Publications

an immunochemical method for fingerprinting clostridium difficile.	the use of sodium dodecyl sulphate-polyacrylamide gel electrophoresis in association with electrophoretic transfer of proteins to nitrocellulose and subsequent probing with antisera appears useful as a method for fingerprinting clostridium difficile. thorough testing of the stability of the antigenic nature of isolates of the organism during subculture and antigen preparation has shown it to be remarkably stable both in vitro and in vivo. minor differences in the method of antigen extraction do ...	1985	3902977
pathogenesis and diagnosis of clostridium difficile enterocolitis.	antibiotic associated clostridium difficile enterocolitis is an infectious disease with symptoms ranging from self-limiting diarrhoea to severe colitis with bloody stools and formation of pseudomembranes. the carrier rate of c. difficile in a general swedish population was found to be low (2%; 11/594). in patients with acute diarrhoea unrelated to antibiotics the bacterium or its toxin was found in 3% (12/398). in patients with diarrhoea associated with antibiotics c. difficile or its toxin was ...	1985	3906856
discovery and development of the monobactams.	a novel procedure designed to detect naturally occurring beta-lactam-containing molecules led to isolation of the monobactams - structurally unique, bacterially produced, monocyclic beta-lactam antibiotics. although none of these monobactams exhibited impressive antimicrobial activity, side-chain variation - as with the penicillins and cephalosporins - resulted in potently active compounds. aztreonam was chosen from hundreds of compounds for extended laboratory studies. in addition to a unique c ...	1985	3909315
clinical experience with aztreonam in the treatment of gram-negative bacteremia.	aztreonam was used for the treatment of gram-negative bacteremia in 101 patients. in 34 instances a second antibiotic was prescribed for the treatment of suspected or documented gram-positive or anaerobic infection. the sources of bacteremia were the urinary tract (50 patients), an intraabdominal site (17), the respiratory tract (8), an intravascular site (9), and an unknown site (17). the clinical response rate was 92% (91 of 99 patients). the bacteriologic response rate was 97% (98 of 101 pati ...	1985	3909338
cefuroxime versus ceftriaxone prophylaxis in cardiovascular surgery.	in a randomized, prospective study a 2-day course of cefuroxime prophylaxis (zinacef, 1.5g every 12 h) was compared with 2-day ceftriaxone prophylaxis (rocephin, 2g i.v. plus 1g i.v. after 24 h). to date 512 patients undergoing cardiac (n = 418) and major vascular surgery (n = 94) entered the study: 258 in the cefuroxime and 254 in the ceftriaxone group. the one-month lethality rate was 1.0%. the total infection rate was 4.7% (12 patients in the cefuroxime and 12 in the cefuroxime group. septica ...	1985	3915287
effects of clostridium difficile toxins given intragastrically to animals.	we examined the activities of clostridium difficile toxin preparations given intragastrically to hamsters, mice, and rats. the culture filtrate from a highly toxigenic strain of c. difficile caused hemorrhage and accumulation of fluid in the small intestine and cecum, diarrhea, and death in hamsters and mice. in rats, the culture filtrate caused only a small amount of fluid accumulation and slight hemorrhage along the small intestine. when toxin a was removed from the culture filtrate, the filtr ...	1985	3917975
[isolation of clostridium difficile from specimens other than stool].		1985	3923135
[a case of clostridium difficile colitis induced by rifampicin].		1985	3925038
in-vitro activity of sch 34343 against nosocomial pathogens: methicillin-resistant staphylococci, gentamicin-susceptible and -resistant streptococcus faecalis, clostridium difficile and bacteroides fragilis.	the in-vitro activity of sch 34343, a new beta-lactam antimicrobial, was studied in vitro by quantitative broth dilution methods. it was found to have good antibacterial activity against four emerging problem pathogens: methicillin-resistant staphylococcus aureus, streptococcus faecalis isolates showing high level resistance to gentamicin (and other aminoglycosides), clostridium difficile (the cause of pseudomembranous colitis), and bacteroides fragilis. on the basis of these promising results, ...	1985	3928577
clostridium difficile colitis mimicking acute peritonitis.	five patients receiving penicillin v potassium or a cephalosporin antibiotic for 18 hours to 22 days developed fever, marked leukocytosis, and signs and symptoms that suggested right-lower-quadrant peritoneal irritation. all underwent emergency laparotomy, at which dilatation and inflammation of the ascending colon were found. only one of the patients had profuse diarrhea, and two patients had no diarrhea prior to laparotomy. postoperatively, clostridium difficile colitis was diagnosed by stool ...	1985	3931611
[significance of ureaplasma urealyticum and clostridium difficile in nongonococcal urethritis].		1985	3932554
[the effect of prostaglandins on cytotoxin and enterotoxin production of clostridium difficile].		1985	3936886
antimicrobial activity of aridicins, novel glycopeptide antibiotics with high and prolonged levels in blood.	three new glycopeptide antibiotics, aridicins a, b, and c, produced by kibdelosporangium aridum have a spectrum of antimicrobial activity in vitro which is similar to that of vancomycin. the antimicrobial activities of these glycopeptides against clinical bacterial isolates were compared with those of vancomycin and other related glycopeptide antibiotics in vitro by agar dilution and microtiter broth dilution tests and in vivo in mouse protection studies. in vitro they were somewhat less effecti ...	1985	3937489
p-cresol formation by cell-free extracts of clostridium difficile.	cell-free extracts of clostridium difficile were shown to form p-cresol by decarboxylation of p-hydroxyphenylacetic acid. this activity required both high and low molecular weight fractions. the active component of the low molecular weight fraction had properties of an amino acid and could be replaced by serine, threonine or the corresponding alpha keto acids. pyruvate was shown to function catalytically. since the high molecular weight fraction was o2-sensitive and since dithionite was as effec ...	1985	3938267
[demonstration of clostridium difficile and toxin b in patients at a university clinic].	107 stool specimens from not hospitalized individuals and 69 stool specimens from 61 hospitalized patients (internal medicine) were examined for c. difficile and toxin b. included were 42 specimens of 33 female patients of the department of maxillo-facial surgery, receiving prophylactic clindamycin and 7 samples from the ward staff. from the samples of the first group, c. difficile was isolated in one case (0.93%), whereas 8 out of 61 internal patients (13%) were positive for c. difficile by cul ...	1985	3939049
etiology of acute infectious diarrhea in a highly industrialized area of switzerland.	during an 18-mo period between 1981 and 1982, a prospective study was conducted in 119 adult patients with acute diarrhea. a diarrhea-inducing microorganism or toxin could be identified in 38.7% of the patients. salmonella sp and campylobacter jejuni were the leading agents that caused diarrheal illness in 25% of the investigated population. clostridium difficile was found in 6%, mainly after previous antibiotic therapy. rotavirus was rarely isolated and enterotoxigenic escherichia coli were not ...	1985	3964774
clinical and endoscopic findings in patients early in the course of clostridium difficile-associated pseudomembranous colitis.	endoscopic and clinical features are reported for 39 patients detected early in the course of pseudomembranous colitis. disease was detected early by virtue of careful surveillance in patients in whom diarrhea developed. early proctosigmoidoscopic findings in pseudomembranous colitis are illustrated. clinical presentation includes development of fever, leukocytosis, abdominal pain, and even an ileus picture on radiography in addition to diarrhea.	1985	3966488
pseudomembranous colitis following prophylactic antibiotic use in primary cesarean section.	a report of a hospital outbreak of pseudomembranous colitis in three patients given prophylactic antibiotic therapy before and after primary cesarean section is presented. all patients shared the same ward and labor and delivery room, and the colitis occurred within an 8-day period. the diagnosis of pseudomembranous colitis was suspected clinically and confirmed by limited colonoscopy and biopsy followed by stool culture and toxin assay for clostridium difficile. the high carrier rate of clostri ...	1985	3966512
monoclonal and specific polyclonal antibodies for immunoassay of clostridium difficile toxin a.	monoclonal antibody, affinity-purified antibody, and monospecific antiserum against toxin a were produced. the monoclonal antibody was an immunoglobulin g2a kappa chain isotype that immunoprecipitated toxin a, as shown by crossed immunoelectrophoresis. these antibodies were compared by counterimmunoelectrophoresis, latex agglutination, and indirect enzyme-linked immunosorbent assay for their sensitivity in detecting toxin a. our findings indicate that these antibodies may be useful as immunodiag ...	1985	3968199
improved gas-liquid chromatography method for the identification of clostridium difficile.		1985	3968205
gas chromatographic identification of clostridium difficile and detection of cytotoxin from a modified selective medium.	a modification of an existing selective medium for clostridium difficile is described. inclusion in the medium of dl nor-leucine and p-hydroxyphenylacetic acid enables identification of c difficile to be made directly from primary isolation plates by gas chromatographic detection of caproic acid and p-cresol. plugs of agar withdrawn from the selective medium also allow the detection of cytotoxin production in vitro.	1985	3968212
effect of antibiotic concentration in a selective medium on the isolation of clostridium difficile from faecal specimens.		1985	3968221
population dynamics of ingested clostridium difficile in the gastrointestinal tract of the syrian hamster.	the population dynamics of clostridium difficile in the hamster gastrointestinal tract were studied after intragastric inoculation with organisms and a 51cr tracer. seventy-eight percent of spores germinated within the small intestine within 1 hr. germinated spores and vegetative cells both showed two phases of elimination from the hamster cecum--an initial phase of rapid death that was not affected by antibiotic treatment followed by a phase of complete inhibition of multiplication. the latter ...	1985	3968453
interaction between penicillin, clindamycin or metronidazole and gentamicin against species of clostridia and anaerobic and facultatively anaerobic gram-positive cocci.	seven anaerobic and facultative gram-positive cocci and 12 clostridial species were tested for in-vitro and in-vivo susceptibilities to penicillin, clindamycin, and metronidazole, used singly or in combination with gentamicin. the in-vitro tests consisted of determination of minimal inhibitory concentration (mic), done without or with constant amounts of gentamicin. when used alone or in combination with penicillin or metronidazole, gentamicin had negligible effects on the bacteria. when used wi ...	1985	3972757
two bacteriophages of clostridium difficile.	two temperate bacteriophages of differing morphology and host range were isolated by screening 94 isolates of clostridium difficile. phage 41 had a 300-nm flexible tail, whereas phage 56 had a shorter tail with a contractile sheath. electron microscopy of phage 56 lysates exposed to elevated magnesium concentrations showed small virus-like particles which were 21 nm in diameter. the addition of mgcl2 to semisolid agar overlays enhanced both the titer and plaque size of phage 56. phage 56 was mor ...	1985	3972994
antimicrobial agents and clostridium difficile in acute enteric disease: epidemiological data from sweden, 1980-1982.	the carrier rate of clostridium difficile in an adult swedish population was found to be 11 (1.9%) of 594. all isolates were toxigenic in vitro, but no healthy individual harbored free cytotoxin in stool. of 398 patients with acute diarrhea not associated with antibiotic use, cytotoxin was found in stool filtrates of four (1%). in 4,793 patients with antibiotic-associated diarrhea from all parts of sweden during 1980-1982, c. difficile cytotoxin was demonstrated in 873 (18%). the tissue culture ...	1985	3973405
indium-111 leukocyte imaging in colitis induced by clostridium difficile.		1985	3973743
modulation of cytotoxin production by clostridium difficile in the intestinal tracts of gnotobiotic mice inoculated with various human intestinal bacteria.	gnotobiotic mice died 2 days after inoculation of a cytotoxigenic clostridium difficile strain. protection occurred when mice were previously inoculated with a strain of escherichia coli or bifidobacterium bifidum. intestinal cytotoxin production was highly reduced in the surviving mice, whereas the c. difficile population level did not decrease to a great extent.	1985	3977313
serogrouping of clostridium difficile strains by slide agglutination.	six different agglutinating antisera were obtained by immunizing rabbits with formol-treated strains of clostridium difficile. after appropriate absorption, these antisera were used to define six serogroups designated by the letters a, b, c, d, f, and g. altogether, 315 strains of c. difficile from various origins were tested for slide agglutination by these antisera; 312 (99%) of them were agglutinated by one of these antisera. a and c were the most common serogroups. an excellent correlation, ...	1985	3980688
detection of clostridium difficile enterotoxin in neonates by latex agglutination.	clostridium difficile enterotoxin (d-1) was detected in 13 symptomatic and nine asymptomatic neonates in the neonatal intensive care unit by latex agglutination test but was not found in 18 healthy neonates in two other newborn nurseries. environmental contamination in the intensive care unit may have been the cause. an association between the presence of enterotoxin and clinical symptoms is discussed.	1985	3985657
effect of adding sodium taurocholate to selective media on the recovery of clostridium difficile from environmental surfaces.	the recovery of clostridium difficile on a medium containing cefoxitin, cycloserine, fructose, and egg yolk was compared with that on media containing one of three preparations of sodium taurocholate. in aerobic environments contaminated with c. difficile, media containing either crude taurocholate from mann research laboratories, new york, n.y., or pure taurocholate from sigma chemical co., st. louis, mo., recovered organisms significantly more often than did cefoxitin-cycloserine-fructose-egg ...	1985	3988904
ceftriaxone: pharmacokinetics and effect on the intestinal microflora in patients with acute bacterial infections.	12 patients with acute bacterial infections were treated with ceftriaxone, 1.5 g intravenously twice daily for 7-13 days. pharmacokinetic variables were studied in 11 patients. in older subjects, serum half-lives were longer and serum clearances lower than in younger individuals. after the last dose, a larger increase in auc compared to the first dose was observed in older patients and a biphasic elimination curve appeared in all patients but 2, with a terminal half-life of 15.6 h and 11.4 in ol ...	1985	3992209
antibiotic-associated pseudomembranous colitis.	all antibiotics, except parenteral aminoglycosides, sulfonamides and vancomycin, can induce pseudomembranous colitis. the worst offenders are clindamycin, ampicillin, amoxicillin and the cephalosporins. the cytotoxin produced by clostridium difficile has been identified as the cause of pseudomembranous colitis. treatment includes an antimicrobial to eradicate the organism and cholestyramine or colestipol to bind the toxin.	1985	3993509
effect of l-cysteine on the activity of penicillin antibiotics against clostridium difficile.	we observed elevated mics of penicillin antibiotics while performing agar dilution susceptibility testing of strains of clostridium difficile on supplemented brain heart infusion agar, an effect which was completely eliminated by the exclusion of l-cysteine from the medium. l-cysteine antagonizes the activity of penicillins against c. difficile, most likely by direct inactivation of the antibiotic.	1985	3994352
pseudomembranous colitis in spinal cord injury.	pseudomembranous colitis is a well-known disease associated with antibiotic administration and caused by the clostridium difficile toxin. clinical presentation is usually marked by watery diarrhea, crampy abdominal pain, and fever. since early appropriate therapy can reduce morbidity and mortality, it is important for health care professionals to be aware of this disease. patients with spinal cord injury have a relatively high incidence of respiratory and urinary tract infections that are treate ...	1985	4004539
enzyme immunoassay for detection of clostridium difficile toxins a and b in patients with antibiotic-associated diarrhoea and colitis.	a sandwich enzyme immunoassay (elisa) was developed to detect clostridium difficile toxins a and b in stools from patients with antibiotic associated diarrhoea and colitis. immune serum to crude clostridium difficile toxin and non-immune serum were coated onto polystyrene microtiter plates to act as capture antibodies; toxins a and b in human stools were detected by antibodies from rabbits immunized with purified toxins a and b. the elisa for toxin b showed cross-reactions with clostridium bifer ...	1985	4006928
enrichment media for isolation of clostridium difficile from faeces.		1985	4006930
evaluation of gas-liquid chromatography for the rapid diagnosis of clostridium difficile associated disease.	direct gas-liquid chromatography of faecal specimens with isocaproic acid as a marker was used for the rapid diagnosis of clostridium difficile associated diarrhoeal diseases. ninety stools were examined and results were compared with conventional culture on selective medium and cytotoxin assay in tissue culture. using a combined analysis of isocaproic acid and butyric acid peak heights we defined three categories: positive, negative, and indeterminate. when the indeterminate group was excluded, ...	1985	4008667
clostridium difficile-associated diarrhoea.		1985	4008969
protection of hamsters against clostridium difficile ileocaecitis by prior colonisation with non-pathogenic strains.	prior colonisation of clindamycin-treated hamsters with non-toxigenic strains of c. difficile protected them from subsequent colonisation with a toxigenic pathogenic strain. in total, 13 of 18 'protected' hamsters survived for up to 27 days whereas all 27 animals challenged with the toxigenic strain alone died within 48 h. protection was not evident if a heat-killed suspension was used or if the colonising non-toxigenic strain was first removed with vancomycin. no antitoxic activity could be det ...	1985	4009689
germinability and heat resistance of spores of clostridium difficile strains.	out of 111 clostridium difficile strains, 108 produced spores in numbers of more than 10(5)/ml and the remaining three did not produce any spores in brain heart infusion medium. the germination frequency in the medium without lysozyme varied widely from strain to strain, ranging from less than 10(-8) to 10(0), and in 77 of the 108 strains the germination frequency was 10(-5) or less. the spores, when treated with sodium thioglycollate and then inoculated into the medium containing lysozyme, germ ...	1985	4010539
[the role of clostridium difficile in antibiotic-associated enteritis].		1985	4010560
evaluation and diagnosis of acute infectious diarrhea.	the appropriate approach to the diagnosis and management of acute infectious diarrhea is determined by the frequency and setting of the illness, the recognizable causes or syndromes, the cost and yield of available diagnostic tests, and the treatability of the disease. acute diarrhea affects everyone throughout the world from one to more than six times each year, depending on age, location, and living conditions. the range of identifiable viral, bacterial, and parasitic etiologies is great, and ...	1985	4014291
in vitro activity of sch 34343 and cefbuperazone against anaerobic bacteria.	the in vitro activities of sch 34343, a new penem antibiotic, and cefbuperazone, a new cephamycin antibiotic, were determined against 459 clinical anaerobic bacterial isolates and compared with the activities of imipenem and cefoxitin, respectively, by an agar dilution method. both penems showed potent and similar activity against all anaerobic bacteria tested, particularly peptococcus spp., bacteroides fragilis, and clostridium perfringens. all organisms except a single strain of fusobacterium ...	1985	4015069
production of toxins a and b by clostridium difficile strains isolated from infants and adults.		1985	4015295
effect of filtrate containing clostridium difficile toxin on rectal mucosa maintained in organ culture.	rectal biopsies were maintained in organ culture over a 24-hour culture period, with good preservation of histological architecture. a filtrate containing clostridium difficile toxin significantly inhibited the rise in epithelial alkaline phosphatase activity normally seen during culture. this effect was abolished by pre-incubation of the filtrate with clostridium sordellii antitoxin, or heat inactivation. this effect is most probably due to a toxin of c. difficile. the method provides a new qua ...	1985	4018440
experimental models of clostridium difficile enterocolitis in gnotobiotic mice.		1985	4022975
kinetics of cytotoxin production in feces of gnotobiotic mice and rats associated with two strains of clostridium difficile.		1985	4022976
clostridium difficile in patients with cystic fibrosis.	one hundred seven patients with cystic fibrosis (cf) and 54 other patients with risk factors for clostridium difficile-associated disease were entered into a bacteriologic study to compare the rate of recovery of c difficile and cytotoxin in feces with occurrence of diarrhea and to investigate potentially protective or permissive relationships of fecal flora. toxigenic c difficile was recovered from 22% of cf patients and 11% of patients with other diagnoses. unlike the latter group, the majorit ...	1985	4025261
activity of a peptidyl prodrug, alafosfalin, against anaerobic bacteria.	alafosfalin, an antibacterial phosphonodipeptide requiring peptide transport for activity, was tested for activity against clinical strains of anaerobic bacteria in peptide-free roche sensitivity test medium no. 5 agar. it was active against bacteroides spp., fusobacterium nucleatum, and clostridium perfringens but not against clostridium difficile. alafosfalin activity was antagonized by appropriate peptides. synergy was obtained with other cell wall-active antibiotics.	1985	4026269
clostridium difficile colitis following head and neck surgery. report of cases.	clostridium difficile, a toxin-producing, gram-positive anaerobe, has been implicated as the causative agent of pseudomembranous colitis, an acute inflammatory bowel disease that generally occurs in association with antimicrobial therapy. this subject has received extensive review in the general surgical, medical, and pediatric literature but has not been specifically addressed in the literature of our specialty. we present the report of four recent cases, including one that progressed to the cl ...	1985	4026668
pseudomembranous colitis and wound infection following perioperative use of multiple antibiotics.	the prophylactic use of antibiotics in elective surgery of the colon is accepted practice, but it has inherent risks. the authors report the case of a 70-year-old woman who had wound infection and severe, relapsing pseudomembranous colitis due to clostridium difficile after a short course of antibiotics given orally and parenterally at the time of elective resection of the colon. perioperatively, she received erythromycin base and neomycin orally, plus netilmicin and metronidazole intravenously. ...	1985	4027790
studies with temocillin in the hamster model of antibiotic-associated colitis.	the studies reported here were designed to ascertain whether or not the new beta-lactam antibiotic, temocillin, would produce antibiotic-associated colitis in the hamster. the experiments were controlled with clindamycin and cefoxitin, which are known to induce antibiotic-associated colitis experimentally and clinically. all three antibiotics were administered to groups of animals both parenterally and orally. clindamycin, at 1 mg/hamster, caused a slow onset of antibiotic-associated colitis by ...	1985	4029030
serum antibody response to clostridium difficile toxins in patients with clostridium difficile diarrhoea.	consecutive serum samples from 61 patients with clostridium difficile diarrhoea were investigated for antibody response to c. difficile toxins a and b in an indirect enzyme immunoassay (elisa) and in a neutralization assay against c. difficile cytotoxin. sera from 64 blood donors, elderly healthy females and patients with other known intestinal enteropathogens served as controls. an immune response was detected by elisa in approximately half of the patients with c. difficile diarrhoea. the speci ...	1985	4030111
comparative in-vitro activity of sch 34343 for a wide spectrum of clinically significant anaerobic bacteria.	one hundred and fifty strains of anaerobic bacteria including 45 bacteroides, 19 fusobacteria, 41 cocci, 34 clostridia, and 11 gram-positive non-sporeforming rods were tested by agar dilution for their susceptibilities to cefoxitin, cefuroxime, latamoxef (moxalactam), penicillin g, chloramphenicol, clindamycin, metronidazole and sch 34343. excluding the 34 clostridia, 115 of the 116 remaining strains were inhibited by less than or equal to 1 mg/l of sch 34343. one isolate of bacteroides fragilis ...	1985	4030546
spontaneous pseudomembranous colitis not associated with clostridium difficile.	this paper describes two patients who developed macroscopically and microscopically typical pseudomembranous colitis without prior exposure to antimicrobial agents and without detectable clostridium difficile or its toxin in the faeces.	1985	4031517
[incidence of diarrhea caused by toxin-producing clostridium difficile in hungary].		1985	4034181
identification of clostridium difficile by detection of p-cresol in a cooked meat medium.		1985	4043071
antibiotic-associated colitis due to clostridium difficile: double-blind comparison of vancomycin with bacitracin.	a randomized double-blind study was carried out in patients with unresolving antibiotic-associated colitis due to clostridium difficile, to compare the effect of bacitracin (80,000 u/day) with vancomycin (500 mg/day) on the resolution of symptoms, clearance of organism, and prevention of relapse. forty-two patients with colitis, 9 of whom had a pseudomembrane, were randomized, 21 patients to each treatment group. the two groups were comparable in age, disease severity, and antibiotic exposure. f ...	1985	4043661
superinfections during antimicrobial treatment with betalactam-aminoglycoside combinations in neutropenic patients with hematologic malignancies.	the frequency, etiology and risk factors of superinfections during and/or within one week after antibiotic therapy with betalactam-aminoglycoside combinations were evaluated in 631 patients with hematologic malignancies admitted to the institute of hematology of rome from january 1982 to december 1984. 356 patients (56%) developed 402 episodes of proven or presumed infection. of these patients, 78 developed 102 superinfections. overall, superinfections responded less satisfactorily to antibiotic ...	1985	4055041
survey of neuraminidase production by clostridium butyricum, clostridium beijerinckii, and clostridium difficile strains from clinical and nonclinical sources.	neuraminidase production was investigated in 57 clostridium butyricum strains, 16 clostridium beijerinckii strains, and 25 clostridium difficile strains. neuraminidase activity was found only in c. butyricum strains originating from one human newborn with neonatal necrotizing enterocolitis, two newborns with hemorrhagic colitis, one infected placenta, and one adult with peritonitis, it was concluded that neuraminidase was not a major virulence factor in c. butyricum strains.	1985	4056013
clostridium difficile and clostridium perfringens in upper gut of infants with protracted diarrhoea.		1985	4056073
[disorders of intestinal flora in intensive care patients].	the intestinal flora under normal conditions prevents colonisation of the intestinal mucosa with pathogenic bacteria. various diseases as well as antibiotics may disturb the host/bacteria balance. if patients are in addition immunocompromised, otherwise commensal bacteria may cause life threatening infections. treatment of intensive care patients with antibiotics thus should account for preservation of resistance against colonization. antibiotics active against anaerobes or poorly absorbed from ...	1985	4058231
clostridium difficile colitis associated with single-dose cefazolin prophylaxis.	diarrhea and pseudomembranous colitis are associated with antimicrobial therapy and prophylaxis. clostridium difficile colitis occurred in a patient who received a single dose of cefazolin for prophylaxis at cesarean section. prompt remission occurred after treatment with oral vancomycin.	1985	4058831
chronic diarrhea associated with hypogammaglobulinemia and enteropathy in infants and children.	in order to define the gastrointestinal manifestations and small intestinal structure and function in a group of infants with chronic nonspecific diarrhea and hypogammaglobulinemia, we retrospectively identified 55 such patients from a population of 518 children evaluated for chronic diarrhea over a 6-year span (10.6%). all patients had igg levels 2.0 sd or more below the mean values for age. patients with biochemical evidence of protein loss (enteropathy or nephropathy) were excluded. there was ...	1985	4064865
identification of clostridium difficile using the api zym system.	the use of the api zym system for the identification of clostridium difficile was investigated. the enzyme profiles generated by this system readily distinguished strains of clostridium difficile from other clostridia commonly isolated from faeces. enzyme activity of clostridium difficile was influenced by the composition of the culture medium but appeared to be independent of the age of the culture. given careful standardisation of techniques the api zym system is a suitable alternative to conv ...	1985	4065138
lack of relationship between clostridium difficile toxin and inflammatory bowel disease in children.	conflicting reports have appeared concerning the role of clostridium difficile toxin in chronic inflammatory bowel disease. therefore, we prospectively evaluated the incidence of c. difficile toxin in 44 children with inflammatory bowel disease of variable clinical severity over a 1-year period. only 3/128 stool specimens provided by these patients were found to be toxin-positive. these three stool specimens were from three different patients with crohn's disease of moderate severity who had no ...	1985	4067226
clostridium difficile-associated diarrhea follows perioperative prophylaxis with cefoxitin.	clostridium difficile-associated diarrhea during prolonged therapy of obstetric and gynecologic infections is known to occur with use of all classes of antibiotics except vancomycin and the aminoglycosides. we present 11 cases of c. difficile-associated diarrhea which followed a short course of perioperative prophylaxis with cefoxitin during a 1-year period. nine of the cases of c. difficile-associated diarrhea were among 162 women who received cefoxitin perioperative prophylaxis for cesarean se ...	1985	4073152
clostridium difficile-associated colitis in uremic patients.	five uremic patients managed in a renal unit developed clostridium difficile-associated colitis. four cases occurred in a cluster at about the same time. all patients had previously received or were on antibiotic therapy at the onset of diarrhea and one patient was also on oral steroid therapy. cefotaxime, a third generation cephalosporin was involved in all five cases. all patients had severe diseases with explosive diarrhea and systemic toxicity. the diagnosis was confirmed in all cases by cul ...	1985	4075596
clostridium difficile colitis in leukemia patients.	leukemia patients with diarrhea or other abdominal symptoms have been investigated for the presence of clostridium difficile and its cytotoxin in stools. of the patients studied 19% had c. difficile, in most cases together with cytotoxin. all patients but one had received antibiotics, while one had been treated with cytotoxic agents only. symptoms of colitis were most often abdominal pain and distension rather than diarrhea. owing to the not infrequent fatal evolution, it is recommended that rou ...	1985	4076283
clostridium difficile induced colitis occurring during cefotaxime therapy.		1985	4082361
in vitro susceptibility of clostridium difficile to new beta-lactam and quinolone antibiotics.	the in vitro susceptibilities of 34 to 73 clinical isolates of clostridium difficile to 24 antimicrobial agents, including 18 beta-lactams, 4 fluoroquinolones, clindamycin, and metronidazole were examined. metronidazole was the most active (mic for 90% of the isolates [mic90], 0.5 microgram/ml), followed by the carbapenems (sch 34343, 4 micrograms/ml; imipenem, 8 micrograms/ml) and the antipseudomonas penicillins (piperacillin, 8 micrograms/ml; ticarcillin, 32 micrograms/ml; carbenicillin, 32 mi ...	1985	4083868
inhibitory effect of a copper-dipeptide complex on the establishment of a clostridium perenne strain in the intestinal tract of gnotobiotic mice.	a semisynthetic diet fed to axenic mice was found to prevent the establishment of a clostridium perenne strain in their intestinal tract. this inhibitory effect did not occur when axenic mice were preinoculated with a strain of clostridium difficile. the inhibitory effect was related to the presence in the intestinal contents of axenic mice of both dietary copper and a dipeptide, aspartic-epsilon-lysine. when c. difficile was inoculated into axenic mice, the dipeptide disappeared from the digest ...	1985	4091557
clostridium difficile in hospital patients.		1985	4093157
effect of the cytotoxin of clostridium difficile on cultured hepatoma cells.	clostridium difficile is the major etiologic agent of human pseudomembranous colitis. it produces two toxins: an enterotoxin and a cytotoxin. in cultured hepatoma cells, at very low doses, the cytotoxin inhibits the incorporation of precursors into biological macromolecules. protein synthesis is more affected than rna and dna synthesis. the toxin also induces severe alterations of the cell morphology consisting in damages to the cytoskeleton and to the cell shape.	1985	2581643
antitoxin activity of human polymorphonuclear leucocytes.	human polymorphonuclear leucocytes (pmnl) inactivate clostridium difficile cytotoxin and c. perfringens phospholipase c, but not c. perfringens enterotoxin. both whole cells and sonicated suspensions possess activity, but mononuclear cell fractions of peripheral blood do not. antitoxin activity closely correlates with cell concentration. the highest cell concentrations tested completely inactivated c. difficile cytotoxin by 2 min. sucrose density gradient fractionation of pmnl showed antitoxin a ...	1985	2859049
the activity of glutaraldehyde against clostridium difficile.	the sporicidal activity of 2% glutaraldehyde against bacillus subtilis var. globigii and bacillus stearothermophilus was compared with that against clostridium difficile. the aerobic species, normally chosen for test purposes, survived for 2 h but cl. difficile was killed in under 10 min. in view of the impractical and lengthy immersions required to satisfy standard tests using non-pathogenic spores, a less stringent standard would probably be more appropriate.	1985	2859321
clostridial toxins active locally in the gastrointestinal tract.	clostridium difficile and clostridium spiroforme have only in recent years been recognized as intestinal pathogens. they both produce toxins that are also produced by other clostridia. c. difficile toxins a and b are produced by c. sordellii and a few strains of c. perfringens whereas c. spiroforme produces the same toxins as c. perfringens type e (iota toxin). iota toxin activity may be the product of two proteins. toxigenic strains of c. spiroforme and type e produce two antigens which possess ...	1985	2861069
crohn's disease with persistence of clostridium difficile, surgical elimination.	clostridium difficile has been associated with increased activity of crohn's disease in some patients, and in them its eradication has proved beneficial. we have seen a patient unresponsive to two courses of vancomycin with persistence of c. difficile colonization and toxin production in whom surgical intervention eliminated the c. difficile cytotoxin and organism.	1985	2862181
ceftazidime in the treatment of neonatal infection.	the efficacy of ceftazidime in the treatment of neonatal sepsis was studied in 42 low birthweight premature babies. forty-nine courses of ceftazidime (25 mg/kg bd, iv or im were administered. in 19 babies, treatment was stopped after 48 h, the remainder were treated for 5 days or more. six neonates had bacteriological evidence of infection, one other was pyrexial and 29 had radiological evidence compatible with respiratory tract infection. eight of the study population died. only one death was a ...	1985	2862190
in vitro effects of sulphasalazine, azodisal sodium, and their metabolites on clostridium difficile and some other faecal bacteria.	the effects of sulphasalazine (sasp), azodisal sodium (ads), and their metabolites were tested in vitro on aerobic and anaerobic faecal bacterial strains. sulphapyridine (sp) had a mild to moderate effect on escherichia coli and streptococcus faecalis. sasp also had a growth-inhibitory effect on strep. faecalis. the other substances had no effect on the aerobic strains. sasp, sp, 5-aminosalicylic acid, and, to a certain extent, n-acetyl-5-aminosalicylic acid exerted a growth-inhibitory effect on ...	1985	2862692
a hospital outbreak of clostridium difficile?	an increase in numbers of patients with clostridium difficile and its toxin in their stools at a hospital in south-west london led to closure of a ward to admissions and to an investigation of a possible nosocomial outbreak. the findings suggested that the increase was not due to an outbreak of related cases but to increased investigation. the cost of the episode both in financial terms and in the effect on patient care, was considerable. this study highlights the need for caution in interpretin ...	1985	2865298
impact of oral ciprofloxacin on the faecal flora of healthy volunteers.	the intestinal flora was studied in 12 volunteers after the administration of 400 mg ciprofloxacin b.i.d. over seven days. stool samples were taken prior to and several times after the initiation of therapy, and qualitative and quantitative analyses of microorganisms were performed. escherichia coli was eliminated in all volunteers after two days of treatment. a selection of resistant enterobacteria could not be observed. a higher incidence of streptococcus faecium was seen, mainly after the end ...	1985	2934338
comparison of the in vitro activities of teicoplanin and vancomycin against clostridium difficile and their interactions with cholestyramine.	the in vitro activity of teicoplanin was compared with that of vancomycin against fecal isolates of clostridium difficile. all strains were susceptible to both antibiotics, but teicoplanin was fourfold more active than vancomycin. cholestyramine was found to bind teicoplanin almost completely, reducing its activity to nondetectable levels.	1985	2935077
[antibiotic-associated colitis and clostridium difficile].		1985	2939996
susceptibility of clostridium difficile strains to new antibiotics: quinolones, efrotomycin, teicoplanin and imipenem.		1985	3159714
antibiotic depression of evoked and spontaneous responses of opossum distal colonic muscularis mucosae in vitro: a factor in antibiotic-associated colitis?	certain antibiotics depress both skeletal neuromuscular transmission and intestinal neuroeffector transmission. impaired intestinal motility may facilitate the proliferation of the bacterium clostridium difficle and thus lead to the development of antibiotic-associated pseudomembranous colitis. many antibiotics accumulate in the colonic lumen at concentrations several times their associated blood levels. this study examined whether certain of these could interfere with colonic muscularis mucosal ...	1985	2982696
a comparison of the effects of cytotoxic cerebrospinal fluid on cell cultures with other cytopathogenic agents.	protein synthesis, antigen synthesis, and cell membrane permeability were analyzed after inoculating human diploid fibroblasts with control or cytotoxic csf, herpes simplex virus type 1 (hsv 1), poliovirus 3, or clostridium difficile toxin. whereas protein synthesis and membrane permeability were affected by the viruses, and virus antigens detectable by pooled human serum were synthesized, the bacterial toxin and cytotoxic csf did not induce any new proteins or antigens, although the cytotoxic c ...	1985	2987025
pharmacokinetic and therapeutic trial of sultamicillin in acute sinusitis.	sultamicillin, an antibiotic combining ampicillin and the beta-lactamase inhibitor sulbactam, was administered to 13 patients diagnosed as having acute sinusitis. specimens from sinus were obtained for all 13 patients by transantral puncture. pharmacokinetics, bacteriology, and therapeutic efficacy were assessed. eighty-five percent (11 of 13) were cured; two treatment failures were subsequently shown to have chronic (rather than acute) sinusitis during surgical exploration. diarrhea was frequen ...	1985	3002247
cytotoxic and cytotonic factors produced by campylobacter jejuni, campylobacter coli, and campylobacter laridis.	complete toxigenicity studies were performed on 341 strains of campylobacter spp., including 23 nonhuman isolates. toxin profiles based on both cytotonic and cytotoxic factors were determined after analyzing responses in vero, hela, cho and y-1 cells. suckling mouse assays were consistently negative for all culture filtrates tested. toxin-producing strains were frequently encountered among both the human and nonhuman strains of campylobacter jejuni, c. coli, and c. laridis investigated. strains ...	1986	3018039
insusceptibility of fetal intestinal mucosa and fetal cells to clostridium difficile toxins.		1986	2954421
[implantation of a mutant of escherichia coli requiring diaminopimelic acid in the digestive tract of gnotobiotic mice].	a dap- auxotroph mutant of escherichia coli dp50 requiring dap and thymidine for growth was used as the receptor strain in genetic engineering. it failed to be implanted in axenic mice. however, when an inoculum containing more than 10(7) bacteria/ml was used, the dap+ reverse mutant devoid of requirement for dap became implanted. when axenic mice were previously associated with clostridium difficile containing dap in the cell wall, the strain dap- became implanted even when the inoculum was too ...	1986	3314677
pharmacokinetics of ciprofloxacin and effect of repeated dosage on salivary and fecal microflora.	the pharmacokinetics of ciprofloxacin was studied in 12 volunteers during a 5-day course of 500 mg of ciprofloxacin given orally twice a day. the effects on the microflora of saliva and feces were also examined. serum and urine samples were assayed for ciprofloxacin microbiologically, and the salivary and fecal microflora were examined quantitatively after processing onto a series of selective media. fecal samples were also investigated for the presence of clostridium difficile and its cytotoxin ...	1986	2940965
comparative in vitro activity of seven quinolones against 100 clinical isolates of clostridium difficile.	the in vitro activity of seven quinolone derivatives against 100 clinical isolates of clostridium difficile was determined. ci934 was the most active, inhibiting 90% of the strains at 4 micrograms/ml and 100% at 8 micrograms/ml. ofloxacin and ciprofloxacin had moderate activity (16 and 32 micrograms/ml) whereas enoxacin, pefloxacin, norfloxacin, and nalidixic acid had poor activity (128 micrograms/ml).	1986	2940968
effect of oral ciprofloxacin on the faecal flora of healthy volunteers.	the effect of oral ciprofloxacin on the intestinal flora was investigated in six male volunteers aged between 21 and 54 years. faecal specimens were cultured quantitatively for aerobic and anaerobic micro-organisms before, during and after a five day course of ciprofloxacin. ciprofloxacin resulted in a significant reduction in aerobic flora in all volunteers and colonisation with resistant coagulase-negative staphylococci or corynebacteria in two volunteers. the total anaerobic flora counts were ...	1986	2941281
effects of topical clindamycin on intestinal microflora in patients with acne.	thirty-two patients with acne completed a randomized, double-blind study using topical 1% clindamycin phosphate or its vehicle applied twice daily for 8 weeks for a study of its effects on the intestinal microflora. two clindamycin patients and one vehicle patient had clostridium difficile in stools prior to therapy. of the remaining twenty-nine patients, four of nineteen patients who used clindamycin and none of ten patients who used vehicle had c. difficile detected during treatment; the diffe ...	1986	2943760
adp-ribosylation in cultured cells treated with clostridium difficile toxin b.	in cultured fibroblasts intoxicated with clostridium difficile toxin b, a radioactive moiety was transferred from [14c-adenosine]nad, but not from [14c-nicotinamide] nad, into a cellular protein (mw 90,000). no labeling was detected in toxin-treated cultures not yet showing any toxin-induced cytopathogenic effect, whereas maximal labeling was obtained in cultures with about half of the cells showing a cytopathogenic effect. the radioactivity was removed from the substrate by treatment with snake ...	1986	2945553
comparative in vitro activities of ciprofloxacin, enoxacin, norfloxacin, ofloxacin and pefloxacin against bacteroides fragilis and clostridium difficile.	the in vitro activity of ciprofloxacin, enoxacin, norfloxacin, ofloxacin and pefloxacin against 99 bacteroides fragilis strains and 105 clostridium difficile strains were determined by the agar dilution method. ofloxacin was the most potent agent. the mic for 90% of the b. fragilis and c. difficile strains was 8 mg/l. ciprofloxacin had mic90's of 16 mg/l for b. fragilis and c. difficile. the mic90's of pefloxacin against b. fragilis and c. difficile were 32 mg/l. 90% of the b. fragilis strains w ...	1986	2939556
pseudomembranous colitis caused by topical clindamycin phosphate.	pseudomembranous colitis was observed on two occasions in the same patient and was associated with the topical administration of clindamycin phosphate. assay for clostridium difficile toxin was positive, and the patient was ultimately cured by oral vancomycin hydrochloride and the withdrawal of clindamycin therapy.	1986	2939805
is clostridium difficile endemic in chronic-care facilities?	an apparent outbreak of clostridium difficile diarrhoea on the chronic hospital ward of a long-term care facility prompted an investigation lasting seven months. approximately a third of patients had stools that were positive for c difficile by either toxin or culture. attempts to eradicate the infection by simultaneously treating all toxin-positive patients with metronidazole, limiting antibiotic use, and implementing enteric isolation were unsuccessful. new cases were both nosocomially acquire ...	1986	2873315