopathological examinatio ...19958650032
in vitro activity of mdl 62,879 against gram-positive bacteria and bacteroides species.the new thiazolyl peptide antibiotic mdl 62,879 (ge2270 a) showed excellent in vitro activity in testing against staphylococci and streptococci, with mic90s ranging from 0.23 to 0.9 mg/l. it was very active against clostridium difficile and propionibacterium acnes (mic90 0.06 mg/l in each case) and had variable activity against bacteroides spp. mdl 62,879 had exceptionally good activity against enterococcus faecalis, including against a collection of high-level aminoglycoside-resistant isolates ...19958681991
usefulness of culture in the diagnosis of clostridium difficile infection. 19958681993
life-threatening gastrointestinal bleeding caused by aphthous ulcers in a patient with perinatal acquired immunodeficiency syndrome. 19958745032
three cases of hemorrhagic colitis in west virginia due to escherichia coli o157:h7.escherichia coli o157:h7 is an emerging cause of food-borne illness. this bacterial pathogen, most commonly transmitted by undercooked ground beef, causes hemorrhagic colitis. it has been associated with the hemolytic uremic syndrome and death, mostly in children and the elderly. this article describes three patients treated for sporadic cases of escherichia coli o157:h7-associated hemorrhagic colitis at charleston area medical center over a three-week period.19958533400
[a rare cause of severe diarrhea in children: pseudomembranous colitis].pseudomembranous colitis is a rare and serious complication of treatment by antibiotics. the case of a patient with a protracted pseudomembranous colitis followed by two relapses is reported.19958547977
antibiotic-induced colitis.most cases of antibiotic-associated diarrhea can be classified into two categories: cases in which clostridium difficile is implicated and cases in which no putative agent or recognized pathophysiological mechanism is recognized. c difficile colonization produces a spectrum of conditions, ranging from asymptomatic carriage to fatal pseudomembranous colitis: it is implicated in virtually all cases of pseudomembranous colitis and up to 25% of cases of antibiotic-associated diarrhea without colitis ...19958548209
synthesis of bluetongue virus chimeric vp3 molecules and their interactions with vp7 protein to assemble into virus core-like particles.bluetongue virus (btv) core-like particles (clps) are formed in the cytoplasm of insect cells when only two major proteins (vp3 and vp7) of the btv core are expressed by baculovirus vectors (t. j. french and p. roy, 1990, j. virol. 64, 1530-1536). we have recently reported that five small internal deletion mutants of vp3 form clps when provided with unmodified vp7 protein (d1-5; s. tanaka and p. roy, 1994, j. virol. 68, 2795-2802). to investigate whether foreign sequences can be inserted into vp ...19958553561
antibiotic-associated pseudomembranous enteritis due to clostridium difficile. 19958562771
rapid polymerase chain reaction method for specific detection of toxigenic clostridium difficile.a rapid polymerase chain reaction (pcr) method for detection of toxigenic clostridium difficile directly from fecal samples by amplification of toxin a gene fragments was investigated. the technique was applied to monitor the spread of the microorganism in a long-term care ward with a relatively high incidence of overt episodes of diarrhea. the pcr approach has several advantages over traditional methods, rapidly allowing the specific detection of toxigenic clostridium difficile strains from sto ...19958565994
[severe forms of pseudomembranous colitis caused by clostridium difficile].clostridium difficile causes a broad spectrum of enteric diseases in humans, ranging from mild antibiotic-associated diarrhoea to more severe pseudomembranous colitis. the authors report four cases of life-threatening pseudomembranous colitis with haemodynamic changes. infection due to clostridium difficile should be kept in mind whenever a patient undergoing antibiotic therapy develops a symptomatology of an acute abdomen.19958572394
pseudomonas aeruginosa as a cause of infectious diarrhea successfully treated with oral ciprofloxacin.to describe an immunocompromised patient (without aids) with nosocomial infectious diarrhea caused by pseudomonas aeruginosa. oral ciprofloxacin therapy proved to be effective.19958573957
epidemiology of infectious and iatrogenic nosocomial diarrhea in a cohort of general medicine patients.nosocomial diarrhea is a common problem in hospitals, but the epidemiology, causes, and consequences of infectious and iatrogenic nosocomial diarrhea are rarely documented in follow-up or surveillance studies of nosocomial infections. the objective of this study was to describe the epidemiology of nosocomial diarrhea in a cohort study of hospitalized patients.19958585641
comparison of arbitrarily primed pcr with restriction endonuclease and immunoblot analyses for typing clostridium difficile isolates.arbitrarily primed pcr (ap-pcr) was used to genotype 26 clinical isolates of clostridium difficile previously analyzed by immunoblotting (ib) and 20 isolates typed by restriction endonuclease analysis (rea) with hindiii. two levels of differentiation were achieved with the ap-pcr approach by use of two different arbitrary primers. with the 19-mer arbitrary primer t-7 (first level of differentiation), a good correlation was found between ib and ap-pcr typing. twenty isolates grouped into six ib t ...19958586695
clostridium difficile-associated diarrhoea and length of hospital stay. 19958586796
diarrhoea caused by clostridium difficile: response time for treatment with metronidazole and vancomycin.one hundred patients, known to have been excreting clostridium difficile cytotoxin in faeces, were reviewed retrospectively to determine the response time for treatment with oral metronidazole and vancomycin, and the effect of the additional administration of anti-motility agents. records were available for 78 patients of whom 58 had received treatment with either metronidazole or vancomycin. response and relapse rates were similar for the two treatment regimens. however, the mean duration of sy ...19958591942
betalactam therapy and intestinal flora.betalactams, mainly when orally administered, may lead to intestinal flora modifications related to their spectrum of activity, rate of absorption and degradation. therefore it is important to investigate the possible influence of recently developed oral cephem derivatives on normal human microflora. we have investigated the impact on normal human intestinal flora in a 10-day course with cefetamet-pivoxil (cet, 500 mg bid) in comparison to cefixime (cfx, 400 mg qd) or cefuroxime axetil (ca, 250 ...19958618110
clostridium difficile, vancomycin, and enterococcus. 199512879532
summary of clostridium difficile workshop and symposium, 4-5 may 1995, tours and paris, france. 199516887548
clostridium difficile suppresses colonic vasoactive intestinal peptide associated with altered motility.we investigated whether clostridium difficile toxin alters colonic tissue levels of vasoactive intestinal peptide (vip) at the expense of changes in colonic motility in the isolated perfused rabbit left colon. colonic inflammation was induced by the intracolonic administration of 10(-8) m c. difflcile toxin. strain gauge transducers were sewn onto the serosal surface of the colon to evaluate colonic motility. c. difflcile administration produced histologic changes consistent with epithelial dama ...199518475679
clostridium difficile: an update on virulence mechanisms. 199616887556
toxin a detection on clostridium difficile colonies from 24-h cultures.objective: performance of a combined approach for the detection of toxigenic strains in patients suspected of having clostridium difficile-associated disease was evaluated. methods: in this approach, stools were cultured for 24 h on a selective medium supplemented with sodium taurocholate (tccfa), in anaerobic conditions created with the martreg anoxomat system, and toxin a detection was performed directly on c. difficile colonies, by enzyme immunoassay (eia). this method was compared with three ...199611866811
case records of the massachusetts general hospital. weekly clinicopathological exercises. case 17-1996. a 48-year-old man with the acquired immunodeficiency syndrome, abdominal pain, and bloody diarrhea. 19968618586
antibiotics a21459 a and b, new inhibitors of bacterial protein synthesis. ii. structure elucidation.the structures of the antibiotics, active against a few gram-negative bacteria and clostridium difficile, were determined on the basis of physicochemical analyses on the intact molecules and on the acid hydrolysate of a21459 a. fab-ms and 1h and 13c nmr investigations identified the amino acid units and determined their sequence. antibiotics a21459 a and b are homodetic cyclic peptides constituted by eight amino acid units. they are glycine, methoxytryptophan, tryptophan, cysteine, alanine, sarc ...19968621355
inactivation of ras by clostridium sordellii lethal toxin-catalyzed glucosylation.the lethal toxin (lt) from clostridium sordellii belongs to the family of large clostridial cytotoxins causing morphological alterations in cultured cell lines accompanied by destruction of the actin cytoskeleton. c. sordellii lt exhibits 90% homology to clostridium difficile toxin b, which has been recently identified as a monoglucosyltransferase (just, i., selzer, j., wilm, m., von eichel-streiber, c., mann, m., and aktories, k. (1995) nature 375, 500-503). we report here that lt too is a gluc ...19968626575
inhibition of fc epsilon-ri-mediated activation of rat basophilic leukemia cells by clostridium difficile toxin b (monoglucosyltransferase)treatment of rat basophilic leukemia (rbl) 2h3-hm1 cells with clostridium difficile toxin b (2 ng/ml), which reportedly depolymerizes the actin cytoskeleton, blocked [3h]serotonin release induced by 2,4-dinitrophenyl-bovine serum albumin, carbachol, mastoparan, and reduced ionophore a23187-stimulated degranulation by about 55-60%. in lysates of rbl cells, toxin b 14c-glucosylated two major and one minor protein. by using two-dimensional gel electrophoresis and immunoblotting, rhoa and cdc42 were ...19968631752
prognostic criteria in clostridium difficile colitis.to determine the prognostic factors in clostridium difficile (cd) colitis.19968633491
udp-glucose deficiency in a mutant cell line protects against glucosyltransferase toxins from clostridium difficile and clostridium sordellii.we have previously isolated a fibroblast mutant cell with high resistance to the two rho-modifying glucosyltransferase toxins a and b of clostridium difficile. we demonstrate here a low level of udp-glucose in the mutant, which explains its toxin resistance since: (i) to obtain a detectable toxin b-mediated rho modification in lysates of mutant cells, addition of udp-glucose was required, and it promoted the rho modification dose-dependently; (ii) high pressure liquid chromatography analysis of ...19968636120
small-bowel bacterial overgrowth in children with chronic diarrhea, abdominal pain, or both.to evaluate the frequency of small-bowel bacterial overgrowth (sbbo) as a cause of chronic digestive symptoms in a large cohort of children, using the glucose breath hydrogen test (bht).19968636812
antigenicity of amino-acid sequences from clostridium difficile toxin b.clostridium difficile toxins a and b cause antibiotic-associated colitis. whereas antigenic determinants specifying neutralisation of toxin a have been partially elucidated, those of toxin b remain unknown. to define antigenic determinants of toxin b, synthetic peptides were prepared for five linear sequences selected by computer analysis for putative t and b epitopes. peptides spanning the carboxy terminal region (aa 2155-2283) were also selected because this region contains repetitive units th ...19968636964
herpes simplex virus (hsv) colitis in a bone marrow transplant recipient.herpes simplex virus (hsv) infections are common in bone marrow transplantation patients. unusual sites may be involved, however colonic disease with hsv is rare. we report a successfully treated case of colitis due to hsv, cytomegalovirus, clostridium difficile and graft-versus-host disease in an allogeneic marrow recipient.19968640181
clostridium difficile colitis associated with cisplatin-based chemotherapy in ovarian cancer patients.the purpose of this study was to examine the incidence and cause of clostridium difficile colitis occurring after cisplatin-based combination chemotherapy in ovarian cancer patients. thirty-three patients with primary ovarian malignancy were treated with cisplatin-based combination chemotherapy ranging from 1 to 12 (mean 4.6) cycles. all patients who developed diarrhea after undergoing the cancer chemotherapy were examined to determine whether or not they were complicated by c difficile colitis. ...19968641617
enhancement of clostridium difficile toxin production in biotin-limited conditions.the effect of biotin on toxin production by clostridium difficile was examined in a defined medium. when toxin production by strain kz 1647, which was isolated from a healthy adult, was examined in relation to its biotin requirement, it was found that with decreasing concentrations of biotin, bacterial growth was decreased, but production of both toxins a and b were remarkably increased, particularly with 0.05 nm biotin. the time course of production of both toxins in biotin-limited conditions w ...19968642571
cell surface properties of clostridium difficile: haemagglutination, relative hydrophobicity and charge.five well characterised strains of clostridium difficile of differing virulence and two escherichia coli strains, a verotoxigenic o157:h7 isolate and a urinary isolate, were examined for cell surface hydrophobicity and charge, and haemagglutinating ability. phase partition in hexadecane or octan-1-ol was similar for c. difficile and e. coli, as was retention by hydrophobic interaction chromatography (hic), indicating moderate hydrophobicity. the salt agglutination test showed e. coli to be hydro ...19968642572
diagnosis of clostridium difficile--associated disease: patient selection and test perfection. 19968644758
clinical prediction rules to optimize cytotoxin testing for clostridium difficile in hospitalized patients with diarrhea.although routine testing of hospitalized patients with diarrhea for clostridium difficile cytotoxin has been advocated as a high-yield procedure, the rationale for this practice has been questioned. to target a low-yield subgroup for whom routine testing could be deferred, we derived a clinical decision rule for predicting results of the c difficile cytotoxin assay in hospitalized adults with diarrhea.19968644759
surgery for pancreatic tumors during pregnancy: a case report and review of the literature.seven cases of surgery of pancreatic tumors during pregnancy have been reported in the literature. six of the cases resulted in live term births. the patient discussed herein, a 37-year-old para 2-0-0-2 white female, had surgery for the removal of a pancreatic mass at 20 2/7 weeks' gestation. no intraoperative complications occurred, and both mother and fetus appeared to have done well. the postoperative course was complicated by pseudomembranous enterocolitis caused by c. difficile, which was t ...19968645381
clostridium difficile colitis in the critically ill.morbidity and treatment of clostridium difficile colitis (cdc) continue to be controversial. some claim minimum morbidity, which may be a function of differences in patient population and/or bacterial virulence.19968646945
biotherapeutic agents. a neglected modality for the treatment and prevention of selected intestinal and vaginal infections.to evaluate the potential of biotherapeutic agents (microorganisms with therapeutic properties) for the prevention and/or treatment of selected intestinal and vaginal infections.19968596226
a new form of particulate single and multiple immunogen delivery system based on recombinant bluetongue virus-derived tubules.the development of particular vector systems for the presentation of immunogenic epitopes provides a powerful approach for the delivery of antigens. these include the core-like particles formed by recombinant bluetongue virus (btv) capsid proteins vp3 and vp7 synthesized in insect cells by recombinant baculoviruses. previously we have reported localization of an antigenic site on the surface of tubular structures formed by the nonstructural protein ns1 of btv, and their potential use for epitope ...19968599217
enteric precautions for clostridium difficile. 19968600710
risk of diarrhoea due to clostridium difficile during cefotaxime treatment. cefotaxime compares favourably with other third generation cephalosporins. 19968605486
risk of diarrhoea due to clostridium difficile during cefotaxime treatment. mortality due to c difficile colitis in elderly people has been underestimated. 19968605487
increased substance p receptor expression by blood vessels and lymphoid aggregates in clostridium difficile-induced pseudomembranous colitis.pseudomembranous colitis is most often caused by toxins secreted by clostridium difficile following bowel flora overgrowth after antibiotic use. the secretory and inflammatory effects observed in c. difficile toxin a-induced enterocolitis in the rat ileum are inhibited by cp-96,345, a substance p (sp) receptor antagonist. to determine if sp plays a role in the pathogenesis of human pseudomembranous colitis, sp receptor distribution was examined in a toxin a-positive specimen of bowel. quantitati ...19968617145
inhibition of receptor signaling to phospholipase d by clostridium difficile toxin b. role of rho proteins.rho proteins have been reported to activate phospholipase d (pld) in in vitro preparations. to examine the role of rho proteins in receptor signaling to pld, we studied the effect of clostridium difficile toxin b, which glucosylates rho proteins, on the regulation of pld activity in human embryonic kidney (hek) cells stably expressing the m3 muscarinic acetylcholine receptor (machr). toxin b treatment of hek cells potently and efficiently blocked machr-stimulated pld. in contrast, basal and phor ...19968576201
the lack of value of repeated clostridium difficile cytotoxicity assays.to determine the value of repeated clostridium difficile cytotoxicity assays (ca).19968554444
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