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inflammatory bowel disease: a descriptive study of 716 local chilean patients.to demographically and clinically characterize inflammatory bowel disease (ibd) from the local registry and update data previously published by our group.201627298570
maldi-tof ms is more accurate than vitek ii anc card and api rapid id 32 a system for the identification of clostridium species.all 50 clostridium difficile strains were definitely identified by vitek2 system, rapid id 32a system, and maldi-tof. for 18 non-difficile clostridium strains, the identification results were correct in 0, 2, and 17 strains by vitek2, rapid id 32a, and maldi-tof, respectively. maldi-tof could be used as the primary tool for identification of clostridium species.201627296834
pleural empyema caused by salmonella enteritidis in a patient with non-hodgkin lymphoma.extraintestinal manifestations of nontyphoidal salmonellosis are usually seen in patients with cellular immunodeficiency. pleural empyema caused by nontyphoidal salmonella is very rare clinical presentation of salmonellosis and there are just a few cases described in a literature. we presented a very rare case of pleural empyema caused by salmonella enteritidis in a patient with non-hodgkin limphoma.201627295915
development and validation of a risk score for clostridium difficile infection in medicare beneficiaries: a population-based cohort study.to create a risk stratification score for clostridium difficile infection (cdi) in elderly adults.201627295521
zoonotic potential of the clostridium difficile rt078 family in taiwan.clostridium difficile is the major cause of nosocomial diarrhea. we have previously demonstrated that in southern taiwan, severe c. difficile-associated diarrhea (cdad) cases were due to the c. difficile rt 126 strain infection, indicating the arrival of an epidemic c. difficile clone in southern taiwan. rt126 has a close genetic relationship with rt078. however, the rt078 family is the predominant strain of c. difficile in animals worldwide, particularly in swine. in this study, we surveyed c. ...201627292030
clostridium difficile ribotype 027 is not evenly distributed in hesse, germany.clostridium difficile-isolates associated with cdi in different healthcare facilities in hesse were analysed. the most common ribotypes were 001 (31.1%) and 027 (27.0%). the proportion of ribotype 027 among regional c. difficile-isolates was 10.8% in north hesse, 17.2% in middle hesse, and 33.5% in the rhine-main metropolitan area. in the latter region, ribotype 027 was the most prevalent ribotype.201627063988
neutrophil-mediated inflammation in the pathogenesis of clostridium difficile infections.clostridium difficile is the most important cause of nosocomial infectious diarrhea in the western world. c. difficile infections are a major healthcare burden with approximately 500,000 new cases every year and an estimated annual cost of nearly $1 billion in the u.s. furthermore, the infections are no longer restricted to health care facilities, and recent studies indicate spread of c. difficile infection to the community as well. the clinical spectrum of c. difficile infection ranges from asy ...201627063896
a cost-effectiveness and budget impact analysis of first-line fidaxomicin for patients with clostridium difficile infection (cdi) in germany.clostridium difficile infection (cdi) represents a significant economic healthcare burden, especially the cost of recurrent disease. fidaxomicin produced significantly lower recurrence rates and higher sustained cure rates in clinical trials. we evaluated the cost-effectiveness and budget impact of fidaxomicin compared with vancomycin in germany in the first-line treatment of patient subgroups with cdi at increased risk of recurrence.201627062378
australasian society of infectious diseases updated guidelines for the management of clostridium difficile infection in adults and children in australia and new zealand.the incidence of clostridium difficile infection (cdi) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. the treatment of c. difficile is a challenge for community and hospital-based clinicians. with the advent of an expanding therapeutic arsenal against c. difficile since the last published australasian guidelines, an update on cdi treatment recommendations for australasian clinicians was required. on behalf of the aus ...201627062204
an experimental platform using human intestinal epithelial cell lines to differentiate between hazardous and non-hazardous proteins.human intestinal epithelial cell lines (t84, caco-2, and hct-8) grown on permeable transwell™ filters serve as models of the gastrointestinal barrier. in this study, this in vitro model system was evaluated for effectiveness at distinguishing between hazardous and non-hazardous proteins. indicators of cytotoxicity (ldh release, mtt conversion), monolayer barrier integrity ([(3)h]-inulin flux, horseradish peroxidase flux, trans-epithelial electrical resistance [teer]), and inflammation (il-8, il- ...201627060235
age and gender differences in clostridium difficile-related hospitalization trends in madrid (spain) over a 12-year period.this study aimed to analyze temporal trends by gender and age in clostridium difficile infection (cdi)-related hospitalization rates in the autonomous community of madrid (spain) over a 12-year period. a population-based cross-sectional study of all hospital admissions with a cdi diagnosis from 2003 to 2014 was carried out. annual age-specific hospitalization rates were calculated by gender. all the analyses were performed separately for total hospitalizations and hospitalizations with cdi as th ...201627056555
identification of clostridium difficile rt078 from patients and environmental surfaces in zhejiang province, china. 201627052780
regulation of protein-ligand binding affinity by hydrogen bond pairing.hydrogen (h)-bonds potentiate diverse cellular functions by facilitating molecular interactions. the mechanism and the extent to which h-bonds regulate molecular interactions are a largely unresolved problem in biology because the h-bonding process continuously competes with bulk water. this interference may significantly alter our understanding of molecular function, for example, in the elucidation of the origin of enzymatic catalytic power. we advance this concept by showing that h-bonds regul ...201627051863
recurrent pseudomembranous colitis in an ovarian cancer patient undergoing carboplatin chemotherapy.background. diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and clostridium difficile infection has been identified as a cause. the proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe clostridium difficile infection (cdi). case. we present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. despite tr ...201627051544
screening glycolipids against proteins in vitro using picodiscs and catch-and-release electrospray ionization-mass spectrometry.this work describes the application of the catch-and-release electrospray ionization-mass spectrometry (car-esi-ms) assay, implemented using picodiscs (complexes comprised of saposin a and lipids, pds), to screen mixtures of glycolipids (gls) against water-soluble proteins to detect specific interactions. to demonstrate the reliability of the method, seven gangliosides (gm1, gm2, gm3, gd1a, gd1b, gd2, and gt1b) were incorporated, either individually or as a mixture, into pds and screened against ...201627049760
use of probiotics in prevention and treatment of patients with clostridium difficile infection.clostridium difficile is an anaerobic, gram positive, sporulating, toxin-producing bacillus which causes a spectrum of clinical disease ranging from an asymptomatic carrier state to toxic megacolon and fulminant disease. infection with c. difficile is an expensive and pervasive health care burden. the current theory regarding the development of c. difficile infection (cdi) suggests that disruption of the structure and/or function of an individual's normal intestinal microbiota enables colonizati ...201627048902
patient perspectives on fecal microbiota transplantation for clostridium difficile infection.clostridium difficile infection (cdi) is a severe and increasingly frequent healthcare-associated infection that develops after disruption of the gut microbiota. immunocompromised, hospitalized patients have an increased likelihood of acquiring cdi, leading to lengthened hospital stays, increased medical fees, and higher rates of morbidity and mortality. treatment of cdi is challenging because of limited treatment options and a 19-20% recurrence rate. thus, there is a need for effective, afforda ...201627048199
pathogenic effects of glucosyltransferase from clostridium difficile toxins.the glucosyltransferase domain ofclostridium difficiletoxins modifies guanine nucleotide-binding proteins of rho family. it is the major virulent domain of the holotoxins. various pathogenic effects ofc. difficiletoxins in response to rho glucosylation have been investigated including cytoskeleton damage, cell death and inflammation. the most recent studies have revealed some significant characteristics of the holotoxins that are independent of glucosylating activity. these findings arouse discu ...201627044305
use your antibiotics wisely. consequences to the intestinal microbiome.antibiotic therapy has long term consequences in the intestinal microbiome. clostridium difficile has a well-known role in antibiotic-associated diarrhea, but in addition, persistent infection with this organism may increase the risk for developing inflammatory bowel disease. here, recent literature on how the intestinal microbiome is altered by antibiotic therapy is presented.201627044298
ega protects mammalian cells from clostridium difficile cdt, clostridium perfringens iota toxin and clostridium botulinum c2 toxin.the pathogenic bacteria clostridium difficile, clostridium perfringens and clostridium botulinum produce the binary actin adp-ribosylating toxins cdt, iota and c2, respectively. these toxins are composed of a transport component (b) and a separate enzyme component (a). when both components assemble on the surface of mammalian target cells, the b components mediate the entry of the a components via endosomes into the cytosol. here, the a components adp-ribosylate g-actin, resulting in depolymeriz ...201627043629
antimicrobial susceptibility of clostridium difficile isolated from food animals on farms.clostridium difficile is commonly associated with a spectrum of disease in humans referred to as c. difficile-associated disease (cdad) and use of antimicrobials is considered a risk factor for development of disease in humans. c. difficile can also inhabit healthy food animals and transmission to humans is possible. as a result of the complexity and cost of testing, c. difficile is rarely tested for antimicrobial susceptibility. a total of 376 c. difficile strains (94 each from swine and dairy ...201627043382
economic evaluation of fecal microbiota transplantation for the treatment of recurrent clostridium difficile infection in australia.clostridium difficile is the most common cause of hospital-acquired diarrhea in australia. in 2013, a randomized controlled trial demonstrated the effectiveness of fecal microbiota transplantation (fmt) for the treatment of recurrent clostridium difficile infection (cdi). the aim of this study is to evaluate the cost-effectiveness of fecal microbiota transplantation-via either nasoduodenal or colorectal delivery-compared with vancomycin for the treatment of recurrent cdi in australia.201627043242
reproducible elimination of clostridium difficile spores using a clinical area washer disinfector in 3 different health care sites.following a clostridium difficile infection outbreak, the infection prevention and control team at our institution queried the risk of transmission via bedpans reprocessed in washer disinfectors (wds). this study's objective was to determine the effectiveness of the mechanical action, detergent, and temperature on the eradication of c difficile spores in 1 type of wd model.201627040564
community-acquired clostridium difficile infections.to describe the management and treatment of community-acquired c. difficile infections (cdi) and to evaluate family physicians' (fp) knowledge and practice.201627039068
fulminant pseudomembranous colitis presenting as sigmoid stricture and severe polyposis with clinical response to intracolonic vancomycin.clostridium difficile infection (cdi) is the most common cause of antibiotic-associated diarrhea. severe diseases carry significant morbidities such as septic shock, acute kidney injury, bowel perforation, and mortality. immunocompromising conditions increase the risk of developing the disease but whether these individuals suffer a more fulminant course or warrant a more potent first-line treatment is still controversial issue. hereby we report a case of a cirrhotic patient with life-threatening ...201627034681
prebiotics and age, but not probiotics affect the transformation of 2-amino-3-methyl-3h-imidazo[4,5-f]quinoline (iq) by fecal microbiota - an in vitro study.heterocyclic aromatic amines (haas) are carcinogens which are formed in meat cooked using high-temperature methods. the human gastrointestinal (gi) microbiota plays a crucial role in maintaining health in humans of different ages, and especially in the elderly. however, the gi microbiota, whose metabolism and composition changes with age, may also be responsible for the activation of mutagenic substances reaching the colon with diet. probiotics and prebiotics are promising in terms of reducing t ...201627034248
proton-pump inhibitors adverse effects: a review of the evidence and position statement by the sociedad española de patología digestiva.in the last few years a significant number of papers have related the use of proton-pump inhibitors (ppis) to potential serious adverse effects that have resulted in social unrest.201627034082
characteristics of clostridium difficile infection in patients with discordant diagnostic test results.clinical features of clostridium difficile infection (cdi) cases diagnosed by detection of polymerase chain reaction (pcr), with negative toxin enzyme immunoassay results (eia) have not been fully elucidated. the purpose of this study was to determine the magnitude of cdi patients who had negative eia toxin determinations but positive pcr tests, and their differences in clinical presentation.201627033878
an economic analysis of strategies to control clostridium difficile transmission and infection using an agent-based simulation model.a number of strategies exist to reduce clostridium difficile (c. difficile) transmission. we conducted an economic evaluation of "bundling" these strategies together.201627031464
magnetic bead-based nucleic acid purification kit: clinical application and performance evaluation in stool specimens.two different methods - the semi-automated magnetic bead-based kit (sk, stool dna/rna purification kit®) and the manual membrane column-based kit (qs, qiaamp® dna stool mini kit) - for purifying nucleic acids from clinical stool samples were compared and evaluated. the sk kit was more user-friendly than qs due to the reduced manual processing, partial automation, and short turnaround time with half cost. furthermore, sk produced high yields in both dna and rna extractions but poor purity in rna ...201627030641
familial autoinflammation with neutrophilic dermatosis reveals a regulatory mechanism of pyrin activation.pyrin responds to pathogen signals and loss of cellular homeostasis by forming an inflammasome complex that drives the cleavage and secretion of interleukin-1β (il-1β). mutations in the b30.2/spry domain cause pathogen-independent activation of pyrin and are responsible for the autoinflammatory disease familial mediterranean fever (fmf). we studied a family with a dominantly inherited autoinflammatory disease, distinct from fmf, characterized by childhood-onset recurrent episodes of neutrophilic ...201627030597
clostridium difficile infection: a model for disruption of the gut microbiota equilibrium.the gut microbiota is a complex ecosystem defined by the combination of microorganisms living in the gastrointestinal tract. its equilibrium is intimately involved in several aspects of vital process for human physiology and nutrition. its composition changes depending on both exogenous and endogenous factors. the disruption of the gut microbiota by antibiotics often leads to an opportunistic infection by clostridium difficile. the unbalanced intestinal microbiota promotes spore germination, gro ...201627028327
principles of dna-based gut microbiota assessment and therapeutic efficacy of fecal microbiota transplantation in gastrointestinal diseases.fecal microbiota transplantation (fmt), a process by which the normal gastrointestinal microbiota is restored, has demonstrated extraordinary cure rates for clostridium difficile infection and low recurrence. the community of microorganisms within the human gut (or microbiota) is critical to health status and functions; therefore, together with the rise of fmt, the gastrointestinal microbiota has emerged as a 'virtual' organ with a level of complexity comparable to that of any other organ system ...201627027524
fecal microbial transplants reduce antibiotic-resistant genes in patients with recurrent clostridium difficile infection.recurrent clostridium difficile infection (rcdi) is associated with repeated antibiotic treatment and the enhanced growth of antibiotic-resistant microbes. this study tested the hypothesis that patients with rcdi would harbor large numbers of antibiotic-resistant microbes and that fecal microbiota transplantation (fmt) would reduce the number of antibiotic-resistant genes.201627025836
a multi-faceted approach of one teaching hospital nhs trust during the clostridium difficile epidemic-antibiotic management and beyond.the incidence of clostridium difficile infection (cdi) in the uk rose dramatically during the early years of this century, in part associated with the emergence of the hyper-virulent ribotype 027 strain. the university hospitals of leicester (uhl), a 2000-bed acute uk nhs trust, implemented a number of interventions, which led to an 80% reduction in new cases over a twelve month period. changes were introduced as a result of collaboration between the infection prevention team, the departments of ...201627025528
a review of quality measures for assessing the impact of antimicrobial stewardship programs in hospitals.the growing problem of antimicrobial resistance (amr) has led to calls for antimicrobial stewardship programs (asp) to control antibiotic use in healthcare settings. key strategies include prospective audit with feedback and intervention, and formulary restriction and preauthorization. education, guidelines, clinical pathways, de-escalation, and intravenous to oral conversion are also part of some programs. impact and quality of asp can be assessed using process or outcome measures. outcome meas ...201627025520
the tip of the four n-terminal α-helices of clostridium sordellii lethal toxin contains the interaction site with membrane phosphatidylserine facilitating small gtpases glucosylation.clostridium sordellii lethal toxin (tcsl) is a powerful virulence factor responsible for severe toxic shock in man and animals. tcsl belongs to the large clostridial glucosylating toxin (lcgt) family which inactivates small gtpases by glucosylation with uridine-diphosphate (udp)-glucose as a cofactor. notably, tcsl modifies rac and ras gtpases, leading to drastic alteration of the actin cytoskeleton and cell viability. tcsl enters cells via receptor-mediated endocytosis and delivers the n-termin ...201627023605
morbidity and mortality in severely burned children with clostridium difficile-associated diarrhea.clostridium difficile is a key culprit underlying nosocomial infectious diarrhea. we investigated the effect of c difficile-associated diarrhea (cdad) on morbidity and mortality in severely burned children and cdad risk factors.201627021599
risk of clostridium difficile infection with the use of a proton pump inhibitor for stress ulcer prophylaxis in critically ill patients.proton pump inhibitors (ppis) and histamine-2 receptor antagonists (h2ras) are commonly prescribed for stress ulcer prophylaxis (sup) in critically ill patients. several studies have suggested that the use of ppis is a potential risk factor for clostridium difficile infection (cdi). we compared the incidences of cdi in the ppi group and h2ra group for sup in critically ill patients.201627021503
evaluating the effects of surotomycin treatment on clostridium difficile toxin a and b production, immune response, and morphological changes.surotomycin is a cyclic lipopeptide in development for clostridium difficile-associated diarrhea. this study aimed to assess the impact of surotomycin exposure on c. difficile toxin a and b concentrations and the associated changes in immune response in comparison to vancomycin and metronidazole. time-kill curve assays were performed using strain r20291 (bi/nap1/027) at supra-mics (4× and 40×) and sub-mics (0.5×) of surotomycin and comparators. following treatment, cfu counts, toxin a and b conc ...201627021314
laboratory-based surveillance of clostridium difficile circulating in australia, september - november 2010.clostridium difficile rose in prominence in the early 2000s with large-scale outbreaks of a particular binary toxin-positive strain, ribotype 027, in north america and europe. in australia outbreaks of the same scale had not and have not been seen. a survey of c. difficile across australia was performed for 1 month in 2010. a collection of 330 c. difficile isolates from all states and territories except victoria and the northern territory was amassed. pcr ribotyping revealed a diverse array of s ...201627020502
significance of a positive clostridium difficile toxin test after hematopoietic stem cell transplantation.patients with hematological malignancies show a high prevalence of asymptomatic colonization with clostridium difficile (cd colonization). therefore, it is difficult to distinguish cd colonization with diarrhea induced by a conditioning regimen from true clostridium difficile infection (cdi) in hematopoietic stem cell transplantation (hsct) recipients. we retrospectively analyzed 308 consecutive patients who underwent a cd toxin a/b enzyme immunoassay test for diarrhea within 100 d after hsct fr ...201627019071
choosing wisely in healthcare epidemiology and antimicrobial stewardship.objective to identify choosing wisely items for the american board of internal medicine foundation. methods the society for healthcare epidemiology of america (shea) elicited potential items from a hospital epidemiology listserv, shea committee members, and a shea-infectious diseases society of america compendium with shea research network members ranking items by delphi method voting. the shea guidelines committee reviewed the top 10 items for appropriateness for choosing wisely. five final rec ...201627019058
in vitro selection of rna-cleaving dnazymes for bacterial detection.dnazymes refer to single-stranded dna molecules with catalytic activity and can be isolated from synthetic random-sequence dna pools using the technique of in vitro selection. dnazymes that cleave rna, known as "rna-cleaving dnazymes", represent one of the best-studied classes of dnazymes and have been widely used for the development of biosensors and bioassays for various analytes. we have been interested in developing rna-cleaving dnazymes as bacterial sensors and these dnazymes are engineered ...201627017912
clostridium difficile infection in hospitalized cirrhotic patients with hepatic encephalopathy. 201627014765
defining the optimal formulation and schedule of a candidate toxoid vaccine against clostridium difficile infection: a randomized phase 2 clinical trial.clostridium difficile, a major cause of nosocomial and antibiotic-associated diarrhea, carries a significant disease and cost burden. this study aimed to select an optimal formulation and schedule for a candidate toxoid vaccine against c. difficile toxins a and b.201627013431
molecular characterization of clostridium difficile isolates from human subjects and the environment.clostridium difficile is a spore-forming, gram-positive, anaerobic bacillus that can cause c. difficile infection (cdi). however, only a few studies on the prevalence and antibiotic resistance of c. difficile in healthy individuals in china have been reported. we employed a spore enrichment culture to screen for c. difficile in the stool samples of 3699 healthy chinese individuals who were divided into 4 groups: infants younger than 2 years of age and living at home with their parents; children ...201627011211
non-clostridium perfringens infectious agents producing necrotic enteritis-like lesions in poultry.necrotic enteritis (ne) produced by clostridium perfringens is amongst the most prevalent enteric diseases of chickens and turkeys. however, several other bacterial, parasitic and viral agents can cause clinical signs, gross and microscopic lesions in poultry very similar to those of ne and the diseases produced by those agents need to be differentiated from ne. the main differential diagnoses for c. perfringens ne include bacterial (clostridium colinum, clostridium sordellii, clostridium diffic ...201627009483
researching effective approaches to cleaning in hospitals: protocol of the reach study, a multi-site stepped-wedge randomised trial.the researching effective approaches to cleaning in hospitals (reach) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. the initiative is an environmental cleaning bundle, with five interdependent, evidence-based components (training, technique, product, audit and communication) implemented with environmental services staff to enhance hospital cleaning practices.201627009342
microarrays--new possibilities for detecting biological factors hazardous for humans and animals, and for use in environmental protection.both the known biological agents that cause infectious diseases, as well as modified (abf-advanced biological factors) or new, emerging agents pose a significant diagnostic problem using previously applied methods, both classical, as well as based on molecular biology methods. the latter, such as pcr and real-time pcr, have significant limitations, both quantitative (low capacity), and qualitative (limited number of targets). the article discusses the results of studies on using the microarray m ...201627007515
improving outcomes in patients receiving dialysis: the peer kidney care initiative.the past decade has witnessed a marked reduction in mortality rates among patients receiving maintenance dialysis. however, the reasons for this welcome development are uncertain, and greater understanding is needed to translate advances in care into additional survival gains. to fill important knowledge gaps and to enable dialysis provider organizations to learn from one another, with the aim of advancing patient care, the peer kidney care initiative (peer) was created in 2014 by the chief medi ...201627006497
routine prophylaxis with proton pump inhibitors and post-transplant complications in kidney transplant recipients undergoing early corticosteroid withdrawal.surgical stress, corticosteroids, and mycophenolate may contribute to gastrointestinal ulcers/bleeding after kidney transplantation. prophylactic acid suppression with h2ras or ppis is often utilized after transplantation, although unclear if truly indicated after early corticosteroid withdrawal (cswd). ppis have been associated with increased risks of clostridium difficile infection (cdi), pneumonia, and acute rejection. this retrospective cohort study investigated benefits and risks of prolong ...201627004722
impact of room location on uv-c irradiance and uv-c dosage and antimicrobial effect delivered by a mobile uv-c light device.objective to evaluate ultraviolet c (uv-c) irradiance, uv-c dosage, and antimicrobial effect achieved by a mobile continuous uv-c device. design prospective observational study. methods we used 6 uv light sensors to determine uv-c irradiance (w/cm2) and uv-c dosage (µwsec/cm2) at various distances from and orientations relative to the uv-c device during 5-minute and 15-minute cycles in an icu room and a surgical ward room. in both rooms, stainless-steel disks inoculated with methicillin-resistan ...201627004524
faecal microbiota transplantation: applications and limitations in treating gastrointestinal disorders.the process of stool transfer from healthy donors to the sick, known as faecal microbiota transplantation (fmt), has an ancient history. however, only recently researchers started investigating its applications in an evidence-based manner. current knowledge of the microbiome, the concept of dysbiosis and results of preliminary research suggest that there is an association between gastrointestinal bacterial disruption and certain disorders. researchers have studied the effects of fmt on various g ...201627239328
clostridium difficile infection: early history, diagnosis and molecular strain typing methods.recognised as the leading cause of nosocomial antibiotic-associated diarrhoea, the incidence of clostridium difficile infection (cdi) remains high despite efforts to improve prevention and reduce the spread of the bacterium in healthcare settings. in the last decade, many studies have focused on the epidemiology and rapid diagnosis of cdi. in addition, different typing methods have been developed for epidemiological studies. this review explores the history of c. difficile and the current scope ...201627238460
nitroimidazole carboxamides as antiparasitic agents targeting giardia lamblia, entamoeba histolytica and trichomonas vaginalis.diarrhoeal diseases caused by the intestinal parasites giardia lamblia and entamoeba histolytica constitute a major global health burden. nitroimidazoles are first-line drugs for the treatment of giardiasis and amebiasis, with metronidazole 1 being the most commonly used drug worldwide. however, treatment failures in giardiasis occur in up to 20% of cases and development of resistance to metronidazole is of concern. we have re-examined 'old' nitroimidazoles as a foundation for the systematic dev ...201627236016
high fecal iga is associated with reduced clostridium difficile colonization in infants.colonization of infants with clostridium difficile is on the rise. although better tolerated by infants than adults, it is a risk factor for future allergic disease. the present study describes associations between infant fecal immunoglobulin a (iga) and colonization with c. difficile in 47 infants enrolled in the canadian healthy infant longitudinal development (child) study. c. difficile colonization was observed in over half (53%) of the infants. median iga was lower in infants colonized with ...201627235197
effect of prolonged diarrhea in renal transplant recipients at a single center in taiwan.post-renal transplantation diarrhea is a common complication; however, it is easily ignored. this study aimed to determine the factors influencing graft function for renal transplant recipients with diarrhea.201627234755
misuse of antibiotics reserved for hospital settings in outpatients: a prospective clinical audit in a university hospital in southern france.some antibiotics are reserved essentially for hospital settings owing to cost effectiveness and in order to fight the emerging antibiotic resistance crisis. in some cases, antibiotics reserved exclusively for use in hospitals may be prescribed in outpatients for serious infections or in the absence of a therapeutic alternative. a 30-day prospective audit of outpatient prescriptions of antibiotics reserved exclusively for use in hospitals was performed. the objective of this study was to evaluate ...201627234677
a roadmap for gene system development in clostridium.clostridium species are both heroes and villains. some cause serious human and animal diseases, those present in the gut microbiota generally contribute to health and wellbeing, while others represent useful industrial chassis for the production of chemicals and fuels. to understand, counter or exploit, there is a fundamental requirement for effective systems that may be used for directed or random genome modifications. we have formulated a simple roadmap whereby the necessary gene systems maybe ...201627234263
fecal microbiota transplantation for severe clostridium difficile infection after left ventricular assist device implantation: a case control study and concise review on the local and regional therapies.we report herein a case of fecal microbiota transplantation (fmt) used for severe clostridium difficile infection for a 65-year-old lebanese man who underwent left ventricular assist device implantation. to the best of our knowledge this is the first case report from lebanon and the region presenting such technique.201627233894
production and characterization of chemically inactivated genetically engineered clostridium difficile toxoids.a recombinant clostridium difficile expression system was used to produce genetically engineered toxoids a and b as immunogens for a prophylactic vaccine against c. difficile-associated disease. although all known enzymatic activities responsible for cytotoxicity were genetically abrogated, the toxoids exhibited residual cytotoxic activity as measured in an in vitro cell-based cytotoxicity assay. the residual cytotoxicity was eliminated by treating the toxoids with 1-ethyl-3-(3-dimethylaminoprop ...201627233688
reduction in post-operative acute kidney injury following a change in antibiotic prophylaxis policy for orthopaedic surgery: an observational study.evidence has shown that a prophylactic antibiotic regimen of flucloxacillin and gentamicin for orthopaedic surgery was associated with increased rates of post-operative acute kidney injury (aki). this resulted in changes in the national antibiotic policy recommendation for orthopaedic surgical prophylaxis. this study aimed to assess whether this change from flucloxacillin and gentamicin to co-amoxiclav was associated with changes in the rates of aki and clostridium difficile infection (cdi).201627231276
[a novel approach to genotyping of hospital isolates of clostridium difficile].development of a novel approach in genotyping of clostridium difficile and its testing on the example of 140 hospital isolates.201627228665
clostridium difficile infection. 201627227752
[fecal microbiota transplantation in relapsing clostridium difficile colitis].since the turn of the millennium there has been an alarming increase in the incidence and severity of clostridium difficile infections. stopping medication with the triggering antibiotic and switching to a recommended antibiotic leads to healing up in 80%. however, patients who relapse have a 40% risk of an additional relapse and those with 2 or more episodes face a 60% risk. fecal microbiota transplantation (fmt) is a new therapeutic option. up to now there only exist two randomized studies (un ...201627221557
chinese physicians' perceptions of fecal microbiota transplantation.to explore chinese physicians' perceptions towards fecal microbiota transplantation (fmt) and to provide information and an assessment of fmt development in china.201627217707
clostridium difficile infection following systemic antibiotic administration in randomised controlled trials: a systematic review and meta-analysis.antibiotics have been the most important risk factor for clostridium difficile infection (cdi). however, only data from non-randomised studies have been reviewed. we sought to evaluate the risk for development of cdi associated with the major antibiotic classes by analysing data from randomised controlled trials (rcts). the pubmed, cochrane and scopus databases were searched and the references of selected rcts were also hand-searched. eligible studies should have compared only one antibiotic ver ...201627216385
recurrence of clostridium difficile infection in patients with inflammatory bowel disease: the recidivism study.recurrent clostridium difficile infection (rcdi) contributes to a significant burden of disease in patients with inflammatory bowel disease (ibd). in this study, we seek to identify risk factors for rcdi in a population of ibd patients at the mount sinai hospital ibd centre.201627215924
fecal microbiota transplantation for recurrent clostridium difficile infection in hematopoietic stem cell transplant recipients.recurrent clostridium difficile infection (cdi) is a consequence of intestinal dysbiosis and is particularly common following hematopoietic stem cell transplantation (hsct). fecal microbiota transplantation (fmt) is an effective method of treating cdi by correcting intestinal dysbiosis by passive transfer of healthy donor microflora. fmt has not been widely used in immunocompromised patients, including hsct recipients, owing to concern for donor-derived infection. here, we describe initial resul ...201627214585
assessing the magnitude and trends in hospital acquired infections in canadian hospitals through sequential point prevalence surveys.healthcare acquired infections (hai) are an important public health problem in developed countries, but comprehensive data on trends over time are lacking. prevalence surveys have been used as a surrogate for incidence studies and can be readily repeated.201627213039
the microbiota and immune response during clostridium difficile infection.clostridium difficile is a gram-positive, spore forming anaerobe that infects the gut when the normal microbiota has been disrupted. c. difficile infection (cdi) is the most common cause of hospital acquired infection in the united states, and the leading cause of death due to gastroenteritis. patients suffering from cdi have varying symptoms which range from mild diarrhea to pseudomembranous colitis and death. the involvement of the immune response to influence disease severity is just beginnin ...201627212111
[role of care surgery in the treatment of pseudomembranous colitis].pseudomembranous colitis, caused by clostridium difficile, has an increased incidence in recent years, driven mainly by the indiscriminate use of antibiotics. although initial treatment is medical, the role of emergency surgery has gained ground due to high mortality and the emergence of increasingly virulent strains. in our country the prevalence is still low so sometimes our experience in handling is limited.201627209466
economic burden of primary compared with recurrent clostridium difficile infection in hospitalized patients: a prospective cohort study.few studies have investigated the additional healthcare costs of recurrent c. difficile infection (cdi).201627209056
risk factors associated with interfacility transfers among patients with clostridium difficile infection.preventing the transmission of clostridium difficile infection (cdi) over the continuum of care presents an important challenge for infection control.201627207161
elevated fecal calprotectin associates with adverse outcomes from clostridium difficile infection in older adults.clostridium difficile infection (cdi) causes a mild to moderate colitis in most patients, but some, especially older adults, develop severe, adverse outcomes. biomarkers predicting outcomes are needed to optimize treatments. this study tested whether fecal calprotectin associated with a composite primary outcome of complicated cdi (intensive care unit admission, colectomy, or death due to cdi within 30 days of diagnosis) and/or 8-week recurrence.201627206404
the surgical management of complicated clostridium difficile infection: alternatives to colectomy.clostridium difficile is the most common nosocomial infection in the united states. there is a subset of patients for whom medical therapy fails or who progress rapidly to the development of complicated disease, often marked by critical systemic illness. patients with complicated clostridium difficile infection (cdi) who progress or fail to improve benefit from surgery.201627206241
antibiotic stewardship programs in u.s. acute care hospitals: findings from the 2014 national healthcare safety network annual hospital survey.the national action plan to combat antibiotic resistant bacteria calls for all us hospitals to improve antibiotic prescribing as a key prevention strategy for resistance and clostridium difficile antibiotic stewardship programs (asps) will be important in this effort but implementation is not well understood.201627199462
fecal microbiota transplantation for the intestinal decolonization of extensively antimicrobial-resistant opportunistic pathogens: a review.treatment options for multidrug-resistant (mdr) bacterial infections are limited and often less effective. non-pharmacologic approaches to preventing or treating mdr infections are currently restricted to improved antimicrobial stewardship and infection control practices. fecal microbiota transplantation (fmt), a highly effective treatment for recurrent clostridium difficile infection, has emerged as a promising therapy for intestinal mdr bacterial decolonization. a total of eight case reports h ...201627194400
new approaches to infection prevention and control: implementing a risk-based model regionally.infectious disease outbreaks result in substantial inconvenience to patients and disruption of clinical activity.201627194074
increasing incidence of clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the italian region with the oldest population.limited information is available on the incidence of clostridium difficile infections (cdis) in italian hospitals. in this study, we assessed the changes in the incidence of cdi over a 5-year period in a teaching hospital in liguria, the italian region with the oldest population. secondary endpoints were the development of severe cdi and 30-day mortality. the annual incidence of cdi/10000 patient-days significantly increased from 0·54 in 2010 to 3·04 in 2014 (χ 2 for trend, p < 0·001). the media ...201627193828
the burden of clostridium difficile after cervical spine surgery.study design retrospective database analysis. objective the purpose of this study is to investigate incidence, comorbidities, and impact on health care resources of clostridium difficile infection after cervical spine surgery. methods a total of 1,602,130 cervical spine surgeries from the nationwide inpatient sample database from 2002 to 2011 were included. patients were included for study based on international classification of diseases ninth revision, clinical modification procedural codes fo ...201627190732
atypical presentation of c. difficile infection: report of a case with literature review.clostridium difficile (c. difficile) is a gram-positive, obligate, anaerobic spore-forming bacillus first reported by hall and o'toole in 1935. it occurs mostly after antibiotic use and invariably presents with watery diarrhea. we describe an atypical presentation of c. difficile in a 64-year-old caucasian female who presented to the our emergency department with abdominal pain, nausea, and vomiting for one day. a complete blood count revealed leukocytosis 30 x 10(9)/l and a subsequent computed ...201627190728
impact of a healthcare provider educational intervention on frequency of clostridium difficile polymerase chain reaction testing in children: a segmented regression analysis.although clostridium difficile infections (cdis) are increasingly diagnosed in children, many children diagnosed with cdi lack classic risk factors. frequent use of highly sensitive tcdb polymerase chain reaction (pcr) testing in low-risk patients leads to cdi misdiagnosis and unnecessary cdi antibiotic use in children with c difficile carriage.201627190172
hiv infection results in metabolic alterations in the gut microbiota different from those induced by other diseases.imbalances in gut bacteria have been associated with multiple diseases. however, whether there are disease-specific changes in gut microbial metabolism remains unknown. here, we demonstrate that human immunodeficiency virus (hiv) infection (n = 33) changes, at quantifiable levels, the metabolism of gut bacteria. these changes are different than those observed in patients with the auto-immune disease systemic lupus erythaematosus (n = 18), and clostridium difficile-associated diarrhoea (n = 6). u ...201627189771
preclinical development of ramizol, an antibiotic belonging to a new class, for the treatment of clostridium difficile colitis.antibiotic-resistant bacteria is a major threat to human health and is predicted to become the leading cause of death from disease by 2050. despite the recent resurgence of research and development in the area, few antibiotics have reached the market, with most of the recently approved antibiotics corresponding to new uses for old antibiotics, or structurally similar derivatives thereof. we have recently reported an in silico approach that led to the design of an entirely new class of antibiotic ...201627189122
adverse event reporting for proton pump inhibitor therapy: an overview of systematic reviews.to assist clinicians in counseling patients regarding the risk of adverse events from proton pump inhibitors (ppis), by synthesizing evidence from published systematic reviews of antireflux therapy.201627188706
predictors of early failure after fecal microbiota transplantation for the therapy of clostridium difficile infection: a multicenter study.fecal microbiota transplant (fmt) is a highly efficacious treatment for recurrent or refractory clostridium difficile infection (cdi); however, 10-20% of patients fail to achieve cure after a single fmt. the aim of this study was to identify risk factors associated with fmt failure and to develop and validate a prediction model for fmt failure.201627185076
impact of sink location on hand hygiene compliance after care of patients with clostridium difficile infection: a cross-sectional study.the impact of sink location on hand washing compliance after contact with patients with clostridium difficile infection (cdi) is poorly understood. the aim of this study is to determine the location of hand wash sinks available to healthcare workers (hcws) after caring for patients with cdi and to assess the impact on hand washing compliance.201627184488
epidemiology of clostridium difficile infection-associated reactive arthritis in children: an underdiagnosed, potentially morbid condition.the incidence of clostridium difficile infection has increased among children. the epidemiology of pediatric c difficile infection-associated reactive arthritis is poorly understood.201627182697
clostridium difficile infection in children: a review.clostridium difficile is a sporogenic, anaerobic, gram-positive, emerging enteric pathogen. it represents the most common cause of health care-associated diarrhoea in the united states, with significantly associated morbidity, mortality, and health care costs. historically regarded as a little more than an innocent coloniser bystander of the gastrointestinal tract of children, c difficile has increasingly demonstrated its behaviour as a true pathogen in the paediatric age groups. this organism m ...201627182626
analysis of clostridium difficile infections in patients hospitalized at the nephrological ward in poland.few studies have evaluated the incidence and risk factors of clostridium difficile infection (cdi) in the adult polish population, in particular in solid organ recipients hospitalized at the nephrological ward.201627180967
probiotics as adjunctive therapy for preventing clostridium difficile infection - what are we waiting for?with the end of the golden era of antibiotic discovery, the emergence of a new post-antibiotic age threatens to thrust global health and modern medicine back to the pre-antibiotic era. antibiotic overuse has resulted in the natural evolution and selection of multi-drug resistant bacteria. one major public health threat, clostridium difficile, is now the single leading cause of hospital-acquired bacterial infections and is by far the most deadly enteric pathogen for the u.s.201627180657
administration of probiotic kefir to mice with clostridium difficile infection exacerbates disease.lifeway(®) kefir, a fermented milk product containing 12 probiotic organisms, is reported to show promise as an alternative to fecal microbiota transplantation for recurrent clostridium difficile infection (cdi). we employed a murine cdi model to study the probiotic protective mechanisms and unexpectedly determined that kefir drastically increased disease severity. our results emphasize the need for further independent clinical testing of kefir as alternative therapy in recurrent cdi.201627180007
structural and functional changes within the gut microbiota and susceptibility to clostridium difficile infection.alteration of the gut microbial community structure and function through antibiotic use increases susceptibility to colonization by clostridium difficile and other enteric pathogens. however, the mechanisms that mediate colonization resistance remain elusive. as the leading definable cause of infectious diarrhea, toxigenic c. difficile represents a burden for patients and health care systems, underscoring the need for better diagnostics and treatment strategies. next-generation sequence data has ...201627180006
n-3 and n-6 fatty acid changes in the erythrocyte membranes of patients with 658240251 clostridium difficile infection.the implications of circulating essential fatty acids (fa) on the inflammatory risk profile and clinical outcome are still unclear. in order to gain a deeper understanding of the role of polyunsaturated fatty acids (pufa) in the pathogenesis of acute infection, we analyzed the fa content in red blood cell (rbc) membranes of patients with clostridium difficile infection (cdi) and controls. we prospectively studied 60 patients including 30 patients with cdi and 30 controls to assess lipid concentr ...201627172707
[fecal microbiota transplantation].fecal microbiota transplantation (fmt) is a therapeutic method, in which the fecal microflora from healthy donors is transmitted to the patient to restore the healthy microbial composition of the gut. in the recent years, there is a growing interest in the therapeutic potential of fmt in various diseases. the standard fmt protocols do not exist. procedures of fmt vary in several aspects such as donor selection, preparation of fecal material, preparation of the recipient and administration way. f ...201627172442
pseudomembranous colitis: not always clostridium difficile.although clostridium difficile infection is the cause of most cases of pseudomembranous colitis, clinicians should consider less common causes, especially if pseudomembranes are seen on endoscopy but testing remains negative for c difficile or if presumed c difficile infection does not respond to treatment. histologic review of colonic mucosal biopsy specimens can provide clues to the underlying cause.201627168512
endogenous il-17 as a factor determining the severity of clostridium difficile infection in mice.clostridium difficile infection (cdi) is a toxin-mediated intestinal disease. toxin a, toxin b and binary toxin are believed to be responsible for the pathogenesis of cdi, which is characterized by massive infiltration of neutrophils at the infected intestinal mucosa. il-17 is one of the cytokines that play critical roles in several inflammatory and immunological diseases through various actions, including promoting neutrophil recruitment. the aim of this study was to examine the role of this cy ...201627166143
gut microbiota composition and clostridium difficile infection in hospitalized elderly individuals: a metagenomic study.the gut microbiota composition of elderly hospitalized patients with clostridium difficile infection (cdi) exposed to previous antibiotic treatment is still poorly investigated. the aim of this study was to compare the microbiota composition by means of 16s rrna microbial profiling among three groups of hospitalized elderly patients (age ≥ 65) under standard diet including 25 cdi-positive (cdi group), 29 cdi-negative exposed to antibiotic treatment (ab+ group) and 30 cdi-negative subjects not on ...201627166072
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