Publications
| Title | Abstract | Year(sorted descending) Filter | PMID Filter |
|---|
| utility of prophylactic antibiotics in nonoperative facial fractures. | facial fractures are commonly managed nonoperatively. patients with facial fractures involving sinus cavities commonly receive 7 to 10 days of prophylactic antibiotics, yet no literature exists to support or refute this practice. the aim of this study was to compare the administration and duration of antibiotic prophylaxis on the incidence of soft tissue infection in nonoperative facial fractures. a total number of 289 patients who were admitted to our level i trauma center with nonoperative fac ... | 2016 | 27391655 |
| an exploratory study to evaluate clostridium difficile polymerase chain reaction ribotypes and infection outcomes. | clostridium difficile infection ranges from mild to severe prolonged diarrhea with systemic symptoms. previous studies have assessed the correlation of some disease severity parameters to c. difficile ribotypes. however, certain clinical parameters of interest have not yet been evaluated. | 2016 | 27390531 |
| the efficacy of intracolonic vancomycin for severe clostridium difficile colitis: a case series. | clostridium difficile infection (cdi) unresponsive to the standard treatments of metronidazole and oral vancomycin requires aggressive medical management and possible surgical intervention including colectomy. intracolonic vancomycin therapy has been reported to be particularly promising in the setting of severe cdi in the presence of ileus. this is a descriptive case series exploring the effect of adjunctive intracolonic vancomycin therapy on the morbidity and mortality in patients with moderat ... | 2016 | 27388627 |
| male veterans with complicated urinary tract infections: influence of a patient-centered antimicrobial stewardship program. | the influence of antimicrobial stewardship programs (asps) on outcomes in male veterans treated for complicated urinary tract infection has not been determined. | 2016 | 27388268 |
| management of inflammatory bowel disease in the elderly. | a substantial and growing proportion of patients with inflammatory bowel disease (ibd) are elderly, and these patients require tailored treatment strategies. however, significant challenges exist in the management of this population due to the paucity of data. establishing the initial diagnosis and assessing the etiology of future symptoms and flares can be challenging as several other prevalent diseases can masquerade as ibd, such as ischemic colitis, diverticular disease, and infectious coliti ... | 2016 | 27387455 |
| active caspase-1 induces plasma membrane pores that precede pyroptotic lysis and are blocked by lanthanides. | canonical inflammasome activation induces a caspase-1/gasdermin d (gsdmd)-dependent lytic cell death called pyroptosis that promotes antimicrobial host defense but may contribute to sepsis. the nature of the caspase-1-dependent change in plasma membrane (pm) permeability during pyroptotic progression remains incompletely defined. we assayed propidium(2+) (pro(2+)) influx kinetics during nlrp3 or pyrin inflammasome activation in murine bone marrow-derived macrophages (bmdms) as an indicator of th ... | 2016 | 27385778 |
| fecal transplant for clostridium difficile infection relapses using "pooled" frozen feces from non-related donors. | 2016 | 27382953 | |
| rifamycin resistance in clostridium difficile is generally associated with a low fitness burden. | we characterized clinically occurring and novel mutations in the β subunit of rna polymerase in clostridium difficile (cdrpob), conferring rifamycin (including rifaximin) resistance. the arg505lys substitution did not impose an in vitro fitness cost, which may be one reason for its dominance among rifamycin-resistant clinical isolates. these observations were supported through the structural modeling of cdrpob. in general, most mutations lacked in vitro fitness costs, suggesting that rifamycin r ... | 2016 | 27381389 |
| non-slip socks: a potential reservoir for transmitting multidrug-resistant organisms in hospitals? | non-slip socks are increasingly used to prevent falls in hospitals. patients use them to walk to various parts of the hospital and also wear them in bed. fifty-four pairs of socks and 35 environmental floor samples were obtained from seven wards in a tertiary referral hospital. vancomycin-resistant enterococci (vre) were detected from 46 (85%) socks and meticillin-resistant staphylococcus aureus (mrsa) from five (9%). environmental sampling cultured vre from 24 (69%) floor samples and mrsa from ... | 2016 | 27380919 |
| receptors and binding structures for clostridium difficile toxins a and b. | two characteristics of toxins a and b from c. difficile (tcda, tcdb) are important for the understanding of the pathogenic effect of these homologous toxins. first, these toxins are huge single-chain but multidomain proteins that display their action intracellularly within the cytosol of host cells. and second, albeit various cell types highly differ in their sensitivity toward these toxins, no toxin-resistant cell type has been described yet. investigation of receptor-mediated uptake of these t ... | 2016 | 27380268 |
| the epidemiology and clinical features of clostridium difficile infection in liver transplant recipients. | clostridium difficile infection (cdi) is common after liver transplantation (lt); however, few studies have examined the risk factors, clinical manifestations, and outcomes of cdi in this population. | 2016 | 27379554 |
| cost-effectiveness analysis of the use of probiotics for the prevention of clostridium difficile-associated diarrhea in a provincial healthcare system. | objective to conduct a full economic evaluation assessing the costs and consequences related to probiotic use for the primary prevention of clostridium difficile-associated diarrhea (cdad). design cost-effectiveness analysis using decision analytic modeling. methods a cost-effectiveness analysis was used to evaluate the risk of cdad and the costs of receiving oral probiotics versus not over a time horizon of 30 days. the target population modeled was all adult inpatients receiving any therapeuti ... | 2016 | 27377992 |
| proton pump inhibitors should be used with caution in critically ill patients to prevent the risk of clostridium difficile infection. | 2016 | 27377737 | |
| community-acquired clostridium difficile infections in emergency departments. | clostridium difficile infection (cdi) has become an emerging infectious disease, especially in community settings. little data is available on its frequency and characteristics in france. we aimed to describe cdi case patients consulting at the emergency department and to compare community-acquired and nosocomial cdis. | 2016 | 27377443 |
| subboiling moist heat favors the selection of enteric pathogen clostridium difficile pcr ribotype 078 spores in food. | emerging enteric pathogens could have not only more antibiotic resistance or virulence traits; they could also have increased resistance to heat. we quantified the effects of minimum recommended cooking and higher temperatures, individually on a collection of c. difficile isolates and on the survival probability of a mixture of emerging c. difficile strains. while minimum recommended cooking time/temperature combinations (63-71°c) allowed concurrently tested strains to survive, higher subboiling ... | 2016 | 27375748 |
| gut microbiome predictors of treatment response and recurrence in primary clostridium difficile infection. | clostridium difficile infection (cdi) may not respond to initial therapy and frequently recurs, but predictors of response and recurrence are inconsistent. the impact of specific alterations in the gut microbiota determining treatment response and recurrence in patients with cdi is unknown. | 2016 | 27481036 |
| ultrastructure variability of the exosporium layer of clostridium difficile spores from sporulating cultures and biofilms. | the anaerobic sporeformer clostridium difficile is the leading cause of nosocomial antibiotic-associated diarrhea in developed and developing countries. the metabolically dormant spore form is considered the morphotype responsible for transmission, infection, and persistence, and the outermost exosporium layer is likely to play a major role in spore-host interactions during recurrent infections, contributing to the persistence of the spore in the host. a recent study (m. pizarro-guajardo, p. cal ... | 2016 | 27474709 |
| normal, regular and standard: scaling the body through fecal microbial transplants. | in 1987, nancy scheper-hughes and margaret lock proposed "three bodies" to think through biomedicine and the kinds of subjects it produces. in the current article, i revise their theory of three bodies in two ways: first, i suggest that the three bodies are a scaling process, which allows medical governance to manage bodies across scales, from the individual to the group; second, i add two new levels of scalar analysis, the molecular and the microbial, in an attempt to flesh out the three bodies ... | 2016 | 27474685 |
| applications of an automated and quantitative ce-based size and charge western blot for therapeutic proteins and vaccines. | capillary electrophoresis (ce) is a versatile and indispensable analytical tool that can be applied to characterize proteins. in recent years, labor-intensive sds-page and ief slab gels have been replaced with ce-sds (cge) and ce-ief methods, respectively, in the biopharmaceutical industry. these two ce-based methods are now an industry standard and are an expectation of the regulatory agencies for biologics characterization. another important and traditional slab gel technique is the western bl ... | 2016 | 27473492 |
| standardised surveillance of clostridium difficile infection in european acute care hospitals: a pilot study, 2013. | clostridium difficile infection (cdi) remains poorly controlled in many european countries, of which several have not yet implemented national cdi surveillance. in 2013, experts from the european cdi surveillance network project and from the european centre for disease prevention and control developed a protocol with three options of cdi surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for cdi cases) and an 'enhanced' ... | 2016 | 27472820 |
| partly fermented infant formulae with specific oligosaccharides support adequate infant growth and are well-tolerated. | fermented formulae (ferm) and a specific mixture of 90% short-chain galacto-oligosaccharides and 10% long-chain fructo-oligosaccharides (scgos/lcfos; 9:1) have a potential beneficial effect on gastrointestinal function and microbiota development in infants. the present study assessed the safety and tolerance of the combination of partly fermented infant milk formulae and scgos/lcfos compared with either 1 feature, in healthy term infants. | 2016 | 27472478 |
| a comparison of current guidelines of five international societies on clostridium difficile infection management. | clostridium difficile infection (cdi) is increasingly recognized as an emerging healthcare problem of elevated importance. prevention and treatment strategies are constantly evolving along with the apperance of new scientific evidence and novel treatment methods, which is well-reflected in the differences among consecutive international guidelines. in this article, we summarize and compare current guidelines of five international medical societies on cdi management, and discuss some of the contr ... | 2016 | 27470257 |
| diversity of clostridium difficile pcr ribotypes in europe: results from the european, multicentre, prospective, biannual, point-prevalence study of clostridium difficile infection in hospitalised patients with diarrhoea (euclid), 2012 and 2013. | clostridium difficile infection (cdi) is the major cause of infective diarrhoea in healthcare environments. as part of the european, multicentre, prospective, biannual, point-prevalence study of clostridium difficile infection in hospitalised patients with diarrhoea (euclid), the largest c. difficile epidemiological study of its type, pcr ribotype distribution of c. difficile isolates in europe was investigated. pcr ribotyping was performed on 1,196 c. difficile isolates from diarrhoeal samples ... | 2016 | 27470194 |
| survey of diagnostic and typing capacity for clostridium difficile infection in europe, 2011 and 2014. | suboptimal laboratory diagnostics for clostridium difficile infection (cdi) impedes its surveillance and control across europe. we evaluated changes in local laboratory cdi diagnostics and changes in national diagnostic and typing capacity for cdi during the european c. difficile infection surveillance network (ecdis-net) project, through cross-sectional surveys in 33 european countries in 2011 and 2014. in 2011, 126 (61%) of a convenience sample of 206 laboratories in 31 countries completed a s ... | 2016 | 27469624 |
| survey of clostridium difficile infection surveillance systems in europe, 2011. | to develop a european surveillance protocol for clostridium difficile infection (cdi), existing national cdi surveillance systems were assessed in 2011. a web-based electronic form was provided for all national coordinators of the european cdi surveillance network (ecdis-net). of 35 national coordinators approached, 33 from 31 european countries replied. surveillance of cdi was in place in 14 of the 31 countries, comprising 18 different nationwide systems. three of 14 countries with cdi surveill ... | 2016 | 27469420 |
| difficile indeed. | 2016 | 27469287 | |
| successful treatments with polymyxin b hemoperfusion and recombinant human thrombomodulin for fulminant clostridium difficile-associated colitis with septic shock and disseminated intravascular coagulation: a case report. | clostridium difficile (cd)-associated colitis (cdac) is endemic and a common nosocomial enteric disease encountered by surgeons in modern hospitals due to prophylactic or therapeutic antibiotic therapies. currently, the incidence of fulminant cdac, which readily causes septic shock followed by multiple organ dysfunction syndromes, is increasing. fulminant cdac requires surgeons to perform a prompt surgery, such as subtotal colectomy, to remove the septic source. it is known that fulminant cdac i ... | 2016 | 27468959 |
| importance of glutamate dehydrogenase (gdh) in clostridium difficile colonization in vivo. | clostridium difficile is the principal cause of antibiotic-associated diarrhea. major metabolic requirements for colonization and expansion of c. difficile after microbiota disturbance have not been fully determined. in this study, we show that glutamate utilization is important for c. difficile to establish itself in the animal gut. when the glud gene, which codes for glutamate dehydrogenase (gdh), was disrupted, the mutant c. difficile was unable to colonize and cause disease in a hamster mode ... | 2016 | 27467167 |
| characterisation of clostridium difficile strains isolated from groote schuur hospital, cape town, south africa. | the c. difficile infection rate in south africa is concerning. many strains previously isolated from diarrhetic patients at groote schuur hospital were ribotype 017. this study further characterised these strains with respect to their clonal relationships, antibiotic susceptibility, toxin production and various attributes impacting on pathogen colonisation. multilocus variable-number tandem-repeat analysis (mlva) was used to characterise all c. difficile isolates. antibiotic susceptibility was d ... | 2016 | 27465145 |
| optimizing the diagnostic testing of clostridium difficile infection. | clostridium difficile infection (cdi) is the leading cause of hospital-acquired diarrhea and is associated with a considerable health and cost burden. however, there is still not a clear consensus on the best laboratory diagnosis approach and a wide variation of testing methods and strategies can be encountered. | 2016 | 27462827 |
| polonium-210 poisoning: a first-hand account. | polonium-210 ((210)po) gained widespread notoriety after the poisoning and subsequent death of mr alexander litvinenko in london, uk, in 2006. exposure to (210)po resulted initially in a clinical course that was indistinguishable from infection or exposure to chemical toxins, such as thallium. | 2016 | 27461439 |
| impact of malignancy on clostridium difficile infection. | the purpose of this study was to investigate the impact of malignancy and chemotherapy on the clinical and microbiological characteristics of clostridium difficile infections (cdi). | 2016 | 27461221 |
| european society of clinical microbiology and infectious diseases: update of the diagnostic guidance document for clostridium difficile infection. | in 2009 the first european society of clinical microbiology and infectious diseases (escmid) guideline for diagnosing clostridium difficile infection (cdi) was launched. since then newer tests for diagnosing cdi have become available, especially nucleic acid amplification tests. the main objectives of this update of the guidance document are to summarize the currently available evidence concerning laboratory diagnosis of cdi and to formulate and revise recommendations to optimize cdi testing. th ... | 2016 | 27460910 |
| rapid detection of clostridium difficile via magnetic bead aggregation in cost-effective polyester microdevices with cell phone image analysis. | pathogen detection has traditionally been accomplished by utilizing methods such as cell culture, immunoassays, and nucleic acid amplification tests; however, these methods are not easily implemented in resource-limited settings because special equipment for detection and thermal cycling is often required. in this study, we present a magnetic bead aggregation assay coupled to an inexpensive microfluidic fabrication technique that allows for cell phone detection and analysis of a notable pathogen ... | 2016 | 27460478 |
| correction for alcalá et al., comparison of genomera c. difficile and xpert c. difficile as confirmatory tests in a multistep algorithm for diagnosis of clostridium difficile infection. | 2016 | 27458271 | |
| adult intussusception caused by ileocecal clostridium difficile pseudomembranous colitis. | 2016 | 27457842 | |
| clostridium difficile toxins tcda and tcdb cause colonic tissue damage by distinct mechanisms. | as the major cause of antibiotic-associated diarrhea, clostridium difficile is a serious problem in health care facilities worldwide. c. difficile produces two large toxins, tcda and tcdb, which are the primary virulence factors in disease. the respective functions of these toxins have been difficult to discern, in part because the cytotoxicity profiles for these toxins differ with concentration and cell type. the goal of this study was to develop a cell culture model that would allow a side-by- ... | 2016 | 27456833 |
| recombinant mucin-type fusion proteins with a galα1,3gal substitution as clostridium difficile toxin a inhibitors. | the capability of a recombinant mucin-like fusion protein, p-selectin glycoprotein ligand-1/mouse igg2b (psgl-1/migg2b), carrying galα1,3galβ1,4glcnac determinants to bind and inhibit clostridium difficile toxin a (tcda) was investigated. the fusion protein, produced by a glyco-engineered stable cho-k1 cell line and designated c-pgc2, was purified by affinity and gel filtration chromatography from large-scale cultures. liquid chromatography-mass spectrometry was used to characterize o-glycans re ... | 2016 | 27456831 |
| characterization of polymorphic forms of rifaximin. | rifaximin is a gut-selective oral antimicrobial that has no systemic adverse effects compared with placebo. it is used for the treatment of hepatic encephalopathy, traveler's diarrhea, irritable bowel syndrome, clostridium difficile infection, ulcerative colitis, and acute diarrhea. the crystalline form present in rifaximin, α, has minimal systemic absorption compared to the amorphous form. the objective of this study was to obtain polymorphic forms of rifaximin using recrystallization processes ... | 2016 | 27455934 |
| risk and severity of hospital-acquired clostridium difficile infection in patients taking proton pump inhibitors. | to compare the rates and severity of hospital-acquired clostridium difficile infection (cdi) among patients taking proton pump inhibitors (ppis) versus those not taking ppis. | 2016 | 27455386 |
| prevalence of nosocominal toxigenic clostridium difficile in children under 5 years in hajar hospital, shahrekord, iran. | 2016 | 27504373 | |
| intravenous adenovirus expressing a multi-specific, single-domain antibody neutralizing tcda and tcdb protects mice from clostridium difficile infection. | clostridium difficile infection (cdi) is the most common cause of antibiotic-associated diarrhea and colitis in developed countries. the disease is mainly mediated via two major exotoxins tcda and tcdb secreted by the bacterium. we have previously developed a novel, potently neutralizing, tetravalent and bispecific heavy-chain-only single domain (vhh) antibody to both tcda and tcdb (designated as aba) that reverses fulminant cdi in mice. since aba has a short serum half-life, in this study a rep ... | 2016 | 27502696 |
| can we improve the therapy of clostridium difficile infection in elderly patients? | clostridium difficile infection (cdi) is becoming a serious problem predominantly in geriatric patients, who are a significant risk group. the goal of this study was to evaluate the risk factors for mortality in cdi patients and to construct a binary logistic regression model that describes the probability of mortality in geriatric patients suffering from cdi. | 2016 | 27501856 |
| effect of metronidazole use on tacrolimus concentrations in transplant patients treated for clostridium difficile. | two case reports suggest that metronidazole treatment for clostridium difficile infections (cdi) increases tacrolimus (tac) trough levels. the primary objective of this study was to determine the clinical significance of this potential interaction in transplant patients receiving cdi treatment. currently, no robust literature exists to estimate a magnitude of pharmacokinetic interaction between metronidazole and tac. | 2016 | 27501504 |
| clostridium difficile infection and inflammatory bowel disease. | 2016 | 27499718 | |
| efficacy of a diagnostic and therapeutic algorithm for clostridium difficile infection. | in july 2012, metronidazole was approved for the treatment of clostridium difficile infection (cdi). to clarify the selection criteria for the drug in terms of cdi severity, we established a diagnostic and therapeutic algorithm with reference to the shea-idsa clinical practice guidelines. we compared patients whose treatments were guided by the algorithm (29 cases, october 2012-september 2013) with patients treated prior to the development of the algorithm (37 cases, october 2011-september 2012) ... | 2016 | 27498935 |
| fecal microbial transplantation in a pediatric case of recurrent clostridium difficile infection and specific antibody deficiency. | 2016 | 27496525 | |
| prevalence and impact of clostridium difficile infection in elderly residents of long-term care facilities, 2011: a nationwide study. | the elderly population is particularly vulnerable to clostridium difficile infection (cdi), but the epidemiology of cdi in long-term care facilities (ltcfs) is unknown.we performed a retrospective cohort study and used us 2011 ltcf resident data from the minimum data set 3.0 linked to medicare claims. we extracted cdi cases based on international classification of diseases-9 coding, and compared residents with the diagnosis of cdi to those who did not have a cdi diagnosis during their ltcf stay. ... | 2016 | 27495022 |
| authors' correction for euro surveill. 2016;21(29). | 2016 | 27494203 | |
| interview with professor mark wilcox. | mark wilcox speaks to georgia patey, commissioning editor: professor mark wilcox is a consultant microbiologist and head of microbiology at the leeds teaching hospitals (leeds, uk), the professor of medical microbiology at the university of leeds (leeds, uk), and is the lead on clostridium difficile and the head of the uk c. difficile reference laboratory for public health england (phe). he was the director of infection prevention (4 years), infection control doctor (8 years) and clinical direct ... | 2016 | 27494150 |
| fecal microbiota transplantation for inflammatory bowel disease. | the gut bacterial microbiome, particularly its role in disease and inflammation, has gained international attention with the successful use of fecal microbiota transplantation (fmt) in the treatment of clostridium difficile infection. this success has led to studies exploring the role of fmt in other conditions, including inflammatory bowel disease (ibd). both crohn's disease and ulcerative colitis are chronic inflammatory conditions of the gastrointestinal system that have multifactorial etiolo ... | 2016 | 27493597 |
| frequency and risks associated with clostridium difficile-associated diarrhea after pediatric solid organ transplantation: a single-center retrospective review. | morbidity and mortality related to clostridium difficile infection (cdi) has increased, but epidemiology and risk factors within pediatric solid organ transplant (sot) recipients are uncertain. | 2016 | 27492796 |
| fecal microbiota transplantation and its usage in neuropsychiatric disorders. | fecal microbiota transplantation has a 1700-year history. this forgotten treatment method has been put into use again during the last 50 years. the interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. new evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. there is a large number of experimental and clinical researches in the field of gut-brain axis. there is limited information on fecal microbiota transplantation. despite this ... | 2016 | 27489376 |
| enhanced surveillance of clostridium difficile infection occurring outside hospital, england, 2011 to 2013. | there are limited national epidemiological data for community-associated (ca)-clostridium difficile infections (cdis). between march 2011 and march 2013, laboratories in england submitted to the clostridium difficile ribotyping network (cdrn) up to 10 diarrhoeal faecal samples from successive patients with ca-cdi, defined here as c. difficile toxin-positive diarrhoea commencing outside hospital (or less than 48 hours after hospital admission), including those cases associated with community-base ... | 2016 | 27487436 |
| total duration of antimicrobial therapy in veterans hospitalized with uncomplicated pneumonia: results of a national medication utilization evaluation. | practice guidelines recommend the shortest duration of antimicrobial therapy appropriate to treat uncomplicated pneumonia be prescribed to reduce the emergence of resistant pathogens. a national evaluation was conducted to assess the duration of therapy for pneumonia. | 2016 | 27527659 |
| multiorgan dysfunction syndrome from strongyloides stercoralis hyperinfection in a patient with human t-cell lymphotropic virus-1 coinfection after initiation of ivermectin treatment. | strongyloides stercoralis is well known to cause hyperinfection syndrome during the period of immunosuppression; but dissemination, worsening hyperinfection, and development of multiorgan dysfunction syndrome after initiation of ivermectin has not been reported in the past. herein, we describe the case of a 62-year-old man with chronic strongyloidiasis and human t-cell lymphotropic virus-1 coinfection, who developed significant clinical worsening after 24-48 hours of initiation of treatment with ... | 2016 | 27527631 |
| disease progression and resolution in rodent models of clostridium difficile infection and impact of antitoxin antibodies and vancomycin. | clostridium difficile causes infections of the colon in susceptible patients. specifically, gut dysbiosis induced by treatment with broad-spectrum antibiotics facilitates germination of ingested c. difficile spores, expansion of vegetative cells, and production of symptom-causing toxins tcda and tcdb. the current standard of care for c. difficile infections (cdi) consists of administration of antibiotics such as vancomycin that target the bacterium but also perpetuate gut dysbiosis, often leadin ... | 2016 | 27527088 |
| synthetic lipoteichoic acid glycans are potential vaccine candidates to protect from clostridium difficile infections. | infections with clostridium difficile increasingly cause morbidity and mortality worldwide. bacterial surface glycans including lipoteichoic acid (lta) were identified as auspicious vaccine antigens to prevent colonization. here, we report on the potential of synthetic lta glycans as vaccine candidates. we identified lta-specific antibodies in the blood of c. difficile patients. therefore, we evaluated the immunogenicity of a semi-synthetic lta-crm197 glycoconjugate. the conjugate elicited lta-s ... | 2016 | 27524293 |
| [characteristic of antibiotic-associated diarrhea in patients with acute cerebral circulation disorder]. | this full-design study included patients admitted to the regional vascular centre in 2013 and was aimed to obtain more detailed information on the need for medical aid, indications for antibacterial therapy and the spectrum of the drugs being prescribed 42 patients presented with antibiotic-associated diarrhea caused by clostridium difficile. the composition of antibiotics used for mono- and combined therapy was analysed, details of the clinical picture are described, the importance of timely di ... | 2016 | 27522728 |
| restrictive antibiotic stewardship associated with reduced hospital mortality in gram-negative infection. | antimicrobial stewardship has an important role in the control of clostridium difficile infection (cdi) and antibiotic resistance. an important component of uk stewardship interventions is the restriction of broad-spectrum beta-lactam antibiotics and promotion of agents associated with a lower risk of cdi such as gentamicin. while the introduction of restrictive antibiotic guidance has been associated with improvements in cdi and antimicrobial resistance, evidence of the effect on outcome follow ... | 2016 | 27521583 |
| clostridium difficile bacteremia in a neonate. | 2016 | 27521152 | |
| fecal microbiota therapy for clostridium difficile infection: a health technology assessment. | fecal microbiota therapy is increasingly being used to treat patients with clostridium difficile infection. this health technology assessment primarily evaluated the effectiveness and cost-effectiveness of fecal microbiota therapy compared with the usual treatment (antibiotic therapy). | 2016 | 27516814 |
| clostridium difficile infection in special high-risk populations. | antibiotic use continues to be the most important risk factor for the development of clostridium difficile infection (cdi) through disruption of the indigenous microbiota of the colon. this factor, together with environmental contamination, makes hospital and other healthcare facilities the perfect breeding ground for the infection. several groups of patients are exposed to the hospital environment and, at the same time, affected by conditions that can make cdi more prevalent, more severe or mak ... | 2016 | 27515721 |
| impact of a prevention bundle on clostridium difficile infection rates in a hospital in the southeastern united states. | we sought to assess the impact of a multicomponent prevention program on hospital-acquired clostridium difficile infections in a hospital in the southeastern united states. we collected retrospective data of 140 patients from years 2009-2014 and applied the poisson regression model for analysis. we did not find any significant associations of increased risk of clostridium difficile infections for the preintervention group. further studies are needed to test multifaceted bundles in hospitals with ... | 2016 | 27515578 |
| antimicrobial stewardship for the infection control practitioner. | antibiotic misuse is a serious patient safety concern and a national public health priority. years of indiscriminant antibiotic use has promoted selection for antibiotic resistant bacteria and clostridium difficile this crisis has led to clinicians being faced with managing untreatable infections, often in the most vulnerable patient populations. this review summarizes the goals of antimicrobial stewardship programs, the essential members needed to initiate a program, various antimicrobial stewa ... | 2016 | 27515147 |
| occupational health update: focus on preventing the acquisition of infections with pre-exposure prophylaxis and postexposure prophylaxis. | health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis b virus, and hepatitis c virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, clostridium difficile). an effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and is ... | 2016 | 27515145 |
| probiotic saccharomyces boulardii cncm i-745 prevents outbreak-associated clostridium difficile-associated cecal inflammation in hamsters. | c. difficile infection (cdi) is a common debilitating nosocomial infection associated with high mortality. several cdi outbreaks have been attributed to ribotypes 027, 017, and 078. clinical and experimental evidence indicates that the nonpathogenic yeast saccharomyces boulardii cncm i-745 (s.b) is effective for the prevention of cdi. however, there is no current evidence suggesting this probiotic can protect from cdi caused by outbreak-associated strains. we used established hamster models infe ... | 2016 | 27514478 |
| crystal structure of clostridium difficile toxin a. | clostridium difficile infection is the leading cause of hospital-acquired diarrhoea and pseudomembranous colitis. disease is mediated by the actions of two toxins, tcda and tcdb, which cause the diarrhoea, as well as inflammation and necrosis within the colon(1,2). the toxins are large (308 and 270 kda, respectively), homologous (47% amino acid identity) glucosyltransferases that target small gtpases within the host(3,4). the multidomain toxins enter cells by receptor-mediated endocytosis and, u ... | 2016 | 27512603 |
| the protein inventory of clostridium difficile grown in complex and minimal medium. | the intestinal pathogen clostridium difficile is causing an increasing number of infections often characterized by severity and high relapse rates. profound knowledge of the physiology of the pathogen could help to develop new treatment strategies. proteomics, a valuable tool to study bacterial physiology, was used in this work to establish a benchmark proteome of reference strain c. difficile 630δerm with ms-based details on all identified proteins. our elaborate annotation and visualization of ... | 2016 | 27511832 |
| risk factors for clostridium difficile infection in hemato-oncological patients: a case control study in 144 patients. | evidence on risk factors for clostridium difficile infection (cdi) in hemato-oncologic patients is conflicting. we studied risk factors for cdi in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center study with a microbiologically confirmed cdi-associated diarrhea. patients were compared with 144 age and sex matched hemato-oncologic patients with cdi negative diarrhea. risk factors such as prior an ... | 2016 | 27510591 |
| [new aspects on clostridium difficile infection]. | clostridium difficile infection (cdi) is a frequent and complex disease which is influenced by the repertoire of bacterial virulence factors, by host immunity and by the intestinal microbiome. these complex interaction opens a number of options which may be used for treatment in the future. one example for new treatment options is fecal microbiota transplantation (fmt). driven by c. difficile related research activities the knowledge of protective microorganism is increasing and it may be assume ... | 2016 | 27509341 |
| clostridium difficile infections in medical intensive care units of a medical center in southern taiwan: variable seasonality and disease severity. | critical patients are susceptible to clostridium difficile infections (cdis), which cause significant morbidity and mortality in the hospital. in taiwan, the epidemiology of cdi in intensive care units (icus) is not well understood. this study was aimed to describe the incidence and the characteristics of cdi in the icus of a medical center in southern taiwan. adult patients with diarrhea but without colostomy/colectomy or laxative use were enrolled. stool samples were collected with or without ... | 2016 | 27509051 |
| a size-exclusion chromatography method for analysis of clostridium difficile vaccine toxins. | high-performance size-exclusion chromatography (hpsec or sec) is a method that can be applied to measure size distribution of proteins, including aggregates, monomers, and fragments. in the biopharmaceutical industry the quantitation of aggregates contained in biotherapeutics and protein-based vaccines is critical given the potential impact on safety, immunogenicity, and efficacy. hence, aggregation analysis of therapeutic proteins or protein-based vaccine products is almost always a requirement ... | 2016 | 27507349 |
| ion-exchange chromatography to analyze components of a clostridium difficile vaccine. | ion-exchange (iex) chromatography is one of many separation techniques that can be employed to analyze proteins. the separation mechanism is based on a reversible interaction between charged amino acids of a protein to the charged ligands attached to a column at a given ph. this interaction depends on both the pi and conformation of the protein being analyzed. the proteins are eluted by increasing the salt concentration or ph gradient. here we describe the use of this technique to characterize t ... | 2016 | 27507348 |
| a practical method for preparation of fecal microbiota transplantation. | clostridium difficile is a challenging infection that can be difficult to treat with antibiotic therapy. this chapter outlines the processing material for fecal microbiota transplantation (fmt), also known as stool transplant. fecal transplantations are effective in treating recurrent c. difficile infection (cdi). fmt uses a stool sample collected from a healthy, screened donor to restore healthy microbiota in the colon of a patient with cdi for symptom resolution. here, we describe a rapid meth ... | 2016 | 27507347 |
| minibioreactor arrays (mbras) as a tool for studying c. difficile physiology in the presence of a complex community. | the commensal microbiome plays an important role in the dynamics of clostridium difficile infection. in this chapter, we describe minibioreactor arrays (mbras), an in vitro cultivation system that we developed that allows for c. difficile physiology to be assayed in the presence of complex fecal microbial communities. the small size of the bioreactors within the mbras allows for dozens of reactors to be run simultaneously and therefore several different variables can be tested with limited time ... | 2016 | 27507346 |
| an in vitro model of the human colon: studies of intestinal biofilms and clostridium difficile infection. | the in vitro gut model is an invaluable research tool to study indigenous gut microbiota communities, the behavior of pathogenic organisms, and the therapeutic and adverse effect of antimicrobial administration on these communities. the model has been validated against the intestinal contents of sudden death victims to reflect the physicochemical and microbiological conditions of the proximal to distal colon, and has been extensively used to investigate the interplay between gut microbiota popul ... | 2016 | 27507345 |
| investigating transfer of large chromosomal regions containing the pathogenicity locus between clostridium difficile strains. | the genomes of all sequenced clostridium difficile isolates contain multiple mobile genetic elements. the chromosomally located pathogenicity locus (paloc), encoding the cytotoxins tcda and tcdb, was previously hypothesized to be a mobile genetic element; however, mobility was not demonstrated. here we describe the methods used to facilitate and detect the transfer of the paloc from a toxigenic strain into non-toxigenic strains of c. difficile. although the precise mechanism of transfer has not ... | 2016 | 27507344 |
| methods for determining transfer of mobile genetic elements in clostridium difficile. | horizontal gene transfer by mobile genetic elements plays an important role in the evolution of bacteria, allowing them to rapidly acquire new traits, including antibiotic resistance. mobile genetic elements such as conjugative and mobilizable transposons make up a considerable part of the c. difficile genome. while sequence analysis has identified a large number of these elements, experimental analysis is required to demonstrate mobility and function. this chapter describes the experimental met ... | 2016 | 27507343 |
| transfer of clostridium difficile genetic elements conferring resistance to macrolide-lincosamide-streptogramin b (mlsb) antibiotics. | molecular analysis is an important tool to investigate clostridium difficile resistance to macrolide-lincosamide-streptogramin b (mlsb). in particular, the protocols described in this chapter have been designed to investigate the genetic organization of erm(b)-containing elements and to evaluate the capability of these elements to transfer in c. difficile recipient strains using filter mating assay. | 2016 | 27507342 |
| induction and purification of c. difficile phage tail-like particles. | due to the inherent limitations of conventional antibiotics for the treatment of c. difficile infection (cdi), there is a growing interest in the development of alternative treatment strategies. both bacteriophages and r-type bacteriocins, also known as phage tail-like particles (ptlps), show promise as potential antibacterial alternatives for treating cdi. similar to bacteriophages, but lacking a viral capsid and genome, ptlps remain capable of killing target bacteria. here we describe our expe ... | 2016 | 27507340 |
| characterization of functional prophages in clostridium difficile. | bacteriophages (phages) are present in almost, if not all ecosystems. some of these bacterial viruses are present as latent "prophages," either integrated within the chromosome of their host, or as episomal dnas. since prophages are ubiquitous throughout the bacterial world, there has been a sustained interest in trying to understand their contribution to the biology of their host. clostridium difficile is no exception to that rule and with the recent release of hundreds of bacterial genome sequ ... | 2016 | 27507339 |
| inducing and quantifying clostridium difficile spore formation. | the gram-positive nosocomial pathogen clostridium difficile induces sporulation during growth in the gastrointestinal tract. sporulation is necessary for this obligate anaerobe to form metabolically dormant spores that can resist antibiotic treatment, survive exit from the mammalian host, and transmit c. difficile infections. in this chapter, we describe a method for inducing c. difficile sporulation in vitro. this method can be used to study sporulation and maximize spore purification yields fo ... | 2016 | 27507338 |
| isolating and purifying clostridium difficile spores. | the ability for the obligate anaerobe, clostridium difficile to form a metabolically dormant spore is critical for the survival of this organism outside of the host. this spore form is resistant to a myriad of environmental stresses, including heat, desiccation, and exposure to disinfectants and antimicrobials. these intrinsic properties of spores allow c. difficile to survive long-term in an oxygenated environment, to be easily transmitted from host-to-host, and to persist within the host follo ... | 2016 | 27507337 |
| intestinal epithelial cell response to clostridium difficile flagella. | clostridium difficile is the bacterium responsible for most antibiotic-associated diarrhea in north america and europe. this bacterium, which colonizes the gut of humans and animals, produces toxins that are known to contribute directly to damage of the gut. it is known that bacterial flagella are involved in intestinal lesions through the inflammatory host response. the c. difficile flagellin recognizes tlr5 and consequently activates the nf-κb and the mapk signaling pathways which elicit the s ... | 2016 | 27507336 |
| clostridium difficile adhesins. | clostridium difficile is responsible for a large spectrum of intestinal diseases ranging from mild diarrhea to fatal colitis depending on the one hand on the strain virulence and on the other on the host. the pathogenesis of c. difficile infection could be seen as a three-step process that takes place after disruption of the digestive microbiota by antibiotics: (1) contamination by and germination of spores; (2) multiplication of vegetative cells in the colonic niche using colonization factors; ... | 2016 | 27507335 |
| a fluorescent reporter for single cell analysis of gene expression in clostridium difficile. | genetically identical cells growing under homogeneous growth conditions often display cell-cell variation in gene expression. this variation stems from noise in gene expression and can be adaptive allowing for division of labor and bet-hedging strategies. in particular, for bacterial pathogens, the expression of phenotypes related to virulence can show cell-cell variation. therefore, understanding virulence-related gene expression requires knowledge of gene expression patterns at the single cell ... | 2016 | 27507334 |
| use of mcherryopt fluorescent protein in clostridium difficile. | here we describe protocols for using the red fluorescent protein mcherryopt in clostridium difficile. the protocols can be readily adapted to similar fluorescent proteins (fps), such as green fluorescent protein (gfp) and cyan fluorescent protein (cfp). there are three critical considerations for using fps in c. difficile. (1) choosing the right color: blue and (especially) red are preferred because c. difficile exhibits considerable yellow-green autofluorescence. (2) codon optimization: most fp ... | 2016 | 27507333 |
| clostridium difficile genome editing using pyre alleles. | precise manipulation (in-frame deletions and substitutions) of the clostridium difficile genome is possible through a two-stage process of single-crossover integration and subsequent isolation of double-crossover excision events using replication-defective plasmids that carry a counterselection marker. use of a coda (cytosine deaminase) or pyre (orotate phosphoribosyltransferase) as counter selection markers appears equally effective, but there is considerable merit in using a pyre mutant as the ... | 2016 | 27507332 |
| direct pcr-ribotyping of clostridium difficile. | pcr-ribotyping, a method based on heterogeneity of ribosomal intergenic spacer region, is the preferred method for genotyping of clostridium difficile. standardly used procedure for pcr-ribotyping is culturing of c. difficile from fecal samples and subsequent typing. in this chapter, we describe a modified pcr-ribotyping method for direct detection of pcr-ribotypes directly in total stool dna extract, without prior need to isolate c. difficile. | 2016 | 27507330 |
| restriction endonuclease analysis typing of clostridium difficile isolates. | restriction endonuclease analysis (rea) typing using hindiii enzyme is a highly discriminatory, reproducible, and consistent method of genetic typing of clostridium difficile (cd) isolates. rea typing analyzes cd whole cellular dna on two levels of discrimination: rea group designation and rea type designation, which distinguishes specific subtypes within the rea group. this methodology has enabled the tracking of epidemiologically significant cd strains over time and in some cases has allowed d ... | 2016 | 27507329 |
| colonization of toxigenic clostridium difficile among icu patients: a prospective study. | a prospective study was performed to investigate the prevalence of colonization among icu patients and to examine whether asymptomatic carriers were the source of subsequent c. difficile infection (cdi) and acquisition of toxigenic c. difficile. | 2016 | 27506470 |
| clostridium difficile infection is associated with lower inpatient mortality when managed by gi surgeons. | patients admitted with clostridium difficile infection are managed in a variety of settings. if their care is inadequate, these patients can rapidly deteriorate. | 2016 | 27505114 |
| a multi-center study of fidaxomicin use for clostridium difficile infection. | fidaxomicin use in real-world clinical practice, especially for severe clostridium difficile infection (cdi), is mainly based on single-center observational studies. the purpose of this pharmacoepidemiology study was to assess outcomes of patients given fidaxomicin based on episode number and use of concomitant antibiotics. | 2016 | 27536508 |
| an update on antibody-based immunotherapies for clostridium difficile infection. | clostridium difficile continues to be one of the most prevalent hospital-acquired bacterial infections in the developed world, despite the recent introduction of a novel and effective antibiotic agent (fidaxomicin). alternative approaches under investigation to combat the anaerobic gram-positive bacteria include fecal transplantation therapy, vaccines, and antibody-based immunotherapies. in this review, we catalog the recent advances in antibody-based approaches under development and in the clin ... | 2016 | 27536153 |
| bolaamphiphile-based nanocomplex delivery of phosphorothioate gapmer antisense oligonucleotides as a treatment for clostridium difficile. | despite being a conceptually appealing alternative to conventional antibiotics, a major challenge toward the successful implementation of antisense treatments for bacterial infections is the development of efficient oligonucleotide delivery systems. cationic vesicles (bolasomes) composed of dequalinium chloride ("dqasomes") have been used to deliver plasmid dna across the cardiolipin-rich inner membrane of mitochondria. as cardiolipin is also a component of many bacterial membranes, we investiga ... | 2016 | 27536102 |
| distribution of pcr ribotypes among recent clostridium difficile isolates collected in two districts of hungary using capillary gel electrophoresis and review of changes in the circulating ribotypes over time. | following the first description of a clostridium difficile case caused by ribotype 027 in hungary in 2007, the rapid spread of c. difficile infection in different hospitals within the country was observed. the aim of this pilot study was to investigate the distribution of different pcr ribotypes among inpatient and outpatient isolates obtained in two geographically different parts of hungary. one hundred and ninety-two toxigenic c. difficile isolates collected between 1 october and 1 december 20 ... | 2016 | 27534855 |
| physical pre-treatment improves efficient dna extraction and qpcr sensitivity from clostridium difficile spores in faecal swine specimens. | a considerable fraction of the faecal microbiota is spore-forming. molecular quantification of bacteria may be underestimated if preceded with nucleic acid extraction without special treatment to extract recalcitrant bacterial spores. the objective of this study was to improve the dna extraction regarding the presence of clostridium difficile spores in faecal swine specimens. sow faeces were inoculated with spores of c. difficile (10(6) cfu), frozen at - 30 °c overnight and subjected to dna extr ... | 2016 | 27534405 |
| infection-related hospitalizations in the first year after inflammatory bowel disease diagnosis. | with the rapid increase in the incidence of inflammatory bowel disease (ibd) in asia, the natural course of the early phase of disease in these patients remains poorly defined. this study aimed to determined the incidence and characteristics of infection-related hospitalization in the first year in patients newly diagnosed with ibd in hong kong sar, china. | 2016 | 27533786 |
| community-acquired clostridium difficile infection, queensland, australia. | 2016 | 27533328 |