Publications
| Title | Abstract | Year(sorted ascending) Filter | PMID Filter |
|---|
| macrofragment localization of the toxin a and toxin b genes of clostridium difficile. | we report the physical mapping of the toxin a and b genes to the bacterial chromosome of clostridium difficile atcc 43594 by pulsed-field gel electrophoresis. single and double digestions with restriction endonucleases nrui and sacii allowed localization of the toxin genes to a specific 577-kb fragment and estimation of genome size to be approximately 3.8 megabases. this effort represents the initial step in the construction of a physical map of the whole genome. | 1996 | 8914776 |
| leukocyte-endothelial cell interactions evoked by mast cells. | in this review we have summarized some of the evidence to support the view that mast cells play a critical role in leukocyte recruitment to sites of inflammation. initially, data using a pharmacological tool, compound 48/80, which directly activates mast cells, is reviewed, demonstrating that this reagent can induce the multi-step recruitment of leukocytes (rolling, adhesion and emigration) to sites of inflammation. the adhesive mechanisms and pro-inflammatory mediators implicated in mast cell-i ... | 1996 | 8915188 |
| manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci. | infection control practices are not uniformly successful in limiting outbreaks of vancomycin-resistant enterococci (vre). despite the implementation of barrier precautions for vre-infected patients, nearly one-half of the inpatients at our center were found to have gastrointestinal colonization by vre. in an attempt to control the outbreak, we altered the antibiotic formulary by restricting the use of cefotaxime and vancomycin and adding beta-lactamase inhibitors to replace third-generation ceph ... | 1996 | 8922796 |
| molecular mimicry in the recognition of glycosphingolipids by gal alpha 3 gal beta 4 glcnac beta-binding clostridium difficile toxin a, human natural anti alpha-galactosyl igg and the monoclonal antibody gal-13: characterization of a binding-active human glycosphingolipid, non-identical with the animal receptor. | glycoconjugates with terminal gal alpha 3gal beta 4glcnac beta sequences have been shown to be recognized by three carbohydrate-binding proteins; toxin a of clostridium difficile, human natural anti alpha-galactosyl igg and the monoclonal antibody gal-13. however, the biological significance of this binding specificity in humans is unclear, since unsubstituted gal alpha 3gal beta 4glcnac beta sequences are not found in human tissues, due to suppression of the gene coding for the enzyme gal beta ... | 1996 | 8922955 |
| [pancolitis caused by clostridium difficile, with a recurrent outbreak]. | 1996 | 8924335 | |
| [85-year-old female patient with abdominal distention and fever]. | 1996 | 8927769 | |
| chronic osteomyelitis caused by clostridium difficile in an adolescent with sickle cell disease. | 1996 | 8933563 | |
| clostridium difficile and sucralfate. | 1996 | 8934235 | |
| risk factors associated with clostridium difficile diarrhea in hospitalized adult patients: a case-control study--sucralfate ingestion is not a negative risk factor. | to assess risk factors associated with clostridium difficile diarrhea in hospitalized adult patients, and to test the hypothesis that sucralfate ingestion is associated with nondetection of c difficile cytotoxin in stool specimens. | 1996 | 8935731 |
| genotyping of outbreak-related and sporadic isolates of clostridium difficile belonging to serogroup c. | serogroup c of clostridium difficile is the serogroup most frequently related to outbreaks. fifty-six toxigenic serogroup c isolates of c. difficile were genotyped by ribotyping pcr (ribo-pcr), random amplified polymorphic dna (rapd) assay, and pulsed-field gel electrophoresis (pfge). thirty-five of the 56 isolates were recovered from four unrelated outbreaks (belgium, 1987, 1992, and 1995; france, 1992 to 1993) 7 derived from a spatiotemporal cluster in cotonou, benin (1992), and 14 were sporad ... | 1996 | 8940447 |
| tyrothricin-containing oral tablets causing clostridium difficile-associated diarrhea. | 1996 | 8943986 | |
| epidemiology and typing of clostridium difficile. | clostridium difficile is now established as the most common nosocomial enteric pathogen causing pseudomembranous colitis, antibiotic-associated colitis and antibiotic-associated diarrhoea. antibiotic therapy is the most important risk factor in colonization and infection with c. difficile. however, other factors are involved such as age and underlying illness. the introduction of reliable typing and fingerprinting methods has demonstrated hospital acquisition and cross-infection with c. difficil ... | 1996 | 8944362 |
| pathogenesis of clostridium difficile-associated diarrhoea. | clostridium difficile is now regarded as a major enteric pathogen in hospitals and nursing-home facilities. the pathophysiology of this pathogen involves alterations of the indigenous colonic flora by antibiotics, ingestion of spores and colonization by c. difficile, followed by release of its toxins. although most of the research on the intestinal effects of c. difficile had been focused on its enterotoxin or toxin a, recent results indicate that toxin b, the cytotoxin of c. difficile, is also ... | 1996 | 8944363 |
| immune response to clostridium difficile infection. | clostridium difficile produces two toxins (a and b) which cause antibiotic-associated diarrhoea and pseudomembranous colitis. one of the most puzzling aspects of c. difficile infection is the wide spectrum of clinical presentation which ranges from asymptomatic carriage to fulminant, life-threatening colitis. this review examines the hypothesis that immune responses to c. difficile underlie these dramatic variations in disease presentation and course. animals can be protected from c. difficile c ... | 1996 | 8944364 |
| management of clostridium difficile infection and other antibiotic-associated diarrhoeas. | most cases of antibiotic-associated diarrhoea are due to clostridium difficile or are enigmatic. patients with c. difficile-associated disease are more likely to have colitis, severe disease and nosocomial acquisition. the preferred diagnostic test is a c. difficile toxin assay using a tissue culture assay or enzyme immunoassay. the usual treatment is withdrawal of the inducing agent, sometimes supplemented with oral vancomycin or metronidazole. response rates approach 100%; the major complicati ... | 1996 | 8944365 |
| human intestinal epithelial cells swell and demonstrate actin rearrangement in response to the metalloprotease toxin of bacteroides fragilis. | enterotoxigenic bacteroides fragilis (etbf) cells produce a 20-kda heat-labile metalloprotease toxin which is potentially important in the pathogenesis of diarrhea associated with this infection. previous studies indicate that subconfluent ht29/c1 cells treated with the b. fragilis toxin (bft) develop morphologic changes with dissolution of tight clusters and apparent swelling. such alterations suggest toxin-stimulated reorganization of the cellular cytoskeleton. the purpose of the current study ... | 1996 | 8945541 |
| bacteroides fragilis toxin rapidly intoxicates human intestinal epithelial cells (ht29/c1) in vitro. | enterotoxigenic bacteroides fragilis strains associated with childhood diarrhea produce a 20-kda protein toxin (bft). purified bft causes striking morphologic changes in subconfluent human colonic epithelial cells (ht29/c1). in a 3-h ht29/c1 cell assay, the estimated half-maximal effective concentration of bft was 12.5 pm, and morphologic effects were detectable as early as 30 min and nearly complete by 1.5 h. concentrations as low as 0.5 pm could also cause intoxication, but morphologic changes ... | 1996 | 8945542 |
| saccharomyces boulardii protease inhibits clostridium difficile toxin a effects in the rat ileum. | saccharomyces boulardii, a nonpathogenic yeast, is effective in treating some patients with clostridium difficile diarrhea and colitis. we have previously reported that s. boulardii inhibits rat ileal secretion in response to c. difficile toxin a possibly by releasing a protease that digests the intestinal receptor for this toxin (c. pothoulakis, c. p. kelly, m. a. joshi, n. gao, c. j. o'keane, i. castagliuolo, and j. t. lamont, gastroenterology 104: 1108-1115, 1993). the aim of this study was t ... | 1996 | 8945570 |
| evaluation of two commercial microtiter cytotoxin assays for the detection of clostridium difficile toxin b in stool specimens. | two commercial microtiter cytotoxin assays using a fibroblast cell line (bartels, baxter diagnostics, inc., deerfield, il) and an epithelial cell line (cytotoxi test, advanced clinical diagnostics, toledo, oh) were evaluated for their ability to detect clostridium difficile toxin b in stool specimens. after 48 hours, the assays had comparable sensitivity (90 versus 92%) and specificity (99 versus 98%). although not statistically significant, the bartels assay detected more toxin-positive specime ... | 1996 | 8950530 |
| in vitro activity of quinolones and other antimicrobial agents against anaerobic bacteria. | the in vitro activities of ciprofloxacin, ofloxacin, sparfloxacin, and du-6859a against peptostreptococci, clostridium perfringens, clostridium difficile, bacteroides fragilis, porphyromonas, prevotella, and fusobacterium were determined by an agar dilution method. these activities were compared with those of piperacillin/tazobactam, cefoxitin, imipenem, clindamycin, and metronidazole. imipenem, metronidazole, and du-6859a were the most active antimicrobial agents that were tested. the in vitro ... | 1996 | 8953101 |
| increased incidence of clostridium difficile-associated diarrhea following decreased restriction of antibiotic use. | removal of antimicrobial agents from formulary restriction status at our center was followed by an increase in the incidence of clostridium difficile-associated diarrhea. the mean monthly incidence of c. difficile diarrhea for the 12-month period before institution of decreased restriction of antibiotic use was 3.4 infections per 1,000 admissions and rose to 6.2 infections per 1,000 admissions during the following 4-month period (p < .05). patients who developed disease before and after decrease ... | 1996 | 8953115 |
| difference in protein substrate specificity between hemorrhagic toxin and lethal toxin from clostridium sordellii. | the hemorrhagic toxin (ht) from clostridium sordellii is pharmacologically related to clostridium difficile toxins a and b and clostridium sordellii lethal toxin which have been recently identified as mono-glucosyl-transferases. here we report that ht, which is coexpressed with lethal toxin, is also a glucosyltransferase. whereas lethal toxin glucosylates the rho subfamily proteins rac and cdc42 and the ras subfamily proteins h-ras and rap, the substrate specificity of ht is strictly confined to ... | 1996 | 8954906 |
| diarrhea and clostridium difficile-associated diarrhea on a surgical service. | to identify the incidence, risk factors, and treatment of diarrhea and clostridium difficile-associated diarrhea (cdad) in surgery patients. | 1996 | 8956776 |
| [severe massive pseudomembranous colitis with a fulminant course]. | pseudomembranous colitis is an inflammatory disease of rectal and colonic mucosa caused by clostridium difficile produced toxin. the inflammation is produced as the consequence of a non-specific response to several agents. it usually presents with abdominal pain and mild watery diarrhea which used to decrease when removing the antibiotic or when starting the therapy with metronidazole or vancomycin. in aged patients, with severe concomitant diseases, may appear complications such as dehydration, ... | 1996 | 8963907 |
| a human antibody binds to alpha-galactose receptors and mimics the effects of clostridium difficile toxin a in rat colon. | nearly all human sera contain an immunoglobulin g antibody (antigalactose) that binds the trisaccharide gal alpha 1-3gal beta 1-4glcnac expressed on cells from most mammals but not humans. because the clostridium difficile toxin a receptor in rodents contains this trisaccharide, the aim of this study was to examine whether antigalactose could mimic the enterotoxic effects of toxin a and bind to receptors containing this trisaccharide. | 1996 | 8964394 |
| [current diagnosis, clinical course and treatment of acute colitis infection with clostridium difficile]. | detection rate of g. intestionalis in feces with direct microscopy has been compared with the immuno-enzymatic technique detecting protein gsa 65 with alexon inc., prospec t/giardia reagents kit. the results obtained with both methods have further been compared with those obtained by microscopic examination of the duodenal content. detectability of giardia intestinalis with eia technique with the use of ready-made kit has been assessed. feces have been collected from 371 patients. protein gsa 65 ... | 1996 | 8966161 |
| [infectious diarrhea]. | infectious diarrhea is a very common, usually self-limited disease. among travellers to developing countries, diarrhea is by far the most common medical problem. the intake of sufficient glucose-electrolyte solutions is the most important step to prevent dehydration. loperamide may be prescribed as a valuable antimotility agent: however, this drug should not be used in patients with high fevers, bloody diarrhea and severe abdominal cramps. stool cultures are recommended in cases without improvem ... | 1996 | 8966415 |
| antibacterial activity of teicoplanin against clostridium difficile. | the in vitro inhibitory action of teicoplanin, vancomycin, metronidazole and clindamycin against clinical isolates of clostridium difficile was investigated. minimum inhibitory concentrations (mics) were determined using e test. teicoplanin (mic range 0.023-0.75 microgram/ml), vancomycin (mic range 0.5-3 micrograms/ml) and metronidazole (mic range 0.19-1 microgram/ml) were all very active against the isolates examined. no resistant strains of c. difficile to those three antimicrobial agents were ... | 1996 | 9185278 |
| wound botulism--california, 1995. from the center for disease control and prevention. | 1996 | 8531319 | |
| [antibiotic-induced diarrhea: recent findings about clostridium difficile]. | from the beginning of the antibiotherapy, diarrhea frequently occurred as a side effect of the treatment. the spectrum of diarrheal disease associated with antibiotic therapy ranges from antibiotic associated diarrhea and colitis, to the more severe pseudomembranous colitis, which is always associated with clostridium difficile (cd). because most of the antibiotics are not active against this sporulated gram positive anaerobe. the pathogenic process occurs only by production of toxins. cd is now ... | 1996 | 9335932 |
| [perioperative managements for postoperative severe infections in compromised host]. | the incidence of postoperative infections, especially due to multi-drug resistant strains such as pseudomonas sp., enterococcus sp., and methicillin resistant staphylococcus aureus (mrsa), is high in compromised hosts. among them, respiratory infection, catheter sepsis, and drug-associated enteritis are frequently observed and respiratory infection is liable to fall into serious illness. these infections have characteristics in causative organisms. pseudomonas aeruginosa or mrsa are frequently i ... | 1996 | 9032782 |
| in vitro activity of meropenem compared to nine other antimicrobial agents: importance of its stability when used in agar dilution systems. | the antibacterial activity of meropenem was tested against 426 clinical isolates representing a wide range of aerobic and anaerobic species. the in vitro activity of meropenem was compared with that of iminpenem, ceftazidime, cefotaxime, ciprofloxacin, piperacillin and tobramycin against aerobic isolates, and also compared with that of imipenem, metronidazole, cefoxitin, clindamycin and piperacillin against the anaerobic isolates. meropenem exhibited an extended spectrum of activity with low min ... | 1996 | 9007956 |
| clostridium difficile colitis--diagnosis and therapy. | clostridium difficile is a gram-positive bacillus which had been identified as the source of potent exotoxins: toxin a and toxin b. c. difficile infection usually follows antibiotic therapy and results from unrestrained growth of pathogenic strains of c. difficile in the colon. typical clinical findings include: diarrhoea with blood and mucus, fever, abdominal pain, nausea, loss of body weight. in the past the diagnosis was based on positive result of stool culture but now several tests are avai ... | 1996 | 9020528 |
| antibiotic-associated diarrhoea. a costly problem. | 1996 | 10160466 | |
| [reccurent pseudomembranous colitis treated with the donor feces]. | 1996 | 10596179 | |
| evaluation of routine enteric pathogens in hospitalized patients: a canadian perspective. | diarrhea is a frequently encountered problem in hospitalized patients. since nosocomial spread of routine enteric pathogens such as salmonella species, shigella species, campylobacter species and escherichia coli o:157 h:7 seldom occurs, testing for these organisms in patients hospitalized for longer than three days has been questioned. the goal of this study was to determine the length of hospitalization preceding detection of routine enteric pathogens and clostridium difficile cytotoxin, and t ... | 1996 | 22514438 |
| decrease in expenditures and selected nosocomial infections following implementation of an antimicrobial-prescribing improvement program. | to evaluate changes in antimicrobial use and expenditures and the rates of selected nosocomial infections due to resistant organisms associated with implementation of an antimicrobial-prescribing improvement program. | 1997 | 10176026 |
| survival of anti-clostridium difficile bovine immunoglobulin concentrate in the human gastrointestinal tract. | to be therapeutically active, oral hyperimmune bovine immunoglobulin concentrate (bic) must survive its passage through the intestinal tract. this led us to study the gastrointestinal stability of orally administered bic directed against clostridium difficile toxins (bic-c. difficile). bic-c. difficile was stable at neutral ph in vitro but was degraded at low ph, particularly in the presence of pepsin. healthy volunteers (n = 6) took bic-c. difficile (45 or 8 g) as a single oral dose. total bovi ... | 1997 | 9021173 |
| il-2 signaling controls actin organization through rho-like protein family, phosphatidylinositol 3-kinase, and protein kinase c-zeta. | il-2 and il-4 induce proliferation of ts1 alpha beta cells. activation of the zeta isoform of protein kinase c is an important step in il-2-, but not il-4-mediated proliferation. in addition, protein kinase c-zeta is implicated in il-2-mediated actin organization. given the established involvement of the rho family of small guanine nucleotide-binding proteins in organization of actin structures, we analyze the possible relationships between rho and protein kinase c-zeta. using the rho-like prote ... | 1997 | 9029085 |
| clostridium difficile colitis presenting as an acute abdomen: case report and review of the literature. | pseudomembranous colitis associated with clostridium difficile rarely manifests as an acute abdomen and even more rarely as an acute abdomen without abnormal radiologic studies. the following is a case report of a 52-year-old white man who had an acute abdomen without abnormal radiologic studies, and was given a final diagnosis of c difficile colitis. surgery was averted only by the ability to do an expeditious flexible sigmoidoscopy with the visualization of pseudomembranes. diagnosis was later ... | 1997 | 9010377 |
| non-clostridium difficile nosocomial diarrhea in the intensive care unit. | it is assumed that most cases of nosocomial diarrhea are due to clostridium difficile because of the widespread use of broad-spectrum antibiotic agents. enteral tube feedings are another important cause of hospital-acquired diarrhea, especially in intensive care units (icus). we report the results of a recent survey of patients in the icu with nosocomial diarrhea and describe an illustrative case. we conclude on the basis of this and a previous larger study that c. difficile diarrhea is very unc ... | 1997 | 9013225 |
| il-8 release and neutrophil activation by clostridium difficile toxin-exposed human monocytes. | neutrophil infiltration is central to the pathogenesis of clostridium difficile toxin a-induced enterocolitis. this study examines whether monocyte activation by c. difficile toxins is instrumental in initiating neutrophil activation and recruitment. human monocytes were exposed to low concentrations of highly purified c. difficile toxins, and the conditioned media were harvested for cytokine and functional assays. monocytes exposed to c. difficile toxin a (10(-10) m) or toxin b (10(-12) m) rele ... | 1997 | 9435559 |
| frequency of isolation of toxigenic clostridium difficile from healthy adults. | an attempt was made to isolate clostridium difficile from 129 faecal specimens from 87 young and 42 elderly healthy adults. c.difficile was isolated using bacterial culture from 7 (5.4%) specimens and the frequency of isolation of toxigenic c. difficile as detected by cytotoxin (tissue culture) assay was 1.1 per cent and 2.4 per cent in healthy young and elderly adults respectively. the carrier rate of toxigenic c. difficile amongst healthy adults is relatively low in this part of our country. | 1997 | 9439094 |
| identification of g protein-coupled receptors potently stimulating migration of human transitional-cell carcinoma cells. | the expression of g protein-coupled receptors inducing calcium mobilization and stimulating cell migration was examined in human transitional-cell carcinoma (j82) cells. measurements of cytoplasmic ca2+ concentration ([ca2+]i) and phospholipase c activity indicated that these cells express several calcium-mobilizing receptors, including those for lysophosphatidic acid (lpa), thrombin, bradykinin, bombesin and histamine, of which only the lpa response was sensitive (approximately 50%) to pertussi ... | 1997 | 9453463 |
| hospital-acquired clostridium difficile diarrhoea and herd immunity. | clostridium difficile diarrhoea represents a significant health-service burden. we recently experienced an outbreak of c difficile diarrhoea associated with increased use of cefotaxime. the question we pose in this paper is how did the introduction and withdrawal of a single antibiotic so greatly affect rates of c difficile diarrhoea? other antibiotics had nearly as high a risk of causing diarrhoea as cefotaxime, and the majority of patients never received cefotaxime. we believe that such outbre ... | 1997 | 9033485 |
| predicting clostridium difficile stool cytotoxin results in hospitalized patients with diarrhea. | to validate a model for the prediction of clostridium difficile cytotoxin assay results, and to identify a subgroup of patients with a very low likelihood of c. difficile-associated disease in whom the yield of routine cytotoxin testing is low. | 1997 | 9034947 |
| positive regulation of clostridium difficile toxins. | the toxigenic element of clostridium difficile vpi 10463 contains a small open reading frame (orf) immediately upstream of the toxin b gene (g. a. hammond and j. l. johnson, microb. pathog. 19:203-213, 1995). the deduced amino acid sequence of the orf, which we have designated txer, encodes a 22-kda protein which contains a helix-turn-helix motif with sequence identity to dna binding regulatory proteins. we used a dna fragment containing the c. difficile toxin a repeating units (aru) as a report ... | 1997 | 9038324 |
| glucosylation of small gtp-binding rho proteins disrupts endothelial barrier function. | the endothelial cytoskeleton is important for the regulation of endothelial barrier function. small gtp-binding rho proteins play a central role in the organization of the microfilament system. clostridium difficile toxin b (tcdb) inactivates rho proteins by glucosylation at thr-37. we used tcdb as a probe to study the role of rho proteins in the regulation of endothelial barrier function. tcdb time (50-170 min) and dose (10-100 ng/ml) dependently increased the hydraulic conductivity of cultured ... | 1997 | 9038900 |
| low albumin gradient ascites complicating severe pseudomembranous colitis. | pseudomembranous colitis (pmc) is a frequently severe, sometimes fatal iatrogenic disease that is antibiotic-associated in almost all cases. the most common clinical features of pmc include abdominal pain, watery diarrhea, fever, leukocytosis, hypoalbuminemia, and hypovolemia. ascites, not considered a well-known feature of pmc, is fairly common, based on a review of the english language literature but has not been characterized fully. this case report describes 5 patients with pmc who presented ... | 1997 | 9041262 |
| yield from stool testing of pediatric inpatients. | to quantify the yield from stool testing in pediatric inpatients and to identify criteria to test stool more deliberately without sacrificing diagnostic sensitivity. | 1997 | 9041868 |
| arbitrary primed pcr rules out clostridium difficile cross-infection among patients in a haematology unit. | eight out of 20 (40%) patients with haematological malignancies hospitalized in the same unit of our hospital from 24 january to 24 april 1995, suffered from diarrhoea due to clostridium difficile. the c. difficile isolates were characterized by serotyping and by arbitrary primed polymerase chain reaction (ap-pcr) using three different 10-mer oligonucleotides. it was found by serotyping that five patients had non-typeable isolates and three had serogroup h isolates. the ap-pcr typed all the isol ... | 1997 | 9049815 |
| surgical aspects of clostridium difficile colitis. | there has been a marked increase in the number of surgical patients developing clostridium difficile colitis. the epidemiology, pathogenesis, diagnosis and management of c. difficile infection were reviewed from a surgical perspective. | 1997 | 9052424 |
| involvement of the appendix in pseudomembranous colitis. | pseudomembranous colitis (pmc) is an inflammatory disorder usually limited to the large intestine and is the consequence of antibiotic associated clostridium difficile overgrowth with production of its toxin. it has a characteristic gross and microscopic appearance. pmc-like changes, usually associated with peri-operative hypotension and with more extensive gastrointestinal tract involvement, have also been described. in neither clinical setting has pseudomembranous appendicitis been recorded. a ... | 1997 | 9059362 |
| bacterial toxins that target rho proteins. | 1997 | 9062338 | |
| [pseudomembranous colitis: report of four cases]. | clostridium difficile is the cause of 25-30% of cases of antibiotic-induced diarrhea. pseudomembranous colitis is the most dramatic manifestation of c. difficile infection. | 1997 | 9471661 |
| isolation of patients with clostridium difficile infection. | 1997 | 9457611 | |
| evidence for differential roles of the rho subfamily of gtp-binding proteins in glucose- and calcium-induced insulin secretion from pancreatic beta cells. | we utilized clostridial toxins (with known specificities for inhibition of gtpases) to ascertain the contribution of candidate gtpases in physiologic insulin secretion from beta cells. exposure of normal rat islets or isolated beta (hit-t15) cells to clostridium difficile toxins a and b catalyzed the glucosylation (and thereby the inactivation) of rac, cdc42, and rho endogenous to beta cells; concomitantly, either toxin reduced glucose- or potassium-induced insulin secretion from rat islets and ... | 1997 | 9464452 |
| nosocomial outbreak of clostridium difficile diarrhea in a pediatric service. | an outbreak of nosocomial diarrhea that occurred in a pediatric orthopedic service between 1 december 1993 and 15 april 1994 is reported. a total of 37 patients (mean age, 9.6 years; range, 2 months-19.3 years) were involved in the outbreak, including six patients with bacteriologically documented clostridium difficile infection. a multivariate analysis identified lincomycin treatment for at least three days as the only significant risk factor. stool samples from four asymptomatic patients were ... | 1997 | 9495676 |
| splenic abscess caused by clostridium difficile. | splenic abscess is a previously unreported complication of clostridium difficile colitis. a case of clostridium difficile splenic abscess is reported that developed after the patient had been in intensive care for five weeks. a response was seen to radiologically guided drainage and antibiotic therapy with formal laparotomy, and surgical drainage not being required. | 1997 | 9495678 |
| clostridium difficile colitis after aortic surgery. | to determine the incidence and outcome of clostridium difficile colitis (cdc) following aortic surgery. | 1997 | 9345243 |
| the c-terminal ligand-binding domain of clostridium difficile toxin a (tcda) abrogates tcda-specific binding to cells and prevents mouse lethality. | we have investigated the ability of a recombinant protein (rep231), derived from clostridium difficile toxin a c-terminal domain, to protect against toxin a (tcda) intoxication in vitro and in vivo. rep231 was cloned, expressed and purified by thyroglobulin affinity chromatography, and demonstrated identical binding properties to tcda. immunofluorescence experiments and in vitro cytotoxicity assays using mouse teratocarcinoma cells f9 showed that specific binding of tcda to f9 cells through its ... | 1997 | 9345763 |
| comparison of cycloserine-cefoxitin-fructose agar (ccfa) and taurocholate-ccfa for recovery of clostridium difficile during surveillance of hospitalized patients. | the effectiveness of cycloserine-cefoxitin-fructose agar (ccfa) and taurocholate-ccfa (tccfa) in isolating clostridium difficile from swabs of the rectum or stools from 184 hospitalized patients who were monitored weekly and when they had diarrhea was compared. the number of surveillance time points ranged from two to eight per patient over a period of 4 to 34 days per patient, totalling 621 comparisons of the media. c. difficile was isolated more frequently by tccfa than ccfa at seven of eight ... | 1997 | 9350408 |
| proline-aminopeptidase test for rapid screening of clostridium difficile. | 1997 | 9350782 | |
| five spontaneous deaths associated with clostridium difficile in a colony of cotton-top tamarins (saguinus oedipus). | clostridium difficile toxin was detected in the feces of five cotton-top tamarins (saguinus oedipus) that died spontaneously over a period of 10 weeks. deaths occurred subsequent to antibiotic therapy for infectious diarrhea associated with campylobacter spp. relevant clinical signs of disease prior to death included weight loss, watery diarrhea, hematochezia, weakness, and sudden collapse. on histologic examination of the colon at necropsy, pseudomembranous colitis was evident in two cases, a l ... | 1997 | 9355088 |
| infectious diarrhoea--an update. | infectious diarrhoea is one of the most common illness affecting mankind. recent advancement have led to detailed understanding of causative agents and the pathogenesis of the infections. fluid and electrolyte replacement remains the most important aspect of treatment. the role of antimicrobial agents is discussed. | 1997 | 9355725 |
| complications and risks of living donor nephrectomy. | short- and long-term patient and graft survival rates are better for living donor (vs. cadaver) kidney transplant recipients. however, donor nephrectomy is associated with at least some morbidity and mortality. we have previously estimated the mortality of living donor nephrectomy to be 0.03%. in our present study, to determine associated perioperative morbidity, we reviewed donor nephrectomies performed at our institution from january 1, 1985, to december 31, 1995. | 1997 | 9355827 |
| multicenter typing comparison of sporadic and outbreak clostridium difficile isolates from geographically diverse hospitals. | in a collaborative study by three laboratories, arbitrarily primed polymerase chain reaction (ap-pcr), hindiii restriction enzyme analysis (rea), and pulsed-field gel electrophoresis (pfge) using smai were compared for typing of clostridium difficile. the study included 30 isolates from nosocomial outbreaks in six geographically disparate hospitals and 15 isolates from sporadic cases of c. difficile diarrhea. rea distinguished a total of 23 types representing 10 groups; ap-pcr performed at deaco ... | 1997 | 9359723 |
| metronidazole. a therapeutic review and update. | the nitroimidazole antibiotic metronidazole has a limited spectrum of activity that encompasses various protozoans and most gram-negative and gram-positive anaerobic bacteria. metronidazole has activity against protozoans like entamoeba histolytica, giardia lamblia and trichomonas vaginalis, for which the drug was first approved as an effective treatment. anaerobic bacteria which are typically sensitive are primarily gram-negative anaerobes belonging to the bacteroides and fusobacterium spp. gra ... | 1997 | 9360057 |
| clostridium difficile-associated diarrhea in rheumatoid arthritis patients who are receiving therapy with low-dose chlorambucil. | 1997 | 9365100 | |
| clostridium difficile toxin a binding to human intestinal epithelial cells. | clostridium difficile radiolabelled toxin a ([3h]-toxin a) bound to human duodenal and colonic epithelial cells isolated from endoscopic biopsies. binding was greater at 4 degrees c than 37 degrees c, consistent with the thermal binding characteristic of toxin a to a carbohydrate moiety. at 37 degrees c colonic cells bound significantly more [3h]-toxin a than duodenal cells. the amount of [3h]-toxin a binding varied considerably between individuals. [3h]-toxin a was displaced by unlabelled toxin ... | 1997 | 9368537 |
| is clostridium difficile a pathogen in the newborn intensive care unit? a prospective evaluation. | the purpose of this study was to investigate (1) the presence of clostridium difficile toxin in patients in the newborn intensive care unit and (2) the association of c. difficile toxin with gastrointestinal tract symptoms in this population. | 1997 | 9373839 |
| multiple organ failure due to clostridium difficile sepsis. a case report. | a case of severe sepsis caused by clostridium difficile infection in a 66-year-old cirrhotic female is described. severe systemic symptoms evolved rapidly to septic shock and ards, with signs and symptoms suggesting an acute abdomen requiring exploration for exclusion of surgical treatable diseases. the delayed diagnosis of clostridium difficile infection probably contributed to the severity of the clinical course. | 1997 | 9374079 |
| epidermal growth factor attenuates clostridium difficile toxin a- and b-induced damage of human colonic mucosa. | epidermal growth factor (egf) exhibits a cytoprotective effect on gastrointestinal epithelia via a receptor-mediated mechanism. we investigated the effect of egf on clostridium difficile toxin a (txa)- and toxin b (txb)-induced damage of human colon. ussing-chambered colonic mucosa was exposed serosally to egf before and during luminal exposure to txa and txb. resistance was calculated from potential difference and short-circuit current. epithelial damage was assessed by light microscopy and alt ... | 1997 | 9374697 |
| [complicated amebic liver abscess--course and therapy]. | we report on a case of an amoebic liver abscess acquired during a holiday in bali. transdiaphragmatic migration and consecutive atelectasis of the right lung caused respiratory insufficiency, requiring immediate surgical intervention. complications consisted of massive bleeding into the colon concomitant with a reactivated cmv-infection. in addition, toxins of clostridium difficile and enterohaemorrhagic e. coli were seen in the faeces. in contrast to the majority of uncomplicated cases of amoeb ... | 1997 | 9376471 |
| intravenous immunoglobulin therapy for severe clostridium difficile colitis. | many individuals have serum antibodies against clostridium difficile toxins. those with an impaired antitoxin response may be susceptible to recurrent, prolonged, or severe c difficile diarrhoea and colitis. | 1997 | 9378393 |
| fecal lactoferrin, interleukin-1beta, and interleukin-8 are elevated in patients with severe clostridium difficile colitis. | twenty-two patients with clostridium difficile colitis as determined by positive enzyme immunoassay for toxin a were evaluated for fecal inflammatory markers and their relationship to the severity of illness. fourteen of 22 specimens were positive for fecal lactoferrin (flf), with titers from 1:50 to 1:800. nine of 10 stools tested had ratios of interleukin-1beta (il-1beta) to il-1 receptor antagonist (il-1ra) of >0.01. seventeen of 22 specimens also had elevated il-8 concentrations, and 12 of 1 ... | 1997 | 9384296 |
| octreotide (sms 201-995) for hematopoietic support-dependent high-dose chemotherapy (hsd-hdc)-related diarrhoea: dose finding study and evaluation of efficacy. | emphasis has been put on the intensification of chemotherapy programs through high-dose chemotherapy regimens. while their myelosuppression is managed through the use of colony-stimulating factors and/or infusion of autologous peripheral blood progenitor cell transfusions (pbpct), extramedullary dose-limiting toxicities, including gastrointestinal mucosal injury, are a treatment-limiting factor and their management is a critical issue in hsd-hdc. octreotide is effective in the control of diarrho ... | 1997 | 9384471 |
| clostridium difficile-associated diarrhea in hiv-infected patients: epidemiology and risk factors. | a retrospective analysis of all the cases of clostridium difficile-associated diarrhea (cdad) in hospitalized patients infected with hiv was performed over a 52-month period to assess the incidence, epidemiology, and risk factors of cdad. a case of cdad was defined as a patient with diarrhea and a positive stool cytotoxin b assay. sixty-seven cases of cdad were recorded in hiv-infected patients between january 1991 and april 1995. the annual incidence of cdad ranged from 1.7 to 6.4 per 100 hiv-i ... | 1997 | 9390569 |
| rho prevents apoptosis through bcl-2 expression: implications for interleukin-2 receptor signal transduction. | here we describe a rho-mediated apoptosis suppression pathway driven by bcl-2 expression in the interleukin (il)-4- or il-2-dependent murine t cell line ts1 alpha beta. il-2, but not il-4, induces bcl-2 expression through rhoa activation which is inhibited by the specific rho family inhibitor, clostridium difficile toxin b, as well as by a dominant negative rhoa mutant. using transient transfections of rhoa mutants tagged with the vesicular stomatitis virus glycoprotein, we show that a constitut ... | 1997 | 9394801 |
| clostridium difficile infection is a risk factor for bacteremia due to vancomycin-resistant enterococci (vre) in vre-colonized patients with acute leukemia. | a cohort study was conducted in a cancer center to identify risk factors for bacteremia with vancomycin-resistant enterococci (vre) in neutropenic cancer patients colonized with vre. there were 10 patients with vre bacteremia among 56 colonized with vre, of whose charts 51 were available for review. one hundred percent of patients with vre bacteremia (10 of 10) vs. 56% of patients without vre bacteremia (23 of 41) had acute leukemia (p = .01, fisher's exact test). four of the 10 patients with vr ... | 1997 | 9402356 |
| nosocomial infections in human immunodeficiency virus-infected patients in a long-term-care setting. | to our knowledge, the epidemiology of hospital-acquired infections in human immunodeficiency virus (hiv)-infected patients during long-term care has not been reported. for 13 months, we observed hiv-infected patients (50 men and 15 women) in a dedicated 21-bed unit in a long-term-care facility to determine the rate of nosocomial infections. the mean age of the patients was 39 years (range, 22-78 years); 74% of the patients had cd4 cell counts of < 200/mm3. there was a total of 152 infections (24 ... | 1997 | 9402386 |
| isolation of toxigenic clostridium difficile from dialysate fluid in a fatal case of chronic ambulatory peritoneal dialysis-related peritonitis. | 1997 | 9402394 | |
| clostridium difficile toxic megacolon following splenectomy. | a case of toxic megacolon following splenectomy for lymphoma is presented. the aetiology of clostridial difficile infection is reviewed and the hazards of perioperative prohylactic antibiotics are discussed. | 1997 | 9403828 |
| diagnostic role of endoscopy, stool culture, and toxin a in clostridium difficile-associated disease. | this retrospective study was designed to assess the roles of stool culture for clostridium difficile, detection of the presence of toxin a, and endoscopic examination in the diagnosis of clostridium difficile-associated disease (cdad). from january 1994 through september 1996, there were 213 patients with stool cultures positive for c. difficile in national taiwan university hospital. of these, 126 had cdad. there were 87 asymptomatic carriers of c. difficile in our study, 12 of whom were positi ... | 1997 | 9409120 |
| physical map of the clostridium difficile chromosome. | clostridium difficile is a causative agent in antibiotically induced diarrhea and pseudomembraneous colitis. the ability of strains of c. difficile to cause disease depends upon the presence of two toxin genes and their corresponding proteins, designated toxin a and toxin b. previous studies conducted in this laboratory indicated that toxigenic strains of c. difficile possess both toxin genes, whereas non-toxigenic strains do not. likewise, the studies showed that toxigenic and non-toxigenic str ... | 1997 | 9409783 |
| colonic disease associated with a positive assay for clostridium difficile toxin: a retrospective study. | in this retrospective review of colonic tissue from 21 patients with a positive stool assay for clostridium difficile toxin, four groups of patients were identified by pathologic examination. classic pseudomembranous colitis was identified in 38% of patients in colon biopsies, resections, and at postmortem examination. one third of patients had acute colitis without specific features on colon biopsies at the time of a positive toxin assay. effects of c. difficile toxin in patients with idiopathi ... | 1997 | 9412955 |
| antisecretory factor suppresses intestinal inflammation and hypersecretion. | antisecretory factor (af) is a recently identified regulatory protein which inhibits the intestinal fluid secretion induced by cholera toxin. | 1997 | 9414971 |
| treating diarrhoea: what might the pituitary offer? | 1997 | 9414990 | |
| comparative in-vitro and in-vivo activity of am-1155 against anaerobic bacteria. | the in-vitro activity of am-1155, a 6-fluoro-8-methoxy quinolone, was compared with those of temafloxacin, sparfloxacin, tosufloxacin, ciprofloxacin, ofloxacin and cefmetazole, a cephamycin, against a variety of anaerobic bacteria. although am-1155 demonstrated only modest activity against the bacteroides fragilis group and prevotella bivia (mic90s > or =3.13 mg/ml), 76% of the b. fragilis strains tested were inhibited at am-1155 concentrations of 0.78 mg/l. am-1155 was highly active against pre ... | 1997 | 9421310 |
| successful control of clostridium difficile infection in an elderly care unit through use of a restrictive antibiotic policy. | toxin-producing clostridium difficile is the commonest bacterial cause of nosocomial diarrhoea and is a well recognized cause of hospital outbreaks in elderly care units. high c. difficile disease rates have been associated with the use of broad-spectrum antibiotics, especially cephalosporins. an outbreak of c. difficile infection in the elderly care unit at gloucestershire royal nhs trust continued despite increased ward cleaning and strict implementation of infection control measures. a restri ... | 1997 | 9421320 |
| increased incidence of clostridium difficile infection. | 1997 | 9421778 | |
| a prospective study of clostridium difficile infection and colonization in pediatric oncology patients. | patients with cancer often receive broad spectrum antibiotics in addition to antineoplastic chemotherapy. both treatments predispose adult oncology patients to infection and colonization with clostridium difficile, but the role of this pathogen in pediatric oncology patients is poorly defined. | 1997 | 9427457 |
| cytokines and the gut. | cytokines are peptide regulatory factors which are involved in initiating, amplifying, perpetuating and resolving the immune and inflammatory responses. each may have several actions, but can be broadly categorized into pro- and anti-inflammatory cytokines. the cytokine profile depends on the nature of the antigen, how it is presented to the host, and which cell types are involved in the response. elucidation of the cytokine cascade will improve understanding of the mechanisms of inflammation, a ... | 1997 | 9431892 |
| [value of proctosigmoidoscopy with bacteriological culture of colonic biopsies in the etiological diagnosis of post-antibiotic acute diarrhea in adults. prospective study in 24 patients]. | the aim of this study was to analyse the interest of proctosigmoidoscopy and biopsies microbiology in antibiotic-associated acute diarrhea in adults. between february 1993 and october 1995, we have studied prospectively 24 patients with antibiotic-associated acute diarrhea. ages ranged from 17 to 83 years. they had taken antibiotics: amoxicillin (n = 8) amoxicillin-clavulanic acid (n = 11), cephalosporinia (n = 3), cotrimoxazole (n = 1), macrolide (n = 1). for each patient, 2 stool cultures with ... | 1997 | 9538468 |
| evaluation of a new enzyme immunoassay for clostridium difficile toxin a. | to evaluate a new enzyme immunoassay (eia) method for detection of clostridium difficile toxin by comparing it to cytotoxicity assay. to investigate the nature of false negative and false positive eia results by evaluating clinical and therapeutic parameters. | 1997 | 9516880 |
| the natural beta-carbolines facilitate inositol phosphate accumulation by activating small g-proteins in human neuroblastoma cells (sh-sy5y). | the naturally occurring beta-carbolines exert psychotropic actions in humans and have numerous behavioral effects in animals. the known in vitro activities of these substances do not provide a satisfactory explanation for their in vivo effects. the present study was undertaken to explore the possibility of a specific signal transduction pathway. the human neuroblastoma cell line sh-sy5y was used as a model system. high-affinity binding sites for [3h]norharman (synonymous: beta-carboline) were de ... | 1997 | 9517450 |
| [value of rectosigmoidoscopy with bacteriological culture of colonic biopsies in the diagnosis of post-antibiotic hemorrhagic colitis related to klebsiella oxytoca]. | we report 7 cases of antibiotic-associated and hemorrhagic colitis due to klebsiella oxytoca. the diagnosis was performed by sigmoidoscopy with bacteriological biopsy culture. | 1997 | 9587518 |
| review article: treatment of clostridium difficile infection. | a systematic review of controlled trials of therapy of clostridium difficile intestinal infection using methodology described by the cochrane collaboration. | 1997 | 9663822 |
| acceptor hydroxyl group mapping for calf thymus alpha-(1-->3)-galactosyltransferase and enzymatic synthesis of alpha-d-galp-(1-->3)-beta-d-galp-(1-->4)-beta d-glcpnac analogs. | the epitope of the acceptor substrate for alpha-(1-->3)-galactosyltransferase from calf thymus has been mapped by using a series of mono-deoxygenated and mono-o-alkylated type ii (beta-d-ga1p-(1-->4)-beta-d-g1cpnac) disaccharides. the 4-oh group of the beta-d-galactopyranosyl residue is a key polar group essential for glycosyl transfer, tolerating neither deoxygenation nor o-alkylation. substitution at positions 6 and 6' by a variety of polar alkyl substituents was readily tolerated, allowing th ... | 1997 | 9648265 |
| high-dose infusional doxorubicin and cyclophosphamide: a feasibility study of tandem high-dose chemotherapy cycles without stem cell support. | the purpose of this study was to determine the maximally tolerated dose of doxorubicin administered during two cycles of intensive chemotherapy with cyclophosphamide and doxorubicin without stem cell support in patients with advanced cancer and to assess the cumulative cardiac toxicity of the regimen by noninvasive radionuclide imaging and by pre-and postchemotherapy endomyocardial biopsies. thirty-eight patients (thirty-six with high risk or metastatic breast cancer) were treated in a dose-esca ... | 1997 | 9815632 |