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rifamycin antibiotics for treatment of clostridium difficile-associated diarrhea.to review the existing data on use of the rifamycin class of antibiotics as therapy for clostridium difficile-associated diarrhea (cdad).200818430792
a case-control study of community-associated clostridium difficile infection.the aim of this study was to determine the incidence of and risk factors for community-associated clostridium difficile infection (cdi).200818434341
comparison of real-time pcr for detection of the tcdc gene with four toxin immunoassays and culture in diagnosis of clostridium difficile infection.we have developed a rapid real-time pcr method using fluorescence resonance energy transfer probes and the lightcycler (roche diagnostics), which will detect the presence of the tcdc gene of clostridium difficile in stool samples. our pcr method also will identify the presence of base pair deletions, one of which (18 bp) has been associated with the "epidemic" toxin-hyperproducing strains. we compared the results of this pcr with those of three c. difficile toxin-detecting enzyme immunoassays (e ...200818434563
human alpha-defensins inhibit clostridium difficile toxin b.clostridium difficile toxins a and b are major virulence factors implicated in pseudomembranous colitis and antibiotic-associated diarrhea. the toxins are glucosyltransferases, which inactivate rho proteins involved in cellular signaling. human alpha-defensins as part of the innate immune system inactivate various microbial pathogens as well as specific bacterial exotoxins. here, we studied the effects of alpha-defensins human neutrophil protein (hnp)-1, hnp-3, and enteric human defensin (hd)-5 ...200818435932
risk factors for the development of fulminant clostridium difficile colitis.the development of fulminant clostridium difficile colitis (fcdc) requires prompt operative intervention and is associated with a high mortality rate. the aim of this study was to use a case-control design to define the clinical and laboratory parameters that predict which patients with clostridium difficile infection are most likely to progress to fcdc.200818436010
diagnostic and treatment delays in recurrent clostridium difficile-associated disease.because clostridium difficile-associated disease (cdad) is primarily an inpatient issue, hospitalists are at the forefront of the timely diagnosis and treatment of patients with this disease.200818438792
both oral metronidazole and oral vancomycin promote persistent overgrowth of vancomycin-resistant enterococci during treatment of clostridium difficile-associated disease.for treatment of mild to moderate clostridium difficile-associated disease (cdad), oral metronidazole has been recommended as the preferred agent, in part due to concern that vancomycin may be more likely to promote colonization by vancomycin-resistant enterococci (vre). we performed a prospective observational study to examine the effects of oral metronidazole or vancomycin treatment of cdad on acquisition and concentration of vre stool colonization. before, during, and after 90 courses of cdad ...200818443120
reducing infection rates. 200818444375
clostridium difficile-associated diarrhea after antibiotic treatment for traveler's diarrhea.diarrhea commonly affects international travelers. episodes are usually short-lasting, but in some patients, symptoms may persist. clostridium difficile infection should be excluded in travelers with prolonged disease. we report what is, to our knowledge, the first reported study of patients with c. difficile-associated diarrhea after receipt of antibiotic treatment for traveler's diarrhea.200818444824
first confirmed cases of clostridium difficile pcr ribotype 027 in norway. 200818445386
nonbloody, red stools from coadministration of cefdinir and iron-supplemented infant formulas.cefdinir is an extended-spectrum, third-generation cephalosporin that may be used for treatment of acute otitis media in patients allergic to penicillin. when administered with iron-containing products, including infant formulas, cefdinir or one of its metabolites may bind to ferric ions, forming a nonabsorbable complex that imparts a reddish color to the stool. we describe a 9-month-old infant with failure to thrive and acute otitis media who developed an erythematous maculopapular rash during ...200818447664
clostridium difficile in broiler chickens sold at market places in zimbabwe and their antimicrobial susceptibility.clostridium difficile has been shown to be a nosocomial pathogen associated with diarrhoea and pseudomembranous colitis in hospitalised patients and the infection is believed to be acquired nosocomially. community-acquired c. difficile-associated diarrhoea has also been reported. recent studies have shown the occurrence of c. difficile in food animals which may act as a source of infection to humans. the aim of this study was to determine the occurrence of c. difficile in broiler chickens sold a ...200818448182
[detection of clostridia toxin markers in different types of the course of acute intestinal infections].the purpose of the investigation was to study the detection rates of markers and the level of c. diffcile a and b toxins and c. perfringens type a enterotoxin in patients with acute intestinal infections (aii). two hundred and seventy-three patients with aii of varying etiology were followed up. according to the clinical syndrome, the patients were divided into 3 groups: (1) patients with the gastroenteritic (ge) type; (2) those with the gastroenterocolitic (gec) type; (3) those with enterocolit ...200818450084
clostridium difficile infection. 200818456087
risk of clostridium difficile infection after perioperative antibacterial prophylaxis before and during an outbreak of infection due to a hypervirulent strain.perioperative antibacterial prophylaxis (pap) is an important component of surgical site infection prevention but may be associated with adverse effects, such as clostridium difficile infection (cdi). since the emergence of a hypervirulent strain of c. difficile, the risk of development of cdi after pap has not been evaluated. the purpose of this study was to determine the risk of pap-induced cdi after selected surgical procedures and to compare such risk before with such risk after the emergenc ...200818462108
nitazoxanide to treat persistent clostridium difficile colitis. 200818462579
rifaximin to treat recurrent clostridium difficile colitis. 200818462580
the molecular pathogenesis of clostridium difficile-associated disease.clostridium difficile-associated disease is a reemerging nosocomial disease of paramount importance not only in the united states, but most of the world as well. recently, c. difficile-associated disease appears to be on the rise, with a parallel increase noted in its severity and extent. although the main virulence factors, the large exotoxins known as toxin a and toxin b, have long been identified, only in the past few years has a near explosion of new information regarding the details of the ...200818462584
gum arabic establishes prebiotic functionality in healthy human volunteers in a dose-dependent manner.the present study was undertaken to determine the prebiotic efficacy of gum arabic upon consumption by man for up to 4 weeks and, if any, to establish the dose-effect relationship. human healthy volunteers consumed various daily doses (5, 10, 20, 40 g) of gum arabic (emulgold) in water for up to 4 weeks. daily consumption of water was taken as the negative control and that of 10 g inulin as the positive control. at 0, 1, 2 and 4 weeks quantification of bacterial numbers in stool samples was perf ...200818466655
clostridium difficile infection in patients with ileal pouch-anal anastomosis.there has been an increase in the incidence and severity of clostridium difficile-associated diarrhea in the u.s. the importance of c difficile infection in patients with ileal pouch-anal anastomosis (ipaa) is unknown. this study was designed to determine risk of acquiring c difficile infection in pouch disorders.200818467184
temporal effects of antibiotic use and hand rub consumption on the incidence of mrsa and clostridium difficile.the aim of this study was to determine the temporal relation between the use of antibiotics and alcohol-based hand rubs (abhrs) and the incidence of methicillin-resistant staphylococcus aureus (mrsa) and clostridium difficile.200818468995
c. difficile challenge. the es department's role in infection control. 200818472478
recent developments on the role of clostridium difficile in inflammatory bowel disease.clostridium difficile (cd), specifically its toxins, have been implicated as a risk factor for exacerbation of the inflammatory process in up to 5% of patients with ulcerative colitis or crohnos disease. typical evidence of colonic changes with cd infection, including pseudomembranous exudate, are often not present; however, a severe clinical course may result, including precipitation of toxic colitis and toxic megacolon. recently, hypervirulent cd strains have been reported raising concern for ...200818473400
uv-visible marker confirms that environmental persistence of clostridium difficile spores in toilets of patients with c. difficile-associated diarrhea is associated with lack of compliance with cleaning protocol.e.an ultraviolet visible marker (uvm) was used to assess the cleaning compliance of housekeeping staff for toilets in a tertiary healthcare setting.200818474086
in vitro and in vivo antibacterial activities of dc-159a, a new fluoroquinolone.dc-159a is a new 8-methoxy fluoroquinolone that possesses a broad spectrum of antibacterial activity, with extended activity against gram-positive pathogens, especially streptococci and staphylococci from patients with community-acquired infections. dc-159a showed activity against streptococcus spp. (mic(90), 0.12 microg/ml) and inhibited the growth of 90% of levofloxacin-intermediate and -resistant strains at 1 microg/ml. the mic 90s of dc-159a against staphylococcus spp. were 0.5 microg/ml or ...200817938194
clostridium difficile: an under-recognized cause of reactive arthritis?reactive arthritis usually presents as a sterile, inflammatory, asymmetric oligoarthritis, affecting large lower extremity joints. extra-articular features (conjunctivitis, uveitis, enthesopathy, urethritis, balanitis, keratoderma blenorrhagicum) may occur. common causes of enteric reactive arthritis are preceding infections attributable to salmonella, shigella, campylobacter, and yersinia. in contrast, clostridium difficile is an uncommon cause of reactive arthritis, with only approximately 40 ...200817902012
fucoidin prevents clostridium difficile toxin-a-induced ileal enteritis in mice.recent reports suggest increased incidence and severity of clostridium difficile-associated diseases. these facts have raised the need for additional clarification of pathogenesis and for a search for new therapeutic strategies. this study evaluated the effects of the polysaccharide fucoidin, an l-selectin blocker, on toxin-a-induced mouse enteritis. fucoidin (25 mg/kg) or saline (0.1 ml) were injected systemically (ocular plexus) 5 min prior to local challenge with toxin a (5 microg/ileal loop) ...200817805968
statins enhance toll-like receptor 4-mediated cytokine gene expression in astrocytes: implication of rho proteins in negative feedback regulation.toll-like receptors (tlrs) are sentinels of innate immunity that recognize pathogenic molecules and trigger inflammatory response. because inflammatory mediators are detrimental to the host, the tlr response is regulated by feedback inhibition. statins, the inhibitors of isoprenoid biosynthesis, have been shown to be potent modulators of tlr activity, and this modulation may provide insight regarding mechanisms of the feedback inhibition. in the present study, we examined feedback mechanisms tha ...200817896797
the effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin.one of the side effects of antimicrobial therapy is a disturbance of the intestinal microbiota potentially resulting in antibiotic-associated diarrhea (aad). in this placebo-controlled double-blind study, the effect of a multispecies probiotic on the composition and metabolic activity of the intestinal microbiota and bowel habits was studied in healthy volunteers taking amoxycillin.200817900321
risk of clostridium difficile diarrhoea in critically ill patients treated with erythromycin-based prokinetic therapy for feed intolerance.to determine the incidence of clostridium difficile (cd) diarrhoea in feed-intolerant, critically ill patients who received erythromycin-based prokinetic therapy.200817701160
the epidemiology and treatment of infections in cancer patients.significant changes in the epidemiology of infectious complications in cancer patients have emerged during the past decade. among blood culture isolates from febrile neutropenic patients, gram-positive pathogens have become predominant, and an increasing spread of methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococci must be taken into consideration. risk factors such as indwelling venous catheters or chemotherapy-induced mucosal damage are associated with an increased ...200817703922
evaluation of two rapid immunochromatography tests for the detection of clostridium difficile toxins.the aim of the study was to evaluate the performance of two rapid immunochromatography tests, the tox a/b quick chek (techlab) and the immunocard toxins a&b test (meridian), in addition to the older tox a/b elisa, against pcr detection of the tcdb gene. two hundred patient-unique stool specimens were tested. in comparison to the polymerase chain reaction results, the sensitivity and specificity of the two rapid tests were 94.7% and 97.2%, respectively; corresponding values for the elisa were 93. ...200817990108
importance of the environment in meticillin-resistant staphylococcus aureus acquisition: the case for hospital cleaning.in the uk, we continue to debate the importance of hospital cleaning in relation to increasing numbers of patients acquiring meticillin-resistant staphylococcus aureus (mrsa). however, there is little direct evidence for the effectiveness of cleaning because it has never been afforded scientific status. hospital hygiene is usually assessed visually, but this does not necessarily correlate with microbiological risk. a more robust case for hospital cleaning can be presented by considering the evid ...200817974481
ileal smooth muscle motility depression on rabbit induced by toxin a from clostridium difficile.this study is aimed at elucidating with in vitro experiments the time course of alteration of ileal motility caused by in vivo exposure of ligated loops of ileum to toxin a (1 microg/ligated loop) of clostridium difficile. in the sham-operated animals no significant alteration of motility was observed. in ligated loops directly injected with toxin a and in loops neighboring those administered with this toxin, a biphasic time course of motility alterations was observed. there was initially (2 h a ...200817987387
a possible role for clostridium difficile in the etiology of calf enteritis.clostridium difficile was investigated as a possible cause of enteritis in calves. the organism and its toxins (tcda and tcdb), respectively, were found in 25.3% and 22.9% of stool samples from diarrheic calves. culture positive samples were more likely than culture negative samples to be toxin positive. however, toxin positive stools were more common among nondiarrheic calves, but diarrheic calves were nearly twice as likely to be culture positive. ribotype 078 was dominant among isolates. salm ...200817964088
small bowel evisceration: a rare complication of laparoscopic ileostomy. 200817944971
excess hospitalisation burden associated with clostridium difficile in patients with inflammatory bowel disease.clostridium difficile is an important cause of diarrhoea in hospitalised patients. an increasing number of cases of c difficile colitis occur in patients with inflammatory bowel disease (ibd)-crohn's disease (cd), ulcerative colitis (uc).200817905821
evaluation of two enzyme immunoassays for detection of clostridium difficile toxins a and b in swine.diagnosis of clostridium difficile-associated disease (cdad) in neonatal pigs is accomplished, in part, by detection of toxins a (tcda) and b (tcdb) in feces or colonic contents. samples (n=115) were tested simultaneously with two toxin assays (clostridium difficile tox a/b ii, techlab, blacksburg, va; gastro-tect clostridium difficile toxin a+b, medical chemical corporation). previous comparison of the tox a/b ii assay to the reference method (toxicity in cho cell monolayers) revealed an overal ...200818006252
laparoscopic parastomal hernia repair.management of the parastomal hernia represents a common clinical dilemma for both the surgeon and patient. once established, these defects are notoriously difficult to treat. although most parastomal hernias can be managed nonoperatively, approximately 30% will require intervention secondary to complications such as obstruction, pain, bleeding, poorly fitting appliances, or leakage. overall complication rates of up to 88%, combined with a growing body of literature citing decreased patient morbi ...200817999128
a rare and unsuspected complication of clostridium difficile infection.to report the occurrence of abdominal compartment syndrome (acs) due to infection with clostridium difficile.200818026931
rapid and reliable diagnostic algorithm for detection of clostridium difficile.we evaluated a two-step algorithm for detection of clostridium difficile in 1,468 stool specimens. first, specimens were screened by an immunoassay for c. difficile glutamate dehydrogenase antigen (c.diff chek-60). second, screen-positive specimens underwent toxin testing by a rapid toxin a/b assay (tox a/b quik chek); toxin-negative specimens were subjected to stool culture. this algorithm allowed final results for 92% of specimens with a turnaround time of 4 h.200818032627
clostridium difficile-associated disease: update and focus on non-antibiotic strategies.clostridium difficile-associated disease (cdad) is a problem of especially the frail elderly. changes in virulence of prevalent strains in the early years of the new century saw mortality and morbidity increase from historical levels. this article explores non-antibiotic strategies including the use of probiotics. a number of avenues of ongoing research appear to have potential future clinical application. evidence exists linking acid-inhibiting drugs to an increased risk of cdad, and the adjunc ...200818033775
comparison of seven techniques for typing international epidemic strains of clostridium difficile: restriction endonuclease analysis, pulsed-field gel electrophoresis, pcr-ribotyping, multilocus sequence typing, multilocus variable-number tandem-repeat analysis, amplified fragment length polymorphism, and surface layer protein a gene sequence typing.using 42 isolates contributed by laboratories in canada, the netherlands, the united kingdom, and the united states, we compared the results of analyses done with seven clostridium difficile typing techniques: multilocus variable-number tandem-repeat analysis (mlva), amplified fragment length polymorphism (aflp), surface layer protein a gene sequence typing (slpast), pcr-ribotyping, restriction endonuclease analysis (rea), multilocus sequence typing (mlst), and pulsed-field gel electrophoresis ( ...200818039796
[update on clostridium difficile infections].purpose: clostridium difficile is an anaerobic gram positive, spore-forming bacterium which is responsible for 15-25% of antibiotic-associated diarrhea and for more than 95% of pseudomembranous colitis (pmc). this paper will review the main knowledge on c. difficile-associated infections and their recent evolution. current knowledge and key points: since 2003, outbreaks of severe c. difficile-associated diarrhea (cdad) have been increasingly reported in canada and the united states. this trend i ...200818023937
emerging toxin a-b+ variant strain of clostridium difficile responsible for pseudomembranous colitis at a tertiary care hospital in korea.sixty percent to 80% of clostridium difficile isolates in korea have been reported to be toxigenic. however, over 1 year, we encountered a high number of tcda-tcb+ strains associated with pseudomembranous colitis (pmc). c. difficile was isolated from 224 of 471 specimens (47.6%) from 371 patients. a subset of the culture-positive specimens (n = 106), containing no duplicate cases, was randomly selected for tcda and tcdb polymerase chain reaction (pcr) assays. pcr results showed that tcda+tcdb+ a ...200818082994
vancomycin-resistant enterococcal colonization appears associated with increased mortality among allogeneic hematopoietic stem cell transplant recipients.there are no cohort studies describing outcomes of patients colonized with vancomycin-resistant enterococci (vre) undergoing allogeneic hematopoietic stem cell transplantation (ahsct). we therefore conducted a retrospective cohort study of 217 consecutive adults undergoing ahsct at the mayo clinic (rochester, mn, usa) from 1998 to 2004. we analyzed the association between vre colonization prior to transplant and 100-day post transplant mortality and morbidity. we identified 22 pretransplant vre ...200818084341
catastrophic clostridium difficile enteritis in a pelvic pouch patient: report of a case.in recent years, clostridium difficile-associated infection has emerged as an increasingly problematic entity. more virulent strains have been isolated and new manifestations of the infection have been described.200818071831
clostridium difficile, ethnicity and religion. 200818079020
aldosterone induces superoxide generation via rac1 activation in endothelial cells.currently, aldosterone is believed to be involved in the development of cardiovascular injury as a potential cardiovascular risk hormone. however, its exact cellular mechanisms remain obscure. this study was undertaken to examine the effect of aldosterone on superoxide production in cultured rat aortic endothelial cells with possible involvement of the small gtp-binding (g) protein rac1. the aldosterone levels showed a time-dependent (6-24 h) and dose-dependent (10(-8) to 10(-6) m) increase in s ...200818079208
do fluoroquinolones predispose patients to clostridium difficile associated disease? a review of the evidence.clostridium difficile associated diarrhea (cdad) is an important cause of hospital-acquired diarrhea, and increasingly of community-acquired diarrhea. the occurrence of cdad in the hospitalized patient is associated with increased length of stay, morbidity, mortality, and healthcare costs. exposure to antimicrobials is the single most important predisposing factor for acquiring cdad. the data suggesting that fluoroquinolones are an important risk factor for cdad is becoming stronger. also, diffe ...200818067688
tetracycline resistance gene tet(w) in the pathogenic bacterium clostridium difficile.in this study, the tet(w) gene region of a human clinical isolate of clostridium difficile resistant to tetracycline was characterized. this gene was a new allele showing 99% sequence identity to the gene found in the human strain bifidobacterium longum f8, and it is not transferable by "in vitro" mating experiments.200818070963
sphingosine-1-phosphate and endothelin-1 induce the expression of rgs16 protein in cardiac myocytes by transcriptional activation of the rgs16 gene.the expression of the negative regulator of g protein signaling 16 (rgs16) is rapidly induced in cardiomyocytes by various stimuli. to identify the promoter of the mouse rgs16 gene, a 1.8-kb deoxyribonucleic acid fragment 5' of the rgs16-coding region was subcloned into a firefly-luciferase reporter vector and four overlapping fragments were analyzed. the luciferase production was quantified in neonatal rat cardiac myocytes (nrcm). a 0.6-kb fragment that induced a tenfold increase in luciferase ...200818046543
rac and pi3 kinase mediate endothelial cell-reactive oxygen species generation during normoxic lung ischemia.abrupt reduction of flow (ischemia) leads to endothelial cell membrane depolarization, nadph oxidase activation, and reactive oxygen species (ros) generation in isolated rat and mouse lungs and in flow-adapted endothelial cells in vitro. here we evaluated the role of pi-3-kinase and rac in activation of endothelial nadph oxidase. endothelium of isolated perfused mouse lungs labeled with 2',7'-dichlorodihydrofluorescein (h(2)dcf) or hydroethidine (he) showed increased ros generation with ischemia ...200818162054
prevalence and risk factors for clostridium difficile colonization in dogs and cats hospitalized in an intensive care unit.clostridium difficile is the most common cause of hospital- and antimicrobial-associated diarrhea in hospitalized humans however the role of c. difficile in diarrhea in dogs has not been defined. a prospective study of c. difficile colonization in dogs and cats was conducted in a veterinary teaching hospital intensive care unit (icu). rectal swabs were taken from patients upon admission to the icu and every third day of hospitalization until discharge or death. c. difficile was isolated from 73/ ...200818164560
clostridium difficile infection precipitating hemolysis in glucose-6-phosphate dehydrogenase-deficient preterm twins causing severe neonatal jaundice.the incidence of glucose-6-phosphate dehydrogenase deficiency in neonates of immigrant mothers in canada is increasing. newborn screening programs in canada do not screen for this disorder. infants with g-6-pd deficiency may develop jaundice resulting in kernicterus with devastating sequelae. in this case report, we speculate that clostridium difficile infection may have triggered severe jaundice in g-6-pd-deficient neonates.200818165833
the changing spectrum of clostridium difficile associated disease: implications for dentistry.clostridium difficile is an anaerobic, spore-forming bacterium that causes a wide range of diseases of the gastrointestinal tract. it is best known for its association with uncomplicated antimicrobial-agent-associated diarrhea.200818167383
c-terminal repeats of clostridium difficile toxin a induce production of chemokine and adhesion molecules in endothelial cells and promote migration of leukocytes.the c-terminal repeating sequences of clostridium difficile toxin a (designated aru) are homologous to the carbohydrate-binding domain of streptococcal glucosyltransferases (gtfs) that were recently identified as potent modulins. to test the hypothesis that aru might exert a similar biological activity on endothelial cells, recombinant aru (raru), which was noncytotoxic to cell cultures, was analyzed using human umbilical vein endothelial cells. the raru could bind directly to endothelial cells ...200818160482
randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia.to compare a strategy of combination therapy with a strategy of monotherapy with broad-spectrum antibiotics for suspected late ventilator-associated pneumonia.200818091545
active immunization of hamsters against clostridium difficile infection using surface-layer protein.clostridium difficile is the leading cause of infectious antibiotic-associated diarrhoea, particularly among the elderly. its surface-layer protein (slp) was tested as a vaccine component in a series of immunization and challenge experiments with golden syrian hamsters, combined with different systemic and mucosal adjuvants. some regimens were also tested in a nonchallenge balb/c mouse model, enabling closer monitoring of the immune response. none of the regimens conferred complete protection in ...200818093141
fulminant clostridium difficile colitis. 200818094201
clostridium difficile colitis in cystic fibrosis patients with and without lung transplantation.despite a large carriage rate of clostridium difficile among cystic fibrosis (cf) patients, c. difficile-associated disease (cdad) is rather rare. in case of lung transplantation, the incidence and clinical aspects of cdad in this patient population are not well known.200817630999
predictors of clostridium difficile colitis infections in hospitals.hospital-level predictors of high rates of 'clostridium difficile-associated disease' (cdad) were evaluated in over 2300 hospitals across california, arizona, and minnesota. american hospital association data were used to determine hospital characteristics associated with high rates of cdad. significant correlations were found between hospital rates of cdad, common infections and other identified pathogens. hospitals in urban areas had higher average rates of cdad; yet, irrespective of geographi ...200817686193
current treatment options for severe clostridium difficile-associated disease.a notable trend toward severe clostridium difficile colitis and poor outcomes has emerged since recognition of the hyper-virulent c. difficile nap1/027 strain. this trend has increased the emphasis on appropriate treatment regimens in refractory cases of c. difficile infection. in mild-to-moderate cases, oral metronidazole remains adequate first-line therapy, but in the absence of a good clinical response, switching to vancomycin may be necessary. oral vancomycin should be used as initial therap ...200821904490
hearing the alarm.many directors of nursing will, like me, have read with interest the healthcare commission ( 2007 ) report into the outbreaks of clostridium difficile at maidstone and tunbridge wells nhs trust, kent, and, being responsible to their trust boards for infection control, will have reassessed their trusts' policies in light of its recommendations.200827724551
rare case of "red man" syndrome in a female patient treated with oral vancomycin for clostridium difficile diarrhoea.a 58-year-old caucasian woman was admitted for knee replacement but during the postoperative period she developed sepsis due to pneumonia, which was treated with coamoxiclav and then piperacillin (for 2 weeks). she had renal failure, which needed haemofiltration. during her recovery she had diarrhoea due to clostridium difficile, which was not controlled with metronidazole. vancomycin was therefore given, but she developed urticarial erythematous skin rash and hence it was stopped. she was not o ...200921886654
clostridium difficile enteritis in a patient after total proctocolectomy.clostridium difficile infection is associated with antibiotic therapy and usually limited to the colonic mucosa. however, it is also a rare cause of enteritis, with only a few cases reported in the literature. in the present report, the case of a 30-year-old woman with clostridium difficile enteritis who previously had a panproctocolectomy with end ileostomy for severe ulcerative colitis is described. previously reported cases of clostridium difficile enteritis are also reviewed. previous antibi ...200921686438
pseudomembranous colitis in four patients with cystic fibrosis following lung transplantation.in the present study, 4 patients with cystic fibrosis undergoing lung transplantation (from a total of 137) who developed fulminant pseudomembranous colitis are described. initial presentation was variable and the mortality rate was 50% despite urgent colectomy. in one case the presenting abdominal distension was thought to be due to meconium ileus equivalent. it is concluded that clostridium difficile colitis may be a difficult diagnosis in patients with cystic fibrosis and follows a fulminant ...200921686410
clostridium difficile-associated colitis following the use of chinese medicine.chinese medicine is becoming widely used in the uk to treat many medical conditions, including acne. we report a case in which chinese medicine, lian qiao bai du wan, was used to treat acne in a teenage boy. the patient then suffered severe diarrhoea with blood and mucus per rectum. examination of the stool revealed clostridium difficile infection. treatment with oral metronidazole improved his symptoms.200921686665
activation of pak1/2 during the shedding of platelet microvesicles.simultaneously to phospholipid flip-flop that supports the procoagulant activity of activated platelets, blebs, supported by actin reorganization, are formed at the plasma membrane and generate microvesicles. the molecular mechanism of microvesicle shedding from activated platelets implicates ca influx and ca-dependent protease, calpain. we previously demonstrated that the formation of lamellipodias and filopodias associated with platelet shape change involved the reorganization of actin filamen ...200920523167
[specific antisepsis and environmental disinfection in preventing "clostridium difficile associated diarrhea"].in the last years, clostridium difficile acquired great interest for public health because of constant increase of clostridium difficile associated diarrhea (cdad), especially in nosocomial field and as a consequences of its pathogenicity and virulence. oro-faecal transmission and great environmental persistence of clostridium difficile indicate hand hygiene of health care workers and environmental disinfection practices as key interventions for prevention and control of nosocomial cdad. the cur ...200920169831
injudicious antibiotic use leading to fulminating clostridium difficile infection: a case report.the case illustrates the myriad of fulminating complications due to clostridium difficile infection in a previously healthy individual without any risk factors. community acquired clostridium difficile infection can occur even many weeks after the course of broad spectrum antibiotics. there is no definitive pattern or guidelines to predict who would develop the fulminating complications.200920181200
[factors associated with clostridium difficile disease in a tertiary-care medical institution in mexico: a case-control study].clostridium difficile-associated disease (cdad) has been clearly associated with the use of broad-spectrum antibiotics worldwide. however, information about cdad is scarce in mexico and latin america.200920184096
nosocomial diarrhoea in adult medical patients: the role of clostridium difficile in a north italian acute care teaching hospital.the number of patients with severe clostridium difficile-associated diarrhoea (cdad) increases. health care facilities are requested to establish rates of nosocomially acquired cdad (n-cdad) to understand the impact of control or prevention measures, and the burden of n-cdad on health care resources.200920099443
clostridium difficile: highlights from anaerobe 2008, the 9th biennial congress of the anaerobe society of the americas, long beach, california, usa, june 24-27, 2008. 200920151487
prevalence and etiology of nosocomial diarrhoea in children < 5 years in tikrit teaching hospital.a cross-sectional hospital-based study was carried out at tikrit teaching hospital, iraq, from october 2004 to september 2005, to identify the prevalence and etiology of nosocomial infectious diarrhoea among children under 5 years of age. of 259 children admitted to the paediatric ward for reasons other than diarrhoea and hospitalized for more than 3 days, clinical and laboratory analysis of stool samples showed nosocomial diarrhoea in 84 children (32.4%). the most common causative agents were e ...200920214124
clostridium difficile in solid organ transplant recipients. 200920070693
infection control: a review for certification. 200920088193
clostridium difficile infection: a critical analysis of the guidance.a recent report by the department of health, clostridium difficile infection: how to deal with the problem - a board to ward approach, is a revised set of guidelines based on best practice and key recommendations for the nhs to ensure the control of clostridium difficile infection (cdi). it takes into account a national framework for clinical governance which did not previously exist, a framework that gives significant weight to infection control as a matter of patient safety, and highlights tha ...200920081684
detection of clostridium difficile infection: a suggested laboratory diagnostic algorithm.currently, the diagnosis of clostridium difficile infection (cdi) relies on the detection of toxins a and b in faeces but the sensitivity of these tests has been questioned, particularly in advanced disease. in this context, additional methods to enhance the diagnosis of c. difficile have been investigated. in this study, 1007 faecal samples are tested using toxigenic culture, an immunoassay for toxins ab and the c. difficile-specific glutamate dehydrogenase (gdh) test. samples positive by any o ...200920095124
battling h1n1. 200920108792
stool transplantation for older patients with clostridium difficile infection. 200920122011
increasing incidence of clostridium difficile-associated diarrhea in inflammatory bowel disease.over the last decade a rise in clostridium difficile-associated diarrhea (cdad) has been observed. a higher incidence of cdad has also been suggested in patients with inflammatory bowel disease (ibd), and may be a challenging factor in the differential diagnosis of flares. it is unclear if the increase is caused by the enhanced use of immunosuppressive therapy in ibd. we investigated if cdad infection is increasing in ibd patients and evaluated outcome and possible predisposing factors.200921172241
diagnosis of clostridium difficile-associated diarrhea. 200921172260
diagnostic algorithm using a sensitive broth culture method for detection of clostridium difficile toxin from stool samples.the two-step glutamate dehydrogenase antigencytotoxicity neutralization assay algorithm has been found to be reliable for the diagnosis of toxigenic clostridium difficile. however, the high sensitivity of the screening method is compromised by the relative low sensitivity of the second step, the direct cytotoxin neutralization assay (dcna) using a fecal filtrate. the objective of the present study was to compare the dcna with an indirect cytotoxin neutralization assay (icna).200921119790
a study of the prevalence of cytotoxic and non-cytotoxic klebsiella oxytoca fecal colonization in two patient populations.klebsiella oxytoca is a cause of antibiotic-associated hemorrhagic colitis. few reports of the occurrence of k oxytoca within stool exist and there is no gold standard method for its isolation.200921119796
clostridium difficile and inflammatory bowel disease: implications for current clinical practice.clostridium difficile infection should always be included in the differential diagnosis of patients with refractory inflammatory bowel disease (ibd) symptoms, as it is well known to induce or mimic a flare of ibd. there is currently an alarming increase in the incidence of c. difficile infection in europe and north america. current epidemiologic data suggest that more virulent strains, such as c. difficile 027/nap1/bi, are emerging. testing for both c. difficile toxins a and b should be done, an ...200920948756
bacteremia due to clostridium difficile: case report and review of the literature.the purpose of this study is to report a case of c. difficile bacteremia in a crohn's disease patient and to review the literature on previously reported cases.200924179365
trends in clostridium difficile disease: epidemiology and intervention.clostridium difficile is the most common cause of nosocomial infectious diarrhea. the incidence of c difficile infection (cdi) is increasing in both inpatients and outpatients, and outbreaks caused by a hypervirulent strain of c difficile are resulting in more severe disease. moreover, community-associated cdi is occurring in persons who lack the traditional risk factors, which include antibiotic use, advanced age, and severe underlying disease. the clinical severity of cdi ranges from a mild, s ...200925237212
increasing seroprevalence of clostridium difficile in an adult danish general population.the incidence of clostridium difficile-associated infections is increasing, but it remains to be defined whether any change in the seroprevalence of c. difficile has also occurred. in a population-based study of the general adult population, 734 subjects, aged 15-69 years, were examined on two occasions 8 years apart (1990 and 1998) for the presence of antibodies against c. difficile in serum. the overall seroprevalence of c. difficile increased significantly from 19% in 1990 to 27% in 1998 (p<0 ...200918503728
rifaximin in treatment of recurrent clostridium difficile-associated diarrhea: an uncontrolled pilot study. 200918385603
reduction in infection risk through treatment of microbially contaminated surfaces with a novel, portable, saturated steam vapor disinfection system.surface-mediated infectious disease transmission is a major concern in various settings, including schools, hospitals, and food-processing facilities. chemical disinfectants are frequently used to reduce contamination, but many pose significant risks to humans, surfaces, and the environment, and all must be properly applied in strict accordance with label instructions to be effective. this study set out to determine the capability of a novel chemical-free, saturated steam vapor disinfection syst ...200918834748
idiopathic pseudomembranous colitis limited to the right colon: a change from clostridium difficile. 200918830611
more bad news on clostridium difficile in inflammatory bowel disease. 200918785624
melanin-concentrating hormone (mch) modulates c difficile toxin a-mediated enteritis in mice.melanin-concentrating hormone (mch) is a hypothalamic orexigenic neuropeptide that regulates energy balance. however, the distribution of mch and its receptor mchr1 in tissues other than brain suggested additional, as yet unappreciated, roles for this neuropeptide. based on previous paradigms and the presence of mch in the intestine as well as in immune cells, its potential role in gut innate immune responses was examined.200918824554
clostridium difficile colitis in a health care worker: case report and review of the literature. 200918594979
emergency laparoscopic surgery for complicated diverticular disease.the aim of this study was to analyse the outcome of emergency laparoscopic surgical management of complicated diverticular disease.200918616737
clostridium difficile-associated disease in children with solid tumors.the goal of this study was to describe the incidence of clostridium difficile-associated disease (cdad) in children with solid tumours.200918802726
toxin-binding treatment for clostridium difficile: a review including reports of studies with tolevamer.clostridium difficile represents an increasing threat to patients, mainly as a hospital-acquired infection causing antibiotic-associated colitis (aac). the emergence of a new more virulent strain in north america and europe has been linked to increased morbidity and mortality. for a long period of time the only available therapeutic options were oral vancomycin and metronidazole. however, both of these antibiotics have limitations either in terms of efficacy, cost, formulation, side effects or t ...200918804351
mechanisms of action of probiotics: recent advances.the intestinal microbiota plays a fundamental role in maintaining immune homeostasis. in controlled clinical trials probiotic bacteria have demonstrated a benefit in treating gastrointestinal diseases, including infectious diarrhea in children, recurrent clostridium difficile-induced infection, and some inflammatory bowel diseases. this evidence has led to the proof of principle that probiotic bacteria can be used as a therapeutic strategy to ameliorate human diseases. the precise mechanisms inf ...200918626975
absence of pseudomembranes in clostridium difficile-associated diarrhea in patients using immunosuppression agents.clostridium difficile is a major cause of diarrhea in hospitalized patients. although pseudomembranes are crucial evidence for diagnosis of c. difficile-associated diarrhea (cdad), some cases do not show any pseudomembranes. the aim of this study was to verify the hypothesis that pseudomembranes are not generated in immunosuppressed patients because of the absence of immunoreactions.200918781540
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