Publications
| Title | Abstract | Year(sorted ascending) Filter | PMID Filter |
|---|
| pulsed faecal microbiota transplantation for recalcitrant recurrent clostridium difficile infection. | 2015 | 25658573 | |
| recurrent clostridium difficile infection is associated with increased mortality. | clostridium difficile infections (cdi) are associated with decreased survival, and up to 30% of cdi patients may experience a recurrence. data on the impact of recurrent cdi on mortality are scarce. the purpose of this study was to determine whether recurrent cdi was independently associated with decreased 6-month survival compared with patients with cdi who did not develop a recurrence. we performed a retrospective cohort study at an academic, urban, tertiary care hospital. data were collected ... | 2015 | 25658560 |
| predicting the risk of clostridium difficile infection following an outpatient visit: development and external validation of a pragmatic, prognostic risk score. | increasing morbidity related to clostridium difficile infection (cdi) has heightened interest in the identification of patients who would most benefit from recognition of risk and intervention. we sought to develop and validate a prognostic risk score to predict cdi risk for individual patients following an outpatient healthcare visit. we assembled a cohort of kaiser permanente northwest (kpnw) patients with an index outpatient visit between 2005 and 2008, and identified cdi in the year followin ... | 2015 | 25658533 |
| burdening questions about clostridium difficile in pediatric inflammatory bowel diseases. | 2015 | 25658059 | |
| a prediction model for clostridium difficile recurrence. | clostridium difficile infection (cdi) is a growing problem in the community and hospital setting. its incidence has been on the rise over the past two decades, and it is quickly becoming a major concern for the health care system. high rate of recurrence is one of the major hurdles in the successful treatment of c. difficile infection. there have been few studies that have looked at patterns of recurrence. the studies currently available have shown a number of risk factors associated with c. dif ... | 2015 | 25656667 |
| manganese superoxide dismutase from human pathogen clostridium difficile. | clostridium difficile is a human pathogen that causes severe antibiotic-associated clostridium difficile infection (cdi). herein the mnsodcd from c. difficile was cloned, expressed in escherichia coli,and characterized by x-ray crystallography, uv/vis and epr spectroscopy, and activity assay, et al. the crystal structure of mnsodcd (2.32 å) reveals a manganese coordination geometry of distorted trigonal bipyramidal, with his111, his197 and asp193 providing the equatorial ligands and with his56 a ... | 2015 | 25655385 |
| emergence of an outbreak-associated clostridium difficile variant with increased virulence. | the prevalence of clostridium difficile infections has increased due to the emergence of epidemic variants from diverse genetic lineages. here we describe the emergence of a novel variant during an outbreak in a costa rican hospital that was associated with severe clinical presentations. this c. difficile variant elicited higher white blood cell counts and caused disease in younger patients than did other strains isolated during the outbreak. furthermore, it had a recurrence rate, a 30-day attri ... | 2015 | 25653402 |
| in vitro susceptibility of clostridium difficile to smt19969 and comparators, as well as the killing kinetics and post-antibiotic effects of smt19969 and comparators against c. difficile. | smt19969 is a novel antimicrobial under clinical development for the treatment of clostridium difficile infection (cdi). the objective was to determine the comparative susceptibility of 82 c. difficile clinical isolates (which included ribotype 027 isolates and isolates with reduced metronidazole susceptibility) to smt19969, fidaxomicin, vancomycin and metronidazole and to determine the killing kinetics and post-antibiotic effects of smt19969, fidaxomicin and vancomycin against c. difficile. | 2015 | 25652750 |
| smt19969 for clostridium difficile infection (cdi): in vivo efficacy compared with fidaxomicin and vancomycin in the hamster model of cdi. | smt19969 is a novel narrow-spectrum antimicrobial under development for the treatment of clostridium difficile infection (cdi). the objectives were to assess the relative efficacies of smt19969, vancomycin and fidaxomicin in the hamster model of cdi. | 2015 | 25652749 |
| environmental transmission of clostridium difficile: association between hospital room size and c. difficile infection. | to evaluate the association between hospital room square footage and acquisition of nosocomial clostridium difficile infection (cdi). | 2015 | 25652311 |
| manipulating the gut microbiota to maintain health and treat disease. | the intestinal microbiota composition varies between healthy and diseased individuals for numerous diseases. although any cause or effect relationship between the alterations in the gut microbiota and disease is not always clear, targeting the intestinal microbiota might offer new possibilities for prevention and/or treatment of disease. | 2015 | 25651995 |
| current status of the treatment of fulminant colitis. | fulminant colitis is not a well-defined entity, that constitutes a severe complication. it usually occurs in the course of úlcerative colitis and clostridium difficile colitis. a multidisciplinary management combining gastroenterologist and surgeons is crucial with intensive medical treatment and early surgery in non-responders. it is important to distinguish if we are facing a flare of ibd or, on the contrary, it is an infectious colitis, due to the fact that although general therapeutic measur ... | 2015 | 25649534 |
| clostridium difficile surface proteins are anchored to the cell wall using cwb2 motifs that recognise the anionic polymer psii. | gram-positive surface proteins can be covalently or non-covalently anchored to the cell wall and can impart important properties on the bacterium in respect of cell envelope organisation and interaction with the environment. we describe here a mechanism of protein anchoring involving tandem cwb2 motifs found in a large number of cell wall proteins in the firmicutes. in the clostridium difficile cell wall protein family, we show the three tandem repeats of the cwb2 motif are essential for correct ... | 2015 | 25649385 |
| high temporal resolution of glucosyltransferase dependent and independent effects of clostridium difficile toxins across multiple cell types. | clostridium difficile toxins a and b (tcda and tcdb), considered to be essential for c. difficile infection, affect the morphology of several cell types with different potencies and timing. however, morphological changes over various time scales are poorly characterized. the toxins' glucosyltransferase domains are critical to their deleterious effects, and cell responses to glucosyltransferase-independent activities are incompletely understood. by tracking morphological changes of multiple cell ... | 2015 | 25648517 |
| acid-suppressing agents and risk for clostridium difficile infection in pediatric patients. | acid-suppressing agents have been associated with increased clostridium difficile infection (cdi) in adults. the objective of this study was to evaluate the association of acid-suppressing therapy with the development of cdi in the pediatric population. | 2015 | 25644650 |
| diagnosis and management of clostridium difficile infection. | there have been dramatic changes in the epidemiology of clostridium difficile infection (cdi), with increases in incidence and severity of disease, attributed to the emergence of a fluoroquinolone-resistant "hypervirulent" strain, ribotype 027. c. difficile is now the most common pathogen causing hospital-acquired infection in u.s. hospitals, and community-acquired infections are increasing. the diagnosis of cdi is based on a combination of signs and symptoms, confirmed by laboratory tests. clin ... | 2015 | 25643269 |
| prevalence and risk factors associated with clostridium difficile shedding in veal calves in italy. | the aim of this study is to describe the prevalence and risk factors of clostridium difficile shedding in six farms belonging to two companies in northern italy. four hundred and twenty veal calves, randomly selected and individually identified, were sampled three times: at 0-16, 90-120, and 150 days after introduction. c. difficile was isolated at least once from 87 out of the 420 calves (20.7%). the prevalence of shedding was 20.24% at the first sampling and dropped to 0.72% at the second samp ... | 2015 | 25638401 |
| role of obesity and adipose tissue-derived cytokine leptin during clostridium difficile infection. | obesity is among the most pressing health concerns in the world since it is increasingly common even in the developing world, and is clearly associated with increased risk for chronic debilitating diseases and death. furthermore, obesity can influence the pathogenesis of infectious diseases by affecting the balance of pathogen clearance and pathological inflammation. the mechanisms that result in enhanced inflammation in obese individuals are poorly understood. clostridium difficile is a major c ... | 2015 | 25638400 |
| how to eradicate clostridium difficile from the environment. | during the last decade, clostridium difficile has emerged as a major cause of healthcare-associated diarrhoea and death. transmission of this spore-forming bacterium is thought to occur via the hands of healthcare providers or via the contaminated environment. therefore, enhanced environmental cleaning/disinfection of the rooms housing c. difficile-infected patients is warranted. guidelines from various scientific bodies have been published. they recommend performing environmental decontaminatio ... | 2015 | 25638358 |
| [acute diarrhea after kidney or kidney-pancreas transplantation]. | diarrhea is a frequent and potentially severe complication of kidney transplantation. we describe here, in a cross-sectional study, the epidemiological and microbiological characteristics of acute and persistent diarrhea in 52 inpatients with kidney and kidney-pancreas transplant in a hospital in buenos aires, 42 (80.8%) of whom had received a kidney and 10 (19.2%) a kidney-pancreas transplant. diarrhea was the reason of admission of 34 cases (65.4%). the etiology could be studied in 50 patients ... | 2015 | 25637897 |
| comparing the economic and health benefits of different approaches to diagnosing clostridium difficile infection. | accurate diagnosis of clostridium difficile infection (cdi) is essential to effectively managing patients and preventing transmission. despite the availability of several diagnostic tests, the optimal strategy is debatable and their economic values are unknown. we modified our previously existing c. difficile simulation model to determine the economic value of different cdi diagnostic approaches from the hospital perspective. we evaluated four diagnostic methods for a patient suspected of having ... | 2015 | 25636938 |
| rectal bacteriotherapy for recurrent clostridium difficile-associated diarrhoea: results from a case series of 55 patients in denmark 2000-2012. | clostridium difficile infection is one of the most common nosocomial infections. among other alternatives to standard treatment with vancomycin for recurrent infection are faecal microbiota transplantation and rectal bacteriotherapy with a fixed mixture of intestinal bacterial strains isolated from faeces of healthy persons to mimic a theoretical normal microflora. developed by dr. tvede and dr. rask-madsen, the latter method has been in use for selected patients during the last 25 years in denm ... | 2015 | 25636927 |
| complete genome sequence of the clostridium difficile laboratory strain 630δerm reveals differences from strain 630, including translocation of the mobile element ctn5. | clostridium difficile strain 630δerm is a spontaneous erythromycin sensitive derivative of the reference strain 630 obtained by serial passaging in antibiotic-free media. it is widely used as a defined and tractable c. difficile strain. though largely similar to the ancestral strain, it demonstrates phenotypic differences that might be the result of underlying genetic changes. here, we performed a de novo assembly based on single-molecule real-time sequencing and an analysis of major methylation ... | 2015 | 25636331 |
| gut check: clostridium difficile testing and treatment in the molecular testing era. | we evaluated the impact of nursing education and stewardship interventions on clostridium difficile testing and treatment appropriateness. diarrhea documentation increased for those with positive tests (45% to 70%); pretreatment laxative use decreased (50% to 19%). appropriate treatment increased for severe infection (57% to 93%), but all asymptomatically colonized patients were treated. | 2015 | 25633006 |
| evaluation of a pulsed xenon ultraviolet disinfection system for reduction of healthcare-associated pathogens in hospital rooms. | objective to determine the effectiveness of a pulsed xenon ultraviolet (px-uv) disinfection device for reduction in recovery of healthcare-associated pathogens. setting two acute-care hospitals. methods we examined the effectiveness of px-uv for killing of clostridium difficile spores, methicillin-resistant staphylococcus aureus (mrsa), and vancomycin-resistant enterococcus (vre) on glass carriers and evaluated the impact of pathogen concentration, distance from the device, organic load, and sha ... | 2015 | 25633002 |
| comorbidities, exposure to medications, and the risk of community-acquired clostridium difficile infection: a systematic review and meta-analysis. | clostridium difficile infection (cdi) has been extensively described in healthcare settings; however, risk factors associated with community-acquired (ca) cdi remain uncertain. this study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with ca-cdi. | 2015 | 25632995 |
| a comparison between national healthcare safety network laboratory-identified event reporting versus traditional surveillance for clostridium difficile infection. | objective hospitals in the national healthcare safety network began reporting laboratory-identified (labid) clostridium difficile infection (cdi) events in january 2013. our study quantified the differences between the labid and traditional surveillance methods. design cohort study. setting a cohort of 29 community hospitals in the southeastern united states. methods a period of 6 months (january 1, 2013, to june 30, 2013) of prospectively collected data using both labid and traditional surveill ... | 2015 | 25632994 |
| evaluation of portability and cost of a fluorescent pcr ribotyping protocol for clostridium difficile epidemiology. | clostridium difficile is the most commonly identified pathogen among health care-associated infections in the united states. there is a need for accurate and low-cost typing tools that produce comparable data across studies (i.e., portable data) to help characterize isolates during epidemiologic investigations of c. difficile outbreaks and sporadic cases of disease. the most popular c. difficile-typing technique is pcr ribotyping, and we previously developed methods using fluorescent pcr primers ... | 2015 | 25631804 |
| in vitro selection of a single-stranded dna molecular recognition element against clostridium difficile toxin b and sensitive detection in human fecal matter. | toxin b is one of the major virulence factors of clostridium difficile, a bacterium that is responsible for a significant number of diarrhea cases in acute care settings. due to the prevalence of c. difficile induced diarrhea, rapid and correct diagnosis is crucial in the disease management. in this study, we have employed a stringent in vitro selection method to identify single-stranded dna molecular recognition elements (mre) specific for toxin b. at the end of the 12-round selection, one mre ... | 2015 | 25734010 |
| continuous proton pump inhibitor therapy and the associated risk of recurrent clostridium difficile infection. | clostridium difficile infection (cdi) is associated with significant morbidity, mortality, and a high risk of recurrence. proton pump inhibitor (ppi) use is associated with an initial episode of cdi, and ppis are frequently overprescribed. for many, the use of ppis could likely be discontinued before cdi recurrence. | 2015 | 25730198 |
| randomised clinical trial: faecal microbiota transplantation by colonoscopy vs. vancomycin for the treatment of recurrent clostridium difficile infection. | faecal microbiota transplantation (fmt) from healthy donors is considered an effective treatment against recurrent clostridium difficile infection. | 2015 | 25728808 |
| reduction in clostridium difficile environmental contamination by hospitalized patients treated with fidaxomicin. | fidaxomicin is sporicidal and may be associated with a reduced time to resolution of diarrhoea when used to treat patients with clostridium difficile infection (cdi). this study investigated whether fidaxomicin for treatment of all patients with cdi reduced c. difficile environmental contamination. surfaces in the rooms of 66 hospitalized patients treated with metronidazole and/or vancomycin and 68 hospitalized patients treated with fidaxomicin were sampled. patients treated with fidaxomicin wer ... | 2015 | 25728208 |
| predictors of asymptomatic clostridium difficile colonization on hospital admission. | clostridium difficile (cd) is the leading cause of health care-associated diarrhea and can result in asymptomatic carriage. rates of asymptomatic cd colonization on hospital admission range from 1.4%-21%. the objective of this study was to evaluate host and bacterial factors associated with colonization on admission. | 2015 | 25728150 |
| understanding the current state of infection prevention to prevent clostridium difficile infection: a human factors and systems engineering approach. | achieving and sustaining high levels of health care worker (hcw) compliance with contact isolation precautions is challenging. the aim of this study was to determine hcw work system barriers to and facilitators of adherence to contact isolation for patients with suspected or confirmed clostridium difficile infection (cdi) using a human factors and systems engineering approach. | 2015 | 25728149 |
| automated 3d rna structure prediction using the rnacomposer method for riboswitches. | understanding the numerous functions of rnas depends critically on the knowledge of their three-dimensional (3d) structure. in contrast to the protein field, a much smaller number of rna 3d structures have been assessed using x-ray crystallography, nmr spectroscopy, and cryomicroscopy. this has led to a great demand to obtain the rna 3d structures using prediction methods. the 3d structure prediction, especially of large rnas, still remains a significant challenge and there is still a great dema ... | 2015 | 25726459 |
| masking autoprocessing of clostridium difficile toxin a by the c-terminus combined repetitive oligo peptides. | clostridium difficile toxin a and b (tcda and tcdb) are the major virulence factors of the bacterium, both of which consist of two enzymatic domains: an effector glucosyltransferase domain (gtd) and a cysteine protease domain (cpd) responsible for autocleavage and release of gtd. although the cpds from both toxins share a similar structure and mechanism of hexakisphosphate (insp6)-induced activation, tcda is substantially less sensitive to the autocleavage as compared with tcdb. in this study, w ... | 2015 | 25725153 |
| the association of antibiotic treatment regimen and hospital mortality in patients hospitalized with legionella pneumonia. | guidelines recommend azithromycin or a quinolone antibiotic for treatment of legionella pneumonia. no clinical study has compared these strategies. | 2015 | 25722195 |
| reactive oxygen species involved in ct26 immunogenic cell death induced by clostridium difficile toxin b. | immunogenic cell death (icd) is a new concept appeared in recent years. despite growing interests of research on icd, the circumstances that trigger immune responses against dying tumor cells remain largely unknown. it was demonstrated that recombinant clostridium difficile toxin b (rtcdb) can induce icd in intoxicated cells, but its mechanism remains unclear. this work aims at exploring whether reactive oxygen species (ros) involved in rtcdb induced icd using the chemical agent n-acetyl cystein ... | 2015 | 25721381 |
| a case of toxic megacolon caused by clostridium difficile infection and treated with fecal microbiota transplantation. | clostridium difficile infection. the mortality rate of fulminant c. difficile infection is reported to be as high as 50%. fecal microbiota transplantation is a highly effective treatment in patients with recurrent or refractory c. difficile infection. however, there are few published articles on the use of such transplantation for fulminant c. difficile infection. here, we report on a patient with toxic megacolon complicated by c. difficile infection who was treated successfully with fecal mi-cr ... | 2015 | 25721003 |
| solution structure and dna binding of the catalytic domain of the large serine resolvase tnpx. | the transfer of antibiotic resistance between bacteria is mediated by mobile genetic elements such as plasmids and transposons. tnpx is a member of the large serine recombinase subgroup of site-specific recombinases and is responsible for the excision and insertion of mobile genetic elements that encode chloramphenicol resistance in the pathogens clostridium perfringens and clostridium difficile. tnpx consists of three structural domains: domain i contains the catalytic site, whereas domains ii ... | 2015 | 25720550 |
| molecular testing for viral and bacterial enteric pathogens: gold standard for viruses, but don't let culture go just yet? | contemporary diagnostic microbiology is increasingly adopting molecular methods as front line tests for a variety of samples. this trend holds true for detection of enteric pathogens (ep), where nucleic acid amplification tests (naat) for viruses are well established as the gold standard, and an increasing number of commercial multi-target assays are now available for bacteria and parasites. naat have significant sensitivity and turnaround time advantages over traditional methods, potentially re ... | 2015 | 25719855 |
| molecular methods for detecting and typing of clostridium difficile. | since the early 2000s, clostridium difficile has emerged as a major international pathogen. recently, strains of c. difficile in circulation appear to be changing, with greater diversity, leading to challenges for diagnostics and surveillance. currently molecular diagnostic methods are favoured for their high sensitivity and rapid processing times; however, a number of issues still exist with molecular tests, in particular high cost, low clinical specificity and failure to detect some variant c. ... | 2015 | 25719853 |
| differential immunodetection of toxin b from highly virulent clostridium difficile bi/nap-1/027. | we developed a simple immunoassay capable of differentially detecting toxin b from highly virulent strains of clostridium difficile (bi/nap-1/027) in stool. this assay can simultaneously confirm the presence of in vivo toxin production and provide strain-related information relevant to infection control epidemiology and disease prognosis. | 2015 | 25716449 |
| toxin synthesis by clostridium difficile is regulated through quorum signaling. | clostridium difficile infection (cdi) is dramatically increasing as a cause of antibiotic- and hospital-associated diarrhea worldwide. c. difficile, a multidrug-resistant pathogen, flourishes in the colon after the gut microbiota has been altered by antibiotic therapy. consequently, it produces toxins a and b that directly cause disease. despite the enormous public health problem posed by this pathogen, the molecular mechanisms that regulate production of the toxins, which are directly responsib ... | 2015 | 25714717 |
| high-throughput analysis of gene essentiality and sporulation in clostridium difficile. | clostridium difficile is the most common cause of antibiotic-associated intestinal infections and a significant cause of morbidity and mortality. infection with c. difficile requires disruption of the intestinal microbiota, most commonly by antibiotic usage. therapeutic intervention largely relies on a small number of broad-spectrum antibiotics, which further exacerbate intestinal dysbiosis and leave the patient acutely sensitive to reinfection. development of novel targeted therapeutic interven ... | 2015 | 25714712 |
| burden of clostridium difficile infection in the united states. | the magnitude and scope of clostridium difficile infection in the united states continue to evolve. | 2015 | 25714160 |
| is combination therapy for carbapenem-resistant klebsiella pneumoniae the new standard of care? | carbapenem-resistant klebsiella pneumoniae causes serious nosocomial infections and therapeutic options are limited. there is increasing evidence suggesting that combination antibiotic therapy is more effective than monotherapy and leads to better outcomes. however, questions remain about which regimen is optimal and how to balance the potential benefits of combination therapy versus the risks and possible complications (e.g., toxicity, increased costs, clostridium difficile infection). well-des ... | 2015 | 25711690 |
| separating the microbiome from the hyperbolome. | microbiome-based therapies are moving quickly towards the clinic, with successes including fecal microbial transplants for recurring clostridium difficile, hints of new antibiotics to come, and possible new microbial biomarkers for common complex diseases. can the microbiome live up to its hype? | 2015 | 25709718 |
| emerging influence of the intestinal microbiota during allogeneic hematopoietic cell transplantation: control the gut and the body will follow. | the intestinal microbiota has many critical roles in maintaining gastrointestinal epithelial and gastrointestinal systemic immune homeostasis. this review provides insight into how allogeneic hematopoietic cell transplantation (hct) and its associated complications and supportive care therapies affect the microbiota. additionally, the review discusses how preservation and restoration of the microbiota might be advantageous in decreasing hct-related morbidity and mortality. | 2015 | 25708215 |
| asymptomatic carriers of toxigenic c. difficile in long-term care facilities: a meta-analysis of prevalence and risk factors. | the impact of clostridium difficile colonization in c. difficile infection (cdi) is inadequately explored. as a result, asymptomatic carriage is not considered in the development of infection control policies and the burden of carrier state in long-term care facilities (ltcfs) is unknown. | 2015 | 25707002 |
| hospital ward antibiotic prescribing and the risks of clostridium difficile infection. | only a portion of hospital-acquired clostridium difficile infections can be traced back to source patients identified as having symptomatic disease. antibiotic exposure is the main risk factor for c difficile infection for individual patients and is also associated with increased asymptomatic shedding. contact with patients taking antibiotics within the same hospital ward may be a transmission risk factor for c difficile infection, but this hypothesis has never been tested. | 2015 | 25705994 |
| impact of sink location on hand hygiene compliance for clostridium difficile infection. | hand hygiene with soap and water after the care of a patient with clostridium difficile infection is essential to reduce nosocomial transmission in an outbreak situation. factors that may pose barriers to user completion of infection prevention measures, such as hand hygiene, are of interest. we undertook a quantitative study to evaluate the relationship between sink location and compliance with handwashing among health care workers and visitors in a surgical transplant unit. we found that place ... | 2015 | 25704256 |
| fecal microbiota transplantation (fmt) for clostridium difficile infection: focus on immunocompromised patients. | clostridium difficile infection (cdi) is an emerging problem worldwide associated with significant morbidity, mortality, recurrence rates and healthcare costs. immunosuppressed patients, including hiv-seropositive individuals, solid organ transplant recipients, patients with malignancies, hematopoietic stem cell transplant recipients, and patients with inflammatory bowel disease are increasingly recognized as being at higher risk of developing cdi where it may be associated with significant comp ... | 2015 | 25703532 |
| pan-european longitudinal surveillance of antibiotic resistance among prevalent clostridium difficile ribotypes. | clostridium difficile infection remains a major healthcare burden. until the recent introduction of fidaxomicin, antimicrobial treatments were limited to metronidazole and vancomycin. the emergence of epidemic c. difficile pcr ribotype 027 and its potential link to decreased antibiotic susceptibility highlight the lack of large-scale antimicrobial susceptibility and epidemiological data available. we report results of epidemiological and antimicrobial susceptibility investigations of c. difficil ... | 2015 | 25701178 |
| case-control comparison of bacterial and protozoan microorganisms associated with gastroenteritis: application of molecular detection. | the introduction of molecular detection of infectious organisms has led to increased numbers of positive findings, as observed for pathogens causing gastroenteritis (ge). however, because little is known about the prevalence of these pathogens in the healthy asymptomatic population, the clinical value of these additional findings is unclear. a case-control study was carried out in a population of patients served by general practitioners in the netherlands. a total of 2710 fecal samples from case ... | 2015 | 25700890 |
| genomic diversity of clostridium difficile strains. | approaches to exploring clostridium difficile genomic diversity have ranged from molecular typing methods to use of comparative genome microarrays and whole genome sequence comparisons. the c. difficile population structure is clonal and distributed into six clades, which correlate well with mlst sts (multilocus sequence types) and pcr ribotypes. however, toxigenic strains and strains with increased virulence are distributed throughout several clades. here we summarize studies on c. difficile ge ... | 2015 | 25700631 |
| clostridium difficile infection: a serbian single-center experience. | clostridium difficile infection (cdi) is the most common cause of hospital-acquired diarrhea. severity of cdi is associated with advanced age and co-morbidities. the clinical spectrum varies from mild watery diarrhea to severe fulminant pseudomembranous colitis with complications. | 2015 | 25699487 |
| risk factors and clinical outcomes of candidaemia in patients treated for clostridium difficile infection. | the alterations occurring in the intestinal flora during clostridium difficile infection (cdi) may promote the translocation of candida to the blood and the development of candidaemia. the aim of our study was to analyse clinical findings of these patients to determine the risk factors associated with the development of candidaemia subsequent to cdi. we compared 35 patients with candidaemia subsequent to cdi with 105 patients with cdi. patients with candidaemia showed more severe infections and ... | 2015 | 25698658 |
| the recombinant lactococcus lactis oral vaccine induces protection against c. difficile spore challenge in a mouse model. | clostridium difficile infection (cdi) causes nosocomial antibiotic-associated diarrhea and colitis in the developed world. two potent cytotoxins, toxin a (tcda) and toxin b (tcdb) are the virulence factors of this disease and can be a good vaccine candidate against cdi. in the present study, we genetically engineered lactococcus lactis to express the nontoxic, recombinant fragments derived from tcda and tcdb c-terminal receptor binding domains (tcd-ac and tcd-bc) as an oral vaccine candidate. th ... | 2015 | 25698490 |
| perspectives on lantibiotic discovery - where have we failed and what improvements are required? | the increasing resistance of bacteria to conventional antimicrobial therapy within both the nosocomial and community environment has enforced the urgent requirement for the discovery of novel agents. this has stimulated increased research efforts within the field of lantibiotic discovery. lantibiotics are ribosomally synthesised, post-translationally modified antimicrobial peptides that exhibit antimicrobial activity against a range of multi-drug-resistant (mdr) bacteria. the success of these ag ... | 2015 | 25697059 |
| state law mandates for reporting of healthcare-associated clostridium difficile infections in hospitals. | us state and territorial laws were reviewed to identify clostridium difficile infection reporting mandates. twenty states require reporting either under state law or by incorporating federal centers for medicare & medicaid services' reporting requirements. although state law mandates are more common, the incorporation of federal reporting requirements has been increasing. | 2015 | 25695178 |
| clostridium difficile infection (cdi) severity and outcome among patients infected with the nap1/bi/027 strain in a non-epidemic setting. | determine whether the nap1 strain identified by polymerase chain reaction (pcr)-based stool assay is correlated with cdi severity and clinical outcomes. | 2015 | 25695169 |
| clostridium difficile recurrence is a strong predictor of 30-day rehospitalization among patients in intensive care. | while incidence, mortality, morbidity, and recurrence rates of c. difficile infection (cdi) among the critically ill have been investigated, the impact of its recurrence on 30-day rehospitalization (read), an important policy focus, has not been examined. | 2015 | 25695168 |
| protease-sensitive inhibitory activity of cell-free supernatant of lactobacillus crispatus 156 synergizes with ciprofloxacin, moxifloxacin and streptomycin against pseudomonas aeruginosa: an in vitro study. | ciprofloxacin and streptomycin are frequently prescribed for the treatment of medical conditions originating due to infection by pseudomonas aeruginosa. however, fluoroquinolone administration has been linked to the outgrowth of clostridium difficile pathogen, especially in immunocompromised patients. secondly, frequent administration of antibiotics may lead to development of resistance in the pathogens. thus, there is a need to explore innovative adjunct therapies to lower the therapeutic doses ... | 2015 | 25693845 |
| refractory clostridium difficile infection cured with fecal microbiota transplantation in vancomycin-resistant enterococcus colonized patient. | the rates and severity of clostridium difficile infections, including pseudomembranous colitis, have increased markedly. however, there are few effective treatments for refractory or recurrent c. difficile infections and the outcomes are poor. fecal microbiota transplantation is becoming increasingly accepted as an effective and safe intervention in patients with recurrent disease, likely due to the restoration of a disrupted microbiome. cure rates of >90% are being consistently reported from mu ... | 2015 | 25691847 |
| ambush of clostridium difficile spores by ramoplanin: activity in an in vitro model. | clostridium difficile infection (cdi) is a gastrointestinal disease caused by c. difficile, a spore-forming bacterium that in its spore form is tolerant to standard antimicrobials. ramoplanin is a glycolipodepsipeptide antibiotic that is active against c. difficile with mics ranging from 0.25 to 0.50 μg/ml. the activity of ramoplanin against the spores of c. difficile has not been well characterized; such activity, however, may hold promise, since posttreatment residual intraluminal spores are l ... | 2015 | 25691641 |
| impact of clostridium difficile recurrence on hospital readmissions. | the impact of recurrent clostridium difficile infections (cdis) on hospital readmissions is unknown. the objective of this study was to determine whether recurrent cdi was independently associated with the number of hospital readmissions and days readmitted. | 2015 | 25690876 |
| fecal microbiota transplantation in patients with cancer undergoing treatment. | fecal microbiota transplantation (fmt) is a technique used to restore the normal body flora to the gut in cases of clostridium difficile infection (cdi). it involves instillation of the stool of a healthy donor through a nasogastric tube or colonoscopy into the gastrointestinal tract of the patient. more research is needed to determine the parameters of fmt use in patients with cancer. | 2015 | 25689657 |
| risk factors for systemic vancomycin exposure following administration of oral vancomycin for the treatment of clostridium difficile infection. | to identify risk factors for systemic exposure to vancomycin (van) following administration of oral vancomycin (pov) for the treatment of clostridium difficile infection (cdi). | 2015 | 25689243 |
| fecal microbiota transplantation for clostridium difficile infection--reply. | 2015 | 25688788 | |
| fecal microbiota transplantation for clostridium difficile infection. | 2015 | 25688787 | |
| impact of polymerase chain reaction testing on clostridium difficile infection rates in an acute health care facility. | two rapid methods of clostridium difficile infection (cdi) diagnosis were compared between june 2012 and march 2013: a genexpert (cepheid, sunnyvale, calif) polymerase chain reaction (pcr) test and an enzyme immunoassay (eia). the influence of these methods on the detection of hospital-acquired cdi and identification of cdi outbreaks was evaluated. we tested 1,592 stool samples for c difficile. the genexpert pcr test identified 211 positive samples (68 determined to be hospital-acquired infectio ... | 2015 | 25687359 |
| rapid spread of clostridium difficile nap1/027/st1 in chile confirms the emergence of the epidemic strain in latin america. | clostridium difficile infection has gained importance in recent years as a result of the rapid spread of epidemic strains, including hypervirulent strains. this study reports the molecular epidemiology of c. difficile obtained from hospitalized patients in chile. seven hundred and nineteen isolates of toxigenic c. difficile from 45 hospitals across the country were characterized through toxin profile, pulsed-field gel electrophoresis (pfge), and sequencing of the tcdc gene. in addition, polymera ... | 2015 | 25687254 |
| predicting clostridium difficile infection in diabetic patients and the effect of metformin therapy: a retrospective, case-control study. | data on risk factors for clostridium difficile infection (cdi) in diabetic patients are scarce. recently, it has been shown that metformin increases the bacteroidetes/firmicutes ratio; therefore, it may yield a protective effect against cdi. we aimed to assess risk factors for cdi in diabetic patients beyond antibiotic treatment, and to determine the impact of metformin therapy on the development of cdi in these patients. in this retrospective, case-control study, all consecutive cdi diabetic pa ... | 2015 | 25686730 |
| clostridium difficile in the long-term care facility: prevention and management. | residents of long-term care facilities are at high risk for clostridium difficile infection due to frequent antibiotic exposure in a population already rendered vulnerable to infection due to advanced age, multiple comorbid conditions and communal living conditions. moreover, asymptomatic carriage of toxigenic c. difficile and recurrent infections are prevalent in this population. here, we discuss epidemiology and management of c. difficile infection among residents of long-term care facilities. ... | 2015 | 25685657 |
| adherence to and outcomes associated with a clostridium difficile guideline at a large teaching institution. | the incidence and virulence of clostridium difficile infection (cdi) has recently increased. national cdi treatment guidelines stratify patients based on clinical symptoms and recommend treatment based on severity of illness. in 2009, advocate lutheran general hospital (park ridge, illinois) adopted guidelines with treatment algorithms identical to the national guidelines. the purpose of this study was to determine whether patients were being treated in accordance with the cdi guidelines and whe ... | 2015 | 25684800 |
| variation in germination of clostridium difficile clinical isolates correlates to disease severity. | over the past two decades, clostridium difficile infections have been increasing in both number and severity throughout the world. as with other spore forming bacteria, germination is a vital step in the life cycle of this pathogen. studies have examined differences in sporulation and toxin production among a number of c. difficile clinical isolates; however, few have examined differences in germination and the relationship between this phenotype and disease severity. here, over 100 c. difficile ... | 2015 | 25681667 |
| automated tracking and ordering of precautions for multidrug-resistant organisms. | the transmission and infection risk associated with multidrug-resistant organism (mdro) carriers necessitates surveillance and tracking to provide proper contact precautions. as mdros increase in scope, automated electronic health record (ehr) systems may help with surveillance demands. | 2015 | 25681303 |
| development and validation of an internationally-standardized, high-resolution capillary gel-based electrophoresis pcr-ribotyping protocol for clostridium difficile. | pcr-ribotyping has been adopted in many laboratories as the method of choice for c. difficile typing and surveillance. however, issues with the conventional agarose gel-based technique, including inter-laboratory variation and interpretation of banding patterns have impeded progress. the method has recently been adapted to incorporate high-resolution capillary gel-based electrophoresis (ce-ribotyping), so improving discrimination, accuracy and reproducibility. however, reports to date have all r ... | 2015 | 25679978 |
| freeze-dried, capsulized fecal microbiota transplantation for relapsing clostridium difficile infection. | 2015 | 25955501 | |
| time series analysis of the impact of an intervention in tayside, scotland to reduce primary care broad-spectrum antimicrobial use. | concern about clostridium difficile infection (cdi) and resistance has driven interventions internationally to reduce broad-spectrum antimicrobial use. an intervention combining guidelines, education and feedback was implemented in tayside, scotland in 2009 aiming to reduce primary care prescribing of co-amoxiclav, cephalosporins, fluoroquinolones and clindamycin ('4c antimicrobials'). our aim was to assess the impact of this real-world intervention on antimicrobial prescribing rates. | 2015 | 25953807 |
| novel handwashes are superior to soap and water in removal of clostridium difficile spores from the hands. | we examined the efficacy of 5 experimental handwash formulations in removing nontoxigenic clostridium difficile spores from the hands of health care workers. handwashing with sand resulted in an additional 0.5-log reduction in spore recovery compared with the current standard of soap and water. | 2015 | 25952050 |
| regional and seasonal variation in clostridium difficile infections among hospitalized patients in the united states, 2001-2010. | this study identified national regional and seasonal variations in clostridium difficile infection (cdi) incidence and mortality among hospitalized patients in the united states over a 10-year period. | 2015 | 25952045 |
| low prevalence of clostridium difficile in slaughter pigs in korea. | clostridium difficile is an important cause of enteric disease in humans and animals. the prevalence of c. difficile infection is increasing, and the bacterium is frequently found in meat products, suggesting the possibility of animal-to-human transmission. therefore, food animals must be assessed for their role as reservoirs of c. difficile. in this study, c. difficile was isolated from 2 (0.3%) of 659 slaughtered pigs in korea. both isolates were characterized as ribotype 078 and were multidru ... | 2015 | 25951403 |
| inflammatory bowel disease: traditional knowledge holds the seeds for the future. | despite the level of sophistication they have reached nowadays, the available tools for treatment of inflammatory bowel disease (ibd) can at best chronicize the disease but not cure it. chances to make leap forward from this hold-back may include designs to reach personalized treatment strategies taking advantage of modern genome associated studies, and shift resources towards unfolding inciting pathogenetic steps rather than continuing to develop drugs that address down-stream phenomena. we hav ... | 2015 | 25949845 |
| dramatic reduction in clostridium difficile ribotype 027-associated mortality with early fecal transplantation by the nasogastric route: a preliminary report. | clostridium difficile ribotype 027 (cd027)-associated diarrhea preferentially affects elderly patients and causes a high mortality rate. fecal microbiota transplantation has become an alternative treatment for recurrent c. difficile infections. an outbreak of cd027 infections has occurred in marseille since march 2013. from march to november 2013, we treated patients using only antibiotics or fecal microbiota transplantation after at least three relapses. beginning in november 2013, we performed ... | 2015 | 25947205 |
| recurrent c. difficile in a patient with igg deficiency. | igg deficiency can predispose to recurrent pyogenic infections. the association of igg deficiency with clostridium difficile infection has been infrequently reported in the literature. we present a case of a middle-age woman with multiple hospitalizations for recurrent c. difficile in a short span of time which prompted consideration of a possible fecal transplant. on evaluation, she was found to have low total igg, with subclass analysis revealing low igg1 and igg3. she was started on monthly i ... | 2015 | 25945268 |
| molecular characterization and antimicrobial susceptibilities of clostridium difficile clinical isolates from victoria, australia. | some australian strain types of clostridium difficile appear unique, highlighting the global diversity of this bacterium. we examined recent and historic local isolates, finding predominantly toxinotype 0 strains, but also toxinotypes v and viii. all isolates tested were susceptible to vancomycin and metronidazole, while moxifloxacin resistance was only detected in recent strains. | 2015 | 25944720 |
| administration of spores of nontoxigenic clostridium difficile strain m3 for prevention of recurrent c. difficile infection: a randomized clinical trial. | clostridium difficile is the most common cause of health care-associated infection in us hospitals. recurrence occurs in 25% to 30% of patients. | 2015 | 25942722 |
| fecal microbiota transplant for clostridium difficile colitis-induced toxic megacolon. | 2015 | 25942309 | |
| effects of surotomycin on clostridium difficile viability and toxin production in vitro. | the increasing incidence and severity of infection by clostridium difficile have stimulated attempts to develop new antimicrobial therapies. we report here the relative abilities of two antibiotics (metronidazole and vancomycin) in current use for treating c. difficile infection and of a third antimicrobial, surotomycin, to kill c. difficile cells at various stages of development and to inhibit the production of the toxin proteins that are the major virulence factors. the results indicate that n ... | 2015 | 25941230 |
| mutations associated with reduced surotomycin susceptibility in clostridium difficile and enterococcus species. | clostridium difficile infection (cdi) is an urgent public health concern causing considerable clinical and economic burdens. cdi can be treated with antibiotics, but recurrence of the disease following successful treatment of the initial episode often occurs. surotomycin is a rapidly bactericidal cyclic lipopeptide antibiotic that is in clinical trials for cdi treatment and that has demonstrated superiority over vancomycin in preventing cdi relapse. surotomycin is a structural analogue of the me ... | 2015 | 25941217 |
| recognition of human milk oligosaccharides by bacterial exotoxins. | the affinities of the most abundant oligosaccharides found in human milk for four bacterial exotoxins (from vibrio cholerae and pathogenic escherichia coli) were quantified for the first time. association constants (ka) for a library of 20 human milk oligosaccharides (hmos) binding to shiga toxin type 2 holotoxin (stx2) and the b subunit homopentamers of cholera toxin, heat-labile toxin and shiga toxin type 1 (ctb5, hltb5 and stx1b5) were measured at 25°c and ph 7 using the direct electrospray i ... | 2015 | 25941008 |
| characterization of the dynamic germination of individual clostridium difficile spores using raman spectroscopy and differential interference contrast microscopy. | the gram-positive spore-forming anaerobe clostridium difficile is a leading cause of nosocomial diarrhea. spores of c. difficile initiate infection when triggered to germinate by bile salts in the gastrointestinal tract. we analyzed germination kinetics of individual c. difficile spores using raman spectroscopy and differential interference contrast (dic) microscopy. similar to bacillus spores, individual c. difficile spores germinating with taurocholate plus glycine began slow leakage of a ∼15% ... | 2015 | 25939833 |
| fecal microbiota transplantation for clostridium difficile infection: a systematic review. | the role of fecal microbiota transplantation (fmt) for clostridium difficile infection (cdi) is not well-known. | 2015 | 25938992 |
| whole-genome sequencing improves discrimination of relapse from reinfection and identifies transmission events among patients with recurrent clostridium difficile infections. | recurrent clostridium difficile infection (cdi) represents a significant healthcare challenge. patients may suffer multiple episodes of cdi with the index strain (relapse) or become infected by another strain acquired nosocomially (reinfection). | 2015 | 25935700 |
| clostridium difficile ribotype 078 cultured from post-surgical non-healing wound in a patient carrying ribotype 014 in the intestinal tract. | extra-intestinal infections caused by clostridium difficile are rare. the risk of extra-intestinal infections associated with c. difficile may be particularly relevant in environments contaminated with c. difficile spores. this paper describes the case of a non-diarrheic patient colonized with c. difficile ribotype 014 in the intestinal tract who developed a post-surgical wound infection by c. difficile ribotype 078. the infection responded to metronidazole administered first intravenously and t ... | 2015 | 25935201 |
| clostridium difficile pcr ribotype 018, a successful epidemic genotype. | clostridium difficile infection (cdi) became a public health problem for the global spreading of the so-called hypervirulent pcr ribotypes (rts) 027 and 078, associated with increases in the transmission and severity of the disease. however, especially in europe, several rts are prevalent, and the concept of hypervirulence is currently debated. we investigated the toxin and resistance profiles and the genetic relatedness of 312 c. difficile strains isolated in a large italian teaching hospital d ... | 2015 | 26041894 |
| a novel quantitative sampling technique for detection and monitoring of clostridium difficile contamination in the clinical environment. | the horizontal transmission of clostridium difficile in the hospital environment is difficult to establish. current methods to detect c. difficile spores on surfaces are not quantitative, lack sensitivity, and are protracted. we propose a novel rapid method to detect and quantify c. difficile contamination on surfaces. sponge swabbing was compared to contact plate sampling to assess the in vitro recovery of c. difficile ribotype 027 contamination (∼10(0), 10(1), or 10(2) cfu of spores) from test ... | 2015 | 26041892 |
| cloning and variation of ground state intestinal stem cells. | stem cells of the gastrointestinal tract, pancreas, liver and other columnar epithelia collectively resist cloning in their elemental states. here we demonstrate the cloning and propagation of highly clonogenic, 'ground state' stem cells of the human intestine and colon. we show that derived stem-cell pedigrees sustain limited copy number and sequence variation despite extensive serial passaging and display exquisitely precise, cell-autonomous commitment to epithelial differentiation consistent ... | 2015 | 26040716 |