Publications

c. difficile may have killed 2000 in quebec: study.		2005	16179430
mortality attributable to nosocomial clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in quebec.	since 2002 an epidemic of clostridium difficile-associated disease (cdad) caused by a hypervirulent toxinotype iii ribotype 027 strain has spread to many hospitals in quebec. the strain has also been found in the united states, the united kingdom and the netherlands. the effects of this epidemic on mortality and duration of hospital stay remain unknown. we measured these effects among patients admitted to a hospital in quebec during 2003 and 2004.	2005	16179431
outbreak from a high-toxin intruder: clostridium difficile.		2005	16182878
toxin production by an emerging strain of clostridium difficile associated with outbreaks of severe disease in north america and europe.	toxins a and b are the primary virulence factors of clostridium difficile. since 2002, an epidemic of c difficile-associated disease with increased morbidity and mortality has been present in quebec province, canada. we characterised the dominant strain of this epidemic to determine whether it produces higher amounts of toxins a and b than those produced by non-epidemic strains.	2005	16182895
gastrointestinal bacteria generate nitric oxide from nitrate and nitrite.	denitrifying bacteria in soil generate nitric oxide (no) from nitrite as a part of the nitrogen cycle, but little is known about no production by commensal bacteria. we used a chemiluminescence assay to explore if human faeces and different representative gut bacteria are able to generate no. bacteria were incubated anaerobically in gas-tight bags, with or without nitrate or nitrite in the growth medium. in addition, luminal no levels were measured in vivo in the intestines in germ-free and conv ...	2005	16183308
use of gastric acid-suppressive agents and the risk of community-acquired clostridium difficile-associated disease.	recent reports suggest an increasing occurrence and severity of clostridium difficile-associated disease. we assessed whether the use of gastric acid-suppressive agents is associated with an increased risk in the community.	2005	16414946
suspected clostridium difficile-associated hemorrhagic diarrhea in a 1-week-old elk calf.	clostridium difficile-associated diarrhea was suspected in a 1-week-old elk (cervus elaphus) calf. the isolation of a toxigenic strain of c. difficile from a diarrheic fecal sample, along with exclusion of other enteropathogens, formed the basis of this presumptive diagnosis. further study is indicated to evaluate the role of c. difficile in neonatal diarrhea in elk.	2005	16422066
tinidazole: a nitroimidazole antiprotozoal agent.	tinidazole, a structural analogue of metrondazole, is an antiprotozoal agent that has been widely used in europe and developing countries for >2 decades with established efficacy and acceptable tolerability. it was recently approved by the us food and drug administration for the treatment of trichomoniasis, giardiasis, amebiasis, and amebic liver abscess.	2005	16507373
diagnostic role of stool culture & toxin detection in antibiotic associated diarrhoea due to clostridium difficile in children.	mere diagnosis of clostridium difficile by culture does not help in the diagnosis of antibiotic associated diarrhoeae (aad) due to c. difficile. detection of toxins a and b form the mainstay in the diagnosis of aad due to c. difficile. this study was undertaken to find out the role of stool culture and toxin detection in the diagnosis of aad due to c. difficile. as there are very few documented reports from india about aad due to c. difficile in children in the age group of 5-12 yr, this age gro ...	2005	16518003
[clostridium difficile toxin a and other enteropathogens in stool specimens of children hospitalized due to acute diarrhoea].	a total of 74 fresh stool specimens obtained from children with acute diarrhoea (43) and without diarrhoea (31) were examined simultaneously for bacteria pathogens (culture methods) and for clostridium difficile toxin a (oxoid toxin a kits) and enteric viruses (only diarrhoeal samples) (slidex rota-adeno kits; biomçrieux). one (49%) or dual with c. difficile (23%) enteric pathogens associated with community-acquired diarrhoea (58% bacteria and 14% viruses) in 31 (72%) children were recognized. c ...	2005	16433313
clostridial enteric infections in pigs.	clostridium perfringens types a and c and clostridium difficile are the principal enteric clostridial pathogens of swine. history, clinical signs of disease, and gross and microscopic findings form the basis for a presumptive diagnosis of c. perfringens type-c enteritis. confirmation is based on isolation of large numbers of type-c c. perfringens and/or detection of beta toxin in intestinal contents. diagnosis of c. perfringens type-a infection, however, remains controversial, mostly because the ...	2005	16475510
severe clostridium difficile-associated disease in populations previously at low risk--four states, 2005.	clostridium difficile is a spore-forming, gram-positive bacillus that produces exotoxins that are pathogenic to humans. c. difficile-associated disease (cdad) ranges in severity from mild diarrhea to fulminant colitis and death. antimicrobial use is the primary risk factor for development of cdad because it disrupts normal bowel flora and promotes c. difficile overgrowth. c. difficile typically has affected older or severely ill patients who are hospital inpatients or residents of long-term-care ...	2005	16319813
a predominantly clonal multi-institutional outbreak of clostridium difficile-associated diarrhea with high morbidity and mortality.	in march 2003, several hospitals in quebec, canada, noted a marked increase in the incidence of clostridium difficile-associated diarrhea.	2005	16322602
an epidemic, toxin gene-variant strain of clostridium difficile.	recent reports suggest that the rate and severity of clostridium difficile-associated disease in the united states are increasing and that the increase may be associated with the emergence of a new strain of c. difficile with increased virulence, resistance, or both.	2005	16322603
the new clostridium difficile--what does it mean?		2005	16322604
in vitro activities of doripenem and comparator agents against 364 anaerobic clinical isolates.	the in vitro activities of doripenem against 364 anaerobic isolates were measured and compared to those of ertapenem, imipenem, meropenem, ceftriaxone, and levofloxacin. all of the carbapenems were active against nearly all bacteroides fragilis group isolates. doripenem was either comparable to or slightly less active than imipenem and meropenem against most isolates but more active than the other penems against clostridium difficile. doripenem appears to have excellent activity against a broad ...	2005	16189137
evidence for clostridial implication in necrotizing enterocolitis through bacterial fermentation in a gnotobiotic quail model.	despite extensive research, the pathogenesis of neonatal necrotizing enterocolitis (nec) remains elusive. the aim of our work was to investigate the role of bacterial strains involved in nec in gnotobiotic quails as experimental model. six groups of germ-free quails that were fed a lactose diet were associated with klebsiella pneumoniae, clostridium perfringens, c. difficile, c. paraputrificum, or c. butyricum (two strains). implantation level, incidence of cecal lesions, production of short-cha ...	2005	16189185
surveillance for resistance to metronidazole and vancomycin in genotypically distinct and uk epidemic clostridium difficile isolates in a large teaching hospital.		2005	16195254
frequency and possible infection control implications of gastrointestinal colonization with methicillin-resistant staphylococcus aureus.	methicillin-resistant staphylococcus aureus (mrsa) is a major cause of health care-associated infections. multiple factors, including transmission from unrecognized reservoirs of mrsa, are responsible for failure to control the spread of mrsa. we conducted prospective surveillance to determine the frequency of gastrointestinal colonization with mrsa among patients and its possible impact on nosocomial transmission of mrsa. stool specimens submitted for clostridium difficile toxin a/b assays were ...	2005	16333087
rapid and simple method for detecting the toxin b gene of clostridium difficile in stool specimens by loop-mediated isothermal amplification.	we applied the loop-mediated isothermal amplification (lamp) assay to the detection of the toxin b gene (tcdb) of clostridium difficile for identification of toxin b (tcdb)-positive c. difficile strains and detection of tcdb in stool specimens. tcdb was detected in all toxin a (tcda)-positive, tcdb-positive (a(+)b(+)) and tcda-negative, tcdb-positive (a(-)b(+)) c. difficile strains but not from tcda-negative, tcdb-negative strains. of the 74 stool specimens examined, a(+)b(+) or a(-)b(+) c. diff ...	2005	16333105
images in clinical medicine. pseudomembranous colitis associated with clostridium difficile.		2005	16339097
an active surveillance study of vancomycin-resistant enterococcus in queen elizabeth hospital, hong kong.	to assess the rate of faecal vancomycin-resistant enterococcus colonisation in high-risk patients in a regional hospital.	2005	16340023
clostridium difficile toxin a-induced colonocyte apoptosis involves p53-dependent p21(waf1/cip1) induction via p38 mitogen-activated protein kinase.	clostridium difficile toxin a causes marked apoptosis of colonocytes in vivo and in vitro, which contributes to the formation of ulcers and pseudomembranes. we investigated the role of p53-dependent pathways and p38 mitogen-activated protein kinase (p38) in toxin a-induced colonocyte apoptosis.	2005	16344056
crystal structure of receptor-binding c-terminal repeats from clostridium difficile toxin a.	clostridium difficile is a major nosocomial pathogen that produces two large protein toxins [toxin a (tcda) and toxin b (tcdb)] capable of disrupting intestinal epithelial cells. both belong to the family of large clostridial cytotoxins, which are characterized by the presence of a repetitive c-terminal repetitive domain (crd). in tcda, the crd is composed of 39 repeats that are responsible for binding to cell surface carbohydrates. to understand the molecular structural basis of cell binding by ...	2005	16344467
[acute infectious (not clostridium difficile-associated) diarrhea in the elderly].	acute diarrhoea, non-antibiotic associated, is a common problem and a significant cause of morbidity and mortality in old age. in most cases diarrhoea has an infectious etiology. a number of different micro organisms can cause infectious diarrhoea. most frequent are viral infections with a benign evolution. rehydration is the only important therapeutic measure. infections with bacteria are less common, antibiotics should be prescribed only in severe cases, and when there is suspicion of invasive ...	2005	16350530
adhesion of selected bifidobacterium strains to human intestinal mucus and the role of adhesion in enteropathogen exclusion.	the ability of potential probiotic strains to adhere to the intestinal mucosa and exclude and displace pathogens is of utmost importance for therapeutic manipulation of the enteric microbiota. the ability of seven selected human bifidobacterial strains and five human enteropathogenic strains to adhere to human intestinal mucus was analyzed and compared with that of four strains isolated from chicken intestines. the adhesion of the bifidobacterial strains ranged from 3 to 16% depending on the str ...	2005	16355841
is campylobacter involved in antibiotic associated diarrhoea?	campylobacter jejuni is an important cause of acute bacterial diarrhoea. in developing countries like india, children gain immunity early during infancy. however, the incidence is higher in non-immune hosts. antibiotic use destabilizes the gut flora and can inhibit the local immune responses, thereby compromising resistance to a variety of infections. it is not yet known whether antibiotic intake can also precipitate c. jejuni enteritis as the infectious dose is low and attack rates are high. we ...	2005	16366118
[a case of clostridium difficile colitis associated with paclitaxel and carboplatin chemotherapy for lung cancer].	a 41-year-old man admitted complaining of dyspnea was found to have lung adenocarcinoma (t4n3m1, stage iv) originating from s1+2. he underwent chemotherapy with carboplatin (cbdca) and paclitaxel (ptx) and partial remission was obtained. however, on the 11th day of the fourth course of chemotherapy, he developed lower abdominal pain, grade 3 bloody diarrhea and grade 2 vomiting. the stool contained clostridium difficile (cd) toxin and stool culture revealed c. difficile growth. we diagnosed cd c ...	2005	16366365
intestinal pseudomembranes: staphylococcus aureus or clostridium difficile or both?		2005	16369220
[antibiotic associated diarrhea and clostridium difficile associated diarrhea in the elderly].	antibiotic associated diarrhea (aad) is a common complication when antibiotics are used and is frequent in the elderly. it has an impact on the length of hospital stay and increases the comorbidity. together with the type of antibiotic that is given, the length of antibiotical treatment and the combination of antibiotics is more predictive for the evolution of diarrhea when compared to the total given dose. mostly aad is benign, but an infection with c. difficile should always be excluded. c. di ...	2005	16398159
clostridium difficile associated severe enterocolitis: a feature of hirschsprung's disease in a neonate presenting late.	we report a case of hirschsprung's disease presenting late in the newborn period with severe enterocolitis and clostridium difficile toxin detectable in the stool. enterocolitis associated with hirschsprung's disease is a potentially fatal complication that may occur at presentation or later in the life of an affected child. its association with toxin-producing clostridium difficile growth in the bowel may be under recognized, especially in newborns.	2005	16398878
horizontal transfer of erythromycin resistance from clostridium difficile to butyrivibrio fibrisolvens.	this study demonstrates for the first time the in vitro transfer of the erythromycin resistance gene erm(b) between two obligate anaerobes, the human spore-forming pathogen clostridium difficile and the rumen commensal butyrivibrio fibrisolvens, suggesting that this event might occur also in the natural environment.	2005	16304188
human mucosa/submucosa interactions during intestinal inflammation: involvement of the enteric nervous system in interleukin-8 secretion.	interleukin-8 (il-8) is a key chemokine upregulated in various forms of intestinal inflammation, especially those induced by bacteria such as clostridium difficile (c. difficile). although interactions between different mucosal and submucosal cellular components have been reported, whether such interactions are involved in the regulation of il-8 secretion during c. difficile infection is unknown. moreover, whether the enteric nervous system, a major component of the submucosa, is involved in il- ...	2005	16309465
antibiotic-associated diarrhoea: an overlooked aetiology?	sixty-three faeces samples from hospital in-patients with probable antibiotic-associated diarrhoea (aad) are investigated. all samples are examined for routine bacterial enteric pathogens, pus cells, red blood cells and parasites. the samples are also screened for clostridium difficile cytotoxin b (cdt), c. perfringens enterotoxin and candida spp. (by microscopy and quantitative culture). faecal samples from two control groups (healthy volunteers and community samples from gp patients) are also ...	2005	16411375
rational antibiotic treatment of outpatient genitourinary infections in a changing environment.	in the outpatient setting, genitourinary infections (guis) remain costly to treat and are a significant cause of morbidity. recent evidence supports more substantial roles for pathogens other than escherichia coli, particularly gram-positive pathogens, in the pathogenesis of guis. broad-spectrum agents should be considered in order to address this etiologic change appropriately. criteria for antimicrobial selection set forth by the council for appropriate and rational antibiotic therapy (carat) ...	2005	15993672
clinical manifestations, treatment and control of infections caused by clostridium difficile.	clostridium difficile should be suspected in patients who present with nosocomial diarrhoea. it is more common in the elderly or in patients with a debilitating underlying condition who have received antimicrobial agents, and up to 20-25% of patients may experience a relapse. the reference method for diagnosis is the cell culture cytotoxin test which detects the presence of toxin b in a cellular culture of human fibroblasts, but recovering c. difficile in culture allows the performance of a ''se ...	2005	15997485
acd, a peptidoglycan hydrolase of clostridium difficile with n-acetylglucosaminidase activity.	a gene encoding a putative peptidoglycan hydrolase was identified by sequence similarity searching in the clostridium difficile 630 genome sequence, and the corresponding protein, named acd (autolysin of c. difficile) was expressed in escherichia coli. the deduced amino acid sequence of acd shows a modular structure with two main domains: an n-terminal domain exhibiting repeated sequences and a c-terminal catalytic domain. the c-terminal domain exhibits sequence similarity with the glucosaminida ...	2005	16000724
lansoprazole-associated collagenous colitis: a case report.	a 57-year-old man developed chronic, watery diarrhea four weeks after helicobacter pylori eradication therapy including lansoprazole followed by lansoprazole monotherapy for gastroesophageal reflux disease. four weeks later the patient was admitted to our hospital. by repeated testing other causes of diarrhea, e. g., infectious diarrhea including clostridium difficile colitis were excluded. endoscopy showed a normal colon, histopathology of random biopsies of all sections of the colon demonstrat ...	2005	16001348
antimicrobial susceptibility of polymerase chain reaction ribotypes of clostridium difficile commonly isolated from symptomatic hospital patients in the uk.	two hundred and seventy-one clinical isolates of clostridium difficile, including the six most common polymerase chain reaction (pcr) ribotypes isolated from symptomatic patients in uk hospitals, were tested against nine antibiotics (imipenem, erythromycin, levofloxacin, piperacillin/tazobactam, ciprofloxacin, co-amoxiclav, cefotaxime, amoxicillin and clindamycin). all 271 strains were susceptible to co-amoxiclav, piperacillin/tazobactam and amoxicillin, and resistant to cefotaxime and ciproflox ...	2005	16002183
a modified pulsed-field gel electrophoresis (pfge) protocol for subtyping previously non-pfge typeable isolates of clostridium difficile polymerase chain reaction ribotype 001.	a modified pulsed-field gel electrophoresis (pfge) protocol was developed and applied to 50 isolates of the uk epidemic strain of clostridium difficile, polymerase chain reaction (pcr) ribotype 001, to develop a pfge-based subtyping scheme. this protocol overcame the inherent dna degradation problems associated with typing this strain of c. difficile by this method, and whole genomic digestion with smai restriction enzyme yielded seven distinct and reproducible pfge banding patterns. modified pf ...	2005	16002184
[study on the diarrhea in patients with percutaneous endoscopic gastrostomy--influence of clostridium difficile on the diarrhea].		2005	16004356
use of nitazoxanide as a new therapeutic option for persistent diarrhea: a pediatric perspective.	despite advances in the management of diarrheal disorders, diarrhea is the second most frequent illness in the world. persistent diarrhea, common in community pediatrics, is often caused by organisms such as giardia lamblia, cryptosporidium parvum and, less frequently, cyclospora, isospora belli, and clostridium difficile. identifying the causative organism is often challenging, and diagnostic tests may be inaccurate and expensive and, thus, of limited benefit. consequently, carefully chosen emp ...	2005	16004666
association of pseudomembranous colitis with henoch-schönlein purpura.	a 79-year-old man was admitted because of cholecystitis that occurred about 40 days after sigmoidectomy had been performed for colonic cancer. though antibiotics improved his condition, the patient had hematochezia, diarrhea, and left lower abdominal pain. colonoscopic findings showed multiple ring-like areas of redness and petechiae in the rectosigmoid colon and marked edema from the descending to the transverse colon. the patient then developed purpura on the extensor surfaces of the legs and ...	2005	16007399
[lyophilized saccharomyces boulardii: example of a probiotic medicine].	saccharomyces boulardii is a natural yeast without genetic modification isolated from the bark of the litchi tree in indochina. in its lyophilized form is an example of the called probiotic medicine. the probiotic denomination is in relation to that itself assets in the gastrointestinal tract in interrelation to that biologic environment. and is labelled as medicine because the lyophilized form has a clinical and pharmaceutical expedient included in the regulation of medicinal products in almost ...	2005	16021204
[viral gastroenteritis in children].	purpose of the trial: to establish the involvement of viruses in the aetiology of diarrhoeal disorders in children, the incidence of individual viruses in various age groups and in different seasons, the impact of the aetiological agent on the clinical picture, the severity of the disorder, therapy and duration of hospital stay. the significance of intestinal viruses as nosocomial pathogens,a comparison of the sensitivity of latex agglutination and electron microscopy in the diagnosis of rotavir ...	2005	16025426
uk launches inquiry into clostridium difficile outbreak.		2005	16027424
probiotic therapy for the prevention and treatment of clostridium difficile-associated diarrhea: a systematic review.	the recent increase in the number and severity of cases of nosocomial clostridium difficile-associated diarrhea (cdad) has prompted interest in the use of probiotics for the prevention and treatment of this disease. we performed a systematic review of randomized controlled trials to assess the effectiveness of probiotic therapy.	2005	16027434
campylobacter jejuni pancolitis mimicking idiopathic ulcerative colitis.	campylobacter jejuni is the most common cause of community-acquired acute bacterial diarrhea. campylobacter diarrhea is usually accompanied by fever and abdominal pain. campylobacter diarrhea is usually watery. nausea, vomiting, headache, and myalgias may also be present. tenesmus is a common feature. the majority of patients with campylobacter diarrhea have some component of segmental colitis, usually beginning in the small bowel and progressing distally to the cecum and colon. c. jejuni is a r ...	2005	16027651
cytomegalovirus colitis mimicking ischemic colitis in an immunocompetent host.	cytomegalovirus (cmv) causes infections in healthy individuals and compromised hosts. in compromised hosts, cmv may cause encephalitis, pneumonia, hepatitis, colitis, and so forth. in immunocompetent hosts, cmv mononucleosis is the most common clinical manifestation and cmv colitis is rare. we present a case of an 82-year-old immunocompetent man who presented with community-acquired bloody diarrhea. a computed tomography scan of the abdomen revealed pan-colitis. his age and abdominal pains sugge ...	2005	16027652
can the law help hewitt take mrsa to the cleaners?		2005	16032959
diarrhea in liver transplant recipients: etiology and management.	diarrhea is common after liver transplantation (lt). the true incidence of diarrhea in liver transplant recipients is unknown but possibly ranges from 10% to 43% based on a few published studies in other solid organ and bone marrow transplantation. infectious etiologies, including cytomegalovirus (cmv), clostridium difficile, and occasional atypical intestinal infections, are the most common causes. diarrhea is also a frequent side effect of immunosuppressive medications. to variable extents, my ...	2005	16035068
clostridium difficile toxin a induces intestinal epithelial cell apoptosis and damage: role of gln and ala-gln in toxin a effects.	the aim of this study was to investigate the effect of clostridium difficile toxin a (txa) on intestinal epithelial cell migration, apoptosis, and transepithelial resistance and to evaluate the effect of glutamine (gln) and its stable derivative, alanyl-glutamine (ala-gln), on txa-induced damage. migration was measured in rat intestinal epithelial cells (iec-6) 6 and 24 hr after a razor scrape of the cell monolayer. cell proliferation was indirectly measured utilizing the tetrazolium salt wst-1. ...	2005	16047471
effect of antibiotic treatment on growth of and toxin production by clostridium difficile in the cecal contents of mice.	in mice, subcutaneous administration of antibiotics that disrupt the anaerobic microflora (i.e., clindamycin, piperacillin-tazobactam, and ceftriaxone) facilitated in vitro growth of and toxin production by clostridium difficile in cecal contents, whereas antibiotics that cause minimal disruption of the anaerobic microflora (i.e., levofloxacin, cefepime, and aztreonam) did not.	2005	16048976
structural basis for the function of clostridium difficile toxin b.	toxin b is a member of the family of large clostridial cytotoxins which are of great medical importance. its catalytic fragment was crystallized in the presence of udp-glucose and mn2+. the structure was determined at 2.2 a resolution, showing that toxin b belongs to the glycosyltransferase type a family. however, toxin b contains as many as 309 residues in addition to the common chainfold, which most likely contribute to the target specificity. a superposition with other glycosyltransferases sh ...	2005	16054646
anisomycin induces cox-2 mrna expression through p38(mapk) and creb independent of small gtpases in intestinal epithelial cells.	cyclooxygenase (cox)-2 expression in intestinal epithelial cells is associated with colorectal carcinogenesis. cox-2 expression is induced by numerous growth factors and gastrointestinal hormones through multiple protein kinase cascades. here, the role of mitogen activated protein kinases (mapks) and small gtpases in cox-2 expression was investigated. anisomycin and sorbitol induced cox-2 expression in non-transformed, intestinal epithelial iec-18 cells. both anisomycin and sorbitol activated p3 ...	2005	16054711
activity of selected oxidizing microbicides against the spores of clostridium difficile: relevance to environmental control.	clostridium difficile is an increasingly common nosocomial pathogen, and its spores are resistant to common environmental surface disinfectants. many high-level disinfectants (eg, aldehydes) are unsuitable for environmental decontamination because they need several hours of contact to be sporicidal. this study tested the potential of selected oxidative microbicides to inactivate c. difficile spores on hard surfaces in relatively short contact times at room temperature.	2005	16061137
rho gtpases regulate rhabdom morphology in octopus photoreceptors.	in the cephalopod retina, light/dark adaptation is accompanied by a decrease/increase in rhabdom size and redistribution of rhodopsin and retinochrome. rearrangements in the actin cytoskeleton probably govern changes in rhabdom size by regulating the degradation/formation of rhabdomere microvilli. photopigment movements may be directed by microtubules present in the outer segment core cytoplasm. we believe that rhodopsin activation by light stimulates rho and rac signaling pathways, affecting th ...	2005	16079005
neutropenic enterocolitis in an advanced epithelial ovarian cancer patient treated with paclitaxel/platinum-based chemotherapy: a case report and review of the literature.	literature data show that neutropenic enterocolitis is a rare but severe complication that can occur in cancer patients treated with chemotherapy and especially with taxanes.	2005	16080485
involvement of a small gtp binding protein in hiv-1 release.	there is evidence suggesting that actin binding to hiv-1 encoded proteins, or even actin dynamics themselves, might play a key role in virus budding and/or release from the infected cell. a crucial step in the reorganisation of the actin cytoskeleton is the engagement of various different gtp binding proteins. we have thus studied the involvement of gtp-binding proteins in the final steps of the hiv-1 viral replication cycle.	2005	16080789
inhibition of clostridium perfringens by a novel strain of bacillus subtilis isolated from the gastrointestinal tracts of healthy chickens.	the objectives of this study were to isolate beneficial strains of microorganisms from the gastrointestinal tracts of healthy chickens and to screen them against clostridium perfringens, a causative agent of necrotic enteritis in poultry. one of the bacteria isolated, a strain of bacillus subtilis, was found to possess an anticlostridial factor that could inhibit the c. perfringens atcc 13124 used in this study. the anticlostridial factor produced by b. subtilis pb6 was found to be fully or part ...	2005	16085801
eradication of enteric helicobacters in mongolian gerbils is complicated by the occurrence of clostridium difficile enterotoxemia.	outbred mongolian gerbils from a united states commercial source were examined for colonization with naturally occurring enterohepatic helicobacter spp. helicobacter spp. were identified in the cecum and colon by culture and by using genus-specific primers in polymerase chain reaction (pcr) assays. nutritionally balanced triple-antibiotic wafers (containing amoxicillin, metronidazole, and bismuth) used previously to eliminate helicobacter infections in mice were administered in an attempt to era ...	2005	16089175
probiotics for recurrent clostridium difficile disease.		2005	16091446
reduction in nosocomial transmission of drug-resistant bacteria after introduction of an alcohol-based handrub.	to assess quantitatively the clinical impact of using an alcohol-based handrub (abhr) in the hospital environment, measuring impact as the incidence of new, nosocomial isolates of drug-resistant organisms.	2005	16092747
inhibition of rac gtpase triggers a c-jun- and bim-dependent mitochondrial apoptotic cascade in cerebellar granule neurons.	rho gtpases are key transducers of integrin/extracellular matrix and growth factor signaling. although integrin-mediated adhesion and trophic support suppress neuronal apoptosis, the role of rho gtpases in neuronal survival is unclear. here, we have identified rac as a critical pro-survival gtpase in cerebellar granule neurons (cgns) and elucidated a death pathway triggered by its inactivation. gtp-loading of rac1 was maintained in cgns by integrin-mediated (rgd-dependent) cell attachment and tr ...	2005	16092944
infectious disease surveillance update.		2005	16094737
luxs/autoinducer-2 quorum sensing molecule regulates transcriptional virulence gene expression in clostridium difficile.	toxigenic clostridium difficile ccug19126 produces the autoinducer-2 (ai-2) quorum sensing molecule that induces bioluminescence in vibrio harveyi bb170 reporter strain. ai-2-containing cell-free supernatants from mid-log phase c. difficile and escherichia coli dh5alpha expressing recombinant luxs(cd) upregulated the transcript levels of tcda (7-10-fold), tcdb (4-6-fold), and tcde (2-3-fold) in early-log c. difficile. in contrast, no induction occurred when cells were exposed to sterile medium o ...	2005	16098481
preoperative oral antibiotics in colorectal surgery increase the rate of clostridium difficile colitis.	bowel preparation traditionally consists of cathartics, oral antibiotics, and intravenous antibiotics. we hypothesize that the use of oral antibiotics in bowel preparation results in a higher rate of postoperative clostridium difficile colitis.	2005	16103284
clostridium perfringens type a & antibiotic associated diarrhoea.	clostridium perfringens type a (cpa) isolates produce lethal necrotizing antigens and the heat resistant forms of the organism are associated with pathogenic outcome in humans. cpa has also been implicated in antibiotic associated diarrhoea (aad). we therefore undertook this study to investigate the presence of cpa in stool samples of patients with aad in a tertiary care setting in north india.	2005	16106091
clostridium difficile-associated diarrhea in 200 canadian children.	clostridium difficile-associated diarrhea is a major problem in adults. the present study was conducted to assess risk factors and outcomes in children with c difficile-associated diarrhea.	2005	16107901
audit is important part of drug safety and regulation.		2005	16110086
[diagnostic tests: clostridium difficile].		2005	16111229
treatment of clostridium difficile-associated disease: old therapies and new strategies.	clostridium difficile-associated disease (cdad) causes substantial morbidity and mortality. the pathogenesis is multifactorial, involving altered bowel flora, production of toxins, and impaired host immunity, often in a nosocomial setting. current guidelines recommend treatment with metronidazole; vancomycin is a second-line agent because of its potential effect on the hospital environment. we present the data that led to these recommendations and explore other therapeutic options, including ant ...	2005	16122678
[comparison of rapid tests of toxin a and glutamate dehydrogenase and culture for detection of clostridium diffcile].	clostridium difficile is a major cause of antibiotics-associated diarrhea (aad), and accounts for 15-20% of all the cases. especially, aad caused by c. difficile is called as c. difficile-associated diarrhea (cdad). diagnosis of cdad is made by identification of c. difficile in the feces obtained from the patients with diarrhea after administration of antibiotics. we herein compared 3 methods, detection of toxin a and glutamate dehydrogenase (gdh) as well as culture for c. difficile. two hundred ...	2005	16124706
genomics of clostridial pathogens: implication of extrachromosomal elements in pathogenicity.	the recently decoded genomes of the major clostridial toxin-producing pathogens clostridium perfringens, clostridium tetani, clostridium botulinum and clostridium difficile have provided a huge amount of new sequence data. recent studies have focused on the identification and investigation of pathogenic determinants and the regulatory events governing their expression. the sequence data revealed also the genomic background of virulence genes, as well as the contribution of extrachromosomal eleme ...	2005	16125440
a large outbreak of clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use.	fluoroquinolones have not been frequently implicated as a cause of clostridium difficile outbreaks. nosocomial c. difficile infections increased from 2.7 to 6.8 cases per 1000 discharges (p < .001). during the first 2 years of the outbreak, there were 253 nosocomial c. difficile infections; of these, 26 resulted in colectomy and 18 resulted in death. we conducted an investigation of a large c. difficile outbreak in our hospital to identify risk factors and characterize the outbreak.	2005	15796280
serotonin-induced regulation of the actin network for learning-related synaptic growth requires cdc42, n-wasp, and pak in aplysia sensory neurons.	application of clostridium difficile toxin b, an inhibitor of the rho family of gtpases, at the aplysia sensory to motor neuron synapse blocks long-term facilitation and the associated growth of new sensory neuron varicosities induced by repeated pulses of serotonin (5-ht). we have isolated cdnas encoding aplysia rho, rac, and cdc42 and found that rho and rac had no effect but that overexpression in sensory neurons of a dominant-negative mutant of apcdc42 or the crib domains of its downstream ef ...	2005	15797550
inhibition of clostridium difficile toxin a-induced colitis in rats by apaza.	a new compound, apaza, consisting of a molecule of 5-aminosalicylic acid linked to one molecule of 4-aminophenylacetic acid by an azo bond, was testedfor its ability to inhibit acute colitis in rats caused by clostridium difficile toxin a. when administered chronically for 5 days in drinking water, apaza significantly inhibited toxin a-induced myeloperoxidase activity, luminal fluid accumulation, and structural damage to the colon at doses of from 1 to 100 mg/kg x day. for comparison, sulfasalaz ...	2005	15810644
tylosin-responsive chronic diarrhea in dogs.	fourteen dogs had shown chronic or intermittent diarrhea for more than 1 year. diarrhea had been successfully treated with tylosin for at least 6 months but recurred when treatment was withdrawn on at least 2 occasions. tylosin-responsive diarrhea (trd) affects typically middle-aged, large-breed dogs and clinical signs indicate that trd affects both the small and large intestine. treatment with tylosin eliminated diarrhea in all dogs within 3 days and in most dogs within 24 hours. tylosin admini ...	2005	15822561
subtyping of clostridium difficile polymerase chain reaction (pcr) ribotype 001 by repetitive extragenic palindromic pcr genomic fingerprinting.	fifty isolates of the most common uk strain of clostridium difficile [polymerase chain reaction (pcr) ribotype 001] were analysed by three pcr-based typing methods in order to determine genomic diversity within this strain that may form the basis of a subtyping method. the three methods used were repetitive extragenic palindromic elements (rep), conserved repetitive dna elements (box), and enterobacterial repetitive pcr intergenic consensus sequences (eric). the performance of each typing method ...	2005	15823658
clostridium difficile infection among health care workers receiving antibiotic therapy.		2005	15825055
clostridium difficile toxin b activates the egf receptor and the erk/map kinase pathway in human colonocytes.	clostridium difficile toxin b (txb) mediates acute inflammatory diarrhea characterized by neutrophil infiltration and intestinal mucosal injury. in a xenograft animal model, txb was shown to induce interleukin (il)-8 gene expression in human colonic epithelium. however, the precise mechanisms of this txb response are unknown. the aim of this study was to investigate the txb-mediated proinflammatory pathway in colonocytes.	2005	15825081
[impact of a non-compulsory antibiotic control program (pacta): cost reductions and decreases in some nosocomial infections].	antibiotics account for 30% of hospital pharmacy expenses. more than 50% of the prescriptions are considered inappropriate; hence, programs devoted to optimizing the prescription of antibiotics should be developed. we present the results of a non-compulsory program for the assessment and control of antibiotic treatment in the university hospital 12 de octubre in madrid.	2005	15826540
antibiotic-associated diarrhea in a turkish outpatient population: investigation of 288 cases.	oral antibiotics are often prescribed, especially for respiratory tract infections in the community. the widespread use of broad-spectrum antibiotics causes an increased incidence of antibiotic-associated diarrhea (aad). although aad has been studied in hospitalized patients, there is little available information concerning the characteristics of aad in outpatient populations. the aim of this study was to investigate the clinical and laboratory findings of adult patients with community-acquired ...	2005	15828448
clostridium difficile toxins: mechanism of action and role in disease.	as the leading cause of hospital-acquired diarrhea, clostridium difficile colonizes the large bowel of patients undergoing antibiotic therapy and produces two toxins, which cause notable disease pathologies. these two toxins, tcda and tcdb, are encoded on a pathogenicity locus along with negative and positive regulators of their expression. following expression and release from the bacterium, tcda and tcdb translocate to the cytosol of target cells and inactivate small gtp-binding proteins, whic ...	2005	15831824
the open anterior paramedian retroperitoneal approach for spine procedures.	with the advent of anterior lumbar interbody fusion and artificial disk replacement as common procedures for the treatment of many spinal problems, anterior exposure has become an increasingly popular procedure for general, thoracic, urologic, and vascular surgeons. despite this, the body of literature describing this procedure, especially the general and vascular surgery literature, is lacking.	2005	15837883
prevalence of the ermb gene in clostridium difficile strains isolated at a university teaching hospital from 1987 through 1998.	we analyzed 226 strains of clostridium difficile for the presence of erythromycin ribosomal methylase b (ermb) genes. forty-four strains (19.4%) carried ermb genes and were resistant to erythromycin. toxin a and toxin b gene sequences were identified in 81.9% of these 44 strains. strains of c. difficile that carry ermb genes are common etiologic agents of c. difficile-associated diarrhea.	2005	15844079
[reactive arthritis induced by clostridium difficile enteritis].	this article reports the case of an acute monoarthritis of the ankle occurring in a hla-b27 positive female patient who presented with diarrhea and fever. we retained the hypothesis of a clostridium difficile colitis, as she had previously received an antibiotic treatment. the culture of the synovial fluid remained sterile, which postulated that this arthritis was reactive. the diagnosis was confirmed by the presence of toxins a and b in the stool and positive culture. the outcome was satisfacto ...	2005	15846952
pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric burkitt lymphoma.	pseudomembranous colitis (pmc) usually manifests as fever and diarrhea in hospitalized patients treated with systemic antibiotics. we described a case of pmc with intestinal obstruction but without diarrhea. a 60-year-old man was hospitalized for chemotherapy for the treatment of burkitt lymphoma of the stomach. the patient became febrile and complained of crampy abdominal pain during the post-chemotherapy nadir. plain abdominal radiography showed some intestinal gas and niveau. because stool cy ...	2005	15849835
c. difficile: will lessons be learned?		2005	15851697
protecting against clostridium difficile illness.		2005	15851708
potential elevation of tacrolimus trough concentrations with concomitant metronidazole therapy.	to report the occurrence of a potential tacrolimus elevation in a renal transplant recipient after adding metronidazole to the medication regimen.	2005	15855244
multidrug resistance in staphylococcus aureus due to overexpression of a novel multidrug and toxin extrusion (mate) transport protein.	efflux is an important mechanism of multidrug resistance (mdr) in bacteria. the multidrug and toxin extrusion (mate) family is the most recently described group of mdr efflux proteins, none of which have previously been identified in staphylococcus aureus. two independently derived s. aureus mutants having efflux-related mdr phenotypes were studied using microarray technology and a marked overexpression of an open reading frame (orf; mepa) encoding a protein homologous with mate family proteins ...	2005	15855507
rifaximin, a poorly absorbed antibiotic: pharmacology and clinical potential.	rifaximin (4-deoxy-4'-methylpyrido[1',2'-1,2]imidazo- [5,4-c]-rifamycin sv) is a synthetic antibiotic designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (gi) absorption while retaining good antibacterial activity. both experimental and clinical pharmacology clearly show that this compound is a nonsystemic antibiotic with a broad spectrum of antibacterial action covering gram-positive and gram-negative organisms, both aerobes and anaerobes. being virtually ...	2005	15855748
antibiotic-associated diarrhea and pseudomembranous colitis: are they less common with poorly absorbed antimicrobials?	diarrhea is a well-known complication of antibiotic therapy. rates of antibiotic-associated diarrhea (aad) vary from 5 to 25%. some antibiotics are more likely to cause diarrhea than others, specifically, those that are broad spectrum and those that target anaerobic flora. this paper reviews the effects of antibiotics on the fecal flora as well as host factors which contribute to aad. clinical features and treatment of aad are also described. prevention of aad rests on wise antibiotic policies, ...	2005	15855751
depolarization induces rho-rho kinase-mediated myosin light chain phosphorylation in kidney tubular cells.	myosin-based contractility plays important roles in the regulation of epithelial functions, particularly paracellular permeability. however, the triggering factors and the signaling pathways that control epithelial myosin light chain (mlc) phosphorylation have not been elucidated. herein we show that plasma membrane depolarization provoked by distinct means, including high extracellular k(+), the lipophilic cation tetraphenylphosphonium, or the ionophore nystatin, induced strong diphosphorylatio ...	2005	15857905
effects of piperacillin/tazobactam on clostridium difficile growth and toxin production in a human gut model.	clostridium difficile infection (cdi) is a major cause of morbidity in the nosocomial environment. antimicrobial agents such as the third-generation cephalosporins, lincosamides and aminopenicillins are well known for their propensity to induce cdi, but the definitive reasons why remain to be elucidated. despite their broad spectrum of activity against both aerobic and anaerobic bacteria, the ureidopenicillins remain a class of antimicrobials infrequently associated with the development of cdi.	2005	15860551
statins decrease toll-like receptor 4 expression and downstream signaling in human cd14+ monocytes.	anti-inflammatory effects of statins contribute to their clinical benefit. molecular mechanisms underlying these effects have not been well explored. because statins attenuate lipopolysaccharide (lps) responsiveness, we hypothesized that part of the pleiotropic effects are mediated through innate immunity.	2005	15860745
statins potentiate the ifn-gamma-induced upregulation of group iia phospholipase a2 in human aortic smooth muscle cells and hepg2 hepatoma cells.	the present study shows that the incubation of human aortic smooth muscle cells (hasmc) and hepg2 cells with atorvastatin and mevastatin as hmg-coa reductase inhibitors potentiated the interferon-gamma (inf-gamma)-induced group iia phospholipase a(2) (spla(2)-iia) expression in a dose- and time-dependent manner. the effect of statins on spla(2)-iia expression was reduced by mevalonate, farnesyl pyrophosphate and geranylgeranyl pyrophosphate. inversely, inhibitors of the farnesyl transferase and ...	2005	15863363
diarrhoea developing in hospital patients.		2005	15868883
the importance of microbiological investigations, medications and artificial feeding in diarrhoea evaluation.	diarrhoea in hospitalised patients is usually attributed to medications especially antibiotics, enteral tube feeding or enteropathogenic bacteria particularly clostridium difficile.	2005	15868885