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clostridium difficile-associated disease acquired in the cardiothoracic intensive care unit.to determine the prevalence, severity, and outcome associated with clostridium difficile-associated disease (cdad) acquired while in the cardiothoracic intensive care unit (cticu).201120638863
detection of cross-infection associated to a brazilian pcr-ribotype of clostridium difficile in a university hospital in rio de janeiro, brazil.clostridium difficile is an important nosocomial enteric pathogen and is the etiological agent of pseudomembranous colites. recently, the rates of c. difficile infection (cdi) have increased worldwide, but in brazil few data about this situation and the incidence of clonal types of c. difficile exist. this study aimed to isolate and characterize c. difficile strains from samples obtained of a university hospital (hucff) in rio de janeiro city, brazil. cdi was identified by elisa in 27.1% of hucf ...201120623188
clostridium difficile infection of the small bowel--two case reports with a literature survey.diseases associated with clostridium difficile range from antibiotic-related diarrhea to pseudomembranous enterocolitis, and are serious nosocomial infections with high morbidity and mortality. the c. difficile infection has thus far been regarded as a disease typically affecting the colon. however, the literature contains an increasing number of reports describing infections of the small bowel with fulminant clinical courses and high mortality rates of 60-83%. we think this situation is not ver ...201120628882
carriage of clostridium difficile and other enteric pathogens among a 4-h avocational cohort.clostridium difficile (cd), salmonella, campylobacter and enterohemorrhagic escherichia coli (ehec) are major causes of morbidity in a variety of enteric diseases in humans and animals, but subclinical carriage in both is probably more common than are clinical cases. little is known regarding the prevalence of these pathogens in animals raised for exhibit at michigan county fairs or the frequency with which michigan citizens raising these animals may have been subclinically colonized. to address ...201120529211
correlations between bed occupancy rates and clostridium difficile infections: a time-series analysis.a time-series analysis was performed to identify the impact of bed occupancy rates and length of hospital stay on the incidence of clostridium difficile infections (cdi). between january 2003 and july 2008, a mean incidence of 0·5 cdi cases/1000 patient days was recorded. application of a multivariate model (r2=0·50) showed that bed occupancy rates on general wards (p<0·01) and length of stay in intensive care units (icus) (p<0·01) influenced the incidence of cdi. overcrowding on general wards a ...201120513253
clostridium difficile does not only affect the colon: a case series. 201120478005
comparison of repetitive extragenic palindromic sequence-based pcr with pcr ribotyping and pulsed-field gel electrophoresis in studying the clonality of clostridium difficile.clostridium difficile infection is most often induced by antibiotic treatment. recently, morbidity and mortality resulting especially from c. difficile pcr ribotype 027 have increased significantly. in addition, more severe disease has been associated with c. difficile pcr ribotype 078 strains. thus, reliable typing methods for epidemic control are needed. in the present study, we compared an automated repetitive extragenic palindromic sequence-based pcr (rep-pcr) method (diversilab; bacterial b ...201120331683
in-hospital and 6-month mortality rates after open elective vs open emergent colectomy in patients older than 80 years.there are few reports of long-term outcomes in elderly patients after open colectomy.201121383568
inositol hexakisphosphate-dependent processing of clostridium sordellii lethal toxin and clostridium novyi alpha-toxin.clostridium sordellii lethal toxin and clostridium novyi +¦-toxin, which are virulence factors involved in the toxic shock and gas gangrene syndromes, are members of the family of clostridial glucosylating toxins. the toxins inactivate rho/ras proteins by glucosylation or attachment of glcnac (+¦-toxin). here, we studied the activation of the autoproteolytic processing of the toxins by inositol hexakisphosphate (insp(6)) and compared it with the processing of clostridium difficile toxin b. in th ...201121385871
comparison of strain typing results for clostridium difficile isolates from north america.accurate strain typing is critical for understanding the changing epidemiology of clostridium difficile infections. we typed 350 isolates of toxigenic c. difficile from 2008 to 2009 from seven laboratories in the united states and canada. typing was performed by pcr-ribotyping, pulsed-field gel electrophoresis (pfge), and restriction endonuclease analysis (rea) of whole-cell dna. the cepheid xpert c. difficile test for presumptive identification of 027/nap1/bi isolates was also tested directly o ...201121389155
in vitro production of clostridium difficile spores for use in the efficacy evaluation of disinfectants: a precollaborative investigation.clostridium difficile is a strict anaerobic spore-forming bacterium, and an increasingly common nosocomial pathogen. the u.s. environmental protection agency (epa) is responsible for the registration of disinfectants, including products designed to treat environmental surfaces contaminated with spores of c. difficile. product efficacy data are required for registration; however, there is a lack of methodology for generating high-quality spore suspensions for evaluating product performance. as su ...201121391503
airborne hydrogen peroxide for disinfection of the hospital environment and infection control: a systematic review.we reviewed the effectiveness of airborne hydrogen peroxide as an environmental disinfectant and infection control measure in clinical settings. systematic review identified ten studies as eligible for inclusion. hydrogen peroxide was delivered in the form of vapour and dry mist in seven and three studies, respectively. pathogens evaluated included meticillin-resistant staphylococcus aureus (mrsa), clostridium difficile and multiple bacterial types, in five, three, and two studies, respectively. ...201121392848
impact of environmental decontamination using hydrogen peroxide vapour on the incidence of clostridium difficile infection in one hospital trust. 201121392849
evidence of intravenous immunoglobulin as a critical supportive therapy against clostridium difficile toxin-mediated lethality in mice.clostridium difficile produces toxins and is an aetiological organism of pseudomembranous colitis. immunoglobulin is one of the treatment strategies against fulminant c. difficile infections, but the clinical evidence is still limited. we examined the efficacy of intravenous immunoglobulin (ivig) in c. difficile toxin (cdt)-mediated lethality and cellular injury in mice.201121393125
activity of rbx 11760, a novel biaryl oxazolidinone, against clostridium difficile.rbx 11760, a novel oxazolidinone, was investigated for in vitro and in vivo activity against clostridium difficile.201121393140
nitazoxanide is active against clostridium difficile strains with reduced susceptibility to metronidazole. 201121393199
prevalence and diversity of clostridium difficile strains in infants.during early infancy asymptomatic intestinal colonization by clostridium difficile is frequent. to update information on infant colonization prevalence and to characterize infant strains, in terms of their virulence factors and their phylogenetic diversity, a prospective screening of c. difficile in the stools of infants 0 to 2 years old was conducted at jean verdier hospital (h+¦pital jean verdier) over an 18 month period. c. difficile was screened by toxigenic culture, and molecular characteri ...201121393454
new types of toxin a-negative, toxin b-positive strains among clinical isolates of clostridium difficile in australia.a total of 817 human clinical isolates of clostridium difficile from all australian states were screened for a(-)b(+) strains by toxin gene pcr assays. nine (1.1ôçè%) strains were confirmed to be a(-)b(+) by enzyme immunoassay for toxin production. of these, six (66.7ôçè%) were binary toxin-positive by pcr. using pcr ribotyping and toxinotyping, the a(-)b(+) strains could be grouped into seven ribotypes and three toxinotypes. only one of the ribotypes had been reported previously (017). the prev ...201121393460
a case-control study of community-associated clostridium difficile infection: no role for proton pump inhibitors.the epidemiology of community-associated clostridium difficile infection is not well known. we performed a multicenter, case-control study to further describe community-associated c. difficile infection and assess novel risk factors.201121396512
lack of association of tcdc type and binary toxin status with disease severity and outcome in toxigenic clostridium difficile.the production of binary toxin and presence of truncating mutations in the putative toxin repressor gene, tcdc, have been associated with the increased virulence and spread of clostridium difficile, especially ribotype 027. we analysed the prevalence of binary toxin genes and tcdc mutations in 207 clinical c. difficile isolates collected between 2008-2010. the majority (83%) belonged to one of five tcdc types and 8% were ribotype 027. there was little evidence of epidemic spread but there was a ...201121396957
risk and rewards of fecal transplants. 201121398226
moist-heat resistance, spore aging, and superdormancy in clostridium difficile.clostridium difficile spores can survive extended heating at 71┬░c (160┬░f), a minimum temperature commonly recommended for adequate cooking of meats. to determine the extent to which higher temperatures would be more effective at killing c. difficile, we quantified (d values) the effect of moist heat at 85┬░c (145┬░f, for 0 to 30 min) on c. difficile spores and compared it to the effects at 71 and 63┬░c. fresh (1-week-old) and aged (ôëñ20-week-old) c. difficile spores from food and food animals ...201121398481
genetic manipulation of clostridium difficile.clostridium difficile is a gram-positive, spore forming, anaerobic, intestinal bacterium and is the most common cause of antibiotic-associated colitis. for many years this organism was considered genetically intractable, but in the past 10 years, multiple methods have been developed or adapted for genetic manipulation of c. difficile. this unit describes the molecular techniques used for genetic modification of this organism, including methods for gene disruption, complementation, plasmid introd ...201121400677
potentially inappropriate treatment of urinary tract infections in two rhode island nursing homes.the aim of this study was to determine the appropriateness of antibiotic initiation, selection, and duration of therapy among patients in nursing homes with results of a urinalysis showing urinary tract infection.201121403040
quantitative mass spectrometry for bacterial protein toxins--a sensitive, specific, high-throughput tool for detection and diagnosis.matrix-assisted laser-desorption time-of-flight (maldi-tof) mass spectrometry (ms) is a valuable high-throughput tool for peptide analysis. liquid chromatography electrospray ionization (lc-esi) tandem-ms provides sensitive and specific quantification of small molecules and peptides. the high analytic power of ms coupled with high-specificity substrates is ideally suited for detection and quantification of bacterial enzymatic activities. as specific examples of the ms applications in disease dia ...201121403598
prevention and treatment of clostridium difficile infection. 201121404793
clostridium difficile infection and treatment in the pediatric inflammatory bowel disease population.recent changes in the epidemiology of clostridium difficile infection include an increase in the incidence of c difficile-associated disease (cdad) and the identification of patients with inflammatory bowel disease (ibd) as a group at risk. in addition, the effectiveness of antimicrobial therapies has been questioned. our aim was to estimate the incidence of cdad in a pediatric ibd population and review treatment efficacy.201121407116
low risk of transmission of clostridium difficile to humans at petting farms. 201121411249
evaluation of four different diagnostic tests to detect clostridium difficile in piglets.clostridium difficile is emerging as pathogen in both humans and animals. in 2000 it was described as one of the causes of neonatal enteritis in piglets, and it is now the most common cause of neonatal diarrhea in the united states. in europe, c. difficile infection (cdi) in both neonatal piglets and adult sows has also been reported. diagnosis of this infection is based on detection of the bacterium c. difficile or its toxins a and b. most detection methods, however, are only validated for diag ...201121411571
modified multiple-locus variable-number tandem-repeat analysis for rapid identification and typing of clostridium difficile during institutional outbreaks.a modified multiple-locus variable-number tandem-repeat analysis (mmlva) method was validated on clostridium difficile-infected stool specimens from institutional outbreaks. the method allows simultaneous detection of toxin genes, deletions, and tandem repeats from cultured isolates or stool specimens. results were used to aid institutional outbreak investigation by identifying clusters of nap1/027.201121411590
nucleotide-binding oligomerization domain 1 mediates recognition of clostridium difficile and induces neutrophil recruitment and protection against the pathogen.clostridium difficile is a gram-positive obligate anaerobic pathogen that causes pseudomembranous colitis in antibiotics-treated individuals. however, host immune protective mechanisms against c. difficile are largely unknown. in this study, we show that c. difficile possesses potent stimulatory activity for nucleotide-binding oligomerization domain 1 (nod1), an intracellular pattern recognition molecule that senses bacterial peptidoglycan-related molecules. nod1(-/-), but not nod2(-/-), mice ex ...201121411735
[investigation of toxin genes of clostridium difficile strains isolated from hospitalized patients with diarrhoea at marmara university hospital].toxigenic clostridium difficile strains cause a spectrum of antibiotic-associated diseases ranging from self-limited diarrhea to severe life-threatening colitis. pathogenesis primarily involves the action of two important cytotoxins, namely toxin a and toxin b. however, epidemics of c.difficile-associated disease due to the novel, highly virulent strains of c.difficile (binary toxin positive and toxin a variant) have been recognised in hospitals of some countries. the aim of this study was to in ...201121341153
fulminating colitis due to clostridium difficile. 201121342687
effect of ceftobiprole treatment on growth of and toxin production by clostridium difficile in cecal contents of mice.ceftobiprole and ceftobiprole medocaril did not promote growth of or toxin production by clostridium difficile in mouse cecal contents, whereas ceftazidime, cefoxitin, ceftriaxone, cefotaxime, and ertapenem did. the relatively low propensity of ceftobiprole to promote c. difficile was attributable to inhibitory activity against c. difficile and sparing of anaerobic microflora.201121343463
diabetes mellitus as a risk factor for recurrence of clostridium difficile infection in the acute care hospital setting.clostridium difficile-associated diarrhea (cdad) is increasingly encountered in the acute care setting with rates of infection increasing dramatically since 2001. reoccurring episodes are being seen with increasing frequency. the purpose of this study was to examine risk factors specifically associated with cdad recurrence in an urban medical center.201121349600
killing kinetics of fidaxomicin and its major metabolite, op-1118, against clostridium difficile.the kinetics of bacterial killing for fidaxomicin and its major metabolite, op-1118, were investigated against clostridium difficile strains, including two clinical strains belonging to the restriction endonuclease analysis group bi (org 1687 and 1698), the atcc 43255 strain and two laboratory-derived mutant strains with decreased susceptibility to fidaxomicin (org 919 and 1620). both fidaxomicin and op-1118 demonstrated time-dependent killing of c. difficile strains. fidaxomicin (at 4× mic) red ...201121349983
immunomodulatory activities of surface-layer proteins obtained from epidemic and hypervirulent clostridium difficile strains.surface-layer proteins (slps) have been detected in all clostridium difficile strains and play a role in adhesion, although an involvement in the inflammatory process may also be supposed, as they cover the bacterial surface and are immunodominant antigens. the aim of this study was to evaluate the immunomodulatory properties of slps obtained from hypervirulent and epidemic (h/e) or non-h/e c. difficile strains, to try to determine whether they contribute to hypervirulence. slps were purified fr ...201121349985
rho/ras-gtpase-dependent and -independent activity of clostridial glucosylating toxins.clostridial glucosylating toxins are the main virulence factors of clostridia responsible for gangrene and/or colitis. these toxins have been well characterized to inactivate rho/ras-gtpases through glucosylation. however, the signalling pathways downstream of rho/ras-gtpases leading to the intracellular effects of these toxins are only partially known. rac-dependent modification of focal adhesion complexes and phosphoinositide metabolism seem to be key processes involved in actin filament depol ...201121349986
reannotation of the genome sequence of clostridium difficile strain 630.a regular update of genome annotations is a prerequisite step to help maintain the accuracy and relevance of the information they contain. five years after the first publication of the complete genome sequence of clostridium difficile strain 630, we manually reannotated each of the coding sequences (cdss), using a high-level annotation platform. the functions of more than 500 genes annotated previously with putative functions were reannotated based on updated sequence similarities to proteins wh ...201121349987
the lmw surface-layer proteins of clostridium difficile pcr ribotypes 027 and 001 share common immunogenic properties.the aim of this study was to investigate the s-layer proteins (slps) of the hypervirulent clostridium difficile pcr ribotype 027 and compare them with those of pcr ribotype 001 and other pcr ribotypes involved in c. difficile infection and outbreaks, by molecular analysis and immunological assays. it has been demonstrated previously that pcr ribotype 027 slpa is conserved in c. difficile strains belonging to this pcr ribotype and that it is a new variant, showing 88?% identity with slpa of pcr r ...201121349988
role of fibronectin-binding protein a in clostridium difficile intestinal colonization.clostridium difficile is a frequent cause of severe, recurrent, post-antibiotic diarrhoea and pseudomembranous colitis. its pathogenicity is mediated mainly by two toxins, tcda and tcdb. however, different adhesins have also been described as important colonization factors which are implicated in the first step of the intestinal infection. in this study, we focused our interest on one of these adhesins, fibronectin-binding protein a (fbpa), and on its role in the intestinal colonization process. ...201121349990
five commercial dna extraction systems tested and compared on a stool sample collection.in this study, 5 different commercial dna extraction systems were tested on a stool sample collection containing 81 clinical stool specimens that were culture-positive for diarrheagenic escherichia coli, campylobacter jejuni, salmonella enterica, or clostridium difficile. the purified dnas were analyzed by polymerase chain reaction (pcr) directed toward the relevant organisms. the results showed that conventional pcr combined with the extraction systems biorobot ez1 (qiagen, hilden, germany), bu ...201121353945
preventing infection in elders with long-term indwelling urinary catheters.to explore selected factors related to the prevention of catheter-associated urinary tract infections (utis) in older adults.201121355945
ward-based rather than team-based junior surgical doctors reduce mortality for patients with a fracture of the proximal femur: results from a two-year observational study.we performed a retrospective study of a departmental database to assess the efficacy of a new model of orthopaedic care on the outcome of patients with a fracture of the proximal femur. all 1578 patients admitted to a university teaching hospital with a fracture of the proximal femur between december 2007 and december 2009 were included. the allocation of foundation doctors years 1 and 2 was restructured from individual teams covering several wards to pairs covering individual wards. no alterati ...201121357963
clinical pearls in infectious diseases. 201121364116
structural basis for reductive radical formation and electron recycling in (r)-2-hydroxyisocaproyl-coa dehydratase.the radical enzyme (r)-2-hydroxyisocaproyl-coa dehydratase catalyzes the dehydration of (r)-2-hydroxyisocaproyl-coa in the fermentation of l-leucine by the human pathogenic bacterium clostridium difficile. in contrast to other radical enzymes, such as bacterial class ii ribonucleotide reductase or biotin synthase, the fe/s cluster containing (r)-2-hydroxyisocaproyl-coa dehydratase requires no special cofactors such as coenzyme b(12) or s-adenosylmethionine for radical generation. instead it uses ...201121366233
tcdb or not tcdb: a tale of two clostridium difficile toxins. 201121366410
is c difficile to blame for your patient's diarrhea? 201121369553
preventing clostridium difficile infections: an executive summary of the association for professionals in infection control and epidemiology's elimination guide.this article is an executive summary of the association for professionals in infection control and epidemiology's clostridium difficile infection elimination guide. infection preventionists are encouraged to obtain the original, full-length elimination guide for more thorough coverage of c difficile infection prevention.201121371783
role of the haem oxygenase/carbon monoxide pathway in clostridium difficile toxin a-induced enteritis in mice.clostridium difficile is the major cause of antibiotic-associated colitis, a disease with significant morbidity and mortality. this study investigated the role of the haem oxygenase-1 (ho-1)/carbon monoxide (co) pathway in c. difficile toxin a-induced enteritis in mice. the ho substrate haemin, zinc protoporphyrin ix (znpp ix), a specific ho-1 inhibitor, dimanganese decacarbonyl (dmdc), a co donor, or an equivalent volume of their respective vehicles were injected subcutaneously 30 min prior to ...201121372182
comparison of two commercial molecular tests for the detection of clostridium difficile in the routine diagnostic laboratory.two commercial real-time pcr assays for the detection of clostridium difficile, bd geneohm cdiff assay (bd diagnostics) and xpert c. difficile assay (cepheid), were compared to each other and to toxigenic culture, which was used as a gold standard, on a set of 194 clinical stools submitted for routine diagnostic analysis. of 28 (14.4?%) toxigenic culture positive samples 23 were positive with both assays, the bd and the cepheid real-time pcr assays, 4 were positive only by cepheid xpert c. diffi ...201121372187
treatment of clostridium difficile infection. 201121372762
nosocomial infections and multidrug-resistant organisms in germany: epidemiological data from kiss (the hospital infection surveillance system).more than 800 hospitals and 586 intensive care units (icus) in germany currently participate in a nationwide surveillance system for nosocomial infections (krankenhaus-infektions-surveillance-system, kiss), which collects data on the frequency of nosocomial infections and pathogens and on the appearance of pathogens of special epidemiological importance.201121373275
clostridium difficile in seafood and fish.the objective of this study was to determine the prevalence of clostridium difficile contamination in retail seafood and fish from canadian grocery stores. c. difficile was found in 4.8% (5/119) of the samples. this study, combined with studies of other food sources, suggests that widespread contamination of food is common.201121376822
clostridium difficile binary toxin (cdt) and diarrhea.clostridium difficile is a major enteropathogen of humans. it produces two main virulence factors, toxins a and b. a third, less well known toxin, c. difficile toxin (cdt), is a binary toxin composed of distinct enzymatic (cdta) and cell binding/translocation (cdtb) proteins. we used a novel enzyme linked immunoassay (eia) to detect cdtb protein in feces and culture fluids. additionally, pcr was used to assay c. difficile isolates from fecal samples for the cdt locus (cdtloc). although the resul ...201121376825
tests for the diagnosis of clostridium difficile infection: the next generation.clostridium difficile (c. difficile) causes 25-30% of cases of antibiotic associated diarrhea and most cases of pseudomembranous colitis. patients presenting with diarrhea after hospitalization for 3 or more days should be tested for c. difficile. there are many options available for testing, each of which has inherent advantages and disadvantages. most laboratories perform toxin testing using an enzyme immunoassay method. in general these tests have sensitivities ranging from 60 to 70% and spec ...201121376826
the impact of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in patients with clostridium difficile infection.there is increasing frequency and severity of disease due to clostridium difficile infection (cdi). in addition, failure of initial antibiotic therapy is increasing. angiotensin-converting enzyme inhibitors (acei) and angiotensin-receptor blockers (arbs) may have local and systemic anti-inflammatory properties to reduce severity of disease in cdi. we performed a retrospective study of 306 patients with cdi over 23 months at a single center in detroit, michigan. patient outcomes (death, death due ...201121377806
clostridium difficile and cytomegalovirus colitis co-infection: search for the hidden 'bug'.d.f. florescu, c. mindru, h.e. chambers, a.c. kalil. clostridium difficile and cytomegalovirus colitis co-infection: search for the hidden 'bug'. transpl infect dis 2011: 13: 411-415. all rights reserved abstract: few cases of co-infection with cytomegalovirus (cmv) and clostridium difficile colitis have been reported previously. we describe 2 cases of cmv and c. difficile colitis, and review 7 previously published reports. we aim to raise awareness of possible cmv-c. difficile co-infection, esp ...201121299777
the epidemiology of clostridium difficile in scotland.the objective of this study was to characterise the epidemiology of clostridium difficile in scotland by determining the distribution of pcr ribotypes and antimicrobial susceptibility in 1613 isolates collected from all healthboard areas of scotland in the period november 2007-december 2009. three pcr ribotypes predominated amongst the scottish isolates of c. difficile; ribotype 106 (29.4%), ribotype 001 (22%) and ribotype 027 (12.6%) followed by the less prevalent ribotypes including 002, 015, ...201121300104
challenges and advances in infection control of hematopoietic stem cell transplant recipients.hematopoietic stem cell transplantation (hsct) has revolutionized the outcome of many malignant and non-malignant disorders; however, infection still accounts for a substantial number of deaths after both allogeneic and autologous transplants. hospital-acquired infections (hai) such as bloodstream infections, pneumonias, and diarrhea are common in this population and account for significant morbidity and cost of care. also, there is renewed focus on epidemiologically important organisms as the c ...201121303337
current status of nonantibiotic and adjunct therapies for clostridium difficile infection.clostridium difficile infection (cdi) is a leading cause of nosocomial infections and the most important cause of health care-associated diarrhea worldwide. standard treatment of cdi consists of modifying underlying antibiotic exposure, aggressive supportive measures, and therapy with specific antibiotics, most commonly metronidazole or vancomycin. this general approach to cdi has remained largely unchanged for decades. in an effort to improve outcomes and reduce recurrences of cdi, interest has ...201121308451
an assessment of thermal stability of clostridium difficile toxoid formulations.strains of clostridium difficile produce toxins a and b that can cause diarrhoea and pseudomembranous colitis. currently, there is no preventative therapy for this infection but antibodies to the toxins provide protection, therefore a toxoid-based vaccine is needed. to evaluate thermal stability, a lyophilized and liquid formulation of toxoids a and b were stored at a range of temperatures for 5 weeks. changes in toxoid structures and immune responses in an animal model before and after the incu ...201121311215
fate and efficacy of lacticin 3147-producing lactococcus lactis in the mammalian gastrointestinal tract.gastrointestinal survival of the bacteriocin-producing strain, lactococcus lactis dpc6520, was evaluated systematically in vitro and in vivo with a view to using this strain to deliver biologically active lacticin 3147, a broad-spectrum bacteriocin, to the gut. the activity of the lacticin 3147 producer was also evaluated against two clinically relevant pathogens: clostridium difficile and listeria monocytogenes. when suspended in an appropriate matrix, the lactococcal strain is capable of survi ...201121314706
germination response of spores of the pathogenic bacterium clostridium perfringens and clostridium difficile to cultured human epithelial cells.spores of pathogenic clostridium perfringens and clostridium difficile must germinate in the food vehicle and/or host's intestinal tract to cause disease. in this work, we examined the germination response of spores of c. perfringens and c. difficile upon incubation with cultured human epithelial cell lines (caco-2, hela and ht-29). c. perfringens spores of various sources were able to germinate to different extents; while spores of a non-food-borne isolate germinated very well, spores of food-b ...201121315167
fidaxomicin versus vancomycin for clostridium difficile infection.clostridium difficile infection is a serious diarrheal illness associated with substantial morbidity and mortality. patients generally have a response to oral vancomycin or metronidazole; however, the rate of recurrence is high. this phase 3 clinical trial compared the efficacy and safety of fidaxomicin with those of vancomycin in treating c. difficile infection.201121288078
the search for effective treatment of clostridium difficile infection. 201121288079
the effectiveness of sodium dichloroisocyanurate treatments against clostridium difficile spores contaminating stainless steel.clostridium difficile is a major cause of hospital-associated infective diarrhea, and its spore form can persist for months in the hospital environment. chlorine-based cleaning agents are recommended for eliminating this reservoir of potential infection.201121288600
surface layer protein a variant of clostridium difficile pcr-ribotype 027. 201121291621
recent trends in the use of antibiotic prophylaxis in pediatric surgery.the use of surgical antibiotic prophylaxis (ap) in children is poorly characterized. the aims of this study were to examine (1) trends in the use of ap for commonly performed operations, (2) appropriateness in the context of available guidelines, and (3) adverse events potentially attributable to ap.201121292089
[prevalence of diarrhea in critical patients units in spain: a multicenter study].diarrhea is a frequent complication in patients admitted to intensive care and nursing consumes a significant percentage of time for them. although this is a common condition, the exact size of the problem is unknown. the main objective of this study has been to determine the prevalence of diarrhea in hospitalized patients in critical care units (ccu)in spain.201121292524
multiple component patient safety intervention in english hospitals: controlled evaluation of second phase.to independently evaluate the impact of the second phase of the health foundation's safer patients initiative (spi2) on a range of patient safety measures. design a controlled before and after design. five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in medical wards; review of case notes from surgical patients; indirect evaluation of hand hygiene by measuring hospital use of handwashing materials; measurement of outcomes (adverse events, mort ...201121292720
rifaximin disc diffusion test for in vitro susceptibility testing of clostridium difficile.rifaximin is a rifampicin derivative, poorly absorbed by the gastro-intestinal tract. we studied the in vitro susceptibility to rifamixin of 1082 clostridium difficile isolates; among these, 184 isolates from a strain collection were tested by an in-house rifaximin disc (40 µg) diffusion test, by an in-house rifaximin broth microdilution test, by rifampicin etest and by rpob gene sequencing. in the absence of respective clsi or eucast mic breakpoints for rifaximin and rifampicin against c. diffi ...201121292853
clostridium difficile infection in 2010: advances in pathogenesis, diagnosis and management of cdi.clostridium difficile infection (cdi) publications have advanced in 2010 at a pace paralleling the increased frequency and severity of clinical infection. both toxins a and b are essential virulence factors, pcr diagnostic testing is rapid, sensitive and specific, and recurrent cdi can be prevented using monoclonal antibodies to toxins a and b.201121293502
fecal matters. 201121297602
healthcare-associated infections in rheumatology in japan.prospective observational study was performed to elucidate the incidence and characteristics of healthcare-associated infections in a university hospital for rheumatology care. in this study, a total of 1,226 patients were prospectively enrolled between march 2004 and february 2006 and between april 2008 and december 2008. healthcare-associated infection was defined as an infection developing after the third day of admission to the rheumatology ward. we detected the following 54 healthcare-assoc ...201121327423
multilocus variable-number tandem repeat analysis: a helpful tool for subtyping french clostridium difficile pcr ribotype 027 isolates.the objective of this study was to evaluate the usefulness of multilocus variable-number tandem repeat analysis (mlva) for typing and subtyping of clostridium difficile. sixty-eight strains were studied, including strains from pcr ribotypes 027, 078/126, 014/020/077, 017 and 023. the stability of variable-number tandem repeat (vntr) loci was tested by comparing the mlva results of two strains subcultured 11 times. after dna extraction, seven tandem repeat loci (a6, b7, c6, e7, f3, g8, h9) from p ...201121330414
infection of hamsters with the uk clostridium difficile ribotype 027 outbreak strain r20291.clostridium difficile is the main cause of antibiotic-associated disease, a disease of high socio-economical importance that has recently been compounded by the global spread of the 027 (bi/nap1/027) ribotype. c. difficile cases attributed to ribotype 027 strains have high recurrence rates (up to 36?%) and increased disease severity. the hamster model of infection is widely accepted as an appropriate model for studying aspects of c. difficile host-pathogen interactions. using this model we chara ...201121330415
comparison of toxin and spore production in clinically relevant strains of clostridium difficile.clostridium difficile is a major cause of nosocomial diarrhoea. the toxins that it produces (tcda and tcdb) are responsible for the characteristic pathology of c. difficile infection (cdi), while its spores persist in the environment, causing its widespread transmission. many different strains of c. difficile exist worldwide and the epidemiology of the strains is ever-changing: in scotland, pcr ribotype 012 was once prevalent, but currently ribotypes 106, 001 and 027 are endemic. this study aime ...201121330434
determinants of the human infant intestinal microbiota after the introduction of first complementary foods in infant samples from five european centres.although it is well established that early infant feeding has a major influence on the establishment of the gut microbiota, very little is understood about how the introduction of first solid food influences the colonization process. this study aimed to determine the impact of weaning on the faecal microbiota composition of infants from five european countries (sweden, scotland, germany, italy and spain) which have different lifestyle characteristics and infant feeding practices. faecal samples ...201121330436
the dlt operon confers resistance to cationic antimicrobial peptides in clostridium difficile.the dlt operon in gram-positive bacteria encodes proteins that are necessary for the addition of d-alanine to teichoic acids of the cell wall. the addition of d-alanine to the cell wall results in a net positive charge on the bacterial cell surface and, as a consequence, can decrease the effectiveness of antimicrobials, such as cationic antimicrobial peptides (camps). although the roles of the dlt genes have been studied for some gram-positive organisms, the arrangement of these genes in clostri ...201121330441
clostridium difficile enteritis: a review and pooled analysis of the cases.clostridium difficile is the most common cause of healthcare-associated infection diarrhea and usually restricted to infection of the colon. however, small bowel involvement of c. difficile infection has been reported. we performed a literature review and pooled analysis of the reported cases of c. difficile enteritis201121334446
irish dietitians' opinions and use of probiotics in patients with clostridium difficile-associated disease. 201121336141
involvement of rac gtpase activation in phosphatidylcholine hydroperoxide-induced thp-1 cell adhesion to icam-1.increasing evidence indicates that phospholipid oxidation plays important roles in atherosclerosis. here, we investigated the involvement of rho-family gtpases inphosphatidylcholine hydroperoxide (pcooh)-induced thp-1 cell adhesion to icam-1. isoprenoid depletion by fluvastatin and geranylgeranyltransferase inhibition by ggti-286 suppressed pcooh-induced cell adhesion to icam-1 and f-actin-rich membrane protrusion formation. pull-down assays demonstrated the activation of rac1 and rac2 in pcooh- ...201121316345
inpatient mortality and death reporting associated with clostridium difficile infection in a large teaching hospital. 201121316799
death certificates provide a poor estimation of attributable mortality due to clostridium difficile when compared to a death review panel using defined criteria. 201121316808
defining an allosteric circuit in the cysteine protease domain of clostridium difficile toxins.an internal cysteine protease domain (cpd) autoproteolytically regulates clostridium difficile glucosylating toxins by releasing a cytotoxic effector domain into target cells. cpd activity is itself allosterically regulated by the eukaryote-specific molecule inositol hexakisphosphate (insp(6)). although allostery controls the function of most proteins, the molecular details underlying this regulatory mechanism are often difficult to characterize. here we use chemical probes to show that apo-cpd ...201121317893
efficient expression and purification of methyltransferase in acetyl-coenzyme a synthesis pathway of the human pathogen clostridium difficile.the wood-ljungdahl pathway is responsible for acetyl-coa biosynthesis and used as a major mean of generating energy for growth in some anaerobic microbes. series of genes, from the anaerobic human pathogen clostridium difficile, have been identified that show striking similarity to the genes involved in this pathway including methyltetrahydrofolate- and corrinoid-dependent methyltransferase. this methyltransferase plays a central role in this pathway that transfers the methyl group from methylte ...201121324365
surveillance for clostridium difficile infection: icd-9 coding has poor sensitivity compared to laboratory diagnosis in hospital patients, singapore.clostridium difficile infection (cdi) is an increasingly recognized nosocomial infection in singapore. surveillance methods include laboratory reporting of clostridium difficile toxin assays (cdta) or use of international classification of diseases, 9(th) revision (icd-9) discharge code 008.45. previous us studies showed good correlation between cdta and icd-9 codes. however, the use of icd-9 codes for cdi surveillance has not been validated in other healthcare settings.201121283751
complete genome sequence of a serotype 11a, st62 streptococcus pneumoniae invasive isolate.streptococcus pneumoniae is an important human pathogen representing a major cause of morbidity and mortality worldwide. we sequenced the genome of a serotype 11a, st62 s. pneumoniae invasive isolate (ap200), that was erythromycin-resistant due to the presence of the erm(tr) determinant, and carried out analysis of the genome organization and comparison with other pneumococcal genomes.201121284853
intestinal microbiota was assessed in cirrhotic patients with hepatitis b virus infection. intestinal microbiota of hbv cirrhotic patients.to unravel the profile of intestinal microecological parameters in chinese patients with asymptomatic carriage of hepatitis b virus (hbv), chronic hepatitis b, decompensated hbv cirrhosis, and health controls and to establish their correlation with liver disease progression, we performed quantitative pcr and immunological techniques to investigate fecal parameters, including population of fecal predominant bacteria and the abundance of some virulence genes derived from escherichia coli, bacteroi ...201121286703
sporicides for clostridium difficile: the devil is in the detail.a taskforce has now been formed with representatives from the department of health's advisory committee on antimicrobial resistance and healthcare associated infection (arhai), the hospital infection society (his), the department of health (england) and the health protection agency. the aims of the arhai/his taskforce on sporicidal disinfectants are: to develop an accepted standard for laboratory testing of disinfectants which claim to have activity against c. difficile spores; to develop a netw ...201121277650
sternal surgical site infection prevention - is there any room for improvement?the objectives of this multicenter study are to evaluate current clinical practices in cardiac surgery concerning the prevention and management of sternal wound infections, to identify room for improvement, and to support implementation of systematic measures.201121277786
lacking the incentive to cure? recurring clostridium difficile diarrhea and our reluctance to use fecal transplantation. 201121278582
[nosocomial diarrhea].hospital acquired or nosocomial diarrhea affects up to one third of hospitalized patients. it increases mortality rates as well as length and costs of the hospital stay. drug side effects are the predominant cause of nosocomial diarrhea whilst clostridium difficile is the most common infectious agent, whose development is closely linked to antibiotic usage. the causal therapy of mild clostridium difficile infections is controversially discussed. nevertheless, the use of metronidazol for mild cas ...201121279316
regulation of induced colonic inflammation by lactobacillus acidophilus deficient in lipoteichoic acid.imbalance in the regulatory immune mechanisms that control intestinal cellular and bacterial homeostasis may lead to induction of the detrimental inflammatory signals characterized in humans as inflammatory bowel disease. induction of proinflammatory cytokines (i.e., il-12) induced by dendritic cells (dcs) expressing pattern recognition receptors may skew naive t cells to t helper 1 polarization, which is strongly implicated in mucosal autoimmunity. recent studies show the ability of probiotic m ...201121282652
[public health surveillance and assessment of emerging infectious threats: method and criteria for risk analysis].one of the objectives of the surveillance systems implemented by the french national institute for public health surveillance is to detect communicable diseases and to reduce their impact. for emerging infections, the detection and risk analysis pose specific challenges due to lack of documented criteria for the event. the surveillance systems detect a variety of events, or "signals" which represent a potential risk, such as a novel germ, a pathogen which may disseminate in a non-endemic area, o ...201121251782
a proposed nomenclature for cell wall proteins of clostridium difficile.strains of clostridium difficile produce a number of surface-localized proteins, including the s-layer proteins (slps) and other proteins that have suspected roles in pathogenesis. during the third international c. difficile symposium (bled, slovenia, september 2010) discussions were held on standardization of nomenclature. gene designations were proposed for the large family of cell wall proteins that are paralogues of the slp and contain putative cell wall binding motifs. this paper summarizes ...201121252271
primary human colonic myofibroblasts are resistant to clostridium difficile toxin a-induced, but not toxin b-induced, cell death.colonic inflammation in clostridium difficile infection is mediated by released toxins a and b. we investigated responses to c. difficile toxins a and b by isolated primary human colonic myofibroblasts, which represent a distinct subpopulation of mucosal cells that are normally located below the intestinal epithelium. following incubation with either purified toxin a or b, there was a change in myofibroblast morphology to stellate cells with processes that were immunoreactive for alpha-smooth mu ...201121245273
toll-like receptor 5 stimulation protects mice from acute clostridium difficile colitis.clostridium difficile is a spore-forming bacterium that infects the lower intestinal tract of humans and is the most common known cause of diarrhea among hospitalized patients. clostridium difficile colitis is mediated by toxins and develops during or following antibiotic administration. we have used a murine model of c. difficile infection, which reproduces the major features of the human disease, to study the effect of innate immune activation on resistance to c. difficile infection. we found ...201121245274
clostridium difficile infection causing multiple organ failure and small-bowel enteritis. 201121256103
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