Publications

albumin, length of stay, and proton pump inhibitors: key factors in clostridium difficile-associated disease in nursing home patients.	to identify risk factors for clostridium difficile-associated disease (cdad) in nursing home patients.	2005	15871884
effect of the prebiotic oligofructose on relapse of clostridium difficile-associated diarrhea: a randomized, controlled study.	ten percent to 20% of patients relapse after successful treatment of their clostridium difficile -associated diarrhea. we set out to determine if the prebiotic oligofructose could alter the fecal bacterial flora and, in addition to antibiotic treatment, reduce the rate of relapse from c difficile infection.	2005	15880313
novel cd47-dependent intercellular adhesion modulates cell migration.	cd47 is a ubiquitously expressed plasma membrane protein, also known as integrin associated protein, that modulates cell adhesion both through alteration of the avidity of integrin binding and through interaction with its own ligands, the extracellular matrix protein thrombospondin (tsp) and the plasma membrane response regulator sirpalpha1. we now show that cd47 expression on fibroblasts can induce intercellular adhesion resulting in cell aggregation in the absence of active integrins, sirpalph ...	2005	15880429
c. difficile strain 20 times more virulent.		2005	15883397
the role of leukotriene b4 in clostridium difficile toxin a-induced ileitis in rats.	clostridium difficile toxin a is a potent intestinal inflammatory agent that has been shown to act at least partially by neurogenic mechanisms involving activation of the transient receptor potential vanilloid 1 (trpv1) (capsaicin) receptor. we tested the hypothesis that leukotriene b4 (ltb4) mediates the effects of toxin a via activation of the trpv1 receptor.	2005	15887113
proteomic analysis of cell surface proteins from clostridium difficile.	clostridium difficile is a bacterium that causes disease of the large intestine, particularly after treatment with antibiotics. the bacterium produces two toxins (a and b) that are responsible for the pathology of the disease. in addition, a number of bacterial virulence factors associated with adhesion to the gut have previously been identified, including the cell wall protein cwp66, the high-molecular weight surface layer protein (hmw-slp) and the flagella. as the genome sequence predicts many ...	2005	15887182
subtyping of clostridium difficile pcr ribotype 001 by rep-pcr and pfge.	the rep-pcr (repetitive sequence-based pcr using repetitive extragenic palindromic primers) typing method and a modified pfge method were applied to isolates of clostridium difficile pcr ribotype 001 with the aim of comparing their performance as methods of subtyping this organism. of 200 isolates from 60 hospitals tested by rep-pcr, eight subtypes were identified and labelled as rep-pcr subtypes 001-008. the predominant subtype, rep-pcr subtype 003, accounted for 47% of the total. fifty-two of ...	2005	15888462
relatively poor outcome after treatment of clostridium difficile colitis with metronidazole.	clostridium difficile is a frequent cause of serious nosocomial infection. earlier reports have suggested that treatment with metronidazole cured nearly 90% of patients, with only a modest rate of recurrence of infection. in recent years, the rate of response to treatment with this drug has appeared to be much lower.	2005	15889354
increasing risk of relapse after treatment of clostridium difficile colitis in quebec, canada.	clinicians who treat patients with clostridium difficile-associated diarrhea (cdad) in quebec, canada, have noted an apparent increase in the proportion of patients who experience relapse.	2005	15889355
metronidazole for clostridium difficile-associated disease: is it okay for mom?		2005	15889356
saccharomyces cerevisiae fungemia: an emerging infectious disease.	saccharomyces cerevisiae is well known in the baking and brewing industry and is also used as a probiotic in humans. however, it is a very uncommon cause of infection in humans.	2005	15889360
the microbial etiologies of diarrhea in hospitalized patients from the puerto rico medical center hospitals.	the development of diarrhea in hospitalized patients is a frequently encountered clinical problem, which may be due to infectious or non-infectious causes. the purpose of this study was to identify which common community enteric pathogens, if any, are responsible for diarrheal episodes in hospitalized patients. stool samples from 76 consecutive, hospitalized patients were analyzed utilizing routine bacterial cultures, smears for identification of ova and parasites and enzyme-link immunoadsorbent ...	2005	15895876
angiotensin ii subtype 1 receptor blockade inhibits clostridium difficile toxin a-induced intestinal secretion in a rabbit model.	angiotensin ii (ang ii) has been described in the regulation of intestinal secretion and absorption via angiotensin subtype 1 (at(1)) and at(2) receptors, respectively, in rats. we investigated the role that ang ii plays in the rabbit ileal-loop model of clostridium difficile infection. expression of at(1), the more abundant ang ii receptor, was demonstrated in ileal loops, and an at(1) receptor blocker, losartan, inhibited hypersecretion induced by c. difficile toxin a (mean volume : length rat ...	2005	15897995
passive immunisation of hamsters against clostridium difficile infection using antibodies to surface layer proteins.	clostridium difficile is a major cause of antibiotic-associated diarrhoea and the primary cause of pseudomembraneous colitis in hospitalised patients. we assessed the protective effect of anti-surface layer protein (slp) antibodies on c. difficile infection in a lethal hamster challenge model. post-challenge survival was significantly prolonged in the anti-slp treated group compared with control groups (p=0.0281 and p=0.0283). the potential mechanism of action of the antiserum was shown to be th ...	2005	15899406
colonization by clostridium difficile of neonates in a hospital, and infants and children in three day-care facilities of kanazawa, japan.	the intestinal-carriage rates of clostridium difficile in neonates hospitalized in the university hospital's center for perinatal and reproductive health and in infants and children enrolled in two day-nurseries and a kindergarten were examined. swab samples from the floors of these facilities were also analyzed to determine the extent of environmental contamination by this organism. c. difficile was found in the stool of only one of 40 neonates during the normal 1-week stay in the hospital afte ...	2005	15906260
gi complications in pediatric patients post-bmt.	this retrospective study comprehensively examined hepatic and gastrointestinal complications post-bone marrow transplant (bmt) in a heterogeneous group of 132 pediatric patients that underwent 142 transplants. hyperbilirubinemia occurred in 28% of this population with clinically evident jaundice in 16%. acute graft-versus-host disease (gvhd) occurred in 46% of the population, with liver involvement in 39% and intestinal involvement in 60% of those with acute gvhd. veno-occlusive disease (vod) oc ...	2005	15908980
pseudomembranous colitis in children.	this review presents the microbiology, management and prevention of pseudomembranous colitis (pmc) in children. pmc is commonly associated with prior antibiotic exposure and hospitalization. it is caused almost exclusively by toxins produced by clostridium difficile. the clinical spectrum of this disease may range from a mild, non-specific diarrhea to severe colitis with toxic megacolon, perforation, and death. pmc may affect all age groups, although a lower incidence has been noted in children. ...	2005	15683418
strains and toxins of clostridium.		2005	15684103
the relationship between hospital infection surveillance and control activities and antibiotic-resistant pathogen rates.	antibiotic-resistant pathogen rates are rising in canada and the united states with significant health and economic costs. the examination of the relationship of surveillance and control activities in hospitals with rates of nosocomial methicillin-resistant staphylococcus aureus (mrsa), clostridium difficile -associated diarrhea (cdad), and vancomycin-resistant enterococcus (vre) may identify strategies for controlling this growing problem.	2005	15685127
[what is so difficult ... with c. difficile?].		2005	15686207
transcription activation of a uv-inducible clostridium perfringens bacteriocin gene by a novel sigma factor.	expression of the plasmid-encoded clostridium perfringens gene for bacteriocin bcn5 was shown to depend in vivo and in vitro on the activity of uvia protein. uvia, also plasmid-encoded, proved to be an rna polymerase sigma factor and was also partly autoregulatory. the uvia gene has two promoters; one provided a uvia-independent, basal level of gene expression while the stronger, uvia-dependent promoter was only utilized after the cell experienced dna damage. as a result, bcn5 synthesis is induc ...	2005	15686564
probiotic therapy of intestinal inflammation and infections.	the author presents evidence published during the past year regarding treatment of clinical and experimental intestinal inflammation and infections by probiotic agents.	2005	15687884
clinical inquiries. what are effective therapies for clostridium difficile-associated diarrhea?		2005	15689297
isolation and characterization of temperate bacteriophages of clostridium difficile.	the lack of information on bacteriophages of clostridium difficile prompted this study. three of 56 clinical c. difficile isolates yielded double-stranded dna phages phic2, phic5, phic6, and phic8 upon induction. superinfection and dna analyses revealed relatedness between the phages, while partial sequencing of phic2 showed nucleotide homology to the sequenced c. difficile strain cd630.	2005	15691969
three surveillance strategies for vancomycin-resistant enterococci in hospitalized patients: detection of colonization efficiency and a cost-effectiveness model.	to evaluate the cost-effectiveness and detection sensitivity associated with three active surveillance strategies for the identification of patients harboring vancomycin-resistant enterococci (vre) to determine which is the most medically and economically useful.	2005	15693407
prebiotic effect of fructo-oligosaccharide supplemented term infant formula at two concentrations compared with unsupplemented formula and human milk.	human milk components, including oligosaccharides, affect the gastrointestinal flora of infants. previous studies in adults have demonstrated that fructo-oligosaccharides increase potentially beneficial fecal bacteria, including bifidobacteria. the purpose of this study was to determine the prebiotic effect of infant formula supplemented with fructo-oligosaccharides.	2005	15699689
etiology of diarrhea in pediatric outpatient settings.	the frequency with which bacteria cause diarrhea evaluated in ambulatory settings is often unknown. we attempted to determine the microbiologic etiology of diarrhea in a private pediatric practice (site a) and a clinic serving largely immigrant children (site b) and to establish guidelines for bacterial culture.	2005	15702043
3-hydroxy-3-methylglutaryl-coenzyme a reductase inhibitors attenuate beta-amyloid-induced microglial inflammatory responses.	alzheimer's disease (ad) is characterized by extracellular deposits of fibrillar beta-amyloid (abeta) in the brain, a fulminant microglial-mediated inflammatory reaction, and neuronal death. the use of 3-hydroxy-3-methylglutaryl-coenzyme a reductase inhibitors (statins) is associated with a reduced risk of ad, which has been attributed to the cholesterol-lowering actions of these drugs. statins have been reported recently to have anti-inflammatory actions in addition to their classic lipid-lower ...	2005	15647473
cytomegalovirus and clostridium difficile co-infection in severe ulcero-hemorrhagic colitis during induction chemotherapy for acute lymphoblastic leukemia.	here we describe the first case of a biopsy-proven cytomegalovirus ulcero-hemorrhagic colitis, associated with clostridium difficile co-infection, occurring during standard induction chemotherapy for common b cell acute lymphoblastic leukemia. we discuss the case and focalize clinical management and diagnostic issues arising from it.	2005	15653455
2-hydroxyisocaproyl-coa dehydratase and its activator from clostridium difficile.	the hadbc and hadi genes from clostridium difficile were functionally expressed in escherichia coli and shown to encode the novel 2-hydroxyisocaproyl-coa dehydratase hadbc and its activator hadi. the activated enzyme catalyses the dehydration of (r)-2-hydroxyisocaproyl-coa to isocaprenoyl-coa in the pathway of leucine fermentation. the extremely oxygen-sensitive homodimeric activator as well as the heterodimeric dehydratase, contain iron and inorganic sulfur; besides varying amounts of zinc, oth ...	2005	15654892
peptide antibiotic and actin-binding protein as mixed-type inhibitors of clostridium difficile cdt toxin activities.	cdt from clostridium difficile is an adp-ribosyltransferase that causes rapid actin disaggregation and cell death. for efficient catalysis, cdt required specific divalent cations and binding by nad which can be substituted by atp but not adp. increasing isolation of cdt-producing strains prompted our search for antagonists like the anti-c. difficile agents bacitracin and vancomycin which were effective cdt inhibitors. other cdt transferase and glycohydrolase inhibitors with consistently low ic50 ...	2005	15629471
characterization of the cleavage site and function of resulting cleavage fragments after limited proteolysis of clostridium difficile toxin b (tcdb) by host cells.	clostridium difficile toxin b (tcdb) is a single-stranded protein consisting of a c-terminal domain responsible for binding to the host cell membrane, a middle part involved in internalization, and the n-terminal catalytic (toxic) part. this study shows that tcdb is processed by a single proteolytic step which cleaves tcdb(10463) between leu(543) and gly(544) and the naturally occurring variant tcdb(8864) between leu(544) and gly(545). the cleavage occurs at neutral ph and is catalysed by a peps ...	2005	15632438
clonal spread of a clostridium difficile strain with a complete set of toxin a, toxin b, and binary toxin genes among polish patients with clostridium difficile-associated diarrhea.	clinically relevant clostridium difficile strains usually produce toxins a and b. some c. difficile strains can produce an additional binary toxin. we report clonality among five strains carrying all toxin genes from polish patients with c. difficile-associated diarrhea. in another strain, possible recombination between binary toxin genes is documented.	2005	15635019
failure of dietary oligofructose to prevent antibiotic-associated diarrhoea.	oligofructose is metabolized by bifidobacteria, increasing their numbers in the colon. high bifidobacteria concentrations are important in providing 'colonization resistance' against pathogenic bacteria.	2005	15709999
treating c. difficile.		2005	15710916
treating c. difficile.		2005	15710921
structural characterization of the cell wall binding domains of clostridium difficile toxins a and b; evidence that ca2+ plays a role in toxin a cell surface association.	clostridium difficile (c.difficile) is a nosocomially acquired intestinal bacillus which can cause chronic diarrhea and life-threatening colitis. the pathogenic effects of the bacillus are mediated by the release of two toxins, a and b. the c-terminal portions of both toxins are composed of 20 and 30 residue repeats known as cell wall binding (cwb) domains. we have cloned and expressed the cwb-domains of toxins a and b and several truncated cwb-domain constructs to investigate their structure an ...	2005	15713474
in vitro activity of ramoplanin against clostridium difficile, including strains with reduced susceptibility to vancomycin or with resistance to metronidazole.	we evaluated the in vitro activity of ramoplanin, an antimicrobial compound that inhibits cell wall synthesis by acting at the level of lipid intermediate formation, against clostridium difficile. we included strains with reduced susceptibilities to vancomycin (vancomycin-intermediate [van(i)] strains) or with resistance to metronidazole (mtz(r)), in order to assess the potential utility of ramoplanin for the treatment of c. difficile-associated diarrhea. we tested the activity of ramoplanin aga ...	2005	15728918
monocytes are highly sensitive to clostridium difficile toxin a-induced apoptotic and nonapoptotic cell death.	in this study we investigated the in vitro responses of peripheral blood mononuclear preparations and purified monocytes to clostridium difficile toxin a. in contrast to the responses of t and b cells, exposure to toxin a led to a rapid loss of monocytes in a time- and dose-dependent fashion (the majority of cells were lost within 24 h of exposure to >100 ng of toxin per ml). transmission electron microscopy, flow cytometry, and fluorescence microscopy after propidium iodide and hoechst staining ...	2005	15731062
saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: a randomized double-blind placebo-controlled trial.	co-treatment with saccharomyces boulardii appears to lower the risk of antibiotic-associated diarrhoea in adults receiving broad-spectrum antibiotics.	2005	15740542
ca2+-dependent regulation of rho gtpases triggers turning of nerve growth cones.	cytoplasmic ca2+ elevation and changes in rho gtpase activity are both known to mediate axon guidance by extracellular factors, but the causal relationship between these two events has been unclear. here we show that direct elevation of cytoplasmic ca2+ by extracellular application of a low concentration of ryanodine, which activated ca2+ release from intracellular stores, upregulated cdc42/rac, but downregulated rhoa, in cultured cerebellar granule cells and human embryonic kidney 293t cells. c ...	2005	15745960
comparison of wild type with recombinant clostridium difficile toxin a.	toxins a and b from clostridium difficile are single-chain proteins of 308,000 and 270,000 da, respectively. they possess transferase activity to monoglucosylate proteins of the rho gtpase family whereby rho, rac, and cdc42 are the canonical substrates. for application of these toxins as specific rho gtpase inhibitors the highest possible purity is of crucial interest. we, therefore, expressed recombinant his-tagged toxin a using the bacillus megaterium expression system. specific antisera raise ...	2005	15748809
clarification of article on clostridium difficile--associated colitis.		2005	15751556
clostridium difficile causing acute renal failure: case presentation and review.	clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of clostridium difficile can be found in up to 5% of the general population. ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with clostridium difficile-associated diarrhea or colitis. little is known about acute renal failure as a consequence of clostridium difficile-associated diarrhea.	2005	15754415
molecular mechanisms in uterine epithelium during trophoblast binding: the role of small gtpase rhoa in human uterine ishikawa cells.	background: embryo implantation requires that uterine epithelium develops competence to bind trophoblast to its apical (free) poles. this essential element of uterine receptivity seems to depend on a destabilisation of the apico-basal polarity of endometrial epithelium. accordingly, a reorganisation of the actin cytoskeleton regulated by the small gtpase rhoa plays an important role in human uterine epithelial rl95-2 cells for binding of human trophoblastoid jar cells. we now obtained new insigh ...	2005	15757515
regulation of h2o2 generation in thyroid cells does not involve rac1 activation.	the h2o2 generating system of the thyrocyte and the o2- generating system of macrophages and leukocytes present numerous functional analogies. the main constituent enzymes belong to the nadph oxidase (nox) family (duox/thox for the thyroid and nox2 /gp91phox for the leukocytes and macrophages), and in both cell types, h2o2 generation is activated by the intracellular generation of ca2+ and diacylglycerol signals. nevertheless, although the controls involved in these two systems are similar, thei ...	2005	15762196
clostridium difficile toxoid vaccine in recurrent c. difficile-associated diarrhea.	recurrent c difficile -associated diarrhea (cdad) is associated with a lack of protective immunity to c difficile toxins. a parenteral c difficile vaccine containing toxoid a and toxoid b was reported previously to be safe and immunogenic in healthy volunteers. our aim was to examine whether the vaccine is also well tolerated and immunogenic in patients with recurrent cdad.	2005	15765411
analysis of the fecal microbiota of irritable bowel syndrome patients and healthy controls with real-time pcr.	the gut microbiota may contribute to the onset and maintenance of irritable bowel syndrome (ibs). in this study, the microbiotas of patients suffering from ibs were compared with a control group devoid of gastrointestinal (gi) symptoms.	2005	15667495
steroid-refractory ulcerative colitis treated with corticosteroids, metronidazole and vancomycin: a case report.	increasing evidence elucidating the pathogenic mechanisms of ulcerative colitis (uc) has accumulated and the disease is widely assumed to be the consequence of genetic susceptibility and an abnormal immune response to commensal bacteria. however evidence regarding an infectious etiology in uc remains elusive.	2005	15667650
quantification of bifidobacterium spp., escherichia coli and clostridium difficile in faecal samples of breast-fed and formula-fed infants by real-time pcr.	to determine the influence of either exclusive breast-feeding or formula feeding on both composition and quantity of the gut microbiota in infants, we have developed real-time, quantitative pcr assays for the detection of bifidobacterium spp. and clostridium difficile. furthermore, we have monitored the prevalence and counts of escherichia coli by applying a previously described real-time pcr assay. we found all 100 infants tested to be colonized by bifidobacterium spp. the bifidobacterial count ...	2005	15668012
alternative treatments for clostridium difficile disease: what really works?	vancomycin and metronidazole have been used for treating clostridium difficile-associated disease (cdad) for the past 25 years, but approximately 20 % of patients develop recurrent disease. the increasing incidence of nosocomial outbreaks, cases of recurrent cdad and other complications (toxic megacolon, ileus, sepsis) has fuelled the search for different types of treatments. as the understanding of the pathogenesis of this disease has matured, newer treatment strategies that take advantage of t ...	2005	15673502
revised nomenclature of clostridium difficile toxins and associated genes.	several different nomenclatures have been applied to the clostridium difficile toxins and their associated genes. this paper summarizes the new nomenclature that has been agreed to by the research groups currently active in the field. the revised nomenclature includes c. difficile toxins and other related large clostridial toxins produced by clostridium sordellii and clostridium novyi, and corresponding toxin genes, as well as toxin production types of c. difficile strains.	2005	15673503
quorum sensing in clostridium difficile: analysis of a luxs-type signalling system.	the increasing incidence of clostridium difficile-associated disease, and the problems associated with its control, highlight the need for additional countermeasures. the attenuation of virulence through the blockade of bacterial cell-to-cell communication (quorum sensing) is one potential therapeutic target. preliminary studies have shown that c. difficile produces at least one potential signalling molecule. through the molecule's ability to induce bioluminescence in a vibrio harveyi luxs repor ...	2005	15673504
effect of phage infection on toxin production by clostridium difficile.	infection with clostridium difficile and subsequent production of toxins a and b may result in c. difficile-associated diarrhoea and pseudomembranous colitis in hospital patients. the effect of four temperate phages, obtained by induction of clinical c. difficile isolates, on toxin production by c. difficile was determined. none of these phages converted a lysogenized non-toxigenic c. difficile strain to toxin production. one of the accessory toxin genes, tcde, was detected in three phages, phic ...	2005	15673505
generation of an erythromycin-sensitive derivative of clostridium difficile strain 630 (630deltaerm) and demonstration that the conjugative transposon tn916deltae enters the genome of this strain at multiple sites.	erythromycin resistance in clostridium difficile strain 630 is conferred by a genetic element termed tn5398 which contains two erm(b) genes: erm1(b) and erm2(b). an erythromycin-sensitive derivative of strain 630 (designated 630deltaerm) was generated by spontaneous mutation after continuous subculture for 30 days. this strain had lost the erm2(b) gene from within tn5398 but retained erm1(b). however, the strain could revert to erythromycin resistance at a frequency of 2.79 x 10(-8), although it ...	2005	15673506
detection of binary-toxin genes (cdta and cdtb) among clostridium difficile strains isolated from patients with c. difficile-associated diarrhoea (cdad) in poland.	clostridium difficile a+ b+ and a- b+ strains isolated from stool samples of patients with c. difficile-associated diarrhoea (cdad) were selected from the university hospital warsaw collection. the binary-toxin genes cdta and cdtb were detected by pcr in five of the 41 a+ b+ strains tested, but in none of the 17 a- b+ strains tested, giving 8.6 % prevalence (5/58) of binary-toxin-positive strains. all of the strains that were positive for binary-toxin genes were grouped into toxinotype iv, sugge ...	2005	15673507
prevalence and characteristics of bacteria and host factors in an outbreak situation of antibiotic-associated diarrhoea.	antibiotic-associated diarrhoea (aad) represents a clinical entity leading to prolonged hospital stays and diagnostic and therapeutic procedures, and results in additional costs. the aim of the present study was to assess the prevalence and characteristics of different bacteria in stools of patients with aad. the reliability of diagnostic procedures under routine conditions was evaluated. host factors were also analysed. from june 2002 to april 2003 89 cases of diarrhoea were reported at a hospi ...	2005	15673508
an improved protocol for pulsed-field gel electrophoresis typing of clostridium difficile.	pulsed-field gel electrophoresis (pfge) is the 'gold standard' technique for bacterial typing and has proved to be discriminatory and reproducible for typing clostridium difficile. nevertheless, a high proportion of strains are non-typable by this technique due to the degradation of the dna during the process. the introduction of several modifications in the pfge standard procedure increased typability from 40% (90 isolates) to 100% (220 isolates) while maintaining the high degree of discriminat ...	2005	15673509
toxigenic status of clostridium difficile in a large spanish teaching hospital.	the aim of this study was to evaluate the toxigenic status of circulating strains of clostridium difficile in a large teaching hospital. overall 220 isolates were studied of which 199 (90.5 %) produced both large clostridial toxins detected by conventional methods. ten more strains (4.5 %) had toxin a and b genes detectable by pcr. eleven (5.0 %) variant strains (a- b+) were detected among the isolates studied and 10 strains (4.5 %) had the binary toxin genes (cdta and cdtb).	2005	15673510
pcr ribotyping of clostridium difficile isolates originating from human and animal sources.	molecular typing of clostridium difficile isolates from animals and humans may be useful for evaluation of the possibility for interspecies transmission. the objective of this study was to evaluate c. difficile isolates from domestic animals and humans using pcr ribotyping. isolates were also tested using pcr for the presence of genes encoding toxins a and b. one hundred and thirty-three isolates of c. difficile from dogs (n = 92), horses (n = 21) and humans (n = 20), plus one each from a cat an ...	2005	15673511
typing by sequencing the slpa gene of clostridium difficile strains causing multiple outbreaks in japan.	previous reports have documented that a surface layer protein (slpa) varies among clostridium difficile isolates. the typing system by sequencing the variable region of the slpa gene was applied to typing c. difficile strains belonging to one pcr ribotype, type smz, which has been identified as frequently causing outbreaks in japan. the pcr ribotype smz strains recovered from patients at different hospitals in japan were examined. among 10 type smz strains tested, three subtypes, smz-1, -2 and - ...	2005	15673512
coexistence of multiple pcr-ribotype strains of clostridium difficile in faecal samples limits epidemiological studies.	clostridium difficile is an important cause of antibiotic-associated diarrhoea. the simultaneous presence of different strains in individual faecal samples has not yet been established, but is important for epidemiological studies. recurrences of clostridium difficile-associated diarrhoea (cdad) are observed in 15-20 % of patients and have been reported as relapses or reinfections with a new strain. in a period of 1 year, 28 faecal samples from 23 patients with a first episode of cdad were colle ...	2005	15673513
clinical features of clostridium difficile-associated diarrhoea due to binary toxin (actin-specific adp-ribosyltransferase)-producing strains.	toxins a and b are known to be the primary virulence factors of clostridium difficile. other potential virulence factors have been identified such as binary toxin (actin-specific adp-ribosyltransferase toxin, or cdt). a retrospective case-control study was performed in order to identify clinical features and risk factors of c. difficile-associated diarrhoea due to binary toxin-producing strains. each case (a patient with diarrhoea due to binary toxin-producing strain) was compared with two contr ...	2005	15673514
laboratory diagnosis of clostridium difficile-associated diarrhoea: a plea for culture.	a routine protocol for diagnosing clostridium difficile-associated diarrhoea (cdad) based on both faecal-cytotoxin detection and toxigenic culture was adopted by the microbiology laboratory of the st luc-ucl university hospital in brussels in 1997. a toxigenic culture is a faecal culture followed, in the case of positivity, by a direct immunoassay on colonies to detect toxin a production. the results obtained over the past 7 years in the hospital are reviewed here. a total of 10,552 diarrhoeal s ...	2005	15673515
immunological properties of surface proteins of clostridium difficile.	sera from patients with clostridium difficile-associated disease (cdad) and sera from a control group were analysed by an elisa to detect antibodies directed against four surface proteins and toxins a and b of c. difficile. the surface proteins were the flagellar cap protein flid, the flagellin flic, the adhesin cwp66 divided into two domains, cwp66-nterminal and cwp66-cterminal, and the fibronectin-binding protein fbp68. for each antigen, antibody levels in the cdad patient group and in the con ...	2005	15673516
bovine antibody-enriched whey to aid in the prevention of a relapse of clostridium difficile-associated diarrhoea: preclinical and preliminary clinical data.	in a pilot study, the feasibility of immune whey protein concentrate (40%; immune wpc-40) to aid the prevention of relapse of clostridium difficile diarrhoea was evaluated. immune wpc-40 was made from milk after immunization of holstein-frisian cows with c. difficile-inactivated toxins and killed whole-cell c. difficile. immune wpc-40 contained a high concentration of specific siga antibodies, and was effective in neutralizing the cytotoxic effect of c. difficile toxins in cell assays in vitro. ...	2005	15673517
antibiotic treatment for clostridium difficile-associated diarrhea in adults.	clostridium difficile (c. difficile) is recognized as a frequent cause of antibiotic-associated diarrhea and colitis.	2005	15674956
probiotics and gastrointestinal diseases.	there is increasing evidence indicating health benefits by consumption of foods containing microorganisms, i.e. probiotics. a number of clinical trials have been performed to evaluate the effects in the prevention and treatment of gastrointestinal diseases caused by pathogenic microorganisms or by disturbances in the normal microflora. gastrointestinal infections caused by helicobacter pylori, traveller's diarrhoea, rotavirus diarrhoea, antibiotic-associated diarrhoea (aad) and clostridium diffi ...	2005	15606379
inhibitory effects of various micro-organisms on the growth of helicobacter pylori.	to examine the in vitro influence of various bacteria species on helicobacter pylori (hp) growth.	2005	15613007
kaposi's sarcoma-associated herpesvirus modulates microtubule dynamics via rhoa-gtp-diaphanous 2 signaling and utilizes the dynein motors to deliver its dna to the nucleus.	human herpesvirus 8 (hhv-8; also called kaposi's sarcoma-associated herpesvirus), which is implicated in the pathogenesis of kaposi's sarcoma (ks) and lymphoproliferative disorders, infects a variety of target cells both in vivo and in vitro. hhv-8 binds to several in vitro target cells via cell surface heparan sulfate and utilizes the alpha3beta1 integrin as one of its entry receptors. interactions with cell surface molecules induce the activation of host cell signaling cascades and cytoskeleta ...	2005	15613346
comparative in vitro activities of xrp 2868, pristinamycin, quinupristin-dalfopristin, vancomycin, daptomycin, linezolid, clarithromycin, telithromycin, clindamycin, and ampicillin against anaerobic gram-positive species, actinomycetes, and lactobacilli.	a comparative study of the in vitro activities of xrp 2868, a new oral streptogramin, against 266 anaerobic gram-positive clinical isolates using the agar dilution method showed that the xrp 2868 mics for 95% (254 of 266) of isolates were < or =0.5 microg/ml. xrp 2868 mics for only two strains, one being clostridium clostridioforme (mic, 16 microg/ml) and the other being clostridium difficile (mic, 32 microg/ml), were >2 microg/ml. depending on its pharmacokinetics and pharmacodynamics, xrp 2868 ...	2005	15616322
interaction of bismuth subsalicylate with fruit juices, ascorbic acid, and thiol-containing substrates to produce soluble bismuth products active against clostridium difficile.	bismuth subsalicylate (bss), the active ingredient of pepto-bismol, has been used for many years to treat various disorders of the gastrointestinal tract. using mass spectrometry and the agar dilution method, we determined that insoluble bss interacts with certain dietary components and organic substrates to produce water-soluble products with activity against clostridium difficile.	2005	15616328
inhibitory effects of mevastatin and a geranylgeranyl transferase i inhibitor (ggti-2166) on mononuclear osteoclast formation induced by receptor activator of nf kappa b ligand (rankl) or tumor necrosis factor-alpha (tnf-alpha).	we have previously reported that the statin mevastatin (compactin) reversibly inhibits the fusion of trap-positive mononuclear preosteoclasts (pocs) into multinucleated osteoclasts and disrupts the actin ring in mature osteoclasts through the inhibition of protein prenylation. protein geranylgeranylation, specifically, is known to be required for poc fusion and for the function and survival of mature osteoclasts. however, it has not been determined whether protein geranylgeranylation is involved ...	2005	15588717
a new periparturient disease in eastern europe, clostridium difficile causes postparturient sow losses.	postparturient sow losses caused by clostridium difficile have not been reported in the veterinary literature. recently in croatia, in a large outdoor production unit with suboptimal environmental conditions, a sudden increase in postparturient sow mortality was diagnosed. after postpartal application of enrofloxacine to postparturient mastitis metritis agalactia (mma) suffering sows, diarrhea, respiratory distress, and mortality of these sows were recorded. while 13% of mma suffering and treate ...	2005	15589270
toxic megacolon complicating escherichia coli o157 infection.	toxic megacolon is a well known complication in inflammatory bowel disease such as ulcerative colitis or crohn's disease. the development of toxic megacolon as a complication of infectious colitis is rare. however it is recognised as a complication of enteric infections caused by clostridium difficile, campylobacter jejuni, shigella, salmonella species, cytomegalovirus and amoebae. we describe a case of necrotising haemorrhagic ileo-colitis in a previously fit and healthy young adult female caus ...	2006	16126276
the outcome of surgery in fulminant clostridium difficile colitis.	the clinical presentation of clostridium difficile infection ranges from asymptomatic carriage, colitis with or without pseudomembranes, to fulminant colitis. although not common, fulminant c. difficile colitis can result in bowel perforation and peritonitis with a high mortality rate. colectomy is often indicated in these cases.	2006	16412077
piperacillin/tazobactam vs ceftazidime in the treatment of neutropenic fever in patients with acute leukemia or following autologous peripheral blood stem cell transplantation: a prospective randomized trial.	piperacillin/tazobactam was compared with ceftazidime for the empirical treatment of febrile neutropenia in patients with acute leukemia or following autologous peripheral blood stem cell transplantation. owing to inclusion criteria, it was possible for the same patient to be randomized several times. a total of 219 individual patients were admitted to a prospective randomized clinical study: 24 patients were included twice. patients (23.5%) remained afebrile. patients who developed febrile neut ...	2006	16400334
antimicrobial resistance of clostridium difficile isolates in a tertiary medical center, israel.	the antimicrobial susceptibilities of 49 clostridium difficile isolates obtained from patients with c. difficile-associated diarrhea to metronidazole, vancomycin, rifampicin, fusidic acid, doxycycline, and linezolid were determined by the disc diffusion and etest (biodisk, solna, sweden). random amplification of polymorphic dna-pcr amplification assay was performed for studying clonality of isolates. resistance to metronidazole was found in 2% (1/49 isolates; mic > or = 256 microg/ml) of isolate ...	2006	16406180
progressive proliferative and dysplastic typhlocolitis in aging syrian hamsters naturally infected with helicobacter spp.: a spontaneous model of inflammatory bowel disease.	helicobacter spp. have been implicated in a variety of gastrointestinal tract diseases, including peptic ulcer disease, gastric cancer, and inflammatory bowel disease (ibd), in humans and animals. although most models of ibd are experimentally induced, spontaneous or natural models of ibd are rare. herein, we describe a long-term study of chronic, progressive lesions that develop in the distal portion of the large bowel of unmanipulated syrian hamsters naturally infected with helicobacter spp. t ...	2006	16407482
small gtp-binding protein rhob is expressed in glial müller cells in the vertebrate retina.	among several small rho gtpases observed in the chick retina, rhob was transiently expressed during development and mainly present in glial müller cells in the adult. the aim of this study was to compare the distribution of rhob in the chick and mouse adult retinas and to study its potential role in the maintenance of cell morphology. the distribution of rhob was studied in situ and pure müller cell cultures were submitted to clostridium difficile toxin a and lysophosphatidic acid (lpa) treatmen ...	2006	16385489
sequence and phylogenetic analysis of the gene for surface layer protein, slpa, from 14 pcr ribotypes of clostridium difficile.	clostridium difficile is the commonest cause of antibiotic-associated diarrhoea, with the hospitalized elderly being at particular risk. the organism makes a crystalline surface protein layer (s-layer), encoded by the slpa gene, the product of which is cleaved to give two mature peptides which associate to form the layer. the larger peptide (high molecular weight; hmw), derived from the c-terminal portion of the precursor, is relatively conserved, whereas the smaller peptide (low molecular weigh ...	2006	16388033
biopeptides and immune exclusion.		2006	16389242
diarrhea in american infants and young children in the community setting: incidence, clinical presentation and microbiology.	the characteristics and microbiology of the full spectrum of pediatric diarrhea occurring in the u.s. community setting are not well-understood.	2006	16395094
caspase and bid involvement in clostridium difficile toxin a-induced apoptosis and modulation of toxin a effects by glutamine and alanyl-glutamine in vivo and in vitro.	clostridium difficile is the leading cause of nosocomial bacterial diarrhea. glutamine and its stable and highly soluble derivative alanyl-glutamine, have been beneficial in models of intestinal injury. in this study, we extend our work on the mechanisms of clostridium difficile toxin a (txa)-induced apoptosis in human intestinal epithelial t84 cells and evaluate the effects of glutamine and alanyl-glutamine on txa-induced apoptosis in vitro and disruption of ileal mucosa in vivo. t84 cells were ...	2006	16368960
isolation of rna polymerase from clostridium difficile and characterization of glutamate dehydrogenase and rrna gene promoters in vitro and in vivo.	clostridium difficile is the primary causative agent of antibiotic-associated diarrheal disease. to facilitate molecular genetic analysis of gene expression in this organism, methods were developed to study transcriptional regulation in vitro and in vivo. that is, c. difficile rna polymerase was partially purified and shown to bind to and initiate transcription in vitro from bona fide c. difficile promoters for rrna and glutamate dehydrogenase genes. in addition, primer extension analyses and a ...	2006	16352825
trends in antimicrobial resistance in health care-associated pathogens and effect on treatment.	antimicrobial resistance in health care-associated pathogens is a growing concern for health care and for public health. a recent shift in the epidemiological profile of methicillin-resistant staphylococcus aureus has resulted not only in health care-associated infections but now, also, in community-associated infections. reports have described s. aureus exhibiting decreased susceptibility and, even, resistance to vancomycin. the rate of vancomycin resistance among enterococci may be leveling; h ...	2006	16355319
continuation of antibiotics is associated with failure of metronidazole for clostridium difficile-associated diarrhea.	metronidazole is first-line therapy for c. difficile-associated diarrhea primarily because of its low cost relative to vancomycin. currently, it is unknown which patients will fail metronidazole therapy. our goal was to prospectively evaluate risk factors for metronidazole failure.	2006	16340634
epidemiology, risk factors and outcome of nosocomial infections in a respiratory intensive care unit in north india.	to determine the epidemiology, risk factors and outcome of infections in a respiratory intensive care unit (ricu) of a tertiary care institute in northern india.	2006	16343637
activation of protein kinase d3 by signaling through rac and the alpha subunits of the heterotrimeric g proteins g12 and g13.	pkd is the founding member of a novel protein kinase family that also includes pkd2 and pkd3. pkd has been the focus of most studies up to date, but little is known about the mechanisms that mediate pkd3 activation. here, we show that addition of aluminum fluoride to cos-7 cells cotransfected with pkd3 and galpha13 or galpha12 induced pkd3 activation, which was associated with a transient plasma membrane translocation of cytosolic pkd3. treatment with clostridium difficile toxin b blocked pkd3 a ...	2006	16198087
role of cdc42 in neurite outgrowth of pc12 cells and cerebellar granule neurons.	inactivation of rho gtpases inhibited the neurite outgrowth of pc12 cells. the role of cdc42 in neurite outgrowth was then studied by selective inhibition of cdc42 signals. overexpression of ack42, cdc42 binding domain of ack-1, inhibited ngf-induced neurite outgrowth in pc12 cells. ack42 also inhibited the neurite outgrowth of pc12 cells induced by constitutively activated mutant of cdc42, but not rac. these results suggest that cdc42 plays an important role in mediating ngf-induced neurite out ...	2006	16328953
centaureidin promotes dendrite retraction of melanocytes by activating rho.	melanosomes synthesized within melanocytes are transferred to keratinocytes through dendrites, resulting in a constant supply of melanin to the epidermis, and this process determines skin pigmentation. during screening for inhibitors of melanosome transfer, we found a novel reagent, centaureidin, that induces significant morphological changes in normal human epidermal melanocytes and inhibits melanocyte dendrite elongation, resulting in a reduction of melanosome transfer in an in vitro melanocyt ...	2006	16476521
distribution of clostridium difficile pcr ribotypes in regions of hungary.	the objective of this survey was to determine the distribution of clostridium difficile pcr ribotypes present across three hungarian geographical regions. a total of 105 isolates of c. difficile from diarrhoeal faeces of both inpatients and outpatients were examined. the toxigenic status of the strains was determined by pcr for the tcda, tcdb, cdta and cdtb genes in szeged (hungary), while strains were subjected to pcr ribotyping in cardiff (uk). a total of 31 ribotypes were detected among the 1 ...	2006	16476791
measuring the presence of chronic diseases.		2006	16477067
management and outcomes of a first recurrence of clostridium difficile-associated disease in quebec, canada.	during an epidemic of clostridium difficile-associated disease (cdad) caused by a strain that is a hyper-producer of toxins a and b, the frequency of a first recurrence after metronidazole treatment of the initial episode doubled in 2003-2004, compared with 1991-2002.	2006	16477549
treatment of first recurrences of clostridium difficile-associated disease: waiting for new treatment options.		2006	16477550
a great masquerader learns a new trick.		2006	16478035
clostridium difficile-associated disease: new challenges from an established pathogen.	clostridium difficile-associated disease (cdad) can range from uncomplicated diarrhea to sepsis and even death. cdad rates and severity are increasing, possibly due to a new strain. transmission of c difficile occurs primarily in health care facilities via the fecal-oral route following transient contamination of the hands of health care workers and patients; contamination of the patient care environment also plays an important role.	2006	16478043
systematic review of antimicrobial drug prescribing in hospitals.	prudent prescribing of antimicrobial drugs to hospital inpatients may reduce incidences of antimicrobial drug resistance and healthcare-associated infection. we reviewed the literature from january 1980 to november 2003 to identify rigorous evaluations of interventions to improve hospital prescribing of antimicrobial drugs. we identified 66 studies with interpretable data, of which 16 reported 20 microbiologic outcomes: gram-negative resistant bacteria, 10 studies; clostridium difficile-associat ...	2006	16494744
prevalence and association of pcr ribotypes of clostridium difficile isolated from symptomatic patients from warsaw with macrolide-lincosamide-streptogramin b (mlsb) type resistance.	isolates (79 in total) of clostridium difficile obtained over a 2 year period from 785 patients suspected of having c. difficile-associated diarrhoea (cdad) and being hospitalized in the university hospital in warsaw were characterized by toxigenicity profile and pcr ribotyping. furthermore, their susceptibility to clindamycin and erythromycin was determined. among the 79 c. difficile isolates, 35 were classified as (a+)b+, 1 as (a+)(b+)cdt+, 36 as (a-)b+ and 7 as (a-)b-. a total of 21 different ...	2006	16434714
incidence of clostridium difficile-associated diarrhea before and after autologous peripheral blood stem cell transplantation for lymphoma and multiple myeloma.	diarrhea is a major cause of morbidity and discomfort for patients undergoing high-dose chemotherapy and autologous peripheral blood stem cell transplantation (apbsct). there are multiple causes of diarrhea in patients undergoing transplantation including antineoplastic chemotherapy, antimicrobials and infection, including clostridium difficile as the most common pathogen involved. the purpose of this study was to determine the incidence of c. difficile-associated diarrhea (cdad) 1 week before a ...	2006	16435018