Publications

TitleAbstractYear(sorted ascending)
Filter
PMID
Filter
clostridium difficile infection: epidemiology, risk factors and management.the epidemiology of clostridium difficile infection (cdi) has changed over the past decade. there has been a dramatic worldwide increase in its incidence, and new cdi populations are emerging, such as those with community-acquired infection and no previous exposure to antibiotics, children, pregnant women and patients with ibd. diagnosis of cdi requires identification of c. difficile toxin a or b in diarrheal stool. the accuracy of current diagnostic tests remains inadequate and the optimal diag ...201021119612
automated surveillance of clostridium difficile infections using biosense.to determine the feasibility of using electronic laboratory and admission-discharge-transfer data from biosense, a national automated surveillance system, to apply new modified clostridium difficile infection (cdi) surveillance definitions and calculate overall and facility-specific rates of disease.201021128815
the continuing crisis in antibiotic resistance.the emergence of antibiotic resistance in bacterial pathogens is an inevitable consequence of antibiotic use. despite repeated warnings, negligent antibiotic use and poor infection-control practice have led to the continuing development of extensive resistance problems worldwide. multidrug-resistant pathogens are now characterized by their heterogeneity, increasing virulence, resistance even to reserve agents and spread within and between hospitals and the community. examples are glycopeptide-re ...201021129629
monomicrobial clostridium difficile bacteraemias and relationship to gut infection. 201021129818
thirty-day mortality of clostridium difficile infection in a uk national health service foundation trust between 2002 and 2008.few standardised data are available on mortality rates in patients with clostridium difficile infection (cdi). the literature often reports 'attributable' mortality or cannot be universally applied. we aimed to investigate the pattern and trends in all-cause mortality in a large unselected cohort of patients affected by cdi. this was done by means of a retrospective cohort study between 2002 and 2008 of all patients with positive stool toxin tests indicating cdi in one national health service (n ...201021129821
herpes simplex virus: a marker of severity in bacterial ventilator-associated pneumonia.purpose: ventilator-associated pneumonia (vap) is the most frequent nosocomial infection in intensive care units and has a high morbidity and mortality rate. it is mainly a bacterial disease, although the potential role of viruses as pathogens or copathogens in vap is under discussion. our study aims were to determine the incidence of herpes simplex virus (hsv) in the lower respiratory tract (lrt) secretions in patients with bacterial vap and to assess its potential clinical relevance. material ...201021129912
gaseous and air decontamination technologies for clostridium difficile in the healthcare environment.the recent data for hospital-acquired infections suggest that infection rates for meticillin-resistant staphylococcus aureus (mrsa) and clostridium difficile are beginning to decrease. however, while there is still pressure to maintain this trend, the resistance of c. difficile spores to standard detergents continues to present a problem for many uk hospitals trying to prevent its spread or control outbreaks. alternative disinfection technologies such as gaseous decontamination are currently bei ...201021130521
infection probability score: a predictor of clostridium difficile-associated disease onset in patients with haematological malignancy.purpose: to assess the predictive power of three systems: infection probability score, apache ii and karnofsky score for the onset of clostridium difficile-associated disease (cdad) in hematology-oncology patients. methods and sample: a retrospective pilot surveillance survey was conducted in the hematology unit of a general hospital in greece. data were collected by using an anonymous standardised case-record form. the sample consisted of 102 hospitalized patients. results: the majority of the ...201021130685
prevalence of clostridium difficile in retailed meat in the netherlands.recent reports indicate that a large proportion of community-acquired clostridium difficile infections (ca-cdi) are not linked to recent antibiotic therapy, older age, significant comorbidity or previous hospitalization. possible community sources for ca-cdi include animals and food, and therefore a surveillance study on the prevalence of c. difficile in meat was performed. samples of different meat species were collected from the retail trade and analyzed for the presence of c. difficile using ...201021131085
protective roles of cx3cr1-mediated signals in toxin a-induced enteritis through the induction of heme oxygenase-1 expression.the injection of clostridium difficile toxin a into the ileal loops caused fluid accumulation with the destruction of intestinal epithelial structure and the recruitment of neutrophils and macrophages. concomitantly, intraileal gene expression of cx3cl1/fractalkine (fkn) and its receptor, cx3cr1, was enhanced. when treated with toxin a in a similar manner, cx3cr1-deficient (cx3cr1(-/-)) mice exhibited exaggerated fluid accumulation, histopathological alterations, and neutrophil recruitment, but ...201021131421
from cosubstrate similarity to inhibitor diversity--inhibitors of adp-ribosyltransferases from kinase inhibitor screening.adp-ribosyltransferases (adp-rts) use nad(+) to transfer an adp-ribosyl group to target proteins. although some adp-rts are bacterial toxins only few inhibitors are known. here we present the development of fluorescence-based assays and a focussed library screening using kinase inhibitors as a new approach towards inhibitors of adp-rts. different screening setups were established using surrogate small molecule substrates or the quantitation of the cofactor nad(+). proof-of-principle screening ex ...201021132207
efficacy of three surface disinfectants against spores of clostridium difficile ribotype 027.the emergence of clostridium difficile ribotype 027 raised the question of sporicidal surface disinfectants are also effective against spores of c. difficile ribotype 027.201021134785
tigecycline exhibits inhibitory activity against clostridium difficile in the colon of mice and does not promote growth or toxin production.tigecycline is a broad-spectrum glycylcycline antibiotic with potent in vitro activity against clostridium difficile. we used a mouse model to test the hypothesis that tigecycline has a low propensity to promote colonization and toxin production by c. difficile due to inhibitory activity in the colon. mice (5 to 8 per group) received subcutaneous injections of tigecycline (low and high doses) alone or in combination with clindamycin for 6 days. growth of and toxin production by 3 strains of c. d ...201021135181
[entero-colitis implicated by antimicrobial agents]. 201021139357
the role of glutamate dehydrogenase for the detection of clostridium difficile in faecal samples: a meta-analysis.clostridium difficile causes a serious, occasionally fatal, hospital-acquired infection. the laboratory diagnosis of c. difficile infection (cdi) needs to be accurate to ensure optimal patient management, infection control and reliable surveillance. commercial enzyme-linked immunosorbent assays for c. difficile toxins have poor sensitivity when compared with cell culture cytotoxin assay (cta) and toxigenic culture (tc). we performed a meta-analysis of the role of glutamate dehydrogenase (gdh) in ...201021145132
critical gastrointestinal bleeding at an inpatient rehabilitation center: incidence, risk factors, and the role of gastrointestinal prophylaxis.to determine the incidence of critical gastrointestinal bleeding at an inpatient rehabilitation center, the risk factors associated with said bleeding, and the role of gastrointestinal prophylaxis.201021145522
in vitro activity and single-step mutational analysis of rifamycin sv tested against enteropathogens associated with traveler's diarrhea and clostridium difficile.rifamycin sv is a broad-spectrum, poorly absorbed antimicrobial agent that, when coupled with mmx technology, is being targeted for the oral treatment of traveler's diarrhea (td) and clostridium difficile-associated disease (cdad). rifamycin sv was tested for activity against 911 td-associated enteropathogens and 30 c. difficile isolates collected from several global surveillance studies. rifamycin sv demonstrated similar antimicrobial activity levels against the enterobacteriaceae, with mic₅₀ v ...201021149623
therapeutic transplantation of the distal gut microbiota.although it is generally accepted that the distal gut microbiota are relatively stable in healthy adult individuals, a collapse of the microbial community structure resulting from antibiotic therapy or pathogen presence can lead to gut dysfunction. however, recent findings demonstrate that it is possible to engraft new microbiota from a donor source, resulting in the restoration of gut functionality and improvement in health. this builds upon decades of case reports and series in which fecal tra ...201021150894
the risk factors of clostridium difficile colitis in colorectal surgery. 201021152130
risk factors for the development of clostridium difficile-associated colitis after colorectal cancer surgery.clostridium difficile (c. difficile)-associated colitis, a known complication of colon and rectal surgery, can increase perioperative morbidity and mortality, leading to increased hospital stay and costs. several contributing factors, including advanced age, mechanical bowel preparation, and antibiotics, have been implicated in this condition. the purpose of this study was to determine the clinical features of and factors responsible for c. difficile-associated colitis after colorectal cancer su ...201021152135
scientists probe herpes in neonates, c. difficile acquisition in children. 201021156940
escherichia coli and selected veterinary and zoonotic pathogens isolated from environmental sites in companion animal veterinary hospitals in southern ontario.hospital-based infection control in veterinary medicine is emerging and the role of the environment in hospital-acquired infections (hai) in veterinary hospitals is largely unknown. this study was initiated to determine the recovery of escherichia coli and selected veterinary and zoonotic pathogens from the environments of 101 community veterinary hospitals. the proportion of hospitals with positive environmental swabs were: e. coli--92%, clostridium difficile--58%, methicillin-resistant staphyl ...201021119862
prevalence and clinical impact of endoscopic pseudomembranes in patients with inflammatory bowel disease and clostridium difficile infection.limited data suggests that pseudomembranes are uncommon in patients with inflammatory bowel disease (ibd) and c. difficile associated disease (cdad), but the reason for this is unknown. we aimed to evaluate the rate of pseudomembranes in this population, identify predictive factors for pseudomembranes' presence and assess its clinical impact.201021122505
testing standards for sporicides.sporicidal products are of considerable importance in healthcare environments due to the requirement for products that are capable of dealing with contamination with clostridium difficile spores. sporicidal testing standards to validate the claims of sporicidal activity are an important tool in the evaluation of commercial sporicides. within europe there are a number of sporicidal testing standards which are often used to validate the claims of commercial sporicides. however, the extent to which ...201021122947
comparison of two commercial molecular assays to a laboratory-developed molecular assay for diagnosis of clostridium difficile infection.we compared two commercial pcr assays, the prodesse progastro cd assay and the bd geneohm cdiff assay, with a laboratory-developed clostridium difficile toxin pcr assay with previously established performance characteristics. results of all methods were in agreement for 333 (96%) of 346 stool specimens. no significant difference in performance among the assays was found (p values, >0.05).201021123537
clostridium difficile infection rates and spectrum of disease among peripartum women at one hospital from 2003 to 2007 with molecular typing analysis of recovered clostridium difficile isolates.peripartum women are at risk for clostridium difficile infection (cdi), but the risk magnitude and clinical disease spectrum are unknown. we determined the incidence and clinical features of cdi in peripartum women in the loyola university medical center system and describe typing of c difficile isolates by restriction endonuclease analysis (rea).201021126802
bacteraemia and breast abscess: unusual extra-intestinal manifestations of clostridium difficile infection.extra-intestinal manifestations of clostridium difficile infection are uncommon. most cases are associated with gastrointestinal disease and often occur as a mixed infection with other gut flora. we report a case of breast abscess following monomicrobial c. difficile bacteraemia in a female with background chronic hepatitis c infection and alcoholic liver disease. no evidence of colitis was found. our case shows that c. difficile is indeed capable of spreading from the gastrointestinal tract.201021127155
toxic megacolon associated clostridium difficile colitis.toxic megacolon is a severe complication of clostridium difficile (c. difficile) colitis. as the prevalence of c. difficile colitis increases and treatments become more refractory, clinicians will encounter more patients with c. difficile associated toxic megacolon in the future. here, we review a case of toxic megacolon secondary to c. difficile colitis and review the current literature on diagnosis and management. we identify both clinical and radiologic criteria for diagnosis and discuss both ...201021160629
severe colitis associated with docetaxel use: a report of four cases.diarrhea is a common side effect of chemotherapy. pseudomembranous colitis is a well known complication of antibiotic treatment that can also be observed, albeit rarely, with certain chemotherapeutic agents. we present four cases of severe colitis in patients undergoing treatment with taxane-based chemotherapy for pancreatic, lung and breast cancer. none of them had recently received antibiotics. one patient presented with a bowel perforation and three had endoscopic findings of pseudomembranous ...201021160890
effect of probiotic lactobacillus (lacidofil® cap) for the prevention of antibiotic-associated diarrhea: a prospective, randomized, double-blind, multicenter study.antibiotic-associated diarrhea (aad) is a common complication of antibiotic use. there is growing interest in probiotics for the treatment of aad and clostridium difficile infection because of the wide availability of probiotics. the aim of this multicenter, randomized, placebo-controlled, double-blind trial was to assess the efficacy of probiotic lactobacillus (lacidofil® cap) for the prevention of aad in adults. from september 2008 to november 2009, a total of 214 patients with respiratory tra ...201021165295
fecal lactoferrin and clostridium spp. in stools of autistic children.stools from autistic and healthy children were studied for fecal lactoferrin, clostridium difficile toxins, clostridium perfringens enterotoxin and cultured for clostridium spp. elevated level of fla was demonstrated in 24.4% stools, all from boys (31.25%). no toxins were detected. clostridium spp. was isolated with similar frequency from all samples. c. perfringens were isolated significantly often from the autistic stools, intermediate sensitive strains to penicillin 19%, to clindamycin 11.3%, ...201021167951
analysis of ultra low genome conservation in clostridium difficile.microarray-based comparative genome hybridisations (cgh) and genome sequencing of clostridium difficile isolates have shown that the genomes of this species are highly variable. to further characterize their genome variation, we employed integration of data from cgh, genome sequencing and putative cellular pathways. transcontinental strain comparison using cgh data confirmed the emergence of a human-specific hypervirulent cluster. however, there was no correlation between total toxin production ...201021170335
clostridium difficile: the importance of toxin a is re-established in clostridium difficile infection. 201021171215
a comparative study of three methods to evaluate an intervention to improve empirical antibiotic therapy for acute bacterial infections in hospitalized patients.in order to limit the use of broad-spectrum antibiotics, standardized empirical therapy against acute bacterial infections has been advocated.201021171827
systematic review: clostridium difficile and inflammatory bowel disease.there is increasing concern about the apparently rising incidence and worsening outcome of clostridium difficile infection (cdi) associated with inflammatory bowel disease (ibd). we have systematically reviewed the literature to evaluate the incidence, risk factors, endoscopic features, treatment and outcome of cdi complicating ibd.201021198703
clostridium difficile-associated disease: impact of the updated shea/idsa guidelines.clostridium difficile-associated disease (cdad) is an increasingly difficult condition to treat because of the emergence of antibiotic resistance and highly pathogenic strains of bacteria. these newly identified strains affect patients in every facet of health care, from individuals in the community to those in intensive care units and all points in between. appropriate management regarding diagnosis, infection control, pharmacotherapy, and prevention is the key to good outcomes in all patient p ...201021172764
[a case of pseudomembranous colitis in a juvenile rheumatoid arthritis patient taking methotrexate].pseudomembranous colitis is mainly caused by antibiotics and clostridium difficile infection. but conditions such as gastrointestinal surgery, antacid medication, anti-neoplastic agent or immunosuppressive agent which influences the normal flora of colon can induce colitis without the administration of any antibiotics. we experienced a 13 year-old male who was taking low-dose methotrexate for juvenile rheumatoid arthritis complained diarrhea and abdominal pain for 3 weeks. sigmoidoscopic finding ...201021173564
pseudomembranous colitis complicating ulcerative colitis.clostridium difficile toxin (cd toxin) causes antibiotic-associated colitis, or pseudomembranous colitis (pmc). although cd toxin is sometimes found in the stools of patients with ulcerative colitis (uc), uc is rarely complicated by pmc. we report herein a case of pmc complicating uc, and present a review of the literature. a 71-year-old woman was diagnosed as having uc of the left colon, and treated with prednisolone and mesalazine. later, however, lumbar spinal stenosis was also detected. afte ...201021175502
clostridium difficile: progress and challenges.there is a surge of new interest in c. difficile infection (cdi) reflecting substantial increases in cases and fatalities. the new challenges by this now old pathogen have brought renewed interest in all facets of the disease. particularly important are the role of fluoroquinolones as inducing agents, the new polymerase chain reaction test to detect toxigenic strains in stools, the important role of the nap-1 strain, recent evidence favoring oral vancomycin over metronidazole in seriously ill pa ...201021175676
clostridium difficile colonization in early infancy is accompanied by changes in intestinal microbiota composition.clostridium difficile is a major enteric pathogen responsible for antibiotic-associated diarrhea. host susceptibility to c. difficile infections results partly from inability of the intestinal microbiota to resist c. difficile colonization. during early infancy, asymptomatic colonization by c. difficile is common and the intestinal microbiota shows low complexity. thus, we investigated the potential relationship between the microbiota composition and the implantation of c. difficile in infant gu ...201021177896
rifaximin therapy for metronidazole-unresponsive clostridium difficile infection: a prospective pilot trial.background:clostridium difficile infection (cdi) is a recent epidemic in the united states, particularly in the hospital setting. oral metronidazole is standard therapy for c. difficile infection, but resistance to metronidazole is becoming a clinical challenge.methods: we evaluated the efficacy of the nonsystemic oral antibiotic rifaximin for the treatment of metronidazole-resistant c. difficile infection. twenty-five patients with c. difficile infection were enrolled in the study. all had mild ...201021180604
use of probiotics in gastrointestinal disorders: what to recommend?perturbation of bacterial microflora of the gastrointestinal (gi) tract may play an important role in the pathophysiology of some gi disorders. probiotics have been used as a treatment modality for over a century. they may restore normal bacterial microflora and effect the functioning of the gi tract by a variety of mechanisms. probiotics are not currently regulated and only few randomized controlled trials exist investigating their efficacy in different gi disorders. they are available in a var ...201021180611
contribution of a government target to controlling clostridium difficile in the nhs in england.the introduction of mandatory surveillance of clostridium difficile infection (cdi) in 2004 showed the scale of the challenge: cases in patients >64 years old reached 55,681 in 2006. the first type 027 outbreaks had been in 2005 and cdi was a headline issue. the prevention and control of cdi requires a tripartite partnership between clinicians, health service managers, and the government/department of health which needs to set standards, ensure that cdi is a priority, set targets and monitor out ...201021182972
simultaneous clostridium difficile-associated colitis and late-onset intestinal cytomegalovirus disease in a renal transplant recipient.infection remains the most common complication following renal transplantation (rt). cytomegalovirus (cmv) is one of the most important pathogens in this patient population and clostridium difficile-associated colitis (cdac) has emerged as one of the most frequent gastrointestinal complications. only few cases of simultaneous cmv enterocolitis and cdac have been reported.201021183880
efficacy and safety of ciprofloxacin for prophylaxis of polyomavirus bk virus-associated hemorrhagic cystitis in allogeneic hematopoietic stem cell transplantation recipients.polyoma virus bk-induced hemorrhagic cystitis is an important cause of morbidity after hematopoietic stem cell transplantation (hsct). fluoroquinolones have been shown in vitro to inhibit bk viral replication by direct inhibition of the bk-encoded dna gyrase. we hypothesized that extended prophylaxis with ciprofloxacin may decrease the incidence of severe (grades 3 and 4) bk virus-associated hemorrhagic cystitis (sbkhc) after hsct. we retrospectively collected patient and transplant data, as wel ...201021185389
[comparison of diagnostic methods for clostridium difficile-associated diarrhea].in order to compare different methods for the diagnosis of clostridium difficile-associated diarrhea, fecal filtrates from patients presenting symptoms compatible with this condition, were analyzed. biological activity on vero cells (biological assay), dot blot with antibodies anti-tcda and anti-tcdb, and a pcr assay for the tcdb gene, were evaluated. titles of biological assays were > or =64 for 44 out of 177 samples. nineteen samples were positive in both biological and pcr assays. the analysi ...201021186669
characterization of tiacumicin b biosynthetic gene cluster affording diversified tiacumicin analogues and revealing a tailoring dihalogenase.the rna polymerase inhibitor tiacumicin b is currently undergoing phase iii clinical trial for treatment of clostridium difficile associated diarrhea with great promise. to understand the biosynthetic logic and to lay a foundation for generating structural analogues via pathway engineering, the tiacumicin b biosynthetic gene cluster was identified and characterized from the producer dactylosporangium aurantiacum subsp. hamdenensis nrrl 18085. sequence analysis of a 110,633 bp dna region revealed ...201021186805
changing prophylactic antibiotic protocol for reducing clostridium difficile-associated diarrhoeal infections.to determine whether a change in prophylactic antibiotic protocol for orthopaedic surgeries may reduce the frequency of clostridium difficile-associated diarrhoeal infections.201021187543
first synthesis of c. difficile ps-ii cell wall polysaccharide repeating unit.clostridium difficile is the most commonly diagnosed cause of nosocomial diarrhea with increasing incidence and mortality among elderly and hospitalized patients. we report the first synthesis of the surface polysaccharide ps-ii repeating unit and its nonphosphorylated analogue, with a linker for conjugation, via a (4 + 2) convergent approach from a common ab(d)c tetrasaccharide intermediate.201021190352
increased rate of irritable bowel syndrome and functional gastrointestinal disorders after clostridium difficile infection. 201021190754
synthesis and antimicrobial evaluation of nitazoxanide-based analogues: identification of selective and broad spectrum activity.a library composed of nitazoxanide-based analogues was synthesized and assayed for increased antibacterial efficacy against the pyruvate-ferredoxin oxidoreductase (pfor) using microorganisms helicobacter pylori, campylobacter jejuni and clostridium difficile. derivatives were found to recapitulate and improve activity against these organisms and select analogues were tested for their ability to disrupt the pfor enzyme directly. the library was also screened for activity against staphylococci and ...201021191957
faecal pharmacokinetics of orally administered vancomycin in patients with suspected clostridium difficile infection.oral vancomycin (125 mg qid) is recommended as treatment of severe clostridium difficile infection (cdi). higher doses (250 or 500 mg qid) are sometimes recommended for patients with very severe cdi, without supporting clinical evidence. we wished to determine to what extent faecal levels of vancomycin vary according to diarrhoea severity and dosage, and whether it is rational to administer high-dose vancomycin to selected patients.201021192802
clostridium difficile infection in an endemic setting in the netherlands.the purpose of this investigation was to study risk factors for clostridium difficile infection (cdi) in an endemic setting. in a 34-month prospective case-control study, we compared the risk factors and clinical characteristics of all consecutively diagnosed hospitalised cdi patients (n = 93) with those of patients without diarrhoea (n = 76) and patients with non-cdi diarrhoea (n = 64). the incidence of cdi was 17.5 per 10,000 hospital admissions. c. difficile polymerase chain reaction (pcr) ri ...201021194003
use of a continuous culture fermentation system to investigate the effect of ganedenbc30 (bacillus coagulans gbi-30, 6086) supplementation on pathogen survival in the human gut microbiota.single-stage continuous fermentation systems were employed to examine the effects of ganedenbc(30) supplementation on the human gastrointestinal microbiota in relation to pathogen challenge in vitro. denaturing gradient gel electrophoresis analysis demonstrated that ganedenbc(30) supplementation modified the microbial profiles in the fermentation systems compared with controls, with profiles clustering according to treatment. overall, ganedenbc(30) supplementation did not elicit major changes in ...201021195203
[c. difficile: new bacterial species significantly more pathogenic]. 201021207759
the ecology and pathobiology of clostridium difficile infections: an interdisciplinary challenge.clostridium difficile is a well recognized pathogen of humans and animals. although c. difficile was first identified over 70 years ago, much remains unknown in regards to the primary source of human acquisition and its pathobiology. these deficits in our knowledge have been intensified by dramatic increases in both the frequency and severity of disease in humans over the last decade. the changes in c. difficile epidemiology might be due to the emergence of a hypervirulent stain of c. difficile, ...201021223531
studies with bioengineered nisin peptides highlight the broad-spectrum potency of nisin v.nisin a is the most thoroughly investigated member of the lantibiotic family of antimicrobial peptides. in addition to a long history of safe use as a food antimicrobial, its activity against multi-drug resistant pathogens has resulted in a renewed interest in applying nisin as a chemotherapeutic to treat bacterial infections. the wealth of nisin-related information that has been generated has also led to the development of the biotechnological capacity to engineer novel nisin variants with a vi ...201021255345
comparative genome-wide analysis of small rnas of major gram-positive pathogens: from identification to application.in the recent years, the number of drug- and multi-drug-resistant microbial strains has increased rapidly. therefore, the need to identify innovative approaches for development of novel anti-infectives and new therapeutic targets is of high priority in global health care. the detection of small rnas (srnas) in bacteria has attracted considerable attention as an emerging class of new gene expression regulators. several experimental technologies to predict srna have been established for the gram-n ...201021255362
[incidence and characteristics of clostridium difficile infection in patients with diarrhea in a prague teaching hospital].description of basic epidemiological and clinical data of patients suffering from clostridium difficile infection (cdi). recognizing important predisposing factors and detecting complications of the disease.201021243600
magnitude and economic effect of overuse of antisecretory therapy in the ambulatory care setting.to determine the prevalence and economic effect of inappropriate proton pump inhibitor (ppi) use in an ambulatory care setting.201021250399
impact of clostridium difficile infection in patients with ulcerative colitis.clostridium difficile infection (cdi) is becoming prevalent in general population as well as in patients with inflammatory bowel disease (ibd).201021272802
synthesis and antimicrobial evaluation of nitazoxanide-based analogues: identification of selective and broad spectrum activity.a library composed of nitazoxanide-based analogues was synthesized and assayed for increased antibacterial efficacy against the pyruvate-ferredoxin oxidoreductase (pfor) using microorganisms helicobacter pylori, campylobacter jejuni and clostridium difficile. derivatives were found to recapitulate and improve activity against these organisms and select analogues were tested for their ability to disrupt the pfor enzyme directly. the library was also screened for activity against staphylococci and ...201021275058
common approaches to the control of multidrug-resistant organisms other than methicillin-resistant staphylococcus aureus (mrsa).curbing antibiotic resistance is a challenge in health care today. infections caused by multidrug-resistant organisms are estimated to cause 12,000 deaths and cost 3.5 billion dollars in excess health care costs in the united states annually. this article focuses on relevant infection control measures for vancomycin-resistant enterococci, multidrug-resistant gram-negative infections, and clostridium difficile. common control strategies targeting these pathogens are reviewed and opportunities for ...201021316000
clostridium difficile infection: an overview of the disease and its pathogenesis, epidemiology and interventions.clostridium difficile infection (cdi) is the primary cause of antibiotic-associated diarrhea and is a significant nosocomial disease. in the past ten years, variant toxin-producing strains of c. difficile have emerged, that have been associated with severe disease as well as outbreaks worldwide. this review summarizes current information on c. difficile pathogenesis and disease, and highlights interventions used to combat single and recurrent episodes of cdi.201021327030
in-depth genetic analysis of clostridium difficile pcr-ribotype 027 strains reveals high genome fluidity including point mutations and inversions.previously, we demonstrated that the recently evolved pcr-ribotype 027 hypervirulent clostridium difficile strain (r20291) has acquired five genetic regions compared to the historic 027 counterpart strain (cd196), that may in part explain phenotypic traits relating to survival, antimicrobial resistance and virulence. closer scrutiny of the three genome sequences reveals that, in addition to gene gain/loss, point mutations and inversions appear to have accumulated. inversions are located upstream ...201021327033
infectious diarrhea: cellular and molecular mechanisms.diarrhea caused by enteric infections is a major factor in morbidity and mortality worldwide. an estimated 2-4 billion episodes of infectious diarrhea occur each year and are especially prevalent in infants. this review highlights the cellular and molecular mechanisms underlying diarrhea associated with the three classes of infectious agents, i.e., bacteria, viruses and parasites. several bacterial pathogens have been chosen as model organisms, including vibrio cholerae as a classical example of ...201021327112
the incidence of nosocomial toxigenic clostridium difficile associated diarrhea in tehran tertiary medical centers.clostridium difficile is the most common cause of nosocomial diarrhea. it is usually a consequence of antibiotic treatment, but sporadic cases can occur. this study was aimed to determine the frequency of the nosocomial clostridium difficile (c. difficile) associated diarrhea in tehran university of medical sciences hospitals and study of antibacterial susceptibility of isolates. in this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in imam khom ...201021287466
ccpa-mediated repression of clostridium difficile toxin gene expression.the presence of glucose or other rapidly metabolizable carbon sources in the bacterial growth medium strongly represses clostridium difficile toxin synthesis independently of strain origin. in gram-positive bacteria, carbon catabolite repression (ccr) is generally regarded as a regulatory mechanism that responds to carbohydrate availability. in the c. difficile genome all elements involved in ccr are present. to elucidate in vivo the role of ccr in c. difficile toxin synthesis, we used the clost ...201021299645
[surfaces of the hospital environment as possible deposits of resistant bacteria: a review].the main objective of this study is to identify, in the literature, articles about the occurrence of contamination from inanimate surfaces and a possible dissemination of resistant bacteria in the hospital environment. a bibliographic survey was performed with articles published in the databases lilacs, medline, science direct, scopus and isi web of knowledge, between 2000 and 2008. twenty-one articles were selected and analyzed. the analyzed studies highlighted the presence of bacteria on monit ...201021337799
clostridium difficile infection: essential information for nurses.clostridium difficile (c. difficile) infection is a challenging problem in the acute care setting. staff nurses are important in the early recognition, diagnosis, and prompt treatment of patients with this bacterial infection. essential information regarding c. difficile, including pathogenesis, risk factors, patient presentation, diagnosis, and treatment approaches, is reviewed.201021337989
[clostridium difficile and ulcerative colitis].different diagnostic considerations take place when a diarrhea of recent development and prolonged or atypical course is evaluated. infectious colitis, including clostridium difficile colitis, and inflammatory bowel disease are the main diagnosis that we put into consideration. we present a 42-year-old woman that begins with diarrhea of probable infectious cause. because of the recurrence of the symptoms we arrived to the diagnosis of clostridium difficile colitis complicating an ulcerative coli ...201021381409
significant impact of terminal room cleaning with bleach on reducing nosocomial clostridium difficile.we were alerted to increased rates of clostridium difficile-positive tests at all 3 hospitals in our health care system by medmined data mining surveillance service, carefusion (san diego, ca). in response, an intervention of terminal room cleaning with dilute bleach was instituted to decrease the amount of c difficile environmental spore contamination from patients with c difficile infection (cdi).201020123150
typing of clostridium difficile isolates endemic in japan by sequencing of slpa and its application to direct typing.a typing system for clostridium difficile using sequencing of the surface-layer protein a encoding gene (slpa) was evaluated and used to analyse clinical isolates in japan. a total of 160 stool specimens from symptomatic patients in japan was examined and 87 c. difficile isolates were recovered. slpa sequence typing was found to have reliable typability and discriminatory power in comparison with pcr ribotyping, and the typing results were highly reproducible and comparable. slpa sequence typing ...201020133413
diagnosing of clostridium difficile colitis. 201020134370
trichomonas vaginalis vast bspa-like gene family: evidence for functional diversity from structural organisation and transcriptomics.trichomonas vaginalis is the most common non-viral human sexually transmitted pathogen and importantly, contributes to facilitating the spread of hiv. yet very little is known about its surface and secreted proteins mediating interactions with, and permitting the invasion and colonisation of, the host mucosa. initial annotations of t. vaginalis genome identified a plethora of candidate extracellular proteins.201020144183
association of ciprofloxacin prescriptions to outpatients to clostridium difficile infections.to study if antibiotic treatment of outpatients had triggered clostridium difficile infections (cdi), prescription numbers were compared with cdi-affected patient numbers. a strong correlation was observed for ciprofloxacin (r=0.917), suggesting that increased use of ciprofloxacin by outpatients contributed to increased numbers of cdi. these findings deserve further investigation as they may have an impact on future decisions regarding antibiotic prescribing.201020144444
evaluation of the risk of transmission of bacterial biofilms and clostridium difficile during gastrointestinal endoscopy.recent attention has focused on the potential for the transmission of bacterial biofilms, clostridium difficile, and other types of pathogenic spore-forming bacteria during gastrointestinal (gi) endoscopy. this study investigates whether gi endoscopy is a risk factor for the transmission of bacterial biofilms and the endospores or vegetative cells of pathogenic spore-forming bacteria including c. difficile. the medical literature was reviewed to evaluate the risk of the transmission of these inf ...201020145448
dose-response efficacy of a proprietary probiotic formula of lactobacillus acidophilus cl1285 and lactobacillus casei lbc80r for antibiotic-associated diarrhea and clostridium difficile-associated diarrhea prophylaxis in adult patients.standard therapies for antibiotic-associated diarrhea (aad) and clostridium difficile-associated diarrhea (cdad) have limited efficacy. probiotic prophylaxis is a promising alternative for reduction of aad and cdad incidence.201020145608
a complex of 2-hydroxyisocaproyl-coenzyme a dehydratase and its activator from clostridium difficile stabilized by aluminium tetrafluoride-adenosine diphosphate.the dehydration of 2-hydroxyisocaproyl-coa to isocaprenoyl-coa is the chemically most demanding step in the reduction of leucine to isocaproate by clostridium difficile, because the beta-hydrogen of the substrate is not acidic (pk(a) ca. 40). a two-component system, composed of a homodimeric activator and an heterodimeric dehydratase, catalyses this unusual alpha,beta-elimination of water. the reduced activator transfers an electron from its [4fe-4s](+) cluster to that of the dehydratase in an a ...201020146278
increasing incidence of community-associated atypical clostridium difficile disease in children.forty-one children with a variety of gastrointestinal complaints were diagnosed with clostridium difficile infections as part of a routine screen over 3 years. the infection had not been suspected prior to the screen. each child responded to treatment with metronidazole with resolution of their symptoms. these data suggest that community-associated c difficile is increasing and may produce atypical disease and lead to misdiagnosis.201020150212
the antimicrobial compound reuterin (3-hydroxypropionaldehyde) induces oxidative stress via interaction with thiol groups.reuterin is an antimicrobial compound produced by lactobacillus reuteri, and has been proposed to mediate, in part, the probiotic health benefits ascribed to this micro-organism. despite 20 years of investigation, the mechanism of action by which reuterin exerts its antimicrobial effects has remained elusive. here we provide evidence that reuterin induces oxidative stress in cells, most likely by modifying thiol groups in proteins and small molecules. escherichia coli cells subjected to subletha ...201020150236
neutralization of clostridium difficile toxin a using antibody combinations.the pathogenicity of clostridium difficile (c. difficile) is mediated by the release of two toxins, a and b. both toxins contain large clusters of repeats known as cell wall binding (cwb) domains responsible for binding epithelial cell surfaces. several murine monoclonal antibodies were generated against the cwb domain of toxin a and screened for their ability to neutralize the toxin individually and in combination. three antibodies capable of neutralizing toxin a all recognized multiple sites o ...201020150758
incidence of clostridium difficile infection in patients with acute leukemia and lymphoma after allogeneic hematopoietic stem cell transplantation. 201020109075
adverse drug events among hospitalized medicare patients: epidemiology and national estimates from a new approach to surveillance.although adverse drug events (ades) are a well-recognized problem among hospitalized patients, there is no system for monitoring them. six high-alert medications and associated adverse events were selected for inclusion in the medicare patient safety monitoring system (mpsms), a national surveillance system designed to identify and track over time inpatient adverse events within the hospitalized fee-for-service medicare population.201020112660
real-time multiplex polymerase chain reaction assay for rapid detection of clostridium difficile toxin-encoding strains.clostridium difficile is considered an important emerging pathogen capable of causing disease in humans and animal species. in our study, we developed and evaluated a multiplex real-time polymerase chain reaction (pcr) assay for the detection of c. difficile genes encoding toxin a (tcda), toxin b (tcdb), and binary toxin (cdta and cdtb). the standardized real-time pcr assay for toxin genes of c. difficile was used to screen for toxigenic c. difficile in fecal samples from 71 preweaned calves, 53 ...201020113206
risk factors for and estimated incidence of community-associated clostridium difficile infection, north carolina, usa.we determined estimated incidence of and risk factors for community-associated clostridium difficile infection (ca-cdi) among patients treated at 6 north carolina hospitals. ca-cdi case-patients were defined as adults (>18 years of age) with a positive stool test result for c. difficile toxin and no hospitalization within the prior 8 weeks. ca-cdi incidence was 21 and 46 per 100,000 person-years in veterans affairs (va) outpatients and durham county populations, respectively. va case-patients we ...201020113547
postoperative clostridium difficile-associated diarrhea.abdominal surgery is thought to be a risk factor for clostridium difficile-associated diarrhea (cdad). the aims of this study were to discern pre-operative factors associated with postoperative cdad, examine outcomes after postoperative cdad, and compare outcomes of postoperative versus medical cdad.201020116817
success of self-administered home fecal transplantation for chronic clostridium difficile infection.clostridium difficile infection (cdi) can relapse in patients with significant comorbidities. a subset of these patients becomes dependent on oral vancomycin therapy for prolonged periods with only temporary clinical improvement. these patients incur significant morbidity from recurrent diarrhea and financial costs from chronic antibiotic therapy.201020117243
reevaluation of the premier clostridium difficile toxin a and b immunoassay with comparison to glutamate dehydrogenase common antigen testing evaluating bartels cytotoxin and prodesse progastro cd polymerase chain reaction as confirmatory procedures.enzyme immunoassays are currently the most common tests used in the clinical laboratory for the detection of clostridium difficile toxins; however, significant problems with their performance have recently been described. we prospectively reevaluated the meridian premier c. difficile toxin a/b assay with direct comparison to a 2-step algorithm that screened for c. difficile common antigen and compared cytotoxin and real-time polymerase chain reaction (pcr) as confirmatory procedures. the premier ...201020117349
should probiotics be routine therapy for the prevention of antibiotic-associated diarrhea? 201020099380
prevalence of diverticulosis in recurrent clostridium difficile infection.to re-evaluate the theory that colonic diverticulosis is associated with relapse of clostridium difficile associated disease (cdad) in light of data suggesting increasing rates of cdad infection and relapse.201020082480
treatment with monoclonal antibodies against clostridium difficile toxins.new therapies are needed to manage the increasing incidence, severity, and high rate of recurrence of clostridium difficile infection.201020089970
clostridium difficile--beyond antibiotics. 201020089977
metabolism of bile salts in mice influences spore germination in clostridium difficile.clostridium difficile, a spore-forming bacterium, causes antibiotic-associated diarrhea. in order to produce toxins and cause disease, c. difficile spores must germinate and grow out as vegetative cells in the host. although a few compounds capable of germinating c. difficile spores in vitro have been identified, the in vivo signal(s) to which the spores respond were not previously known. examination of intestinal and cecal extracts from untreated and antibiotic-treated mice revealed that extrac ...201020090901
disease transmission model for community-associated clostridium difficile infection.participating researchers and public health personnel at a canadian workshop in 2007, noted considerable gaps in current understanding of community-associated clostridium difficile infection (ca-cdi), specifically infection sources and risk factors. a disease transmission model for ca-cdi was requested as an initial step towards a risk assessment, to analyse infection sources and risk factors, addressing priority research areas. the developed model contains eight infection states (susceptible, g ...201020092667
four distinct structural domains in clostridium difficile toxin b visualized using saxs.clostridium difficile is a nosocomial bacterial pathogen causing antibiotic-associated diarrhea and fatal pseudomembranous colitis. key virulence factors are toxin a and toxin b (tcdb), two highly related toxins that are members of the large clostridial toxin family. these large multifunctional proteins disrupt cell function using a glucosyltransferase domain that is translocated into the cytosol after vesicular internalization of intact holotoxin. although substantial information about the bioc ...201020070948
fidaxomicin: a macrocyclic antibiotic for the management of clostridium difficile infection.to evaluate the efficacy and safety of fidaxomicin for the treatment of clostridium difficile infection.201020071495
coexistence of multiple multilocus variable-number tandem-repeat analysis subtypes of clostridium difficile pcr ribotype 027 strains within fecal specimens.we investigated whether multilocus variable-number tandem-repeat analysis (mlva) typing could identify different subtypes of clostridium difficile ribotype 027 within the same feces specimen. five of 39 specimens yielded at least one isolate with an mlva profile different (more than five summed tandem repeat differences) from that of other isolates in the same specimen, thereby potentially obscuring epidemiological links between c. difficile infection cases.201020071546
comparison of immunocard toxins a&b and the new semiautomated vidas clostridium difficile toxin a&b tests for diagnosis of c. difficile infection. 201020071550
clostridium difficile testing in the clinical laboratory by use of multiple testing algorithms.the incidence of clostridium difficile infection (cdi) has risen almost 3-fold in the united states over the past decade, emphasizing the need for rapid and accurate tests for cdi. the cepheid xpert c. difficile assay is an integrated, closed, nucleic acid amplification system that automates sample preparation and real-time pcr detection of the toxin b gene (tcdb). a total of 432 stool specimens from symptomatic patients were tested by a glutamate dehydrogenase (gdh) assay, a toxin a and b enzym ...201020071552
Refresh
firstprev
...51525354555657585960...
nextlast
Displaying items 5701 - 5800 of 12134