Publications
| Title | Abstract | Year(sorted ascending) Filter | PMID Filter |
|---|
| control of an outbreak of infection with the hypervirulent clostridium difficile bi strain in a university hospital using a comprehensive "bundle" approach. | background: in june 2000, the hospital-acquired clostridium difficile (cd) infection rate in our hospital (university of pittsburgh medical center-presbyterian, pittsburgh, pa) increased to 10.4 infections per 1000 hospital discharges (hds); the annual rate increased from 2.7 infections per 1000 hds to 7.2 infections per 1000 hds and was accompanied by an increase in the frequency of severe outcomes. forty-seven (51%) of 92 ha cd isolates in 2001 were identified as the "epidemic bi strain." a co ... | 2007 | 17968819 |
| confronting clostridium difficile in inpatient health care facilities. | 2007 | 17968820 | |
| rac2 gtpase activation by angiotensin ii is modulated by ca2+/calcineurin and mitogen-activated protein kinases in human neutrophils. | angiotensin ii (ang ii) highly stimulates superoxide anion production by neutrophils. the g-protein rac2 modulates the activity of nadph oxidase in response to various stimuli. here, we describe that ang ii induced both rac2 translocation from the cytosol to the plasma membrane and rac2 gtp-binding activity. furthermore, clostridium difficile toxin a, an inhibitor of the rho-gtpases family rho, rac and cdc42, prevented ang ii-elicited o2-/ros production, phosphorylation of the mitogen-activated ... | 2007 | 17975262 |
| outcome of metronidazole therapy for clostridium difficile disease and correlation with a scoring system. | to determine the response rate of clostridium difficile disease (cdd) to treatment with metronidazole and assess a scoring system to predict response to treatment with metronidazole when applied at the time of cdd diagnosis. | 2007 | 17983659 |
| epidemiology of clostridium difficile-associated diarrhea in a peruvian tertiary care hospital. | the prevalence, incidence, and epidemiologic factors of clostridium difficile-associated diarrhea (cdad) in a peruvian hospital were studied. we conducted a cross-sectional study in patients > 14 years of age from medical/surgical wards of the cayetano heredia national hospital (lima, peru) from september 2005 to may 2006. cdad was defined in a case of nosocomial diarrhea when c. difficile toxin a and/or toxin b was detected by enzyme immune assay (eia) in stools. a total of 4,264 patients were ... | 2007 | 17984329 |
| [diarrhea associated to clostridium difficile in an elderly patient. global perspective]. | 2007 | 18021658 | |
| detection of clostridium difficile in stool samples from patients in the early period after liver transplantation. | we examined the frequency of detection of clostridium difficile (cd) toxins compared with the recovery of c. difficile in stool specimen cultures among orthotopic liver transplant (olt) patients with nosocomial diarrhea in the early period. | 2007 | 18021993 |
| editorial commentary: vancomycin for your mother, metronidazole for your mother-in-law. | 2007 | 17988743 | |
| association of proton-pump inhibitors with outcomes in clostridium difficile colitis. | the role of concurrent use of proton-pump inhibitors (ppis) in the outcomes of treatment for clostridium difficile colitis was studied. methods. the records of inpatients at a large veterans affairs medical center in whom c. difficile colitis was diagnosed between june 2004 and july 2005 were retrospectively reviewed. data collected included patient characteristics at baseline, antibiotic therapy prescribed before and during therapy for c. difficile colitis, concurrent treatment with a ppi, resp ... | 2007 | 17989446 |
| acute trust boards still failing in bug battle, watchdog claims. | 2007 | 18019262 | |
| clostridium difficile infection frequency in patients with nosocomial infections or using antibiotics. | clostridium difficile is the most common cause of nosocomial infectious diarrhea. the frequency of colonization in hospitalized patients varies between 10 and 43%. | 2007 | 18019703 |
| infection control. behind closed doors: is kent scandal a one-off. | 2007 | 18020250 | |
| probiotics in the management of colonic disorders. | probiotics have been used in humans for almost a century and widely recommended for the treatment of a variety of ills assumed to be of colonic origin, including diarrhea, constipation, bloating, and flatulence. more recently, probiotics have been evaluated in the management of specific colonic disorders such as inflammatory bowel disease, irritable bowel syndrome, and clostridium difficile colitis. it is evident that no two probiotics are exactly alike; why then should we expect reproducible re ... | 2007 | 17991347 |
| update of clostridium difficile-associated disease due to pcr ribotype 027 in europe. | recent outbreaks of clostridium difficile-associated diarrhoea (cdad) with increased severity, high relapse rate and significant mortality have been related to the emergence of a new, hypervirulent c. difficile strain in north america, japan and europe. definitions have been proposed by the european centre of disease prevention and control (ecdc) to identify severe cases of cdad and to differentiate community-acquired cases from nosocomial cdad (http://www.ecdc.europa.eu/documents/pdf/cl_dif_v2. ... | 2007 | 17991399 |
| annual incidence of mrsa falls in england, but c difficile continues to rise. | 2007 | 17991958 | |
| long-term survival in a patient with acinar cell carcinoma of pancreas. a case report and review of literature. | acinar cell carcinoma of the pancreas is a rare malignancy that may have acinar and endocrine differentiation. clinical practice guidelines exist for pancreatic ductal adenocarcinoma. however, treatment protocols for acinar cell carcinoma of the pancreas have not been standardized. | 2007 | 17993731 |
| trans-cinnamaldehyde from cinnamomum zeylanicum bark essential oil reduces the clindamycin resistance of clostridium difficile in vitro. | therapy with antimicrobial drugs, such as clindamycin, that perturb the intestinal flora but fail to inhibit growth of other microorganisms can permit the proliferation of clostridium difficile and the elaboration of exotoxin. therefore, there has been increasing interest in the use of inhibitors of antibiotic resistance for use in combination therapy. the essential oil of cinnamomum zeylanicum bark enhanced the bactericidal activity of clindamycin and decreased the minimum inhibitory concentrat ... | 2007 | 17995898 |
| a case of clostridium difficile-associated disease due to the highly virulent clone of clostridium difficile pcr ribotype 027, march 2007 in germany. | 2007 | 18005641 | |
| confirmed cases and report of clusters of severe infections due to clostridium difficile pcr ribotype 027 in germany. | 2007 | 18005642 | |
| first isolation of clostridium difficile pcr ribotype 027 in finland. | 2007 | 18005648 | |
| difficulties with clostridium difficile. | 2007 | 18171113 | |
| the burden of clostridium difficile in surgical patients in the united states. | clostridium difficile colitis is the predominant hospital-acquired gastrointestinal infection in the united states and has emerged as an important nosocomial cause of morbidity and death. although several institutional studies have examined the effects of c. difficile on hospitalized patients, its nationwide impact on surgical patients has yet to be defined. | 2007 | 18171114 |
| clostridium difficile-negative antibiotic-associated hemorrhagic colitis: the role of cytotoxin-producing klebsiella oxytoca. | 2007 | 18192958 | |
| treatment of diarrhea in patients with inflammatory bowel disease: concepts and cautions. | diarrhea continues to be a prevalent symptom in patients with inflammatory bowel disease (ibd), requiring a wide differential diagnosis to define the pathophysiologic mechanisms in individual patients. it is essential that physicians properly evaluate complaints of diarrhea by assessing both patient symptoms and potential physiologic impacts on fluid and electrolyte status. underlying mechanisms of diarrhea with ibd are the location, extent, and severity of inflammation; malabsorption; altered m ... | 2007 | 18192964 |
| strategies to prevent and control clostridium difficile: one hospital's account. | 2007 | 18286843 | |
| rifaximin: recent advances in gastroenterology and hepatology. | rifaximin was initially developed for the treatment of bacteria-related diarrhea, but appreciation of its potentially broader use has increased as understanding of the importance of enteric bacteria in many organic and functional gastrointestinal diseases has advanced. this article reviews data that have been presented at medical meetings or published in medical journals since the publication of a 2006 rifaximin review in this journal. the data presented expand previous research, suggesting that ... | 2007 | 23329908 |
| beating the bug. | nhs trusts across england are under orders from the chief nursing officer christine beasley to step up their efforts to control clostridium difficile infection rates. | 2007 | 27732112 |
| clostridium difficile infection control monitoring tightened. | infection control teams must now report cases of clostridium difficile associated diarrhoea (cdad) in all patients aged two years and over. | 2007 | 27316610 |
| increased sporulation rate of epidemic clostridium difficile type 027/nap1. | clostridium difficile pcr ribotype 027 comprised 0.2% of a collection of swedish isolates in 1997-2001 (3 of 1,325 isolates). these isolates had lower moxifloxacin mics than the epidemic type 027 isolates, but they had the same tcdc sequence and toxin yield. type 027 produced 3- to 13-fold more toxin than did major swedish types. one epidemic strain (027/nap1a) sporulated more than did other type 027 isolates, a feature that should contribute to its survival and spread. | 2008 | 18287318 |
| recurrent infection with epidemic clostridium difficile in a peripartum woman whose infant was asymptomatically colonized with the same strain. | 2008 | 18288909 | |
| binary actin-adp-ribosylating toxins and their use as molecular trojan horses for drug delivery into eukaryotic cells. | binary bacterial toxins are unique ab-type toxins, composed of two non-linked proteins that act as a binding/translocation component and an enzyme component. all known actin-adp-ribosylating toxins from clostridia possess this binary structure. this toxin family is comprised of the prototypical clostridium botulinum c2 toxin, clostridium perfringens iota toxin, clostridium difficile cdt, and clostridium spiroforme toxin. once in the cytosol of host cells, these toxins transfer an adp-ribose moie ... | 2008 | 18289001 |
| clostridium difficile toxins: more than mere inhibitors of rho proteins. | toxin a (tcda) and toxin b (tcdb) are the major pathogenicity factors of the clostridium difficile-associated diarrhoea (cdad). the single-chained protein toxins enter their target cells by receptor-mediated endocytosis. new data show the critical role of auto-catalytic processing for target cell entry. inside the cell, the toxins mono-glucosylate and thereby inactivate low molecular mass gtp-binding proteins of the rho subfamily. toxin-treated cells respond to rhoa glucosylation with up-regulat ... | 2008 | 18289919 |
| surgical-site infection with toxin a-nonproducing and toxin b-producing clostridium difficile. | to date, few cases of extraintestinal infection with clostridium difficile have been reported. we describe a case of surgical-site infection with c. difficile following a colonic operation. administration of metronidazole was considered to be effective for treatment of the infection. the isolate was a toxin a-nonproducing and toxin b-producing strain. | 2008 | 18297452 |
| infectious disease emergencies. | this article reviews principles of recognition and management of a selection of commonly encountered infectious disease emergencies, including sepsis, necrotizing soft tissue infections, acute meningitis, and the emerging issue of severe clostridium difficile colitis. less common but potentially deadly environmentally acquired or zoonotic pathogens are discussed, as are special patient populations, including the febrile returning traveler and the asplenic patient. | 2008 | 18298987 |
| clostridium difficile colitis associated with other complications following liver transplantation. | 2008 | 18300388 | |
| clostridium difficile: the increasingly difficult pathogen. | the epidemiology of clostridium difficile infection is changing as a result of the epidemic spread of the hypervirulent north american pulsefield type 1 strain. clinicians are likely to encounter this disease more frequently than ever in their practice, and should be familiar with the updates in its diagnosis and treatment. | 2008 | 18304376 |
| probiotics: sorting the evidence from the myths. | probiotics consist of yeast or bacteria, especially lactic acid bacteria. they are available as capsules, powder, fermented milks or yoghurts. probiotics exhibit strain-specific differences in their resistance to acid and bile, ability to colonise the gastrointestinal tract, clinical efficacy, and benefits to the health of the host. there is level i evidence for the use of probiotics in treating acute infectious diarrhoea and preventing antibiotic-associated diarrhoea, with lactobacillus rhamnos ... | 2008 | 18312197 |
| clostridium difficile colitis in lung transplantation. | clostridium difficile colitis (cdc) is the most common nosocomial infection of the gastrointestinal tract in patients with recent antibiotic use or hospitalization. lung transplant recipients receive aggressive antimicrobial therapy postoperatively for treatment and prophylaxis of respiratory infections. this report describes the epidemiology of cdc in lung recipients from a single center and explores possible associations with bronchiolitis obliterans syndrome (bos), a surrogate marker of chron ... | 2008 | 18312477 |
| [relationship between clostridium difficile associated diarrhea and intestinal microecosystem disorder in patients received allogeneic hematopoietic stem cell transplantation]. | this study was to investigate the relationship between clostridium difficile associated diarrhea (cdad) and intestinal microecosystem in patients received allogeneic hematopoietic stem cell transplantation (allo-hsct) and to clarify clinical characteristics of intestinal microecosystem disorder. clostridium difficile (cd) was isolated and identified by enzyme-linked-immunosorbent assay using clostridium difficile premier toxins a&b kit and anaerobic culture in 44 cases with diarrhea. fecal flora ... | 2008 | 18315917 |
| conformational changes and reaction of clostridial glycosylating toxins. | the crystal structures of the catalytic fragments of 'lethal toxin' from clostridium sordellii and of 'alpha-toxin' from clostridium novyi have been established. almost half of the residues follow the chain fold of the glycosyl-transferase type a family of enzymes; the other half forms large alpha-helical protrusions that are likely to confer specificity for the respective targeted subgroup of rho proteins in the cell. in the crystal, the active center of alpha-toxin contained no substrates and ... | 2008 | 18325534 |
| cytomegalovirus colitis in a critically ill patient following elective repair of an abdominal aortic aneurysm. | we describe a case of cytomegalovirus colitis in a critically ill but otherwise immunocompetent 61-year-old male. infection was demonstrated by histology and confirmed by plasma polymerase chain reaction and detection of cytomegalovirus igm antibody. the patient was treated with ganciclovir with resolution of the cytomegalovirus viraemia. cytomegalovirus colitis may be an under-recognised problem in immunocompetent patients who are critically ill. quantification of plasma cytomegalovirus dna by ... | 2008 | 18326142 |
| clostridium difficile pcr ribotype 078: an emerging strain in humans and in pigs? | 2008 | 18326836 | |
| clostridium difficile and chlorine-releasing disinfectants. | 2008 | 18328922 | |
| biochemistry: radicals by reduction. | 2008 | 18337811 | |
| an allylic ketyl radical intermediate in clostridial amino-acid fermentation. | the human pathogenic bacterium clostridium difficile thrives by the fermentation of l-leucine to ammonia, co(2), 3-methylbutanoate and 4-methylpentanoate under anaerobic conditions. the reductive branch to 4-methylpentanoate proceeds by means of the dehydration of (r)-2-hydroxy-4-methylpentanoyl-coa to 4-methylpent-2-enoyl-coa, which is chemically the most demanding step. ketyl radicals have been proposed to mediate this reaction catalysed by an iron-sulphur-cluster-containing dehydratase, which ... | 2008 | 18337824 |
| a new formulation of tolevamer, a novel nonantibiotic polymer, is safe and well-tolerated in healthy volunteers: a randomized phase i trial. | to evaluate the safety and tolerability of a new oral solution formulation of tolevamer potassium sodium, a nonantibiotic polymer that binds clostridium difficile toxins a and b. | 2008 | 18341677 |
| the management of clostridium difficile infection: antibiotics, probiotics and other strategies. | clostridium difficile-associated disease remains an important nosocomial infection associated with significant morbidity and mortality. in recent years, there has been an upward trend in the incidence of this condition with continuing high rates of recurrent disease with available treatment regimens. in this article, we review the current literature on the management of c. difficile-associated disease (cdad). the potential role for alternative therapeutic options for the treatment of cdad, inclu ... | 2008 | 18343738 |
| a single training center's experience with 200 consecutive cases of diverticulitis: can all patients be approached laparoscopically? | this study aimed to evaluate the outcomes for consecutive patients with diverticular disease who underwent elective laparoscopic sigmoid colectomy. | 2008 | 18347863 |
| clinical severity of clostridium difficile pcr ribotype 027: a case-case study. | clostridium difficile is a leading infectious cause of health care associated diarrhoea. several industrialised countries have reported increased c. difficile infections and outbreaks, which have been attributed to the emergent pcr ribotype 027 strain. | 2008 | 18350149 |
| deaths involving clostridium difficle: england and wales, 1999 and 2001-06. | 2008 | 18351026 | |
| mortality of patients with antibiotic-associated diarrhoea: the impact of clostridium difficile. | previous studies have shown conflicting results concerning mortality related to clostridium difficile infection. the objective of this study was to determine the impact of c. difficile infection on short- and long-term mortality in hospitalised patients with antibiotic-associated diarrhoea. we therefore undertook a prospective case-control study of 217 hospitalised patients who received antibiotics, developed diarrhoea and underwent stool enzyme immunoassay for c. difficile tox a/b. the kaplan-m ... | 2008 | 18353491 |
| clostridium difficile infection following hip fracture. | 2008 | 18353494 | |
| laboratory diagnosis of clostridium difficile-associated disease in the republic of ireland: a survey of irish microbiology laboratories. | the health protection surveillance centre (hpsc) established a group to produce national guidelines for clostridium difficile in ireland in 2006. a laboratory questionnaire was distributed to determine current c. difficile diagnostic practices. twenty-nine out of 44 laboratories providing c. difficile diagnostic services to 34 hospitals responded. twenty-five out of 29 (86%) laboratories processed specimens for c. difficile and four (13.8%) forwarded specimens to another laboratory. sixteen labo ... | 2008 | 18353502 |
| infection in solid-organ transplant recipients. | 2008 | 18354113 | |
| comparative genomic analysis of t-box regulatory systems in bacteria. | t-box antitermination is one of the main mechanisms of regulation of genes involved in amino acid metabolism in gram-positive bacteria. t-box regulatory sites consist of conserved sequence and rna secondary structure elements. using a set of known t-box sites, we constructed the common pattern and used it to scan available bacterial genomes. new t-boxes were found in various gram-positive bacteria, some gram-negative bacteria (delta-proteobacteria), and some other bacterial groups (deinococcales ... | 2008 | 18359782 |
| treatment of clostridium difficile colitis in the critical care setting. | clostridium difficile colitis is a debilitating infection with a remarkably high associated mortality. infection is contagious and spreads especially rapidly in an intensive care setting because patients who are there have all the associated risk factors, including major underlying illnesses, prior antibiotic therapy, and use of agents that suppress gastric acidity. prevention of disease is the responsibility of every health care provider in the critical care setting. this article emphasizes tre ... | 2008 | 18361946 |
| antibiotic-associated diarrhea: candidate organisms other than clostridium difficile. | the direct toxic effects of antibiotics on the intestine can alter digestive functions and cause pathogenic bacterial overgrowth leading to antibiotic-associated diarrhea (aad). clostridium difficile (c. difficile) is widely known to be responsible for 10 approximately 20% of aad cases. however, klebsiella oxytoca, clostridium perfringens, staphylococcus aureus, and candida species might also contribute to aad. | 2008 | 18363274 |
| opt-80, a macrocyclic antimicrobial agent for the treatment of clostridium difficile infections: a review. | clostridium difficile-associated diarrhoea has become a major problem over the last years. increasing incidence and more severe clinical cases initiated the search for new treatment options. | 2008 | 18363518 |
| a probiotic drink prevented diarrhoea and clostridium difficile-associated diarrhoea in older patients taking antibiotics. | 2008 | 18364427 | |
| ageing and the gut. | 2008 | 18372803 | |
| a probiotic drink prevented diarrhoea and clostridium difficile infection in older patients taking antibiotics. | 2008 | 18375699 | |
| antimicrobial stewardship programs: interventions and associated outcomes. | guidelines regarding antimicrobial stewardship programs recommend an infectious diseases-trained physician and an infectious diseases-trained pharmacist as core members. inclusion of clinical microbiologists, infection-control practitioners, information systems experts and hospital epidemiologists is considered optimal. recommended stewardship interventions include prospective audit and intervention, formulary restriction, education, guideline development, clinical pathway development, antimicro ... | 2008 | 18380603 |
| clostridium difficile enteritis: a cause for high ileostomy output. | 2008 | 18380751 | |
| role of phospholipase a2 and tyrosine kinase in clostridium difficile toxin a-induced disruption of epithelial integrity, histologic inflammatory damage and intestinal secretion. | clostridium difficile-associated disease causes diarrhea to fulminant colitis and death. we investigated the role of phospholipase a2 (pla2) inhibitors, aristolochic acid (aa), bromophenacyl bromide (bpb) and quinacrine (quin) on the c. difficile toxin a-induced disruption of epithelial integrity, histologic inflammatory damage and intestinal secretion. toxin a caused severe hemorrhagic and inflammatory fluid secretion at 6-8 h in rabbit ileal segments, an effect that was significantly inhibited ... | 2008 | 18381687 |
| pcr detection of clostridium difficile triose phosphate isomerase (tpi), toxin a (tcda), toxin b (tcdb), binary toxin (cdta, cdtb), and tcdc genes in vhembe district, south africa. | specific polymerase chain reaction (pcr) protocols were used to determine the prevalence of toxigenic clostridium difficile in vhembe, south africa. of 322 stool samples collected, toxigenic c. difficile was found in 23 (7.1%) cases and was significantly associated with diarrhea 20 (11.4%) compared with 3 (2%) in non-diarrheal samples (chi(2) = 426, p = 0.001), intestinal inflammation in 18 (12.1%) compared with 5 (2.9%) in lactoferrin-negative samples (chi(2) = 10.194, p = 0.001), and occult bl ... | 2008 | 18385352 |
| yersinia controls type iii effector delivery into host cells by modulating rho activity. | yersinia pseudotuberculosis binds to beta1 integrin receptors, and uses the type iii secretion proteins yopb and yopd to introduce pores and to translocate yop effectors directly into host cells. y. pseudotuberculosis lacking effectors that inhibit rho gtpases, yope and yopt, have high pore forming activity. here, we present evidence that y. pseudotuberculosis selectively modulates rho activity to induce cellular changes that control pore formation and effector translocation. inhibition of actin ... | 2008 | 18193942 |
| the maxwell finland lecture: for the duration-rational antibiotic administration in an era of antimicrobial resistance and clostridium difficile. | antimicrobial resistance is frequently associated with clinical use of antibiotics. this close association suggests that efforts to manage our use of these potent agents can have an impact on the prevalence of resistance. unfortunately, one size does not fit all when considering the response of bacterial pathogens to antimicrobial exposure. measures that may prevent resistance in some species (such as using multiple antibiotics to treat tuberculosis) may exacerbate the problem of resistance in o ... | 2008 | 18194098 |
| comparative efficacies of rifaximin and vancomycin for treatment of clostridium difficile-associated diarrhea and prevention of disease recurrence in hamsters. | clostridium difficile-associated colitis is an increasing cause of morbidity and mortality in hospitalized patients, with high relapse rates following conventional therapy. we sought to determine the efficacy of rifaximin, a novel nonabsorbed antibiotic, in the hamster model of c. difficile-associated diarrhea (cdad). hamsters received clindamycin subcutaneously and 24 h later were infected by gavage with one of two c. difficile strains: a reference strain (vpi 10463) and a current epidemic stra ... | 2008 | 18195066 |
| short- and long-term attributable costs of clostridium difficile-associated disease in nonsurgical inpatients. | the incidence of clostridium difficile-associated disease (cdad) is increasing. there are few data on the short-term and long-term attributable costs of cdad. the objective of this study was to determine the acute and 180-day attributable inpatient costs of cdad. | 2008 | 18197759 |
| the economics of clostridium difficile-associated disease for providers and payers. | 2008 | 18197762 | |
| decreased diversity of the fecal microbiome in recurrent clostridium difficile-associated diarrhea. | antibiotic-associated diarrhea due to clostridium difficile (cdad) is thought to reflect colonization of a disrupted microbial community by the pathogen. we profiled the fecal microbiota of patients with cdad (both initial and recurrent episodes) by culture-independent phylogenetic analysis of 16s rrna-encoding gene sequences. compared with those from control subjects and patients with an initial episode, the fecal communities in patients with recurrent cdad were highly variable in bacterial com ... | 2008 | 18199029 |
| increasing prevalence of toxin a-negative, toxin b-positive isolates of clostridium difficile in korea: impact on laboratory diagnosis. | of 462 korean clostridium difficile isolates, 77.5% were toxin b positive but 21.4% were toxin a negative (a(-) b(+)). the binary toxin gene was detected in nine isolates. a higher fluoroquinolone resistance of a(-) b(+) strains may contribute to the increase of these strains. toxin a detection alone may underdiagnose c. difficile-associated disease. | 2008 | 18199783 |
| are probiotic or synbiotic preparations effective for the management of clostridium difficile-associated or radiation-induced diarrhea? | 2008 | 18199939 | |
| clostridium difficile in urology. | the objective was to determine the incidence of clostridium difficile infection in a uk urology ward from 2000 to 2005, and correlate and compare the data with other specialty wards and national figures. | 2008 | 18201498 |
| overprescribing ppis: time for a hospital antacid policy on clostridium difficile. | 2008 | 18202039 | |
| survival of clostridium difficile on copper and steel: futuristic options for hospital hygiene. | clostridium difficile is rapidly becoming a major cause of hospital-acquired infections worldwide, due in part to transmission of the faecal pathogen between contaminated hands and contact surfaces. accordingly, this study evaluated survival of c. difficile vegetative cells and spores on the contact surface commonly found in healthcare settings, stainless steel, compared to five copper alloys (65-100% copper content). c. difficile requires prolonged incubation to grow and therefore the total num ... | 2008 | 18207284 |
| effect of antibiotic therapy on human fecal microbiota and the relation to the development of clostridium difficile. | the gastrointestinal tract is a complex ecosystem. recent studies have shown that the human fecal microbiota is composed of a consortium of microorganism. it is known that antibiotic treatment alters the microbiota, facilitating the proliferation of opportunists that may occupy ecological niches previously unavailable to them. it is therefore important to characterize resident microbiota to evaluate its latent ability to permit the development of pathogens such as clostridium difficile. using sa ... | 2008 | 18209965 |
| use of highly discriminatory fingerprinting to analyze clusters of clostridium difficile infection cases due to epidemic ribotype 027 strains. | we compared multilocus variable-number tandem-repeat analysis (mlva) and macrorestriction endonuclease analysis using pulsed-field gel electrophoresis (pfge) to determine their utility to identify clusters of clostridium difficile infection (cdi) among 91 isolates of pcr ribotype 027 (nap1, for north american pulsed-field type 1) from nine hospitals (and 10 general practitioners associated with one institution) in england. we also examined whether mortality in cdi cases was associated with speci ... | 2008 | 18216211 |
| aerial dissemination of clostridium difficile spores. | clostridium difficile-associated diarrhoea (cdad) is a frequently occurring healthcare-associated infection, which is responsible for significant morbidity and mortality amongst elderly patients in healthcare facilities. environmental contamination is known to play an important contributory role in the spread of cdad and it is suspected that contamination might be occurring as a result of aerial dissemination of c. difficile spores. however previous studies have failed to isolate c. difficile fr ... | 2008 | 18218089 |
| speciation of fecal candida isolates in antibiotic-associated diarrhea in non-hiv patients. | candida is the most frequently encountered fungal infection of the gastrointestinal tract after antibiotic exposure. the pathogenesis of candida probably varies with each species. the speciation of fecal candida after antibiotic use is not well investigated. one hundred and eleven fecal samples negative for clostridium difficile toxin and for other enteric pathogens formed the basis of our investigation. the diarrheic samples came from patients receiving antibiotics in a hospital setting. in add ... | 2008 | 18219125 |
| preformulation studies of clostridium difficile toxoids a and b. | to enhance the physical stability of clostridium difficile toxoids a and b, screening for stabilizing compounds was performed. the screening of 30 gras compounds at various concentrations and in several combinations was performed in two parts. first, a high-throughput aggregation assay was used to screen for compounds which delayed or prevented aggregation of toxoids under stress conditions (toxoids at ph 5-5.5 were incubated at 55 degrees c for 55 or 75 min). compounds which stabilized both pro ... | 2008 | 18228584 |
| prospective, controlled, cross-over trial of alcohol-based hand gel in critical care units . | there are limited data from prospective studies to indicate whether improvement in hand hygiene associated with the use of alcohol-based hand hygiene products results in improved patient outcomes. | 2008 | 18171181 |
| case-control study of antibiotic use and subsequent clostridium difficile-associated diarrhea in hospitalized patients. | to determine which antibiotics increase or decrease the risk of clostridium difficile-associated diarrhea (cdad). | 2008 | 18171186 |
| update on the changing epidemiology of clostridium difficile-associated disease. | in the past, clostridium difficile-associated disease (cdad) was thought of mainly as a nosocomial disease associated with the use of broad-spectrum antibiotics, but its epidemiology seems to be changing. since 2002, outbreaks of severe cdad associated with increased mortality and reduced effectiveness of treatment with metronidazole have focused attention on this challenging pathogen. a fluoroquinolone-resistant strain of c. difficile (bi/nap1/027) has been predominantly associated with these o ... | 2008 | 18174906 |
| comparison of the premier toxin a and b assay and the tox a/b ii assay for diagnosis of clostridium difficile infection. | clostridium difficile causes nosocomial diarrhea and is responsible for complications such as pseudomembranous colitis, megacolon, and perforation. using 442 stool specimens, we compared the sensitivities and specificities of the premier toxin a and b (meridian bioscience, inc.) and c. difficile tox a/b ii (techlab, inc., blacksburg, va) immunoassays in the virology department of the kaiser permanente regional reference laboratories. the premier toxin a and b assay demonstrated a higher sensitiv ... | 2008 | 18175802 |
| clinical recognition and diagnosis of clostridium difficile infection. | prompt and precise diagnosis is an important aspect of effective management of clostridium difficile infection (cdi). cdi causes 15%-25% of all cases of antibiotic-associated diarrhea, the severity of which ranges from mild diarrhea to fulminant pseudomembranous colitis. several factors, especially advanced age and hospitalization, should be considered in the diagnosis of cdi. in particular, nosocomial diarrhea arising >72 hours after admission among patients receiving antibiotics is highly like ... | 2008 | 18177217 |
| antimicrobial-associated risk factors for clostridium difficile infection. | antimicrobial therapy plays a central role in the pathogenesis of clostridium difficile infection (cdi), presumably through disruption of indigenous intestinal microflora, thereby allowing c. difficile to grow and produce toxin. investigations involving animal models and studies performed in vitro suggest that inhibitory activity against c. difficile and differences in the propensity to stimulate toxin production may also influence the likelihood that particular drugs may cause cdi. although nea ... | 2008 | 18177218 |
| treatment of clostridium difficile infection. | recent outbreaks of clostridium difficile infection (cdi) in north america have been due to a more virulent, possibly more resistant strain that causes more-severe disease, making prompt recognition of cases and optimal management of infection essential for a successful therapeutic outcome. treatment algorithms are presented to help guide the management of patients with cdi. metronidazole has been recommended as initial therapy since the late 1990s and continues to be the first choice for all bu ... | 2008 | 18177219 |
| historical perspectives on studies of clostridium difficile and c. difficile infection. | the initial period of studies on clostridium difficile (published during 1978-1980) appeared to provide a nearly complete portfolio of criteria for diagnosing and treating c. difficile infection (cdi). the putative pathogenic role of c. difficile was established using koch's postulates, risk factors were well-defined, use of a cell cytotoxicity assay as the diagnostic test provided accurate results, and treatment with oral vancomycin was highly effective and rapidly incorporated into practice. d ... | 2008 | 18177220 |
| measures to control and prevent clostridium difficile infection. | control of clostridium difficile infection (cdi) outbreaks in health care facilities presents significant challenges to infection control specialists and other health care workers. c. difficile spores survive routine environmental cleaning with detergents and hand hygiene with alcohol-based gels. enhanced cleaning of all potentially contaminated surfaces with 10% sodium hypochlorite reduces the environmental burden of c. difficile, and use of barrier precautions reduces c. difficile transmission ... | 2008 | 18177221 |
| [clostridium difficile infections: an unexpected re-emergence]. | 2008 | 18178330 | |
| is diarrhea enough to assess the severity of clostridium difficile-associated disease? | 2008 | 18179377 | |
| efficacy of sodium hypochlorite-based disinfectants against clostridium difficile spores. | 2008 | 18179379 | |
| clinical indications for probiotics: an overview. | probiotic bacteria are used to treat or prevent a broad range of human diseases, conditions, and syndromes. in addition, there are areas of medical use that have been proposed for future probiotic applications. randomized double-blind studies have provided evidence of probiotic effectiveness for the treatment and prevention of acute diarrhea and antibiotic-induced diarrhea, as well as for the prevention of cow milk-induced food allergy in infants and young children. research studies have also pr ... | 2008 | 18181732 |
| clostridium difficile skin contamination in patients with c. difficile-associated disease. | in a prospective study of 27 patients with clostridium difficile-associated disease, we found that c. difficile frequently contaminated multiple skin sites, including groin, chest, abdomen, forearms, and hands, and was easily acquired on investigators' hands. skin contamination often persisted on patients' chest and abdomen after resolution of diarrhea. | 2008 | 18181742 |
| clostridium difficile: from obscurity to superbug. | according to the uk media and popular press, clostridium difficile is now a fully fledged member of that notorious but ill-defined group of microorganisms portrayed to the general public as superbugs. following the trail blazed by methicillin-resistant staphylococcus aureus (mrsa), c. difficile has made the transition from being an obscure anaerobic bacterium, mainly of interest to specialist anaerobic microbiologists, to that of an infamous superbug responsible for outbreaks of hospital-acquire ... | 2008 | 18476496 |
| controlling healthcare-associated infections in the nhs. | the prevention and control of healthcare-associated infection (hcai) is a priority for the nhs. the delivery of national targets for reducing methicillin resistant staphylococcus aureus bacteraemias and clostridium difficile infection are supported by enhanced mandatory surveillance through the health protection agency and a department of health improvement programme that promotes policies and protocols for enhancing clinical procedures and places infection prevention and control at the centre o ... | 2008 | 18478854 |
| clostridium difficile. | 2008 | 18480322 | |
| clostridium difficile toxin synthesis is negatively regulated by tcdc. | clostridium difficile toxin synthesis is growth phase-dependent and is regulated by various environmental signals. the toxin genes tcda and tcdb are located in a pathogenicity locus, which also includes three accessory genes, tcdr, tcdc and tcde. tcdr has been shown to act as an alternative sigma factor that mediates positive regulation of both the toxin genes and its own gene. the tcda, tcdb and tcdr genes are transcribed during the stationary growth phase. the tcdc gene, however, is expressed ... | 2008 | 18480323 |
| processing of clostridium difficile toxins. | the pathogenicity of clostridium difficile depends on the large clostridial glucosylating toxins a and b (tcda and tcdb). the proteins accomplish their own uptake by a modular structure comprising a catalytic and a binding/translocation domain. based on a proteolytic processing step solely the catalytic domain reaches the cytosol. within the cells, the glucosyltransferases inactivate small gtpases by mono-o-glucosylation. here, a short overview is given regarding latest insights into the intramo ... | 2008 | 18480324 |