Publications
Title | Abstract | Year(sorted ascending) Filter | PMID Filter |
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clostridium difficile colitis. | 2009 | 19258589 | |
overutilization of proton pump inhibitors: a review of cost-effectiveness and risk [corrected]. | proton pump inhibitors (ppis) are superior to histamine-2 receptor antagonists for the treatment of gastroesophageal reflux disease (gerd) and erosive esophagitis. antisecretory therapy (ast), however, accounts for significant cost expenditure in the united states including over-the-counter and prescription formulations. moreover, emerging data illustrate the potential risks associated with long-term ppi therapy including variations in bioavailability of common medications, vitamin b12 deficienc ... | 2009 | 19262544 |
mecillinam: a low-risk antimicrobial agent for induction of clostridium difficile infection in an in vitro human gut model. | 2009 | 19211576 | |
clostridium difficile-associated enteric disease after percutaneous endoscopic gastrostomy. | percutaneous endoscopic gastrostomy (peg) has become established as a useful enteral nutrition technique. although various adverse events related to peg are known, few reports have described clostridium difficile-associated enteric disease (cded) after peg. we encountered several cases of cded with onset soon after peg. the present study examined these cases in detail and analyzed potential risk factors. | 2009 | 19214673 |
complete restriction of fluoroquinolone use to control an outbreak of clostridium difficile infection at a community hospital. | to review the effect of interventions, including a complete restriction in the use of fluoroquinolones (fqs), used to control an outbreak of hospital-onset clostridium difficile infection (ho-cdi) caused primarily by the epidemic north american pulsed-field gel electrophoresis type 1 strain. | 2009 | 19215193 |
risk factors related to a hospital-associated cluster of clostridium difficile pcr ribotype 027 infections in germany during 2007. | in 2007, clostridium difficile polymerase chain reaction (pcr) ribotype 027 emerged in germany. we conducted a hospital-based case-control study to identify specific risk factors for infection with this strain. logistic regression analysis involving 15 case patients and 31 control patients revealed that exposure to fluoroquinolones (matched odds ratio, 36.2; p < .01) or cephalosporins (matched odds ratio, 19.1; p < .01) was independently related to c. difficile pcr ribotype 027 infection. | 2009 | 19215194 |
antibiotic prophylaxis for cardiac surgery: a shift away from traditional cephalosporins? | 2009 | 19217314 | |
a rare cause of acute abdomen after proctocolectomy. | although proctocolectomy and ileal pouch surgery is a routine part of modern-day management for complicated ulcerative colitis, these patients are often debilitated and require close and attentive management in the early postoperative period. here we present a rare but clinically important postoperative complication. | 2009 | 19217607 |
[diarrhea from the infectologist's point of view]. | gastroenteritis is a nonspecific term for various pathologic states of the gastrointestinal tract. gastroenteritis causing pathogens are the second leading cause of morbidity and mortality worldwide. in the developed countries diarrhea is the most common reason for missing work, while in the developing world, it is a leading cause of death. internationally, the mortality rate is 5-10 million deaths each year. "traveller's diarrhea" is a polyetiologic common health problem of international travel ... | 2009 | 19218145 |
altered early infant gut microbiota in children developing allergy up to 5 years of age. | early colonization with bifidobacteria and lactobacilli is postulated to protect children from allergy, while clostridium (c.) difficile colonization might be associated with allergic disease. previous studies of infant gut microbiota in relation to subsequent allergy development have mostly employed culture-dependent techniques, studied genera of bacteria and the follow-up period was limited to 2 years. | 2009 | 19220322 |
withdrawn: in vitro activity of rifaximin and rifampin against clinical isolates of clostridium difficile in houston, texas. | 2009 | 19223017 | |
tolevamer is not efficacious in the neutralization of cytotoxin in a human gut model of clostridium difficile infection. | the efficacy of tolevamer, a nonantimicrobial styrene derivative toxin-binding agent, in treating simulated clostridium difficile infection in an in vitro human gut model was investigated. tolevamer reduced neither the duration nor magnitude of cytotoxin activity by c. difficile, reflecting poor efficacy observed in recent phase iii clinical trials. | 2009 | 19223641 |
long-term follow-up of patients with fulminant clostridium difficile colitis. | the purpose of this study was to determine the long-term survival rate, rate of gastrointestinal continuity restoration, and rate of recurrence following an attack of fulminant clostridium difficile colitis. | 2009 | 19224298 |
management of severe clostridium difficile-associated diarrhea. | 2009 | 19225882 | |
infectious complications in three double hand recipients: experience from a single center. | composite tissue allograft (cta) recipients require high level of immunosuppression and, therefore, are at significant risk to acquire opportunistic infections. | 2009 | 19328916 |
contamination of pet therapy dogs with mrsa and clostridium difficile. | 2009 | 19329224 | |
risk factors for mortality following emergency colectomy for fulminant clostridium difficile infection. | this study evaluated risk factors for mortality after emergency colectomy for fulminant clostridium difficile infection. | 2009 | 19333038 |
rapid detection of the clostridium difficile ribotype 027 tcdc gene frame shift mutation at position 117 by real-time pcr and melt curve analysis. | the emergence of the hypervirulent strain clostridium difficile pcr ribotype 027 has increased the necessity for rapid c. difficile typing tests for clinical and epidemiological purposes. we developed a rapid real-time polymerase chain reaction (pcr) test for the detection of c. difficile. as the target, we chose the tcdc gene, which encodes for a negative regulator in toxin production. a deletion at position 117 of the tcdc gene, which is associated with severe tcdc truncation, is well conserve ... | 2009 | 19333630 |
do nsaids, antibiotics, infections, or stress trigger flares in ibd? | non-steroidal anti-inflammatory drugs (nsaids), antibiotics, enteric or other systemic infections, and stress have all been reported to be potential triggers of inflammatory bowel disease (ibd). although a mechanism of triggering a flare of ibd can be hypothesized for each factor, the associations of these factors with flares of ibd remains confusing. in this review, we analyze the literature that explores these associations. there is some evidence to support an association between nsaid use and ... | 2009 | 19337242 |
thinking beyond the colon-small bowel involvement in clostridium difficile infection. | small intestinal clostridium difficile seems to be increasing in incidence. the spectrum of clostridium difficile infection (cdi) has definitely expanded with small bowel involvement. they are more frequently reported in patients with inflammatory bowel disease (ibd) who have undergone total colectomy or patients with ileal anal pouch anastomosis. the most common presentation is increased ileostomy output with associated dehydration. high clinical suspicion, early recognition and appropriate tre ... | 2009 | 19338685 |
clostridium difficile associated infection, diarrhea and colitis. | a new, hypervirulent strain of clostridium difficile, called nap1/bi/027, has been implicated in c. difficile outbreaks associated with increased morbidity and mortality since the early 2000s. the epidemic strain is resistant to fluoroquinolones in vitro, which was infrequent prior to 2001. the name of this strain reflects its characteristics, demonstrated by different typing methods: pulsed-field gel electrophoresis (nap1), restriction endonuclease analysis (bi) and polymerase chain reaction (0 ... | 2009 | 19340897 |
[interaction of clostridium difficile with bacterial associations of parietal biofilm in colon of mice]. | using electron microscopy, ultrastructural organization of microbial parietal biofilm in colon of immunodeficient mice line b10-hr(rhy) was studied before and after peroral inoculation with enteropathogenic strain of clostridium difficile. it was shown that infection leads to dispersion of normal biofilm in various sites and imbalance in natural proportions of different bacterial associations. also, clear ultrastructural signs of involution of gram-negative microorganisms were observed. in the r ... | 2009 | 19340962 |
activation of a c-jun-nh2-terminal kinase pathway by the lethal toxin from clostridium sordellii, tcsl-82, occurs independently of the toxin intrinsic enzymatic activity and facilitates small gtpase glucosylation. | in the present study, we show that lethal toxin from clostridium sordellii (tcsl-82) activates the three map kinase pathways, but that only a permeable and specific c-jun-nh2-terminal kinase (jnk) inhibitor, jnk inhibitor ii, prevents toxin-dependent actin depolymerization and cell rounding. we show that jnk activation is dependent on entry of the toxin n-terminal domain into the cytosol as bafilomycin a1, which prevents acidification of endocytic vesicle and subsequent cytosolic translocation o ... | 2009 | 19341436 |
health care-associated infections: is there an end in sight? | overview: health care-associated infections (hais) have emerged as a significant concern in policy as well as clinical circles. an hai is an infection acquired during treatment for another condition. some of the hai-causing bacteria have become drug-resistant; methicillin-resistant staphylococcus aureus, or mrsa, is a familiar example. tied to perhaps 100,000 deaths and $20 billion in health care costs each year, hais have given rise to state laws, legislative proposals at the federal level, pub ... | 2009 | 19343832 |
high profile outbreaks inform new guidance. | while the nhs appears to be making progress in reducing the number of outbreaks of the bacterium, the need for continuing prudence and sound practical measures in preventing and managing c. difficile infection cases is highlighted in new guidance compiled by the health protection agency for the department of health. drawing on healthcare commission (hcc) reports into outbreaks at several trusts and a joint healthcare commission/health protection authority (hpa) review, a new publication, "clostr ... | 2009 | 19343998 |
is the war being won?--an expert's view. | with new dh guidance on dealing effectively with clostridium difficile in healthcare settings recently published (see p40-43), health estate journal spoke to department of health inspector of microbiology and infection control professor brian duerden, asking him how much progress has been made in preventing outbreaks and containing spread, what lessons have been learned from some of the more high profile outbreaks, and what innovations, if any, are on the horizon to help eradicate the bacterium ... | 2009 | 19344002 |
clostridium difficile infection in a health care worker. | 2009 | 19344257 | |
laboratory diagnosis of clostridium difficile infection. an evaluation of tests for faecal toxin, glutamate dehydrogenase, lactoferrin and toxigenic culture in the diagnostic laboratory. | faecal samples from 1007 patients suspected of having diarrhoea caused by clostridium difficile infection are investigated for the presence of toxins a and b and for the presence of c. difficile-specific glutamate dehydrogenase (gdh). toxigenic culture is performed on all samples and is used as the 'gold standard' for the purpose of the study. a marker for intestinal inflammation, faecal lactoferrin, is used on any samples that give a positive result in any of the above tests. part of the study ... | 2009 | 19348118 |
the evolving epidemiology of inflammatory bowel disease. | epidemiologic studies in inflammatory bowel disease (ibd) include assessments of disease burden and evolving patterns of disease presentation. although it is hoped that sound epidemiologic studies provide aetiological clues, traditional risk factor-based epidemiology has provided limited insights into either crohn's disease or ulcerative colitis etiopathogenesis. in this update, we will summarize how the changing epidemiology of ibd associated with modernization can be reconciled with current co ... | 2009 | 19349861 |
advances in inflammatory bowel diseases. | the annual clinical and research conference of the crohn's and colitis foundation of america, advances in inflammatory bowel diseases, provided a comprehensive overview of the year's newest developments regarding inflammatory bowel diseases (ibd). the program was again successful. attracting a wide range of participants including leaders in the field from around the world, the program offered a unique opportunity to review and debate the most important clinical studies, current controversies in ... | 2009 | 19351281 |
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 ... | 2009 | 19351643 |
accounting for regression-to-the-mean in tests for recent changes in institutional performance: analysis and power. | recent changes in individual units are often of interest when monitoring and assessing the performance of healthcare providers. we consider three high profile examples: (a) annual teenage pregnancy rates in english local authorities, (b) quarterly rates of the hospital-acquired infection clostridium difficile in national health service (nhs) trusts and (c) annual mortality rates following heart surgery in new york state hospitals. increasingly, government targets call for continual improvements, ... | 2009 | 19358144 |
[comparison of susceptibility of spores of bacillus subtilis and czech strains of clostridium difficile to disinfectants]. | an important factor in the prevention of nosocomial outbreaks caused by clostridium difficile ribotype 027 is the disinfection of a patient environment by reliable sporicidal disinfectants. sporicidal activity of particular agents is tested on spores of bacillus subtilis. questions are brought up if the disinfectant which works on b. subtilis spores will be equally effective on the spores of c. difficile. therefore we have compared the effects of five disinfectants available on the czech market ... | 2009 | 19358452 |
lactobacillus and bifidobacteria combinations: a strategy to reduce hospital-acquired clostridium difficile diarrhea incidence and mortality. | incidence and virulence of clostridium difficile-associated disease (cdad) is increasing, particularly in institutional settings. morbidity, mortality, and costs associated with this condition are high. broad-spectrum antibiotics have long been recognized as the primary risk factor for cdad due to disruption of protective normal gastrointestinal flora. we suggest that administration of appropriate lactobacilli and bifidobacteria probiotics could be employed as a strategy to protect hospitalized ... | 2009 | 19359104 |
medical staff at a london district hospital are not chronic vectors of mrsa or clostridium difficile. | 2009 | 19362741 | |
molecular analysis of the gyra and gyrb quinolone resistance-determining regions of fluoroquinolone-resistant clostridium difficile mutants selected in vitro. | recent studies have suggested that exposure to fluoroquinolones represents a risk factor for the development of clostridium difficile infections and that the acquisition of resistance to the newer fluoroquinolones is the major reason facilitating wide dissemination. in particular, moxifloxacin (mx) and levofloxacin (le) have been recently associated with outbreaks caused by the c. difficile toxinotype iii/pcr ribotype 027/pulsed-field gel electrophoresis type nap1 strain. in this study, we evalu ... | 2009 | 19364867 |
diagnostic value of repeated enzyme immunoassays in clostridium difficile infection. | there has been a significant increase in the prevalence, severity, and mortality of clostridium difficile infection (cdi), with an estimated three million new cases per year in the united states. yet diagnosing cdi remains problematic. the most commonly used test is stool enzyme immunoassay (eia) detecting toxin a and/or b, but there are no clear guidelines specifying the optimal number of tests to be ordered in the diagnostic workup, although multiple tests are frequently ordered. thus, we desi ... | 2009 | 19367273 |
prevention of clostridium difficile infection with saccharomyces boulardii: a systematic review. | clostridium difficile is a major cause of antibiotic-associated diarrhea within the hospital setting. the yeast saccharomyces boulardii has been found to have some effect in reducing the risk of c difficile infection (cdi); however, its role in preventive therapy has yet to be firmly established. | 2009 | 20011734 |
changes in laboratory and clinical workload for clostridium difficile infection from 2003-2007. | abstract clostridium difficile infection (cdi) is a growing concern with increases in incidence and associated financial burden. retrospective analysis of patients admitted to hospitals in edinburgh from 2003-2007 and tested for c. difficile toxins was performed. a total of 45412 faecal samples were tested and 6286 (13.8%) were positive. overall cdi was identified in 1.7 cases/1000 in-patient occupied bed days (obd). the incidence of cdi fell from 1.98 cases/1000 obd in 2006 to 1.48 cases/1000 o ... | 2009 | 20041900 |
assessment of the potential risk of infection associated with clostridium difficile from porcine xenografts. | there are numerous concerns over the potential for transfer of pathogens between species during clinical xenotransplantation, and although current clinical application is limited, porcine xenografts have been previously used to treat patients with severe burns. donor animals providing the xenografts are sourced from a healthy commercial herd, however, as pigs are a known source of zoonotic agents, a number of diseases are required to be excluded from pigs used for xenotransplantation purposes. m ... | 2009 | 20042046 |
c. difficile outside hospital. | 2009 | 20009039 | |
[clostridium difficile associated diarrhea (cdad)--hard to crack]. | clostridium difficile-associated diarrhea (cdad) is the most common documented cause of nosocomial diarrhea in developed countries. in recent years morbidity and mortality associated with this pathogen have increased significantly, simultaneously with the appearance of a new strain--nap1/bi/027--which was implicated in epidemics of severe disease in hospitals around the world. despite the accumulated experience in identification and treatment of patients, physicians continue to face complicated ... | 2009 | 20027984 |
[clostridium difficile-associated diarrhea due to antimicrobial for perioperative antibacterial prophylaxis-clinical observation in 8 patients]. | 2009 | 20034326 | |
enteric pathogens in hiv/aids from a tertiary care hospital. | patterns of enteric infections in hiv in developing countries may differ in several important ways from developed countries, the knowledge of which can often guide therapy when resource limitations hamper the exact diagnosis of the etiological agent in hiv-associated diarrhea. | 2009 | 20049303 |
18-f fluorodeoxyglucose positron emission tomography indicating unsuspected infections in two patients with dermatomyositis. | dermatomyositis is an idiopathic inflammatory myopathy that may be associated with malignancies. the technique of 18-f fluorodeoxyglucose (fdg)-positron emission tomography (pet) is an important tool to investigate underlying malignancy in patients with a possible paraneoplastic syndrome. we report two consecutive patients with dermatomyositis in whom 18-f fdg-pet revealed unsuspected infections. physicians should be aware that a positive 18-f fdg-pet is not specific for malignancy and may revea ... | 2009 | 20055842 |
therapy- and non-therapy-dependent infectious complications in inflammatory bowel disease. | patients with inflammatory bowel disease (ibd) are susceptible to infections. | 2009 | 19897974 |
application of a novel decontamination process using gaseous ozone. | environmental disinfection in a health care setting is an important aspect of infection control. recently, there has been interest in the use of vapor- and gas-based treatments for decontamination of surfaces and rooms. we describe preliminary results for an ozone-based decontamination of surfaces seeded with a range of vegetative cells and spores of bacteria of clinical relevance. the efficacy of the approach for room sanitization was also assessed. the protocol included use of a quenching agen ... | 2009 | 19898532 |
antimicrobial prophylaxis in colorectal surgery: focus on ertapenem. | despite improvement in infection control measures and surgical practice, surgical site infections (ssis) remain a major cause of morbidity and mortality. in colorectal surgery, perioperative administration of a suitable antimicrobial regimen that covers both anaerobic and aerobic bacteria is universally accepted. in a prospective, double-blind, randomized study ertapenem was recently found to be more effective than cefotetan, a parenteral cephalosporin so broadly used as to be considered as gold ... | 2009 | 19898647 |
historical and changing epidemiology of healthcare-associated infections. | this review compares the historical perspectives on healthcare-associated infections (hcais) with the current changing epidemiological picture as it relates to these infections. evidence in support of these changes is given using trends in mortality for clostridium difficile and meticillin-resistant staphylococcus aureus bacteraemia in england as examples. the impact of current intervention programmes which target these, and other hcais, is also considered and knowledge gaps and options for chan ... | 2009 | 19925942 |
[infections with clostridium difficile following antibiotic therapy]. | 2009 | 19927920 | |
still difficult; clinical practice guidelines for clostridium difficile infection. | 2009 | 19929971 | |
european society of clinical microbiology and infectious diseases (escmid): data review and recommendations for diagnosing clostridium difficile-infection (cdi). | the aim of the present systematic review was to evaluate the available evidence on laboratory diagnosis of cdi and to formulate recommendations to optimize cdi testing. in comparison with cell culture cytotoxicity assay (cca) and toxigenic culture (tc) of stools, we analyzed the test characteristics of 13 commercial available enzyme immunoasssays (eia) detecting toxins a and/or b, 4 eias detecting clostridium difficile glutamate dehydrogenase (gdh), and a real-time pcr for c. difficile toxin b g ... | 2009 | 19929972 |
european society of clinical microbiology and infectious diseases (escmid): treatment guidance document for clostridium difficile infection (cdi). | clostridium difficile infection (cdi) is a potentially fatal illness with an increasing incidence worldwide. despite extensive ongoing research into cdi treatment, management of cdi still poses important problems, such as a high propensity to relapse and refractoriness to treatment, especially when there is an ileus and oral drugs cannot be administered. this guideline evaluates the available literature, discusses criteria for disease severity and provides recommendations for cdi treatment, indi ... | 2009 | 19929973 |
correlation of multidrug resistance, toxinotypes and pcr ribotypes in clostridium difficile isolates from kuwait. | clostridium difficile is a common cause of nosocomial diarrhea. its role in community-acquired diarrhea is also becoming an important public health concern. hardly any studies have correlated strain ribotypes, toxinotypes and multidrug resistant (mdr) profiles. to investigate these characteristics, 65 c. difficile isolates obtained from stool samples of patients whose cultures were negative on admission but became positive after 48 h of admission to the icus of our hospitals were studied to dete ... | 2009 | 19933043 |
antimicrobial resistance in clostridium difficile. | clostridium difficile is the leading cause of hospital-acquired diarrhoea and the number of outbreaks has risen markedly since 2003. the emergence and spread of resistance in c. difficile is complicating treatment and prevention. most isolates are still susceptible to vancomycin and metronidazole (mtz), however transient and heteroresistance to mtz have been reported. the prevalence of resistance to other antimicrobial agents is highly variable in different populations and in different countries ... | 2009 | 19828299 |
[a case of pseudomenbranous colitis after paclitaxel and carboplatin chemotherapy]. | antibiotics-associated pseudomembranous colitis is well documented and caused by abnormal overgrowth of toxin producing clostridium difficile colonizing the large bowel of patients undergoing antibiotic therapy. administration of chemotherapeutic agents is frequently complicated by diarrhea and enterocolitis. however, pseudomembranous colitis related to chemotherapeutic agent usage is very rare. we experienced a 67 old-years male patient diagnosed of non-small cell lung carcinoma who complained ... | 2009 | 19934614 |
clostridium difficile ribotypes 001, 017, and 027 are associated with lethal c. difficile infection in hesse, germany. | from january 2008 to april 2009, 72 cases of severe clostridium difficile infection were reported from 18 different districts in the state of hesse, germany. a total of 41 c. difficile isolates from 41 patients were subjected to pcr ribotyping. pcr ribotype (rt) 027 was the most prevalent strain accounting for 24 of 41 (59%) of typed isolates, followed by rt 001 (eight isolates, 20%), rt 017 and 042 (two isolates each), and rt 003, 066, 078, 081, and rki-034 (one isolate each). eighteen patients ... | 2009 | 19941785 |
decrease of hypervirulent clostridium difficile pcr ribotype 027 in the netherlands. | after the first outbreaks of clostridium difficile pcr ribotype 027 (north american pulsed-field type 1, restriction endonuclease analysis group bi) in the netherlands in 2005, a national surveillance programme for c. difficile infection (cdi) was started. furthermore, national guidelines were developed to rapidly recognise type 027 infections and prevent further spread. the mean incidence of cdi measured in 14 hospitals remained stable throughout the years: an incidence of 18 per 10,000 admissi ... | 2009 | 19941791 |
introduction to the special issue on clostridium difficile. | 2009 | 19944988 | |
infection control practices in assisted living communities. | few states require assisted living communities (alcs) to have an infection control plan (icp), nor do they provide guidelines about infection control practices in alcs or require communicable disease reporting to appropriate health agencies or even within the community itself. most communities do not have an icp that addresses prevention, detection, investigation, control, monitoring, or communication of an infectious outbreak. this article discusses the presentation and management of pneumonia, ... | 2009 | 19963152 |
post-operative antibiotic use in nonperforated appendicitis. | the appropriate use of preoperative antibiotics in patients undergoing appendectomy for acute appendicitis has been shown to decrease the rate of surgical site infections (ssis). the benefits of postoperative courses of antibiotics in these patients, however, remain unclear. | 2009 | 19969124 |
clostridium difficile enteritis after colectomy. | clostridium difficile infection of the colon is, unfortunately, a relatively common occurrence that typically follows treatment with antibiotics; however, c. difficile infection of the small bowel is a much more rare phenomenon with only 19 cases reported to date. we present three cases of isolated c. difficile enteritis after colectomy. although all three patients were identified early and successfully treated with medical management without the need for surgical intervention, previous authors ... | 2009 | 19999913 |
prescribing cascade in an 80-year-old japanese immigrant. | 2009 | 20002762 | |
infectious agents detected in the feces of diarrheic foals: a retrospective study of 233 cases (2003-2008). | diarrhea is common in foals but there are no studies investigating the relative prevalence of common infectious agents in a population of hospitalized diarrheic foals. | 2009 | 19747192 |
motility and flagellar glycosylation in clostridium difficile. | in this study, intact flagellin proteins were purified from strains of clostridium difficile and analyzed using quadrupole time of flight and linear ion trap mass spectrometers. top-down studies showed the flagellin proteins to have a mass greater than that predicted from the corresponding gene sequence. these top-down studies revealed marker ions characteristic of glycan modifications. additionally, diversity in the observed masses of glycan modifications was seen between strains. electron tran ... | 2009 | 19749038 |
proposed checklist of hospital interventions to decrease the incidence of healthcare-associated clostridium difficile infection. | the incidence and severity of clostridium difficile infection (cdi) are increasing, and previously described interventions for controlling the spread of cdi are not easily generalized to multiple healthcare institutions. | 2009 | 19751156 |
distinctive profiles of infection and pathology in hamsters infected with clostridium difficile strains 630 and b1. | currently, the golden syrian hamster is widely considered an important model of clostridium difficile disease, as oral infection of this animal pretreated with antibiotics reproduces many of the symptoms observed in humans. two c. difficile strains, b1 and 630, showed significant differences in the progression and severity of disease in this model. b1-infected hamsters exhibited more severe pathology and a shorter time to death than hamsters infected with 630. histological changes in the gut did ... | 2009 | 19752031 |
clostridium difficile infection in the elderly. | the aging society and the advanced of supportive treatment means that large numbers of elderly patients with risk factors for c difficile enterocolitis will continue to receive care in intensive care unit. antibiotic resistance and older, sicker patients means that combination antibiotic therapy will become a trend in clinical setting. age, several co-morbidities, and gastrointestinal surgery appear to be specific risk factors for c difficile infection. diarrhea which is the only symptom in hosp ... | 2009 | 19752488 |
clostridium difficile infection: a re-emerging threat. | clostridium difficile infection is an important health care-associated infection. the incidence and severity of c. difficile infection are increasing. recent c. difficile infection outbreaks with high proportions of severe outcomes have been linked to an emerging, hypervirulent strain of c. difficile. recently recognized risk factors of c. difficile infection include fluoroquinolone exposure and gastric acid suppression. effective prevention measures for c. difficile infection include contact pr ... | 2009 | 19753922 |
typing and susceptibility of bacterial isolates from the fidaxomicin (opt-80) phase ii study for c. difficile infection. | clostridium difficile infection (cdi) has been increasing in incidence and severity in recent years, coincident with the spread of a "hypervirulent" strain, rea type bi (ribotype 027, pfge nap 1). exacerbating the problem has been the observation that metronidazole may be showing decreased effectiveness, particularly in the more severe cases. fidaxomicin is an 18-membered macrocycle currently in phase 3 trials for the treatment of c. difficile infection (cdi). an open-label, phase ii study in cd ... | 2009 | 19755166 |
clostridium difficile infection: historic review. | 2009 | 19755167 | |
epidemiology of opportunistic infections and its correlation with cd4 t-lymphocyte counts and plasma viral load among hiv-positive patients at a tertiary care hospital in india. | the study was conducted to find the correlation of cd4 counts and plasma viral load (pvl) with opportunistic infections (ois) in hiv-positive patients. a total of 43 drug-naive patients enrolled in the study. absolute cd4 counts and pvl were measured. on the basis of symptoms, sputum, stool, and blood samples were obtained for laboratory tests. oral swabs were obtained from all the patients. pneumocystis jiroveci pneumonia was found in 45.2% patients (odds ratio [or] = 12.8 for cd4 counts <or=10 ... | 2009 | 19755619 |
responsibility for managing healthcare-associated infections: where does the buck stop? | the prevention and control of healthcare-associated infections (hcais) requires a tripartite partnership between clinicians and carers, managers and government/department of health (doh) across the whole health and social care community. mandatory surveillance of meticillin-resistant staphylococcus aureus bacteraemia and clostridium difficile infection has shown a significant fall from peak numbers in 2003/04 and 2006, respectively, and there is now a zero tolerance approach to preventable infec ... | 2009 | 19765862 |
infections caused by gram-positive bacteria: a review of the global challenge. | infections caused by multidrug-resistant gram-positive bacteria represent a major public health burden, not just in terms of morbidity and mortality, but also in terms of increased expenditure on patient management and implementation of infection control measures. staphylococcus aureus and enterococcus spp. are established pathogens in the hospital environment, and their frequent multidrug resistance complicates therapy. the archetypal hospital "superbug", methicillin-resistant s. aureus (mrsa), ... | 2009 | 19766888 |
nmr-based metabonomics analysis of mouse urine and fecal extracts following oral treatment with the broad-spectrum antibiotic enrofloxacin (baytril). | the human gastrointestinal tract is home to hundreds of species of bacteria and the balance between beneficial and pathogenic bacteria plays a critical role in human health and disease. the human infant, however, is born with a sterile gut and the complex gastrointestinal host/bacterial ecosystem is only established after birth by rapid bacterial colonization. composition of newborn gut flora depends on several factors including type of birth (ceasarian or natural), manner of early feeding (brea ... | 2009 | 19768747 |
infections in patients with multiple myeloma in the era of high-dose therapy and novel agents. | the introduction of stem cell transplantation and the novel anti-myeloma agents, bortezomib, thalidomide, and lenalidomide, have improved the outcome of patients with multiple myeloma. these advances have transformed myeloma into a chronic condition, with multiple relapses and salvage therapies, all of which result in cumulative immunosuppression and higher risk of infection. in addition to the immunodeficiency related to myeloma and its complications, the type of anti-myeloma therapy used also ... | 2009 | 19769539 |
preventing healthcare-associated infection: risks, healthcare systems and behaviour. | more than 177 000 potentially preventable healthcare-associated infections (hais) occur per annum in australia with sizable attributable mortality. organizational systems to protect against hai in hospitals in australia are relatively poorly developed. awareness and practice of infection control by medical and other healthcare staff are often poor. these lapses in practice create significant risk for patients and staff from hai. excessive patient exposure to antimicrobials is another key factor ... | 2009 | 19769680 |
public reports of infection rates urged. | 2009 | 19770253 | |
relationship between antibiotic consumption and clostridium difficile-associated diarrhea: an epidemiological note. | 2009 | 19770290 | |
comparison of vidas cdab and cda immunoassay for the detection of clostridium difficile in a tcda- tcdb+ c. difficile prevalent area. | enzyme immunoassays for tcda and/or tcdb are widely used for diagnosis of c. difficile infection. this study compared the performance of the new vidas c. difficile toxin a & b assay (cdab) with that of the existing vidas c. difficile toxin a ii assay (cda) in a tcda(-)tcdb(+) prevalent area. a total of 555 fecal samples were cultured and tested using cdab and cda. c. difficile was isolated in 150 samples and the concordance rate was 81.8% (454/555) between cdab and cda. pcr assays for tcda and/o ... | 2009 | 19772927 |
infection control and iv therapy in patients with clostridium difficile. | clostridium difficile is a spore-forming anaerobe belonging to the family clostridium, with the bacteria being found in low numbers in approximately 5% of the healthy adult population. together with meticillin-resistant staphylococcus aureus, it is a major healthcare-associated infection and is responsible for considerable morbidity and mortality. antibiotics administered to patients can alter normal gut flora, allowing the proliferation of c. difficile and causing antibiotic-associated diarrhoe ... | 2009 | 19773686 |
deaths involving clostridium difficile: england and wales, 2008. | 2009 | 19774833 | |
fulminant clostridium difficile colitis isolated to the ascending colon by a diverting transverse loop colostomy. | 2009 | 19774963 | |
bacteriophage-mediated toxin gene regulation in clostridium difficile. | clostridium difficile has been identified as the most important single identifiable cause of nosocomial antibiotic-associated diarrhea and colitis. virulent strains of c. difficile produce two large protein toxins, toxin a and toxin b, which are involved in pathogenesis. in this study, we examined the effect of lysogeny by phicd119 on c. difficile toxin production. transcriptional analysis demonstrated a decrease in the expression of pathogenicity locus (paloc) genes tcda, tcdb, tcdr, tcde, and ... | 2009 | 19776116 |
fecal bacteriotherapy for recurrent clostridium difficile infection. | clostridium difficile infection (cdi) has emerged as a major complication associated with the use of systemic antimicrobial agents. broad-spectrum antimicrobial agents disrupt the ecological bacterial balance in the colon and create an opportunity for c. difficile overgrowth with attendant production of toxins and clinical symptoms of colitis. recommended therapies for cdi include oral administration of metronidazole or vancomycin for 10-14 days. however, 5% to 35% of patients experience infecti ... | 2009 | 19778623 |
varied prevalence of clostridium difficile in an integrated swine operation. | the objectives of this study were to compare the prevalence of clostridium difficile (cd) among different age and production groups of swine in a vertically integrated swine operation in texas in 2006 and to compare our isolates to other animal and human isolates. results are based on 131 cd isolates from 1008 swine fecal samples and pork trim samples (overall prevalence of 13%). the prevalence (number positive/number tested in production type) of cd was different between the groups (p<or=0.001) ... | 2009 | 19778624 |
the use of new and better antibiotics for bacterial infections in patients with leukemia. | bacterial infection is the most common complication of chemotherapy-induced neutropenia particularly in patients with hematologic malignancies. bacterial infections predominate during the initial phases of neutropenic episodes. the spectrum of bacterial infection continues to evolve globally and locally at the institutional level, as do patterns of antimicrobial susceptibility/resistance. these trends are often associated with local treatment practices (eg, use of antimicrobial prophylaxis, open ... | 2009 | 19778864 |
molecular epidemiology of clostridium difficile over the course of 10 years in a tertiary care hospital. | the molecular epidemiology of endemic and outbreak clostridium difficile strains across time is not well known. | 2009 | 19780659 |
the a, b, bi, and cs of clostridium difficile. | 2009 | 19780660 | |
comparative genome and phenotypic analysis of clostridium difficile 027 strains provides insight into the evolution of a hypervirulent bacterium. | the continued rise of clostridium difficile infections worldwide has been accompanied by the rapid emergence of a highly virulent clone designated pcr-ribotype 027. to understand more about the evolution of this virulent clone, we made a three-way genomic and phenotypic comparison of an 'historic' non-epidemic 027 c. difficile (cd196), a recent epidemic and hypervirulent 027 (r20291) and a previously sequenced pcr-ribotype 012 strain (630). | 2009 | 19781061 |
characterization of the sporulation initiation pathway of clostridium difficile and its role in toxin production. | clostridium difficile is responsible for significant mortality and morbidity in the hospitalized elderly. c. difficile spores are infectious and are a major factor contributing to nosocomial transmission. the spo0a response regulator is the master regulator for sporulation initiation and can influence many other cellular processes. using the clostron gene knockout system, we inactivated genes encoding spo0a and a putative sporulation-associated sensor histidine kinase in c. difficile. inactivati ... | 2009 | 19783633 |
treatment of irritable bowel syndrome with probiotics. an etiopathogenic approach at last? | irritable bowel syndrome (ibs) is the most common functional digestive disorder, and may affect 11-20% of the adult population in industrialized countries. in accordance with rome iii criteria (2006) ibs involves abdominal pain and bowel habit disturbance, which are not explained by structural or biochemical abnormalities. several hypotheses attempt to account for the pathophysiology of ibs, but the etiology still remains uncertain or obscure, perhaps multifactorial. abnormalities in colonic mic ... | 2009 | 19785495 |
tales from the c. difficile trenches. | 2009 | 19786472 | |
a systems ergonomics analysis of the maidstone and tunbridge wells infection outbreaks. | this paper describes a systems ergonomics analysis of the recent outbreaks of clostridium difficile, which occurred over the period 2005-07 within the uk maidstone and tunbridge wells nhs trust. the analysis used documents related to the outbreak, alongside the construction of a system model in order to probe deeper into the nature of contributory factors within the trust. the findings from the analysis demonstrate the value of looking further at cross-level and whole-system aspects of infection ... | 2009 | 19787500 |
pka and epac cooperate to augment bradykinin-induced interleukin-8 release from human airway smooth muscle cells. | airway smooth muscle contributes to the pathogenesis of pulmonary diseases by secreting inflammatory mediators such as interleukin-8 (il-8). il-8 production is in part regulated via activation of gq-and gs-coupled receptors. here we study the role of the cyclic amp (camp) effectors protein kinase a (pka) and exchange proteins directly activated by camp (epac1 and epac2) in the bradykinin-induced il-8 release from a human airway smooth muscle cell line and the underlying molecular mechanisms of t ... | 2009 | 19788733 |
comparison of a rapid molecular method, the bd geneohm cdiff assay, to the most frequently used laboratory tests for detection of toxin-producing clostridium difficile in diarrheal feces. | six hundred diarrheal stool specimens were collected from inpatients and outpatients at local university hospitals for the detection of toxigenic clostridium difficile using three parallel methods, the bd geneohm cdiff assay, the tissue culture cytotoxicity assay, and a commercially available enzyme-linked fluorescence immunoassay (elfa) (vidas c. difficile toxin a and b assay; biomérieux). toxigenic c. difficile culture was also performed to further clarify discordant results. during a 3-month ... | 2009 | 19794052 |
antiapoptotic proteins bcl-2 and bcl-xl inhibit clostridium difficile toxin a-induced cell death in human epithelial cells. | it has been well established that clostridium difficile toxin a (tcda) induces cell death in human epithelial cells. however, the mechanism of tcda-induced cell death remains to be fully characterized. here, we show that tcda induces dose-dependent cell death in ovarian carcinoma and colonic carcinoma cell lines. tcda-mediated cell death, as well as caspase 8 and caspase 3 activation, were specifically abrogated by anti-toxin antibodies. although caspase 8 and caspase 3 were activated by tcda in ... | 2009 | 19797069 |
growth-inhibiting activities of phenethyl isothiocyanate and its derivatives against intestinal bacteria. | the growth-inhibiting activities of sinapis alba l. seed-derived materials were examined on the growth of bifidobacterium bifidum, b. breve, b. longum, clostridium difficile, c. perfringens, escherichia coli, lactobacillus acidophilus, and l. casei. the active component of s. alba seeds was purified using silica gel column chromatography and hplc and was identified as phenethyl isothiocyanate by various spectroscopic analyses. the antimicrobial activity of phenethyl isothiocyanate varied accordi ... | 2009 | 19799675 |
use of longitudinal surveillance data to assess the effectiveness of infection control in critical care. | a simple method for quantifying nosocomial infection and colonization with multidrug-resistant organisms is described. this method is applied to the intensive care unit of an academic medical center where longitudinal surveillance data have been used to assess the impact of infection control interventions and antibiotic use. | 2009 | 19803721 |
use of international classification of diseases, ninth revision, clinical modification codes and medication use data to identify nosocomial clostridium difficile infection. | the international classification of diseases, ninth revision, clinical modification (icd-9-cm) code for clostridium difficile infection (cdi) is used for surveillance of cdi. however, the icd-9-cm code alone cannot separate nosocomial cases from cases acquired outside the institution. the purpose of this study was to determine whether combining the icd-9-cm code with medication treatment data for cdi in hospitalized patients could enable us to distinguish between patients with nosocomial cdi and ... | 2009 | 19803724 |