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regulatory oversight and safety of probiotic use.depending on intended use of a probiotic (drug vs. dietary supplement), regulatory requirements differ greatly. for dietary supplements, premarketing demonstration of safety and efficacy and approval by the food and drug administration are not required; only premarket notification is required. saccharomyces boulardii is a probiotic regulated as a dietary supplement intended for use by the general healthy population, not as a drug to prevent, treat, or mitigate disease. however, since recent incr ...201021029521
clostridium difficile-associated disease among patients in dhahran, saudi arabia.clostridium difficile-associated diarrhea (cdad) is an important healthcare-associated infection. however, there are no data from saudi arabia on this disease. a two-year prospective, observational study on the incidence of cdad in a hospital in saudi arabia was carried out. stool analysis for c. difficile toxins a and b was carried out by an enzyme-linked immunosorbent assay. medical and laboratory records were reviewed. of the total number of patients, there were 53.3% male and the mean age wa ...201021030314
evaluation of sporicidal activities of selected environmental surface disinfectants: carrier tests with the spores of clostridium difficile and its surrogates.the emergence of clostridium difficile as a major nosocomial pathogen points to the need for safe, effective, and fast-acting environmental sporicides for infection prevention and control. available and fast-acting sporicides are generally corrosive and unsafe for both humans and the environment.201021034981
real-time pcr and typing of clostridium difficile isolates colonizing mare-foal pairs.clostridium difficile infection can occur in the dams of sick foals, but it is unknown if mares and foals share the same isolates. in this study, c. difficile isolates from fecal samples of 11 mares paired with 11 foals were genotyped by arbitrarily primed pcr; two mares and three foals in five mare-foal pairs had diarrhea. fecal immunoassays were utilized to detect c. difficile common antigen and toxin a. quantitative real-time pcr (qpcr) systems were developed to detect genes for toxins a and ...201021035363
prevalence of clostridium difficile in retail pork.clostridium difficile was isolated from 1.8% (7/393) of retail pork samples obtained from 4 canadian provinces. five ribotypes and 3 toxinotypes were identified. three isolates were indistinguishable from the international outbreak strain ribotype 027 and were toxinotype iii. although the implications for food safety practices remain elusive, the frequency of toxigenic isolates and isolates indistinguishable from known human pathogenic strains suggests contaminated pork may be a source of c. dif ...201021037888
a homology model for clostridium difficile methionyl trna synthetase: active site analysis and docking interactions.treatment of c. difficile infection is one of the most difficult biomedical challenges. to develop novel antibacterials, researchers have been targeting bacterial molecular functions that are essential for its growth. the methionyl trna synthetase (metrs) is strictly required for protein biosynthesis and success was reported in developing antibacterials to inhibit this enzyme. the present study was aimed at building and analyzing a homology model for c. difficile metrs in the context of drug des ...201021042822
autoproteolytic cleavage mediates cytotoxicity of clostridium difficile toxin a.toxin a and toxin b from clostridium difficile are the causative agents of the antibiotic-associated pseudomembranous colitis. they are of an a/b structure type and possess inositol hexakisphosphate-inducible autoproteolytic activity to release their glucosyltransferase domain to the cytoplasm of target cells. in this study, we investigated the effect of extracellular and intracellular autoproteolytic cleavage on the function of tcda. extracellular cleavage led to functional inactivation albeit ...201021046073
interscience conference on antimicrobial agents and chemotherapy - 50th annual meeting - research on promising new agents: part 1.the 50th annual interscience conference on antimicrobial agents and chemotherapy (icaac), held in boston, included topics covering new therapeutic developments in the field of infectious disease. this conference report highlights selected presentations on research with novel antimicrobial agents. investigational drugs discussed include the dicationic porphyrin derivative xf-73 (destiny pharma), the tetracycline analog tp-434 (tetraphase pharmaceuticals), an elongation factor tu inhibitor (novart ...201021046515
[environmental contamination by clostridium difficile]. 201021046723
comparative metagenomic study of alterations to the intestinal microbiota and risk of nosocomial clostridum difficile-associated disease.this study investigated the relationship between hospital exposures, intestinal microbiota, and subsequent risk of clostridium difficile-associated disease (cdad), with use of a nested case-control design. the study included 599 patients, hospitalized from september 2006 through may 2007 in montreal, quebec, from whom fecal samples were obtained within 72 h after admission; 25 developed cdad, and 50 matched controls were selected for analysis. nonsteroidal anti-inflammatory drugs and antibiotic ...201021050115
clostridium difficile infections in patients with severe burns.with improved survival in burn patients, clostridium difficile infection (cdi) remains a significant potential complication. the incidence of, risk factors for, and outcomes of cdi in severely burned patients are poorly studied and remain unclear. this study involves retrospective case control and cohort studies using electronic medical records from february 1, 2002 to january 31, 2009 at the us department of defense's only burn unit. demographic, risk factor, and outcome data were collected for ...201021050662
inhibition of rho-kinase abrogates migration of human transitional cell carcinoma cells: results of an in vitro study.migration of cells involves a complex signaling network. the aim of the present study was to elucidate the impact of rho-kinase (rok) on g protein-coupled receptor-induced migration of human transitional cell carcinoma cells in an in vitro experimental setting.201021051874
'thumbprinting'. 201020862786
peptide inhibitors targeting clostridium difficile toxins a and b.clostridium difficile causes severe hospital-acquired antibiotic-associated diarrhea due to the activity of two large protein toxins. current treatments suffer from a high relapse rate and are generating resistant strains; thus new methods of dealing with these infections that target the virulence factors directly are of interest. phage display was used to identify peptides that bind to the catalytic domain of c. difficile toxin a. library screening and subsequent quantitative binding and inhibi ...201020863124
clostridium difficile spore germination: an update.endospore production is vital for the spread of clostridium difficile infection. however, in order to cause disease, these spores must germinate and return to vegetative cell growth. knowledge of germination is therefore important, with potential practical implications for routine cleaning, outbreak management and potentially in the design of new therapeutics. germination has been well studied in bacillus, but until recently there had been few studies reported in c. difficile. the role of bile s ...201020863888
update: detection of a verona integron-encoded metallo-beta-lactamase in klebsiella pneumoniae --- united states, 2010.in july 2010, cdc was notified of a patient with a carbapenem-resistant klebsiella pneumoniae strain that produced a verona integron-encoded metallo-beta-lactamase (vim) carbapenemase not reported previously among enterobacteriaceae in the united states. the patient was a woman from the united states who became ill with diarrhea during a mediterranean cruise and was hospitalized in greece, where she received a diagnosis of sepsis and clostridium difficile infection. after 12 days in two hospital ...201020864922
proteomic analysis of the insoluble subproteome of clostridium difficile strain 630.clostridium difficile, a gram-positive spore-forming anaerobe, causes infections in humans ranging from mild diarrhoeal to potentially life-threatening pseudomembranous colitis. the availability of genomic information for a range of c. difficile strains affords researchers the opportunity to better understand not only the evolution of these organisms but also their basic physiology and biochemistry. we used proteomics to characterize the insoluble subproteome of c. difficile strain 630. gel-base ...201020868380
preventing catheter-associated urinary tract infections: an executive summary of the association for professionals in infection control and epidemiology, inc, elimination guide.the association for professionals in infection control and epidemiology (apic) began publishing their series of elimination guides in 2007. since then, 9 elimination guides have been developed that cover a range of important infection prevention issues, including the prevention of catheter-related bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections (cautis), as well as mediastinitis surgical site surveillance. multidrug-resistant organisms, i ...201020868930
epidemiology of community-onset clostridium difficile infection in a community in the south of england.clostridium difficile infection (cdi) has traditionally been considered a hospital acquired infection but there are a rising number of infections in the community. this study estimates the prevalence of community-onset cdi (co-cdi), defined as onset of symptoms in a community setting and outside the hospital, and examines the risk factors for co-cdi in 2-64 year-olds.201020869672
quantifying interhospital patient sharing as a mechanism for infectious disease spread.assessments of infectious disease spread in hospitals seldom account for interfacility patient sharing. this is particularly important for pathogens with prolonged incubation periods or carrier states.201020874503
incidence, case fatality and genotypes causing clostridium difficile infections, finland, 2008*clin microbiol infect abstract: since 2000, the epidemiology of c. difficile infections (cdi) has changed in the us and europe. few population-based assessments of both incidence and case fatality of cdi have been performed. in this study, the finnish nationwide laboratory-based surveillance data from the year 2008 were analysed to assess the incidence and case fatality of cdi, and to detect regional differences in relation to molecular epidemiology. a total of 6201 episodes of cdi were identifi ...201020874814
clostridium difficile infections among hospitalized children, united states, 1997-2006. 201020875309
clostridium difficile knowledge in healthcare workers: conclusions in the absence of broader evaluation. 201020883611
an outbreak case of clostridium difficile-associated diarrhea among elderly inpatients of an intensive care unit of a tertiary hospital in rio de janeiro, brazil.the aim of this study was to investigate clostridium difficile-associated diarrhea (cdad) in an intensive care unit (icu) of a tertiary hospital in rio de janeiro, brazil, and to characterize epidemiologically c. difficile strains obtained from an outbreak of cdad. within almost a 4-year surveillance period, cdad incidence was determined for the first time in brazil, and a 3-fold increase was observed in the average rate of cdad, featuring an outbreak. about 80% of the patients were over 65 year ...201020884155
fulminant clostridium difficile toxic megacolon in a pediatric heart transplant recipient.patel a, gossett jj, benton t, rowell e, russell h, cham e, pahl e. fulminant clostridium difficile toxic megacolon in a pediatric heart transplant recipient.
pediatr transplantation 2010: 00: 000-000. © 2010 john wiley & sons a/s. abstract:  cd can be a cause of diarrhea in pediatric heart transplant recipients. fulminant colitis can develop in immunocompromised patients with cd and progress to toxic megacolon. we report a case of a 10-yr-old girl who developed cd diarrhea and subsequently fulm ...201020887401
analysis of prevalence, risk factors and molecular epidemiology of clostridium difficile infection in kuwait over a 3-year period.we conducted a prospective study to evaluate the prevalence and epidemiology of cdi in kuwait government hospitals over a 3-year period, january 2003 to december 2005, to determine the ribotypes responsible for cdi and to estimate the prevalence of ribotype 027. we also conducted a case-control study to identify the risk factors in our patient population. a total of 697 stool samples from patients with suspected cdi were obtained and sent to anaerobe reference laboratory, faculty of medicine, ku ...201020887795
[the microbiota and infectious diarrhea].understanding the importance of the fecal microbiota has been key in understanding the pathophysiology of some infectious diarrheas. in addition to normal protective measures of bile, gastric acid, and immune response, among others, we now know that the healthy gut flora protects us from some infectious diarrheas. antibiotic associated diarrhea (aad) is an excellent example, as antibiotics perturb the normal flora; the resulting diarrhea may be due to changes in short chain fatty acid metabolism ...201020889002
[recent advances in saccharomyces boulardii research].this review summarizes the probiotic mechanisms of action of saccharomyces boulardii (s. boulardii) against inflammatory and non-inflammatory diarrheal conditions. s. boulardii is distributed in lyophilized form in many countries and used for the prevention of diarrhea in children and adults, including clostridium difficile (c. difficile) associated infection. the main mechanisms of action of s. boulardii include inhibition of activities of bacterial pathogenic products, trophic effects on the i ...201020889007
investigation of toxin gene diversity, molecular epidemiology, and antimicrobial resistance of clostridium difficile isolated from 12 hospitals in south korea.clostridium difficile is a major cause of antibiotic-associated diarrhea. the objective of this study was to characterize clinical isolates of c. difficile obtained from various regions in korea with regard to their toxin status, molecular type, and antimicrobial susceptibility.201020890081
[antimicrobial activity of oral quinolones against clinical isolates of bifidobacterium group and clostridium difficile].administrations of antimicrobial agent influence human intestinal flora, and sometimes lead to cause clostridium difficile colitis (cdc). it has been well known that antimicrobial agents, such as clindamycin (cldm), ampicillin (abpc) and cephems, frequently cause c. difficile colitis, however, recently some respiratory quinolones, such as garenoxacin (grnx) and moxifloxacin (mflx), have paid to attention. bifidobacterium species would be highly associated with the preservation of normal intestin ...201020919497
prevalence of antimicrobial resistance and association with toxin genes in clostridium difficile in commercial swine.to estimate prevalence and determine association between antimicrobia resistance and toxin gene profile of clostridium difficile in commercial pigs at the preharvest food-safety level.201020919905
in the clinic. clostridium difficile infection.this issue provides a clinical overview of clostridium difficile infection focusing on prevention, diagnosis, treatment, practice improvement, and patient information. readers can complete the accompanying cme quiz for 1.5 credits. only acp members and individual subscribers can access the electronic features of in the clinic. non-subscribers who wish to access this issue of in the clinic can elect "pay for view." subscribers can receive 1.5 category 1 cme credits by completing the cme quiz that ...201020921540
clostridium difficile infection and liver disease.the rates of the predominantly hospital acquired infection, clostridium difficile, have increased throughout the world. several risk factors and susceptible patient populations have been identified. patients with pre-existing liver disease represent an important cohort; recent evidence suggests that clostridium difficile infection (cdi) is associated with a worse outcome and increased health care costs. this review focuses on the epidemiology, risk factors, pathogenesis, treatment options and ou ...201020922196
[epidemiology of severe clostridium difficile infections in hesse, germany in 2008-2009].clostridium difficile is a major cause of health care associated infections in industrialized countries. during the past decade, the incidence and clinical severity of c. difficile infections (cdi) have increased markedly. this increase has been associated with the emergence of a possibly highly virulent strain, the c. difficile pcr ribotype 027. we investigated the emergence of severe cdi and the associated pcr ribotypes in hesse, germany.201020922636
potential value of repeat stool testing for clostridium difficile stool toxin using enzyme immunoassay?the aim of this brief review is to summarize the literature as it relates to the potential value of repeat stool testing for clostridium difficile (c. difficile) toxin using an enzyme immunoassay (eia) for toxin a&b and also propose a potential newer algorithm for diagnosing c. difficile.201020923255
intravenous immunoglobulin for the treatment of clostridium difficile infection: a review.clostridium difficile infection (cdi) has increased sharply in incidence, mortality rate, and burden on the healthcare system over the past decade. therefore, novel treatment modalities have been developed, including intravenous immunoglobulin (ivig). the level of immune response to clostridium difficile colonization is the major determinant of the magnitude and duration of clinical manifestations. this effect is mediated predominantly by serum igg anti-toxin a antibodies. based on this finding, ...201020924675
a classification system for hospital-based infection outbreaks.outbreaks of infection within semi-closed environments such as hospitals, whether inherent in the environment (such as clostridium difficile (c.diff) or methicillin-resistant staphylococcus aureus (mrsa) or imported from the wider community (such as norwalk-like viruses (nlvs)), are difficult to manage. as part of our work on modelling such outbreaks, we have developed a classification system to describe the impact of a particular outbreak upon an organization. this classification system may the ...201020924858
spores of clostridium difficile in hospital air. 201020925506
effect of ceftobiprole on the normal human intestinal microflora.ceftobiprole is a new broad-spectrum pyrrolidinone cephem active against meticillin-resistant staphylococcus aureus, vancomycin-resistant enterococcus faecalis and gram-negative bacteria such as enterobacteriaceae and pseudomonas spp. the purpose of the present study was to investigate the effect of administration of ceftobiprole on the normal intestinal microflora. twelve healthy subjects (six males and six females) aged 20-31 years received ceftobiprole 500 mg by intravenous infusion every 8h ...201020926263
rifampin plus metronidazole for clostridium difficile infection. 201020929305
global epidemiology of clostridium difficile infection in 2010.the past decade has been characterized by an epidemic of clostridium difficile infection in north america and europe that threatens to extend to the rest of the world. the epidemic is due in part to the emergence of a previously rare and now more lethal c. difficile strain variously named group bi, ribotype 027, and north american pulsed‐field gel electrophoresis type 1.201020929364
detection of clostridium difficile infection.there has been a recent surge of interest in clostridium difficile infection, which reflects an impressive increase in the number and severity of these infections. this review addresses some of the newer methods for detection of c. difficile infection at the bedside and in the laboratory. particularly important are the new rapid diagnostic tests that detect toxigenic c. difficile using polymerase chain reaction and the combination tests that, either simultaneously or sequentially, screen for c. ...201020929365
prevention of healthcare‐associated clostridium difficile infection: what works?prevention of clostridium difficile infection has become extremely important because of increases in its incidence and severity. unfortunately, efforts at c. difficile infection prevention are hampered by lack of data to support optimal prevention methods, especially for endemic c. difficile infection. studies are needed to define the optimal prevention practices and to investigate novel prevention methods.201020929366
sequencing of superbugs seen as key to combating their spread. 201020930725
medical microbiology: a toxin contest. 201020930831
impact of clostridium difficile on inflammatory bowel disease.clostridium difficile infection (cdi) has been increasing in incidence among those with underlying inflammatory bowel disease (ibd) and is associated with substantial morbidity, the need for surgery and even mortality. the similar clinical presentation between cdi and a flare of underlying ibd makes prompt diagnosis essential to prevent deterioration which would accompany an escalation of immunosuppression in the absence of appropriate antibiotic therapy. classical risk factors (antibiotic or he ...201020932144
nosocomial infections and multidrug-resistant bacterial organisms in the pediatric intensive care unit.nosocomial infections in pediatric intensive care units (picus) caused by multidrug-resistant bacterial organisms are increasing. this review attempts to report on significant findings in the current literature related to nosocomial infections in picu settings with an international perspective. the types of nosocomial infections are addressed, including catheter-related bloodstream infections, ventilator-associated pneumonia, urinary tract infections, gastrointestinal infections and post-surgica ...201020936380
[clostridium difficile]. 201020942043
evaluation of the cepheid xpert clostridium difficile epi assay for diagnosis of clostridium difficile infection and typing of the nap1 strain at a cancer hospital.clostridium difficile is the most common cause of health care-associated diarrhea. accurate and rapid diagnosis is essential to improve patient outcome and prevent disease spread. we compared our two-step diagnostic algorithm, an enzyme immunoassay for glutamate dehydrogenase (gdh) followed by the cytotoxin neutralization test (cyt) with a turnaround time of 24 to 48 h, versus the cepheid xpert c. difficile epi assay, a pcr-based assay with a turnaround time of <1 h. in the first phase of the st ...201020943860
clostridium difficile-associated diarrhea in a tertiary care medical center.this retrospective, case-control study aimed to identify variables associated with the incidence of clostridium difficile-associated diarrhea (cdad) in acute care facilities and to specifically identify the relationship of fluoroquinolones and acid suppressive agents in the development of cdad. seventy-one symptomatic patients positive for c. difficile toxin a or b hospitalized for at least 72 hours were compared with 142 control patients hospitalized for at least 72 hours who were not positive ...201020944758
outcomes of patients who develop symptomatic clostridium difficile infection after solid organ transplantation.clostridium difficile-associated diarrhea is the most common cause of hospital-associated diarrhea in the uk. infection can produce a spectrum of manifestations from mild diarrhea to toxic megacolon, colonic perforation, and death. the aim of this study was to evaluate the outcomes of patients who developed symptomatic clostridium difficile infection (cdi) within the first year after solid organ transplantation. between 2004 and 2007, we performed 682 transplantation: 433 from deceased-donor kid ...201020832558
evaluating the link between the management of clinical waste in the national health service (nhs) and the risk of the spread of infections: a case study of three hospitals in england.this study aimed to evaluate waste management practices in three case study nhs trusts in england and the potential risks of the spread of pathogens causing healthcare associated infections (hcais). using a combination of microbiological techniques, interviews and questionnaire surveys, four target microbes were studied, namely: meticillin resistant staphylococcus aureus (mrsa), meticillin sensitive staphylococcus aureus (mssa), clostridium difficile (c. difficile) and vancomycin-resistant enter ...201020833586
[emergence of clostridium difficile ribotype 027 in germany: epidemiological and clinical characteristics].in september 2007 an increase of severe clostridium difficile-associated infections (cdi) was noticed in a hospital in the city of trier, germany. it was assumed that a new, possibly hypervirulent strain (pcr ribotype 027) was related to these events. an outbreak investigation was initiated by the local health authorities and the robert koch institute to describe the epidemiology of the possible outbreak and to identify and control the possible sources.201020839161
[a case of pseudomembranous colitis with febrile neutropenia induced by chemotherapy and effectively treated by vancomycin enemas].pseudomembranous colitis, an antibiotic-associated diarrhea, needs early diagnosis and treatment for the high fatality rate in severe cases. we report a case of pseudomembranous colitis following the use of antibiotics in febrile neutropenia (fn). a 74-year-old man with non-curative resected sigmoid colon cancer was treated with cefepime in fn induced by chemotherapy. complications of diarrhea were seen on day 2. paralytic ileus and disseminated intravascular coagulation were also complications. ...201020841956
improved eradication of clostridium difficile spores from toilets of hospitalized patients using an accelerated hydrogen peroxide as the cleaning agent.c. difficle spores in the environment of patients with c. difficile associated disease (cdad) are difficult to eliminate. bleach (5000 ppm) has been advocated as an effective disinfectant for the environmental surfaces of patients with cdad. few alternatives to bleach for non-outbreak conditions have been evaluated in controlled healthcare studies.201020843348
effect of mother's weight on infant's microbiota acquisition, composition, and activity during early infancy: a prospective follow-up study initiated in early pregnancy.it has been reported that deviations in gut microbiota composition may predispose toward obesity, and specific groups of commensal gut bacteria may harvest energy from food more efficiently than others. alterations in microbiota compositions of mothers may be transferred to infants and lead to an increased risk of overweight.201020844065
the role of toxin a and toxin b in clostridium difficile infection.clostridium difficile infection is the leading cause of healthcare-associated diarrhoea in europe and north america. during infection, c. difficile produces two key virulence determinants, toxin a and toxin b. experiments with purified toxins have indicated that toxin a alone is able to evoke the symptoms of c. difficile infection, but toxin b is unable to do so unless it is mixed with toxin a or there is prior damage to the gut mucosa. however, a recent study indicated that toxin b is essential ...201020844489
comparison of public perceptions associated with healthcare-associated infections (hcais) in northern ireland following the 2007/2008 outbreak of clostridium difficile in the northern trust. 201020844732
epidemiology and clinical relevance of microbial resistance determinants versus anti-gram-positive agents.gram-positive pathogens are a major cause of community-acquired and hospital-acquired infections, and exhibit a remarkable ability to develop antibiotic resistance. methicillin-resistant staphylococcus aureus (mrsa), glycopeptide-resistant enterococci (gre) and multidrug-resistant pneumococci are currently the major resistance challenges among gram-positives, due to their global dissemination and overall clinical impact. the mechanisms of evolution of these resistance phenotypes are based on a d ...201020846900
dysbiosis of fecal microbiota in crohn's disease patients as revealed by a custom phylogenetic microarray.a custom phylogenetic microarray composed of small subunit ribosomal rna probes, representing ≈500 bacterial species from the human and animal gut, was developed and evaluated for analysis of gut microbial diversity using fecal samples from healthy subjects and crohn's disease (cd) patients.201020848492
interventions to improve hand hygiene compliance in patient care.health care-associated infection is a major cause of morbidity and mortality. hand hygiene is regarded as an effective preventive measure.201020824842
when diarrhea gets deadly: a look at gastroenteritis outbreaks in nursing homes. 201020825307
[gut translocation septicemia in infant].intestinal microbiotype necessary for life is a source of complications in childhood. bacterial translocation is responsible of endogenous septicaemia and invasive complications. we report five cases of severe invasive infections associated with diarrhoea, digestive bleeding or sepsis. biological parameters for inflammation are highly positive, and blood cultures reveal bacterial identification: salmonella enteridis, enterobacter cloacae, campylobacter jejuni, escherichia coli or clostridium dif ...201020826329
clostridium difficile in a nursing home patient. 201020827932
the pathogenesis of infection and immune response.an understanding of the pathogenesis of infection, and the complex and fascinating 'relationship', or interaction, between the infecting organism and the host are advantageous when caring for patients with infections/infectious diseases, particularly as many of the clinical features of infection are as a consequence of the defence mechanisms mounted by the immune system. this article aims to provide a brief overview of the pathogenesis of infection, explaining how the two branches of the immune ...201020852457
clostridium difficile: moving beyond antimicrobial therapy. 201020854648
post-esophagectomy pseudomembranous inflammation of the interposed colon.pseudomembranous colitis (pmc) usually is caused by antibiotic-related changes in colonic anaerobic microflora, leading to clostridium difficile overgrowth and overproduction of toxins. we present the first reported case of pmc affecting the intrathoracic, interposed colon of an esophagectomy patient in the absence of inflammation of the in situ colon.201020858162
antimicrobial susceptibility and heteroresistance in chinese clostridium difficile strains.one hundred and ten toxigenic clostridium difficile isolates collected between december 2008 and may 2009 at fudan university hospital huashan were analyzed for their antibiotic susceptibility patterns and resistance molecular basis. the heteroresistance to metronidazole in fresh isolates were detected as well. sixteen different pcr ribotypes were identified with a dominant clone 017 accounting for 37.3% of the isolates, followed by 001 and h. ribotype 027 was not found but one isolate belonged ...201020849968
prevalence of diarrhea and enteropathogens in racing sled dogs.diarrhea is highly prevalent in racing sled dogs, although the underlying causes are poorly understood. hypothesis: clostridium perfringens enterotoxin (cpe) and clostridium difficile toxin a and b are associated with diarrhea in racing sled dogs.201019925573
in-plane parallel scanning: a microarray technology for point-of-care testing.a new microarray technology is described for rapid, inexpensive, multiplex diagnostics assays. referred to as "in-plane parallel scanning" (ipps), this technology replaces expensive laser scanning with a grid of 100-μm-wide waveguides embedded in the chip's substrate, enabling real-time quantification of molecular complex formation on the chip's surface. compared to conventional microarray technology, ipps has advantages of shorter assay time and lower instrument cost and complexity so that the ...201020945920
a common polymorphism in the interleukin-8 gene promoter is associated with an increased risk for recurrent clostridium difficile infection.neutrophil recruitment coordinated by intestinal interleukin (il)-8 secretion is a key component in the pathogenesis of clostridium difficile infection (cdi). we hypothesized that a common single-nucleotide polymorphism (snp) in the -251 region of the il-8 gene promoter may be predictive of recurrent cdi.201021058913
sustained reduction in antimicrobial use and decrease in methicillin-resistant staphylococcus aureus and clostridium difficile infections following implementation of an electronic medical record at a tertiary-care teaching hospital.we evaluated the effect of implementation of an electronic medical record (emr) on the use of antimicrobial agents and on the rates of infections with clostridium difficile and methicillin-resistant staphylococcus aureus (mrsa).201021059617
the effect of hospital-acquired clostridium difficile infection on in-hospital mortality.the effects of hospital-acquired clostridium difficile infection (cdi) on patient outcomes are incompletely understood. we conducted this study to determine the independent impact of hospital-acquired cdi on in-hospital mortality after adjusting for the time-varying nature of cdi and baseline mortality risk at hospital admission.201021059973
therapeutic success of rifaximin for clostridium difficile infection refractory to metronidazole and vancomycin.we report the case of a 46-year-old white male with confirmed clostridium difficile infection for >4 weeks after fluoroquinolone therapy. the patient received two courses of metronidazole 500 mg three times daily (t.i.d.) during which time diarrhea resolved; however, symptoms recurred 14-15 days after treatment termination. he received a 2-week course of vancomycin 125 mg four times daily, with symptoms recurring 10 days after treatment conclusion. the patient then received a pulsed tapering sch ...201021060709
manganese binds to clostridium difficile fbp68 and is essential for fibronectin binding.clostridium difficile is an etiological agent of pseudomembranous colitis and antibiotic-associated diarrhea. adhesion is the crucial first step in bacterial infection. thus, in addition to toxins, the importance of colonization factors in c. difficile-associated disease is recognized. in this study, we identified fbp68, one of the colonization factors that bind to fibronectin (fn), as a manganese-binding protein (k(d) = 52.70 ± 1.97 nm). furthermore, the conformation of fbp68 changed dramatical ...201021062746
targeting selenium metabolism and selenoproteins: novel avenues for drug discovery.selenoproteins play a wide range of roles in metabolism and oxidative stress defense and are produced by organisms in all three domains of life. recent evidence has been presented that metal based cancer drugs target the selenol nucleophile of the active site selenocysteine in thioredoxin reductase isoenzymes. other metals and metalloids, such as tin, arsenic and gold, have also recently been shown to form stable complexes with hydrogen selenide, a required precursor for the synthesis of selenop ...201021069141
anti-pseudomonal beta-lactams for the initial, empirical, treatment of febrile neutropenia: comparison of beta-lactams.several beta-lactams are recommended as single agents for the treatment of febrile neutropenia.201021069685
clostridium difficile in vegetables, canada.clostridium difficile is an important gastrointestinal pathogen of humans and animals. it has been isolated from various foods, including meat and ready-to-eat salads, and concern has been expressed regarding food as a possible source of human c. difficile infection (cdi).201021069911
antibiotic prophylaxis in variceal hemorrhage: timing, effectiveness and clostridium difficile rates.to investigate if antibiotics administered within 8 h of endoscopy reduce mortality or increase the incidence of clostridium difficile infection (cdi).201021072894
universal phosphatase-coupled glycosyltransferase assay.a nonradioactive glycosyltransferase assay is described here. this method takes advantage of specific phosphatases that can be added into glycosyltransferase reactions to quantitatively release inorganic phosphate from the leaving groups of glycosyltransferase reactions. the released phosphate group is then detected using colorimetric malachite-based reagents. because the amount of phosphate released is directly proportional to the sugar molecule transferred in a glycosyltransferase reaction, th ...201021081508
human c. difficile infections are increasing in incidence and severity. 201021083827
using the lived experiences of patients with clostridium difficile infection to improve care.to better understand the lived experiences and needs of patients who have clostridium difficile infection.201021086831
using the waterlow tool to predict clostridium difficile infection risk in hospital settings.c difficile is the most important cause of infectious healthcare acquired diarrhoea and risk of infection is a public concern. many acute and primary care trusts are working to further reduce rates of c difficile and targets have been set. global reduction strategies include prudent antibiotic prescribing and intensive cleaning programmes. while risk assessment tools for c difficile exist, they are not easy to use in hospital. this article introduces an inexpensive and easy to use assessment too ...201021086834
insights into the mechanism of type i dehydroquinate dehydratases from structures of reaction intermediates.the biosynthetic shikimate pathway consists of seven enzymes that catalyze sequential reactions to generate chorismate, a critical branch point in the synthesis of the aromatic amino acids. the third enzyme in the pathway, dehydroquinate dehydratase (dhqd), catalyzes the dehydration of 3-dehydroquinate to 3-dehydroshikimate. we present three crystal structures of the type i dhqd from the intestinal pathogens clostridium difficile and salmonella enterica. structures of the enzyme with substrate a ...201021087925
practice of gastroenterologists in treating flaring inflammatory bowel disease patients with clostridium difficile: antibiotics alone or combined antibiotics/immunomodulators?background:: the optimal management of clostridium difficile infection (cdi) in flaring inflammatory bowel disease (ibd) patients has not been defined. limited data suggest that coadministration of immunomodulators (im) with antibiotics (ab) results in a worse outcome. we investigated the prevalent practice among north american gastroenterologists in this scenario. methods:: a structured questionnaire presented the clinical cases of two hospitalized patients with ulcerative colitis and concomita ...201021089183
[clostridium difficile: a serious outpatient infection?].secondary to severe hospital outbreaks due to hypervirulent strains of clostridium difficile, several surveillance systems in north-america and europe observed an increase in infections due to this micro-organism, also in the outpatient setting. the case reported in the present article illustrates the fulminant presentation that a c. difficile colitis can show in a previously healthy person without prior contact with healthcare facilities. it introduces a review of some recent publications on th ...201021089556
a rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report.abstract:201021092091
disarming clostridium difficile.in this issue, puriet al. (2010) present inhibitors that prevent the autocatalytic activation of the clostridial toxin tcdb in vivo. their approach is likely to provide guidance for the development of novel drugs targeting virulence factors and thereby rendering bacterial pathogens innocuous.201021095563
rational design of inhibitors and activity-based probes targeting clostridium difficile virulence factor tcdb.clostridium difficile is a leading cause of nosocomial infections. the major virulence factors of this pathogen are the multi-domain toxins tcda and tcdb. these toxins contain a cysteine protease domain (cpd) that autoproteolytically releases a cytotoxic effector domain upon binding intracellular inositol hexakisphosphate. currently, there are no known inhibitors of this protease. here, we describe the rational design of covalent small molecule inhibitors of tcdb cpd. we identified compounds tha ...201021095570
clostridium perfringens tpel glycosylates the rac and ras subfamily proteins.clostridium perfringens tpel belongs to a family of large clostridial cytotoxins that encompasses clostridium difficile toxin a (tcda) and b (tcdb) and clostridium sordellii lethal toxin (tcsl). we report here the identification of the tpel-catalyzed modification of small gtpases. a recombinant protein (tpel1-525) derived from the tpel n-terminal catalytic domain in the presence of streptolysin o (slo) induced the rounding of vero cells and the glycosylation of cellular rac1. among several hexos ...201021098103
cyclic-di-gmp reaches out into the bacterial rna world.the ubiquitous bacterial signaling molecule bis-(3'-5')-cyclic guanosine monophosphate (c-di-gmp) has brought second messenger signaling back onto the agenda of molecular microbiologists. this is due not only to its general role in promoting biofilm formation, but also to the increasingly diverse array of effector molecules bound by c-di-gmp and of the target processes affected. effectors include diverse transcription factors and proteins that directly interact with complex cellular machineries, ...201021098727
update on clostridium difficile infection.purpose of review: this review summarizes the most recent epidemiological data and advances in research into the pathogenesis, diagnosis and treatment of clostridium difficile infection (cdi). recent findings: the epidemiology of cdi has changed with the emergence of hypervirulent strains. cdi rates have increased in the community, in children and in patients with inflammatory bowel disease. although the north american pulsed-field gel electrophoresis type 1, restriction endonuclease analysis gr ...201021099432
rapid and sensitive loop-mediated isothermal amplification test for clostridium difficile detection challenges cytotoxin b cell test and culture as gold standard.compared to the composite gold standard cytotoxin b assay and toxigenic culture, the loop-mediated isothermal amplification (lamp) test for clostridium difficile had a sensitivity and specificity of 98%, positive predictive value of 92%, and negative predictive value of >99%. a one-hour turnaround time for the lamp test provides rapid diagnosis and cost savings.201021106782
acquisition of clostridium difficile by piglets.clostridium difficile is recognized as an important cause of nosocomial diarrhoea in humans especially in association with administration of antibiotics. in pigs, c. difficile can cause neonatal enteritis and can be isolated from faeces from both diseased and healthy animals. the presented prospective study describes how soon c. difficile can be isolated from newborn piglets after normal parturition and how c. difficile spreads within a pig farm. six sows, their farrowing crates and their litter ...201021111541
[use of endorectal tube actiflo in the management of clostridium difficile colitis in icu]. 201021112728
pneumatosis coli associated with pseudomembranous colitis in a patient following colonic surgery.pneumatosis intestinalis is a rare disorder characterized by gas-filled cysts within the subserosal and/or submucosal regions of the intestinal wall. the source of this gas and its translocation across the mucosa is incompletely understood. most (85%) cases are associated with medical conditions, ranging from psychiatric through respiratory disorders to gastrointestinal-related diseases; the remaining 15% lack any recognizable cause or association. in this case report, pneumatosis coli (affectin ...201021113293
alternative therapies for clostridium difficile infections.clostridium difficile infection is a serious condition responsible for significant morbidity and mortality, especially in patients being treated with antimicrobials. increasing frequency of the infection and hypervirulent c. difficile strains have resulted in more severe disease as well as therapeutic failures with traditional treatment (metronidazole and vancomycin). to review the studies assessing nontraditional therapies for the prevention and treatment of primary or recurrent c. difficile in ...201021114394
outcome for gram-negative bacteraemia when following restrictive empirical antibiotic guidelines.restrictions in prescribing broad spectrum antimicrobials have been part of a strategy to reduce clostridium difficile cases in the uk in recent years. however, there has been little work on assessing the safety of alternative antimicrobial agents.201021115461
adenosine deaminase inhibition prevents clostridium difficile toxin a-induced enteritis in mice.toxin a (txa) is able to induce most of the classical features of clostridium difficile-associated disease in animal models. the objective of this study was to determine the effect of an inhibitor of adenosine deaminase, ehna [erythro-9-(2-hydroxy-3-nonyl)-adenine], on txa-induced enteritis in c57bl6 mice and on the gene expression of adenosine receptors. ehna (90 μmol/kg) or phosphate-buffered saline (pbs) was injected intraperitoneally (i.p.) 30 min prior to txa (50 μg) or pbs injection into t ...201021115723
reference assays for clostridium difficile infection: one or two gold standards?accurate diagnosis of clostridium difficile infection (cdi) is essential for optimal treatment, prevention and control. there are two reference assays for cdi diagnosis: the cell cytotoxicity assay (ccta) and toxigenic culture (tc). importantly, these tests actually detect different targets: ccta detects the presence of c difficile toxins (primarily toxin b, but also toxin a), whereas tc detects the presence in the stool of c difficile with the potential to produce toxin. not surprisingly studie ...201021118850
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