Publications

chronic diarrhoea in dogs associated with clostridium difficile infection.		1986	3952954
pseudomembranous colitis in children and adults.	pseudomembranous colitis remains a potentially lethal complication of antibiotic usage. identification of clostridium difficile as the major pathogen has led to a rational successful approach to therapy and has widened the spectrum of associated disease. the frequent asymptomatic colonization of healthy neonates by c. difficile remains an enigma.	1986	3955286
significance of clostridium difficile and its cytotoxin in children.	stools of 147 children belonging to different age groups were examined for the presence of clostridium difficile, its cytotoxin and other enteric pathogens. none of the 31 full-term neonates, 5 (16%) of the 32 premature neonates, 27 (46%) of the 59 infants and 1 (4%) of the 25 older children excreted c. difficile in their stools. faecal cytotoxin was only detected in four infants (7%). there was no correlation with diarrhoea, previous antibiotic therapy, type of diet, or the concomitant presence ...	1986	3956538
recurrent clostridium difficile-associated colitis responding to cholestyramine.	we describe a patient with relapses of clostridium difficile cytotoxin-positive pseudomembranous colitis (pmc) after treatment with vancomycin, a course of metronidazole and a trial of bacitracin. she remains free of disease after a prolonged course of cholestyramine. we suggest there may be a role for anion-exchange resins in patients with pmc relapsing after vancomycin therapy.	1986	3956890
clostridium difficile in the normal adult faecal flora.	one hundred and seventy-seven out of 324 routine non-diarrhoeal faecal specimens investigated for the presence of clostridium difficile were culture-positive. twelve of the faecal specimens obtained from thirty-six normal healthy volunteers yielded cl. difficile prior to oral administration of clindamycin. thereafter all the volunteers excreted the organism from the second day to the fifth day during clindamycin administration. three months after stoppage of oral clindamycin sixteen of the thirt ...	1986	3031964
cytotoxic and cytotonic factors produced by campylobacter jejuni, campylobacter coli, and campylobacter laridis.	complete toxigenicity studies were performed on 341 strains of campylobacter spp., including 23 nonhuman isolates. toxin profiles based on both cytotonic and cytotoxic factors were determined after analyzing responses in vero, hela, cho and y-1 cells. suckling mouse assays were consistently negative for all culture filtrates tested. toxin-producing strains were frequently encountered among both the human and nonhuman strains of campylobacter jejuni, c. coli, and c. laridis investigated. strains ...	1986	3018039
inhibitory activity of fecal flora against the multiplication of clostridium difficile.		1986	3296983
care study--clostridium difficile: enteric spread of infection.		1986	3635777
[medical topics: clostridium difficile diarrhea of patients with chronic disease; rounded blood cells of runners].		1986	3650465
enterocolitis in hirschsprung's disease: a controlled study of the etiologic role of clostridium difficile.	cytopathic toxin neutralized by clostridium sordellii antiserum was found in the feces of seven out of 13 children with hirschsprung's disease complicated by enterocolitis (54%). clostridium difficile was isolated from ten of these 13 children (77%). the frequency of fecal toxin positivity, the magnitude of toxin titers, and the isolation rate of c difficile were all significantly greater in children with hirschsprung's enterocolitis than in children whose hirschsprung's disease was not complica ...	1986	3511213
gnotobiotic models for study of the microbial ecology of clostridium difficile and escherichia coli.	hamster flora introduced into germfree mice reduced the cecum to conventional size, suppressed populations of escherichia coli and clostridium difficile to the same degree that mouse flora did, and corrected the hypocellularity that is characteristic of the small bowel of germfree mice. a highly toxigenic strain of c. difficile readily induced cecitis in germfree and antibiotic-treated conventional mice, and histological examination frequently revealed pseudomembranes. toxins a and b were both d ...	1986	3512730
bacterial diarrhoea.	bacterial infections are important causes of diarrhoea in infants and children, particularly in developing countries and in other settings where standards of personal and community hygiene are low. knowledge of bacterial diarrhoeas has been significantly expanded in recent years by the finding that many episodes of acute diarrhoea are due to infections with bacteria which produce enterotoxins that interfere with intestinal fluid and electrolyte transport (the 'enterotoxigenic' diarrhoeas). sever ...	1986	3514008
effect of clindamycin on the ability of a continuous culture of colonic bacteria to ferment carbohydrate.	a continuous culture model of the proximal colon was used to study the effect of clindamycin on the ability of colonic bacteria to ferment carbohydrate. six steady state anaerobic cultures of human faeces, in a medium simulating ileostomy effluent, were treated with 26 micrograms/ml clindamycin. they were paired with six untreated cultures, run under identical conditions. clindamycin treatment eliminated the anaerobic bacteria, significantly decreased osmolality and the output of volatile fatty ...	1986	3514388
[transfer of the cecal flora of the hamster to the germfree c3h mouse: use of this model to study the flora of the anti-clostridium difficile barrier].	the purpose of this work was the research and development of an experimental model to study anti-clostridium difficile caecal microflora in the hamster. first the existence of this "barrier" was verified in conventional hamsters. then, the caecal flora from these animals was orally transferred to c3h germfree mice. the barrier effect was maintained in the axenic mice. the comparative bacteriological analysis of hamster and mouse feces did not reveal important variations in the dominant anaerobic ...	1986	3516351
considerations in the laboratory diagnosis of antibiotic-associated gastroenteritis.	clostridium difficile has been shown to be the major cause of antibiotic-associated gastroenteritis in both humans and experimental animals. during the past few years an increasing number of laboratories have attempted to detect, isolate, and identify this organism and its toxin from clinical samples. direct visualization of c. difficile in patient specimens using immunofluorescent microscopy has been proposed. the major disadvantage of this method was its lack of specificity due to crossreactio ...	1986	3516548
detection of clostridium difficile toxin a by immunoblotting.	a clinical isolate of clostridium difficile has been tested for its toxin production. both toxins, toxin a and toxin b, could be detected by tissue culture and in animal models as well. antibodies against a crude toxin a preparation have been prepared. these antibodies are able to neutralize the toxin both in the mouse lethality test and tissue culture test systems. the specificity of this antiserum has been analysed by electroimmunoprecipitation methods. using immunoblotting, it could be demons ...	1986	3518293
comparison of minitek anaerobe ii, api an-ident, and rapid ana systems for identification of clostridium difficile.	three commercial anaerobic systems, minitek (bbl microbiology systems, cockeysville, md), api an-ident (analytab products, plainview, ny), and rapid ana (innovative diagnostic systems, decatur, ga) were evaluated for ability to identify 45 clostridium difficile isolates accurately. minitek correctly identified 66% of c. difficile isolates to species, 27% were incompletely identified, and 7% were misidentified. most of the discrepancies with minitek were due to false negative biochemical results. ...	1986	3518405
[clostridium difficile-induced enterocolitis: pathogenesis, clinical course, epidemiology and laboratory diagnosis].	clostridium difficile-induced enterocolitis almost exclusively occurs associated with antibiotic exposure. the organisms produce several exotoxins of which toxins a (enterotoxin) and b (cytotoxin) are of primary importance. it is assumed that preceding antibiotic therapy creates an ecological niche allowing massive proliferation of the organisms and production of their toxins. the clinical course varies from mild diarrhoea to severe pseudomembranous colitis. patients over 40 years of age are pri ...	1986	3519433
antibiotic-associated colitis caused by clostridium difficile: relapse and risk factors.	relapse is a common sequel of antibiotic-associated colitis due to clostridium difficile. it has been suggested that cl. difficile may persist in the stools in spite of the resolution of symptoms after treatment and this may cause the relapse. our study was designed to define the factors that predispose to relapse and to determine if prolonging treatment to clear cl. difficile from the stools might prevent relapse. of 60 consecutive patients, 36 with more severe disease required treatment. treat ...	1986	3520264
oral bacitracin vs vancomycin therapy for clostridium difficile-induced diarrhea. a randomized double-blind trial.	the effectiveness of a ten-day course of either oral bacitracin or oral vancomycin hydrochloride for treatment of clostridium difficile-induced antibiotic-associated diarrhea was compared in a randomized double-blind study. bacitracin was as effective as vancomycin in resolving diarrhea; most patients responded within five days of therapy with either drug. three patients receiving bacitracin worsened during therapy; two of these were considered treatment failures. neither c difficile nor its tox ...	1986	3521518
clostridium difficile in habitats other than the human gastro-intestinal tract.		1986	3522751
review of clostridium difficile-associated diseases.	clostridium difficile has recently become recognized as an important nosocomial pathogen. this review summarizes what is known about the isolation of the organism, the spectrum of clinical disease, virulence factors, treatments, and methods of prevention. risk factors for c. difficile disease are also discussed. the most important risk factor is the use of certain antibiotics (ampicillin, cephalosporins, and clindamycin). c. difficile is associated with 96% to 100% of cases of pseudomembraneous ...	1986	3524319
[adverse effects of antimicrobiological agents and countermeasures--clostridium difficile enteritis: with special reference to early diagnosis].		1986	3531585
interaction of clostridium difficile and escherichia coli with microfloras in continuous-flow cultures and gnotobiotic mice.	we studied the interactions between the entire cecal flora of hamsters and the pathogens clostridium difficile and escherichia coli in gnotobiotic mice and in a continuous-flow (cf) culture system in which the growth medium consisted of an extract of fecal pellets from germfree mice. cf cultures and germfree mice were colonized first with c. difficile and e. coli and then with the cecal flora of hamsters. both in vivo and in vitro hamster flora markedly suppressed the potential pathogens. conten ...	1986	3533778
review of frequency-pulsed electron-capture gas-liquid chromatography studies of diarrheal diseases caused by members of the family enterobacteriaceae, clostridium difficile, and rotavirus.		1986	3533981
[isolation of clostridium difficile from the stools of hospitalized patients with diarrhea].	408 stool samples from 354 hospitalized patients with diarrhea were evaluated for the presence of clostridium difficile. c. difficile was detected in stools of 42 patients (12%), 19 of them being hospitalized in neurosurgery units. the strains were cytotoxigenic in 31 cases and non cototoxigenic in 11 cases. the diagnosis of c. difficile induced diarrhea was based on the clinical setting [presence of diarrhea that could be attributed to antimicrobial therapy and endoscopy for detection of pseudo ...	1986	3534766
[clostridium difficile--one of the causes of enterocolitis in man].		1986	3538722
diagnosis of clostridium difficile-associated intestinal disease.	toxigenic clostridium difficile is the major cause of antimicrobial agent-associated pseudomembranous colitis and is the etiological agent of approximately 30% of cases of nonspecific colitis and diarrhea (without colitis) induced by antimicrobial agents. in addition, c. difficile has been implicated in certain intestinal diseases not related to prior antimicrobial administration. c. difficile has been reported to be one of the most common enteropathogens isolated from stool specimens submitted ...	1986	3539522
[clostridium difficile and its cytotoxin in the stools of young hospitalized children. influence of antibiotic treatment].	clostridium difficile has been searched in 153 stool samples from 138 children aged 0 to 12 months. we divided the population in two groups depending on the antibiotic treatment. we have found c difficile in 39 samples (25%). the colonization rate increases with age ranging from 5% before 1 month, to 36% between 1 and 6 months and 54% between 6 and 13 months. an environmental sampling yielded once c difficile. contamination may be related to the environment. 29% of the isolates produced a cytopa ...	1986	3543815
lysosomal involvement in cellular intoxication with clostridium difficile toxin b.	the process of internalisation of clostridium difficile toxin b into human lung fibroblasts was further studied, with the aim of elucidating the fate of endocytosed toxin. development of the toxin-induced cytopathogenic effect was reversibly inhibited at 18 degrees c and in the presence of 200 mm kcl or 1-20 mm benzyl alcohol, i.e. at conditions when the fusion between endosomes and lysosomes is prevented. fibroblasts treated with toxin at 37 degrees c but transferred to 18 degrees c within 10 m ...	1986	3508493
cytotoxicity and antibiotic-associated diarrhea related to clostridium difficile.		1986	3465839
[implantation of a mutant of escherichia coli requiring diaminopimelic acid in the digestive tract of gnotobiotic mice].	a dap- auxotroph mutant of escherichia coli dp50 requiring dap and thymidine for growth was used as the receptor strain in genetic engineering. it failed to be implanted in axenic mice. however, when an inoculum containing more than 10(7) bacteria/ml was used, the dap+ reverse mutant devoid of requirement for dap became implanted. when axenic mice were previously associated with clostridium difficile containing dap in the cell wall, the strain dap- became implanted even when the inoculum was too ...	1986	3314677
ability of two clostridium difficile strains from man and hare to produce cytotoxin in vitro and in gnotobiotic rodent intestines.	cytotoxin production by human (vp1) and hare (fd) strains of clostridium difficile were compared both in vitro in a broth culture and in vivo in intestinal contents of gnotobiotic rodents. strain vp1 produced about 1,000 times more cytotoxin than the fd strain, both in vitro and in vivo, although the population levels of the two strains were not significantly different either in vitro or in vivo. ninety percent of gnotobiotic rats and 100% of gnotobiotic mice established with the vp1 strain died ...	1986	3435052
faecal metronidazole concentrations during oral and intravenous therapy for antibiotic associated colitis due to clostridium difficile.	faecal metronidazole and hydroxymetronidazole concentrations measured by high pressure liquid chromatography are reported during 10 episodes of clostridium difficile colitis in nine patients. bactericidal faecal concentrations were present in all patients with acute disease receiving oral or intravenous metronidazole, and all responded to therapy. metronidazole and hydroxymetronidazole concentrations fell as the diarrhoea improved and neither substance was detectable in the faeces of five patien ...	1986	3781329
comparison of serogrouping and polyacrylamide gel electrophoresis for typing clostridium difficile.	a typing scheme for clostridium difficile based on slide agglutination with rabbit antisera was previously described. it allows the differentiation of 10 serogroups designated a, b, c, d, f, g, h, i, k, and x. we studied the correlation between serogrouping and polyacrylamide gel electrophoresis (page) of whole-cell proteins. a total of 202 isolates from different sources were analyzed by page after ultrasonic disintegration of cells from an 18-h liquid culture and treatment with sodium dodecyl ...	1986	3782463
[clostridium difficile in the feces of children with and without diarrhea].		1986	3790227
a role for colonic stasis in the pathogenesis of disease related to clostridium difficile.	the records of 133 consecutive patients (65 men, 68 women; age range, 15 months to 88 years; median, 57 years) with either a positive clostridium difficile stool culture or toxin assay from 1982 to 1984 were reviewed in order to assess the pattern of this disease in a large hospital and to examine the type of patient at risk. all patients had diarrhea and/or bloody stools (121 and 36, respectively). less specific symptoms were common. most patients had been exposed to multiple antibiotics, but o ...	1986	3792161
evaluation of aztreonam, cefoperazone, latamoxef and ceftazidime in the hamster colitis model.	aztreonam, ceftazidime, cefoperazone and latamoxef (moxalactam) were evaluated in a hamster model for antibiotic-associated colitis. aztreonam, a novel monocyclic beta-lactam antibiotic specifically directed against aerobic gram-negative bacteria with limited activity against gram-positive and anaerobic bacteria did not cause haemorrhagic caecitis and death in hamsters when administered intraperitioneally or orally. quantitative caecal cultures showed no changes in the anaerobic caecal microflor ...	1986	3546243
anaerobic infections and clostridium difficile colitis emerging during antibacterial therapy.	almost all cases of clostridium difficile-related pseudomembranous colitis are related to antimicrobial therapy. virtually all antibacterial agents have been implicated, notable exceptions being vancomycin and parenterally administered aminoglycosides. the most prominent causes of colitis are ampicillin, clindamycin and various cephalosporins. in general, this complication is related to suppression of indigenous flora and overgrowth of c. difficile. in the case of ampicillin, however, c. diffici ...	1986	3547621
effect of beta-lactam prodrugs on human intestinal microflora.	the ampicillin prodrugs bacampicillin, pivampicillin, and talampicillin, the mecillinam prodrug pivmecillinam and the sulbactam prodrug sulbactam pivoxil all have a greatly improved oral availability compared to the parent drug. they show no antibacterial activity themselves until transformed into active drugs after absorption. this double advantage makes them less likely to influence the intestinal microbial ecosystem. ampicillin has been reported to cause marked changes in the colon microflora ...	1986	3547627
pharmacokinetic differentiation and consequences for normal microflora.	the pharmacokinetic properties of a drug are decisive for effective antibacterial therapy, the ability of the drug to reach a site of infection, but they also contribute to whether concentrations become undesirably high in places where the antibiotics are not wanted but where they may interfere with the normal microflora. the microflora in the intestines is particularly important because of the sheer numbers of bacteria present there and the consequences of imbalance such as diarrhoea and select ...	1986	3547629
successful pregnancy in a renal transplant recipient taking cyclosporin a.	a 27 year old woman with a fourth cadaveric renal transplant successfully completed a 33 week pregnancy whilst taking cyclosporin a and prednisolone. her renal function remained stable despite recurrent urinary tract infections, hypertension, gestational diabetes, and clostridium difficile associated diarrhea. the infant, delivered electively at 33 weeks, was small for gestational age but otherwise normal.	1986	3551903
[evaluation of an experimental animal model allowing the study of the cecal microflora in the hamster, antagonistic to clostridium difficile].	the purpose of this study was the development and evaluation of an experimental model allowing the investigation of hamster anti-clostridium difficile coecal microflora. the existence of this "barrier" was verified in conventional hamsters. such hamster coecal flora was then orally transferred to c3h germ-free mice. in such animals, the "barrier effect" was maintained. after treatment with erythromycin, the colonization resistance was always maintained; despite two subsequent processes, dilution ...	1986	3674782
prevalence of clostridium difficile in pseudomembranous and antibiotic-associated colitis in north india.		1986	3584906
isolation of clostridium difficile from various colonies of laboratory mice.	an attempt was made to isolate clostridium difficile from a total of 565 mice from nine different conventional mouse colonies and six different specified-pathogen-free mouse colonies. c. difficile was isolated from all the conventional colonies but from none of the specified-pathogen-free colonies. ampicillin injected intraperitoneally increased the isolation rate of c. difficile from mouse faeces to 63.6% compared with 19.4% from untreated mice.	1986	3795866
antibiotic depression of evoked and spontaneous responses of opossum distal colonic muscularis mucosae in vitro: a factor in antibiotic-associated colitis?	certain antibiotics depress both skeletal neuromuscular transmission and intestinal neuroeffector transmission. impaired intestinal motility may facilitate the proliferation of the bacterium clostridium difficle and thus lead to the development of antibiotic-associated pseudomembranous colitis. many antibiotics accumulate in the colonic lumen at concentrations several times their associated blood levels. this study examined whether certain of these could interfere with colonic muscularis mucosal ...	1985	2982696
a comparison of the effects of cytotoxic cerebrospinal fluid on cell cultures with other cytopathogenic agents.	protein synthesis, antigen synthesis, and cell membrane permeability were analyzed after inoculating human diploid fibroblasts with control or cytotoxic csf, herpes simplex virus type 1 (hsv 1), poliovirus 3, or clostridium difficile toxin. whereas protein synthesis and membrane permeability were affected by the viruses, and virus antigens detectable by pooled human serum were synthesized, the bacterial toxin and cytotoxic csf did not induce any new proteins or antigens, although the cytotoxic c ...	1985	2987025
pharmacokinetic and therapeutic trial of sultamicillin in acute sinusitis.	sultamicillin, an antibiotic combining ampicillin and the beta-lactamase inhibitor sulbactam, was administered to 13 patients diagnosed as having acute sinusitis. specimens from sinus were obtained for all 13 patients by transantral puncture. pharmacokinetics, bacteriology, and therapeutic efficacy were assessed. eighty-five percent (11 of 13) were cured; two treatment failures were subsequently shown to have chronic (rather than acute) sinusitis during surgical exploration. diarrhea was frequen ...	1985	3002247
susceptibility of clostridium difficile strains to new antibiotics: quinolones, efrotomycin, teicoplanin and imipenem.		1985	3159714
etiology of acute infectious diarrhea in a highly industrialized area of switzerland.	during an 18-mo period between 1981 and 1982, a prospective study was conducted in 119 adult patients with acute diarrhea. a diarrhea-inducing microorganism or toxin could be identified in 38.7% of the patients. salmonella sp and campylobacter jejuni were the leading agents that caused diarrheal illness in 25% of the investigated population. clostridium difficile was found in 6%, mainly after previous antibiotic therapy. rotavirus was rarely isolated and enterotoxigenic escherichia coli were not ...	1985	3964774
clinical and endoscopic findings in patients early in the course of clostridium difficile-associated pseudomembranous colitis.	endoscopic and clinical features are reported for 39 patients detected early in the course of pseudomembranous colitis. disease was detected early by virtue of careful surveillance in patients in whom diarrhea developed. early proctosigmoidoscopic findings in pseudomembranous colitis are illustrated. clinical presentation includes development of fever, leukocytosis, abdominal pain, and even an ileus picture on radiography in addition to diarrhea.	1985	3966488
pseudomembranous colitis following prophylactic antibiotic use in primary cesarean section.	a report of a hospital outbreak of pseudomembranous colitis in three patients given prophylactic antibiotic therapy before and after primary cesarean section is presented. all patients shared the same ward and labor and delivery room, and the colitis occurred within an 8-day period. the diagnosis of pseudomembranous colitis was suspected clinically and confirmed by limited colonoscopy and biopsy followed by stool culture and toxin assay for clostridium difficile. the high carrier rate of clostri ...	1985	3966512
monoclonal and specific polyclonal antibodies for immunoassay of clostridium difficile toxin a.	monoclonal antibody, affinity-purified antibody, and monospecific antiserum against toxin a were produced. the monoclonal antibody was an immunoglobulin g2a kappa chain isotype that immunoprecipitated toxin a, as shown by crossed immunoelectrophoresis. these antibodies were compared by counterimmunoelectrophoresis, latex agglutination, and indirect enzyme-linked immunosorbent assay for their sensitivity in detecting toxin a. our findings indicate that these antibodies may be useful as immunodiag ...	1985	3968199
improved gas-liquid chromatography method for the identification of clostridium difficile.		1985	3968205
gas chromatographic identification of clostridium difficile and detection of cytotoxin from a modified selective medium.	a modification of an existing selective medium for clostridium difficile is described. inclusion in the medium of dl nor-leucine and p-hydroxyphenylacetic acid enables identification of c difficile to be made directly from primary isolation plates by gas chromatographic detection of caproic acid and p-cresol. plugs of agar withdrawn from the selective medium also allow the detection of cytotoxin production in vitro.	1985	3968212
effect of antibiotic concentration in a selective medium on the isolation of clostridium difficile from faecal specimens.		1985	3968221
population dynamics of ingested clostridium difficile in the gastrointestinal tract of the syrian hamster.	the population dynamics of clostridium difficile in the hamster gastrointestinal tract were studied after intragastric inoculation with organisms and a 51cr tracer. seventy-eight percent of spores germinated within the small intestine within 1 hr. germinated spores and vegetative cells both showed two phases of elimination from the hamster cecum--an initial phase of rapid death that was not affected by antibiotic treatment followed by a phase of complete inhibition of multiplication. the latter ...	1985	3968453
interaction between penicillin, clindamycin or metronidazole and gentamicin against species of clostridia and anaerobic and facultatively anaerobic gram-positive cocci.	seven anaerobic and facultative gram-positive cocci and 12 clostridial species were tested for in-vitro and in-vivo susceptibilities to penicillin, clindamycin, and metronidazole, used singly or in combination with gentamicin. the in-vitro tests consisted of determination of minimal inhibitory concentration (mic), done without or with constant amounts of gentamicin. when used alone or in combination with penicillin or metronidazole, gentamicin had negligible effects on the bacteria. when used wi ...	1985	3972757
two bacteriophages of clostridium difficile.	two temperate bacteriophages of differing morphology and host range were isolated by screening 94 isolates of clostridium difficile. phage 41 had a 300-nm flexible tail, whereas phage 56 had a shorter tail with a contractile sheath. electron microscopy of phage 56 lysates exposed to elevated magnesium concentrations showed small virus-like particles which were 21 nm in diameter. the addition of mgcl2 to semisolid agar overlays enhanced both the titer and plaque size of phage 56. phage 56 was mor ...	1985	3972994
antimicrobial agents and clostridium difficile in acute enteric disease: epidemiological data from sweden, 1980-1982.	the carrier rate of clostridium difficile in an adult swedish population was found to be 11 (1.9%) of 594. all isolates were toxigenic in vitro, but no healthy individual harbored free cytotoxin in stool. of 398 patients with acute diarrhea not associated with antibiotic use, cytotoxin was found in stool filtrates of four (1%). in 4,793 patients with antibiotic-associated diarrhea from all parts of sweden during 1980-1982, c. difficile cytotoxin was demonstrated in 873 (18%). the tissue culture ...	1985	3973405
indium-111 leukocyte imaging in colitis induced by clostridium difficile.		1985	3973743
modulation of cytotoxin production by clostridium difficile in the intestinal tracts of gnotobiotic mice inoculated with various human intestinal bacteria.	gnotobiotic mice died 2 days after inoculation of a cytotoxigenic clostridium difficile strain. protection occurred when mice were previously inoculated with a strain of escherichia coli or bifidobacterium bifidum. intestinal cytotoxin production was highly reduced in the surviving mice, whereas the c. difficile population level did not decrease to a great extent.	1985	3977313
serogrouping of clostridium difficile strains by slide agglutination.	six different agglutinating antisera were obtained by immunizing rabbits with formol-treated strains of clostridium difficile. after appropriate absorption, these antisera were used to define six serogroups designated by the letters a, b, c, d, f, and g. altogether, 315 strains of c. difficile from various origins were tested for slide agglutination by these antisera; 312 (99%) of them were agglutinated by one of these antisera. a and c were the most common serogroups. an excellent correlation, ...	1985	3980688
detection of clostridium difficile enterotoxin in neonates by latex agglutination.	clostridium difficile enterotoxin (d-1) was detected in 13 symptomatic and nine asymptomatic neonates in the neonatal intensive care unit by latex agglutination test but was not found in 18 healthy neonates in two other newborn nurseries. environmental contamination in the intensive care unit may have been the cause. an association between the presence of enterotoxin and clinical symptoms is discussed.	1985	3985657
effect of adding sodium taurocholate to selective media on the recovery of clostridium difficile from environmental surfaces.	the recovery of clostridium difficile on a medium containing cefoxitin, cycloserine, fructose, and egg yolk was compared with that on media containing one of three preparations of sodium taurocholate. in aerobic environments contaminated with c. difficile, media containing either crude taurocholate from mann research laboratories, new york, n.y., or pure taurocholate from sigma chemical co., st. louis, mo., recovered organisms significantly more often than did cefoxitin-cycloserine-fructose-egg ...	1985	3988904
ceftriaxone: pharmacokinetics and effect on the intestinal microflora in patients with acute bacterial infections.	12 patients with acute bacterial infections were treated with ceftriaxone, 1.5 g intravenously twice daily for 7-13 days. pharmacokinetic variables were studied in 11 patients. in older subjects, serum half-lives were longer and serum clearances lower than in younger individuals. after the last dose, a larger increase in auc compared to the first dose was observed in older patients and a biphasic elimination curve appeared in all patients but 2, with a terminal half-life of 15.6 h and 11.4 in ol ...	1985	3992209
antibiotic-associated pseudomembranous colitis.	all antibiotics, except parenteral aminoglycosides, sulfonamides and vancomycin, can induce pseudomembranous colitis. the worst offenders are clindamycin, ampicillin, amoxicillin and the cephalosporins. the cytotoxin produced by clostridium difficile has been identified as the cause of pseudomembranous colitis. treatment includes an antimicrobial to eradicate the organism and cholestyramine or colestipol to bind the toxin.	1985	3993509
effect of l-cysteine on the activity of penicillin antibiotics against clostridium difficile.	we observed elevated mics of penicillin antibiotics while performing agar dilution susceptibility testing of strains of clostridium difficile on supplemented brain heart infusion agar, an effect which was completely eliminated by the exclusion of l-cysteine from the medium. l-cysteine antagonizes the activity of penicillins against c. difficile, most likely by direct inactivation of the antibiotic.	1985	3994352
pseudomembranous colitis in spinal cord injury.	pseudomembranous colitis is a well-known disease associated with antibiotic administration and caused by the clostridium difficile toxin. clinical presentation is usually marked by watery diarrhea, crampy abdominal pain, and fever. since early appropriate therapy can reduce morbidity and mortality, it is important for health care professionals to be aware of this disease. patients with spinal cord injury have a relatively high incidence of respiratory and urinary tract infections that are treate ...	1985	4004539
enzyme immunoassay for detection of clostridium difficile toxins a and b in patients with antibiotic-associated diarrhoea and colitis.	a sandwich enzyme immunoassay (elisa) was developed to detect clostridium difficile toxins a and b in stools from patients with antibiotic associated diarrhoea and colitis. immune serum to crude clostridium difficile toxin and non-immune serum were coated onto polystyrene microtiter plates to act as capture antibodies; toxins a and b in human stools were detected by antibodies from rabbits immunized with purified toxins a and b. the elisa for toxin b showed cross-reactions with clostridium bifer ...	1985	4006928
enrichment media for isolation of clostridium difficile from faeces.		1985	4006930
evaluation of gas-liquid chromatography for the rapid diagnosis of clostridium difficile associated disease.	direct gas-liquid chromatography of faecal specimens with isocaproic acid as a marker was used for the rapid diagnosis of clostridium difficile associated diarrhoeal diseases. ninety stools were examined and results were compared with conventional culture on selective medium and cytotoxin assay in tissue culture. using a combined analysis of isocaproic acid and butyric acid peak heights we defined three categories: positive, negative, and indeterminate. when the indeterminate group was excluded, ...	1985	4008667
clostridium difficile-associated diarrhoea.		1985	4008969
protection of hamsters against clostridium difficile ileocaecitis by prior colonisation with non-pathogenic strains.	prior colonisation of clindamycin-treated hamsters with non-toxigenic strains of c. difficile protected them from subsequent colonisation with a toxigenic pathogenic strain. in total, 13 of 18 'protected' hamsters survived for up to 27 days whereas all 27 animals challenged with the toxigenic strain alone died within 48 h. protection was not evident if a heat-killed suspension was used or if the colonising non-toxigenic strain was first removed with vancomycin. no antitoxic activity could be det ...	1985	4009689
germinability and heat resistance of spores of clostridium difficile strains.	out of 111 clostridium difficile strains, 108 produced spores in numbers of more than 10(5)/ml and the remaining three did not produce any spores in brain heart infusion medium. the germination frequency in the medium without lysozyme varied widely from strain to strain, ranging from less than 10(-8) to 10(0), and in 77 of the 108 strains the germination frequency was 10(-5) or less. the spores, when treated with sodium thioglycollate and then inoculated into the medium containing lysozyme, germ ...	1985	4010539
[the role of clostridium difficile in antibiotic-associated enteritis].		1985	4010560
evaluation and diagnosis of acute infectious diarrhea.	the appropriate approach to the diagnosis and management of acute infectious diarrhea is determined by the frequency and setting of the illness, the recognizable causes or syndromes, the cost and yield of available diagnostic tests, and the treatability of the disease. acute diarrhea affects everyone throughout the world from one to more than six times each year, depending on age, location, and living conditions. the range of identifiable viral, bacterial, and parasitic etiologies is great, and ...	1985	4014291
in vitro activity of sch 34343 and cefbuperazone against anaerobic bacteria.	the in vitro activities of sch 34343, a new penem antibiotic, and cefbuperazone, a new cephamycin antibiotic, were determined against 459 clinical anaerobic bacterial isolates and compared with the activities of imipenem and cefoxitin, respectively, by an agar dilution method. both penems showed potent and similar activity against all anaerobic bacteria tested, particularly peptococcus spp., bacteroides fragilis, and clostridium perfringens. all organisms except a single strain of fusobacterium ...	1985	4015069
production of toxins a and b by clostridium difficile strains isolated from infants and adults.		1985	4015295
effect of filtrate containing clostridium difficile toxin on rectal mucosa maintained in organ culture.	rectal biopsies were maintained in organ culture over a 24-hour culture period, with good preservation of histological architecture. a filtrate containing clostridium difficile toxin significantly inhibited the rise in epithelial alkaline phosphatase activity normally seen during culture. this effect was abolished by pre-incubation of the filtrate with clostridium sordellii antitoxin, or heat inactivation. this effect is most probably due to a toxin of c. difficile. the method provides a new qua ...	1985	4018440
experimental models of clostridium difficile enterocolitis in gnotobiotic mice.		1985	4022975
kinetics of cytotoxin production in feces of gnotobiotic mice and rats associated with two strains of clostridium difficile.		1985	4022976
clostridium difficile in patients with cystic fibrosis.	one hundred seven patients with cystic fibrosis (cf) and 54 other patients with risk factors for clostridium difficile-associated disease were entered into a bacteriologic study to compare the rate of recovery of c difficile and cytotoxin in feces with occurrence of diarrhea and to investigate potentially protective or permissive relationships of fecal flora. toxigenic c difficile was recovered from 22% of cf patients and 11% of patients with other diagnoses. unlike the latter group, the majorit ...	1985	4025261
activity of a peptidyl prodrug, alafosfalin, against anaerobic bacteria.	alafosfalin, an antibacterial phosphonodipeptide requiring peptide transport for activity, was tested for activity against clinical strains of anaerobic bacteria in peptide-free roche sensitivity test medium no. 5 agar. it was active against bacteroides spp., fusobacterium nucleatum, and clostridium perfringens but not against clostridium difficile. alafosfalin activity was antagonized by appropriate peptides. synergy was obtained with other cell wall-active antibiotics.	1985	4026269
clostridium difficile colitis following head and neck surgery. report of cases.	clostridium difficile, a toxin-producing, gram-positive anaerobe, has been implicated as the causative agent of pseudomembranous colitis, an acute inflammatory bowel disease that generally occurs in association with antimicrobial therapy. this subject has received extensive review in the general surgical, medical, and pediatric literature but has not been specifically addressed in the literature of our specialty. we present the report of four recent cases, including one that progressed to the cl ...	1985	4026668
pseudomembranous colitis and wound infection following perioperative use of multiple antibiotics.	the prophylactic use of antibiotics in elective surgery of the colon is accepted practice, but it has inherent risks. the authors report the case of a 70-year-old woman who had wound infection and severe, relapsing pseudomembranous colitis due to clostridium difficile after a short course of antibiotics given orally and parenterally at the time of elective resection of the colon. perioperatively, she received erythromycin base and neomycin orally, plus netilmicin and metronidazole intravenously. ...	1985	4027790
studies with temocillin in the hamster model of antibiotic-associated colitis.	the studies reported here were designed to ascertain whether or not the new beta-lactam antibiotic, temocillin, would produce antibiotic-associated colitis in the hamster. the experiments were controlled with clindamycin and cefoxitin, which are known to induce antibiotic-associated colitis experimentally and clinically. all three antibiotics were administered to groups of animals both parenterally and orally. clindamycin, at 1 mg/hamster, caused a slow onset of antibiotic-associated colitis by ...	1985	4029030
serum antibody response to clostridium difficile toxins in patients with clostridium difficile diarrhoea.	consecutive serum samples from 61 patients with clostridium difficile diarrhoea were investigated for antibody response to c. difficile toxins a and b in an indirect enzyme immunoassay (elisa) and in a neutralization assay against c. difficile cytotoxin. sera from 64 blood donors, elderly healthy females and patients with other known intestinal enteropathogens served as controls. an immune response was detected by elisa in approximately half of the patients with c. difficile diarrhoea. the speci ...	1985	4030111
comparative in-vitro activity of sch 34343 for a wide spectrum of clinically significant anaerobic bacteria.	one hundred and fifty strains of anaerobic bacteria including 45 bacteroides, 19 fusobacteria, 41 cocci, 34 clostridia, and 11 gram-positive non-sporeforming rods were tested by agar dilution for their susceptibilities to cefoxitin, cefuroxime, latamoxef (moxalactam), penicillin g, chloramphenicol, clindamycin, metronidazole and sch 34343. excluding the 34 clostridia, 115 of the 116 remaining strains were inhibited by less than or equal to 1 mg/l of sch 34343. one isolate of bacteroides fragilis ...	1985	4030546
spontaneous pseudomembranous colitis not associated with clostridium difficile.	this paper describes two patients who developed macroscopically and microscopically typical pseudomembranous colitis without prior exposure to antimicrobial agents and without detectable clostridium difficile or its toxin in the faeces.	1985	4031517
[incidence of diarrhea caused by toxin-producing clostridium difficile in hungary].		1985	4034181
identification of clostridium difficile by detection of p-cresol in a cooked meat medium.		1985	4043071
antibiotic-associated colitis due to clostridium difficile: double-blind comparison of vancomycin with bacitracin.	a randomized double-blind study was carried out in patients with unresolving antibiotic-associated colitis due to clostridium difficile, to compare the effect of bacitracin (80,000 u/day) with vancomycin (500 mg/day) on the resolution of symptoms, clearance of organism, and prevention of relapse. forty-two patients with colitis, 9 of whom had a pseudomembrane, were randomized, 21 patients to each treatment group. the two groups were comparable in age, disease severity, and antibiotic exposure. f ...	1985	4043661
superinfections during antimicrobial treatment with betalactam-aminoglycoside combinations in neutropenic patients with hematologic malignancies.	the frequency, etiology and risk factors of superinfections during and/or within one week after antibiotic therapy with betalactam-aminoglycoside combinations were evaluated in 631 patients with hematologic malignancies admitted to the institute of hematology of rome from january 1982 to december 1984. 356 patients (56%) developed 402 episodes of proven or presumed infection. of these patients, 78 developed 102 superinfections. overall, superinfections responded less satisfactorily to antibiotic ...	1985	4055041
survey of neuraminidase production by clostridium butyricum, clostridium beijerinckii, and clostridium difficile strains from clinical and nonclinical sources.	neuraminidase production was investigated in 57 clostridium butyricum strains, 16 clostridium beijerinckii strains, and 25 clostridium difficile strains. neuraminidase activity was found only in c. butyricum strains originating from one human newborn with neonatal necrotizing enterocolitis, two newborns with hemorrhagic colitis, one infected placenta, and one adult with peritonitis, it was concluded that neuraminidase was not a major virulence factor in c. butyricum strains.	1985	4056013
clostridium difficile and clostridium perfringens in upper gut of infants with protracted diarrhoea.		1985	4056073
[disorders of intestinal flora in intensive care patients].	the intestinal flora under normal conditions prevents colonisation of the intestinal mucosa with pathogenic bacteria. various diseases as well as antibiotics may disturb the host/bacteria balance. if patients are in addition immunocompromised, otherwise commensal bacteria may cause life threatening infections. treatment of intensive care patients with antibiotics thus should account for preservation of resistance against colonization. antibiotics active against anaerobes or poorly absorbed from ...	1985	4058231
clostridium difficile colitis associated with single-dose cefazolin prophylaxis.	diarrhea and pseudomembranous colitis are associated with antimicrobial therapy and prophylaxis. clostridium difficile colitis occurred in a patient who received a single dose of cefazolin for prophylaxis at cesarean section. prompt remission occurred after treatment with oral vancomycin.	1985	4058831
chronic diarrhea associated with hypogammaglobulinemia and enteropathy in infants and children.	in order to define the gastrointestinal manifestations and small intestinal structure and function in a group of infants with chronic nonspecific diarrhea and hypogammaglobulinemia, we retrospectively identified 55 such patients from a population of 518 children evaluated for chronic diarrhea over a 6-year span (10.6%). all patients had igg levels 2.0 sd or more below the mean values for age. patients with biochemical evidence of protein loss (enteropathy or nephropathy) were excluded. there was ...	1985	4064865
identification of clostridium difficile using the api zym system.	the use of the api zym system for the identification of clostridium difficile was investigated. the enzyme profiles generated by this system readily distinguished strains of clostridium difficile from other clostridia commonly isolated from faeces. enzyme activity of clostridium difficile was influenced by the composition of the culture medium but appeared to be independent of the age of the culture. given careful standardisation of techniques the api zym system is a suitable alternative to conv ...	1985	4065138