Publications

the role of probiotics in the treatment of intestinal infections and inflammation.	clinical studies have established that certain probiotics are useful in a variety of intestinal disorders, including viral diarrhea, antibiotic-associated diarrhea, clostridium difficile-associated diarrhea, and traveler's diarrhea. evolving data suggest that probiotics might be useful in the control of inflammatory diseases, treatment and prevention of allergic diseases, cancer prevention, and stimulation of the immune system, which may result in the reduction in respiratory disease. a review o ...	2001	17031151
induction of mucosal immune responses by bacteria and bacterial components.	bacteria have well documented abilities to induce protective as well as pathogenic mucosal immune responses, with the type of response dependent on the genetically programmed balance of pro- and anti-inflammatory cytokines and t-lymphocyte subsets. inflammatory bowel disease, especially crohn disease and periodontal disease, appear to be overly aggressive cellular immune responses to some, but not all, normal resident bacteria. recent evidence suggests that the balance of protective (probiotic) ...	2001	17031218
probiotics in gastroenterology.	recent evidence has suggested the potential therapeutic role for probiotics in the prevention or treatment of gastrointestinal diseases. several studies have shown that probiotics are of benefit in gastrointestinal infections, including viral diarrhea, clostridium difficile-associated diarrhea, traveler's diarrhea, and antibiotic-associated diarrhea. recent data support the potential beneficial therapeutic effect in inflammatory bowel disease as well. other possible indications for probiotic tre ...	2002	17033293
limited value of routine microbiological diagnostics in patients hospitalized for community-acquired pneumonia.	current guidelines recommend microbiological diagnostic procedures as a part of the management of patients hospitalized for community-acquired pneumonia (cap), but the value of such efforts has been questioned. patients hospitalized for cap were studied retrospectively, focusing on the use of aetiological diagnostic methods and their clinical impact. adult patients, without known human immunodeficiency virus infection, admitted to hospital for cap during 12 months, were evaluated with regard to ...	2002	12587618
[cultivation of fungi from fecal specimens in cases of antibiotic associated diarrhea (aad)].	the aim of performed examinations was to isolate, identify and determine a drug susceptibility of fungi cultured from faecal specimens submitted for detection of clostridium difficile in cases of antibiotic-associated diarrhoea (aad). one hundred samples of diarrhoeic faeces were examined using routine bacteriological methods (isolation and identification of c. difficile), serological test (detection of c. difficile toxins a/b) and mycological methods (isolation, identification and drug suscepti ...	2002	12650060
the clostridial mobilisable transposons.	mobilisable transposons are transposable genetic elements that also encode mobilisation functions but are not in themselves conjugative. they rely on coresident conjugative elements to facilitate their transfer to recipient cells. clostridial mobilisable transposons include tn4451 and tn4452 from clostridium perfringens, and tn4453a and tn4453b from clostridium difficile, all of which are closely related, and tn5398 from c. difficile. the tn4451 group of elements encodes resistance to chloramphe ...	2002	12568329
clostridium difficile.	clostridium difficile is the most commonly identified infective cause of antibiotic associated diarrhoea. broad spectrum antibiotics, are most frequently incriminated, although short (<3 day) antibiotic courses cause fewer episodes. gold standard cell-culture based cytotoxin assays have been compared to rapid immunoassays, which are less effective, especially since toxin a negative, toxin b positive strains have been shown to be truly virulent. details of colonization and adherence mechanisms ha ...	2002	12686885
characterization of clostridium difficile isolates from foals with diarrhea: 28 cases (1993-1997).	to determine molecular characteristics of clostridium difficile isolates from foals with diarrhea and identify clinical abnormalities in affected foals.	2002	12680451
pseudomembranous colitis with fatal outcome in a 43-year-old man.	pseudomembranous colitis is a life-threatening complication of broad spectrum antibiotic therapy caused by clostridium difficile. untreated, the disease can lead to severe and in many cases fatal complications such as peritonitis due to colonic wall perforation, shock as a consequence of volume depletion, toxic megacolon and massive lower gastrointestinal haemorrhage. fatal complications mostly occur in elderly people with a high degree of comorbidity. we report the case of a 43-year-old patient ...	2002	12935660
protein kinase c signaling regulates zo-1 translocation and increased paracellular flux of t84 colonocytes exposed to clostridium difficile toxin a.	clostridium difficile toxin a increases paracellular permeability in colonic epithelial t84 cells by mechanisms involving rhoa glucosylation and actin depolymerization. however, we previously observed that toxin a-mediated decline in transepithelial electrical resistance preceded changes in cell morphology and tight junction ultrastructure (hecht, g., pothoulakis, c., lamont, j. t., and madara, j. l. (1988) j. clin. invest. 82, 1516-1524). recent studies also showed that c. difficile toxins indu ...	2002	11729192
health care costs and mortality associated with nosocomial diarrhea due to clostridium difficile.	a total of 271 patients were prospectively followed up to determine whether patients whose hospital stay is complicated by diarrhea due to clostridium difficile experience differences in cost and length of stay and survival rates when compared with patients whose stay is not complicated by c. difficile-associated diarrhea. forty patients (15%) developed nosocomial c. difficile-associated diarrhea. these patients incurred adjusted hospital costs of $3669--that is, 54% (95% confidence interval [ci ...	2002	11774082
impact of quinupristin/dalfopristin (rp59500) on the faecal microflora in healthy volunteers.	the effect of 5 days' administration of quinupristin/dalfopristin (rp59500) on the faecal microflora was evaluated in healthy volunteers. twenty healthy volunteers received 7.5 mg/kg of quinupristin/dalfopristin infused over 1 h twice daily for 5 days and four received a matched placebo. faecal samples were collected before, during and after treatment (days -1/-2, 6, 8, 14/15, 35 +/- 2, 60 +/- 4, 90 +/- 4). in the treated volunteers, anaerobes, including sporulating and gram-negative bacteria, d ...	2002	11751777
molecular fingerprinting of clostridium difficile isolates: pulsed-field gel electrophoresis versus amplified fragment length polymorphism.	two molecular fingerprinting techniques, pulsed-field gel electrophoresis (pfge) and amplified fragment length polymorphism (aflp), were used to investigate the epidemiological relatedness among clostridium difficile isolates from suspected outbreaks in three general hospitals. analysis by pfge yielded inconclusive data as a result of extensive dna degradation. although this degradation could be prevented to a certain extent by the inclusion of thiourea in the electrophoresis buffer, the weak dn ...	2002	11773100
phospholipase d stimulation is required for sphingosine-1-phosphate activation of actin stress fibre assembly in human airway epithelial cells.	in human airway epithelial cells, sphingosine-1-phosphate (spp) and lysophosphatidic acid (lpa) stimulated the production of phosphatidic acid (pa), which was inhibited by the primary alcohol butan-1-ol, but not by the inactive butan-2-ol, clearly indicating phospholipase d (pld) involvement. both spp and lpa stimulated actin stress fibre formation, which was also butan-2-ol-insensitive and inhibited by butan-1-ol. spp-induced pld activation and cytoskeletal remodelling were insensitive to brefe ...	2002	11747992
genetic deficiency in the chemokine receptor ccr1 protects against acute clostridium difficile toxin a enteritis in mice.	the role of the cc chemokine receptor (ccr) 1 in acute enteritis was investigated by subjecting ccr1 knockout mice to clostridium difficile toxin a treatment.	2002	11875005
fulminant clostridium difficile: an underappreciated and increasing cause of death and complications.	to review the epidemiology and characteristics of patients who died or underwent colectomy secondary to fulminant clostridium difficile colitis.	2002	11882758
the cdc42 and rac1 gtpases are required for capillary lumen formation in three-dimensional extracellular matrices.	here we show a requirement for the cdc42 and rac1 gtpases in endothelial cell (ec) morphogenesis in three-dimensional extracellular matrices. cdc42 and rac1 specifically regulate ec intracellular vacuole and lumen formation in both collagen and fibrin matrices. clostridium difficile toxin b (which blocks all three rho gtpases) completely inhibited the ability of ecs to form both vacuoles and lumens, whereas c3 transferase, a selective inhibitor of rho, did not. expression of either dominant-nega ...	2002	11884513
microvilli-like structures are associated with the internalization of virulent capsulated neisseria meningitidis into vascular endothelial cells.	bacterial pathogens are internalized into non-phagocytic cells either by a zipper mechanism involving a direct contact between a bacterial ligand and a cellular receptor or a trigger mechanism secondary to the formation of membrane ruffles. here we show that internalization of capsulated neisseria meningitidis within endothelial cells following type iv pilus-mediated adhesion is associated with the formation of cellular protrusions at the site of bacterial attachment. these protrusions, like mic ...	2002	11884522
[clostridium difficile infection].	clostridium difficile is an anaerobic species consisting of bacilli with large, oval, subterminal spores, normally found in intestines. it uses two toxins, which produce cytopathic changes in the intestinal mucosae, causing diarrhea. patients can present a spectrum of disease that varies from uncomplicated antibiotic-associated diarrhea to life threatening antibiotic-associated pseudomembranous colitis. c. difficile is the only species. there are no defined sterotypes. toxigenic and nontox ...	2002	11885130
characterization of clostridium perfringens strains isolated from polish patients with suspected antibiotic-associated diarrhea.	the aim of our research was to investigate the role of enterotoxin- producing anaerobic bacteria other than clostridium difficile in the etiology of antibiotic-associated diarrhea. this article presents data related to c. perfringens.	2002	11887023
severe clostridium difficile colitis: the role of intracolonic vancomycin?		2002	11893379
[what measures are necessary in the demonstration of clostridium difficile toxin?].		2002	11894182
gastrointestinal: clostridium difficile colitis.		2002	11895561
mechanism of lovastatin-induced apoptosis in intestinal epithelial cells.	we earlier showed that lovastatin potentiated the chemopreventive effects of sulindac against colon neoplasia in a rodent model and augments apoptosis induced by 5-fu and cisplatin in human colon cancer cells. in the present study, we investigated effects of lovastatin in spontaneously immortalized rat intestinal epithelial cells, iec-18 and their k-ras transformed clones. lovastatin induced morphologic changes (cell rounding and detachment) and apoptosis that were not influenced by k-ras mutati ...	2002	11895868
comparative in vitro activities of ertapenem (mk-0826) against 469 less frequently identified anaerobes isolated from human infections.	we studied the in vitro activity of ertapenem against 469 less frequently identified anaerobes from 11 genera and 52 species isolated from human infections. ertapenem was uniformly active against 460 of 469 (98%) strains at concentrations of < or = 4 microg/ml. only 4 of 14 clostridium difficile, 1 of 11 clostridium innocuum, and 4 of 6 lactobacillus sp. strains required ertapenem concentrations of > or = 8 microg/ml for inhibition.	2002	11897608
clostridium difficile infection associated with levofloxacin treatment.	nine cases of clostridium difficile (cd) infection were observed in the period of six months at a nursing home. eight of them occurred during or after antibiotic treatment. levofloxacin was used alone in three cases and in combination with another antibiotic in three other cases. cd infection occurred with other antibiotics in two cases. in one case, cd infection occurred without any antibiotic treatment. it is generally accepted that quinolones rarely cause cd infection. levofloxacin, a new ant ...	2002	11898264
phylogenetic analysis and pcr detection of clostridium chauvoei, clostridium haemolyticum, clostridium novyi types a and b, and clostridium septicum based on the flagellin gene.	the flagellin genes (flic) of clostridium chauvoei, clostridium haemolyticum, clostridium novyi types a and b, and clostridium septicum were analysed by pcr amplification and dna sequencing. the five clostridium species have at least two copies of the flagellin gene (flic) arranged in tandem on the chromosome. the deduced n- and c-terminal aminoacid sequences of the flagellin proteins (flics) of these clostridia are well conserved but their central region aminoacid sequences are not. phylogenic ...	2002	11900959
[probiotics in gastroenterology].	probiotics are defined as live microorganisms of human origin. their use may favorably influence human health and ameliorate or prevent certain diseases. prebiotics are non-digestible foodstuffs (fiber, oligofructans - "colonic foods"), which enter the colon and are metabolized by the probiotics. probiotics should fulfill the following criteria: phenotypic and genotypic classification, no pathogenic properties, human origin, application in the living state, resistance to gastric acid and bile, a ...	2002	11901455
linkage between toxin production and purine biosynthesis in clostridium difficile.	the production of toxins a and b by clostridium difficile was greatly enhanced under biotin-limited conditions, in which a 140-kda protein was expressed strongly. gene cloning revealed that this protein was a homologue of formylglycinamidine ribonucleotide synthetase (fgam synthetase, ec 6.3.5.3), which is known as purl in escherichia coli and catalyses the fourth step of the de novo purine biosynthesis pathway. this enzyme consisted of a single polypeptide, although fgam synthetases of gram-pos ...	2002	11800470
preferential initiation of pc12 neurites in directions of changing substrate adhesivity.	when pc12 cells are grown on substrates showing a gradient of nonspecific adhesion, they preferentially initiate neurites in directions of changing adhesivity, whether that change is in the direction of increasing or decreasing adhesivity. this preference for changing adhesivity is ablated both by c. difficile toxin a, which inhibits all rho-family gtpases, and by c. botulinum c3 exoenzyme, which specifically inhibits rho.	2002	11813236
successful treatment of a colonic adenocarcinoma in a horse.		2002	11817546
osmotic stress activates rac and cdc42 in neutrophils: role in hypertonicity-induced actin polymerization.	hypertonicity inhibits a variety of neutrophil functions through poorly defined mechanisms. our earlier studies suggest that osmotically induced actin polymerization and cytoskeleton remodeling is a key component in the hypertonic block of exocytosis and cell movement. to gain insight into the signaling mechanisms underlying the hyperosmotic f-actin response, we investigated whether hypertonicity stimulates rac and cdc42 and, if so, whether their activation contributes to the hypertonic rise in ...	2002	11788338
[5-fluorouracil-induced colitis--a review based upon consideration of 6 cases].	at increasing use of high-dose 5-fluorouracil-based chemotherapy for metastatic colorectal and gastric cancer complicated drug-induced colitis is observed more frequently. from may 1998 to november 2000 we observed 6 cases of 5-fluorouracil-induced colitis, in which we looked for involvement of small intestine. we report summing up on the 6 cases including both endoscopic and histological findings in both sites of the gut.	2002	11857099
clindamycin resistant strains of clostridium difficile isolated from cases of c. difficile associated diarrhea (cdad) in a hospital in sweden.	fifty three strains of c. difficile recovered from the stools of 13 patients with clinical c. difficile associated diarrhea (cdad) were analyzed for the presence of the ermb gene, for toxigenicity and fingerprinting profile by pcr based assays. forty five percent of the isolates were resistant to clindamycin and positive for the ermb gene. all clindamycin resistant isolates were ermb positive and belonged to the same fingerprinting group, suggesting clonal spread. these preliminary results sugge ...	2002	11858913
images in clinical medicine. clostridium difficile colitis.		2002	11821510
clinical practice. antibiotic-associated diarrhea.		2002	11821511
clostridium difficile infection in patients with neutropenia.		2002	11823965
marketing hand hygiene in hospitals--a case study.	hand hygiene of healthcare workers is frequently poor despite the efforts of infection control teams to promote hand decontamination as the most important method to prevent transmission of hospital-acquired infections. in this case study, we describe how principles of societal marketing were applied to improve hand hygiene. pre-marketing analysis of strengths, weaknesses, opportunities and threats to implementation; attention to product, price, promotion and placement; and post-marketing 'custom ...	2002	11825051
the mushroom marasmius oreades lectin is a blood group type b agglutinin that recognizes the galalpha 1,3gal and galalpha 1,3galbeta 1,4glcnac porcine xenotransplantation epitopes with high affinity.	a blood group b-specific lectin from the mushroom marasmius oreades (moa) was investigated with respect to its molecular structure and carbohydrate binding properties. sds-page mass spectrometric analysis showed it to consist of an intact (h; 33 kda) and truncated (l; 23 kda) subunit in addition to a small polypeptide (p; 10 kda). isolation in the presence of edta produced only the h subunits, indicating that the latter two are formed by metalloprotease cleavage of the intact h subunit. tryptic ...	2002	11836253
epidemiology of clostridium difficile infection in a large population of hospitalized us military veterans.	the patient treatment file (ptf) of the department of veterans affairs (va) comprises the computerized records of all inpatients treated at all va hospitals throughout the united states. the database was utilized to study the clinical epidemiology and impact of c. difficile colitis on health care among hospitalized us military veterans. the computerized medical records of 15,091 cases with c. difficile colitis and 61,931 controls without the diagnosis were extracted from the annual files between ...	2002	11837725
severe antibiotic-associated colitis in a patient with cystic fibrosis and colonic wall thickening.		2002	11840045
interaction of the rho-adp-ribosylating c3 exoenzyme with rala.	rhoa, -b, and -c are adp-ribosylated and biologically inactivated by clostridium botulinum c3 exoenzyme and related c3-like transferases. we report that rala gtpase, which is not adp-ribosylated by c3, inhibits adp-ribosylation of rhoa by c3 from c. botulinum (c3bot), clostridium limosum (c3lim), and bacillus cereus (c3cer) but not from staphylococcus aureus (c3stau) in human platelet membranes and rat brain lysate. inhibition by rala occurs with the gdp- and guanosine 5'-3-o-(thio)triphosphate- ...	2002	11847234
rho and rho kinase modulation of barrier properties: cultured endothelial cells and intact microvessels of rats and mice.	previous experiments using cultured endothelial monolayers indicate that rho-family small gtpases are involved in modulation of endothelial monolayer permeability by regulating assembly of the cellular actin filament scaffold, activity of myosin-based contractility and junctional distribution of the ca2+-dependent endothelial cell adhesion molecule, ve-cadherin. we investigated these mechanisms using both cultured endothelial cells (from porcine pulmonary artery and mouse heart) and vascular end ...	2002	11850521
[resistance problems in gastrointestinal infections].	a variety of world-wide resistance problems in bacterial gastrointestinal pathogens have emerged within the last decade. particularly, antibiotics used to treat salmonella, campylobacter and helicobacter pylori have lost their efficacy in a high proportion of isolates. of major clinical significance is the resistance of h. pylori to metronidazole and clarithromycin, of campylobacter spp. to fluoroquinolones and macrolides and of salmonella spp. to fluoroquinolones and third generation cephalospo ...	2002	11851045
role of the enteric nervous system in the pathophysiology of secretory diarrhea.	details of the physiology and pathophysiology of epithelial secretion in the gastrointestinal tract are becoming clear, leading to new models of the mechanisms underlying diarrhea. the enteric nervous system is a critical component of the mechanism regulating fluid secretion in the normal gut and a key element in the pathophysiology of diarrhea. neural reflex pathways increase epithelial fluid secretion in response to several enteric pathogens of veterinary importance such as salmonella spp., cr ...	2002	12041649
how strictly should a patient with c. difficile be isolated?		2002	12512485
pneumatosis intestinalis after pediatric thoracic organ transplantation.	to review and describe pneumatosis intestinalis (pi) in children who have undergone thoracic organ transplantation and evaluate potential risk factors.	2002	11986484
neutropenic enterocolitis (typhlitis) after pediatric bone marrow transplant.	neutropenic enterocolitis (typhlitis) is a common consideration after bone marrow transplantation. this study reviews the authors' experience with abdominal pain and typhlitis in an active pediatric bone marrow transplant program.	2002	11987097
changes in predominant bacterial populations in human faeces with age and with clostridium difficile infection.	the bacterial composition of human faeces can vary greatly with factors such as age and disease, although relatively few studies have monitored these events, particularly at species level. in this investigation, bacteria were isolated from faecal samples from healthy young adults and elderly subjects, and elderly patients with clostridium difficile-associated diarrhoea (cdad). the organisms were identified to species level on the basis of their cellular fatty acid profiles with the midi system. ...	2002	11990498
case of the month. pseudomembranous colitis.		2002	11990652
distinct signaling pathways mediate cardiomyocyte phospholipase d stimulation by endothelin-1 and thrombin.	several g protein-coupled receptors which stimulate phospholipase c (plc) also activate phospholipase d (pld) in cardiomyocytes. here, we characterized pld activation in neonatal rat cardiomyocytes by the plc-stimulatory thrombin receptor par1, in comparison to the endothelin-1 receptor et(a)r, which induces pld stimulation by activation of protein kinase c (pkc) delta and epsilon. similar to et(a)r, activation of par1 induced pld stimulation, which, however, was insensitive to pkc inhibition. f ...	2002	11991733
in vitro anti-anaerobic activity of the cephalosporin derivative rwj 54428, compared to seven other compounds.	agar dilution mic was used to test the activity of rwj 54428, a new cephalosporin derivative, compared to imipenem, meropenem, ceftriaxone, piperacillin, piperacillin-tazobactam, clindamycin and metronidazole against 363 anaerobes isolated from clinical specimens. rwj 54428 had low mics against most beta-lactamase-negative gram-negative rods, and all gram-positive strains except clostridium difficile. imipenem and meropenem had the lowest mics (mic50s of 0.125 mg/l and mic90s of 1.0 mg/l). piper ...	2002	12519357
[clostridium difficile small intestinal involvement occurring after total colectomy].		2002	12534128
clostridium difficile infections in animals with special reference to the horse. a review.	in human medicine, clostridium (c.) difficile is since many years a well-known cause of nosocomial diarrhea induced by antibiotic treatment. in horses, c. difficile was recently suggested as a possible enteric pathogen. the bacterium is associated with acute colitis in mature horses following treatment with antibiotics. c. difficile, and/or its cytotoxin, is also associated with acute colitis in mares when their foals are being treated with erythromycin and rifampicin for rhodococcus equi pneumo ...	2002	12540137
epidemiology and outcome of clostridium difficile infection and diarrhea in hiv infected inpatients.	clostridium difficile causes diarrhea in hiv infected patients but reports of prevalence, risk factors, and outcome vary. we studied the impact of c. difficile in 161 hiv infected inpatients admitted to cook county hospital. patients with c. difficile had more hospital admissions in the previous 6 months (p =.04), spent more days in the hospital in the previous 3 months (p =.02), more often had previously received h2 blockers or treatment for pneumocystis carinii (p <.05), and had a more frequen ...	2002	12543536
[role of clostridium difficile infection in the relapse of ulcerative colitis].	a case of nosocomial diarrhea by clostridium difficile in an older woman with an old history of increasing stool frequency, is reported. colonoscopy and biopsy was performed due to an incomplete response to vancomicyn, and the diagnosis of underlying ulcerative colitis was made. the incidence of clostridium difficile infection associated with the relapse of ulcerative colitis is nearly 10%. in patients with ulcerative colitis, macroscopic pseudomembranes and the usual predisposing factors for cl ...	2002	12593034
faecal lactoferrin assay as an adjunct to clostridium difficile diarrhoea.	inflammation is the hallmark of clostridium difficile associated diarrhoea and lactoferrin is produced by inflammatory cells. the aim of this study was to find out whether faecal lactoferrin latex agglutination (flla) assay done simultaneously with clostridium difficile toxin (cdt) assay would help in the diagnosis of c. difficile infection in paediatric patients. one hundred and fifty faecal samples were obtained from paediatric group of patients. both flla and cdt assays were done in conjuncti ...	2002	12593568
ulcerative colitis complicating pseudomembranous colitis of the right colon.	a 65-year-old man in the remission stage of ulcerative colitis developed severe bloody diarrhea and high fever. he was treated with imipenem/cilastatin and clindamycin for infectious enterocolitis at a local hospital, but there was no improvement in his condition. steroid pulse therapy was also ineffective. colonoscopy revealed pseudomembranous colitis extending from the ascending colon to the cecum, and clostridium difficile toxin was positive in the feces. the administration of vancomycin in a ...	2002	11993517
[evaluation of an advisory program in antibiotic therapy].	increases in microbial resistance and pharmaceutical costs have prompted an interest in antibiotic control programs (acp). nevertheless, there is controversy on the optimal acp design and implementation. an acp based on the infectious diseases' specialist recommendations was evaluated.	2002	11996759
clostridium difficile toxin a alters in vitro-adherent neutrophil morphology and function.	the effects of purified toxin a in vitro on the shape and function of polymorphonuclear leukocytes (pmnl) were examined. toxin a induced changes in adherent pmnl shape from a compact spherical or pyramidal shape to a thin and rope-like shape. this change in shape was accompanied by rearrangement of the f-actin cytoskeleton into aggregates. toxin a-treated pmnl exhibited increased adherence and expressed less l-selectin and more mac-1, compared with untreated pmnl. in contrast to these proinflamm ...	2002	12001047
analysis of macrolide-lincosamide-streptogramin b (mls(b)) resistance determinant in strains of clostridium difficile.	the macrolide-lincosamide-streptogramin b (mlsb) resistance determinants have been detected among clostridia in both c. perfringens and c. difficile strains. previous studies have shown that mlsb-resistant c. difficile strains can be differentiated by specific hybridizing bands using an erm(b) probe. a recent study has demonstrated that c. difficile 630, a strain highly resistant to clindamycin and erythromycin (mic > or = 256 ml/l), showing a hybridizing band at 9.7 kb, contains two copies of a ...	2002	12002649
early versus late enteral feeding of mechanically ventilated patients: results of a clinical trial.	this study sought to compare 2 strategies for the administration of enteral feeding to mechanically ventilated medical patients.	2002	12005458
diarrhoea following renal transplantation.	in this study, we retrospectively evaluated all attacks of diarrhoea in our renal transplant recipients that came to our medical attention between 1985 and 2000. also, the clinical features of patients with diarrhoea were compared with the features of recipients without diarrhoea. we diagnosed 41 attacks of diarrhoea in 39 (12.6%) of 308 renal transplant recipients during this time period. an aetiology was detected in 33 (80.5%) of all diarrhoeal episodes and in seven (17.1%) of those the specif ...	2002	12010146
variable flagella expression among clonal toxin a-/b+clostridium difficile strains with highly homogeneous flagellin genes.		2002	12010175
reassessment of clostridium difficile susceptibility to metronidazole and vancomycin.	clostridium difficile is the most frequently identified enteric pathogen in patients with nosocomially acquired, antibiotic-associated diarrhea. the drugs most commonly used to treat diseases associated with c. difficile are metronidazole and vancomycin. most clinical laboratories assume that all c. difficile isolates are susceptible to metronidazole and vancomycin. we report on the antimicrobial susceptibilities of 415 c. difficile isolates to metronidazole and vancomycin over an 8-year period ...	2002	12019070
nitazoxanide as a broad-spectrum antiparasitic agent.		2002	12023782
conditions associated with leukocytosis in a tertiary care hospital, with particular attention to the role of infection caused by clostridium difficile.	few modern studies have enumerated the conditions associated with leukocytosis. our clinical experience has implicated clostridium difficile infection in a substantial proportion of patients with leukocytosis. in a prospective, observational study of 400 inpatients with wbc counts of >/=15,000 cells/mm(3), we documented >/=1 infection in 207 patients (53%). of these 207 patients, 97 (47%) had pneumonia, 60 (29%) had urinary tract infection, 34 (16%) had soft-tissue infection, and 34 (16%) had c. ...	2002	12032893
evaluation of a test for clostridium difficile toxins a and b for the diagnosis of neonatal swine enteritis.	a commercially available 1-hour enzyme immunoassay (eia) for detecting the presence of clostridium difficile toxins a and b was evaluated for use in diagnosis of c. difficile infections in neonatal swine. this test was compared with a tissue culture cytotoxicity assay, which is considered to be the reference standard for the detection of c. difficile toxins. twenty-seven samples of colonic contents and 23 fecal samples were collected from freshly euthanized neonatal swine with a history of scour ...	2002	12033686
prevalence and genetic characterization of toxin a variant strains of clostridium difficile among adults and children with diarrhea in france.	toxin a variant strains (toxin a-negative, toxin b-positive strains) of clostridium difficile have been reported to be responsible for diarrhea or pseudomembranous colitis in humans. these strains lack parts of the repeating sequences of the toxin a gene (tcda) and are toxin a negative by commercial enzyme immunoassays (eia). here, we report the prevalence of the toxin a variant strains in 334 patients with c. difficile-associated diarrhea in france. the repeating segment of the tcda gene (1,200 ...	2002	12037068
development and evaluation of a pcr method for detection of the clostridium difficile toxin b gene in stool specimens.	a pcr assay detecting clostridium difficile toxin b gene in stool specimens was compared to the cytotoxicity assay as the reference standard for the diagnosis of c. difficile antibiotic-associated diarrhea (cdad). overall, 118 stool samples were tested. all of the specimens that were negative by the cytotoxicity assay (59 out of 118) were also negative by the pcr method (specificity of 100%). of the 59 cytotoxin-positive samples, 54 were pcr positive (sensitivity of 91.5%). this pcr method is pr ...	2002	12037113
caveolin-associated filamentous actin (cav-actin) defines a novel f-actin structure in adipocytes.	dynamic actin remodeling has been implicated in the translocation of the insulin-responsive glucose transporter 4 (glut4) to the plasma membrane in adipocytes. here we show that fully differentiated 3t3l1 adipocytes have unique cortical filamentous actin structure, designated cav-actin (caveolae-associated f-actin). during 3t3l1 adipocyte differentiation, rhodamine-phalloidin staining demonstrated the formation of a cortical actin cytoskeleton that is composed of small dot-like f-actin spikes li ...	2002	12039946
a case if infant botulism due to neurotoxigenic clostridium butyricum type e associated with clostridium difficile colitis.	reported here is the sixth case of intestinal toxemia botulism caused by clostridium butyricum type e in italy since 1984. in this case, the patient was concomitantly affected with colitis due to clostridium difficile toxin. a review of previously reported cases revealed that some of these patients may also have had intestinal toxemia botulism associated with clostridium difficile colitis, based on the reported symptoms. given that this association has been shown to exist not only in italy but a ...	2002	12479171
neuroimmune and epithelial interactions in intestinal inflammation.	the gastrointestinal tract contains the most extensive immune system in the body as well as the largest and most diverse collection of nerves outside of the central nervous system. these systems are continuously involved in ongoing physiological activities of the bowel and they play an active role in pathophysiological processes. it is becoming increasingly clear that intestinal inflammation involves a dynamic interplay between at least three different cell systems: immune cells, neurons and muc ...	2002	12482729
clostridium difficile toxin a triggers human colonocyte il-8 release via mitochondrial oxygen radical generation.	clostridium difficile toxin a causes mitochondrial dysfunction resulting in generation of oxygen radicals and adenosine triphosphate (atp) depletion. we investigated whether mitochondrial dysfunction is involved in nuclear factor kappab (nf-kappab) activation and interleukin (il)-8 release from toxin a-exposed enterocytes.	2002	11910356
incidence of pseudomembranous colitis after vancomycin-treated mrsa infection.		2002	11913373
e test susceptibility testing of nosocomial clostridium difficile isolates against metronidazole, vancomycin, fusidic acid and the novel agents moxifloxacin, gatifloxacin, and linezolid.		2002	11913510
morbidity, mortality, and healthcare burden of nosocomial clostridium difficile-associated diarrhea in canadian hospitals.	to assess the healthcare burden, morbidity, and mortality of nosocomial clostridium difficile-associated diarrhea (n-cdad) in canadian hospitals.	2002	11918118
binding of clostridium difficile to caco-2 epithelial cell line and to extracellular matrix proteins.	adhesion of clostridium difficile to caco-2 was examined as a function of monolayers polarization and differentiation. the number of adherent c. difficile c253 bacteria per cell strongly decreased when postconfluent 15-day-old monolayers were used (1.7 bacteria per cell versus 17.3 with 3-day-old monolayers). following disruption of intercellular junctions by ethylene glycol-bis(beta-aminoethyl ether)-n,n,n',n',-tetraacetic acid, a significant rise in the level of bacterial adhesion was observed ...	2002	11934566
emergence of cotrimoxazole- and quinolone-resistant campylobacter infections in bone marrow transplant recipients.	clinical and microbiological data were collected prospectively from 704 patients who underwent bone marrow transplantation (bmt) during an 11-year period (1991-2001), and the first two cases of campylobacter infection occurring in bmt recipients in the pre-engraftment period were identified. the two cases occurred on days 2 and 3 post-bmt, respectively. both patients had campylobacter jejuni enteritis, and one case was complicated by bacteraemia. in both cases the presenting symptoms were indist ...	2002	11939393
colorectal disease in liver allograft recipients -- a clinicopathological study with follow-up.	to determine the spectrum and outcome of colorectal diseases occurring in adult liver allograft recipients.	2002	11953686
effect of changes in surgical practice on the rate and detection of nosocomial infections: a prospective analysis.	the practice of surgery is being performed increasingly on an outpatient basis. how these changes have influenced the nosocomial infection rate and the ability of standard, center for disease control (cdc)-designed surveillance techniques to detect these infections is unknown. the goal of this study was to determine whether recent changes in surgical care have led to an increased nosocomial infection rate based on number of discharges and whether current surveillance techniques are adequate to d ...	2002	11954823
in vitro activity of linezolid against clostridium difficile.	we examined the in vitro activity of linezolid against clostridium difficile, including isolates with reduced susceptibility to metronidazole or vancomycin. the mic at which 50% of the isolates were inhibited (mic50) and mic90 were 0.5 and 2 microg/ml, respectively (range, 0.03 to 4 microg/ml). mics were always <or= 4 microg/ml, and thus, all isolates were considered susceptible.	2002	11959617
recurrent pseudomembranous colitis as a cause of recurrent severe sepsis.	clostridium difficile (c. difficile) colitis accounts for nearly 15-20 % of antibiotic-associated diarrhea. manifestations include asymptomatic carriage, self-limited diarrhea, and pseudomembranous colitis, which is sometimes life-threatening. despite effective therapy with metronidazole and vancomycin relapse rates are 15-33 %. although colitis is seen in critically ill patients treated with combinations of broad-spectrum antibiotics, reports describing severe sepsis as a result of c. difficile ...	2002	11961735
molecular characterization of phenyllactate dehydratase and its initiator from clostridium sporogenes.	the heterotrimeric phenyllactate dehydratase from clostridium sporogenes, fldabc, catalyses the reversible dehydration of (r)-phenyllactate to (e)-cinnamate in two steps: (i) coa-transfer from the cofactor cinnamoyl-coa to phenyllactate to yield phenyllactyl-coa and the product cinnamate mediated by flda, a (r)-phenyllactate coa-transferase; followed by (ii) dehydration of phenyllactyl-coa to cinnamoyl-coa mediated by heterodimeric fldbc, a phenyllactyl-coa dehydratase. phenyllactate dehydratase ...	2002	11967068
abdominal infections in patients with acute leukaemia: a prospective study applying ultrasonography and microbiology.	a prospective study of 62 chemotherapy-induced neutropenic episodes in patients with acute leukaemia was conducted to determine the incidence and causes of abdominal infections, and to assess the diagnostic value of the combined use of ultrasonography (us) and microbiology. each patient underwent us of liver, gallbladder and complete bowel before chemotherapy, on days 2-4 after the end of chemotherapy and in cases of fever, diarrhoea or abdominal pain. us was combined with a standardized clinica ...	2002	11972517
high-density microarray of small-subunit ribosomal dna probes.	ribosomal dna sequence analysis, originally conceived as a way to provide a universal phylogeny for life forms, has proven useful in many areas of biological research. some of the most promising applications of this approach are presently limited by the rate at which sequences can be analyzed. as a step toward overcoming this limitation, we have investigated the use of photolithography chip technology to perform sequence analyses on amplified small-subunit rrna genes. the genechip (affymetrix co ...	2002	11976131
nadph oxidase mediates tissue factor-dependent surface procoagulant activity by thrombin in human vascular smooth muscle cells.	tissue factor (tf) initiates the extrinsic coagulation cascade leading to thrombin formation. thrombin induces tf mrna in vascular smooth muscle cells (vsmcs), thereby contributing to the prolonged procoagulant activity and enhanced thrombogenicity at sites of vascular injury. however, the signaling mechanisms mediating this thrombogenic cycle are unclear. characteristically, vascular injury promotes the generation of reactive oxygen species (ros). because ros exert signaling functions, we inves ...	2002	11980681
etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in south india.	no studies so far have examined enteric infections in patients undergoing bone marrow transplantation (bmt) in developing countries where asymptomatic carriage and colonization with enteric pathogens is frequent.	2002	11981416
comparative study of cefuroxime axetil versus amoxicillin in children with early lyme disease.	cefuroxime axetil has been shown to have efficacy comparable to doxycycline in adults with early lyme disease (ld). because of toxicity, doxycycline is usually avoided in children. for children who are unable to tolerate amoxicillin, there is currently no proven alternative oral therapy for ld. this randomized, unblinded study compared 2 dosage regimens of cefuroxime axetil (20 mg/kg/d and 30 mg/kg/d) with amoxicillin (50 mg/kg/d), each given for 20 days. children were enrolled if they were 6 mo ...	2002	12042561
probiotics in clinical conditions.	probiotics are nonpathogenic microorganisms which, when ingested, exert a positive influence on the health or physiology of the host. their mechanisms of action and effects are now studied using the same pharmacological approach as for drugs. this article summarizes and comments on evidence for the positive effects of probiotics in various clinical situations. substantial evidence can be achieved when randomized controlled trials or meta-analyses show positive results. the clinical situations st ...	2002	12043384
the commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant staphylococcus aureus, enterococcus, gram-negative bacilli, clostridium difficile, and candida.	recent years have witnessed a rapidly growing crisis in antimicrobial resistance, especially among microorganisms that cause nosocomial infection. to better understand common risk factors among multiresistant organisms, this review explores risk factors for nosocomial infection with methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococcus, clostridium difficile, extended-spectrum beta-lactamase-producing gram-negative bacilli, and candida. this review comprises data from 74 ...	2002	12044132
clostridium difficile diarrhea on a burn unit.		2002	12052382
theodore e. woodward award. how bacterial enterotoxins work: insights from in vivo studies.	clostridium difficile is a spore forming, gram-positive anaerobic bacillus first described in 1935 by hall and o'toole as a commensal organism in the fecal flora of healthy newborn infants (1). the organism was given its unusual name because it grew slowly and was difficult to isolate in pure culture. its presence in the stool of healthy neonates suggested that c. difficile was a nonpathogen, even though it produced toxins in broth culture. following its original description, c. difficile passed ...	2002	12053708
interleukin-1 inhibits angiotensin ii-stimulated protein kinase b pathway in renal mesangial cells via the inducible nitric oxide synthase.	exposure of rat renal mesangial cells to angiotensin ii and angiotensin iii leads to a rapid phosphorylation and activation of the protein kinase b (pkb) pathway. the angiotensin ii analogs angiotensin-(1-7), angiotensin-(1-6) and angiotensin-(3-8) were unable to activate pkb. the angiotensin ii and iii effects are mediated by the angiotensin type 1 receptor as documented by the inhibitory action of valsartan. furthermore, angiotensin ii-induced activation of pkb involves neither a pertussis tox ...	2002	12065072
experimental effects of saccharomyces boulardii on diarrheal pathogens.	saccharomyces boulardii is a selected strain of yeast that may have applications in the prevention and treatment of intestinal infections. the animal models and in vitro studies developed to elucidate the mechanisms of this protection are reviewed and discussed.	2002	12067833
signalling components involved in the coupling of alpha 1-adrenoceptors to phospholipase d in neonatal rat cardiac myocytes.	activation of phospholipase d (pld) is assumed to be one major pathway by which alpha(1)-adrenoceptors (alpha(1)ars) induce hypertrophic responses in cardiac myocytes. heterotrimeric g proteins, protein kinase c (pkc) isoforms, protein tyrosine kinases, monomeric gtpases of the adp-ribosylation factor (arf) and rho families, and as important cofactor phosphatidylinositol 4,5-bisphosphate (pip(2)) seem to participate in the g protein-coupled receptor dependent regulation of pld. we therefore stud ...	2002	12070761
inhibition of in vitro cell adherence of clostridium difficile by saccharomyces boulardii.	the influence on the adherence of clostridium difficile to vero cells of the yeast saccharomyces boulardii, the yeast fractions (cytoplasm and cell wall) and the culture supernatant was investigated in vitro. c. difficile adherence was significantly inhibited when bacteria were pre-incubated with the whole yeast and the cell wall fraction; this adherence inhibition was dose-dependent. the cell wall fraction also acts upon the target cultured cells inasmuch as the level of adherence was significa ...	2002	12071678
patterns of sequence conservation in the s-layer proteins and related sequences in clostridium difficile.	clostridium difficile is the etiological agent of antibiotic-associated diarrhea. among the factors that may play a role in infection are s-layer proteins (slps). previous work has shown these to consist mainly of two components, resulting from the cleavage of a precursor encoded by the slpa gene. the high-molecular-weight (mw) subunit is related both to amidases from b. subtilis and to at least another 28 gene products in c. difficile strain 630. to gain insight into the functions of the slps a ...	2002	12081960
nutritional advantages of probiotics and prebiotics.	the potential 'nutritional advantages' of probiotics and prebiotics consist of preventive, and sometimes curative, effects against certain diseases. the evidence supporting such advantages, which requires randomised controlled trials and consistency of results from study to study, is rapidly increasing. this article summarizes the effects against diseases of intestinal origin. there is a high level of evidence for positive effects of some prebiotics to alleviate constipation and treat hepatic en ...	2002	12088512
c difficile induced pneumatosis intestinalis in a neutropenic child.		2002	12089138