Publications

regulation of toxin and bacteriocin synthesis in clostridium species by a new subgroup of rna polymerase sigma-factors.	many clostridium species are pathogenic for humans and animals, and most of the resulting diseases, such as tetanus, botulism, gas gangrene and pseudomembranous colitis, are due to the production of potent extracellular toxins. the biochemical mechanisms of action of clostridium toxins have been extensively studied in the past ten years. however, detailed information about the regulation of toxin gene expression has only recently emerged. tcdr, botr, tetr and uvia are now known to be related alt ...	2006	16439101
management of clostridium difficile in nhs trusts.		2006	16439419
rapid diagnosis of toxinogenic clostridium difficile in faecal samples with internally controlled real-time pcr.	a real-time pcr assay for clostridium difficile was developed, based on the tcdb gene, which detected all known toxinogenic reference strains (n = 45), within 30 serogroups and 24 toxinotypes. the analytical sensitivity was 1 x 10(3) cfu/ml, and the detection limit in faeces was 1 x 10(5) cfu/g. the optimal protocol for dna extraction from faecal samples involved use of the magnapure system with a stool transport and recovery (star) buffer pre-treatment. in a 1-month prospective study of 85 pati ...	2006	16441459
poor infection control, not fluoroquinolones, likely to be primary cause of clostridium difficile-associated diarrhea outbreaks in quebec.		2006	16447121
clostridium difficile-associated diarrhea outbreaks: the name of the game is isolation and cleaning.		2006	16447122
statins revert doxorubicin resistance via nitric oxide in malignant mesothelioma.	human malignant mesothelioma (hmm) is resistant to many anticancer drugs, including doxorubicin. mevastatin and simvastatin, 2 inhibitors of 3-hydroxy-3-methylglutaryl coenzyme a (hmgcoa) reductase, potentiated the intracellular accumulation and the cytotoxicity of doxorubicin in hmm cells constitutively expressing p-glycoprotein and multidrug resistance-associated protein 3. this effect of statins was nitric oxide (no)-dependent, since it was reverted by either an no synthase inhibitor or an no ...	2006	16450390
correlation of disease severity with fecal toxin levels in patients with clostridium difficile-associated diarrhea and distribution of pcr ribotypes and toxin yields in vitro of corresponding isolates.	we investigated in vivo and in vitro yields of toxins a and b from and pcr ribotypes of clostridium difficile isolates from 164 patients with differing severities of c. difficile-associated diarrhea (cdad) (patients were grouped as follows: <3 loose stools per day, n = 45; 3 to 10 per day, n = 97; >10 per day, n = 22). the median fecal toxin levels in each group were 0.5, 6.8, and 149 u/g feces (p < 0.001), respectively. patients with severe diarrhea also had more-frequent occurrence of blood in ...	2006	16455883
[antibiotic-associated diarrhea].	the incidence of antibiotic-associated diarrhea (aad) differs with the antibiotic and varies from 15 - 25 %. most cases of aad are directly or indirectly caused by alterations of gut microflora by the antibiotics resulting in clinically mild aad cases due to functional disturbances of intestinal carbohydrate or bile acid metabolism. alternatively, changes in the gut flora allow pathogens to proliferate. clostridium difficile is responsible for 10 - 15 % of all cases of aad and almost of all case ...	2006	16456762
clostridium difficile epidemic strain far reaching.		2006	16456988
prevalence of zoonotic agents in dogs visiting hospitalized people in ontario: implications for infection control.	visitation of hospitalized people by dogs is becoming commonplace, but little is known about the potential health risks of introducing dogs to healthcare settings. this cross-sectional study evaluated the prevalence of zoonotic agents in a group of 102 visitation dogs from a variety of sources across ontario. between may and july 2004, owners were interviewed by a standardized questionnaire while dogs underwent a standardized physical examination. one specimen of faeces, hair-coat brushings and ...	2006	16466831
analysis of a mitotic role of cdc42.	rho gtpases including rho, rac, and cdc42 determine the cell shape by regulating the actin and microtubule dynamics. through these actions on cytoskeleton, rho gtpases also regulate cell cycle progression. specifically, rho, rac, and cdc42 regulate g1-s progression, and rho regulates cytokinesis. however, involvement of these gtpases in nuclear division has not been definitely shown. this seems to be due to the lack of standard procedures examining mitosis-specific functions of these gtpases. re ...	2006	16472695
[pseudomembranous colitis after helicobacter pylori eradication therapy].	a 69-year-old woman with gastritis was prescribed a 1-week triple regimen therapy of amoxicillin, clarithromycin, and lansoprazole to eradicate helicobacter pylori (h. pylori) starting on march 7, 2005. h. pylori was detected on the gastric mucosa by the urease test. twenty days after eradication therapy, she began to suffer from profuse watery diarrhea. colonoscopy on april 12 showed multiple pseudomembranes in the cecum and the transverse colon, leading to a diagnosis of pseudomembranous colit ...	2006	16519125
use of nitazoxanide for gastrointestinal tract infections: treatment of protozoan parasitic infection and beyond.	the united states food and drug administration has approved the parasiticidal agent nitazoxanide for treatment of diarrhea caused by giardia lamblia/intestinalis or cryptosporidium parvum. this novel agent has a broad spectrum of activity against many other gastrointestinal pathogens, including bacteria, roundworms, flatworms, and flukes. nitazoxanide is used in many areas of the world, especially in central and south america, as a broad-spectrum parasiticidal agent in adults and children. nitaz ...	2006	16524544
probiotics and prebiotics for gastrointestinal infections.	there is growing interest in and knowledge about the potential health-promoting benefits of both probiotics and prebiotics. multiple mechanisms of action for the beneficial effect of probiotics and prebiotics have been postulated, including prevention of pathogenic bacteria growth, production of antimicrobial agents, stimulation of mucosal barrier function, and altering immunoregulation. clinical trials support the efficacy of probiotics in the treatment of acute infectious diarrhea, the prevent ...	2006	16524546
intravenous immunoglobulin for the treatment of severe, refractory, and recurrent clostridium difficile diarrhea.	clostridium difficile diarrhea is common in elderly patients and leads to prolonged hospitalization. patients with severe or recurrent clostridium difficile diarrhea have poor antitoxin antibody responses. intravenous immunoglobulin has been advocated in these patients. this study was designed to assess the response of patients with refractory, recurrent, or severe clostridium difficile diarrhea to intravenous immunoglobulin.	2006	16525744
impact of a piperacillin-tazobactam shortage on antimicrobial prescribing and the rate of vancomycin-resistant enterococci and clostridium difficile infections.	states in 2002 on antimicrobial prescribing and associated rates of vancomycin-resistant enterococci (vre) and clostridium difficile infections.design. retrospective chart review.setting. university-affiliated medical center. measurements and main results. microbiologic reports, patient demographics, and antimicrobial utilization were evaluated for patients admitted 6 months before the shortage (march 1-august 31, 2001) and for 6 months during the shortage (march 1-august 31, 2002). significant ...	2006	16509027
severe diarrhea and shock.		2006	16511400
cholesterol-dependent pore formation of clostridium difficile toxin a.	the large clostridial cytotoxins toxin a and toxin b from clostridium difficile are major virulence factors known to cause antibiotic-associated diarrhea and pseudomembranous colitis. both toxins mono-glucosylate and thereby inactivate small gtpases of the rho family. recently, it was reported that toxin b, but not toxin a, induces pore formation in membranes of target cells under acidic conditions. here, we reassessed data on pore formation of toxin a in cells derived from human colon carcinoma ...	2006	16513641
effective detection of toxigenic clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin.	we evaluated a two-step algorithm for detecting toxigenic clostridium difficile: an enzyme immunoassay for glutamate dehydrogenase antigen (ag-eia) and then, for antigen-positive specimens, a concurrent cell culture cytotoxicity neutralization assay (ccna). antigen-negative results were > or = 99% predictive of ccna negativity. because the ag-eia reduced cell culture workload by approximately 75 to 80% and two-step testing was complete in < or = 3 days, we decided that this algorithm would be ef ...	2006	16517916
recovery of clostridium difficile from hospital environments.		2006	16517932
colitis due to clostridium difficile toxins: underdiagnosed, highly virulent, and nosocomial.	clostridium difficile colitis is a major complication of antibiotic therapy. antibiotics cause a reduction in bacteria that normally reside in the colon. if an antibiotic-treated patient ingests c. difficile bacteria, this organism may proliferate in the colon because it is resistant to most antibiotics and because it does not have to compete with the normal bacteria for nutrients. if the c. difficile organism has the gene for toxin production, the toxin can produce a colitis. in addition to ant ...	2006	16424922
ileal perforation secondary to clostridium difficile enteritis: report of 2 cases.	two cases of small-bowel perforation secondary to clostridium difficile enteritis are described and compared with the 8 cases of c difficile enteritis reported in the medical literature. the cause of small-bowel involvement with c difficile is unknown, but prior antibiotic use, prior colectomy, chronic alterations in small-bowel flora, and other host factors are discussed.	2006	16415419
erythromycin for prokinesis: imprudent prescribing?	problems with antibiotic resistant bacteria are increasing in the hospital and particularly in the intensive care unit. methicillin-resistant staphylococcus aureus, acinetobacter baumanii and extended spectrum beta-lactamase producing gram-negative bacilli constitute a therapeutic and infection control challenge. early enteral feeding improves survival in patients in the intensive care unit. prokinetic agents are routinely used in patients with inappropriate gastrointestinal motility. the use of ...	2006	16420656
clostridium difficile-associated disease: an emerging threat to patient safety: insights from the society of infectious diseases pharmacists.	a formerly infrequently isolated strain of clostridium difficile known as bi/nap1 has resulted in geographically diverse outbreaks of c. difficile-associated disease. such rapid dissemination and distribution of an outbreak strain of c. difficile are unprecedented, with many regions across north america, as well as several countries in europe, being affected, all in such a short period of time. also of note is that nontraditional hosts (e.g., otherwise healthy, noninstitutionalized persons resid ...	2006	16503710
quebec strain of c. difficile in 7 provinces.		2006	16505449
[a case of multiple recurrence of clostridium difficile-associated diarrhea--analysis of isolates from the patient using pcr ribotyping].	recurrence of clostridium difficile-associated diarrhea (cdad) is a serious and still unsolved problem. little is known about the precise mechanism of the recurrence with cdad. to elucidate the issue, we analyzed c. difficile strains obtained from the patient with multiple recurrence of cdad. a 72-year-old female received rectoidectomy was developed cdad after administration of cefmetazole sodium for 5 days. she was recovered from illness by the administration 2g of vancomycin hydrochloride for ...	2006	16506665
molecular characterization of clostridium difficile isolates from horses in an intensive care unit and association of disease severity with strain type.	to determine molecular characteristics, antimicrobial susceptibility, and toxigenicity of clostridium difficile isolates from horses in an intensive care unit and evaluate associations among severity of clinical disease with specific strains of c difficile.	2006	16506942
toxigenic c. difficile induced inflammatory marker expression by human intestinal epithelial cells is asymmetrical.	clostridium difficile infection of the intestinal epithelium and consequent pseudomembranous colitis is an important cause of morbidity and mortality. pathogenesis has been ascribed exclusively to toxin production. using in vitro models of human intestinal epithelial layers, we show that exposure to toxigenic c. difficile upregulates epithelial expression of il-8 and icam-1, two molecules important in neutrophil chemoattraction and adhesion and subsequent inflammation. il-8 production was also s ...	2006	16185718
intravenous immunoglobulin for resistant clostridium difficile infection.	clostridium difficile (cd)-associated diarrhoea and colitis may relapse in up to 20% of treated patients. we present a patient who failed to respond over a 6-month period to treatment either singly or in combination with metronidazole, vancomycin, rifampicin, cholestyramine and probiotics. her diarrhoea rapidly resolved after a 3-day course of intravenous immunoglobulin. this treatment may compensate for a failed immune response to cd toxin and should be considered for relapsing cd-associated di ...	2006	16303776
prevalence and clinical features of clostridium difficile-associated diarrhea in a tertiary hospital in northern taiwan.	although the clinical manifestations of and risk factors for clostridium difficile-associated diarrhea (cdad) have been extensively investigated in western populations, data from taiwanese patients are comparatively limited. this study investigated the incidence density of cdad in taiwanese patients and also the risk factors and clinical manifestations of cdad.	2006	16783456
the outcome of surgery in fulminant clostridium difficile colitis.		2006	16784480
[evaluation of four immunoenzymatic tests for detecting clostridium difficile toxins a and b].	four immunoenzymatic tests for detecting clostridium difficile toxins a and b were studied: two rapid tests (tox a/b quik chek-techlab and noviview toxine-a-hiss diagnostics) and two elisa tests (c. difficile tox a/b ii -techlab and toxin a+b elisa test, novitec-hiss diagnostics). the results were compared to those obtained with immunocard tox a+b -ictab (meridian), c. difficile toxine a (oxoid) for rapid test and elisa premier a+b meridian for elisa. a total of 41 stools and 16 isolates were st ...	2006	17027189
who are susceptible to pseudomembranous colitis among patients with presumed antibiotic-associated diarrhea?	pseudomembranous colitis is a severe form of antibiotic-associated diarrhea. however, there have been no reports about the factors that make patients with presumed antibiotic-associated diarrhea susceptible to pseudomembranous colitis. this study was designed to determine the clinical risk factors for pseudomembranous colitis among the patients with presumed antibiotic-associated diarrhea.	2006	17028914
bacterial aetiology of diarrhoea in young children: high prevalence of enteropathogenic escherichia coli (epec) not belonging to the classical epec serogroups.	diarrhoeal disease continues to be one of the most common causes of admittance in children hospital emergency. the aim of the present study was to investigate the relative contribution of enteropathogenic and enterohemorrhagic escherichia coli (epec and ehec, respectively) as a cause of infectious bacterial diarrhoea in children from the region of toulouse. we analysed 280 samples of stools from 280 children (<2 years) with diarrhoea admitted in the "hopital des enfants" from january to august 2 ...	2006	17030460
tigecycline does not induce proliferation or cytotoxin production by epidemic clostridium difficile strains in a human gut model.	data on the risk of clostridium difficile infection (cdi) associated with specific antibiotics are difficult to obtain because of confounding clinical factors. it is particularly important to evaluate the propensity of new antibiotics to induce cdi. we have examined the propensity of tigecycline to induce cdi using a human gut model.	2006	17030519
clostridium difficile lacks detectable superantigen activity.	clostridium difficile colitis causes striking leukocytosis. we examined the possibility that toxins a or b, or other nontoxin products of c. difficile, act as superantigens, thereby stimulating leukocytosis. our results failed to show major histocompatibility complex class ii-dependent t lymphocyte proliferation, the hallmark of superantigen activity. elevated white blood cell counts in c. difficile colitis are probably due to increased generation of cytokines such as interleukin-6 (il-6) or il- ...	2006	16831215
tolevamer, a novel nonantibiotic polymer, compared with vancomycin in the treatment of mild to moderately severe clostridium difficile-associated diarrhea.	current antibiotic therapies for clostridium difficile-associated diarrhea have limitations, including progression to severe disease, recurrent c. difficile-associated diarrhea, and selection for nosocomial pathogens. tolevamer, a soluble, high-molecular weight, anionic polymer that binds c. difficile toxins a and b is a unique nonantibiotic treatment option.	2006	16838228
nitazoxanide for the treatment of clostridium difficile colitis.	clostridium difficile colitis has increased in incidence and severity, and treatment failure with metronidazole therapy has increasingly been documented. it is uncertain whether treatment with vancomycin is more effective than treatment with metronidazole, but concern over the emergence of vancomycin resistance has motivated the search for alternative therapy. nitazoxanide, a nitrothiazolide, blocks anaerobic metabolism of eukaryocyes and effectively treats intestinal infestation due to cryptosp ...	2006	16838229
new drugs for clostridium difficile infection.		2006	16838230
effect of dalbavancin on the normal intestinal microflora.	dalbavancin is a new lipoglycopeptide antibiotic active in vitro against most gram-positive bacteria. it is administered parenterally as a weekly regimen, is eliminated both in urine and faeces, and has t(1/2) in plasma of 8.5 days. investigating the impact of antibiotics on endogenous microflora is important since alteration of the balance may facilitate colonization by new potentially pathogenic strains or enable microorganisms in the normal flora to develop resistance. the purpose of the pres ...	2006	16840427
prophylactic antibiotics and clostridium difficile infection.		2006	16860438
adhesion properties and competitive pathogen exclusion ability of bifidobacteria with acquired acid resistance.	the adhesion properties of bifidobacterium longum and bifidobacterium catenulatum strains with an acquired resistance to acid and their ability to competitively exclude salmonella enterica serovar typhimurium, escherichia coli, listeria monocytogenes, enterobacter sakazakii, and clostridium difficile from adhering to human intestinal mucus were evaluated and compared with the results when the same experiments were run with the original acid-sensitive strains. in half of the four studied cases, t ...	2006	16865903
burden of clostridium difficile-associated diarrhea in a long-term care facility.	to describe the incidence and prevalence of clostridium difficile-associated diarrhea (cdad) in a long-term care facility (ltcf).	2006	16866677
in vitro activities of daptomycin, vancomycin, and penicillin against clostridium difficile, c. perfringens, finegoldia magna, and propionibacterium acnes.	daptomycin has in vitro activity against gram-positive anaerobic bacteria, although limited numbers of species have been tested. we studied the in vitro activities of daptomycin, vancomycin, and penicillin against more than 100 strains each of clostridium difficile, c. perfringens, finegoldia magna, and propionibacterium acnes. daptomycin etest mics and results from time-kill studies were determined for selected strains. for 392 of 421 strains (93%), daptomycin was inhibitory at < or =1 microg/m ...	2006	16870765
number of c difficile cases rises.		2006	16873836
pitfalls in the diagnosis of enteroviral infection in young children.	three infants with enteroviral infections were admitted to a neonatal intensive care unit (nicu). investigation into the possible nosocomial spread of enterovirus identified 31 other infected infants. only 1 of the 31 was truly positive; 30 were false-positive results.	2006	16874166
qualitative and quantitative comparison of gut bacterial colonization in enterally and parenterally fed neonatal pigs.	total parenteral nutrition (tpn) has been associated with mucosal atrophy, impaired gut barrier function, and translocation of luminal bacteria with resultant sepsis in preterm human infants. currently, we examined the effects of enteral (ent) or tpn treatments on translocation events in neonatal pigs and on colonization and composition of microbiota in the neonatal gut. newborn, colostrum-deprived pigs (<24 hours old) were fitted with intravenous catheters and were fed either ent (n = 13) or tp ...	2006	16875420
lactic acid bacteria as probiotics.	a number of lactobacillus species, bifidobacterium sp, saccharomyces boulardii, and some other microbes have been proposed as and are used as probiotic strains, i.e. live microorganisms as food supplement in order to benefit health. the health claims range from rather vague as regulation of bowel activity and increasing of well-being to more specific, such as exerting antagonistic effect on the gastroenteric pathogens clostridium difficile, campylobacter jejuni, helicobacter pylori and rotavirus ...	2006	16875422
prevalence of clostridium difficile colonization at admission to rehabilitation.	to assess the prevalence of intestinal colonization with clostridium difficile (c. difficile) at admission to acute rehabilitation and to identify risk factors associated with colonization.	2006	16876554
4-hydroxyphenylacetate decarboxylases: properties of a novel subclass of glycyl radical enzyme systems.	the 4-hydroxyphenylacetate decarboxylases from clostridium difficile and clostridium scatologenes, which catalyze the formation of p-cresol, form a distinct group of glycyl radical enzymes (gres). cresol formation provides metabolic toxicity, which allows an active suppression of other microbes and may provide growth advantages for the producers in highly competitive environments. the gre decarboxylases are characterized by a small subunit, which is not similar to any protein of known function i ...	2006	16878993
an update on diagnosis, treatment, and prevention of clostridium difficile-associated disease.	clostridium difficile is an important cause of nosocomial morbidity and mortality and is implicated in recent epidemics. data support the treatment of colitis with oral metronidazole in a dose of 1.0 to 1.5 g/d, with oral vancomycin as a second-line agent, not because its efficacy is questioned but because of environmental concerns. nitazoxanide and other drugs are currently under intense study as alternatives. treatment of asymptomatic patients is not recommended. current management strategies ...	2006	16880068
probiotics in the prevention and treatment of gastrointestinal infections.	probiotics have been studied in a variety of gi infections, and are an appealing concept given their favorable safety profiles. several placebo-controlled trials indicated that lactobacilli have a suppressive effect on h pylori infection. although some studies reported improvement in h pylori eradication, others failed to confirm this. controlled trials support the use of lactobacillus gg and s boulardii for the prevention of aad, and have demonstrated the effectiveness of s boulardii as adjunct ...	2006	16880070
moxifloxacin prophylaxis in neutropenic patients.	recent studies have shown a beneficial impact of fluoroquinolones on infection-related morbidity and mortality for patients with haematological malignancies during neutropenia. among the fluoroquinolones moxifloxacin currently provides one of the broadest spectra of antibacterial activity and may be suitable for prophylaxis during neutropenia.	2006	16880172
factors influencing the composition of the intestinal microbiota in early infancy.	the aim of this study was to examine the contribution of a broad range of external influences to the gut microbiotic composition in early infancy.	2006	16882802
listeria monocytogenes induced rac1-dependent signal transduction in endothelial cells.	infection of endothelial cells by listeria monocytogenes is an essential step in the pathogenesis of listeriosis. small gtpases of the rho family act as molecular switches in signal transduction. we tested the hypothesis that rho gtpases contribute to the regulation of cytokine expression following l. monocytogenes infection. l. monocytogenes induced release of distinct cc and cxc, as well as th1 and th2 cytokines and growth factors by endothelial cells and activated rhoa and rac1. inhibition of ...	2006	16884694
prospective, randomized inpatient study of oral metronidazole versus oral metronidazole and rifampin for treatment of primary episode of clostridium difficile-associated diarrhea.	to date, no randomized trial to address the use of adjunctive rifampin in addition to metronidazole for the treatment of clostridium difficile-associated diarrhea has been reported. rifampin has excellent in vitro activity against c. difficile and penetrates into cellular materials where the organisms may persist.	2006	16886144
improving the treatment of clostridium difficile-associated disease: where should we start?		2006	16886145
a novel fluorescence imaging technique combining deconvolution microscopy and spectral analysis for quantitative detection of opportunistic pathogens.	a novel fluorescence imaging technique based on deconvolution microscopy and spectral analysis is presented here as an alternative to confocal laser scanning microscopy. it allowed rapid, specific and simultaneous identification of five major opportunistic pathogens, relevant for public health, in suspension and provided quantitative results.	2006	16887225
the conjugative transposon tn5397 has a strong preference for integration into its clostridium difficile target site.	tn5397 is a conjugative transposon, originally isolated from clostridium difficile. the tn5397 transposase tndx is related to the phage-encoded serine integrases and the clostridium perfringens tn4451 transposase tnpx. tndx is required for the insertion and excision of the transposon. tn5397 inserts at one locus, attb(cd), in c. difficile but at multiple sites in bacillus subtilis. apart from a conserved 5' ga dinucleotide at the recombination site, there appears to be little sequence conservati ...	2006	16788196
larry's story.		2006	17038849
analysis of proline reduction in the nosocomial pathogen clostridium difficile.	clostridium difficile, a proteolytic strict anaerobe, has emerged as a clinically significant nosocomial pathogen in recent years. pathogenesis is due to the production of lethal toxins, a and b, members of the large clostridial cytotoxin family. although it has been established that alterations in the amino acid content of the growth medium affect toxin production, the molecular mechanism for this observed effect is not yet known. since there is a paucity of information on the amino acid fermen ...	2006	17041035
ehrho1, a rhoa-like gtpase of entamoeba histolytica, is modified by clostridial glucosylating cytotoxins.	clostridial glucosylating cytotoxins inactivate mammalian rho gtpases by mono-o glucosylation of a conserved threonine residue located in the switch 1 region of the target protein. here we report that ehrho1, a rhoa-like gtpase from the protozoan parasite entamoeba histolytica, is glucosylated by clostridial cytotoxins. recombinant glutathione s-transferase-ehrho1 and ehrho1 from cell lysate of entamoeba histolytica were glucosylated by clostridium difficile toxin b and clostridium novyi alpha-t ...	2006	17056697
in vitro killing of nosocomial pathogens by acid and acidified nitrite.	exposure to ph 1 or 2 buffers or acidic gastric contents resulted in the killing of vancomycin-resistant enterococcus sp., klebsiella pneumoniae, staphylococcus aureus, and candida glabrata but not clostridium difficile spores. nitrite enhanced killing under acidic conditions, but significant killing of c. difficile spores required nitrite concentrations above usual physiological levels.	2006	17065628
are probiotics effective for treating clostridium difficile disease and antibiotic-associated diarrhea?		2006	17068492
risk factors for clostridium difficile-associated diarrhea on an adult hematology-oncology ward.	nosocomial diarrhea caused by clostridium difficile causes significant morbidity and mortality in an increasing proportion of hospitalized patients annually. this case-control study of patients admitted to the hematology-oncology ward of a tertiary academic medical center over a 2-year period demonstrates that patients with clostridium difficile-associated diarrhea (cdad) were 22 times more likely than ward-matched controls with diarrhea to have received any antibiotic either during hospitalizat ...	2006	17072575
fluoroquinolones and risk for methicillin-resistant staphylococcus aureus, canada.	receipt of fluoroquinolones was the predominant risk factor for clostridium difficile-associated disease (cdad) during an epidemic in quebec, canada. to determine the role of antimicrobial drugs in facilitating healthcare-associated methicillin-resistant staphylococcus aureus (mrsa) colonization and infection and to compare this role with their effects on methicillin-susceptible s. aureus infection and cdad, we conducted a retrospective cohort study of patients in a quebec hospital. for 7371 epi ...	2006	17073089
nosocomial infections in neurocritical care.	development of nosocomial infections is a commonly encountered problem for critically ill patients. approximately half of all nosocomial pneumonias in the neurointensive care unit (nicu) are associated with ventilator-associated pneumonia. prompt diagnosis with appropriate specimen analysis is required in order to prevent increased morbidity. catheter-related blood stream infection imposes financial as well as medical implications. multifaceted interventions are helpful to ensure adherence with ...	2006	17074289
emergence of clostridium difficile toxinotype iii, pcr-ribotype 027-associated disease, france, 2006.		2006	17075146
epidemiology of clostridium difficile toxinotype iii, pcr-ribotype 027 associated disease in belgium, 2006.		2006	17075147
first isolation of clostridium difficile pcr ribotype 027 in austria.		2006	17075148
final report and recommendations from the national notifiable diseases working group.	the national notifiable diseases working group performed a ranking of 48 communicable diseases to assist with determining priorities for national surveillance. the wg offers six specific recommendations relating to the addition or deletion of communicable diseases from the list of nationally notifiable diseases. key recommendations: 1. clostridium difficile-associated diarrhea, paralytic shellfish poisoning, and invasive listeriosis are recommended for addition to the nationally notifiable disea ...	2006	17076030
lessons from stoke mandeville.		2006	17077764
helicobacter pylori and clostridium difficile in cystic fibrosis patients.	we describe the prevalence of h. pylori and toxigenic clostridium difficile (cd) infection and its relationship with gastrointestinal symptoms and pancreatic sufficiency (ps) or insufficiency (pi) in cystic fibrosis (cf) patients. stool specimens from 30 consecutive patients with cf, aged 1-44, and from 30 healthy similarly aged subjects were tested for the h. pylori antigen by specific monoclonal antibodies and for cd toxins by tox a/b assay and tox a assay. cf patients were assessed clinically ...	2006	17078007
proton pump inhibitors and hospitalization for clostridium difficile-associated disease: a population-based study.	previous studies have examined the association between proton pump inhibitor (ppi) use and the risk of clostridium difficile-associated disease (cdad), with conflicting results. whether outpatient ppi use influences the risk of hospital admission for cdad among older patients who have recently been treated with antibiotics is unknown.	2006	17051491
antimicrobial therapy of clostridium difficile-associated diarrhea.	clostridium difficile-associated diarrhea (cdad) is the most common etiologically-defined cause of hospital-acquired diarrhea. caused by the toxins of certain strains of c difficile, cdad represents a growing concern, with epidemic outbreaks in some hospitals where very aggressive and difficult-to-treat strains have recently been found. incidence of cdad varies ordinarily between 1 to 10 in every 1,000 admissions. evidence shows that cdad increases morbidity, length of stay, and costs. this arti ...	2006	17116441
narrative review: the new epidemic of clostridium difficile-associated enteric disease.	antibiotic-associated diarrhea and colitis were well established soon after antibiotics became available. early work implicated staphylococcus aureus, but in 1978 clostridium difficile became the established pathogen in the vast majority of cases. in the first 5 years (1978 through 1983), the most common cause was clindamycin, the standard diagnostic test was the cytotoxin assay, and standard management was to withdraw the implicated antibiotic and treat with oral vancomycin. most patients respo ...	2006	17116920
emerging therapies in the treatment of clostridium difficile-associated disease.	to describe emergent therapies, such as rifaximin, nitazoxanide, intravenous immunoglobulin (ivig), tinidazole, tolevamer, and the possible use of a vaccine, in clostridium difficile-associated disease (cdad), one of the most common causes of diarrhea in hospitalized adults in north america.	2006	17119105
colonic irritation.		2006	17120341
experimental evaluation of an automated endoscope reprocessor with in situ generation of peracetic acid for disinfection of semicritical devices.	to evaluate the effectiveness of a high-level disinfection solution generated inside an endoscope processing system for decontaminating external and internal surfaces of experimentally contaminated heat-sensitive medical devices.	2006	17080376
management of an outbreak of clostridium difficile-associated disease among geriatric patients.	to describe a nosocomial outbreak of clostridium difficile-associated disease (cdad).	2006	17080377
the potential role of computerized decision support systems to improve empirical antibiotic prescribing.	prudent antibiotic prescribing is a cornerstone of efforts to control the emergence and spread of antimicrobial resistance and to reduce the occurrence of clostridium difficile associated diarrhoea, and is also currently the subject of a joint working party of the british society for antimicrobial chemotherapy and the hospital infection society. an article in this issue of the journal describes a cluster randomized trial of an intervention to improve antibiotic prescribing using treat, a compute ...	2006	17082202
treatment of clostridium difficile-associated disease (cdad).		2006	17082738
enhancing patient safety through the management of clostridium difficile at toronto east general hospital.	in 2005 toronto east general hospital experienced a steady increase in the number of c. difficile cases diagnosed within the hospital. this was identified as a patient safety issue, and several areas of the hospital came together to address the problem. pharmacy immediately started a medication review of past cases. environmental services took the lead on the environmental cleaning, and a process was put into place with infection control so that housekeeping knew of every room that contained a p ...	2006	17087168
high unmet-need infectious disease opportunities.	despite advances in pharmaceutical science, considerable unmet medical needs exist in the field of anti-infective therapies. while pharmaceutical companies have focused research efforts on a few selected areas of the field, new microbial diseases have steadily increased in prevalence. three emerging areas in the field of anti-infectives now represent large commercial opportunities: gram-negative infections, community-acquired methicillin-resistant staphylococcus aureus, and clostridium difficile ...	2006	17096298
clostridium difficile-associated pouchitis.	pouchitis is the most common long-term sequela of ileal pouch-anal anastomosis (ipaa) following total proctocolectomy. no single pathogen is identified as being solely responsible for the pathogenesis of the disease. here we describe a case of clostridium difficile-associated pouchitis that was successfully treated with ciprofloxacin and tinidazole. diagnosis and management of a patient with medically refractory pouchitis associated with clostridium difficile infection is described. a 63-year-ol ...	2006	17103037
a probiotic treatment containing lactobacillus, bifidobacterium and enterococcus improves ibs symptoms in an open label trial.	to evaluate the efficacy and safety of live combined bifidobacterium, lactobacillus and enterococcus capsules in treatment of irritable bowel syndrome.	2006	17111468
clostridium difficile pcr ribotypes in calves, canada.	we investigated clostridium difficile in calves and the similarity between bovine and human c. difficile pcr ribotypes by conducting a case-control study of calves from 102 dairy farms in canada. fecal samples from 144 calves with diarrhea and 134 control calves were cultured for c. difficile and tested with an elisa for c. difficile toxins a and b. c. difficile was isolated from 31 of 278 calves: 11 (7.6%) of 144 with diarrhea and 20 (14.9%) of 134 controls (p = 0.009). toxins were detected in ...	2006	17283624
[report of icaac congress 2006: colitis caused by clostridium difficile].		2006	17290548
update on emerging infections from the centers for disease control and prevention. severe clostridium difficile-associated disease in populations previously at low risk--four states, 2005.		2006	16791928
clostridium difficile pcr ribotype 027 outbreaks in the netherlands: recent surveillance data indicate that outbreaks are not easily controlled but interhospital transmission is limited.		2006	16801713
effects of interleukin-1 on calcium signaling and the increase of filamentous actin in isolated and in situ articular chondrocytes.	to determine whether interleukin-1 (il-1) initiates transient changes in the intracellular concentration of [ca2+]i and the organization of filamentous actin (f-actin) in articular chondrocytes.	2006	16802354
the multidrug-resistant human pathogen clostridium difficile has a highly mobile, mosaic genome.	we determined the complete genome sequence of clostridium difficile strain 630, a virulent and multidrug-resistant strain. our analysis indicates that a large proportion (11%) of the genome consists of mobile genetic elements, mainly in the form of conjugative transposons. these mobile elements are putatively responsible for the acquisition by c. difficile of an extensive array of genes involved in antimicrobial resistance, virulence, host interaction and the production of surface structures. th ...	2006	16804543
pondering probiotics.		2006	16807114
antimicrobial stewardship.	antimicrobial stewardship is a key component of a multifaceted approach to preventing emergence of antimicrobial resistance. good antimicrobial stewardship involves selecting an appropriate drug and optimizing its dose and duration to cure an infection while minimizing toxicity and conditions for selection of resistant bacterial strains. studies conducted over the years indicate that antibiotic use is unnecessary or inappropriate in as many as 50% of cases in the united states, and this creates ...	2006	16813983
jnk phosphorylation of paxillin, acting through the rac1 and cdc42 signaling cascade, mediates neurite extension in n1e-115 cells.	neurons extend neurites from the cell body before formation of the polarized processes of an axon and dendrites. neurite outgrowth involves remodeling of the cytoskeletal components, which are initially regulated by small gtpases of the rho family. here we show that c-jun n-terminal kinase (jnk), which is controlled by rho gtpases rac1 and cdc42, is activated following neurite extension in mouse n1e-115 neuroblastoma cells as a model. the extension is inhibited by jnk inhibitors (sp600125 and th ...	2006	16814769
saccharomyces boulardii inhibits erk1/2 mitogen-activated protein kinase activation both in vitro and in vivo and protects against clostridium difficile toxin a-induced enteritis.	saccharomyces boulardii (sb), a probiotic yeast, protects against intestinal injury and inflammation caused by a wide variety of enteric pathogens, including clostridium difficile. given the broad range of protective effects of sb in multiple gastrointestinal disorders, we hypothesize that sb modulates host signaling pathways involved in intestinal inflammatory responses. in this study, we found that sb culture supernatant (sbs) inhibits interleukin-8 production induced by c. difficile toxin a o ...	2006	16816386
first cluster of c. difficile toxinotype iii, pcr-ribotype 027 associated disease in france: preliminary report.		2006	16816455
epithelial cell i kappa b-kinase beta has an important protective role in clostridium difficile toxin a-induced mucosal injury.	toxin a released by clostridium difficile interacts with the single layer of intestinal epithelial cells that lines the host's intestinal tract and leads to mucosal damage and inflammation that manifests clinically as antibiotic-associated diarrhea and pseudomembranous colitis. activation of the transcription factor nf-kappab in intestinal epithelial cells is important for regulating the expression of epithelial cell proinflammatory genes and cell survival. however, the role of nf-kappab activat ...	2006	16818780
it's right under our nose: homage to the nobel prize and other stories!		2006	16819477
development of a toxa gene knock-out mutant of pasteurella multocida and evaluation of its protective effects.	pasteurella multocida is an important veterinary and opportunistic human pathogen. in particular, strains of p. multocida serogroup d cause progressive atrophic rhinitis, and produce a potent, intracellular, mitogenic toxin known as p. multocida toxin (pmt), which is encoded by the toxa gene. to further investigate the toxigenic and pathogenic effects of pmt, a toxa-deleted mutant was developed by homologous gene recombination. when administrated to mice, the toxigenicity of the toxa mutant p. m ...	2006	16820762