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clostridium difficile. 200819093359
could clostridium difficile delay dental treatment for geriatric patients? 200819068062
increase in clostridium difficile-related hospitalizations among infants in the united states, 2000-2005.virulence and mortality of clostridium difficile-associated disease (cdad) are increasing in the united states. infant cdad hospitalization incidence nearly doubled from 2.8 to 5.1 cases per 10,000 hospitalizations between 2000 and 2005. because incidence of hospitalizations with other infectious enteritides has remained essentially stable, this growth in cdad cannot be explained by a gastroenteritis reporting bias.200819068517
infectious disease. vancomycin should be the drug of choice for severe clostridium difficile-associated diarrhea. 200819107100
recent advances in clostridium difficile-associated disease.the main purpose of this article is to review recent developments in the management of acute and recurrent clostridium difficile-associated disease, with consideration of existing and new antibiotic and non-antibiotic agents for treatment. details of the current developmental stage of new agents are provided and the role of surgery in the management of severe disease is discussed. infection control measures considered comprise prudent use of antimicrobials, prevention of cross-infection and surv ...200818252748
probiotics for treatment of clostridium difficile-associated colitis in adults.probiotics are live microorganisms consisting of non-pathogenic yeast and bacteria that are believed to restore the microbial balance of the gastrointestinal tract altered by infection with clostridium difficile (c. difficile).200818254055
is a two-step glutamate dehyrogenase antigen-cytotoxicity neutralization assay algorithm superior to the premier toxin a and b enzyme immunoassay for laboratory detection of clostridium difficile?a two-step algorithm for the detection of clostridium difficile by the use of c. diff quik chek (techlab, blacksburg, va) and a tissue culture cytotoxicity neutralization assay was found to be more sensitive than the widely used solid-phase enzyme immunoassay (eia), the premier toxin a and b eia (meridian bioscience, cincinnati, oh), and a newly developed, rapid single-test eia for c. difficile toxins a and b (tox a/b quik chek; techlab).200818256226
physical characterization of clostridium difficile toxins and toxoids: effect of the formaldehyde crosslinking on thermal stability.nosocomial diarrhea and pseudomembranous colitis causing toxins a and b from clostridium difficile were studied at ph 5-8 and over the temperature range of 10-85 degrees c. the proteins were crosslinked with formaldehyde to inactivate them to toxoid forms and permit their use as vaccines. structural changes and aggregation behavior were monitored with circular dichroism, intrinsic and extrinsic (ans) fluorescence spectroscopy, turbidity measurements, high-resolution uv absorbance spectroscopy an ...200818257030
clostridium difficile infections in a canadian tertiary care hospital before and during a regional epidemic associated with the bi/nap1/027 strain.since 2002, an epidemic of clostridium difficile infections has occurred in southern quebec, canada. at hôpital maisonneuve-rosemont, montreal, quebec, canada, the incidence of c. difficile infections increased from 11/1,000 admissions (1999 to 2002) to 27/1,000 admissions (2003 to 2005). we compared the exposures and outcomes for patients infected with strains with different ribopatterns isolated before (n = 55) and during (n = 175) the epidemic, as well as the in vitro activities of antibiotic ...200818573937
holding back the tide. 200818575205
changing pattern of clostridium difficile associated diarrhoea in a tertiary care hospital: a 5 year retrospective study.frequent use of broad spectrum antibiotics in hospitalized patients has increased the incidence of clostridium difficile diarrhoea in recent years. in our tertiary care hospital in north india, c. difficile was responsible for 15 per cent of cases of nosocomial diarrhoea in 1999. a retrospective study was carried out to determine the frequency of c. difficile associated diarrhoea (cdad) in our hospital, and to assess the effect of awareness among the hospital personnel and control measures taken ...200818577793
surveillance for clostridium difficile-associated diarrhea in long-term care facilities: what you get is not what you see. 200818578671
clostridium difficile pancolitis in adults with cystic fibrosis.we report three cases of clostridium difficile pancolitis in adults with cystic fibrosis (cf) in whom the presenting symptoms were atypical. all three required treatment with systemic steroids, in addition to oral vancomycin and metronidazole to achieve resolution of the colitis. this experience suggests that c. difficile colitis should be considered in individuals with cf presenting with non-specific abdominal symptoms.200818585983
safety, tolerance, and pharmacokinetic studies of opt-80 in healthy volunteers following single and multiple oral doses.current therapies for clostridium difficile infection (cdi) are encumbered by treatment failures and recurrences. due to its high in vitro activity against c. difficile but low activity against the typical intestinal flora, minimal absorption, and durable cure in the hamster model of c. difficile infection, opt-80 was considered for clinical development as a therapy for cdi. this trial consisted of two phases. four single oral doses of opt-80 (100, 200, 300, and 450 mg) were administered in a cr ...200818268081
early surgical intervention for fulminant pseudomembranous colitis.the objective of this study of a retrospective case series was to determine factors associated with survival after surgical intervention in pseudomembranous colitis (pmc). the study was conducted at a tertiary care medical center and comprised 36 patients who underwent colectomy for fulminant pmc from 1995 to 2006. patients including 21 females ranged from 40 to 89 years of age (mean, 70 years). comorbidities included diabetes (39%), cardiovascular disease (77%), chronic obstructive pulmonary di ...200818274423
defining surgical therapy for pseudomembranous colitis with toxic megacolon.pseudomembranous colitis has increased in incidence and severity over the past 10 years. toxic megacolon is a rare but reported presentation of severe pseudomembranous colitis. this article reviews the reported cases of clostridium difficile with toxic megacolon in the literature and introduces an additional case that underscores the importance of early diagnosis in guiding appropriate therapy.200818277885
bench-to-bedside review: clostridium difficile colitis.in recent years, the incidence and severity of clostridium difficile-associated disease (cdad) have increased dramatically. beginning in 2000, widespread regional outbreaks associated with a previously uncommon hypervirulent strain of c. difficile have occurred in north america and europe. most likely because of increased toxin production as well as other virulence factors, this epidemic strain has caused more severe and refractory disease leading to complications, including intensive care unit ...200818279531
predictors of mortality after colectomy for fulminant clostridium difficile colitis.to present, to our knowledge, the largest experience with colectomy for fulminant clostridium difficile colitis and to propose factors significant in predicting mortality.200818283139
[treatment of osteoarticular infections with clindamycin in adults].the main characteristics of clindamycin are adequate for treatment of osteoarticular infections (oai): good bone diffusion, broad spectrum of antibacterial activity and oral use.200818718729
a clinical risk index for clostridium difficile infection in hospitalised patients receiving broad-spectrum antibiotics.identification of a population at high risk for clostridium difficile infection (cdi) would enable cdi prevention strategies to be designed. the purpose of this study was to create a clinical risk index that would predict those at risk for cdi. a cdi risk index was therefore developed, based on a cohort of hospital patients given broad-spectrum antibiotics, and divided into a development and validation cohort. logistic regression equations helped identify significant predictors of cdi. a scoring ...200818723249
chronic multifocal osteomyelitis due to clostridium difficile in an adolescent with sickle cell anemia. 200818724265
in vitro activity of opt-80 tested against clinical isolates of toxin-producing clostridium difficile.agar dilution antimicrobial susceptibility testing (clsi, m11-a7, 2007) performed for 208 toxin-producing clinical isolates of clostridium difficile resulted in opt-80 mics ranging from 0.06 to 1 microg/ml, with 90% of the isolates inhibited by a concentration of 0.5 microg/ml. the in vitro activity of opt-80 was independent of the susceptibilities of isolates to nine other antimicrobial agents.200818725442
new advances in clostridium difficile infection: changing epidemiology, diagnosis, treatment and control.clostridium difficile infection and clostridium difficile-associated diarrhea (cdad) are growing worldwide health threats. recent studies have identified new host risk factors, diagnostic approaches and therapies of cdad. the present review focuses on scientific papers published in the past 18 months in an attempt to provide the latest information on the topic.200818725800
clathrin- and caveolae-independent entry of feline infectious peritonitis virus in monocytes depends on dynamin.feline infectious peritonitis virus (fipv), a coronavirus that causes a lethal chronic disease in cats, enters feline monocytes via endocytosis. in this study, the pathway of internalization is characterized by evaluating the effect of chemical inhibitors and/or expression of dominant-negative (dn) proteins on the percentage of internalized virions per cell and infection. further, co-localization studies were performed to determine the involvement of certain cellular internalization proteins. fi ...200818753224
severe clostridium difficile-associated disease in children.three cases of clostridium difficile-associated disease in children were detected within a short time interval. intensive therapy was required in 2 cases with colectomy in one of them. one of the severe cases was community-acquired. two patients had underlying diseases (hirschprung disease, down syndrome) and also tested positive for enteric viruses (rotavirus, calicivirus).200818756189
update in infectious disease treatment.studies published during the past year on the treatment of several infectious diseases provide valuable information that should enable us to treat our patients more effectively. among those findings: oral vancomycin (vancocin) is superior to oral metronidazole (flagyl) for treating patients with severe clostridium difficile-associated disease. the risk of death from any cause may be higher with the use of cefepime (maxipime) than with other beta-lactam antibiotics. in patients presenting to prim ...200818756840
[ulcerous colitis and infection with cytomegalovirus, herpes simplex virus and clostridium difficile].the treatment of severe flares of ulcerative colitis is based on systemic corticosteroids, immunomodulators such as cyclosporine and azathioprine and in some cases tnf-alpha-antagonists, respectively. these immunosuppressed patients are susceptible for infectious pathogens. here we report the case of a patient with a severe flare of ulcerative colitis that was first treated with systemic corticosteroids combined with immunomodulators and subsequent with infliximab. the patient then experienced a ...200818759202
clindamycin-resistant clone of clostridium difficile pcr ribotype 027, europe. 200818760028
increasing incidence of clostridium difficile-associated disease, singapore. 200818760029
increasing rates in clostridium difficile infection (cdi) among hospitalised patients, spain 1999-2007.limited information is available on the burden and epidemiology of clostridium difficile infection (cdi) in spain. the present report communicates the secular trends in prevalence of cdi among hospitalised patients in spain from 1999 through 2007. data were obtained through the epine study (estudio de prevalencia de las infecciones nosocomiales en los hospitales españoles), a point prevalence study series of nosocomial infections among patients admitted to hospital in spain. a total of 378 cases ...200818761902
update of clostridium difficile infection due to pcr ribotype 027 in europe, 2008.outbreaks of clostridium difficile infections (cdi) 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 and europe. this emerging strain is referred to as pcr ribotype 027 (type 027). since 2005, individual countries have developed surveillance studies about the spread of type 027.c. difficile type 027 has been reported in 16 european countries. it has been responsible for outbreaks i ...200818761903
clostridium difficile: summary of actions in the european union. 200818761907
first cases of clostridium difficile pcr ribotype 027 acquired in austria. 200818761973
clostridium difficile-associated disease in the hiv-infected patient. 200818762141
trusts warned c diff probe decision sets no precedent. 200818763346
clostridium difficile: a reemerging pathogen.clostridium difficile is an important health care-associated pathogen, especially among older adults who are disproportionately affected by c difficile infection (cdi). during the current decade, there has been a dramatic increase in the incidence and severity of health care-associated cdi. these clinically relevant changes are temporally associated with the emergence of a hypervirulent strain of c difficile that has now become widely disseminated. the increased burden of disease and incidence o ...200818763846
clathrin-independent endocytosis of erbb2 in geldanamycin-treated human breast cancer cells.the epidermal growth factor (egf)-receptor family member erbb2 is commonly overexpressed in human breast cancer cells and correlates with poor prognosis. geldanamycin (ga) induces the ubiquitylation, intracellular accumulation and degradation of erbb2. whether ga stimulates erbb2 internalization is controversial. we found that erbb2 was internalized constitutively at a rate that was not affected by ga in sk-br-3 breast cancer cells. instead, ga treatment altered endosomal sorting, causing the tr ...200818765569
comparison of oritavancin versus vancomycin as treatments for clindamycin-induced clostridium difficile pcr ribotype 027 infection in a human gut model.to compare the efficacy of oritavancin and vancomycin in the treatment of clostridium difficile infection (cdi) using an in vitro human gut model.200818772161
clostridium difficile infection: a surgical disease in evolution.several recent publications suggest an increase in the incidence of clostridium difficile colitis. however, such studies commonly lack denominators over which to index this rise. there is also concern in the literature that disease virulence is increasing.200818612709
[the efficacy of probiotics in gastrointestinal disease].probiotics are live microbial feed supplement which beneficially affects the host animals by improving its microbial balance. probiotics have been used in the treatment of bacterial or viral induced acute intestinal infection. in recent years, some clinical studies have shown the therapeutic effects of probiotics in the treatment of chronic inflammatory bowel disease (ibd) or prevention of allergic disease. evidence exists for therapeutic use of probiotics in acute infectious diarrhea, clostridi ...200818616132
single-dose cefuroxime with gentamicin reduces clostridium difficile-associated disease in hip-fracture patients.antibiotic-associated clostridium difficile diarrhoea may complicate recovery from surgery for proximal femoral fracture. we undertook a four-year case-control study to evaluate a change in antibiotic prophylaxis in our department. during the period january 2003 to january 2005, patients received three doses of prophylactic cefuroxime (1.5g). we then introduced a new regimen, comprising of one single dose of cefuroxime (1.5g) with gentamicin (240mg) at induction. prior to the change in prophylax ...200818621442
potential adverse effects of proton pump inhibitors.proton pump inhibitors (ppis) have revolutionized the management of gastroesophageal reflux disease and peptic ulcer disease over the past two decades. among the most commonly prescribed agents worldwide, ppis' overall safety profile is unquestionable. however, emerging evidence indicates that ppi therapy, particularly with long-term and/or high-dose administration, is associated with several potential adverse effects, including enteric infections (eg, clostridium difficile), community-acquired ...200818625128
comparison of three commercial methods for rapid detection of clostridium difficile toxins a and b from fecal specimens.three rapid enzyme immunoassays (x/pect clostridium difficile toxin a/b test, wampole tox a/b quik chek, and immunocard toxins a&b) were compared for the diagnosis of clostridium difficile infection. of the 367 stool specimens tested, 102 (27.8%) were positive for toxigenic c. difficile when a combination of direct cytotoxicity assay and cytotoxic culture was used as the gold standard. sensitivity/specificity values were 49.0%/95.8%, 54.9%/95.5%, and 66.7%/95.1%, respectively. the median times t ...200818784313
nonutility of repeat laboratory testing for detection of clostridium difficile by use of pcr or enzyme immunoassay.the diagnostic gains of repeat testing for clostridium difficile by enzyme immunoassay and pcr (i.e., initial negative result followed by positive result) within a 7-day period were 1.9 and 1.7%, respectively. there is little value of repeat testing for c. difficile by enzyme immunoassay or pcr.200818784320
deaths involving mrsa and clostridium difficile by communal establishment: england and wales, 2001-06. 200818595388
attributable outcomes of endemic clostridium difficile-associated disease in nonsurgical patients.data are limited on the attributable outcomes of clostridium difficile-associated disease (cdad), particularly in cdad-endemic settings. we conducted a retrospective cohort study of nonsurgical inpatients admitted for >/=48 hours in 2003 (n = 18,050). the adjusted hazard ratios for readmission (hazard ratio 2.19, 95% confidence interval [ci] 1.87-2.55) and deaths within 180 days (hazard ratio 1.23, 95% ci 1.03-1.46) were significantly different among cdad case-patients and noncase patients. in a ...200818598621
toxinotype v clostridium difficile in humans and food animals.clostridium difficile is a recognized pathogen in neonatal pigs and may contribute to enteritis in calves. toxinotype v strains have been rare causes of human c. difficile-associated disease (cdad). we examined toxinotype v in human disease, the genetic relationship of animal and human toxinotype v strains, and in vitro toxin production of these strains. from 2001 through 2006, 8 (1.3%) of 620 patient isolates were identified as toxinotype v; before 2001, 7 (<0.02%) of approximately 6,000 isolat ...200818598622
pandemic and seasonal influenza: therapeutic challenges.influenza a viruses cause significant morbidity and mortality annually, and the threat of a pandemic underscores the need for new therapeutic strategies. here, we briefly discuss novel antiviral agents under investigation, the limitations of current antiviral therapy and stress the importance of secondary bacterial infections in seasonal and pandemic influenza. additionally, the lack of new antibiotics available to treat increasingly drug resistant organisms such as methicillin-resistant staphyl ...200818598914
rho gtpase, rac1, regulates skp2 levels, vascular smooth muscle cell proliferation, and intima formation in vitro and in vivo.vascular smooth muscle cell (vsmc) proliferation contributes to intima formation after angioplasty or venous by-pass grafting, and during atherosclerosis. vsmc proliferation requires degradation of p27(kip1) promoted by s-phase kinase-associated protein-2 (skp2), an f-box protein component of the skp-cullin-f-box(skp2) ubiquitin-ligase. we investigated the role of rac(1) in the regulation of skp2 in rat vsmc.200818599477
the ifn-gamma-induced transcriptional program of the ciita gene is inhibited by statins.statins are 3-hydroxy-3-methylglutaryl-coenzyme a (hmg-coa) reductase inhibitors that exert anti-inflammatory effects. ifn-gamma induction of class ii mhc expression, which requires the class ii transactivator (ciita), is inhibited by statins; however, the molecular basis for suppression is undetermined. we describe that statins inhibit ifn-gamma-induced class ii mhc expression by suppressing ciita gene expression, which is dependent on the hmg-coa reductase pathway. in addition, ciita expressio ...200818601229
costs of nosocomial clostridium difficile-associated diarrhoea.nosocomial clostridium difficile-associated disease (cdad) is a common infection in hospitals. a matched case-control study was carried out to determine hospital-wide excess costs due to cdad. cases were assessed by prospective hospital-wide surveillance in a tertiary care university hospital in 2006. nosocomial cases of cdad (>72h after admission) were matched to control patients without cdad in a ratio 1:3 using the same diagnosis-related group in the same year, for a hospital stay at least as ...200818602185
is over-use of proton pump inhibitors fuelling the current epidemic of clostridium difficile-associated diarrhoea?many developed countries have seen an increase in cases of clostridium difficile-associated diarrhoea (cdad) in recent years. this has occurred despite heightened awareness of the risks of broad-spectrum antibiotics, overall reduction in antibiotic use and increased focus on hospital hygiene. some of the increase is due to the introduction of new hypervirulent strains, but it predates the description of these. the epidemic coincides with increased use of proton pump inhibitors (ppis), much of wh ...200818602190
clostridium perfringens enterotoxin in antibiotic-associated diarrhea.clostridium perfringens type a is associated with 5-20% cases of antibiotic-associated diarrhea (aad) even though clostridium difficile is implicated in the most severe cases. fecal specimens from one hundred hospitalized patients, who developed diarrhea regardless of antibiotic intake and who were negative for c. difficile toxin assay, were investigated for c. perfringens enterotoxin (cpe). simultaneously, cultures were set up for other possible aetiological factors. ten healthy controls were a ...200818603680
novel risk factors for clostridium difficile-associated disease in a setting of endemicity? 200818605911
environmental control critical for controlling clostridium difficile infections. 200818606597
in vitro susceptibility of genotypically distinct and clonal clostridium difficile strains to oritavancin.clostridium difficile infection is a nosocomial disease of increasing importance. first-line treatment is limited to metronidazole or vancomycin. oritavancin is a lipoglycopeptide with activity against gram-positive bacteria, including drug-resistant pathogens. mics of oritavancin, metronidazole and vancomycin for genotypically distinct c. difficile strains, including epidemic c. difficile pcr ribotypes 001 and 027, were determined by agar incorporation and broth macrodilution methods. in agar i ...200818606787
[recurrence of clostridium difficile-associated diarrhoea prevented by the administration of a whey concentrate from specifically immunised cows; prospective study].to try to prevent recurrences of clostridium difficile-associated diarrhoea (cdad) by treatment with a specific neutralising secretory iga-enriched whey-protein concentrate (40%) made from the milk of cows immunised with c. difficile and its toxins.200818808082
[treatment of recurrent clostridium difficile-associated diarrhoea with a suspension of donor faeces].to study the effect of treating recurrent clostridium difficile-associated diarrhoea (cdad) with a suspension of donor faeces.200818808083
[epidemiology of clostridium difficile pcr ribotype 027 in the netherlands 2005-present and the emergence of other subtypes].outbreaks of clostridium difficile associated diarrhoea (cdad) involving the virulent pcrribotype 027, toxinotype iii were first reported in the netherlands in 2005. this ribotype has now been detected in 26 of the 97 hospitals in the netherlands. in 13 of the hospitals, the introduction of ribotype 027 was linked to increased cdad incidence; this was found in 2 hospitals since december 2006. ribotype 027 has also been detected in to nursing homes. in 2007, no evidence of ribotype 27 was found i ...200818808085
role of klebsiella oxytoca in antibiotic-associated diarrhea.klebsiella oxytoca was recently shown to be the causative agent of antibiotic-associated hemorrhagic colitis. because it is unclear whether k. oxytoca also causes nonhemorrhagic antibiotic-associated diarrhea, our study investigated a possible association between k. oxytoca and that disorder.200818808355
emergence of clostridium difficile infection due to a new hypervirulent strain, polymerase chain reaction ribotype 078.since 2005, an increase in the prevalence of clostridium difficile infection (cdi) due to polymerase chain reaction ribotype 078 has been noticed in the netherlands. this strain has also been identified as the predominant strain in pigs and calves.200818808358
deaths involving clostridium difficile; england and wales, 2003-07. 200818810888
international infection control council. global consensus conference on infection prevention and control practice for clostridium difficile associated disease (cdad). 200818811105
antibiotic-associated diarrhea: epidemiology, trends and treatment.a common complication of antibiotic use is the development of gastrointestinal disease. this complication ranges from mild diarrhea to pseudomembranous colitis. outbreaks of antibiotic-associated diarrhea (aad) may also occur in healthcare settings, usually caused by clostridium difficile. aad typically occurs in 5-35% of patients taking antibiotics and varies depending upon the specific type of antibiotic, the health of the host and exposure to pathogens. the pathogenesis of aad may be mediated ...200818811240
evaluation of the risks of shedding salmonellae and other potential pathogens by therapy dogs fed raw diets in ontario and alberta.dogs that participate in animal-assisted interventions (aais), often called 'therapy dogs', commonly interact with humans whose immune systems are not functioning optimally. the advisability of feeding raw meat (including poultry) to these animals remains a highly contentious issue, in spite of increasing evidence that raw meat is frequently contaminated with salmonella. we set out to determine if consuming raw meat influences the risk of therapy dogs shedding salmonella and other pathogens. two ...200818811908
mechanisms of infectious diarrhea.infectious diarrhea is an important public health problem worldwide. research has provided new insights into the mechanisms of diarrhea caused by various pathogens that are classified as noninflammatory, inflammatory or invasive. these three groups of organisms cause two diarrheal syndromes--noninflammatory diarrhea and inflammatory diarrhea. the noninflammatory diarrheas are caused by enterotoxin-producing organisms such as vibrio cholerae and enterotoxigenic escherichia coli, or by viruses tha ...200818813221
contamination of hospital curtains with healthcare-associated pathogens.in a culture survey, we found that 42% of hospital privacy curtains were contaminated with vancomycin-resistant enterococci, 22% with ethicillin-resistant staphylococcus aureus, and 4% with clostridium difficile. hand imprint cultures demonstrated that these pathogens were easily acquired on hands. hospital curtains are a potential source for dissemination of healthcare-associated pathogens.200818823274
[comparison of three enzyme immunoassays for detection of clostridium difficile toxins a and b].diagnosis of clostridium difficile-associated diarrhea is classically based on detection of toxin a and/or toxins a+b by using several techniques. however, these techniques show important differences in terms of sensitivity and specificity. in this work, we compared three commercial immunoenzymatic tests for detecting c. difficile toxins.200818824307
clostridium difficile-positive stools: a retrospective identification of risk factors.in an attempt to determine the association of potential risk factors and an increase in the rate of clostridium difficile-associated diarrhea (cdad) at a tertiary teaching institution in the midwest united states, all cdad cases among admissions from a period of 20 consecutive months were analyzed. a retrospective chart review was performed on 4992 admissions from this period. logistic regression analysis suggested a correlation between cdad and multiple factors.200818786452
intestinal inflammation in nursing infants: different causes and a single treatment ... but of protected origin.three case histories of nursing infants suffering from different forms of intestinal problems, who underwent special dietary therapy in order to solve situations that would be difficult to deal with using the special artificial milk varieties on the market, are presented. these children were administered a homemade food consisting ofparmigiano reggiano cheese seasoned for at least 36 months, rice or maize custard and tapioca, sugar, maize oil. in the first case the diagnosis of "widespread nonsp ...200818788512
metronidazole and vancomycin: equivalence of initial efficacy in cdad. 200818796117
[clostridium difficile and clostridium difficile colitis - what are the novelties?]. 200818798363
genetic relatedness of clostridium difficile isolates from various origins determined by triple-locus sequence analysis based on toxin regulatory genes tcdc, tcdr, and cdtr.a triple-locus nucleotide sequence analysis based on toxin regulatory genes tcdc, tcdr and cdtr was initiated to assess the sequence variability of these genes among clostridium difficile isolates and to study the genetic relatedness between isolates. a preliminary investigation of the variability of the tcdc gene was done with 57 clinical and veterinary isolates. twenty-three isolates representing nine main clusters were selected for tcdc, tcdr, and cdtr analysis. the numbers of alleles found f ...200818832125
antibiotic prescribing. 200818833972
a comparison of infection control program resources, activities, and antibiotic resistant organism rates in canadian acute care hospitals in 1999 and 2005: pre- and post-severe acute respiratory syndrome.the resources for infection control in hospitals (rich) project assessed infection control programs and rates of antibiotic-resistant organisms (aros) in canadian acute care hospitals in 1999. in the meantime, the severe acute respiratory syndrome (sars) outbreak and the concern over pandemic influenza have stimulated considerable government and health care institutional efforts to improve infection control systems in canada.200818834747
clostridium difficile cell-surface polysaccharides composed of pentaglycosyl and hexaglycosyl phosphate repeating units.clostridium difficile is a gram-positive bacterium that is known to be a cause of enteric diseases in humans. it is the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis. recently, large outbreaks of c. difficile-associated diarrhea have been reported internationally, and there have been reports of increases in severe disease, mortality and relapse rates. at the moment, there is no vaccine against c. difficile, and the medical prevention of c. difficile infection is mo ...200818237724
clostridium difficile-associated disease: diagnosis, prevention, treatment, and nursing care. 200818238935
evaluation of clostridium difficile-associated diarrhea with a drug formulary change in preferred fluoroquinolones.recent publications report that gatifloxacin might be associated with a greater incidence of clostridium difficile-associated diarrhea (c. difficile, cdad) than are other fluoroquinolones. we performed a drug use evaluation to examine this issue after adding gatifloxacin to the formulary and changing from levofloxacin to gatifloxacin as the preferred oral fluoroquinolone in 10 department of veterans affairs (va) medical centers in the northeastern united states.200818240880
assessment of clostridium difficile-associated disease surveillance definitions, north carolina, 2005.to determine the timing of community-onset clostridium difficile-associated disease (cdad) relative to the patient's last healthcare facility discharge, the association of postdischarge cases with healthcare facility-onset cases, and the influence of postdischarge cases on overall rates and interhospital comparison of rates of cdad.200818241032
simulated-use testing of bedpan and urinal washer disinfectors: evaluation of clostridium difficile spore survival and cleaning efficacy.reusable bedpans and urinals are frequently cleaned and decontaminated using washer-disinfectors (wds) that may be located in the central processing department (cpd) or on the ward. the objective of this study was to determine how efficiently the wds provided cleaning and to evaluate the ability of such wds to kill clostridium difficile spores.200818241730
primary prophylaxis of sbp. 200818242238
regulation of dopamine-induced na+ current response by small g-protein rhob or c and phospholipase d in aplysia neurons.a family of gtp-binding proteins, rho, plays critical roles in cell migration, morphological change, cytokinesis, and smooth muscle contraction. furthermore, evidence has recently been accumulating for an involvement in regulation of receptor-operated ionic channels. we previously reported that stimulation of d1-like receptor by dopamine (da) induces a slow na+ current response in the identified neurons of aplysia under voltage-clamp. to further study a regulatory mechanism of the da-induced res ...200818242417
thiosemicarbazones active against clostridium difficile.a set of closely related furylidene thiosemicarbazones was prepared and screened against various clinically important gram-positive bacteria. one compound containing an ethylene spacer and a 5-nitrofuryl group was found to have promising activity against clostridium difficile.200818243694
bile salts and glycine as cogerminants for clostridium difficile spores.spore formation by clostridium difficile is a significant obstacle to overcoming hospital-acquired c. difficile-associated disease. spores are resistant to heat, radiation, chemicals, and antibiotics, making a contaminated environment difficult to clean. to cause disease, however, spores must germinate and grow out as vegetative cells. the germination of c. difficile spores has not been examined in detail. in an effort to understand the germination of c. difficile spores, we characterized the re ...200818245298
simultaneous control of norovirus and clostridium difficile outbreaks due to enhanced infection prevention and control measures. 200818192079
prognosis in clostridium difficile infection complicating inflammatory bowel disease. 200818192450
repeated enzyme immunoassays have limited utility in diagnosing clostridium difficile.many clinical laboratories use enzyme immunoassays (eia) to diagnose clostridium difficile-associated disease (cdad). clinicians frequently order three eias to "rule out" cdad. we performed a retrospective cohort study to determine the clinical utility of repeating eia testing to diagnose cdad. we reviewed all eias performed by our laboratory during 2005, determined the total number of tests per patient and per testing episode, and calculated the relative negative predictive value (npv) of one e ...200818189148
essential role of toxin a in c. difficile 027 and reference strain supernatant-mediated disruption of caco-2 intestinal epithelial barrier function.clostridium difficile induces mucosal inflammation via secreted toxins a and b and initial interactions between the toxins and intestinal epithelial cells (which lead to loss of barrier function) are believed to be important in disease pathogenesis. secreted toxin-specific antibodies may inhibit such interactions. using the caco-2 epithelial cell line, we have investigated the use of an anti-toxin a monoclonal antibody (ataa) in providing protection against toxin a-mediated disruption of epithel ...200818505424
comparative genomic analysis of the gut bacterium bifidobacterium longum reveals loci susceptible to deletion during pure culture growth.bifidobacteria are frequently proposed to be associated with good intestinal health primarily because of their overriding dominance in the feces of breast fed infants. however, clinical feeding studies with exogenous bifidobacteria show they don't remain in the intestine, suggesting they may lose competitive fitness when grown outside the gut.200818505588
inhibition of the glucosyltransferase activity of clostridial rho/ras-glucosylating toxins by castanospermine.castanospermine was identified as an inhibitor of the rho/ras-glucosylating clostridium sordellii lethal toxin and clostridium difficile toxin b. microinjection of castanospermine into embryonic bovine lung cells prevented the cytotoxic effects of toxins. the crystal structure of the glucosyltransferase domain of c. sordellii lethal toxin in complex with castanospermine, udp and a calcium ion was solved at a resolution of 2.3a. the inhibitor binds in a conformation that brings its four hydroxyl ...200818505687
absence of gastrointestinal infections in a cohort of patients with zollinger-ellison syndrome and other acid hypersecretors receiving long-term acid suppression with lansoprazole.the relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial.200818507843
increase in adult clostridium difficile-related hospitalizations and case-fatality rate, united states, 2000-2005.virulence of and deaths from clostridium difficile-associated disease (cdad) are on the rise in the united states. the incidence of adult cdad hospitalizations doubled from 5.5 cases per 10,000 population in 2000 to 11.2 in 2005, and the cdad-related age-adjusted case-fatality rate rose from 1.2% in 2000 to 2.2% in 2004.200818507904
functional properties of the carboxy-terminal host cell-binding domains of the two toxins, tcda and tcdb, expressed by clostridium difficile.the biological and ligand-binding properties of recombinant c-terminal cell-binding domains (cbds) and subdomains of the two large exotoxins, toxin a (tcda) and toxin b (tcdb) expressed by clostridium difficile were examined in the hemagglutination and verocytotoxicity neutralization assays and by qualitative affinity chromatography using sepharose-linked alpha gal(1,3)betagal(1,4)beta glc as well as the direct electrospray ionization mass spectrometry (es-ms) assay. these studies revealed that, ...200818509107
clinical microbiology and infectious diseases (eccmid)--18th european congress. new antimicrobial agents: selected poster presentations. 200818509778
clinical microbiology and infectious diseases (eccmid)--18th european congress. drug resistance among gram-negative and gram-positive bacteria. 200818509779
diagnostic value of five commercial tests for the rapid diagnosis of clostridium difficile-associated disease.we compared five commercial immunoassays (biostar oia cdtox ab, immunocard toxins a&b - meridian, xpect c. difficile toxin a/b -remel, c. difficile toxin a test- oxoid, and tox a/b quik chek- techlab) which allow a rapid diagnosis of c. difficile associated disease. the tests were performed directly on patient's stool specimen submitted for routine investigation of c. difficile infection from two university hospitals in brussels. the cell cytotoxicity assay was considered as the gold standard. o ...200818510038
clostridium difficile infection: a critical overview.clostridium difficile is a gram-positive, spore-forming, toxin-producing anaerobic bacillus identified as the causal agent of a variety of manifestations typically isolated to the colon, but in its severe form, it can lead to sepsis and death. c. difficile infection due to a toxin gene variant strain (bi/nap1) has been identified at the center of outbreaks and has resulted in increased mortality. many questions remain as to how this strain appeared so quickly and has harmed or killed so many pat ...200818510876
different ribotypes in community-acquired clostridium difficile. 200818511151
molecular analysis of the digestive microbiota in a gnotobiotic mouse model during antibiotic treatment: influence of saccharomyces boulardii.the probiotic saccharomyces boulardii is a non-pathogenic yeast that has been proven efficient in the prevention of antimicrobial-associated diarrhea and of clostridium difficile associated colitis. we evaluated the influence of the administration of s. boulardii on the composition of the fecal microbiota in a human microbiota-associated mouse model. this evaluation was run before, during and after a 7-day oral treatment with amoxicillin clavulanic acid. predominant groups of bacteria were quant ...200818511310
report names hospitals with highest proportions of deaths related to mrsa and c difficile. 200818511792
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