Publications

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
a comparison of vancomycin and metronidazole for the treatment of clostridium difficile-associated diarrhea, stratified by disease severity.	the incidence and severity of clostridium difficile-associated diarrhea (cdad) has been increasing, and there have been recent reports of metronidazole treatment failure. metronidazole is still commonly used as first-line treatment for cdad but has never been compared with vancomycin in a prospective, randomized, double-blind, placebo-controlled trial. we conducted such a trial, stratifying patients according to disease severity, to investigate whether one agent was superior for treating either ...	2007	17599306
value of repeat stool testing for clostridium difficile.		2007	17602913
use of probiotic lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial.	to determine the efficacy of a probiotic drink containing lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by clostridium difficile.	2007	17604300
hand hygiene and clostridium difficile.		2007	17606966
use of intravenous immunoglobulin for the treatment of severe clostridium difficile colitis.	clostridium difficile is a gram-positive, anaerobic, spore-forming, rod-shaped bacterium responsible for most of the hospital-acquired diarrhea in developed countries. the organism received its name because it was difficult to isolate and grow in culture. infections in the elderly have been associated with significant morbidity and mortality as well as prolonged hospitalization.	2007	17608247
clostridium difficile: changing epidemiology and new treatment options.	the review summarizes changes in the epidemiology and treatment of clostridium difficile-associated disease.	2007	17609596
association of interleukin-8 polymorphism and immunoglobulin g anti-toxin a in patients with clostridium difficile-associated diarrhea.	previous studies have shown that failure to produce serum antibodies to c. difficile (cd) toxin a is associated with more severe and recurrent c. difficile-associated diarrhea (cdad); and that presence of aa genotype in the interleukin (il)-8 gene promoter -251 position is associated with increased susceptibility to cdad. this study examined the relationship between serum immunoglobulin g antibodies to cd toxin a and the presence of il-8 aa genotype in hospitalized patients with cdad.	2007	17618838
salmonella pseudomembranous colitis.	pseudomembranous colitis is most often associated with antibiotic use and caused most often by clostridium difficile. aclinical syndrome and pathology that is identical can be caused rarely by other organisms. we report a case of salmonella enterica pseudomembranous colitis and briefly review the literature regarding rare causes of this syndrome.	2007	17619469
efficacy of hospital cleaning agents and germicides against epidemic clostridium difficile strains.	to compare the effects of hospital cleaning agents and germicides on the survival of epidemic clostridium difficile strains.	2007	17620238
onset of symptoms and time to diagnosis of clostridium difficile-associated disease following discharge from an acute care hospital.	to identify patients with a diagnosis of clostridium difficile-associated disease (cdad) in the ambulatory care setting and determine the relationship of symptom onset and diagnosis to prior hospitalization and exposure to antimicrobials.	2007	17620239
emergence and control of fluoroquinolone-resistant, toxin a-negative, toxin b-positive clostridium difficile.	clostridium difficile is a major cause of infectious diarrhea in hospitalized patients. between august 2003 and january 2004, we experienced an increase in the incidence of c. difficile-associated disease. we describe the investigation into and management of the outbreak in this article.	2007	17620240
longitudinal trends in antibiotic resistance in us nursing homes, 2000-2004.	we evaluated antibiotic resistance trends in us nursing homes using the minimum data set. significant increases in the number and proportion of infections caused by antibiotic-resistant bacteria were documented over the 5-year study. further research on antibiotic resistance in nursing homes is urgently needed.	2007	17620252
probiotics for preventing and treating nosocomial infections: review of current evidence and recommendations.	objective: to review the available clinical data supporting the use of probiotics in preventing and treating serious nosocomial infections. data source: a medline database from 1996 to july 2006 and references from identified articles were used to perform a literature search relating to the clinical applications of probiotics in preventing and treating clostridium difficile-associated diarrhea (cdd) and prevention of hospital-associated pneumonia (hap). conclusion: nosocomial infections like hap ...	2007	17625089
acute appendicitis in the setting of clostridium difficile colitis: case report and review of the literature.	a 72-year-old man was hospitalized for exacerbation of chronic obstructive pulmonary disease and was treated with oral prednisone and 7 days of moxifloxacin. five days after completing the antibiotic course, he developed watery diarrhea and diffuse, crampy abdominal pain. on presentation he was afebrile, and abdominal examination revealed diffuse tenderness without peritoneal signs. stool tested positive for clostridium difficile toxin a by enzyme-linked immunosorbent assay. despite starting ora ...	2007	17625978
diarrhoea associated with antibiotic use.		2007	17626915
signaling pathways involved in oxpapc-induced pulmonary endothelial barrier protection.	increased tissue or serum levels of oxidized phospholipids have been detected in a variety of chronic and acute pathological conditions such as hyperlipidemia, atherosclerosis, heart attack, cell apoptosis, acute inflammation and injury. we have recently described signaling cascades activated by oxidized 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (oxpapc)in the human pulmonary artery endothelial cells (ec) and reported potent barrier-protective effects of oxpapc, which were mediated ...	2007	17292425
the safety of whey protein concentrate derived from the milk of cows immunized against clostridium difficile.	a whey protein concentrate prepared from the milk of cows that have been immunized against clostridium difficile (c. difficile) and its toxins, toxin a and toxin b, is produced for use as a medical food for the dietary management of patients with c. difficile-associated diarrhea (cdad) to prevent a relapse of the infection. the safety of anti-c. difficile whey protein concentrate (anti-cd wpc) is supported by analytical data comparing the composition of raw milk from immunized cows versus that f ...	2007	17293018
laboratory diagnosis of antibiotic-associated diarrhea: a polish pilot study into the clinical relevance of clostridium difficile and clostridium perfringens toxins.	in the present study, we investigated the prevalence of the clostridium perfringens enterotoxin (cpent) in stool samples originally submitted for detection of clostridium difficile toxins. fifty-two fecal samples from inpatients were screened simultaneously for c. difficile and c. perfringens toxins: 75% of the specimens were positive for tcda/tcdb toxins, 40% were positive for cpent, and 31% gave positive test results for both. it is interesting to note that only a relatively small number of c. ...	2007	17300901
interruption of recurrent clostridium difficile-associated diarrhea episodes by serial therapy with vancomycin and rifaximin.	eight women who each experienced 4-8 episodes of clostridium difficile-associated diarrhea were given a 2-week course of rifaximin therapy when they were asymptomatic, immediately after completing their last course of vancomycin therapy. seven of the 8 patients experienced no further diarrhea recurrence. the patient who had a recurrence responded to a second course of rifaximin therapy, but rifaximin-resistant c. difficile was recovered after treatment. a controlled trial for treating recurrent ...	2007	17304459
mutations in fusa associated with posttherapy fusidic acid resistance in clostridium difficile.	in silico, we identified fusa (2,067 bp) in clostridium difficile 630. sequencing of fusa in posttherapy fusidic acid-resistant c. difficile isolates from 12 patients with c. difficile-associated diarrhea (cdad) identified fusa mutations, one or two nonsynonymous substitutions, or in one case a deletion of one codon associated with resistance. five of these mutations have previously been described in fusa of fusidic acid-resistant staphylococcus aureus, but seven were novel fusa mutations. fusid ...	2007	17307985
volatile organic compounds from feces and their potential for diagnosis of gastrointestinal disease.	little is known about the volatile organic compounds (vocs) in feces and their potential health consequences. patients and healthcare professionals have observed that feces often smell abnormal during gastrointestinal disease. the aim of this work was to define the volatiles emitted from the feces of healthy donors and patients with gastrointestinal disease. our hypotheses were that i) vocs would be shared in health; ii) vocs would be constant in individuals; and iii) specific changes in vocs wo ...	2007	17314143
toxin profiles and resistances to macrolides and newer fluoroquinolones as epidemicity determinants of clinical isolates of clostridium difficile from warsaw, poland.	amplified fragment length polymorphism genotypes, antibiotic resistance profiles, and toxin profiles of clostridium difficile strains from warsaw were determined. the isolates segregate in six major genotypes, coinciding with toxin profiles. most of the toxin a-negative toxin b-positive toxin cdt-negative strains possess ermb, and several strains were resistant to fluoroquinolones. resistograms and toxin types of c. difficile strains are epidemicity determinants.	2007	17314219
variant forms of the binary toxin cdt locus and tcdc gene in clostridium difficile strains.	variability in the genes for toxin a, toxin b and other pathogenicity locus regions is well known and is the basis for the distribution of clostridium difficile strains into variant toxinotypes. previous data have indicated that some c. difficile strains have a non-functional truncated form of the binary toxin (cdt) locus. this study analysed variability in the cdt locus and the presence of deleted tcdc genes in c. difficile strains. a total of 146 strains were screened, including known variant ...	2007	17314362
saccharomyces cerevisiae strain 905 reduces the translocation of salmonella enterica serotype typhimurium and stimulates the immune system in gnotobiotic and conventional mice.	previous results in the laboratory of the authors showed that saccharomyces cerevisiae strain 905, isolated during 'cachaça' production, was able to colonize and survive in the gastrointestinal tract of germ-free and conventional mice, and to protect these animals against oral challenge with salmonella enterica serotype typhimurium or clostridium difficile. in the present work, the effects of s. cerevisiae 905 on the translocation of salm. typhimurium (mesenteric lymph nodes, peyer's patches, sp ...	2007	17314366
molecular characterization of clostridium difficile clinical isolates in a geriatric hospital.	the discriminatory potential of a combination of various typing methods was evaluated on a set of 21 clostridium difficile isolates obtained from symptomatic patients hospitalized in a geriatric unit and 7 non-toxigenic isolates from the same hospital. isolates were firstly serotyped and toxinotyped. of the 28 isolates, 19 belonged to serogroup a. pcr-ribotyping and pcr-rflp on the flic and slpa genes were then applied to these 19 isolates. the results suggest that the combination of pcr-ribotyp ...	2007	17314371
conflicting targets.		2007	17317599
c. difficile 'endemic in health service'.		2007	17319518
the complete genome sequence of clostridium difficile phage phic2 and comparisons to phicd119 and inducible prophages of cd630.	the complete genomic sequence of a previously characterized temperate phage of clostridium difficile, c2, is reported. the genome is 56 538 bp and organized into 84 putative orfs in six functional modules. the head and tail structural proteins showed similarities to that of c. difficile phage cd119 and streptococcus pneumoniae phage ej-1, respectively. homologues of structural and replication proteins were found in prophages 1 and 2 of the sequenced c. difficile cd630 genome. a putative holin ap ...	2007	17322187
jun n-terminal protein kinase enhances middle ear mucosal proliferation during bacterial otitis media.	mucosal hyperplasia is a characteristic component of otitis media. the present study investigated the participation of signaling via the jun n-terminal protein kinase (jnk) mitogen-activated protein kinase in middle ear mucosal hyperplasia in animal models of bacterial otitis media. otitis media was induced by the inoculation of nontypeable haemophilus influenzae into the middle ear cavity. western blotting revealed that phosphorylation of jnk isoforms in the middle ear mucosa preceded but paral ...	2007	17325051
methicillin-resistant staphylococcus aureus, clostridium difficile, and extended-spectrum beta-lactamase-producing escherichia coli in the community: assessing the problem and controlling the spread.	although health care-associated methicillin resistant staphylococcus aureus and clostridium difficile strains are primarily a risk to hospital patients, people are increasingly concerned about their potential to circulate in the community and the home. they are thus looking for support in order to understand the extent of the risk, and guidance on how to deal with situations where preventing infection from these species becomes their responsibility. a further concern are the community-acquired m ...	2007	17327186
clinical outcomes of intravenous immune globulin in severe clostridium difficile-associated diarrhea.	our objective was to determine if use of intravenous immune globulin (ivig) decreases the incidence of mortality, colectomies, and length of stay in the hospital in patients presenting with severe clostridium difficile-associated diarrhea (cdad).	2007	17327194
drug evaluation: opt-80, a narrow-spectrum macrocyclic antibiotic.	optimer pharmaceuticals inc, in collaboration with par pharmaceutical companies inc, is developing opt-80, a narrow-spectrum macrocyclic antibiotic secreted by the actinomycete dactylosporangium aurantiacum, for the potential treatment of clostridium difficile-associated diarrhea (cdad) and vancomycin-resistant enterococcus infection. a phase iib/iii clinical trial of opt-80 in patients with cdad is underway.	2007	17328233
clostridium difficile: association with thrombocytosis and leukocytosis.	apart from leukocytosis, few laboratory markers suggestive of clostridium difficile infections have been described.	2007	17330684
is clostridium difficile-associated infection a potentially zoonotic and foodborne disease?	clostridium difficile has received much attention in recent years because of the increased incidence and severity of nosocomial disease caused by this organism, but c. difficile-associated disease has also been reported in the community, and c. difficile is an emerging pathogen in animals. early typing comparisons did not identify animals as an important source for human infection, but recent reports have shown a marked overlap between isolates from calves and humans, including two of the predom ...	2007	17331126
autocatalytic cleavage of clostridium difficile toxin b.	clostridium difficile, the causative agent of nosocomial antibiotic-associated diarrhoea and pseudomembranous colitis, possesses two main virulence factors: the large clostridial cytotoxins a and b. it has been proposed that toxin b is cleaved by a cytosolic factor of the eukaryotic target cell during its cellular uptake. here we report that cleavage of not only toxin b, but also all other large clostridial cytotoxins, is an autocatalytic process dependent on host cytosolic inositolphosphate cof ...	2007	17334356
prevalence of toxin a-nonproducing/toxin-b-producing clostridium difficile in the tsukuba-tsuchiura district, japan.	in japan, many clinical laboratories may not have recognized toxin a-nonproducing/toxin b-producing (a-/b+) clostridium difficile, because rapid diagnostic kits detecting toxin b of c. difficile have not been available in the laboratories. therefore, we examined the prevalence of a-/b+ strains in the tsukuba-tsuchiura district, japan. fecal specimens submitted for c. difficile toxin tests in four tertiary hospitals in the district were collected for 6 months. several c. difficile a-/b+ strains, ...	2007	17334727
association between gastric acid suppressants and clostridium difficile colitis and community-acquired pneumonia: analysis using pharmacovigilance tools.	recent epidemiological studies identifying an association between some classes of gastric acid suppressants and clostridium difficile colitis and community-acquired pneumonia prompted our analysis. our objective was to retrospectively apply data mining algorithms (dmas) to the food and drug administration (fda) drug safety database to see if they might have directed/redirected attention to the reported association of gastric acid suppressive drugs with c. difficile colitis and community-acquired ...	2007	17336566
colonic delivery of compression coated nisin tablets using pectin/hpmc polymer mixture.	nisin containing pectin/hpmc compression coated tablets were prepared and their in vitro behavior tested for colonic delivery. nisin is a 34-amino-acid residue long, heat stable peptide belonging to the group a lantibiotics with wide antimicrobial activity against gram-positive bacteria. the invention can be useful for treating colonic infectious diseases such as by clostridium difficile, and also by colonization of vancomycin-resistant enterococci. in this study, each 100mg core tablet of nisin ...	2007	17337171
clostridium difficile colitis that fails conventional metronidazole therapy: response to nitazoxanide.	clostridium difficile-associated disease has increased in incidence and severity. recommended treatments include metronidazole and vancomycin. recent investigations, however, document the failure of metronidazole to cure a substantial proportion of patients with clostridium difficile colitis, but oral administration of vancomycin raises concerns over selection of antibiotic-resistant organisms in the hospital environment. we have recently shown that nitazoxanide is as effective as metronidazole ...	2007	17337513
[usefulness of immunological detection of both toxin a and toxin b in stool samples for rapid diagnosis of clostridium difficile-associated diarrhea].	toxin detection from stool specimens is critical for the diagnosis of clostridium difficile-associated diarrhea (cdad). in japan, only two toxin detection kits targeting toxin a alone are commercially available. we evaluated immunocard toxin a & b (immunocard), based on enzyme immunoassay for the rapid detection of both c. difficile toxins a and b in stool specimens, compared to a toxin a detection kit (uniquick) and cytotoxin assay. c. difficile was also cultured from stool specimens and the to ...	2007	17338314
mapk interacts with xgef and is required for cpeb activation during meiosis in xenopus oocytes.	meiotic progression in xenopus oocytes, and all other oocytes investigated, is dependent on polyadenylation-induced translation of stockpiled maternal mrnas. early during meiotic resumption, phosphorylation of cpe-binding protein (cpeb) is required for polyadenylation-induced translation of mrnas encoding cell cycle regulators. xenopus gef (xgef), a rho-family guanine-exchange factor, influences the activating phosphorylation of cpeb. an exchange-deficient version of xgef does not, therefore imp ...	2007	17344432
clostridium difficile-associated disease: changing epidemiology and implications for management.	clostridium difficile-associated disease (cdad) is increasingly being reported in many regions throughout the world. the reasons for this are unknown, are likely to be multifactorial, and are the subject of several current investigations. in addition to the upsurge in frequency of cdad, an increased rate of relapse/recurrence, disease severity and refractoriness to traditional treatment have also been noted. moreover, severe disease has been reported in non-traditional hosts (e.g. younger age, s ...	2007	17352510
possible patient overlap in studies.		2007	17353538
[infectious diseases (beside aids)].	important epidemiological developments include the continuing dissemination of influenza a h5n1. it is not adapted to human beings, but its potential to cause a pandemic is confirmed. chikungunya has spread around the indian ocean. a new resistant staphylococcus aureus in increasingly prevalent in the community. finally, a virulent strain of clostridium difficile is emerging in north america and europe. new therapeutic developments are scarce. several studies promote a rational use of available ...	2007	17354657
crystal structures reveal a thiol protease-like catalytic triad in the c-terminal region of pasteurella multocida toxin.	pasteurella multocida toxin (pmt), one of the virulence factors produced by the bacteria, exerts its toxicity by up-regulating various signaling cascades downstream of the heterotrimeric gtpases gq and g12/13 in an unknown fashion. here, we present the crystal structure of the c-terminal region (residues 575-1,285) of pmt, which carries an intracellularly active moiety. the overall structure of c-terminal region of pmt displays a trojan horse-like shape, composed of three domains with a "feet"-, ...	2007	17360394
does the nose know? the odiferous diagnosis of clostridium difficile-associated diarrhea.		2007	17366472
diagnosis of colitis: making the initial diagnosis.	the evaluation of patients with colitis of recent onset is a relatively common clinical challenge. the main considerations are infectious colitides, idiopathic ibd, ie, ulcerative and crohn's colitis, and colonic ischemia. an initial risk assessment on the basis of such factors as concurrent symptoms in contacts, travel history, medications, and human immunodeficiency virus risk factors should be followed by a thorough clinical history, physical examination, stool studies, blood tests, and, in s ...	2007	17368227
inflammatory bowel disease and clostridium difficile-associated diarrhea: a growing problem.		2007	17368229
incidence of clostridium difficile infection in inflammatory bowel disease.	clostridium difficile-associated disease (cdad) rates have been increasing. we sought to determine whether cdad incidence has increased specifically in hospitalized patients with ibd. we also explored possible differences in the risk for and time to presentation of cdad between ibd and non-ibd patients.	2007	17368233
impact of clostridium difficile on inflammatory bowel disease.	clostridium difficile-associated disease has increased significantly in north american medical centers. the impact of c difficile on patients with ibd (crohn's disease, ulcerative colitis) at the present time is unknown.	2007	17368234
clostridium difficile in discharged inpatients, germany.		2007	17370545
first isolation of clostridium difficile 027 in japan.		2007	17370932
transcutaneous immunization with clostridium difficile toxoid a induces systemic and mucosal immune responses and toxin a-neutralizing antibodies in mice.	clostridium difficile is the leading cause of nosocomial infectious diarrhea. c. difficile produces two toxins (a and b), and systemic and mucosal anti-toxin a antibodies prevent or limit c. difficile-associated diarrhea. to evaluate whether transcutaneous immunization with formalin-treated c. difficile toxin a (cda) induces systemic and mucosal anti-cda immune responses, we transcutaneously immunized three cohorts of mice with cda with or without immunoadjuvantative cholera toxin (ct) on days 0 ...	2007	17371854
a comparison of available and investigational antibiotics for complicated skin infections and treatment-resistant staphylococcus aureus and enterococcus.	this article compares vancomycin, teicoplanin, quinupristin-dalfopristin, linezolid, daptomycin, tigecyline, dalbavancin, telavancin, ceftobiprole, oritavancin, and ramoplanin for the treatment of complicated skin and skin structure infections (csssi), methicillin-resistant staphylococcus aureus (mrsa), enterococcus, and vancomycin-resistant enterococcus. vancomycin, a glycopeptide antibiotic, is administered intravenously, and is the mainstay of treatment for mrsa and csssi. while not available ...	2007	17373167
deaths involving clostridium difficile: england and wales, 2001-2005.		2007	17373384
a novel toxin homologous to large clostridial cytotoxins found in culture supernatant of clostridium perfringens type c.	an unknown cytotoxin was identified in the culture supernatant of clostridium perfringens type c. the cytotoxin, named tpel, which was purified using mab-based affinity chromatography, had a lethal activity of 62 minimum lethal dose (mld) mg(-1) in mice and a cytotoxic activity of 6.2x10(5) cytotoxic units (cu) mg(-1) in vero cells. the nucleotide sequence of tpel was determined. the entire orf had a length of 4953 bases, and the same nucleotide sequence was not recorded in the genbank/embl/ddbj ...	2007	17379729
review: clostridium difficile-associated disorders/diarrhea and clostridium difficile colitis: the emergence of a more virulent era.		2007	17380404
infection control. an outbreak of innovation.		2007	17380937
infection control. the big c.	c difficile is endemic in some hospitals and is difficult to eradicate as its spores can survive indefinitely. there is a compelling incentive for trusts to reduce cases as each one extends length of stay and costs pound 4,000. isolating infected patients has been shown to be effective but can be tricky to achieve.	2007	17380967
clostridium difficile in cardiac surgery: risk factors and impact on postoperative outcome.	clostridium difficile-associated diarrhea (cdad) is a potentially preventable and often troublesome gastrointestinal complication after cardiac surgery.	2007	17383346
predicting clostridium difficile toxin in hospitalized patients with antibiotic-associated diarrhea.	clostridium difficile infection is implicated in 20%-30% of cases of antibiotic-associated diarrhea. studying hospitalized patients who received antibiotic therapy and developed diarrhea, our objective was to compare the clinical characteristics of patients who developed c. difficile-associated diarrhea (cdad) with those of patients with a negative result of a stool assay for c. difficile toxin.	2007	17385141
successful use of feedback to improve antibiotic prescribing and reduce clostridium difficile infection: a controlled interrupted time series.	to investigate the effect of reinforcing a narrow-spectrum antibiotic policy on antibiotic prescription and clostridium difficile infection (cdi) rates by feedback of antibiotic use to doctors, as part of a departmental audit and feedback programme.	2007	17387117
how knowledgeable are nurses about c. difficile?	jacqueline randle and colleagues report the results of their small-scale study of infection control link professionals' knowledge about clostridium difficile and how they use this knowledge in practice.	2007	17388150
c. difficile inquest too narrow as "quebec strain" goes international.		2007	17389432
clostridium difficile enteritis: an early postoperative complication in inflammatory bowel disease patients after colectomy.	clostridium difficile, the leading cause of hospital-acquired diarrhea, is known to cause severe colitis. c. difficile small bowel enteritis is rare (14 case reports) with mortality rates ranging from 60 to 83%. c. difficile has increased in incidence particularly among patients with inflammatory bowel disease. this case series of six patients from 2004 to 2006 is the largest in the literature. all patients received antibiotics before colectomies for ulcerative colitis and developed severe enter ...	2007	17390162
isolation and characterisation of toxin a-negative, toxin b-positive clostridium difficile in dublin, ireland.	clostridium difficile is a major cause of infectious diarrhoea in hospitalised patients. most pathogenic c. difficile strains produce two toxins, a and b; however, clinically relevant toxin a-negative, toxin b-positive (a- b+) strains of c. difficile that cause diarrhoea and colitis in humans have been isolated worldwide. the aims of this study were to isolate and characterise a- b+ strains from two university hospitals in dublin, ireland. samples positive for c. difficile were identified daily ...	2007	17391385
a 31-year-old, hiv-positive man presenting with emesis and bloody diarrhea. c. difficile infection.		2007	17396470
upregulation of the immediate early gene product rhob by exoenzyme c3 from clostridium limosum and toxin b from clostridium difficile.	adp-ribosylation of rho(a,b,c) by the family of exoenzyme c3-like transferases induces reorganization of the actin cytoskeleton based on inactivation of rhoa. no data are available on the role of rhob in c3-treated cells. in murine fibroblasts treated with the cell-permeable exoenzyme c3 from clostridium limosum (c3), an increase in the level of rhob was observed. this upregulation of rhob was based on transcriptional activation, as it was responsive to inhibition by actinomycin d and accompanie ...	2007	17397186
[clostridium difficile associated diarrhea in the elderly patient].	clostridium difficile is the leading cause of infectious nosocomial diarrhea in the elderly. it may cause colitis of variable severity and extraintestinal involvement. hand transmission is the most important, and it is related to prolonged antibiotic therapies in elderly patients with severe baseline disease. diagnosis is based on culture and immunological tests to detect its toxins. when there is no response to conservative treatment (withdrawal of the antibiotic and support therapy), metronida ...	2007	17397570
treatment of clostridium difficile--associated disease (cdad).		2007	17400866
epidemiology, pathogenesis, and management of clostridium difficile infection.	clostridium difficile infection is an important health problem worldwide and leads to increased morbidity and mortality, particularly among the elderly population. antibiotics, especially those with a broad spectrum, often trigger the infection; hence the use of unnecessary antibiotics should be avoided. mild to moderate cases respond to metronidazole or vancomycin. severe cases may require bowel resection. chronic relapsing cases require a prolonged course of antibiotics, immunoglobulin, probio ...	2007	17404858
spores, babies, and alcohol. a nurse's battle with c. diff.		2007	17405362
clostridium difficile colitis in solid organ transplantation--a single-center experience.	clostridium difficile (cd) is one of the most common causes of diarrhea in solid organ transplantation (sot). between 1996 and 2005, a total of 2474 solid organ transplants were performed at our institution, of which 43 patients developed cd-associated diarrhea. there were 3 lung, 3 heart, 20 liver, 8 kidney-pancreas, 6 kidney, 1 composite tissue, and 2 multivisceral recipients. onset of cd infection ranged from 5 to 2453 days posttransplant. all patients presented with abdominal pain and watery ...	2007	17406820
fatal fulminant clostridium difficile colitis during chop therapy for lymphoma: an autopsy case.	although clostridium difficile colitis is a common problem during chemotherapy, fulminant expression is rarely observed. here, we describe a 68-year-old woman who developed fatal colitis due to clostridium difficile infection. the patient was treated with chop therapy for relapsed lymphoma. in the nadir phase, she developed severe bloody diarrhea with a high fever and died within 12 hours after the beginning of symptoms. clostridium difficile was identified in her stool and an autopsy showed hem ...	2007	17409606
evaluation of two immunochromatographic tests (immunocard toxins a&b, xpect c. difficile toxin a&b) and pcr for the detection of clostridium difficile toxins in faecal samples.		2007	17412423
urocortin ii mediates pro-inflammatory effects in human colonocytes via corticotropin-releasing hormone receptor 2alpha.	urocortin ii (ucnii) is a neuropeptide that binds with high affinity to the corticotropin-releasing hormone receptor 2 (crhr2) in peripheral tissues. ucnii is synthesised in the intestine, but its role in human intestinal inflammation is largely unknown.	2007	17412781
hospital acquired infection.		2007	17413144
improvement targets for c difficile must be valid.		2007	17413147
[current topics concerning emerging and re-emerging bacterial infections].		2007	17419432
molecular analysis of clostridium difficile isolates recovered from horses with diarrhea.	clostridium difficile is an important cause of diarrhea in horses, causing sporadic and epidemic disease of varying severity. this study evaluated the molecular characteristics of 48 c. difficile isolates recovered from diarrheic horses admitted to a veterinary hospital by using pcr-ribotyping and toxin gene profile. additionally, feces were tested for the presence of c. difficile toxin a/b via enzyme immunosorbant assay (eia) in 38 horses. the toxin genes tcda, tcdb and cdtb were present in 27 ...	2007	17112686
gut microbes, the innate immune system and inflammatory bowel disease: location, location, location.		2007	17133076
update on clostridium difficile associated disease.	the aim of this article is to report recent changes in the epidemiology of clostridium difficile associated disease.	2007	17133077