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clostridium difficile infection and partial membrane cofactor protein (cd46) deficiency. 201223101426
[clostridium difficile--unfairly set in the corner?]. 201223097893
vitamin d deficiency: a potential risk factor for clostridium difficile infection. 201223097616
[clostridium difficile epidemic, chile 2012: report of the chilean society for infectious diseases. a scientific historical analysis].a summary report from the chilean society for infectious diseases regarding the presence of a clostridium difficile epidemic with several fatalities in chile's premier emergency public hospital in santiago is used to make a scientific historical analysis of the situation. this summary report identifies several hygienic and sanitary shortcomings that may have played a role in triggering this major epidemic. these include deficiencies in hand washing policies, overcrowding of beds in wards, relaxa ...201223096554
[clostridium difficile associated infections: an updated view].clostridium difficile is an emerging anaerobic, spore forming pathogen, recognized as the etiological agent of ~ 30% of antibiotic associated diarrheas. clinical symptoms can fluctuate from mild to moderate diarrhea, pseudomembranous colitis and toxic megacolon. the incidence of c. difficile associated infections (cdai) is ~ 1% of total hospitalized patients. cdai has a mortality rate of ~1 to 5%, and a relapse rate of ~ 20%. the appearance of severe outbreaks of cdai could be attributed to chan ...201223096544
toward an understanding of changes in diversity associated with fecal microbiome transplantation based on 16s rrna gene deep sequencing.fecal microbiome transplantation by low-volume enema is an effective, safe, and inexpensive alternative to antibiotic therapy for patients with chronic relapsing clostridium difficile infection (cdi). we explored the microbial diversity of pre- and posttransplant stool specimens from cdi patients (n = 6) using deep sequencing of the 16s rrna gene. while interindividual variability in microbiota change occurs with fecal transplantation and vancomycin exposure, in this pilot study we note that cli ...201223093385
comparison of genexpert pcr to bd geneohm for detecting c. difficile toxin gene in gdh positive toxin negative samples.the need for rapid diagnosis of clostridium difficile (c. difficile) associated infection in a clinical microbiology laboratory has provided the stimulus for new diagnostic tests and testing protocols. a two-test algorithm has been proposed using assays such as quik chek complete, which detects both c. difficile glutamate dehydrogenase (gdh) and c. difficile toxins a and b, followed by reflex testing of samples having inconclusive results (gdh positive and toxin negative) with pcr for identifica ...201223090736
current and future challenges in the development of antimicrobial agents.micro-organisms exist to survive. even in the absence of antimicrobial agents, many have determinants of resistance that may be expressed phenotypically, should the need arise. with the advent of the antibiotic age, as more and more drugs were developed to treat serious infections, micro-organisms (particularly bacteria) rapidly developed resistance determinants to prevent their own demise.the most important determinants of resistance have been in the gram-positive and gram-negative bacteria. am ...201223090595
[clostridium-difficile-colitis: more frequent and more severe]. 201223088039
immune responses to clostridium difficile infection.clostridium difficile is the causal agent of antibiotic-associated diarrhea and is a leading cause of hospital-acquired infections in the us. c. difficile has been known to cause severe diarrhea and colitis for more than 30 years, but the emergence of a newer, hypervirulent strain of c. difficile (bi/nap1) has further compounded the problem, and recently both the number of cases and mortality associated with c. difficile-associated diarrhea have been increasing. one of the major drivers of disea ...201223084763
impact of infectious complications after elective surgery on hospital readmission and late deaths in the u.s. medicare population.whereas the negative impact of infectious complications (ic) during the index hospitalization after elective surgery is well established, the long-term ramifications of hospital-acquired post-operative infections are not well studied. this analysis evaluated the impact of a hospital-acquired ic after open abdominal vascular surgery on the readmission rate and the mortality rates 30 and 90 days after initial discharge.201223082877
prevalence of clostridium difficile toxin in diarhoeal stool samples of patients from a tertiary hospital in north eastern penisular malaysia.this study describes the prevalence of clostridium difficile toxin (cdt) in loose stool samples from inpatients aged more than two years of a tertiary hospital. a total of 175 samples that had been examined were from stool samples that were sent to the medical microbiology & parasitology laboratory for various clinical indications. the toxin was detected by a commercial immunochromatograhic test, and the patients' demography, clinical features, treatment and outcomes were analyzed from their med ...201223082450
association of decreased serum protein fractions with clostridium difficile infection in the acute care setting: a case-control study.this study examines the association of decreased levels of serum proteins with the occurrence of clostridium difficile-associated diarrhea (cdad) in hospitalized patients.201223075246
retraction notice to "apoptosis of ct26 colorectal cancer cells induced by clostridium difficile toxin a stimulates potent anti-tumor immunity" [biochem. biophys. res. commun. 422 (2012) 15-21]. 201223071973
modeling the role of peroxisome proliferator-activated receptor γ and microrna-146 in mucosal immune responses to clostridium difficile.clostridium difficile is an anaerobic bacterium that has re-emerged as a facultative pathogen and can cause nosocomial diarrhea, colitis or even death. peroxisome proliferator-activated receptor (ppar) γ has been implicated in the prevention of inflammation in autoimmune and infectious diseases; however, its role in the immunoregulatory mechanisms modulating host responses to c. difficile and its toxins remains largely unknown. to characterize the role of pparγ in c. difficile-associated disease ...201223071818
succession in the gut microbiome following antibiotic and antibody therapies for clostridium difficile.antibiotic disruption of the intestinal microbiota may cause susceptibility to pathogens that is resolved by progressive bacterial outgrowth and colonization. succession is central to ecological theory but not widely documented in studies of the vertebrate microbiome. here, we study succession in the hamster gut after treatment with antibiotics and exposure to clostridium difficile. c. difficile infection is typically lethal in hamsters, but protection can be conferred with neutralizing antibodi ...201223071679
aminoacyl-trna synthetase inhibitors as antimicrobial agents: a patent review from 2006 till present.aminoacyl-trna synthetases (aarss) are one of the leading targets for development of antimicrobial agents. although these enzymes are well conserved among prokaryotes, significant divergence has occurred between prokaryotic and eukaryotic aarss, which can be exploited in the discovery of broad-spectrum antibacterial agents. although several aars inhibitors have been reported before, they failed as a result of poor selectivity and limited cell penetration.201223062029
impact of clostridium difficile colitis on 5-year health outcomes in patients with ulcerative colitis.clostridium difficile colitis (cdc) is associated with an increased short-term mortality risk in hospitalised ulcerative colitis (uc) patients. we sought to determine whether cdc also impacts long-term risks of adverse health events in this population.201223061526
clostridium difficile postantibiotic diarrhoea diagnosis.to study the frequency of clostridium difficile in postantibiotic diarrhoea in patients admitted to the medical ward of a secondary care hospital.201223058147
diagnosis of clostridium difficile-associated disease: examination of multiple algorithms using toxin eia, glutamate dehydrogenase eia and loop-mediated isothermal amplification.the laboratory diagnosis of clostridium difficile infection (cdi) needs to be accurate and timely to ensure optimal patient management, infection control and reliable surveillance. three methods are evaluated using 810 consecutive stool samples against toxigenic culture: cdt tox a/b premier enzyme immunoassay (eia) kit (meridian bioscience, europe), premier eia for c. difficile glutamate dehydrogenase (gdh) (meridian bioscience, europe) and the illumigene kit (meridian bioscience, europe), both ...201223057158
clostridium difficile: changing epidemiology, treatment and infection prevention measures.clostridium difficile was first reported as a cause of antibiotic-associated colitis in 1978. in more recent years we have witnessed disturbing trends associated with c. difficile infection (cdi). cdi has become more common, affecting populations previously considered at low risk, more severe with an associated increase in mortality, and more difficult to treat with some patients experiencing multiple relapses and a reduced responsiveness to previously effective antibiotics. these trends have be ...201223054932
[clostridium difficile associated diarrhea: reliable therapy with vancomycin capsules]. 201223045940
recent changes in clostridium difficile infection.clostridium difficile is the main cause of nosocomial diarrhea. diarrhea associated with c. difficile has increased incidence, morbidity, and mortality in the last few years. the major related risk factors include use of antibiotics, elderly patients and prolonged hospital stay. many patients receive combinations of antibiotics or multiple antibiotics, which represents the main risk to develop diarrhea associated to c. difficile or its recurrence. therefore, interventions to improve antibiotic p ...201223045838
intrarectal instillation of clostridium difficile toxin a triggers colonic inflammation and tissue damage: development of a novel and efficient mouse model of clostridium difficile toxin exposure.clostridium difficile, a major cause of hospital-acquired diarrhea, triggers disease through the release of two toxins, toxin a (tcda) and toxin b (tcdb). these toxins disrupt the cytoskeleton of the intestinal epithelial cell, increasing intestinal permeability and triggering the release of inflammatory mediators resulting in intestinal injury and inflammation. the most prevalent animal model to study tcda/tcdb-induced intestinal injury involves injecting toxin into the lumen of a surgically ge ...201223045481
contribution of adenosine a(2b) receptors in clostridium difficile intoxication and infection.clostridium difficile toxins a (tcda) and b (tcdb) induce a pronounced systemic and intestinal inflammatory response. a(2b) adenosine receptors (a(2b)ars) are the predominant adenosine receptors in the intestinal epithelium. we investigated whether a(2b)ars are upregulated in human intestinal cells by tcda or tcdb and whether blockade of a(2b)ars can ameliorate c. difficile tcda-induced enteritis and alter the outcome of c. difficile infection (cdi). adenosine receptor subtype (a(1), a(2a), a(2b ...201223045479
hospital-onset clostridium difficile infection rates in persons with cancer or hematopoietic stem cell transplant: a c3ic network report.a multicenter survey of 11 cancer centers was performed to determine the rate of hospital-onset clostridium difficile infection (ho-cdi) and surveillance practices. pooled rates of ho-cdi in patients with cancer were twice the rates reported for all us patients (15.8 vs 7.4 per 10,000 patient-days). rates were elevated regardless of diagnostic test used.201223041818
burden of clostridium difficile infection in long-term care facilities in monroe county, new york.long-term care facility (ltcf) residents are at increased risk of clostridium difficile infection (cdi). however, little is known about the incidence, recurrence, and severity of cdi in ltcfs or the extent to which acute care exposure contributes to cdi in ltcfs. we describe the epidemiology of cdi in a cohort of ltcf residents in monroe county, new york, where recent estimates suggest a cdi incidence in hospitals of 9.2 cases per 10,000 patient-days.201223041808
empirical antimicrobial prescriptions in patients with clostridium difficile infection at hospital admission and impact on clinical outcome.to determine, among patients with clostridium difficile infection (cdi) at hospital admission, the impact of concurrent use of systemic, non-cdi-related antimicrobials on clinical outcomes and the risk factors associated with unnecessary antimicrobial prescribing.201223041807
effect of hospital-wide chlorhexidine patient bathing on healthcare-associated infections.chlorhexidine gluconate (chg) bathing has been used primarily in critical care to prevent central line-associated bloodstream infections and infections due to multidrug-resistant organisms. the objective was to determine the effect of hospital-wide chg patient bathing on healthcare-associated infections (hais).201223041806
equal efficacy of glucoprotamin and an aldehyde product for environmental disinfection in a hematologic transplant unit: a prospective crossover trial.the inanimate hospital environment has emerged as an important reservoir of nosocomial pathogens. in particular, multidrug-resistant pathogens, such as methicillin-resistant staphylococcus aureus, acinetobacter species, and clostridium difficile, play a major role in the transmission of hospital-acquired infections. in europe, aldehydes, chlorine, and quaternary ammonium compounds have been commonly used for environmental disinfection. glucoprotamin, a newer active compound for disinfectants, ha ...201223041803
association of relapse of clostridium difficile disease with bi/nap1/027.recurrent clostridium difficile infection (cdi) occurs in up to 35% of patients. recurrences can be due to either relapse with the same strain or reinfection with another strain. in this study, multilocus variable-number tandem-repeat analysis (mlva) was performed on c. difficile isolates from patients with recurrent cdi to distinguish relapse from reinfection. in addition, univariate and multivariate analyses were performed to identify risk factors associated with relapse. among patients with a ...201223052318
clostridium difficile in young farm animals and slaughter animals in belgium.faecal carriage of clostridium difficile in healthy animals has been reported recently, especially in piglets and calves. however there is limited data about carriage in animals just prior to slaughter in europe. the main objective of this study was to determine the presence of c. difficile in pigs and cattle at the slaughterhouse. c. difficile was isolated in 6.9% of the cattle at the slaughterhouse. none of the pig slaughter samples were positive for c. difficile after an enrichment time of 72 ...201223041559
outcome of clostridium difficile-associated disease in solid organ transplant recipients: a prospective and multicentre cohort study.clostridium difficile-associated disease (cdad) is the most common cause of nosocomial diarrhea. information about cdad in solid organ transplant (sot) recipients is scarce. to determine its epidemiology and risk factors, we conducted a cohort study in which 4472 sot patients were prospectively included in the resitra/reipi (spanish research network for the study of infection in transplantation) database between july 2003 and july 2006. forty-two episodes of cdad were diagnosed in 36 patients. t ...201223039822
prebiotics, probiotics and digestive health.the human gastrointestinal lumen is inhabited by a wide variety of microbiota. our understanding of the intestinal microbiota and its full consequences on gastrointestinal health is still evolving. however, it is well accepted that altered colonic flora drives the pathogenesis of many disorders and diseases as seen in antibiotic-associated diarrhea and clostridium difficile infection. recent works published in the area of probiotics are reviewed here.201223037903
clostridium difficile-associated infection: a disease of varying severity.clostridium difficile-associated infection (cdi) can have varying severity from asymptomatic carriage to fulminant colitis. its incidence and virulence in north america are increasing. the increase in virulence is associated with emergence of the highly toxigenic north american pulsed field gel electrophoresis-1 strain. the major risk factor for cdi is exposure to antibiotics. another major risk factor is hospitalization. the spectrum of cdi ranges from asymptomatic carriers to fulminant disease ...201223036604
the microbiome and inflammatory bowel disease: is there a therapeutic role for fecal microbiota transplantation?one hypothesis for the etiology of inflammatory bowel disease is that an altered or pathogenic microbiota causes inflammation in a genetically susceptible individual. understanding the microbiota's role in the pathogenesis of the disease could lead to new ibd treatments aimed at shifting the bacteria in the gut back to eubiosis. probiotics have some efficacy in the treatment of ulcerative colitis (uc), but our current repertoire is limited in potency. fecal microbiota therapy (fmt) is an emergin ...201223034604
proton pump inhibitor use and association with spontaneous bacterial peritonitis in patients with cirrhosis and ascites.to evaluate the literature regarding the efficacy and safety of proton pump inhibitors (ppis) when they are used in patients with cirrhosis and ascites.201223032651
[epidemiology, diagnosis, complications and surgery in inflammatory bowel disease].in digestive disease week 2012, held in san diego, numerous studies were presented on the epidemiology of inflammatory bowel disease. some of these studies were population-based, providing greater information on known risk factors and helping to eliminate proposed risk factors for which there is no known evidence. in this meeting, special attention was paid to the natural history of the disease as well as surgery in patients aged more than 65 years old who should clearly be treated as a separate ...201223018008
temporal differential proteomes of clostridium difficile in the pig ileal-ligated loop model.the impact of clostridium difficile infection (cdi) on healthcare is becoming increasingly recognized as it represents a major cause of nosocomial diarrhea. a rising number of cdi cases and outbreaks have been reported worldwide. here, we developed the pig ileal-ligated loop model for semi-quantitative analysis comparing temporal differential proteomes in c. difficile following in vivo incubation with in vitro growth using isobaric tags for relative and absolute quantification (itraq). proteins ...201223029131
icesp1116, the genetic element responsible for erm(b)-mediated, inducible resistance to erythromycin in streptococcus pyogenes.icesp1116, responsible for erm(b)-mediated, inducible erythromycin resistance in streptococcus pyogenes, was comprehensively characterized, and its chromosomal integration site was determined. it displayed a unique mosaic organization consisting of a scaffold, related to tngallo1 from streptococcus gallolyticus, with two inserted fragments separated by is1216. one fragment, containing erm(b), displayed high-level identity to a portion of the s. pyogenes plasmid psm19035; the other, containing a ...201223027190
the role of acute care surgery in the treatment of severe, complicated clostridium difficile-associated disease.clostridium difficile associated disease (cdad) is the result of colonic bacterial overgrowth with this gram positive anaerobic organism and the production of toxins that typically induce diarrhea. most patients with cdad respond to treatment with oral metronidazole or vancomycin, but a subset of patients will develop a severe systemic illness, multiple organ failure, and death. there are no reliable combinations of clinical or laboratory findings that will distinguish patients who will respond ...201223026914
duexis(®) (ibuprofen 800 mg, famotidine 26.6 mg): a new approach to gastroprotection for patients with chronic pain and inflammation who require treatment with a nonsteroidal anti-inflammatory drug.chronic pain conditions affect at least 116 million us adults and more than one-third of adults worldwide. nonsteroidal anti-inflammatory drugs (nsaids) are used extensively for the treatment of chronic pain due to their efficacy as anti-inflammatory and analgesic agents. gastrointestinal toxicity is the most well known adverse effect of nsaid therapy and it may manifest as dyspepsia, ulcers, or bleeding. current guidelines for the management of patients who require nsaids for chronic pain and i ...201223024710
results from the second scottish national prevalence survey: the changing epidemiology of healthcare-associated infection in scotland.healthcare-associated infections (hais) are a recognized public health problem worldwide. point prevalence surveys (ppss) can be used to measure the burden of all hai types.201223022370
wide variation in adoption of screening and infection control interventions for multidrug-resistant organisms: a national study.we performed a survey of national healthcare safety network hospitals in 2008 to describe adoption of screening and infection control policies aimed at multidrug-resistant organisms (mdro) in intensive care units (icus) and identify predictors of their presence, monitoring, and implementation.201223021413
associations between nosocomial meticillin-resistant staphylococcus aureus and nosocomial clostridium difficile-associated diarrhoea in 89 german hospitals.clostridium difficile is mainly considered as a hospital-acquired pathogen causing diarrhoea in healthcare settings.201223021304
the burden of clostridium difficile-associated disease following digestive tract surgery in japan.although surgery is considered a risk for clostridium difficile-associated disease (cdad), large-scale data on outcomes of postsurgical cdad are rare.201223021129
improving the quality of antibiotic prescribing in the nhs by developing a new antimicrobial stewardship programme: start smart--then focus.there has been dramatic change in antibiotic use in english hospitals. data from 2004 and 2009 show that the focus on reducing fluoroquinolone and second- and third-generation cephalosporin use seems to have been heeded in nhs secondary care, and has been associated with a substantial decline in hospital clostridium difficile rates. however, there has been a substantial increase in use of co-amoxiclav, carbapenems and piperacillin/tazobactam. in primary care, antibiotic prescribing fell markedly ...201222855879
corticosteroids in the treatment of pseudomembranous colitis: a report of 3 cases.clostridium difficile associated diarrhoea has been an increasing problem in the last decade in the uk and is a cause of significant morbidity. at the most severe end of the spectrum it causes pseudomembranous colitis which has a significant associated mortality rate and can be refractory to standard treatments. here we present three cases of proven pseudomembranous colitis in which systemic corticosteroids were used as an adjunct to treatment, raising the possibility of a new treatment option f ...201227785209
clostridium difficile clinical isolates exhibit variable susceptibility and proteome alterations upon exposure to mammalian cationic antimicrobial peptides.clostridium difficile is a leading cause of hospital-acquired bacterial infections in the united states, and the increased incidence of recurrent c. difficile infections is particularly problematic. the molecular mechanisms of c. difficile colonization, including its ability to evade host innate immune responses, is poorly understood. we hypothesized that epidemic-associated c. difficile clinical isolates would exhibit increased resistance to mammalian, gut-associated, cationic antimicrobial pep ...201223017940
attributing cause of death for patients with clostridium difficile infection. 201223017180
multicenter clinical evaluation of the portrait toxigenic c. difficile assay for detection of toxigenic clostridium difficile strains in clinical stool specimens.we compared the portrait toxigenic c. difficile assay, a new semiautomated sample-to-result molecular test, to a toxigenic bacterial culture/cell cytotoxin neutralization assay (tbc/ccna) for the detection of toxigenic clostridium difficile in 549 stool specimens. stool specimens were also tested by one of three alternative fda-cleared molecular tests for toxigenic c. difficile (xpert c. difficile, illumigene c. difficile, or geneohm cdiff). the sensitivities and specificities of the molecular t ...201223015667
proton pump inhibitors: potential adverse effects.this review summarizes adverse effects of potential proton pump inhibitors (ppis), including nutritional deficiencies (b12 and magnesium), rebound acid hypersecretion, acute interstitial nephritis, gastric carcinoid tumor, cardiovascular risk with clopidogrel and ppi coprescription, bone fractures, enteric infections and pneumonia. an epidemiologic framework is applied to assess clinical relevance and reinforce best practice recommendations.201223010681
a pilot randomised controlled trial in intensive care patients comparing 7 days' treatment with empirical antibiotics with 2 days' treatment for hospital-acquired infection of unknown origin.management of cardiac intensive care unit (icu) sepsis is complicated by the high incidence of systemic inflammatory response syndrome, which mimics sepsis but without an infective cause. this pilot randomised trial investigated whether or not, in the icu, 48 hours of broad-spectrum antibiotic treatment was adequate to safely treat suspected sepsis of unknown and unproven origin and also the predictive power of newer biomarkers of sepsis.201223010339
outcomes in patients tested for clostridium difficile toxins.clostridium difficile testing is shifting from toxin detection to c. difficile detection. yet, up to 60% of patients with c. difficile by culture test negative for toxins and it is unclear whether they are infected or carriers. we reviewed medical records for 7046 inpatients with a c. difficile toxin test from 2005 to 2009 to determine the duration of diarrhea and rate of complications and mortality among toxin-positive (toxin+) and toxin- patients. overall, toxin- patients had less severe diarr ...201223009731
ppi therapy and albumin are better predictors of recurrent clostridium difficile colitis than choice of antibiotics.recurrent clostridium difficile colitis (rcdc) is common, but data regarding recurrence rates and predisposing factors are sparse.201223007285
[adverse events associated with long-term use of proton pump inhibitors].proton pump inhibitors (ppi) remain the leading therapy for acid-related disorders. long-term ppi use increases the risk of pneumonia and enteric bacterial infections and of nosocomial clostridium difficile-associated diarrhoea. ppis do not lead to vitamin b12 or iron deficiencies and do not induce malignancies or increase the risk of major birth defects. prolonged ppi use may be a weak risk factor for certain fractures and results in hypergastrinaemia and parietal cell hyperplasia leading to re ...201223006222
different antibiotic resistance and sporulation properties within multiclonal clostridium difficile pcr ribotypes 078, 126, and 033 in a single calf farm.clostridium difficile strains were sampled periodically from 50 animals at a single veal calf farm over a period of 6 months. at arrival, 10% of animals were c. difficile positive, and the peak incidence was determined to occur at the age of 18 days (16%). the prevalence then decreased, and at slaughter, c. difficile could not be isolated. six different pcr ribotypes were detected, and strains within a single pcr ribotype could be differentiated further by pulsed-field gel electrophoresis (pfge) ...201223001653
the impact of mechanical bowel preparation on postoperative complications for patients undergoing cystectomy and urinary diversion.the benefit of routine mechanical bowel preparation for patients undergoing radical cystectomy is not well established. we compared postoperative complications in patients who did or did not undergo mechanical bowel preparation before radical cystectomy.201222999697
clostridium difficile ribotype does not predict severe infection.studies of clostridium difficile outbreaks suggested that certain ribotypes (eg, 027 and 078) cause more severe disease than other ribotypes. a growing number of studies challenge the validity of this hypothesis.201222972866
systematic review and meta-analysis of outcomes following emergency surgery for clostridium difficile colitis.only a small proportion of patients with severe clostridium difficile infection (cdi) undergo emergency surgery, the timing and nature of which is unclear. the aim of this study was to describe the operations performed and to identify factors predictive of death following emergency surgery for cdi.201222972525
in vivo detection of mucosal healing-involved histiocytes by confocal laser endomicroscopy.histiocytes have a pivotal role in wound repair and intestinal epithelial recovery - the most important goal to sustain gut functionality. yet, an in vivo description of colonic histiocytes by confocal laser endomicroscopy (cle) is missing. here, we report the case of a 45-years-old male patient who was referred to our clinic with weight loss and a history of two consecutive clostridium difficile colitis episodes, the latter cured 3 wk before present admission. stool microbiology was negative. c ...201222969212
comparison of bacterial quantities in left and right colon biopsies and faeces.to compare quantities of predominant and pathogenic bacteria in mucosal and faecal samples.201222969206
proton pump inhibitors are associated with a high rate of serious infections in veterans with decompensated cirrhosis.there is increasing evidence that proton pump inhibitors (ppis) increase the rate of infections in patients with decompensated cirrhosis.201222966967
a first-in-human, randomized, double-blind, placebo-controlled, single- and multiple-ascending oral dose study to assess the safety and tolerability of lff571 in healthy volunteers.clostridium difficile is the leading cause of hospital-acquired infectious diarrhea. lff571 is a novel inhibitor of the prokaryotic translation elongation factor tu and is active against a range of bacterial species, including c. difficile. this first-in-human study investigated the safety and pharmacokinetics of single and multiple ascending oral doses of lff571 in healthy subjects. this was a randomized, double-blind, placebo-controlled study. except for one cohort, lff571 was given with a hig ...201222964250
reducing adverse effects of proton pump inhibitors.proton pump inhibitors effectively treat gastroesophageal reflux disease, erosive esophagitis, duodenal ulcers, and pathologic hypersecretory conditions. proton pump inhibitors cause few adverse effects with short-term use; however, long-term use has been scrutinized for appropriateness, drug-drug interactions, and the potential for adverse effects (e.g., hip fractures, cardiac events, iron deficiency, clostridium difficile infection, pneumonia). adults 65 years and older are more vulnerable to ...201222962914
daily disinfection of high-touch surfaces in isolation rooms to reduce contamination of healthcare workers' hands.in a randomized nonblinded trial, we demonstrated that daily disinfection of high-touch surfaces in rooms of patients with clostridium difficile infection and methicillin-resistant staphylococcus aureus colonization reduced acquisition of the pathogens on hands after contacting high-touch surfaces and reduced contamination of hands of healthcare workers caring for the patients.201222961024
epidemiology and healthcare costs of incident clostridium difficile infections identified in the outpatient healthcare setting.to describe the epidemiology and healthcare costs of clostridium difficile infection (cdi) identified in the outpatient setting.201222961023
in vitro evaluation of the antimicrobial activity of a range of probiotics against pathogens: evidence for the effects of organic acids.the aim of this study was to investigate the antimicrobial properties of fifteen selected strains belonging to the lactobacillus, bifidobacterium, lactococcus, streptococcus and bacillus genera against gram-positive and gram-negative pathogenic bacteria. in vitro antibacterial activity was initially investigated by an agar spot method. results from the agar spot test showed that most of the selected strains were able to produce active compounds on solid media with antagonistic properties against ...201222959627
mortality and clostridium difficile infection: a review. 201222958425
antimicrobial stewardship in scotland: impact of a national programme.the scottish antimicrobial prescribing group (sapg) was established by the scottish government in 2008 to lead the first national initiative to actively address antimicrobial stewardship. healthcare associated infection (hai) is a priority in scotland and the work of sapg contributes to the national hai delivery plan. sapg's early work has focused on restricting the use of antibiotics associated with a high risk of clostridium difficile infection (cdi) and development of national prescribing ind ...201222958296
prolongation of length of stay and clostridium difficile infection: a review of the methods used to examine length of stay due to healthcare associated infections. 201222958238
clostridium difficile spore-macrophage interactions: spore survival.clostridium difficile is the main cause of nosocomial infections including antibiotic associated diarrhea, pseudomembranous colitis and toxic megacolon. during the course of clostridium difficile infections (cdi), c. difficile undergoes sporulation and releases spores to the colonic environment. the elevated relapse rates of cdi suggest that c. difficile spores has a mechanism(s) to efficiently persist in the host colonic environment.201222952726
comparison of bd geneohm cdiff and seegene seeplex ace pcr assays using toxigenic clostridium difficile culture for direct detection of tcdb from stool specimens.we evaluated the performances of 2 pcr assays (bd geneohm and seegene ace) for direct detection of tcdb from stool specimens. the concordance rate between bd and seegene was 96.3%. the sensitivities, specificities, positive predictive values (ppvs), and negative predictive values (npvs) of bd and seegene were 95.7%, 96.5%, 91.8%, and 98.2% and 90.0%, 97.1%, 92.6%, and 96.0%, respectively.201222952270
a novel use of rectal swab to test for clostridium difficile infection by real-time pcr. 201222951884
clostridium difficile detection: identification of colonization, subclinical and overt disease. 201222951306
prevalence and distribution of clostridium difficile pcr ribotypes in cats and dogs from animal shelters in thuringia, germany.clostridium difficile is an important cause of nosocomial diarrhoea in humans. pet animals and livestock are discussed as potential natural reservoirs and sources of infection. in this study faecal samples from dogs and cats were collected at 10 animal shelters in thuringia, germany. c. difficile was isolated from 9 out of 165 (5.5%) canine and 5 out of 135 (3.7%) feline samples. five pcr ribotypes (010, 014/020, 039, 045, slo 066) were identified. pcr ribotypes 010 and 014/020 were detected in ...201222951303
evaluation of the xpert clostridium difficile assay for the diagnosis of clostridium difficile infection.infection with clostridium difficile is a growing concern because of the increasing prevalence and spread of nosocomial infections. emergence of the hypervirulent 027/nap1/bi strain is also notable. existing diagnostic methods have low sensitivity or are time-consuming. therefore, establishing a rapid and accurate microbiological diagnostic assay is needed. we evaluated the xpert c. difficile assay (xpert cd assay; cepheid, usa) to detect toxigenic c. difficile. this assay is a real-time multipl ...201222950071
clostridium difficile colitis and neutropenic fever associated with docetaxel chemotherapy in a patient with advanced extramammary paget's disease.extramammary paget's disease is a rare cutaneous malignant neoplasm. previous studies indicated the efficacy of docetaxel in advanced cases. the common side effects of docetaxel are usually tolerable and seldom life-threatening. we experienced a case of severe pseudomembranous colitis and neutropenic fever that developed just after the first cycle of docetaxel chemotherapy. to the best of our knowledge, there are few reports of pseudomembranous colitis associated with docetaxel administration fo ...201222949901
morbidity and mortality associated with clostridium difficile ribotype 078: a case-case study.the morbidity and mortality associated with clostridium difficile ribotype 078 were examined by comparison with other known outbreak strains. a healthcare interaction within eight weeks of a positive specimen significantly increased the likelihood of ribotype 078 compared with ribotype 027. individuals with ribotype 078 also tended to come from community sources, have a hospital stay post specimen similar to ribotype 027 and a lower 30-day mortality, but these differences were not statistically ...201222947650
[risk factors of clostridium difficile-associated diarrhea in children].to explore the risk factors of clostridium difficile-associated diarrhea (cdad) in children.201222944235
fidaxomicin versus vancomycin for clostridium difficile infection: meta-analysis of pivotal randomized controlled trials.two recently completed phase 3 trials (003 and 004) showed fidaxomicin to be noninferior to vancomycin for curing clostridium difficile infection (cdi) and superior for reducing cdi recurrences. in both studies, adults with active cdi were randomized to receive blinded fidaxomicin 200 mg twice daily or vancomycin 125 mg 4 times a day for 10 days. post hoc exploratory intent-to-treat (itt) time-to-event analyses were undertaken on the combined study 003 and 004 data, using fixed-effects meta-anal ...201222752871
predictors of first recurrence of clostridium difficile infection: implications for initial management.symptomatic recurrence of clostridium difficile infection (cdi) occurs in approximately 20% of patients and is challenging to treat. identifying those at high risk could allow targeted initial management and improve outcomes. adult toxin enzyme immunoassay-positive cdi cases in a population of approximately 600,000 persons from september 2006 through december 2010 were combined with epidemiological/clinical data. the cumulative incidence of recurrence ≥ 14 days after the diagnosis and/or onset o ...201222752869
[segmental necrotizing colitis in a patient with e. coli o104:h4 infection].a 29-year-old man presented with abdominal cramps and bloody diarrhoea. blood tests revealed elevated c-reactive protein (21.3 mg/dl; normal range 0.01 - 0. 82 mg/dl) and white blood cells (28200/μl, normal range 4000 - 10000/μl). stool tests were negative for enteropathogenic bacteria and clostridium difficile toxins a/b. ultrasound and computed tomography showed massive swelling of the transverse colon and right colonic flexure. at endoscopy, circular necrosis of the mucosa was encountered in ...201222298100
outpatient parenteral antimicrobial therapy with ceftriaxone, a review.more than 30 years since it was developed for clinical use, the third-generation cephalosporin ceftriaxone remains the most commonly used agent for outpatient parental antimicrobial therapy (opat). recent antimicrobial stewardship programmes have tended to restrict ceftriaxone use in hospitals to control antibiotic resistance and outbreaks of clostridium difficle infection (cdi). considering the expansion of opat programmes both in the uk and worldwide, revisiting the role of ceftriaxone in opat ...201222527482
cryptosporidium enteritis in solid organ transplant recipients: multicenter retrospective evaluation of 10 cases reveals an association with elevated tacrolimus concentrations.cryptosporidial enteritis, a diarrheal infection of the small intestine caused by the apicomplexan protozoa cryptosporidium, is infrequently recognized in transplant recipients from developed countries.201222340660
detection of clostridium difficile as a routine diagnosis: comparison of real-time pcr and enzyme immunoassay. 201222338064
an evaluation of repeat stool testing for clostridium difficile infection by polymerase chain reaction.to evaluate the yield of repeat stool polymerase chain reaction (pcr) testing in patients with suspected clostridium difficile infection (cdi).201222334221
multidrug-resistant north american pulsotype 2 clostridium difficile was the predominant toxigenic hospital-acquired strain in the province of manitoba, canada, in 2006-2007.the objective of the current study was to determine whether the antimicrobial susceptibility profile or genotype of hospital-acquired isolates of clostridium difficile differed from isolates causing community-acquired disease. five hundred diarrhoeal stool samples (one >2 ml sample per patient) from patients across manitoba, canada, in 2006-2007 that were reported as c. difficile toxin positive were cultured, resulting in 432 isolates of toxin-positive c. difficile for analysis. of these 432 iso ...201222301615
guanine-nucleotide exchange factor h1 mediates lipopolysaccharide-induced interleukin 6 and tumor necrosis factor α expression in endothelial cells via activation of nuclear factor κb.the development of sepsis is multifactorial. tissue damage and organ dysfunction may be caused not only by the microorganisms but also by the inflammatory mediators released in response to the infection. interleukin 6 (il-6) and tumor necrosis factor α (tnf-α) levels in serum are well known to be upregulated in humans with sepsis and can be used to predict outcome. using human umbilical vein endothelial cells, we analyzed the role of guanine-nucleotide exchange factor h1 (gef-h1) on lipopolysacc ...201222301607
glutamate dehydrogenase is highly conserved among clostridium difficile ribotypes.glud was highly conserved and glutamate dehydrogenase (gdh) was readily expressed in vitro by all 77 clostridium difficile ribotypes assayed. all ribotypes, including arl 002, arl 027, and arl 106, were reactive in assays that detect c. difficile gdh.201222301027
frequency of outbreak investigations in us hospitals: results of a national survey of infection preventionists.a survey of infection preventionists was conducted to determine the frequency of outbreak investigations in us hospitals.201222300590
considerations for the use of proton-pump inhibitors in older adults.to investigate current concerns regarding the use of proton-pump inhibitors (ppis) in older adults.201222330952
clinical and laboratory evaluation of a real-time pcr for clostridium difficile toxin a and b genes.many laboratories use enzyme immunoassays (eias) for the diagnosis of clostridium difficile infection (cdi). more recently, polymerase chain reaction (pcr)-based diagnosis has been described as a sensitive test. real-time pcr for the detection of c. difficile toxin a and b genes was evaluated. a prospective evaluation was performed on stool samples from 150 hospitalized adult patients and 141 healthy volunteers. pcr was compared to toxigenic culture (tc), direct cytotoxicity test (ctt), immunoca ...201222327373
fidaxomicin versus vancomycin for infection with clostridium difficile in europe, canada, and the usa: a double-blind, non-inferiority, randomised controlled trial.infection with clostridium difficile is the primary infective cause of antibiotic-associated diarrhoea. we aimed to compare efficacy and safety of fidaxomicin and vancomycin to treat patients with c difficile infection in europe, canada, and the usa.201222321770
u.k. laboratory diagnosis of clostridium difficile infection: in a state of transition, confusion, or both? 201222321724
fidaxomicin for the treatment of clostridium difficile infections.to evaluate the pharmacology, microbiology, safety, and efficacy of fidaxomicin for treatment of clostridium difficile infections (cdi).201222318930
discovery of lff571: an investigational agent for clostridium difficile infection.clostridium difficile (c. difficile) is a gram positive, anaerobic bacterium that infects the lumen of the large intestine and produces toxins. this results in a range of syndromes from mild diarrhea to severe toxic megacolon and death. alarmingly, the prevalence and severity of c. difficile infection are increasing; thus, associated morbidity and mortality rates are rising. 4-aminothiazolyl analogues of the antibiotic natural product ge2270 a (1) were designed, synthesized, and optimized for th ...201222315981
clostridium difficile o27 colitis: hospital-onset but community-acquired.large outbreaks of clostridium difficile (cd) associated colitis in north america and europe have been attributed to the emergence of the epidemic/toxin pcr ribotype o27 cd strain (cd027). due to the increased virulence of this epidemic strain and its propension for causing outbreaks, we performed a structured risk-assessment approach in order to determine the risks associated with the introduction of this strain within our university hospital. from february 2009 to january 2010, we identified 3 ...201222314411
implementing automated surveillance for tracking clostridium difficile infection at multiple healthcare facilities.automated surveillance using electronically available data has been found to be accurate and save time. an automated clostridium difficile infection (cdi) surveillance algorithm was validated at 4 centers for disease control and prevention epicenter hospitals. electronic surveillance was highly sensitive, specific, and showed good to excellent agreement for hospital-onset; community-onset, study facility-associated; indeterminate; and recurrent cdi.201222314071
a meta-analysis and systematic review on the effect of probiotics in acute diarrhea.diarrhea the second leading cause of death in childhood is caused by a variety of organisms. rehydration reduces the risk of death but it is not effective in shortening duration of disease. recently, probiotics have been recommended for prevention or treatment of gastrointestinal disorders including diarrhea. considering existing documents from different aspects, it seems that results are somehow controversial or non-conclusive. thus, we aimed to meta-analyze clinical trials to show actual benef ...201222309079
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