Publications

TitleAbstractYear(sorted ascending)
Filter
PMID
Filter
rapid detection of clostridium difficile toxins from stool samples using real-time multiplex pcr.in this study, a total of 650 stool samples were tested to show that our method is capable of detecting four clostridium difficile genes; tcda, tcdb, encoding toxin a (tcda) and toxin b (tcdb), and the binary toxin c. difficile transferase genes (cdta and/or cdtb) encoding cdt toxin. besides detecting the targeted c. difficile genes, our method can be used to detect the presence of any inhibitory components in the pcr. this assay, combined with a selective culture medium, such as the chromid™ c. ...201323788597
clostridium difficile infections in south east scotland: mortality and recurrence in a region without pcr ribotype 027.three hundred and thirty-five patients with laboratory-confirmed clostridium difficile infections (cdis) were studied for epidemiological features, clinical presentation and laboratory markers. they were followed up for 1 year to determine recurrence and mortality. four hundred and thirty-two episodes were recorded. one year mortality was 41.8 % of which cdi was listed on 20 % of the death certificates. one year recurrence rate was 22.9 %. pcr ribotype 001 was the commonest epidemiological type ...201323788595
laboratory diagnosis of clostridium difficile infections: there is light at the end of the colon.single molecular or multistep assays (glutamate dehydrogenase, toxin a/b, ± molecular) are recommended for the diagnosis of cdi in patients with clinically significant diarrhea. rapid and accurate tests can improve resource allocations and improve patient care. enzyme immunoassay (eia) for toxins a/b is too insensitive for use as a stand-alone assay. this guideline will examine the use of molecular tests and multitest algorithms for the diagnosis of clostridium difficile infection (cdi). these n ...201323788237
impact of cleaning and other interventions on the reduction of hospital-acquired clostridium difficile infections in two hospitals in england assessed using a breakpoint model.clostridium difficile infection remains a major challenge for hospitals. although targeted infection control initiatives have been shown to be effective in reducing the incidence of hospital-acquired c. difficile infection, there is little evidence available to assess the effectiveness of specific interventions.201323787167
challenges for standardization of clostridium difficile typing methods.typing of clostridium difficile facilitates understanding of the epidemiology of the infection. some evaluations have shown that certain strain types (for example, ribotype 027) are more virulent than others and are associated with worse clinical outcomes. although restriction endonuclease analysis (rea) and pulsed-field gel electrophoresis have been widely used in the past, pcr ribotyping is the current method of choice for typing of c. difficile. however, global standardization of ribotyping r ...201323784128
clostridium difficile infection in newly diagnosed pediatric inflammatory bowel disease in the mid-southern united states.clostridium difficile is an emerging opportunistic pathogen that infects patients with underlying chronic disorders such as inflammatory bowel diseases (ibd) at high rates. an extremely high prevalence of clostridium difficile infection (cdi) was noted recently in new-onset pediatric ibd from eastern europe (poland). we examined the rate of cdi in our new pediatric ibd patients (123 tested) from 2010 to 2012. the overall prevalence of cdi at disease onset was 8.1%, significantly (p < 0.0001) low ...201323783013
the functional vangcd cluster of clostridium difficile does not confer vancomycin resistance.vangcd, a cryptic gene cluster highly homologous to the vang gene cluster of enterococcus faecalis is largely spread in clostridium difficile. since emergence of vancomycin resistance would have dramatic clinical consequences, we have evaluated the capacity of the vangcd cluster to confer resistance. we showed that expression of vangcd is inducible by vancomycin and that vangcd , vanxycd and vantcd are functional, exhibiting d-ala : d-ser ligase, d,d-dipeptidase and d-ser racemase activities res ...201323782343
twenty-three-hour stay loop ileostomy closures: a pilot study.in uk in 2010-2011, 4,463 ileostomy closures were performed (35,442 bed days) with a median inpatient stay of 5 days (hospital episode statistics data). this seems anomalous when there are reports of 23-h stay colectomies. we present our early experience of 23-h discharge for loop ileostomy closures.201322936588
alkaline detergent combined with a routine ward bedpan washer disinfector cycle eradicates clostridium difficile spores from the surface of plastic bedpans.the cleaning efficiency of a ward bedpan washer disinfector was evaluated using various cycle parameters and detergent to determine which conditions could effectively eliminate clostridium difficile spores from the surface of bedpans. results revealed that the regular intensive cycle with thermal conditions of 85°c for 60 seconds plus the addition of an alkaline detergent was sufficient to eradicate c difficile spores. however, these thermal conditions alone, without detergent, were not adequate ...201323040603
clinical impact of switching conventional enzyme immunoassay with nucleic acid amplification test for suspected clostridium difficile-associated diarrhea.the impact of a new clostridium difficile nucleic acid amplification test (naat) on antibiotic utilization in patients with suspected c difficile infection was assessed. this single-center, cross-sectional study of 270 patients demonstrated that the use of naat decreased antibiotic expenditure by reducing prolonged empiric days of therapy in these patients.201323040489
empiric antibiotics pending bronchoalveolar lavage data in patients without pneumonia significantly alters the flora, but not the resistance profile, if a subsequent pneumonia develops.ventilator-associated pneumonia (vap) occurs in up to 25% of mechanically ventilated patients, with an associated mortality up to 50%. early diagnosis and appropriate empiric antibiotic coverage of vap are crucial. given the multitude of noninfectious clinical and radiographic anomalies within trauma patients, microbiology from bronchioalveolar lavage (bal) is often needed. empiric antibiotics are administered while awaiting bal culture data. little is known about the effects of these empiric an ...201322906560
knowledge, attitudes and practice regarding clostridium difficile: a survey of physicians in an academic medical center.using current guidelines, we surveyed physicians at our hospital to ascertain knowledge, attitudes, and practice regarding clostridium difficile infection. the survey identified significant gaps in knowledge and practice. infection control professionals should include physician education on clostridium difficile infection diagnosis, isolation precautions, and treatment as part of a comprehensive control program.201322981165
electronic screening of patients for predisposition to clostridium difficile infection in a community hospital.clostridium difficile infection (cdi) continues to cause significant morbidity and mortality among hospitalized patients. early diagnosis, contact precautions, and prompt therapy are crucial to the control of the disease and its spread. this study aims to develop an electronic screening tool to help identify patients who are at risk of cdi.201322990298
improved detection of toxigenic clostridium difficile using the cepheid xpert c difficile assay and impact on c difficile infection rates in a tertiary hospital: a double-edged sword.recent recommendations suggest implementation of a 2-step diagnostic algorithm for the laboratory detection of toxigenic clostridium difficile. we found that the rate of toxigenic c difficile detection in our laboratory doubled after the introduction of an algorithm that incorporated polymerase chain reaction testing. this led to an abrupt 70% increase in the overall rate of c difficile infection in our institution.201322939418
comparison of antigen and two molecular methods for the detection of clostridium difficile toxins.clostridium difficile (cd) is considered an important cause of diarrhoea associated with the antimicrobial treatment of infections. the pathogenicity of cd is due to toxins a and b, produced by toxigenic cd strains.201322998479
severe anaphylaxis caused by orally administered vancomycin to a patient with clostridium difficile infection.we report the first case of anaphylaxis to oral vancomycin in a cystic fibrosis patient with severe and relapsing clostridium difficile infection (cdi) refractory to metronidazole. the patient's colitis has been successfully treated with a combination of intravenous metronidazole and tigecycline.201322996384
impact of the type of diagnostic assay on clostridium difficile infection and complication rates in a mandatory reporting program.most clostridium difficile infection (cdi) surveillance programs neither specify the diagnostic method to be used nor stratify rates accordingly. we assessed the difference in healthcare-associated cdi (ha-cdi) incidence and complication rates obtained by 2 validated diagnostic methods.201323011147
unnecessary repeat clostridium difficile pcr testing in hospitalized adults with c. difficile-negative diarrhea.the aim of this study was to determine the extent and associated costs of repeat clostridium difficile stool polymerase chain reaction (pcr) assays in patients with initially negative pcrs. c. difficile stool pcrs were done on adult hospitalized patients with diarrhea. the number/time course of repeat pcrs on initially negative pcr patients was determined. of 5,027 c. difficile stool pcrs, 814 (16.2 %) were positive and 4,213 (83.8 %) were negative. ninety-seven of the initially pcr-negative pat ...201323010903
modification of plant rac/rop gtpase signalling using bacterial toxin transgenes.bacterial protein toxins which modify rho gtpase are useful for the analysis of rho signalling in animal cells, but these toxins cannot be taken up by plant cells. we demonstrate in vitro deamidation of arabidopsis rop4 by escherichia coli cytotoxic necrotizing factor 1 (cnf1) and glucosylation by clostridium difficile toxin b. expression of the catalytic domain of cnf1 caused modification and activation of co-expressed arabidopsis rop4 gtpase in tobacco leaves, resulting in hypersensitive-like ...201323020817
fidaxomicin "chaser" regimen following vancomycin for patients with multiple clostridium difficile recurrences. 201323024296
c-reactive protein is a useful predictor of metronidazole treatment failure in mild-to-moderate clostridium difficile infection.to assess the ability of c-reactive (crp) protein, against the other commonly used metrics, to predict metronidazole treatment failure in clostridium difficile infection.201323026925
ribotyping of clostridium difficile strains associated with nosocomial transmission and relapses in a swedish county.clostridium difficile is an emerging threat in hospital environments. to analyse possible transmission and to distinguish between relapse and reinfection a collection of c. difficile isolates, sampled from 162 consecutive episodes of c. difficile infection, were pcr ribotyped. two ribotypes (001 and 012) were prone to cause nosocomial acquisition. moreover, ribotype 001 had a tendency to cause relapses as almost one in two patients with this ribotype had one or more relapses. by using pcr riboty ...201323030627
fecal microbiota transplantation: past, present and future.fecal microbiota transplantation (fmt) re-establishes a balanced intestinal flora with resultant cure of recurrent clostridium difficile infection (rcdi). fmt has also been used to treat other gastrointestinal (gi) diseases including inflammatory bowel disease (ibd), irritable bowel syndrome (ibs), and chronic constipation and a variety of non-gi disorders. the purpose of this review is to discuss the intestinal microbiota and fmt treatment of gi and non-gi diseases.201323041678
an evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms.admission to a room previously occupied by a patient with certain multidrug-resistant organisms (mdros) increases the risk of acquisition. traditional cleaning strategies do not remove all environmental mdros. we evaluated the environmental and clinical impact of hydrogen peroxide vapor (hpv) room disinfection.201323042972
does candida species overgrowth protect against clostridium difficile infection? 201323042967
stability of vancomycin in syrspend sf.vancomycin is administered orally for the treatment of pseudomembranous colitis induced by clostridium difficile. vancomycin is marketed for this purpose by viropharma as vancocin in 125-mg and 250-mg capsules. the need for other dose form options for those patients who cannot take capsules has led compounding pharmacies to seek other alternatives, namely oral solutions and suspensions. additionally, some patients are unable to use suspending agents containing alcohol or sorbitol. the objective ...201323050329
increased susceptibility of melanin-concentrating hormone-deficient mice to infection with salmonella enterica serovar typhimurium.melanin-concentrating hormone (mch) was initially identified in mammals as a hypothalamic neuropeptide regulating appetite and energy balance. however, the wide distribution of mch receptors in peripheral tissues suggests additional functions for mch which remain largely unknown. we have previously reported that mice lacking mch develop attenuated intestinal inflammation when exposed to clostridium difficile toxin a. to further characterize the role of mch in host defense mechanisms against inte ...201323115043
evaluation of clostridium difficile fecal load and limit of detection during a prospective comparison of two molecular tests, the illumigene c. difficile and xpert c. difficile/epi tests.in a large prospective comparison, the illumigene test detected clostridium difficile in 98% of toxin-positive and 58% of toxin-negative samples confirmed positive by other methods. the xpert was uniformly sensitive. most samples with discrepant results had c. difficile concentrations below the illumigene limit of detection. the significance of low-level c. difficile detection needs investigation.201323052320
acute kidney injury is an independent marker of severity in clostridium difficile infection: a nationwide survey.to examine clinical outcomes in hospitalized clostridium difficile infection (cdi) patients with acute kidney injury (aki) using the national hospital discharge survey for 2005 to 2009.201323059411
ageing and gut microbes: perspectives for health maintenance and longevity.the ageing process affects the human gut microbiota phylogenetic composition and its interaction with the immune system. age-related gut microbiota modifications are associated with immunosenescence and inflamm-ageing in a sort of self-sustaining loop, which allows the placement of gut microbiota unbalances among both the causes and the effects of the inflamm-ageing process. even if, up to now, the link between gut microbiota and the ageing process is only partially understood, the gut ecosystem ...201323079287
predicting recurrence of c. difficile colitis using bacterial virulence factors: binary toxin is the key.recurrent clostridium difficile colitis is common, yet the ability to predict recurrence is poorly developed.201323086451
rifaximin in the treatment of recurrent clostridium difficile infection.clostridium difficile can cause severe antibiotic-associated colitis. conventional treatments with metronidazole and vancomycin improve symptoms, but after discontinuation of treatment, c. difficile infection (cdi) recurs in a number of patients. rifaximin is a rifamycin-based non-systemic antibiotic that has effect against c. difficile.201323095030
clostridium difficile testing: have we got it right? 201323100357
response failure to the treatment of clostridium difficile infection and its impact on 30-day mortality.few data are available on response failure and hospital mortality. this study aimed to evaluate the association between response failure to the treatment of cdi and 30-day mortality.201323108084
comparison of a frozen human foreskin fibroblast cell assay to an enzyme immunoassay and toxigenic culture for the detection of toxigenic clostridium difficile.this study set out to validate the hs27 readycell assay (rccna) as an alternative ccna method compared against a commonly used commercial enzyme immunoassay (eia) method and toxigenic culture (tc) reference standard. a total of 860 samples were identified from those submitted to the health protection agency microbiology laboratories over a 30-week period. rccna performed much better than eia when using tc as a gold standard, with sensitivities of 90.8% versus 78.6% and positive predictive value ...201323107315
analysis of metronidazole susceptibility in different clostridium difficile pcr ribotypes.susceptibility to metronidazole was investigated in 81 clostridium difficile strains, belonging to nine different pcr ribotypes, by three different laboratory methods.201323104495
diagnosis of clostridium difficile infection using real-time pcr.clostridium difficile is known to cause antibiotic-associated diarrhea and pseudomembranous colitis. toxinogenic strains of the bacterium produce toxins a (tcda) and b (tcdb), which are associated with the pathogenicity. the standard methods for diagnosis of c. difficile infection include the cell cytotoxicity assay and the culture of a toxinogenic strain. due to the long turnaround time of these methods, more rapid methods are preferred. enzyme immunoassays are fast, but lack sensitivity. there ...201323104294
clostridium difficile: a european perspective.clostridium difficile infection is the leading cause of diarrhoea in the industrialised world. first identified in 1935, our knowledge about the clonal population structure, toxins and pcr ribotypes is still increasing. new pcr ribotypes and sequence types are frequently added. in the last decade hypervirulent strains have emerged and been associated with increased severity of disease, high recurrence and significant mortality. although previously a primarily hospital- or health-care acquired in ...201323103666
electronic ward round: finding time for the inpatient with clostridium difficile infection. 201323103665
from natural product to marketed drug: the tiacumicin odyssey.the first members of the tiacumicin family of antibiotics, encompassing more than 40 compounds, were isolated in 1975. structurally, the core aglycon is an 18-membered macrolactone having two conjugated diene units, one isolated double bond, 5 stereogenic centers and most often, at least one glycosidic linkage. tiacumicin b, a rna synthesis inhibitor, is a narrow-spectrum antibiotic against clostridia. for the treatment of clostridium difficile infection (cdi), it has the same cure rate as vanco ...201323111588
faecal microbiota transplantation for severe clostridium difficile infection in the intensive care unit.we describe a case of faecal microbiota transplantation (fmt) used for severe binary toxin-positive clostridium difficile infection in an intensive care setting. the patient was admitted to the icu of a tertiary hospital and failed traditional maximal pharmacological management. adjunctive therapy with fmt given through gastroscopy resulted in resolution of the c. difficile-related symptoms. although there is a growing experience with fmt for recurrent c. difficile infection, published evidence ...201323117471
quantitative fecal lactoferrin in toxin-positive and toxin-negative clostridium difficile specimens.quantitative fecal lactoferrin was measured in 112 patients tested for toxigenic clostridium difficile using glutamate dehydrogenase (gdh) and toxin immunoassays combined with tcdb pcr. lactoferrin levels were higher in the gdh-positive/toxin-positive group (79 μg/ml) than in the gdh-positive/toxin-negative/pcr-positive (21 μg/ml) and the gdh-negative groups (13 μg/ml). differences in fecal lactoferrin levels suggest variable presence or severity of c. difficile infection among toxin-positive an ...201323135940
the surgical management of active ulcerative colitis complicated by clostridium difficile infection.clostridium difficile stool toxin is detected in 5-20 % of patients with acute exacerbations of ulcerative colitis (uc). there is little data regarding the safety of surgery for uc with concurrent c. difficile.201323135837
antibody against tcdb, but not tcda, prevents development of gastrointestinal and systemic clostridium difficile disease.a dramatic increase in morbidity and mortality from clostridium difficile infection (cdi) due to the recent emergence of virulent, antibiotic-resistant strains has led to a search for alternatives to antibiotics, including vaccines and immune-based therapy that target the 2 key toxins-tcda and tcdb.201323125448
colectomy in intensive care patients: operative findings and outcomes.with a critical illness, intestinal complications are associated with high morbidity and mortality.201323142989
fidaxomicin inhibits toxin production in clostridium difficile.fidaxomicin, which was recently approved for the treatment of clostridium difficile-associated diarrhoea, demonstrates narrow-spectrum bactericidal activity via inhibition of rna polymerase. in this study we evaluated its inhibitory activity versus c. difficile toxin gene expression and toxin production by quantifying toxin mrna and protein.201323208832
important clinical advances in the understanding of clostridium difficile infection.clostridium difficile remains an important cause of infectious colitis, particularly in healthcare facilities. this review summarizes recent advances in the epidemiology, diagnosis, and treatment of this endemic pathogen.201323207596
antimicrobial susceptibility and resistance mechanisms of clinical clostridium difficile from a chinese tertiary hospital.clostridium difficile is a predominant cause of antibiotic-associated diarrhoea. it is increasingly difficult to treat c. difficile infection efficiently owing to its multidrug resistance. in the present study, 60 clinical c. difficile isolates were collected and analysed for their genotype, antimicrobial susceptibility and resistance mechanisms. tandem repeat sequence typing (trst) generated 21 types, including the epidemic clone tr017. antimicrobial susceptibility testing of eight antibiotics ...201323148985
vancomycin treatment's association with delayed intestinal tissue injury, clostridial overgrowth, and recurrence of clostridium difficile infection in mice.antibiotic treatment, including vancomycin, for clostridium difficile infection (cdi) has been associated with recurrence of disease in up to 25% of infected persons. this study investigated the effects of vancomycin on the clinical outcomes, intestinal histopathology, and anaerobic community during and after treatment in a murine model of cdi. c57bl/6 mice were challenged with c. difficile strain vpi 10463 after pretreatment with an antibiotic cocktail. twenty-four hours after infection, mice w ...201323147742
both fidaxomicin and vancomycin inhibit outgrowth of clostridium difficile spores.fidaxomicin (fdx) is approved to treat clostridium difficile-associated diarrhea and is superior to vancomycin in providing a sustained clinical response (cure without recurrence in the subsequent 25 days). the mechanism(s) behind the low recurrence rate of fdx-treated patients could be multifactorial. here, we tested effects of fdx, its metabolite op-1118, and vancomycin on spore germination and determined that none affected the initiation of spore germination but all inhibited outgrowth of veg ...201323147724
protective antibody responses against clostridium difficile elicited by a dna vaccine expressing the enzymatic domain of toxin b.a dna vaccination approach was used in the current study to screen for the immunogenicity of different fragments of toxin a and toxin b from clostridium difficile. with this approach, protein antigens do not need to be produced in vitro and the immunogenicity of candidate c. difficile antigens can be identified directly in animals. codon optimized toxin gene fragments were individually cloned into the dna vaccine vector and tested in mice and rabbits for their ability to elicit c. difficile toxi ...201323143772
ribotyping in the detection of clostridium difficile outbreaks in a single university hospital.clostridium difficile infection (cdi) is the most important bacterial cause of hospital-acquired diarrhoea. although reports of deaths associated with cdi have been decreasing since a peak in 2007 in england and northern ireland, it remains a major cause of morbidity and mortality. the health protection agency's clostridium difficile ribotyping network (cdrn) aims to provide information to help optimize the management of cases of cdi. this study assesses the value of ribotyping to detect outbrea ...201323158685
significance of proton pump inhibitor types for clostridium difficile infection. 201323164689
relationship of symptom duration and fecal bacteriotherapy in clostridium difficile infection-pooled data analysis and a systematic review.clostridium difficle-associated infection (cdi) is usually treated with antibiotics; nevertheless, the infection has a high relapse rate. case series and case reports using fecal microbiota transplant (fmt) for cdi show promising results. however, there are no large studies to provide evidence for the efficacy of this therapy. the aim of this pooled patient data meta-analysis was to determine the efficacy of fmt in cdi.201323163886
simultaneous detection of viral and bacterial enteric pathogens using the seeplex® diarrhea ace detection system.a panel of 223 faecal samples was analysed to determine the clinical utility of the seeplex® diarrhea ace detection multiplex pcr system (seeplex system; seegene, korea), a qualitative multiplexing pcr technology that enables simultaneous multi-pathogen detection of four viruses and/or ten bacteria associated with acute gastroenteritis. conventional diagnostic methods and a norovirus-specific multiplex real-time rt–pcr detected 98 pathogens in 96 samples. the seeplex system detected 81 pathogens ...201323211606
internal delorme's procedure for rectal outlet obstruction.the outcome of the internal delorme's procedure (idp) for obstructed defaecation was assessed.201323216880
fecal microbiome transplantation for recurrent clostridium difficile infection: report on a case series.clostridium difficile infection (cdi) continues to increase in incidence and severity, and was the most common nosocomial infection in the usa in 2010. most cases of cdi respond to a standard course of antibiotics, but recurrent c. difficile infection (rcdi) has become increasingly frequent, and alternative treatments are needed. we examined the efficacy of fecal microbiota transplantation (fmt) instilled into the upper gastrointestinal tract for rcdi.201323182843
preventing clostridium difficile infection in the intensive care unit.clostridium difficile is a formidable problem in the twenty-first century. because of injudicious use of antibiotics, the emergence of the hypervirulent epidemic strain of this organism has been difficult to contain. the nap1/bi/027 strain causes more-severe disease than other widely prevalent strains and affects patients who were not traditionally thought to be at risk for clostridium difficile infection. critically ill patients remain at high risk for this pathogen, and preventive measures, su ...201323182524
real-time polymerase chain reaction method for detection of toxigenic clostridium difficile from stools and presumptive identification of nap1 clone.this study describes the development of a cost-effective, multiplex real-time polymerase chain reaction (rtpcr) method for detection of toxigenic clostridium difficile from stools and presumptive identification of the nap-1 strain. the diagnostic value of the new method is for the detection of toxigenic c. difficile which has the following performance characteristics: 99.8% specificity, 95.1% sensitivity, 97.5% positive predictive value, and 99.5% negative predictive value. examination of 24 spe ...201323182075
lymphopenia as a novel marker of clostridium difficile infection recurrence.treatment of clostridium difficile infection (cdi) is often limited by recurrence in 25% of cases. the objective of this study was to determine risk factors of cdi recurrence during a provincial endemic.201323178420
clinical audit: recent practice in caring for patients with acute severe colitis compared with published guidelines--is there a problem?acute severe colitis (asc) is a serious condition with possible outcomes of emergency colectomy and mortality. validated guidelines exist to help avoid these.201323176535
multiple factors modulate biofilm formation by the anaerobic pathogen clostridium difficile.bacteria within biofilms are protected from multiple stresses, including immune responses and antimicrobial agents. the biofilm-forming ability of bacterial pathogens has been associated with increased antibiotic resistance and chronic recurrent infections. although biofilms have been well studied for several gut pathogens, little is known about biofilm formation by anaerobic gut species. the obligate anaerobe clostridium difficile causes c. difficile infection (cdi), a major health care-associa ...201323175653
development and evaluation of a novel, semiautomated clostridium difficile typing platform.we describe a novel, semiautomated clostridium difficile typing platform that is based on pcr-ribotyping in conjunction with a semiautomated molecular typing system. the platform is reproducible with minimal intra- or interassay variability. this method exhibited a discriminatory index of 0.954 and is therefore comparable to more arduous typing systems, such as pulsed-field gel electrophoresis.201323175261
epidemiology, risk factors, and outcomes of clostridium difficile infection in kidney transplant recipients.we sought to describe the epidemiology and risk factors for clostridium difficile infection (cdi) among kidney transplant recipients (ktr) between 1 january 2008 and 31 december 2010.201323173772
clostridium difficile isolated from the fecal contents of swine in japan.a total of 250 fecal content samples were collected from 25 farrow-to-finish pig farms and examined for the prevalence of clostridium difficile by using ethanol treatment followed by plating onto selective media--cycloserine-cefoxitin-mannitol agar--for the isolation of clostridium difficile. two specimens (0.8%, 95% confidential interval: 0-2.9%) were positive for c. difficile. one isolate was only positive for toxin b, and the other isolate was negative for both toxins a and b. thus, prevalenc ...201323171688
immunisation of mares with binding domains of toxins a and b of clostridium difficile elicits serum and colostral antibodies that block toxin binding.enterocolitis caused by clostridium difficile (c. difficile) is a serious, sometimes fatal, disease of neonatal foals and older horses. toxins a and b (tcda and b) produced by c. difficile are important virulence factors. immunisation of mares with receptor binding domains of toxins may prevent or reduce the severity of c. difficile colitis in foals.201323206274
recombinational switching of the clostridium difficile s-layer and a novel glycosylation gene cluster revealed by large-scale whole-genome sequencing.clostridium difficile is a major cause of nosocomial diarrhea, with 30-day mortality reaching 30%. the cell surface comprises a paracrystalline proteinaceous s-layer encoded by the slpa gene within the cell wall protein (cwp) gene cluster. our purpose was to understand the diversity and evolution of slpa and nearby genes also encoding immunodominant cell surface antigens.201323204167
reduction in clostridium difficile infections in finland, 2008-2010.in january 2008, laboratory-based surveillance of clostridium difficile was initiated as a part of the finnish national infectious disease register (nidr) and enhanced surveillance of hospitalized patients with c. difficile-associated infections (cdi) by the finnish hospital infection programme (siro).201323201398
comparison of two selective media for the recovery of clostridium difficile from environmental surfaces.two culture media were compared for their ability to isolate clostridium difficile from environmental sites within a uk hospital. the media were cefoxitin-cycloserine-egg yolk agar plus lysozyme (ccey/l) and chromid c. difficile. a wide range of environmental surfaces was sampled using sterile sponges (polywipes) and these were inoculated on to both media. c. difficile was recovered from 105 of 496 sites (21%) using a combination of both media. the sensitivity of chromid c. difficile was 87.6% c ...201323201396
laboratory tests for diagnosis of clostridium difficile infection: past, present, and future. 201323200729
understanding factors that impact on public and patient's risk perceptions and responses toward clostridium difficile and other health care-associated infections: a structured literature review.clostridium difficile is the most common health care-associated infection and a major cause of death and increased morbidity. it is vital that patients and the public are provided with the right information and communication to assist them to understand their role in preventative measures. successful implementation of communication and management strategies hinges on individuals' risk perceptions.201323199700
renal impairment after high-dose flucloxacillin and single-dose gentamicin prophylaxis in patients undergoing elective hip and knee replacement.following advice from the scottish antimicrobial prescribing group, we switched our antibiotic prophylaxis for elective hip and knee replacement surgery from cefuroxime to flucloxacillin with single-dose gentamicin in order to reduce the incidence of clostridium difficile associated diarrhoea (cdad). a clinical impression that more patients subsequently developed acute kidney injury (aki) led us to examine this possibility in more detail.201323197677
neutropenic enterocolitis, a growing concern in the era of widespread use of aggressive chemotherapy.neutropenic enterocolitis (nec) is a life-threatening disease with substantial morbidity and mortality, seen primarily in patients with hematologic malignancies. the frequency of nec has increased with the widespread use of chemotherapeutic agents such as the taxanes, which cause severe gastrointestinal mucositis. neutropenic patients with fever and abdominal symptoms (cramping, pain, distention, diarrhea, gi bleeding), should undergo evaluation of the abdomen for bowel wall thickening of >4 mm, ...201323196957
virulence and clinical outcomes in clostridium difficile infection: a complex business. 201323196956
retrospective analysis of fluoroquinolone prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation.patients undergoing allogeneic hematopoietic stem cell transplant are at a high risk for infection-related mortality in the immediate post-transplantation phase. prophylaxis with a fluoroquinolone is now recommended to reduce this risk with the stipulation that surveillance for increased fluoroquinolone resistance clostridium difficile associated diarrhea be conducted.201323184539
changing epidemiology of clostridium difficile-associated disease during stem cell transplantation.the incidence and severity of clostridium difficile-associated disease (cdad) within the general population has risen dramatically over the past decade, yet little data are available from hematopoietic stem cell transplantation (hsct) centers. in the present study, we performed a chart review of 822 consecutive autologous and allogeneic hcst recipients treated at northwestern memorial hospital between 2004 and 2008 to determine the incidence of cdad at our institution. variables including age, s ...201323219779
implementation of hospital-wide enhanced terminal cleaning of targeted patient rooms and its impact on endemic clostridium difficile infection rates.implementation of a hospital-wide program of terminal cleaning of patient rooms revolving around hydrogen peroxide vapor (hpv) technology and evaluation of its impact on endemic nosocomial clostridium difficile-associated diarrhea (cdad) have not been previously reported.201323219675
patient-days used for isolation in a community hospital.isolation of patients with known or suspected infection strains the resources of hospitals, but little information exists on the actual utilization of isolation beds.201323219671
characteristics of patients with clostridium difficile infection in taiwan.the medical records of 84 patients with stool cultures positive for clostridium difficile during the period august 2007 to june 2009 were retrospectively reviewed. a case of confirmed (toxigenic)c. difficile infection (cdi) was defined by the presence of symptoms (fever, diarrhoea, abdominal discomfort or distension, ileus) and the presence of toxigenic c. difficile. patients with compatible clinical symptoms and stool cultures positive for non-toxigenic c. difficile isolates were defined as pro ...201323218131
kefir-isolated lactococcus lactis subsp. lactis inhibits the cytotoxic effect of clostridium difficile in vitro.kefir is a dairy product obtained by fermentation of milk with a complex microbial population and several health-promoting properties have been attributed to its consumption. in this work, we tested the ability of different kefir-isolated bacterial and yeast strains (lactobacillus kefir, lb. plantarum, lactococcus lactis subps. lactis, saccharomyces cerevisiae and kluyveromyces marxianus) or a mixture of them (mm) to antagonise the cytopathic effect of toxins from clostridium difficile (tcda and ...201323217732
proton pump inhibitor use may be associated with an increased risk of clostridium difficile infection. 201323220471
clostridium difficile flagellin stimulates toll-like receptor 5, and toxin b promotes flagellin-induced chemokine production via tlr5.clostridium difficile is an important pathogen in nosocomial infections. although c. difficile toxins are considered to be major virulence factors, pathogenesis of c. difficile associated diseases remains to be determined. in this study, we investigated whether c. difficile flagellin is involved in the pathogenesis of c. difficile-associated diseases.201323261530
[when should request a stool culture?].a stool culture needs a medical prescription and is justified only in a case of clearly defined acute diarrhea. the clinical context must be suggestive of a bacterial etiology. the detection of the bacterial agents has to follow a well-defined strategy to optimize a rigorous prescription. standardized stool culture is for patients treated in medical community practice and for patients hospitalized for less than 3 days. clostridium difficile toxin testing is systematically performed in case of no ...201323260762
[why should antibiotic therapy be avoided in case of acute infectious diarrhea?].antibiotic prescription for acute diarrhea is not devoid of risks. there are individual risks for the patient, such as allergy, gastrointestinal side effects, clostridium difficile infection. there is also a risk of selection of antibiotic resistance in the digestive microbiota, leading to the emergence of multiresistant isolates such as extended-spectrum β-lactamase or carbapenemase producing enterobacteriaceae, which are able to disseminate worldwide. antibiotic prescriptions may thus be limit ...201323228474
physician attitudes toward the use of fecal transplantation for recurrent clostridium difficile infection in a metropolitan area. 201323223589
emergence and global spread of epidemic healthcare-associated clostridium difficile.epidemic c. difficile (027/bi/nap1) has rapidly emerged in the past decade as the leading cause of antibiotic-associated diarrhea worldwide. however, the key events in evolutionary history leading to its emergence and the subsequent patterns of global spread remain unknown. here, we define the global population structure of c. difficile 027/bi/nap1 using whole-genome sequencing and phylogenetic analysis. we show that two distinct epidemic lineages, fqr1 and fqr2, not one as previously thought, e ...201323222960
proline-dependent regulation of clostridium difficile stickland metabolism.clostridium difficile, a proteolytic gram-positive anaerobe, has emerged as a significant nosocomial pathogen. stickland fermentation reactions are thought to be important for growth of c. difficile and appear to influence toxin production. in stickland reactions, pairs of amino acids donate and accept electrons, generating atp and reducing power in the process. reduction of the electron acceptors proline and glycine requires the d-proline reductase (pr) and the glycine reductase (gr) enzyme com ...201323222730
fidaxomicin in the treatment of clostridium difficile-associated diarrhoea. 201323233241
infection: understanding how clostridium difficile infection in health-care settings spread around the world. 201323247509
a systematic evaluation of methods to optimize culture-based recovery of clostridium difficile from stool specimens.with the increasing prevalence of clostridium difficile infection among hospitalized patients, a clear understanding of c. difficile epidemiology is needed to evaluate current prevention policies, and to create new and effective policies. to determine the epidemiology of c. difficile, the most sensitive methods for detection of c. difficile are required. the purpose of this study was to systematically assess multiple methods to determine the most sensitive method to recover c. difficile from sto ...201323247066
recent trends in the epidemiology and treatment of c. difficile infection in children.clostridium difficile is the most common cause of healthcare-associated diarrhea among adults in western countries, and is increasingly recognized as an important pathogen in children. this review provides an update on the changing epidemiology of c. difficile infection (cdi) for pediatric providers and summarizes current knowledge regarding available therapies.201323241874
[acute infectious diarrhea in adults: epidemiology and management].acute diarrhea is defined as an abnormally frequent discharge of semisolid or fluid fecal matter from the bowel, lasting less than 14 days. more than three millions cases of acute diarrhea, presumably due to intestinal infections, are seen in general practice every year in france. most of the cases are benign and resolve under symptomatic treatment within 3 days, without need for biological tests or antibiotics. in special contexts (septicemic syndrome, visible blood in stools, severe dehydratio ...201323253255
surveillance for clostridium difficile infection in nursing homes.to define the time of onset of clostridium difficile infection (cdi) in the community nursing home setting.201323253029
letter: clostridium difficile colitis in patients with ulcerative colitis. 201323252787
influence of environmental conditions on the expression and the maturation process of the clostridium difficile surface associated protease cwp84.expression of the clostridium difficile protease gene, cwp84, was moderately up-regulated by decreasing ph due to glucose metabolism. purification under different ph conditions influenced the proteolytic process of cwp84. given this, acidic ph could favor the appearance of different forms of cwp84 that may have different roles during the infection.201323257307
microbial ecosystems therapeutics: a new paradigm in medicine?increasing evidence indicates that the complex microbial ecosystem of the human intestine plays a critical role in protecting the host against disease. this review discusses gut dysbiosis (here defined as a state of imbalance in the gut microbial ecosystem, including overgrowth of some organisms and loss of others) as the foundation for several diseases, and the applicability of refined microbial ecosystem replacement therapies as a future treatment modality. consistent with the concept of a 'co ...201323257018
clostridium difficile tcdc protein binds four-stranded g-quadruplex structures.clostridium difficile infections are increasing worldwide due to emergence of virulent strains. infections can result in diarrhea and potentially fatal pseudomembranous colitis. the main virulence factors of c. difficile are clostridial toxins tcda and tcdb. transcription of the toxins is positively regulated by the sigma factor tcdr. negative regulation is believed to occur through tcdc, a proposed anti-sigma factor. here, we describe the biochemical properties of tcdc to understand the mechani ...201323303781
clostridium difficile progress lags other infection-control goals. 201323292259
the c-di-gmp recognition mechanism of the pilz domain of bacterial cellulose synthase subunit a.in some proteobacteria and firmicutes such as pseudomonas aeruginosa, vibrio cholerae, xanthomonas campestris, and clostridium difficile, cyclic dimeric guanosine monophosphate (c-di-gmp) is known to regulate cellular processes, including motility, biofilm formation, and virulence, as a second messenger. cellulose production in acetobacter xylinum, a model organism of cellulose biosynthesis, also depends on by cellular c-di-gmp level. in cellulose-synthesizing bacteria, a terminal complex locali ...201323291177
all-cause and disease-specific mortality in hospitalized patients with clostridium difficile infection: a multicenter cohort study.mortality among patients with clostridium difficile infection (cdi) is high. because of high age and multiple underlying diseases, cdi-related mortality is difficult to estimate. we estimated cdi-related mortality in an endemic situation, not influenced by outbreaks and consequently certain patients and c. difficile strains.201323300235
Refresh
firstprev
...81828384858687888990...
nextlast
Displaying items 8101 - 8200 of 12134