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genetics of clostridium difficile toxins. 200010981356
molecular mode of action of the large clostridial cytotoxins. 200010981357
cytotoxic effects of the clostridium difficile toxins. 200010981358
large clostridial cytotoxins as tools in cell biology. 200010981359
pathogenesis and clinical manifestations of clostridium difficile diarrhea and colitis. 200010981360
treatment of clostridium difficile-associated diarrhea and colitis.treatment of c. difficile diarrhea with metronidazole or vancomycin is highly effective at relieving symptoms. the high rate of diarrhea recurrence is concerning, but fortunately most patients respond to a second course of treatment. the problem of vancomycin resistance in hospital organisms has markedly reduced usage of this agent as a first-line treatment for c. difficile diarrhea, leaving metronidazole as the mainstay of treatment in the united states where teicoplanin and fusidic acid are no ...200010981361
antibiotic policies and clostridium difficile-associated diarrhoea. 200010985451
metronidazole resistance in clostridium difficile. 200010987742
toxin gene analysis of a variant strain of clostridium difficile that causes human clinical disease.a toxin variant strain of clostridium difficile was isolated from two patients with c. difficile-associated disease (cdad), one of whom died from extensive pseudomembranous colitis. this strain, identified by restriction endonuclease analysis (rea) as type cf2, was not detected by an immunoassay for c. difficile toxin a. culture supernatants of cf2 failed to elicit significant enterotoxic activity in the rabbit ileal loop assay but did produce atypical cytopathic effects in cell culture assay. s ...200010992443
toxins, butyric acid, and other short-chain fatty acids are coordinately expressed and down-regulated by cysteine in clostridium difficile.it was recently found that a mixture of nine amino acids down-regulate clostridium difficile toxin production when added to peptone yeast extract (py) cultures of strain vpi 10463 (s. karlsson, l. g. burman, and t. akerlund, microbiology 145:1683-1693, 1999). in the present study, seven of these amino acids were found to exhibit a moderate suppression of toxin production, whereas proline and particularly cysteine had the greatest impact, on both reference strains (n = 6) and clinical isolates (n ...200010992498
diagnosis of clostridium difficile antibiotic associated diarrhoea culture versus toxin assay.to compare the results of clostridium difficile (cd) on culture with detection of c. difficile toxin by enzyme immunoassay (eia) in the stool specimens of hospitalized patients with antibiotic associated diarrhoea (aad).200010992705
pediatric clostridium difficile: a phantom menace or clinical reality? 200010997362
extrinsic surgical denervation inhibits clostridium difficile toxin a-induced enteritis in rats.clostridium difficile enteritis is caused by toxin a (ta) which stimulates substance p release and subsequent receptor activation. this receptor stimulation results in secretion, inflammation, and structural damage. however, it is unclear as to which subset of neurons is required to initiate substance p release following toxin stimulation. five centimeter ileal segments were surgically denervated. after 10 days, three ileal loops were constructed in each rat: the denervated loop was injected int ...200010998557
surveillance for nosocomial and central line-related infections among pediatric hematology-oncology patients.to determine the incidence of all nosocomial infections (nis) in pediatric hematology-oncology patients, as well as central venous access device (cvad)-associated infections acquired during home care.200011001263
regulation of dendritic spine morphology by the rho family of small gtpases: antagonistic roles of rac and rho.dendritic spines mediate most excitatory transmission in the mammalian cns and have been traditionally considered stable structures. following the suggestion that spines may 'twitch', it has been recently shown that spines are capable of rapid morphological rearrangements. because of the role of the small gtpases from the rho family in controlling neuronal morphogenesis, we investigated the effects of several members of this biochemical signaling pathway in the maintenance of the morphology of e ...200011007543
the role of sonography in children with abdominal pain after recent successful reduction of intussusception. 200011009308
inhibition of small g proteins of the rho family by statins or clostridium difficile toxin b enhances cytokine-mediated induction of no synthase ii.in order to investigate the involvement of ras and/or rho proteins in the induction of the inducible isoform of nitric oxide synthase (nos ii) we used hmg-coa reductase inhibitors (statins) and clostridium difficile toxin b (tcdb) as pharmacological tools. statins indirectly inhibit small g proteins by preventing their essential farnesylation (ras) and/or geranylgeranylation (rho). in contrast, tcdb is a glucosyltransferase and inactivates rho-proteins directly. human a549/8- and dld-1 cells as ...200011015307
the role of physical proximity in nosocomial diarrhea.to examine physical proximity as a risk factor for the nosocomial acquisition of clostridium difficile-associated diarrhea (cdad) and of antibiotic-associated diarrhea (aad), we assessed a retrospective cohort of 2859 patients admitted to a community hospital from 1 march 1987 through 31 august 1987. of these patients, 68 had nosocomial cdad and 54 had nosocomial aad. in multivariate analysis, physical proximity to a patient with cdad (relative risk [rr], 1.86; 95% confidence interval [ci], 1.06 ...200011017821
in vitro activity of new generation fluoroquinolones against genotypically distinct and indistinguishable clostridium difficile isolates.we compared the activities of ciprofloxacin and levofloxacin with those of the newer fluoroquinolones grepafloxacin, moxifloxacin, sparfloxacin and trovafloxacin against clostridium difficile isolates. as there is good evidence of marked clonal spread of c. difficile, we studied both genotypically distinct (n = 26) and indistinguishable (n = 28) isolates as determined by random amplified polymorphic dna and ribosomal spacer pcr fingerprinting. the indistinguishable strains examined represent the ...200011020251
effect of supplements with lactic acid bacteria and oligofructose on the intestinal microflora during administration of cefpodoxime proxetil.thirty healthy volunteers in three groups participated in a study of the effect on the intestinal microflora of oral supplementation with bifidobacterium longum, lactobacillus acidophilus and oligofructose, an indigestible oligosaccharide, during oral administration of cefpodoxime proxetil bd for 7 days. those in group a also received an oral supplement with c.1011 cfu of b. longum bb 536 and l. acidophilus ncfb 1748 and 15 g oligofructose daily, those in group b received a supplement with oligo ...200011020259
clarithromycin appears to be linked with clostridium difficile-associated diarrhoea in the elderly. 200011020269
probiotics in pediatric gastrointestinal disorders.probiotics have been defined most recently as living microorganisms which, upon ingestion in certain numbers, exact health benefits beyond inherent general nutrition. they have been a part of human nutrition for centuries, but in recent years they have been more closely studied for their potential to improve health and treat disease. this review of probiotics is not extensive, highlighting the most recent reviews and well controlled clinical studies in both animals and humans. the safety issues ...200011021414
isolation of environmental clostridium difficile from a veterinary teaching hospital.an environmental survey of a veterinary teaching hospital for the presence of clostridium difficile was performed using contact plates and cycloserine-cefoxitin-fructose with 0.1% sodium taurocholate agar. clostridium difficile was isolated from 24 of 381 sites (6.3%). growth was obtained from 4.5% (9/202) of sites sampled in the large animal clinic, from 8.1% (13/160) of sites within the small animal clinic, and from 20% (2/10) of sites sampled elsewhere. fourteen of 21 strains tested produced ...200011021433
simultaneous occurrence of clostridium difficile and cytomegalovirus colitis in a recipient of autologous stem cell transplantation. 200011025618
activation of mmp-2 by clostridium difficile toxin b in bovine smooth muscle cells.matrix metalloproteinase-2 (mmp-2) plays critical roles in cell migration through the breakdown of the extracellular matrix. cell movements require dynamic actin reorganization, which is controlled by rho family gtpases. in order to examine the relation between mmp-2 regulation and actin reorganization, we used several inhibitors of rho family gtpases. treatment of smooth muscle cells with clostridium difficile toxin b known to inactivate rho family gtpases activated mmp-2. however, neither c3 t ...200011027636
clostridium difficile toxins influence hepatocyte protein synthesis through the interleukin 1 receptor.clostridium difficile toxins require interleukin 1 (il-1) production or a functioning il-1 receptor to elicit acute-phase protein production by murine hepatocytes.200011030883
[detection of toxin-producing pathogenic bacterial strains by polymerase chain reaction].polymerase chain reaction (pcr) was used for detection of pathogenic clostridium botulinum, clostridium perfringens, clostridium difficile, and escherichia coli. with this aim in view, primers to botulinic toxins types a, b, c1, d, e, f, and g, perfringens enterotoxin, difficile toxin, and types 1 and 2 shigella-like toxins were chosen and synthesized. optimal amplification conditions were selected for each pair of primers, with dna and the respective agent as the reaction mixture matrices. pcr ...200011031435
bifidobacterium strains from resident infant human gastrointestinal microflora exert antimicrobial activity.the gastrointestinal microflora exerts a barrier effect against enteropathogens. the aim of this study was to examine if bifidobacteria, a major species of the human colonic microflora, participates in the barrier effect by developing antimicrobial activity against enterovirulent bacteria.200011034580
purification and evaluation of large clostridial cytotoxins that inhibit small gtpases of rho and ras subfamilies. 200011036597
dna sequence of the insertional hot spot of tn916 in the clostridium difficile genome and discovery of a tn916-like element in an environmental isolate integrated in the same hot spot.tn916 is a broad host range tetracycline resistance conjugative transposon. in most bacteria, this element enters the bacterial genome at multiple sites. however, in clostridium difficile, the element has a strong hot spot when introduced by filter mating from bacillus subtilis. in this work, the dna sequence of the preferred insertion site (att916) was obtained. an environmental isolate of c. difficile was also discovered which contained an element indistinguishable from tn916, tn916cd. tn916cd ...200011040422
fermentation of 4-aminobutyrate by clostridium aminobutyricum: cloning of two genes involved in the formation and dehydration of 4-hydroxybutyryl-coa.clostridium aminobutyricum ferments 4-aminobutyrate via succinic semialdehyde, 4-hydroxybutyrate, 4-hydroxybutyryl-coa and crotonyl-coa to acetate and butyrate. the genes coding for the enzymes that catalyse the interconversion of these intermediates are arranged in the order abfd (4-hydroxybutyryl-coa dehydratase), abft (4-hydroxybutyrate coa-transferase), and abfh (nad-dependent 4-hydroxybutyrate dehydrogenase). the genes abfd and abft were cloned, sequenced and expressed as active enzymes in ...200011041350
evidence for rho protein regulation of renal tubular epithelial cell function.rho proteins are small guanine 5'-triphosphate (gtp)-binding proteins felt to be important regulators of several aspects of cell function, including the organization of the actin cytoskeleton. the effects of rho proteins on the regulation of renal tubular epithelial cell function are not known.200011044220
perioperative complications after living donor lobectomy.clinical lung transplantation has been limited by availability of suitable cadaveric donor lungs. living donor lobectomy provides right and left lower lobes from a pair of living donors for each recipient. we reviewed our experience with living donor lobectomy from july 1994 to february 2000.200011044317
environmental control to reduce transmission of clostridium difficile.restrictive antibiotic policies and infection control measures have been shown to reduce the incidence of clostridium difficile-associated diarrhea (cdad) among hospitalized patients. to date, the role of environmental disinfectants in reducing nosocomial cdad rates has not been well studied. in a before-and-after intervention study, patients in 3 units were evaluated to determine if unbuffered 1:10 hypochlorite solution is effective as an environmental disinfectant in reducing the incidence of ...200011049782
the search for a better treatment for recurrent clostridium difficile disease: use of high-dose vancomycin combined with saccharomyces boulardii.recurrent clostridium difficile disease (cdd) is a difficult clinical problem because antibiotic therapy often does not prevent further recurrences. in a previous study, the biotherapeutic agent saccharomyces boulardii was used in combination with standard antibiotics and was found to be effective in reducing subsequent recurrences of cdd. in an effort to further refine a standard regimen, we tested patients receiving a regimen of a standard antibiotic for 10 days and then added either s. boular ...200011049785
effect on the human normal microflora of oral antibiotics for treatment of urinary tract infections.oral administration of antibiotics for treatment of urinary tract infections (utis) can cause ecological disturbances in the normal intestinal microflora. poorly absorbed drugs can reach the colon in active form, suppress susceptible microorganisms and disturb the ecological balance. suppression of the normal microflora may lead to reduced colonization resistance with subsequent overgrowth of pre-existing, naturally resistant microorganisms, such as yeasts and clostridium difficile. new coloniza ...200011051623
evaluation of 16s rrna and cellular fatty acid profiles as markers of human intestinal bacterial growth in the chemostat.chemostats were used to study the effects of carbon and nitrogen limitation and specific growth rate on 16s rrna synthesis and cellular fatty acid (cfa) profiles in four human intestinal bacteria (bacteroides thetaiotaomicron, bifidobacterium adolescentis, clostridium bifermentans and cl. difficile). cellular fatty acid synthesis varied with dilution rate and nutrient availability in different species, but these cellular constituents were relatively stable phenotypic characteristics in bact. the ...200011054172
beneficial microbes: health or hazard?normal microbial flora support the health of the host by diverse mechanisms. when antibiotics, stress, disease or medications disrupt normal microflora, the ability to ward off infection by pathogens is compromised. the use of beneficial microbes (also known as biotherapeutic agents, probiotics, synbiotics) has been shown to be an effective therapeutic agent for some diseases. various types of diarrhoea (antibiotic-associated diarrhoea, clostridium difficile disease, traveller's diarrhoea) are m ...200011057450
knowledge of centers for disease control and prevention guidelines for the use of vancomycin at a large tertiary care children's hospital.in 1994, the centers for disease control and prevention (cdc) published guidelines to encourage prudent use of vancomycin. we sought to determine whether physicians could demonstrate knowledge consistent with the guidelines.200011060537
pharmacokinetics and comparative effects of telithromycin (hmr 3647) and clarithromycin on the oropharyngeal and intestinal microflora.the pharmacokinetics in plasma and saliva of a new ketolide, telithromycin (hmr 3647), and the effect on the normal oropharyngeal and intestinal microflora were studied in healthy volunteers and compared with those of clarithromycin. ten subjects received 800 mg telithromycin perorally once daily and 10 other subjects received 500 mg clarithromycin bid for 10 days. blood, saliva and faecal specimens were collected at defined intervals before, during and after administration for pharmacokinetic a ...200011062193
microflora-associated characteristics in faeces from allergic and nonallergic infants.the prevalence of allergic diseases has increased particularly over the past 30-40 years. a reduced microbial stimulation during infancy may result in a development of a disturbed balance between th1- and th2-like immunity. the gut flora is, quantitatively, the most important source for such stimulation.200011069568
transposition of tn4451 and tn4453 involves a circular intermediate that forms a promoter for the large resolvase, tnpx.tn4451 is the paradigm element of a family of mobilizable chloramphenicol resistance transposons from clostridium perfringens and clostridium difficile. the unique feature of these 6.3 kb elements is that their excision to form a circular molecule is mediated by tnpx, a member of the large resolvase family of site-specific recombinases. by optimizing the transposition assay system in escherichia coli, we showed that tn4453a from c. difficile transposed at a higher frequency than the c. perfringe ...200011069682
hospital disinfectants and spore formation by clostridium difficile.evidence is lacking on how best to decontaminate the hospital environment of clostridium difficile. we compared sporulation levels in the uk epidemic c. difficile strain (p24), another clinical isolate (b31), and an environmental strain (e4) cultured in faecal emulsion containing subinhibitory concentrations of one of five hospital cleaning agents. the epidemic strain produced significantly more spores than the non-prevalent strains, and sporulation was further enhanced when this strain was cult ...200011073024
the large resolvase tndx is required and sufficient for integration and excision of derivatives of the novel conjugative transposon tn5397.tn5397 is a novel conjugative transposon, originally isolated from clostridium difficile. this element can transfer between c. difficile strains and to and from bacillus subtilis. it encodes a conjugation system that is very similar to that of tn916. however, insertion and excision of tn5397 appears to be dependent on the product of the element encoded gene tndx, a member of the large resolvase family of site-specific recombinases. to test the role of tndx, the gene was cloned and the protein wa ...200011073898
clostridium difficile infection in allogeneic stem cell transplant recipients is associated with severe graft-versus-host disease and non-relapse mortality.we retrospectively evaluated 75 allogeneic stem cell transplant recipients to ascertain the incidence, risk factors and outcome of infection with clostridium difficile. ten patients (13%) had clostridium difficile infection at a median of 38 days (range day -6 to day +72) following the transplant. there was no difference in the duration or severity of diarrhoea in patients with clostridium difficile infection compared to the uninfected patients and no relationship to the prior antibiotic or chem ...200011081387
[diarrhea associated with clostridium difficile secondary to the use of ciprofloxacin, complicating a first occurrence of intestinal inflammatory disease]. 200011084823
bacterial infections of the colon.the colon is a common site of infection for a heterogeneous group of bacterial pathogens. the presentation of disease in the colon is generally in the form of distinct syndromes, and it is important for physicians to recognize the causative organisms, because specific treatment is highly effective. the flouroquinolones have emerged as the treatment of choice for most food-borne bacterial pathogens. resistance to these agents is not a major issue at present except in campylobacter. clostridium di ...200011097742
novel targets for the pharmacotherapy of diarrhoea: a view for the millennium.acute diarrhoea continues to carry a high morbidity and mortality worldwide. intestinal infection is the major cause of acute diarrhoea although the prevalence of individual pathogens varies according to geographic location. in many countries in the industrialized world, reports of intestinal infections continue to increase; these are largely related to waterborne and foodborne outbreaks. acute diarrhoea may be due to increased intestinal secretion, commonly as a result of infection with enterot ...200011100992
[recurrent clostridium difficile enterocolitis].pseudomembranous enterocolitis generally occurs after antibiotic treatment. the standard treatment is oral metronidazol or vancomycin. nevertheless, relapses of clostridium difficile enterocolitis are observed in 10-25% of cases. factors associated with recurrences include endogenous reinfection by spore formation, selective igg1 or iga deficiency or infection with mutated strains of clostridium difficile. recurrent clostridium difficile enterocolitis may be treated with repeat oral vancomycin c ...200011103440
enterotoxins and the enteric nervous system--a fatal attraction.although there has been extensive investigation of the biochemical consequences of the interactions between bacterial enterotoxins and intestinal epithelial cells and the mechanisms by which they induce intestinal secretion, relatively little attention has been given to other aspects of the host response to these enterotoxins. there is now compelling evidence that the enteric nervous system has a major role in enhancing the secretory state induced by cholera toxin, the e. coli enterotoxins and p ...200011111932
treatment and prevention of antibiotic associated diarrhea.mild or severe episodes of antibiotic-associated diarrhea (aad) are common side effects of antibiotic therapy. the incidence of aad differs with the antibiotic and varies from 5 to 25%. the major form of intestinal disorders is the pseudomembranous colitis associated with clostridium difficile which occurs in 10-20% of all aad. in most cases of aad discontinuation or replacement of the inciting antibiotic by another drug with lower aad risk can be effective. for more severe cases involving c. di ...200011118872
clostridium difficile, disinfectant, and elemental diet. 200011145517
clostridium difficile and vancomycin-resistant enterococcus: the new nosocomial alliance.the aims of this study were to determine the frequency of the association between clostridium difficile (c. difficile) and vancomycin-resistant enterococcus (vre) and delineate the role of c. difficile coinfection as a predictor of vre infection versus colonization and adverse outcome.200011151886
usefulness of simultaneous detection of toxin a and glutamate dehydrogenase for the diagnosis of clostridium difficile-associated diseases.the aim of this study was to evaluate an immunoassay (triage; biosite diagnostics, bmd, france) for detecting both a specific antigen of clostridium difficile (glutamate dehydrogenase [gdh]) and toxin a. evaluation of the test was carried out in 304 fecal samples from patients suspected of having clostridium difficile-associated diseases. the results with gdh and toxin a were compared with those of a culture and cytotoxicity assay (toxin b). the prevalence rates for toxin b-positive and culture- ...200010947228
re: probiotics and c difficile diarrhea. 200010950076
in vitro and in vivo activities of nitazoxanide against clostridium difficile.we have used the hamster model of antibiotic-induced clostridium difficile intestinal disease to evaluate nitazoxanide (ntz), a nitrothiazole benzamide antimicrobial agent. the following in vitro and in vivo activities of ntz in the adult hamster were examined and compared to those of metronidazole and vancomycin: (i) mics and minimum bactericidal concentrations (mbcs) against c. difficile, (ii) toxicity, (iii) ability to prevent c. difficile-associated ileocecitis, and (iv) propensity to induce ...200010952564
images in clinical medicine. pseudomembranous colitis. 200010954764
[pseudomembranous colitis caused by clostridium difficile]. 200010958059
toxic pseudomembranous colitis in a patient with ulcerative colitis.toxic colitis is a severe disease that may be caused by several inflammatory and/or infectious diseases. ulcerative colitis is one of the most frequent causes of toxic colitis in the united states. toxic megacolon complicating clostridium difficile colitis is a rare occurrence with significant morbidity and mortality. case report: a 52-year-old male presented with rectal bleeding and tenesmus. he had been treated for amebiasis with metronidazole, and had improved. two weeks later, symptoms recur ...200010961591
infectious gastro-enteritis: an uncommon cause of diarrhoea in adult allogeneic and autologous stem cell transplant recipients.the incidence and aetiology of acute diarrhoea in 60 adult allogeneic or autologous stem cell transplant (sct) recipients was determined in a prospective study. stool specimens were obtained prior to sct and on days +20, +40, +60 and +100 post transplant. microbiological evaluation was performed for pathogenic bacteria, fungi, parasites and viruses. forty-seven patients were evaluable of whom 31 had a total of 48 acute diarrhoeal episodes. diarrhoea occurred in 79% of allogeneic and 47% of autol ...200010967569
effect on the human normal microflora of oral antibiotics for treatment of urinary tract infections.oral administration of antibiotics for treatment of urinary tract infections (utis) can cause ecological disturbances in the normal intestinal microflora. poorly absorbed drugs can reach the colon in active form, suppress susceptible microorganisms and disturb the ecological balance. suppression of the normal microflora may lead to reduced colonization resistance with subsequent overgrowth of pre-existing, naturally resistant microorganisms, such as yeasts and clostridium difficile. new coloniza ...200010969051
phenotypic and genotypic diversity of the flagellin gene (flic) among clostridium difficile isolates from different serogroups.phenotypic and genotypic diversity of the flagellin gene (flic) of clostridium difficile was studied in 47 isolates from various origins belonging to the serogroups a, b, c, d, f, g, h, i, k, x, and s3. electron microscopy revealed 17 nonflagellated strains and 30 flagellated strains. pcr and reverse transcription-pcr demonstrated that the flagellin gene was present in all strains and that the flic gene was expressed in both flagellated and nonflagellated strains. southern blotting showed the pr ...200010970353
hormone-stimulated calcium release is inhibited by cytoskeleton-disrupting toxins in ar4-2j cells.we have studied the role of the actin cytoskeleton in bombesin-induced inositol 1,4,5-trisphosphate (ip(3))-production and ca(2+)release in the pancreatic acinar tumour cell line ar4-2j. intracellular and extracellular free ca(2+)concentrations were measured in cell suspensions, using fura-2. disruption of the actin cytoskeleton by pretreatment of the cells with latrunculin b (10 microm), cytochalasin d (10 microm) or toxin b from clostridium difficile (20 ng/ml) for 5-29 h led to inhibition of ...200010970764
prevalence of toxin a negative/b positive clostridium difficile strains. 200010973753
developmental control of endocytosis in dendritic cells by cdc42.dendritic cells (dcs) developmentally regulate antigen uptake by controlling their endocytic capacity. immature dcs actively internalize antigen. however, mature dcs are poorly endocytic, functioning instead to present antigens to t cells. we have found that endocytic downregulation reflects a decrease in endocytic activity controlled by rho family gtpases, especially cdc42. blocking cdc42 function by toxin b treatment or injection of dominant-negative inhibitors of cdc42 abrogates endocytosis i ...200010975523
clostridium difficile-associated diseases. the clinical courses of 18 fatal cases.severe cases of clostridium difficile-associated diseases with sepsis seem to be rare, as are case reports about the pathogen involved and sepsis. our objective was to investigate the frequency and the clinical courses of severe cases of c. difficile-associated diseases with a fatal outcome in our hospital.200010872133
inhibition of protein isoprenylation impairs rho-regulated early cellular response to genotoxic stress.activation of c-jun n-terminal kinases (jnks) and nuclear factor-kappab (nf-kappab) are early cellular responses to genotoxic stress involved in the regulation of gene expression. pretreatment of cells with the hydroxymethyl glutaryl-coa reductase inhibitor lovastatin blocked stimulation of jnk1 activity by uv irradiation and by treatment with the alkylating compound methyl methanesulfonate but did not affect activation of extracellular signal-regulated kinase 2 by uv light. lovastatin also atte ...200011093778
[the risk factors for clostridium difficile infection in elderly patients. a case-control study].to study the main risk factors associated with clostridium difficile infection in a geriatric unit.200011093871
[nosocomial diarrhea due to clostridium difficile]. 200011093872
leukocytosis and clostridium difficile-associated diarrhea. 200011095311
"flora power"-- fecal bacteria cure chronic c. difficile diarrhea. 200011095314
leukocytosis as a harbinger and surrogate marker of clostridium difficile infection in hospitalized patients with diarrhea.clostridium difficile is the etiological agent of antibiotic-associated diarrhea and pseudomembranous colitis and is a leading cause of nosocomial diarrhea. the objective of the study was to examine if leukocytosis could be a harbinger and surrogate marker of c. difficile infection in hospitalized patients.200011095331
treatment of recurrent clostridium difficile-associated diarrhea by administration of donated stool directly through a colonoscope. 200011095355
asymptomatic carriage of clostridium difficile and serum levels of igg antibody against toxin a.clostridium difficile infection can result in asymptomatic carriage, mild diarrhea, or fulminant pseudomembranous colitis. we studied whether antibody responses to c. difficile toxins affect the risks of colonization, diarrhea, and asymptomatic carriage.200010666429
analysis of the pathogenicity locus in clostridium difficile strains.the genes for clostridium difficile toxins a and b (tcda and tcdb) are part of a 19.6-kb pathogenicity locus (paloc) that includes the genes tcdd, tcde, and tcdc. to determine whether the c. difficile paloc is a stable and conserved genetic unit in toxigenic strains, a multiplex polymerase chain reaction was used to analyze 50 toxigenic, 39 nontoxigenic, and 2 toxin-defective isolates. the respective amplicons were identified for tcda-e in the toxigenic isolates; these were absent in the nontoxi ...200010669352
polarization of chemoattractant receptor signaling during neutrophil chemotaxis.morphologic polarity is necessary for chemotaxis of mammalian cells. as a probe of intracellular signals responsible for this asymmetry, the pleckstrin homology domain of the akt protein kinase (or protein kinase b), tagged with the green fluorescent protein (phakt-gfp), was expressed in neutrophils. upon exposure of cells to chemoattractant, phakt-gfp is recruited selectively to membrane at the cell's leading edge, indicating an internal signaling gradient that is much steeper than that of the ...200010669415
new method to generate enzymatically deficient clostridium difficile toxin b as an antigen for immunization.the family of the large clostridial cytotoxins, encompassing clostridium difficile toxins a and b as well as the lethal and hemorrhagic toxins from clostridium sordellii, monoglucosylate the rho gtpases by transferring a glucose moiety from the cosubstrate udp-glucose. here we present a new detoxification procedure to block the enzyme activity by treatment with the reactive udp-2', 3'-dialdehyde to result in alkylation of toxin a and b. alkylation is likely to occur in the catalytic domain, beca ...200010678912
enhancement of the migration of metastatic human breast cancer cells by phosphatidic acid.phosphatidic acid (pa), lysophosphatidic acid (lpa), and sphingosine 1-phosphate (spp) are naturally occurring phospholipids which induce a variety of effects as extracellular messengers. in this study, we compared the effects of these phospholipid signaling molecules on the migration of invasive and noninvasive breast cancer cell lines, an index of the metastatic potential of these cells. as previously demonstrated, invasive mda-mb-231 breast cancer cells exhibited increased constitutive (nonst ...200010679229
in vitro activities of novel trans-3,5-disubstituted pyrrolidinylthio-1beta-methylcarbapenems with potent activities against methicillin-resistant staphylococcus aureus and pseudomonas aeruginosa.the in vitro activities of the novel 1beta-methylcarbapenems j-111, 225, j-114,870, and j-114,871, which have a structurally unique side chain that consists of a trans-3,5-disubstituted 5-arylpyrrolidin-3-ylthio moiety at the c-2 position, were compared with those of reference antibiotics. among isolates of both methicillin-resistant staphylococcus aureus (mrsa) and methicillin-resistant coagulase-negative staphylococci (mrcons), 90% were inhibited by j-111,347 (prototype), j-111,225, j-114,870, ...200010681308
the macrolide-lincosamide-streptogramin b resistance determinant from clostridium difficile 630 contains two erm(b) genes.the ermb macrolide-lincosamide-streptogramin b (mls) resistance determinant from clostridium difficile 630 contains two copies of an erm(b) gene, separated by a 1.34-kb direct repeat also found in an erm(b) determinant from clostridium perfringens. in addition, both erm(b) genes are flanked by variants of the direct repeat sequence. this genetic arrangement is novel for an ermb mls resistance determinant.200010639372
clostridium difficile toxin: cytoskeletal changes and lactate dehydrogenase release in hepatocytes.we have found that clostridium difficile toxins can evoke hepatocyte acute-phase protein synthesis, and that this effect is dependent on a functioning interleukin-1 (il-1) receptor. the present study was undertaken to determine if c. difficile toxicity, as determined by actin rearrangement and lactate dehydrogenase (ldh) release, also requires a functioning il-1 receptor.200010644484
identification of a novel genetic locus that is required for in vitro adhesion of a clinical isolate of enterohaemorrhagic escherichia coli to epithelial cells.enterohaemorrhagic escherichia coli (ehec) are food-borne intestinal pathogens with a low infectious dose. adhesion of some ehec strains to epithelial cells is attributed, in part, to intimin, but other factors may be required for the intestinal colonizing ability of these bacteria. in order to identify additional adherence factors of ehec, we generated transposon mutants of a clinical ehec isolate of serotype o111:h-, which displayed high levels of adherence to cultured chinese hamster ovary (c ...200010652089
high prevalence of diarrhea but infrequency of documented clostridium difficile in autologous peripheral blood progenitor cell transplant recipients.autologous peripheral blood progenitor cell (pbpc) transplant recipients frequently receive multiple antibiotics for neutropenic fever in addition to high-dose chemotherapy. although there are many possible causes for diarrhea in this population, empiric therapy for possible c. difficile colitis is common in some centers. this study sought to define the frequency of diarrhea and of a positive c. difficile toxin assay in pbpc transplant recipients. data were collected on 80 patients enrolled in a ...200010654017
pseudomembranous colitis: an update.clostridium difficile is the most common nosocomial infection of the gastrointestinal tract. most cases are associated with antibiotic therapy that alters the fecal flora, allowing overgrowth of c difficile with production of its toxins. diagnosis is made by detection of the organism or toxin in the stools. a variety of different tests can be used, but none is perfect. a stool culture can be positive in someone without diarrhea, ie, a carrier. while the cytotoxin is the gold standard, it is expe ...200010655027
polymeric iga is superior to monomeric iga and igg carrying the same variable domain in preventing clostridium difficile toxin a damaging of t84 monolayers.the two exotoxins a and b produced by clostridium difficile are responsible for antibiotic-associated enterocolitis in human and animals. when added apically to human colonic carcinoma-derived t84 cell monolayers, toxin a, but not toxin b, abolished the transepithelial electrical resistance and altered the morphological integrity. apical addition of suboptimal concentration of toxin a made the cell monolayer sensitive to toxin b. both toxins induced drastic and rapid epithelial alterations when ...200010657645
comparative in vitro activity of moxifloxacin against gram-positive clinical isolates.the in vitro activity of moxifloxacin was compared with that of 15 antibacterial agents against 513 gram-positive microorganisms. the mic(90) (mg/l) of moxifloxacin was 0.06 for quinolone-susceptible staphylococcus aureus and staphylococcus epidermidis, 0.12 for streptococcus pyogenes and streptococcus agalactiae; 0.25 for streptococcus pneumoniae, streptococcus mitis, streptococcus bovis, streptococcus anginosus and actinomyces pyogenes; 0.5 for streptococcus sanguis and listeria monocytogenes, ...200010629010
value of lysozyme agar incorporation and alkaline thioglycollate exposure for the environmental recovery of clostridium difficile.clostridium difficile is an increasingly prevalent nosocomial pathogen. environmental contamination by spores is believed to be a major factor propagating the spread of c. difficile. various approaches including the use of bile salts have been described to enhance the recovery of c. difficile from clinical and environmental specimens. we found that lysozyme (5 mg/l) incorporated into a selective medium containing bile salts significantly increased the recovery of c. difficile from swabs of 197 e ...200010633056
probiotics and gastrointestinal health.evidence for positive health benefits of lactobacilli applies to only a few strains used for commercial applications. it is generally agreed that a probiotic must be capable of colonizing the intestinal tract to influence human health; this requirement disqualifies many of the strains currently used in fermented dairy products. lactobacillus gg, a variant of l. casei sps rhamnosus, has been studied extensively in adults and children. when consumed as a dairy product or as a lyophilized powder, l ...200010634218
the effect of probiotics on clostridium difficile diarrhea.clostridium difficile is the leading cause of nosocomially acquired intestinal infection in the united states, affecting virtually all cases of pseudomembranous colitis and up to 20% of cases of antibiotic-associated diarrhea. even after receiving antibiotic treatment with either metronidazole or vancomycin, 20% of patients will have recurrent clostridium difficile diarrhea. an innovative approach to the problem involves the introduction of competing, nonpathogenic (probiotic) organisms into the ...200010634221
probiotics and infectious diarrhea.numerous probiotic agents have been studied for the management of diarrheal disease. in particular, the prevention and management of acute viral diarrhea, the treatment of recurrent clostridium difficile diarrhea, as well as the control of antibiotic-associated diarrhea seem to be areas of significant potential benefit. a few agents, including lactobacillus gg, lactobacillus reuteri, and saccharomyces boulardii, seem to be promising agents for the amelioration of the course of acute diarrhea in ...200010634223
p21-activated kinase 1 phosphorylates the death agonist bad and protects cells from apoptosis.bad is a critical regulatory component of the intrinsic cell death machinery that exerts its death-promoting effect upon heterodimerization with the antiapoptotic proteins bcl-2 and bcl-x(l). growth factors promote cell survival through phosphorylation of bad, resulting in its dissociation from bcl-2 and bcl-x(l) and its association with 14-3-3tau. survival of interleukin 3 (il-3)-dependent fl5.12 lymphoid progenitor cells is attenuated upon treatment with the rho gtpase-inactivating toxin b fro ...200010611223
re: clinical characteristics and antibiotic utilization in surgical patients with clostridium difficile-associated diarrhea. 200010759208
re: kreiss et al.: pneumatosis intestinalis complicating c. difficile pseudomembranous colitis. 200010763988
recurrent clostridium difficile-associated diarrhea and colitis treated with saccharomyces cerevisiae (baker's yeast) in combination with antibiotic therapy: a case report. 200010764197
the small g-protein rac mediates depolarization-induced superoxide formation in human endothelial cells.superoxide anions impair nitric oxide-mediated responses and are involved in the development of hypertensive vascular hypertrophy. the regulation of their production in the vascular system is, however, poorly understood. we investigated whether changes in membrane potential that occur in hypertensive vessels modulate endothelial superoxide production. in cultured human umbilical vein endothelial cells, changes in membrane potential were induced by high potassium buffer, the non-selective potassi ...200010764736
comparison of the tox a/b test to a cell culture cytotoxicity assay for the detection of clostridium difficile in stools.the tox a/b test (techlab, blacksburg, va, usa) was compared to cell culture cytotoxicity assay on 1109 consecutive diarrheal stool samples collected from patients with the presumptive diagnosis of clostridium difficile disease. the tox a/b test is an enzyme immunoassay in a microtiter format that detects both toxins a and b. the procedure used for this study takes approximately 1.5 h to perform. cell culture cytotoxicity was performed by using a fibroblast cell line in a microtiter format read ...200010764962
fecal incontinence in hospitalized patients who are acutely ill.information about fecal incontinence experienced by patients in acute-care settings is lacking. the relationship of fecal incontinence to several well-known nosocomial or iatrogenic causes of diarrhea has not been determined.200010768587
ph-induced conformational changes in clostridium difficile toxin b.toxin b from clostridium difficile is a monoglucosylating toxin that targets substrates within the cytosol of mammalian cells. in this study, we investigated the impact of acidic ph on cytosolic entry and structural changes within toxin b. bafilomycin a1 was used to block endosomal acidification and subsequent toxin b translocation. cytopathic effects could be completely blocked by addition of bafilomycin a1 up to 20 min following toxin treatment. furthermore, providing a low extracellular ph co ...200010768933
p38 map kinase activation by clostridium difficile toxin a mediates monocyte necrosis, il-8 production, and enteritis.clostridium difficile toxin a causes acute neutrophil infiltration and intestinal mucosal injury. in cultured cells, toxin a inactivates rho proteins by monoglucosylation. in monocytes, toxin a induces il-8 production and necrosis by unknown mechanisms. we investigated the role of mitogen-activated protein (map) kinases in these events. in thp-1 monocytic cells, toxin a activated the 3 main map kinase cascades within 1 to 2 minutes. activation of p38 was sustained, whereas stimulation of extrace ...200010772660
systemic vancomycin overexposure in a patient with spinal cord injury who had staphylococcal sepsis and clostridium difficile colitis. 200010774640
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