Publications
| Title | Abstract | Year(sorted ascending) Filter | PMID Filter |
|---|
| clostridium difficile-associated disease in oregon: increasing incidence and hospital-level risk factors. | the incidence of clostridium difficile-associated disease (cdad) appears to be increasing. population-based estimates of disease have been limited, and analyses of hospital-level risk factors for cdad are lacking. we sought to determine the incidence and trends of cdad in oregon and to identify hospital-level factors associated with increases in disease. | 2007 | 17265391 |
| clostridium difficile in the intensive care unit: epidemiology, costs, and colonization pressure. | to evaluate the epidemiology, outcomes, and importance of clostridium difficile colonization pressure (ccp) as a risk factor for c. difficile-associated disease (cdad) acquisition in intensive care unit (icu) patients. | 2007 | 17265392 |
| clinical features of clostridium difficile-associated infections and molecular characterization of strains: results of a retrospective study, 2000-2004. | recent outbreaks of severe cases of clostridium difficile-associated diarrhea (cdad) reported in north america, the united kingdom, and the netherlands have emphasized the importance of an ongoing epidemiological surveillance of cdad. | 2007 | 17265393 |
| recommendations for surveillance of clostridium difficile-associated disease. | background: the epidemiology of clostridium difficile-associated disease (cdad) is changing, with evidence of increased incidence and severity. however, the understanding of the magnitude of and reasons for this change is currently hampered by the lack of standardized surveillance methods. objective and methods: an ad hoc c. difficile surveillance working group was formed to develop interim surveillance definitions and recommendations based on existing literature and expert opinion that can help ... | 2007 | 17265394 |
| moxifloxacin therapy as a risk factor for clostridium difficile-associated disease during an outbreak: attempts to control a new epidemic strain. | an outbreak of clostridium difficile-associated disease (cdad) caused by the epidemic north american pulsed-field gel electrophoresis type 1 (nap1) strain began after a formulary change from levofloxacin to moxifloxacin. cases of cdad were associated with moxifloxacin use, but a formulary change back to levofloxacin failed to reduce rates of disease. substituting use of one fluoroquinolone with use of another without also controlling the overall use of drugs from this class is unlikely to contro ... | 2007 | 17265402 |
| risk factors for clostridium difficile infection in a hepatology ward. | during 2001, clostridium difficile infection was observed in 23 patients hospitalized in a hepatology ward (attack rate, 0.9%). since strain typing ruled out a clonal dissemination, we performed a case-control study. in addition to antibiotic use as a risk factor, the c. difficile infection rate was higher among patients with autoimmune hepatitis (p<.01). | 2007 | 17265403 |
| use of hypochlorite solution to decrease rates of clostridium difficile-associated diarrhea. | an increased rate of clostridium difficile-associated diarrhea (cdad) was noted in 2 intensive care units of a university-affiliated tertiary care facility. one unit instituted enhanced environmental cleaning with a hypochlorite solution in all rooms, whereas the other unit used hypochlorite solution only in rooms of patients with cdad. the cdad rates decreased in both units. | 2007 | 17265404 |
| severity of clostridium difficile-associated disease (cdad) in allogeneic stem cell transplant recipients: evaluation of a cdad severity grading system. | the purpose of this study was to develop and test a clostridium difficile-associated disease (cdad) grading system based on presenting symptoms in allogeneic stem cell transplant recipients. patients with severe cdad had significantly shorter median survival times and more adverse outcomes than patients with mild or moderate cdad. | 2007 | 17265405 |
| an outbreak of severe clostridium difficile-associated disease possibly related to inappropriate antimicrobial therapy for community-acquired pneumonia. | we report a severe outbreak of clostridium difficile infection. according to a chart review, half of the patients who received treatment for bacterial pneumonia before they developed c. difficile infection may not have had pneumonia. excessive use of the hospital's new pneumonia care plan during the influenza season may have contributed to the intensity of this outbreak. | 2007 | 17265406 |
| response to the article: mcfarland lv. meta-analysis of probiotics for the prevention of antibiotic-associated diarrhea and the treatment of clostridium difficile disease. am j gastroenterol 2006; 101:812-22. | 2007 | 17266694 | |
| fulminant postcesarean clostridium difficile pseudomembranous colitis. | pseudomembranous colitis due to clostridium difficile infection is rarely reported in the obstetric literature. this disease process is associated with prior antibiotic exposure. | 2007 | 17267888 |
| effects of combination therapy with direct hemoperfusion using polymyxin b-immobilized fiber and oral vancomycin on fulminant pseudomembranous colitis with septic shock. | we report 2 cases of fulminant pseudomembranous colitis with septic shock. the first case showed few symptoms, whereas the second case showed recurrence. both cases rapidly developed shock and blood pressure was uncontrollable except with the use of pressor agents. direct hemoperfusion using polymyxin b-immobilized fiber, which was previously demonstrated to have excellent therapeutic effects for the treatment of hypotension in septic shock by removing circulating lipopolysaccharide and oral van ... | 2007 | 17273924 |
| which specimens should be tested for clostridium difficile toxin? | 2007 | 17275962 | |
| inappropriate use of meta-analysis to estimate efficacy of probiotics. | 2007 | 17278265 | |
| bugs be gone? prophylaxis of infection in acute pancreatitis. | 2007 | 17278269 | |
| antibiotics and clostridium difficile: cause and cure. | 2007 | 17198057 | |
| direct e-test (ab biodisk) of respiratory samples improves antimicrobial use in ventilator-associated pneumonia. | ventilator-associated pneumonia is the most frequently observed nosocomial infection in intensive care units, and it is associated with high morbidity and mortality. early microbiological diagnosis and the initial administration of appropriate antimicrobial therapy are associated with decreased mortality and potentially reduced costs. our study evaluates the clinical and financial impact of performing rapid antimicrobial susceptibility tests directly on samples obtained from the lower respirator ... | 2007 | 17205445 |
| accuracy of icd-9 coding for clostridium difficile infections: a retrospective cohort. | clostridium difficile (c. diff) is a major nosocomial problem. epidemiological surveillance of the disease can be accomplished by microbiological or administrative data. microbiological tracking is problematic since it does not always translate into clinical disease, and it is not always available. tracking by administrative data is attractive, but icd-9 code accuracy for c. diff is unknown. by using a large administrative database of hospitalized patients with c. diff (by icd-9 code or cytotoxi ... | 2007 | 17156501 |
| antiparasitic drug nitazoxanide inhibits the pyruvate oxidoreductases of helicobacter pylori, selected anaerobic bacteria and parasites, and campylobacter jejuni. | nitazoxanide (ntz) exhibits broad-spectrum activity against anaerobic bacteria and parasites and the ulcer-causing pathogen helicobacter pylori. here we show that ntz is a noncompetitive inhibitor (k(i), 2 to 10 microm) of the pyruvate:ferredoxin/flavodoxin oxidoreductases (pfors) of trichomonas vaginalis, entamoeba histolytica, giardia intestinalis, clostridium difficile, clostridium perfringens, h. pylori, and campylobacter jejuni and is weakly active against the pyruvate dehydrogenase of esch ... | 2007 | 17158936 |
| nitazoxanide versus metronidazole for clostridium difficile-associated colitis. | 2007 | 17143841 | |
| epidemiology and incidence of clostridium difficile-associated diarrhoea diagnosed upon admission to a university hospital. | patients with clostridium difficile-associated diarrhoea (cdad) may initially develop symptoms in the community and be subsequently diagnosed at hospital admission. at the present time there is no national surveillance system and no standardized case definition of cdad in the usa, and baseline data on the incidence and epidemiology of cdad are scarce. the objective of this study was to report the incidence of cdad at a tertiary care hospital, and to determine the epidemiology of cases diagnosed ... | 2007 | 17145108 |
| difference in the cytotoxic effects of toxin b from clostridium difficile strain vpi 10463 and toxin b from variant clostridium difficile strain 1470. | glucosylation of rhoa, rac1, and cdc42 by clostridium difficile toxin b from strain vpi 10463 (tcdb) results in actin reorganization (cytopathic effect) and apoptosis (cytotoxic effect). toxin b from variant c. difficile strain 1470 serotype f (tcdbf) differs from tcdb with regard to substrate proteins, as it glucosylates rac1 and r-ras but not rhoa and cdc42. in this study, we addressed the question of whether the cellular effects of the toxins depend on their protein substrate specificity. rat ... | 2007 | 17145947 |
| lactobacillus plantarum 299v enhances the concentrations of fecal short-chain fatty acids in patients with recurrent clostridium difficile-associated diarrhea. | our objective was to document how intake of lactobacillus plantarum 299v affects the concentrations of fecal organic acids during and after metronidazole treatment in 19 patients with recurrent clostridium difficile-associated diarrhea. fecal samples were analyzed by gas-liquid chromatography. after intake of metronidazole a significant decrease in total short-chain fatty acids was seen in the placebo group (from 77.1 to 45.5 micromol/g; p=0.028) but not in the lactobacillus group (79.8-60.4 mic ... | 2007 | 17420953 |
| [investigation of the presence of clostridium difficile in antibiotic associated diarrhea patients by culture and toxin detection methods]. | clostridium difficile-associated disease can be observed especially in hospitalized patients who use broad-spectrum antibiotics. the aim of this study was to investigate the presence of c. difficile as the causative agent of diarrhea in outpatients and inpatients. during january-december 2005, 45 outpatients and 46 inpatients (of them 11 were intensive care unit patients) who had developed diarrhea due to antibiotic use, were included to the study. in addition 7 intensive care unit personnel and ... | 2007 | 17427550 |
| prevalence of pcr ribotypes among clostridium difficile isolates from pigs, calves, and other species. | pcr ribotypes were obtained for 144 clostridium difficile isolates from neonatal pigs. porcine isolates comprised four pcr ribotypes, but one, ribotype 078, predominated (83%). this was also the most common ribotype (94%) among 33 calf isolates but was rarely identified in other species. | 2007 | 17428945 |
| [treatment of community acquired pneumonia]. | the s3 guidelines for diagnosis and therapy use german epidemiological data to set the standards for a risk and degree of severity based treatment of community acquired pneumonia (cap). over the last few years, a change in pathogen epidemiology has been recognized with the significance of staphylococci and enterobacteria increasing. cap is becoming increasingly a disease of the elderly, for whom a more broadly effective initial therapy appears to be needed. resistant pathogens play an important ... | 2007 | 17431572 |
| diminished intestinal colonization by clostridium difficile and immune response in mice after mucosal immunization with surface proteins of clostridium difficile. | clostridium difficile pathogenesis is mainly due to toxins a and b. however, the first step of pathogenesis is the colonization process. we evaluated c. difficile surface proteins as vaccine antigens to diminish intestinal colonization in a human flora-associated mouse model. first, we used the flagellar cap protein flid of c. difficile, in order to test several immunization routes: intranasal, rectal, and intragastric. the rectal route, which is the most efficient, was used to vaccine groups of ... | 2007 | 17433506 |
| clostridium difficile toxin a-induced apoptosis is p53-independent but depends on glucosylation of rho gtpases. | clostridium difficile toxin a (tcda) is one of two homologous glucosyltransferases that mono-glucosylate rho gtpases. ht29 cells were challenged with wild-type and mutant tcda to investigate the mechanism by which apoptosis is induced. the tcda-induced re-organization of the actin cytoskeleton led to an increased number of cells within the g2/m phase. depolymerization of the actin filaments with subsequent g2/m arrest, however, was not causative for apoptosis, as shown in a comparative study usi ... | 2007 | 17437185 |
| enterocolitis due to simultaneous infection with rotavirus and clostridium difficile in adult and pediatric solid organ transplantation. | diarrhea is a well-known complication of immunosuppression but is also frequently caused by pathogens such as clostridium difficile (cd) and rotavirus (rv). three adult and five pediatric solid organ recipients (sors) developed diarrhea with simultaneous identification of cd and rv. rotavirus was identified using an immunochromatografic- or enzyme-linked immunosorbent assay; cd was identified using a rapid immunoassay or enzyme immunoassay. one adult renal, one adult kidney-pancreas, one adult l ... | 2007 | 17440792 |
| c. difficile-associated disease on the rise. a newly recognized strain of a bacterium found mostly in hospitals is causing more illness. | 2007 | 17441266 | |
| nosocomial clostridium difficile infection: possible cause of anastomotic leakage after anterior resection of the rectum. | 2007 | 17444873 | |
| prediction of specific pathogens in patients with sepsis: evaluation of treat, a computerized decision support system. | prediction of bacterial infections and their pathogens allows for early, directed investigation and treatment. we assessed the ability of treat, a computerized decision support system, to predict specific pathogens. | 2007 | 17449883 |
| self-cutting to kill: new insights into the processing of clostridium difficile toxins. | clostridium difficile toxins a and b are the major cause of antibiotic-associated diarrhea and pseudomembranous colitis. the toxins are one of the biggest protein toxins known, but only the n-terminal catalytic domains of the large proteins enter the cytosol. now, a new study shows that the toxins are processed by autocatalytic cleavage, which depends on the presence of inositol hexaphosphate. | 2007 | 17455899 |
| a prospective, case control study evaluating the association between clostridium difficile toxins in the colon of neonatal swine and gross and microscopic lesions. | clostridium difficile infection in swine has most often been described in suckling pigs, where it has been associated with mesocolonic edema and typhlocolitis. this prospective study was designed to assess the correlation between the presence of c. difficile toxins (tcd) in the colon contents of neonatal pigs and a number of parameters, including gross evidence of diarrhea, mesocoloninc edema, typhlitis, and colitis. c. difficile was isolated from 51% (66/129) of large intestines and tcd was det ... | 2007 | 17459832 |
| clostridium difficile-associated diarrhea after living donor liver transplantation. | to assess the incidence and analyze the risk factors for clostridium difficile-associated diarrhea (cdad) after living donor liver transplantation (ldlt) in adult. | 2007 | 17465450 |
| no evidence for a clear link between active intestinal inflammation and autism based on analyses of faecal calprotectin and rectal nitric oxide. | due to parental concern regarding the child's bowel habits and the ongoing discussion whether there might be an association between autism and intestinal inflammation, two inflammatory markers were analysed in a group of children with autism. | 2007 | 17465982 |
| clostridium difficile small-bowel enteritis after total proctocolectomy: a rare but fatal, easily missed diagnosis. report of a case. | clostridium difficile enteritis is a rare infection, with less than a dozen cases reported in the literature. we present a case of a patient with total proctocolectomy and ileostomy, developing clostridium difficile infection of small bowel. we discuss the role of clostridium difficile toxins and review previously reported cases of clostridium difficile enteritis after total colectomy. | 2007 | 17468989 |
| natural and experimental infection of neonatal calves with clostridium difficile. | clostridium difficile toxins were associated with calf diarrhea in a recent retrospective study; however, no causal relationship has been prospectively investigated. this infection study tested whether the oral inoculation of neonatal calves with a toxigenic strain of c. difficile (pcr-ribotype 077) results in enteric disease. fourteen 6-24 h old male colostrums-fed holstein calves, received either three doses of c. difficile (1.4 x 10(8) +/- 3.5 x 10(8) cfu) (n = 8) or sterile culture broth (n ... | 2007 | 17481830 |
| implications of the changing face of clostridium difficile disease for health care practitioners. | recent reported outbreaks of clostridium difficile-associated disease in canada have changed the profile of c difficile infections. historically, c difficile disease was thought of mainly as a nosocomial disease associated with broad-spectrum antibiotics, and the disease was usually not life threatening. the emergence of an epidemic strain, bi/nap1/027, which produces a binary toxin in addition to the 2 classic c difficile toxins a and b and is resistant to some fluoroquinolones, was associated ... | 2007 | 17482995 |
| effect of metronidazole on growth and toxin production by epidemic clostridium difficile pcr ribotypes 001 and 027 in a human gut model. | we compared the behaviour of clostridium difficile pcr ribotypes 001 and 027 in a human gut model, and compared the responses to metronidazole exposure. | 2007 | 17483547 |
| case of the month. pseudomembranous colitis. | 2007 | 17484335 | |
| hospitals to report c. difficile and mrsa. | 2007 | 17485683 | |
| hypervirulent strains of clostridium difficile. | north america has seen increasing numbers of hospitalised patients and others in nursing homes and the community, with more severe clostridium difficile associated diarrhoea. this is also described in northern europe and surveillance systems are being developed or improved to monitor the situation. one strain (ribotype o27) is described in detail and, like other emerging strains, is demonstrating increasing antimicrobial resistance, notably to quinolone antibiotics. however, its association with ... | 2007 | 17488855 |
| [common errors in the management of the seriously ill patient with inflammatory bowel disease]. | 2007 | 17493441 | |
| prevention of porcine clostridium difficile-associated disease by competitive exclusion with nontoxigenic organisms. | clostridium difficile is widely known as a cause of disease in humans, and has emerged as an important problem in neonatal swine. no commercial product is available for immunoprophylaxis of c. difficile-associated disease, but success in preventing experimental infections in hamsters by use of nontoxigenic strains to competitively exclude toxigenic strains led us to try this method in neonatal pigs. spores were administered orally to newborn pigs or were sprayed onto perineum and teats of dams. ... | 2007 | 17493774 |
| how long should we treat community-acquired pneumonia? | the studies reviewed in this article suggest that a shorter duration of antibiotic therapy is comparable to standard therapy in the treatment of community-acquired pneumonia and promotes reduction of adverse events, microbial resistance, cost, and improved patient compliance. | 2007 | 17496577 |
| the missing care bundle: antibiotic prescribing in hospitals. | the care bundle involves grouping together key elements of care for procedures and the management of specific diagnoses in order to provide a systematic method to improve and monitor the delivery of clinical care processes. in short, care bundles aim to ensure that all patients consistently receive the best care or treatment, all of the time. this approach has been successfully applied to the management of various conditions, particularly in the critical care setting. the institute for healthcar ... | 2007 | 17499482 |
| postoperative hirschsprung's enterocolitis after minimally invasive swenson's procedure. | our preferred minimally invasive technique of swenson's procedure has evolved from laparoscopic (lapswen) to swenson's transanal pullthrough (swap). we studied the incidence of postoperative hirschsprung's enterocolitis (hec) over the past decade. | 2007 | 17502205 |
| simvastatin inhibits ifn-gamma-induced cd40 gene expression by suppressing stat-1alpha. | cd40, a member of the tnf receptor superfamily, is critical for productive immune responses. macrophages constitutively express cd40 at low levels, which are enhanced by ifn-gamma. ifn-gamma-induced cd40 expression involves activation of stat-1alpha as well as nf-kappab activation through an autocrine response to ifn-gamma-induced tnf-alpha production. statins are 3-hydroxy-3-methylglutaryl (hmg)-coa reductase inhibitors, which exert anti-inflammatory effects independent of their cholesterol-low ... | 2007 | 17507688 |
| systematic review of the risk of enteric infection in patients taking acid suppression. | proton pump inhibitors (ppis) and h(2) receptor antagonists (h(2)ras) have become the mainstay of therapy in acid-related upper gastrointestinal disorders. there have been concerns raised about the possible association of ppis with enteric infections. | 2007 | 17509031 |
| antimicrobial phenotypes and molecular basis in clinical strains of clostridium difficile. | clostridium difficile remains the leading cause of nosocomial-acquired diarrhea. this study investigated antimicrobial susceptibility patterns of c. difficile over a 3-year period. three hundred seventeen c. difficile isolates recovered between 2002 and 2004 were analyzed for their susceptibility to erythromycin (ery), clindamycin (cli), moxifloxacin (mxf), doxycycline (dox), vancomycin (van), and metronidazole (mtr) by etest. the molecular basis for resistance was investigated using polymerase ... | 2007 | 17509804 |
| etiologic agents of diarrhea in solid organ recipients. | after transplantation, diarrhea may be caused by infectious agents, drug-specific effects, metabolic conditions, or mechanical complications of surgery. determining the cause helps to determine whether to initiate antimicrobial therapy and the duration of treatment. in this study we aimed to determine the causes of diarrhea in kidney or liver recipients. fifty-two diarrhea episodes among 43 solid organ recipients were evaluated. the cause of diarrhea was detected in 43 patients (82.6%). infectio ... | 2007 | 17511817 |
| rac1, rhoa, and cdc42 participate in hela cell invasion by group b streptococcus. | the group b streptococcus (gbs) is an important human pathogen with the ability to cause invasive disease. to do so, the bacteria must invade host cells. it has been well documented that gbs are able to invade a variety of nonphagocytic host cell types, and this process is thought to involve a number of pathogen-host cell interactions. while some of the molecular aspects of the gbs-host cell invasion process have been characterized, many events still remain unclear. the objective of this investi ... | 2007 | 17517067 |
| hospital-acquired clostridium difficile-associated disease in the intensive care unit setting: epidemiology, clinical course and outcome. | clostridium difficile-associated disease (cdad) is a serious nosocomial infection, however few studies have assessed cdad outcome in the intensive care unit (icu). we evaluated the epidemiology, clinical course and outcome of hospital-acquired cdad in the critical care setting. | 2007 | 17517130 |
| in vitro activities of 15 antimicrobial agents against 110 toxigenic clostridium difficile clinical isolates collected from 1983 to 2004. | the incidence and severity of clostridium difficile-associated disease (cdad) is increasing, and standard treatment is not always effective. therefore, more-effective antimicrobial agents and treatment strategies are needed. we used the agar dilution method to determine the in vitro susceptibility of the following antimicrobials against 110 toxigenic clinical isolates of c. difficile from 1983 to 2004, primarily from the united states: doripenem, meropenem, gatifloxacin, levofloxacin, moxifloxac ... | 2007 | 17517836 |
| the large clostridial toxins from clostridium sordellii and c. difficile repress glucocorticoid receptor activity. | we have previously shown that bacillus anthracis lethal toxin represses glucocorticoid receptor (gr) transactivation. we now report that repression of gr activity also occurs with the large clostridial toxins produced by clostridium sordellii and c. difficile. this was demonstrated using a transient transfection assay system for gr transactivation. we also report that c. sordellii lethal toxin inhibited gr function in an ex vivo assay, where toxin reduced the dexamethasone suppression of the pro ... | 2007 | 17517870 |
| clostridium difficile toxins a and b directly stimulate human mast cells. | clostridium difficile toxins a and b (tcda and tcdb) are the causative agents of antibiotic-associated pseudomembranous colitis. mucosal mast cells play a crucial role in the inflammatory processes underlying this disease. we studied the direct effects of tcda and tcdb on the human mast cell line hmc-1 with respect to degranulation, cytokine release, and the activation of proinflammatory signal pathways. tcda and tcdb inactivate rho gtpases, the master regulators of the actin cytoskeleton. the i ... | 2007 | 17517880 |
| genome sequence of a proteolytic (group i) clostridium botulinum strain hall a and comparative analysis of the clostridial genomes. | clostridium botulinum is a heterogeneous gram-positive species that comprises four genetically and physiologically distinct groups of bacteria that share the ability to produce botulinum neurotoxin, the most poisonous toxin known to man, and the causative agent of botulism, a severe disease of humans and animals. we report here the complete genome sequence of a representative of group i (proteolytic) c. botulinum (strain hall a, atcc 3502). the genome consists of a chromosome (3,886,916 bp) and ... | 2007 | 17519437 |
| clostridium difficile-associated diarrhoea: bovine anti-clostridium difficile whey protein to help aid the prevention of relapses. | 2007 | 17519495 | |
| molecular characterization and antimicrobial susceptibilities of extra-intestinal clostridium difficile isolates. | amongst 25 extra-intestinal clinical isolates of clostridium difficile, a(+)b(+) (72%) and a(-)b(+) (4%) toxigenic phenotypes, as well as the non-toxigenic phenotype (a(-)b(-)) (24%), were identified. the a(-)b(-) isolates did not express toxin, yet carried part of the tcda and tcdb gene and are of a previously unreported toxinotype. six a(+)b(+) isolates also carried binary toxin genes. resistance to erythromycin (20%), clindamycin (48%), tetracycline (16%), moxifloxacin (16%) and imipenem (11% ... | 2007 | 17531516 |
| evaluation of clostridium difficile-associated disease pressure as a risk factor for c difficile-associated disease. | colonization pressure has been identified as an important risk factor in the transmission of methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococcus species, but the role of colonization pressure in the transmission of clostridium difficile-associated disease (cdad) is unclear. the purpose of this study was to evaluate cdad pressure, a modified form of colonization pressure based on symptomatic cdad cases, as a risk factor for cdad. | 2007 | 17533213 |
| increasing incidence of clostridium difficile-associated diarrhea in african-american and hispanic patients: association with the use of proton pump inhibitor therapy. | clostridium difficile-associated diarrhea (cdad) has been increasingly diagnosed in hospitalized patients. the number of prescriptions for proton pump inhibitors (ppis) has also increased significantly over time. few studies have reported an association between cdad and ppi use; however, the results are inconclusive. | 2007 | 17534007 |
| surveillance of prescription drug-related mortality using death certificate data. | the prescription drugs or drug classes that are most frequently associated with death in the us might be identifiable from death certificate data. | 2007 | 17536879 |
| beating the bug. | 2007 | 17539395 | |
| environmental contamination makes an important contribution to hospital infection. | meticillin-resistant staphylococcus aureus (mrsa) and vancomycin-resistant enterococci (vre) are capable of surviving for days to weeks on environmental surfaces in healthcare facilities. environmental surfaces frequently touched by healthcare workers are commonly contaminated in the rooms of patients colonized or infected with mrsa or vre. a number of studies have documented that healthcare workers may contaminate their hands or gloves by touching contaminated environmental surfaces, and that h ... | 2007 | 17540242 |
| clostridium difficile toxin expression is inhibited by the novel regulator tcdc. | clostridium difficile, an emerging nosocomial pathogen of increasing clinical significance, produces two large protein toxins that are responsible for the cellular damage associated with the disease. the precise mechanisms by which toxin synthesis is regulated in response to environmental change have yet to be discovered. the toxin genes (tcda and tcdb) are located in a pathogenicity locus (paloc), along with tcdr and tcdc. tcdr is an alternative rna polymerase sigma factor that directly activat ... | 2007 | 17542920 |
| recurrent clostridium difficile infection: an immunodeficiency state? | 2007 | 17544993 | |
| association between igg2 and igg3 subclass responses to toxin a and recurrent clostridium difficile-associated disease. | individuals who mount a significant serum immunoglobulin (ig)g response to toxin a are protected against recurrent clostridium difficile-associated disease (cdad). we investigated whether humoral immune deficiencies and/or specific igg subclass responses are associated with recurrent cdad. | 2007 | 17544998 |
| no-touch taps help combat c. diff spread. | dart valley's mike allen explains how no-touch taps can assist in the fight against an organism which continues to attract much attention. | 2007 | 17549948 |
| clostridium difficile in retail ground meat, canada. | clostridium difficile was isolated from 12 (20%) of 60 retail ground meat samples purchased over a 10-month period in 2005 in canada. eleven isolates were toxigenic, and 8 (67%) were classified as toxinotype iii. the human health implications of this finding are unclear, but with the virulence of toxinotype iii strains further studies are required. | 2007 | 17552108 |
| clostridium difficile-associated disease in new jersey hospitals, 2000-2004. | recent emergence of a virulent strain of clostridium difficile demonstrates the importance of tracking c. difficile incidence locally. our survey of new jersey hospitals documented increases in the rates of c. difficile disease (by 2-fold), c. difficile-associated complications (by 7-fold), and c. difficile outbreaks (by 12-fold) during 2000-2004. | 2007 | 17552112 |
| gyra mutations in fluoroquinolone-resistant clostridium difficile pcr-027. | 2007 | 17552115 | |
| antimicrobial drugs and community-acquired clostridium difficile-associated disease, uk. | in a population-based case-control study of community acquired clostridium difficile-associated disease (cdad), we matched 1,233 cases to 12,330 controls. cdad risk increased 3-fold with use of any antimicrobial agent and 6-fold with use of fluoroquinolones. prior use of antimicrobial agents did not affect risk for cdad after 6 months. | 2007 | 17553260 |
| acute colonic pseudo-obstruction. | acute colonic pseudo-obstruction (acpo) is a syndrome of massive dilation of the colon without mechanical obstruction that develops in hospitalized patients with serious underlying medical and surgical conditions. increasing age, cecal diameter, delay in decompression, and status of the bowel significantly influence mortality, which is approximately 40% when ischemia or perforation is present. evaluation of the markedly distended colon involves excluding mechanical obstruction and other causes o ... | 2007 | 17556152 |
| identification, optimal management, and infection control measures for clostridium difficile-associated disease in long-term care. | residents of long-term care facilities are at an increased risk of exposure to clostridium difficile and become more susceptible to infection after receiving antimicrobial therapy. an increasing number and more severe cases of c. difficile-associated disease (cdad) have been reported over the last few years and have been linked to the emergence of a new, more virulent strain of c. difficile. these serious cases of disease have also been associated with a more atypical clinical presentation and h ... | 2007 | 17561015 |
| vegetative clostridium difficile survives in room air on moist surfaces and in gastric contents with reduced acidity: a potential mechanism to explain the association between proton pump inhibitors and c. difficile-associated diarrhea? | proton pump inhibitors (ppis) have been identified as a risk factor for clostridium difficile-associated diarrhea (cdad), though the mechanism is unclear because gastric acid does not kill c. difficile spores. we hypothesized that the vegetative form of c. difficile, which is killed by acid, could contribute to disease pathogenesis if it survives in room air and in gastric contents with elevated ph. we compared the numbers of c. difficile spores and vegetative cells in stools of patients prior t ... | 2007 | 17562803 |
| effect of fluoroquinolone treatment on growth of and toxin production by epidemic and nonepidemic clostridium difficile strains in the cecal contents of mice. | several recent outbreaks of clostridium difficile-associated disease (cdad) have been attributed to the emergence of an epidemic strain with increased resistance to fluoroquinolone antibiotics. some clinical studies have suggested that fluoroquinolones with enhanced antianaerobic activity (i.e., gatifloxacin and moxifloxacin) may have a greater propensity to induce cdad than ciprofloxacin and levofloxacin do. we examined the effects of subcutaneous fluoroquinolone treatment on in vitro growth of ... | 2007 | 17562807 |
| three novel highly charged copper-based biocides: safety and efficacy against healthcare-associated organisms. | we investigated three novel highly charged copper-based inorganic biocidal formulations for their activity against organisms highly relevant to healthcare-associated infection. | 2007 | 17567632 |
| detection of clostridium difficile toxin: comparison of enzyme immunoassay results with results obtained by cytotoxicity assay. | several kinds of laboratory techniques are available to detect clostridium difficile toxin in fecal samples. because questions have been raised about the reliability of immunoassays compared to the accepted standard, cytotoxicity assay, we studied three enzyme immunoassays (eias) and one rapid eia, which demonstrated relatively good sensitivities and specificities compared to cytotoxicity assay. | 2007 | 17567791 |
| protease-activated receptor 2, dipeptidyl peptidase i, and proteases mediate clostridium difficile toxin a enteritis. | we studied the role of protease-activated receptor 2 (par(2)) and its activating enzymes, trypsins and tryptase, in clostridium difficile toxin a (txa)-induced enteritis. | 2007 | 17570216 |
| protease-activated receptor 2 in the intestinal inflammatory response induced by clostridium difficile toxin a. | 2007 | 17570231 | |
| clostridium difficile in the long-term care setting. | the incidence of clostridium difficile-associated disease (cdad) has increased over the past few years and more severe cases of cdad have been reported. this changing epidemiology is possibly a result of the emergence of a more virulent strain of c difficile that is more resistant to fluoroquinolones and is associated with increased morbidity and mortality. because of advanced age and frequent courses of antibiotic therapy, patients in long-term care facilities are at increased risk of c diffici ... | 2007 | 17570307 |
| analysis of 30-day mortality for clostridium difficile-associated disease in the icu setting. | to examine the 30-day mortality rate among patients with clostridium difficile-associated disease (cdad) requiring intensive care. | 2007 | 17573523 |
| a case of pseudomembranous colitis presenting with massive ascites. | clostridium difficile-associated disease seems to be increasing worldwide. a wide spectrum of clinical manifestations, ranging from asymptomatic to life-threatening disease, has been described. a case of pseudomembranous colitis with massive ascites as the main presenting manifestation is described in order to illustrate the changing clinical pattern of antibiotic-associated colitis. | 2007 | 17574110 |
| point prevalence survey for healthcare-associated infections within canadian adult acute-care hospitals. | a survey of adult patients 19 years of age and older was conducted in february 2002 in hospitals across canada to estimate the prevalence of healthcare-associated infections (hais). a total of 5750 adults were surveyed; 601 of these had 667 hais, giving a prevalence of 10.5% infected patients and 11.6% hais. urinary tract infections (uti) were the most frequent hai, shown by 194 (3.4%) of the patients surveyed. pneumonia was found in 175 (3.0%) of the patients, surgical site infections (ssi) in ... | 2007 | 17574304 |
| molecular characterization and antimicrobial susceptibility patterns of clostridium difficile strains isolated from hospitals in south-east scotland. | clostridium difficile isolates (n=149) collected in south-east scotland between august and october 2005 were typed by four different methods and their susceptibility to seven different antibiotics was determined. the aims were to define the types of strain occurring in this region and to determine whether there were any clonal relationships among them with respect to genotype and antibiotic resistance pattern. ribotyping revealed that 001 was the most common type (n=113, 75.8 %), followed by rib ... | 2007 | 17577057 |
| antimicrobial activity of lacticin 3,147 against clinical clostridium difficile strains. | clostridium difficile-associated diarrhoea (cdad) is the most common hospital-acquired diarrhoea, and is a major type of gastroenteritis infection in nursing homes and facilities for the elderly. in this study the antimicrobial activity of the two-component lantibiotic, lacticin 3,147, against a range of genetically distinct c. difficile isolates was studied. the bacteriocin exhibited an mic(50) of 3.6 microg ml(-1) for 10 genetically distinct c. difficile strains isolated from healthy subjects, ... | 2007 | 17577060 |
| designing a protocol that eliminates clostridium difficile: a collaborative venture. | clostridium difficile is a health care-associated pathogen that is difficult to eradicate in the health care environment through the use of common hospital disinfectants. many of these disinfectants fail to inactivate c difficile spores, which can result in patient-to-patient transmission. this study demonstrates that the use of 10% hypochlorite solution, along with interventions, reduced the incidence of health care-associated c. difficile infection. | 2007 | 17577477 |
| prevalence of clostridium difficile environmental contamination and strain variability in multiple health care facilities. | clostridium difficile spores can contaminate the hospital environment. little is known about the prevalence and strain variability of c. difficile environmental contamination in health care facilities. the objective of this study was to assess c. difficile environmental contamination at various health care facilities in a metropolitan area and determine if the north american pulsed field gel electrophoresis type 1 (nap1) strain was present. | 2007 | 17577478 |
| the challenges posed by reemerging clostridium difficile infection. | there have been recent, marked increases in the incidence and severity of clostridium difficile-associated disease (cdad). these may be attributable to the emergence of a hypervirulent strain of c. difficile that produces increased levels of toxins a and b, as well as an extra toxin known as "binary toxin." this previously uncommon strain has become epidemic, coincident with its development of increased resistance to fluoroquinolones, the use of which is increasingly associated with cdad outbrea ... | 2007 | 17578783 |
| reduction of clostridium difficile and vancomycin-resistant enterococcus contamination of environmental surfaces after an intervention to improve cleaning methods. | contaminated environmental surfaces may play an important role in transmission of some healthcare-associated pathogens. in this study, we assessed the adequacy of cleaning practices in rooms of patients with clostridium difficile-associated diarrhea (cdad) and vancomycin-resistant enterococcus (vre) colonization or infection and examined whether an intervention would result in improved decontamination of surfaces. | 2007 | 17584935 |
| auto-catalytic cleavage of clostridium difficile toxins a and b depends on cysteine protease activity. | the action of clostridium difficile toxins a and b depends on processing and translocation of the catalytic glucosyltransferase domain into the cytosol of target cells where rho gtpases are modified. here we studied the processing of the toxins. dithiothreitol and beta-mercaptoethanol induced auto-cleavage of purified native toxin a and toxin b into approximately 250/210- and approximately 63-kda fragments. the 63-kda fragment was identified by mass spectrometric analysis as the n-terminal gluco ... | 2007 | 17591770 |
| stress ulcer prophylaxis in hospitalized patients not in intensive care units. | a review is presented of the evidence behind the current use of therapies for the prevention of stress-related mucosal disease and bleeding in the nonintensive care unit (icu), general medicine population. | 2007 | 17592004 |
| clostridium difficile: recent epidemiologic findings and advances in therapy. | clostridium difficile-associated disease (cdad) has become an important public health problem. the causative organism is acquired by the oral route from an environmental source or by contact with an infected person or a health care worker who serves as a vector. disruption of the bowel microflora, generally by antibiotics, creates an environment that allows c. difficile to proliferate. organisms produce toxins a and b, which cause intense inflammation of the colonic mucosa. the syndrome that res ... | 2007 | 17594209 |
| probiotics for clostridium difficile diarrhea: putting it into perspective. | clostridium difficile diarrhea is an expensive, life-threatening infection associated with serious morbidity and mortality, even among previously healthy individuals. relapses from the infection are common following standard antibiotic treatments, with 3-5% of patients who contract c. difficile diarrhea unable to discontinue vancomycin due to continual relapses. such patients may have a focal immunodeficiency in which they fail to mount an immune response against c. difficile. for these individu ... | 2007 | 17595302 |
| probiotics for clostridium difficile-associated diarrhea: focus on lactobacillus rhamnosus gg and saccharomyces boulardii. | to review the literature on the use of probiotics to treat or prevent recurrences of clostridium difficile-associated diarrhea (cdad) by replacing normal gastric flora. | 2007 | 17595306 |
| pharmacodynamic studies of vancomycin, metronidazole and fusidic acid against clostridium difficile. | pharmacodynamic studies of antibiotics have attracted great interest in recent years. however, studies on the pharmacodynamics of different antibiotics against clostridium difficile are scarce. | 2007 | 17595541 |
| hcais: statutory code of practice in england and wales. | healthcare-associated infections (hcais) such as meticillin resistant staphylococcus aureus (mrsa) and clostridium difficile (c. dif) are never far from the media headlines. in january 2006 a leaked memo identified the government's concerns that its target of halving mrsa infection rates by april 2008 may not be met (boseley 2007). during 2004-5, 30 people died following two outbreaks of c. dif at stoke mandeville (boseley 2007). in this article the author will focus on and discuss in detail key ... | 2007 | 17598676 |
| changing trends in bacterial infections: staphylococcus aureus, bacterial pneumonia, clostridium difficile. | changing bacterial diseases in the general population of which hiv practitioners should be aware include: new staphylococcal syndromes caused by community-acquired methicillin-resistant staphylococcus aureus usa300 strains (eg, necrotizing skin infections, pneumonia, fasciitis); continued high rates of community-acquired pneumonia in the potent antiretroviral therapy era; increase rates and severity of clostridium difficile-associated disease due to the fluoroquinolone-resistant nap1 strain, and ... | 2007 | 17598928 |
| fulminant clostridium difficile colitis. | clostridium difficile is the most common cause of nosocomial infectious diarrhea in adults. the purpose of this review is to increase awareness that infection from c. difficile is not always indolent, but with fulminant colitis, it can be lethal. the epidemiology, pathogenesis and treatment of c. difficile infection are discussed, with special emphasis on management of fulminant colitis. | 2007 | 17599017 |