Publications
| Title | Abstract | Year(sorted ascending) Filter | PMID Filter |
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| clostridium difficile toxins facilitate bacterial colonization by modulating the fence and gate function of colonic epithelium. | the contribution of clostridium difficile toxin a and b (tcda and tcdb) to cellular intoxication has been studied extensively, but their impact on bacterial colonization remains unclear. by setting up 2- and 3-dimensional in vitro models of polarized gut epithelium, we investigated how c. difficile infection is affected by host cell polarity and whether tcda and tcdb contribute to such events. indeed, we observed that c. difficile adhesion and penetration of the mucosal barrier are substantially ... | 2014 | 24273043 |
| use of proton pump inhibitors for the provision of stress ulcer prophylaxis: clinical and economic consequences. | the provision of stress ulcer prophylaxis (sup) for the prevention of clinically significant bleeding is widely recognized as a crucial component of care in critically ill patients. nevertheless, sup is often provided to non-critically ill patients despite a risk for clinically significant bleeding of roughly 0.1 %. the overuse of sup therefore introduces added risks for adverse drug events and cost, with minimal expected benefit in clinical outcome. historically, histamine-2-receptor antagonist ... | 2014 | 24271943 |
| clostridium difficile infection in the elderly. | clostridium difficile-associated illness is an increasingly prevalent and morbid condition. the elderly population is at a disproportionate risk of developing symptomatic disease and associated complications, including progression to severe or fulminant disease, and development of recurrent infections. this article analyzes the factors that influence c difficile disease propensity and severity, with particular attention directed toward features relevant to the rapidly aging population. | 2014 | 24267604 |
| acute inflammatory surgical disease. | infectious and inflammatory diseases comprise some of the most common gastrointestinal disorders resulting in hospitalization in the united states. accordingly, they occupy a significant proportion of the workload of the acute care surgeon. this article discusses the diagnosis, management, and treatment of appendicitis, acute cholecystitis/cholangitis, acute pancreatitis, diverticulitis, and clostridium difficile colitis. | 2014 | 24267493 |
| therapeutic faecal microbiota transplantation: current status and future developments. | faecal microbiota transplantation (fmt) has undergone dramatic progression over the past year and continues to evolve as knowledge of the gastrointestinal microbiota (gimb) develops. this review summarizes therapeutic advances in fmt, latest fmt therapies and presents the potential of fmt therapeutics in other gastrointestinal and extra-intestinal conditions. | 2014 | 24257037 |
| gastrointestinal infections after transplantation. | recipients of both solid organ transplant and hematopoietic stem cell transplantation are at increased risk for infectious morbidity and mortality after transplantation due to on-going immunosuppression. gastrointestinal infections have been increasingly reported in these populations. | 2014 | 24257036 |
| investigations of the mode of action and resistance development of cadazolid, a new antibiotic for treatment of clostridium difficile infections. | cadazolid is a new oxazolidinone-type antibiotic currently in clinical development for the treatment of clostridium difficile-associated diarrhea. here, we report investigations on the mode of action and the propensity for spontaneous resistance development in c. difficile strains. macromolecular labeling experiments indicated that cadazolid acts as a potent inhibitor of protein synthesis, while inhibition of dna synthesis was also observed, albeit only at substantially higher concentrations of ... | 2014 | 24277035 |
| in vitro and in vivo antibacterial evaluation of cadazolid, a new antibiotic for treatment of clostridium difficile infections. | clostridium difficile is a leading cause of health care-associated diarrhea with significant morbidity and mortality, and new options for the treatment of c. difficile-associated diarrhea (cdad) are needed. cadazolid is a new oxazolidinone-type antibiotic that is currently in clinical development for treatment of cdad. here, we report the in vitro and in vivo antibacterial evaluation of cadazolid against c. difficile. cadazolid showed potent in vitro activity against c. difficile with a mic rang ... | 2014 | 24277020 |
| probing the metal specificity mechanism of superoxide dismutase from human pathogen clostridium difficile. | the molecular mechanism of the metal specificity to superoxide dismutase from human pathogen c. difficile (sodcd) was investigated by x-ray crystallography, spectroscopy, sod activity assay, electrochemistry, and dft calculations, and the results indicate that the cognate metal characters tuned by the metal micro-environment dominate the metal specificity of the sodcd. | 2014 | 24275896 |
| emerging infectious colitis. | the present review will highlight recent advances in the knowledge of emerging pathogens causing infectious colitis and provide a description of the most important food-borne outbreaks. | 2014 | 24275672 |
| fecal microbiota transplantation for clostridium difficile infection: benefits and barriers. | the incidence and severity of clostridium difficile infection (cdi) have increased worldwide in the past two decades. a principal function of the gut microbiota is to protect the intestine against colonization by exogenous pathogens. increasingly, the gut microbiota have been shown to influence susceptibility to other genetic and environmentally acquired conditions. transplantation of healthy donor fecal material in patients with cdi may re-establish the normal composition of the gut microbiota ... | 2014 | 24275671 |
| multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study. | laboratory diagnosis and clinical management of inpatients with diarrhoea is complex and time consuming. tests are often requested sequentially and undertaken in different laboratories. this causes prolonged unnecessary presumptive isolation of patients, because most cases are non-infectious. a molecular multiplex test (luminex(®) gastrointestinal pathogen panel (gpp)) was compared with conventional testing over 8 months to determine diagnostic accuracy, turnaround times, laboratory costs, use o ... | 2014 | 24274687 |
| prevalence and duration of asymptomatic clostridium difficile carriage among healthy subjects in pittsburgh, pennsylvania. | previous studies suggested that 7 to 15% of healthy adults are colonized with toxigenic clostridium difficile. to investigate the epidemiology, genetic diversity, and duration of c. difficile colonization in asymptomatic persons, we recruited healthy adults from the general population in allegheny county, pennsylvania. participants provided epidemiological and dietary intake data and submitted stool specimens. the presence of c. difficile in stool specimens was determined by anaerobic culture. s ... | 2014 | 24759727 |
| molecular test based on isothermal helicase-dependent amplification for detection of the clostridium difficile toxin a gene. | the amplivue clostridium difficile assay and a glutamate dehydrogenase (gdh)-illumigene algorithm were evaluated using 308 diarrheal stool specimens of patients suspected of having c. difficile infection. compared to the enriched toxigenic culture method, the sensitivities, specificities, and positive and negative predictive values of the amplivue c. difficile assay and the gdh-illumigene-based algorithm were 91.7% (95% confidence interval [ci], 76.4 to 97.8), 100% (95% ci, 98.3 to 100), 100% (9 ... | 2014 | 24759714 |
| recombinant clostridium difficile toxin fragments as carrier protein for psii surface polysaccharide preserve their neutralizing activity. | clostridium difficile is a gram-positive bacterium and is the most commonly diagnosed cause of hospital-associated and antimicrobial-associated diarrhea. despite the emergence of epidemic c. difficile strains having led to an increase in the incidence of the disease, a vaccine against this pathogen is not currently available. c. difficile strains produce two main toxins (tcda and tcdb) and express three highly complex cell-surface polysaccharides (psi, psii and psiii). psii is the more abundantl ... | 2014 | 24759173 |
| epidemiological surveillance of bacterial nosocomial infections in the surgical intensive care unit. | intensive care units (icus) are associated with a greater risk of developing nosocomial infections (nis) than other departments. | 2014 | 24757393 |
| prevalence and risk factors for asymptomatic clostridium difficile carriage. | clostridium difficile infection (cdi) incidence has increased dramatically over the last decade. recent studies suggest that asymptomatic carriers may be an important reservoir of c. difficile in healthcare settings. we sought to identify the prevalence and risk factors for asymptomatic c. difficile carriage on admission to the hospital. | 2014 | 24755858 |
| epidemiology and outcomes of community-acquired clostridium difficile infections in medicare beneficiaries. | the incidence of community-acquired clostridium difficile (cacd) is increasing in the united states. many cacd infections occur in the elderly, who are predisposed to poor outcomes. we aimed to describe the epidemiology and outcomes of cacd in a nationally representative sample of medicare beneficiaries. | 2014 | 24755188 |
| the effect of new neonatal porcine diarrhoea syndrome (nnpds) on average daily gain and mortality in 4 danish pig herds. | the study evaluated the effect of new neonatal porcine diarrhoea syndrome (nnpds) on average daily gain (adg) and mortality and described the clinical manifestations in four herds suffering from the syndrome. nnpds is a diarrhoeic syndrome affecting piglets within the first week of life, which is not caused by enterotoxigenic escherichia coli (etec), clostridium perfringens (c. perfringens) type a/c, clostridium difficile (c. difficile), rotavirus a, coronavirus, cystoisospora suis, strongyloide ... | 2014 | 24755093 |
| strain types and antimicrobial resistance patterns of clostridium difficile isolates from the united states, 2011 to 2013. | we determined the pcr ribotypes and antimicrobial susceptibility patterns of 508 toxigenic clostridium difficile isolates collected between 2011 and 2013 from 32 u.s. hospitals. of the 29 pcr ribotypes identified, the 027 strain type was the most common (28.1%), although the rates varied by geographic region. ribotype 014/020 isolates appear to be emerging. clindamycin and moxifloxacin resistances (36.8% and 35.8%, respectively) were the most frequent resistance phenotypes observed. reduced susc ... | 2014 | 24752264 |
| characteristics of clostridium difficile colonization in japanese children. | in children, asymptomatic colonization with clostridium difficile is well known, but its prevalence in japanese children is not fully understood. the objective of this study was to determine the colonization rate of c. difficile and to identify the risk factors for c. difficile colonization in japanese children. single fecal samples were prospectively collected from children hospitalized in saitama city hospital between august 1, 2012, and march 31, 2013. samples were obtained from neonates, at ... | 2014 | 24751233 |
| clostridium difficile in a children's hospital: assessment of environmental contamination. | clostridium difficile infection (cdi) is the most frequent infectious cause of health care-associated diarrhea. three cases of cdi, in children age 2, 3, and 14 years, occurred in the hematology/oncology ward of our children's hospital over 48 hours. we aimed to assess environmental contamination with c difficile in the shared areas of this unit, and to determine whether person-to-person transmission occurred. c difficile was recovered from 5 of 18 samples (28%). we compared c difficile isolated ... | 2014 | 24751141 |
| fecal microbiota transplantation for management of clostridium difficile infection. | the widespread use of antibiotics has led clostridium difficile infection (cdi) to become a common problem with pronounced medical and economic effects. the recurrence of cdi after treatment with standard antibiotics is becoming more common with the emergence of more resistant strains of c. difficile. as cdi is an antibiotic-associated disease, further treatment with antibiotic is best avoided. as the gut flora is severely disturbed in cdi, approaches that restore the gut microbiota may become g ... | 2014 | 24748025 |
| disinfecting the ipad: evaluating effective methods. | tablet computers are increasingly used in healthcare, but they may carry nosocomial pathogens. there are few data available on how to clean an ipad effectively for use in the clinical setting. | 2014 | 24746231 |
| effectiveness of deep cleaning followed by hydrogen peroxide decontamination during high clostridium difficile infection incidence. | clostridium difficile infection (cdi) remains an infection control challenge, especially when environmental spore contamination and suboptimal cleaning may increase transmission risk. | 2014 | 24746230 |
| [a case of severe enteritis induced by adjuvant chemotherapy for colon cancer]. | a 77-year-old man underwent surgery for sigmoid colon cancer. he was diagnosed with stage iiia colon cancer; there- fore, we initiated oral administration of adjuvant chemotherapy comprising uracil/tegafur(uft)plus leucovorin(lv). however, chemotherapy was stopped after 21 days because of fatigue and diarrhea. he recovered after 3 weeks, and we administered the same regimen with a dose reduction. however, he again experienced fatigue and diarrhea after 20 days; therefore, chemotherapy was discon ... | 2014 | 24743369 |
| donor fecal transfer for recurrent clostridium difficile-associated diarrhea in heart transplantation. | 2014 | 24742697 | |
| clostridium difficile epidemic outbreak in an oncology unit. | contributions to the knowledge of some peculiarities of c. difficile involvement in human pathology, nosocomial infections (ni) included. | 2014 | 24741794 |
| outbreak of clostridium difficile pcr ribotype 027--the recent experience of a regional hospital. | clostridium difficile infection (cdi) is the leading cause of healthcare-associated diarrhea, and several outbreaks with increased severity and mortality have been reported. in this study we report a c. difficile pcr ribotype 027 outbreak in portugal, aiming to contribute to a better knowledge of the epidemiology of this agent in europe. | 2014 | 24739945 |
| lrp1 is a receptor for clostridium perfringens tpel toxin indicating a two-receptor model of clostridial glycosylating toxins. | large glycosylating toxins are major virulence factors of various species of pathogenic clostridia. prototypes are clostridium difficile toxins a and b, which cause antibiotics-associated diarrhea and pseudomembranous colitis. the current model of the toxins' action suggests that receptor binding is mediated by a c-terminal domain of combined repetitive oligopeptides (crop). this model is challenged by the glycosylating clostridium perfringens large cytotoxin (tpel toxin) that is devoid of the c ... | 2014 | 24737893 |
| lactobacillus acidophilus modulates the virulence of clostridium difficile. | clostridium difficile is a spore-forming, toxin-producing, anaerobic bacterium that colonizes the human gastrointestinal tract. this pathogen causes antibiotic-associated diarrhea and colitis in animals and humans. antibiotic-associated diseases may be treated with probiotics, and interest is increasing in such uses of probiotics. this study investigated the effect of lactobacillus strains on the quorum-sensing signals and toxin production of c. difficile. in addition, an in vivo experiment was ... | 2014 | 24856984 |
| species and genus level resolution analysis of gut microbiota in clostridium difficile patients following fecal microbiota transplantation. | clostridium difficile is an opportunistic human intestinal pathogen, and c. difficile infection (cdi) is one of the main causes of antibiotic-induced diarrhea and colitis. one successful approach to combat cdi, particularly recurrent form of cdi, is through transplantation of fecal microbiota from a healthy donor to the infected patient. in this study we investigated the distal gut microbial communities of three cdi patients before and after fecal microbiota transplantation, and we compared thes ... | 2014 | 24855561 |
| clinical and economic consequences of vancomycin and fidaxomicin for the treatment of clostridium difficile infection in canada. | clostridium difficile infection (cdi) represents a public health problem with increasing incidence and severity. | 2014 | 24855476 |
| timing and type of surgical treatment of clostridium difficile-associated disease: a practice management guideline from the eastern association for the surgery of trauma. | clostridium difficile infection is the leading cause of nosocomial diarrhea in the united states; however, few patients will develop fulminant c. difficile-associated disease (cdad), necessitating an urgent operative intervention. mortality for patients who require operative intervention is very high, up to 80% in some series. since there is no consensus in the literature regarding the best operative treatment for this disease, we sought to answer the following:pico [population, intervention, co ... | 2014 | 24854320 |
| puerperal retroperitoneal abscess caused by clostridium difficile: case report and review of the literature. | retroperitoneal infection can be lethal. optimal management is still elusive to describe because of the small number of case reports. we presented here a case of retroperitoneal abscess caused by clostridium difficile arising in the puerperal period. | 2014 | 24853835 |
| fecal microbiota transplantation in children with recurrent clostridium difficile infection. | clostridium difficile eradication using fecal microbiota transplantation (fmt) has been successful in adults but little information is available in pediatrics. we report 6 pediatric patients with refractory c. difficile cured by fmt with no recurrences to date. our results demonstrate that fmt can be an effective treatment for refractory c. difficile infection in pediatrics. long-term safety and efficacy need to be studied. | 2014 | 24853539 |
| serum bacterial toxins are related to the progression of inflammatory bowel disease. | inflammatory bowel disease (ibd), including crohn's disease (cd) and ulcerative colitis (uc), is an autoimmune disease. disorder of intestinal microbes is thought to play a critical role in the pathogenesis of ibd. detection of bacterial toxins could become a new approach to judge the situation of this disease. | 2014 | 24853095 |
| asymptomatic clostridium difficile colonization as a reservoir for clostridium difficile infection. | clostridium difficile (cd) infection (cdi) is the leading cause of healthcare associated diarrhea despite intense hospital infection prevention programs. a substantial proportion of the population is asymptomatically colonized with cd, and evidence is mounting that these individuals serve as a reservoir for cdi. the purpose of this review is to discuss the mechanisms by which individuals may harbor toxigenic cd but remain asymptomatic, the evidence that asymptomatically colonized individuals ser ... | 2014 | 24848084 |
| [clostridium difficile infections: update on new european recommendations]. | clostridium difficile infections: update on new european recommandations while metronidazole and vancomycin have been the only drug options to date for the treatment of c. difficile infection, new therapeutic approaches with promising results have recently emerged for the treatment of the first episode and relapses. fidaxomicin is a new macrocyclic antibiotic more active against c. difficile and with a narrow spectrum allowing preservation of the intestinal microbiota. while having the same effi ... | 2014 | 24843988 |
| managing clostridium difficile in inflammatory bowel disease (ibd). | clostridium difficile (c. difficile) infection has emerged as a significant clinical challenge for patients suffering from inflammatory bowel disease (ibd). c. difficile can both precipitate and worsen flares of ibd, contributing to emergent colectomies and mortality. advances in the management of c. difficile infection in ibd include recommendations for testing for this infection in the setting of clinical flare and hospitalization, improved diagnostic testing, identification of high rates of c ... | 2014 | 24838421 |
| a high-throughput small-molecule screen to identify a novel chemical inhibitor of clostridium difficile. | clostridium difficile, a highly drug-resistant gram-positive, spore-forming bacterium, remains a leading cause of hospital-acquired diarrhoea and antibiotic-associated colitis. clinically, only a handful of antibiotics are used for treating c. difficile infection (cdi), suggesting a necessity for the development of new treatment options. here we performed a high-throughput screen of 2000 drug-like compounds for inhibition of c. difficile. from this screen, one compound, 5-nitro-1,10-phenanthroli ... | 2014 | 24837414 |
| the effect of pharmacy restriction of clindamycin on clostridium difficile infection rates in an orthopedics ward. | a high consumption of clindamycin was noted in an orthopedics ward with high rates of clostridium difficile infection (cdi). we restricted clindamycin for the entire ward. a reduction of 88% in cdi (1.07 to 0.12 × 1,000 patients-days, p = .056) and 84% for all-cause diarrhea (2.40 to 0.38 × 1,000 patients-days, p = .021) was achieved. clindamycin was reduced 92.61% without an increase in other antibiotics. we identified high consumption of clindamycin as a risk factor for cdi. | 2014 | 24837129 |
| risk factors associated with clostridium difficile infection severity in hospitalized patients. | 2014 | 24837124 | |
| hospital clostridium difficile outbreak linked to laundry machine malfunction. | clostridium difficile is a gram-positive, spore-forming anaerobic bacillus that is associated with diarrheal disease. c difficile is shed in the feces of affected individuals and its spores can survive on surfaces for prolonged periods of time. these spores can contaminate a hospital environment by spread through health care workers and suboptimal environmental cleaning practices. we report an outbreak of health care facility-onset c difficile infection that was eventually linked to contaminated ... | 2014 | 24837118 |
| implementation and impact of ultraviolet environmental disinfection in an acute care setting. | multiple-drug-resistant organisms (mdros) and clostridium difficile (cd) are significant problems in health care. evidence suggests that these organisms are transmitted to patients by the contaminated environment. | 2014 | 24837107 |
| prevalence and in-hospital mortality trends of infections among patients with cirrhosis: a nationwide study of hospitalised patients in the united states. | data on bacterial infections in hospitalised patients in the us with cirrhosis are derived largely from single centre data. countrywide data in this population are lacking. | 2014 | 24832591 |
| transanal minimally invasive surgery for benign and malignant rectal neoplasia. | transanal minimally invasive surgery (tamis), an alternative technique to transanal endoscopic microsurgery, was developed in 2009. herein, we describe our initial experience using tamis for benign and malignant rectal neoplasia. | 2014 | 24832238 |
| fecal microbiota transplantation in treating clostridium difficile infection. | clostridium difficile infection (cdi) is an increasingly common and severe international health problem. customary treatment of this infection, usually with antibiotics, is often ineffective and its recurrence is common. in recent years the treatment of recurrent or refractory cdi by the transfer of stool from an uninfected person, so called fecal "microbiota transplantation" has become recognized as effective and generally safe. the effectiveness of this novel treatment is incompletely defined ... | 2014 | 24825534 |
| fulminant clostridium difficile enteritis causing abdominal compartment syndrome. | clostridium difficile infection of the small bowel, or c. difficile enteritis (cde), is an uncommon condition. cases reported previously have been described in patients with inflammatory bowel disease (ibd), compromised immune systems, or a history of colectomy or small bowel surgery. | 2014 | 24824419 |
| analysis of clostridium difficile infections after cardiac surgery: epidemiologic and economic implications from national data. | clostridium difficile infections (cdis) have increased during the past 2 decades, especially among cardiac surgical patients, who share many of the comorbidity risk factors for cdi. our objectives were to use a large national database to identify the regional-, hospital-, patient-, and procedure-level risk factors for cdi; and determine mortality, resource usage, and cost of cdis in cardiac surgery. | 2014 | 24823282 |
| mechanism of action and epitopes of clostridium difficile toxin b-neutralizing antibody bezlotoxumab revealed by x-ray crystallography. | the symptoms of clostridium difficile infections are caused by two exotoxins, tcda and tcdb, which target host colonocytes by binding to unknown cell surface receptors, at least in part via their combined repetitive oligopeptide (crop) domains. a combination of the anti-tcda antibody actoxumab and the anti-tcdb antibody bezlotoxumab is currently under development for the prevention of recurrent c. difficile infections. we demonstrate here through various biophysical approaches that bezlotoxumab ... | 2014 | 24821719 |
| [saccharomyces cerevisiae fungemia in an elderly patient following probiotic treatment]. | saccharomyces cerevisiae, known as baker's yeast, is also used as a probiotic agent to treat gastroenteritis by modulating the endogenous flora and immune system. however, since there have been increasing reports of fungemia due to s.cerevisiae and its subspecies s.boulardii, it is recommended that probiotics should be cautiously used in immunosuppressed patients, people with underlying diseases and low-birth weight babies. to emphasize this phenomenon, in this report, a case of s.cerevisiae fun ... | 2014 | 24819274 |
| antimicrobial prophylaxis for colorectal surgery. | research shows that administration of prophylactic antibiotics before colorectal surgery prevents postoperative surgical wound infection. the best antibiotic choice, timing of administration and route of administration remain undetermined. | 2014 | 24817514 |
| identification and characterization of glycoproteins on the spore surface of clostridium difficile. | in this study, we identify a major spore surface protein, bcla, and provide evidence that this protein is glycosylated. following extraction of the spore surface, solubilized proteins were separated by one-dimensional page and stained with glycostain to reveal a reactive high-molecular-mass region of approximately 600 kda. tandem mass spectrometry analysis of in-gel digests showed this band to contain peptides corresponding to a putative exosporangial glycoprotein (bcla3) and identified a number ... | 2014 | 24816601 |
| statins use and risk of mortality in patient with clostridium difficile infection. | current evidence suggests that statins may improve outcome in infectious diseases. this study aims to assess whether statins use is associated with reduced risk of 30-day mortality in clostridium difficile infection (cdi). using the computerized database of clalit, the largest healthcare provider in israel, we identified a cohort of adult subjects (age ≥40 years) who tested positive on a c. difficile toxin assay performed between january 2011 and december 2012. subjects were defined as current s ... | 2014 | 24816303 |
| funding healthcare-associated infection research: a systematic analysis of uk research investments, 1997-2010. | healthcare-associated infections (hcais) are a cause of high health and economic burden in the uk. the number of hcai research studies funded in the uk, and the associated amount of investment, has not previously been analysed. | 2014 | 24815767 |
| hospital-acquired clostridium difficile infections: estimating all-cause mortality and length of stay. | clostridium difficile is a health care-associated infection of increasing importance. the purpose of this study was to estimate the time until death from any cause and time until release among patients with c. difficile, comparing the burden of those in the intensive care unit (icu) with those in the general hospital population. | 2014 | 24815305 |
| colonic marbling in clostridium difficile pancolitis. | 2014 | 24814091 | |
| expert panel evaluation of health information technology effects on adverse events. | adverse events (aes) among hospitalized patients occur frequently and result in significant sequelae. federal policy is incentivizing health information technology (hit) use, although research demonstrating safety benefits from hit is mixed. our objective was to evaluate the potential effects of hit on reducing 21 different inpatient aes. identifying aes most likely to be reduced by hit can inform the design of future studies evaluating its effectiveness. | 2014 | 24813820 |
| clinical characteristics and outcome of patients with clostridium difficile infection diagnosed by pcr versus a three-step algorithm. | clinical features of clostridium difficile infections (cdi) detected by pcr, but not by conventional methods, are poorly understood. we compared the clinical features of cdi cases detected by pcr only and cases detected by both pcr and a three-step algorithm. we performed a retrospective cohort study of patients fulfilling a standardized definition over a 13-month period. stool specimens were tested in parallel by pcr and an algorithm based on enzyme immunoassay and cytotoxicity assay (eia/cca). ... | 2014 | 24813402 |
| towards point of care testing for c. difficile infection by volatile profiling, using the combination of a short multi-capillary gas chromatography column with metal oxide sensor detection. | rapid volatile profiling of stool sample headspace was achieved using a combination of short multi-capillary chromatography column (smcc), highly sensitive heated metal oxide semiconductor (mos) sensor and artificial neural network (ann) software. for direct analysis of biological samples this prototype offers alternatives to conventional gc detectors and electronic nose technology. the performance was compared to an identical instrument incorporating a long single capillary column (lscc). the a ... | 2014 | 27212803 |
| response to p. destrez concerning g.j. hughes et al.: 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. | 2014 | 24811116 | |
| clostridium difficile as a cause of healthcare-associated diarrhoea among children in auckland, new zealand: clinical and molecular epidemiology. | we aimed to determine the incidence of clostridium difficile infection (cdi), the molecular epidemiology of circulating c. difficile strains and risk factors for cdi among hospitalised children in the auckland region. a cross-sectional study was undertaken of hospitalised children <15 years of age in two hospitals investigated for healthcare-associated diarrhoea between november 2011 and june 2012. stool specimens were analysed for the presence of c. difficile using a two-step testing algorithm ... | 2014 | 24810967 |
| clostridium difficile spores: a major threat to the hospital environment. | clostridium difficile is a gram-positive, anaerobic spore former and is an important nosocomial and community-acquired pathogenic bacterium. c. difficile infections (cdi) are a leading cause of infections worldwide with elevated rates of morbidity. despite the fact that two major virulence factors, the enterotoxin tcda and the cytotoxin tcdb, are essential in the development of cdi, c. difficile spores are the main vehicle of infection, and persistence and transmission of cdi and are thought to ... | 2014 | 24810347 |
| relative incidences and outcomes of clostridium difficile infection following transplantation of unrelated cord blood, unrelated bone marrow, and related peripheral blood in adult patients: a single institute study. | clostridium difficile is a major cause of nosocomial diarrhea. the incidence and prognosis of c. difficile-associated diarrhea (cdad) has not yet been assessed in adult patients after unrelated cord blood transplantation (ucbt). | 2014 | 24810244 |
| a review of the economics of treating clostridium difficile infection. | clostridium difficile infection (cdi) is a costly result of antibiotic use, responsible for an estimated 14,000 deaths annually in the usa according to the centers for disease control and prevention. annual costs attributable to cdi are in excess of $us 1 billion. this review summarizes appropriate utilization of prevention and treatment methods for cdi that have the potential to reduce the economic and humanistic costs of the disease. some cost-effective strategies to prevent cdi include screen ... | 2014 | 24807468 |
| ulcerative colitis worsened after clostridium difficile infection: efficacy of infliximab. | the incidence of clostridium difficile (c. difficile) infection (cdi) is 1.8%-5.7% in admitted patients with ulcerative colitis (uc). cdi can worsen uc and increase the risk for colectomy or even death, thus necessitating therapy escalation, such as increasing the corticoid therapy or starting a biologic treatment. several reported cases with infliximab therapy have provided favorable outcomes in uc patients with cdi, suggesting that infliximab treatment may be protective; however, the optimal i ... | 2014 | 24803831 |
| microbiome data distinguish patients with clostridium difficile infection and non-c. difficile-associated diarrhea from healthy controls. | antibiotic usage is the most commonly cited risk factor for hospital-acquired clostridium difficile infections (cdi). the increased risk is due to disruption of the indigenous microbiome and a subsequent decrease in colonization resistance by the perturbed bacterial community; however, the specific changes in the microbiome that lead to increased risk are poorly understood. we developed statistical models that incorporated microbiome data with clinical and demographic data to better understand w ... | 2014 | 24803517 |
| urinary tract infections: leading initiatives in selecting empiric outpatient treatment (utilise). | overuse of fluoroquinolone antibiotics is associated with outbreaks of methicillin-resistant staphylococcus aureus and of clostridium difficile-associated diarrhea and increasing resistance in gram-negative organisms. over the past decade, resistance of escherichia coli to ciprofloxacin has increased in the regina qu'appelle health region. in august 2011, an exploratory audit of the regina general hospital (rgh) emergency department showed that 20% of new antibiotic orders were for fluoroquinolo ... | 2014 | 24799721 |
| real-time polymerase chain reaction detection of asymptomatic clostridium difficile colonization and rising c. difficile-associated disease rates. | to evaluate the accuracy of real-time polymerase chain reaction (pcr) for clostridium difficile-associated disease (cdad) detection, after hospital cdad rates significantly increased following real-time pcr initiation for cdad diagnosis. | 2014 | 24799643 |
| strategies to prevent clostridium difficile infections in acute care hospitals: 2014 update. | 2014 | 24799639 | |
| occurrence of clostridium difficile pcr-ribotype 027 and it's closely related pcr-ribotype 176 in hospitals in poland in 2008-2010. | since 2003, a rising incidence of clostridium difficile infection (cdi) in north america and europe has coincided with outbreaks of c. difficile pcr ribotype 027. this ribotype was not observed in poland until 2008. in the period 2008-2010, outbreaks of antibiotic-associated diarrhoea occurred in three different hospitals in poland. of 30 c. difficile isolates available for microbiological characterisation, 17 (56%) were positive for binary toxin genes and belonged to pcr ribotype 027 (n = 7) an ... | 2014 | 24799338 |
| vancomycin, metronidazole, or tolevamer for clostridium difficile infection: results from two multinational, randomized, controlled trials. | clostridium difficile infection (cdi) is a common complication of antibiotic therapy that is treated with antibiotics, contributing to ongoing disruption of the colonic microbiota and cdi recurrence. two multinational trials were conducted to compare the efficacy of tolevamer, a nonantibiotic, toxin-binding polymer, with vancomycin and metronidazole. | 2014 | 24799326 |
| editorial commentary: the trials and tribulations of treating clostridium difficile infection-one step backward, one step forward, but still progress. | 2014 | 24799325 | |
| surotomycin demonstrates low in vitro frequency of resistance and rapid bactericidal activity in clostridium difficile, enterococcus faecalis, and enterococcus faecium. | surotomycin (cb-183,315) is an orally administered, minimally absorbed, selective bactericidal cyclic lipopeptide in phase 3 development for the treatment of clostridium difficile-associated diarrhea. the aim of this study was to evaluate the emergence of resistance in c. difficile (atcc 700057 and three recent clinical isolates from the restriction endonuclease analysis groups bi, bk, and k), vancomycin-susceptible (vs) enterococcus faecalis (atcc 49452), vancomycin-resistant (vr) e. faecalis ( ... | 2014 | 24798273 |
| impact of a change in antibacterial prophylaxis on bacteremia and hospitalization rates following outpatient autologous peripheral blood stem cell transplantation for multiple myeloma. | levofloxacin is routinely used for the prevention of invasive bacterial infections during autologous peripheral blood stem cell transplantation (apbsct). however, increasing rates of bacterial sepsis were noted at our institution among multiple myeloma (mm) patients undergoing outpatient apbsct with melphalan-based chemotherapy and levofloxacin prophylaxis. we assessed the impact of a change in antibacterial prophylaxis from oral levofloxacin (period 1) to sequential oral levofloxacin followed b ... | 2014 | 24797543 |
| practical approaches to probiotics use. | probiotics are microorganisms exerting beneficial effects on the host. they can be ingested through foods or supplements and their inclusion in these products is regulated in canada by the health canada health products and food branch. the aim of this article is to summarize current evidence from randomized controlled trials and guidelines from health canada, the world health organization, and internationally recognized expert committees in the hope that it will help practitioners and profession ... | 2014 | 24797031 |
| fecal microbial therapy: promises and pitfalls. | a rapidly expanding range of diverse human diseases is now associated with perturbations to the gastrointestinal microbiome. fecal microbial transplant (fmt) has been used with high rates of efficacy to treat gastrointestinal microbiome perturbation associated with recurrent clostridium difficile infection, and is now being considered for other indications. here we discuss the gut microbiome, review published and ongoing studies using fmt as a treatment modality for human disease, consider the r ... | 2014 | 24796803 |
| real-time polymerase chain reaction correlates well with clinical diagnosis of clostridium difficile infection. | to determine the clinical utility of a rapid molecular assay for clostridium difficile infection (cdi) in an acute hospital setting. | 2014 | 24795170 |
| clostridium difficile colonization and disease in patients undergoing hematopoietic stem cell transplantation. | there was an increase in the clostridium difficile infection (cdi) rate in our bone marrow transplantation unit. to evaluate the role of unit-based transmission, c. difficile screening was performed on adult patients admitted for hematopoietic stem cell transplantation (hsct) over a 2-year period, and c. difficile isolates were typed. c. difficile testing was performed using a 2-step c. difficile glutamate dehydrogenase antigen plus toxin a/b enzyme immunoassay (eia) and cytotoxin assay (or mole ... | 2014 | 24792871 |
| fecal transplant for recurrent clostridium difficile infection in children with and without inflammatory bowel disease. | ten children at our institution received single-infusion fecal microbiome transplant (fmt) using healthy, related screened donor stool to treat recurrent clostridium difficile infection (rcdi) via nasogastric tube (2 patients) or colonoscopic delivery. nine of the 10 (90%) children had resolution of their symptoms after a single-infusion fmt with follow-up of 1 month to 4 years. no concerning related adverse events were recognized during short- or long-term follow-up. three of these children had ... | 2014 | 24792627 |
| clinical and microbiological characterization of clostridium difficile infection in a tertiary care hospital in shanghai, china. | over the last decade, clostridium difficile infection (cdi) has emerged as a significant nosocomial infection, yet little has been reported from china. this study aimed to characterize the clinical and microbiological features of cdi from a hospital in shanghai. | 2014 | 24791861 |
| evaluation of a rapid membrane enzyme immunoassay for the simultaneous detection of glutamate dehydrogenase and toxin for the diagnosis of clostridium difficile infection. | we evaluated the new c. diff quik chek complete (cd complete; techlab, usa), which is a rapid membrane enzyme immunoassay that uses a combination of glutamate dehydrogenase (gdh) antigen and toxin a and b detection. a total of 608 consecutive loose stool specimens collected from the patients with suspected clostridium difficile infection (cdi) from august to december 2012 were subjected to the cd complete and vidas clostridium difficile a & b (vidas cdab; biomérieux, france). their performances ... | 2014 | 24790912 |
| antibodies for treatment of clostridium difficile infection. | antibodies for the treatment of clostridium difficile infection (cdi) have been demonstrated to be effective in the research and clinical environments. early uncertainties about molecular and treatment modalities now appear to have converged upon the systemic dosing of mixtures of human igg1. although multiple examples of high-potency monoclonal antibodies (mabs) exist, significant difficulties were initially encountered in their discovery. this minireview describes historical and contemporary m ... | 2014 | 24789799 |
| comparison of planktonic and biofilm-associated communities of clostridium difficile and indigenous gut microbiota in a triple-stage chemostat gut model. | biofilms are characteristic of some chronic or recurrent infections and this mode of growth tends to reduce treatment efficacy. clostridium difficile infection (cdi) is associated with a high rate of recurrent symptomatic disease. the presence and behaviour of c. difficile within intestinal biofilms remains largely unexplored, but may factor in recurrent infection. | 2014 | 24788662 |
| the prevalence of clostridium difficile infection in pediatric and adult patients with inflammatory bowel disease. | adults with inflammatory bowel disease (ibd) have a high prevalence of clostridium difficile infection (cdi). cdi in children with ibd may differ from adults. we aim to compare the prevalence of cdi in hospitalized pediatric and adult ibd patients and patients without ibd. | 2014 | 24788321 |
| high colonization rate and prolonged shedding of clostridium difficile in pediatric oncology patients. | surveillance testing for clostridium difficile among pediatric oncology patients identified stool colonization in 29% of patients without gastrointestinal symptoms and in 55% of patients with prior c. difficile infection (cdi). a high prevalence of c. difficile colonization and diarrhea complicates the diagnosis of cdi in this population. | 2014 | 24785235 |
| editorial commentary: clostridium difficile in pediatric oncology patients: more questions than answers. | 2014 | 24785232 | |
| clostridium difficile infection diagnosis in a paediatric population: comparison of methodologies. | the increasing incidence of clostridium difficile infection (cdi) in paediatric hospitalised populations, combined with the emergence of hypervirulent strains, community-acquired cdi and the need for prompt treatment and infection control, makes the rapid, accurate diagnosis of cdi crucial. we validated commonly used c. difficile diagnostic tests in a paediatric hospital population. from october 2011 to january 2012, 150 consecutive stools were collected from 75 patients at a tertiary paediatric ... | 2014 | 24781004 |
| a prospective study of community-associated clostridium difficile infections: the role of antibiotics and co-infections. | this prospective study was performed to determine the incidence, risk factors, severity and outcomes of community-associated clostridium difficile infection (ca-cdi) in the se of scotland. | 2014 | 24780765 |
| surgical management of toxic megacolon. | toxic megacolon carries still a substantial mortality and the decision when to per form emergent colectomy needs precise predictors outcome. | 2014 | 26176049 |
| the role and influence of gut microbiota in pathogenesis and management of obesity and metabolic syndrome. | the obesity epidemic has drastically impacted the state of health care in the united states. aside from poor diet hygiene and genetics, there are many other factors thought to play a role in the emergence of obesity and the metabolic syndrome. there has been a paradigm shift toward further investigating the gut microbiota and its implications in the pathogenesis of a variety of disease states, including inflammatory bowel disease, clostridium difficile, and most recently obesity and the metaboli ... | 2014 | 24778627 |
| changes in the incidence of health care-associated pathogens at a university hospital from 2005 to 2011. | data on health care-associated infections (hais) outside of intensive care units (icu) are scarce. we assessed hospital-wide changes in the incidence of health care-associated pathogens by infection site and by service between 2005 and 2011. | 2014 | 24775560 |
| outcomes of a ventilator-associated pneumonia bundle on rates of ventilator-associated pneumonia and other health care-associated infections in a long-term acute care hospital setting. | long-term trends in ventilator-associated pneumonia (vap) rates, and other health care-associated infections, were examined prior to, during, and after introduction of a vap bundle in a long-term acute care hospital setting. vap incidence rate declined in a step-wise fashion and reached a null value. incidence rates of bacteremia from any cause declined in a similar fashion. the incidence rates of vancomycin-resistant enterococci and methicillin-resistant staphylococcus aureus colonization or in ... | 2014 | 24773791 |
| environmental cleaning resources and activities in canadian acute care hospitals. | environmental cleaning interventions have increased cleaning effectiveness and reduced antibiotic-resistant organisms in hospitals. this study examined cleaning in canadian acute care hospitals with the goal of developing strategies to improve cleaning and reduce antibiotic-resistant organism rates. | 2014 | 24773787 |
| international typing study of clostridium difficile. | we report the results of an international clostridium difficile typing study to cross reference strain designations for seven typing methodologies and facilitate inter-laboratory communication. four genotypic and three phenotypic methods were used to type 100 isolates and compare the results to 39 pcr ribotypes identified among the collection. | 2014 | 24768986 |
| chemoprophylaxis of clostridium difficile infections in high-risk hospitalized patients. | 2014 | 24768812 | |
| challenges in the diagnosis of clostridium difficile infection. | 2014 | 24768590 | |
| findings of a hospital surveillance-based outcome evaluation study for clostridium difficile-associated colitis. | we completed a prospective study of 164 patients involved in a clostridium difficile surveillance programme, evaluating a range of variables such as disease severity, treatment regimen and known clinical risk factors, for their effect on case lethality. the aim of this study was to determine if there are any additional clinical variables worth considering for inclusion in the therapeutic decision-making process. beyond common risk factors, secondary immunodeficiencies such as diabetes mellitus, ... | 2014 | 24766614 |
| pyknotic cell death induced by clostridium difficile tcdb: chromatin condensation and nuclear blister are induced independently of the glucosyltransferase activity. | tcda and tcdb are the main pathogenicity factors of clostridium difficile-associated diseases. both toxins inhibit rho gtpases, and consequently, apoptosis is induced in the affected cells. we found that tcdb at higher concentrations exhibits cytotoxic effects that are independent on rho glucosylation. tcdb and the glucosyltransferase-deficient mutant tcdb d286/288n induced pyknotic cell death which was associated with chromatin condensation and reduced h3 phosphorylation. affected cells showed ... | 2014 | 24898616 |