Publications
| Title | Abstract | Year(sorted descending) Filter | PMID Filter |
|---|
| faecal microbiota transplant for recurrent clostridium difficile infection using long-term frozen stool is effective: clinical efficacy and bacterial viability data. | faecal microbial transplant (fmt) for recurrent clostridium difficile infection (rcdi) is greatly facilitated by frozen stool banks. however, the effect of frozen storage of stool for greater than 2 months on the viability of stool bacteria is unknown and the efficacy of fmt is not clear. | 2015 | 26264455 |
| variable alterations of the microbiota, without metabolic or immunological change, following faecal microbiota transplantation in patients with chronic pouchitis. | faecal microbiota transplantation (fmt) is effective in the treatment of clostridium difficile infection, where efficacy correlates with changes in microbiota diversity and composition. the effects of fmt on recipient microbiota in inflammatory bowel diseases (ibd) remain unclear. we assessed the effects of fmt on microbiota composition and function, mucosal immune response, and clinical outcome in patients with chronic pouchitis. eight patients with chronic pouchitis (current pdai ≥7) were trea ... | 2015 | 26264409 |
| [fecal microbiota transfer (fmt) in a patient with refractory irritable bowel syndrome]. | irritable bowel syndrome is a disorder of the gastrointestinal tract with unknown etiology. recent clinical data support a link between changes in fecal microbiota with decreased biodiversity and the development of irritable bowel syndrome. whether these changes of the microbiota are caused by the disease or whether they develop during the course of the disease remains unclear. several studies demonstrated that fecal microbiota transfer (fmt) successfully attenuates clostridium difficile infecti ... | 2015 | 26261935 |
| a hospital-level cost-effectiveness analysis model for toxigenic clostridium difficile detection algorithms. | despite thorough analyses of the analytical performance of clostridium difficile tests and test algorithms, the financial impact at hospital level has not been well described. such a model should take institution-specific variables into account, such as incidence, request behaviour and infection control policies. | 2015 | 26231269 |
| prevalence of clostridium difficile toxinotypes in infected patients at a tertiary care center in lebanon. | due to the increase in the incidence of clostridium difficile associated diseases at a tertiary care center in lebanon, this study was undertaken to determine the prevalent c. difficile toxinotypes. | 2015 | 26230123 |
| systems modeling of interactions between mucosal immunity and the gut microbiome during clostridium difficile infection. | clostridium difficile infections are associated with the use of broad-spectrum antibiotics and result in an exuberant inflammatory response, leading to nosocomial diarrhea, colitis and even death. to better understand the dynamics of mucosal immunity during c. difficile infection from initiation through expansion to resolution, we built a computational model of the mucosal immune response to the bacterium. the model was calibrated using data from a mouse model of c. difficile infection. the mode ... | 2015 | 26230099 |
| epidemiology of clostridium difficile in germany based on a single center long-term surveillance and german-wide genotyping of recent isolates provided to the advisory laboratory for diagnostic reasons. | epidemiology of clostridium difficile is characterized by worldwide increase of c. difficile infections (cdi) and the emergence of new epidemic outbreak strains with the capacity for global spreading. long-term local surveillance at the university of saarland medical center between 2000 and 2013 shows that the incidence rate of laboratory-confirmed cdi was influenced by local epidemiology as well as by testing strategies. since 2008, molecular typing of c. difficile was regularly performed for s ... | 2015 | 26341328 |
| [development of new vaccines]. | recent and important advances in the fields of immunology, genomics, functional genomics, immunogenetics, immunogenomics, bioinformatics, microbiology, genetic engineering, systems biology, synthetic biochemistry, proteomics, metabolomics and nanotechnology, among others, have led to new approaches in the development of vaccines. the better identification of ideal epitopes, the strengthening of the immune response due to new adjuvants, and the search of new routes of vaccine administration, are ... | 2015 | 26341041 |
| building a better crystal ball for predicting complications of clostridium difficile infection. | 2015 | 26338793 | |
| factors associated with complications of clostridium difficile infection in a multicenter prospective cohort. | clostridium difficile infection (cdi) is the most common cause of nosocomial infectious diarrhea and may result in severe complications including death. we conducted a prospective study to identify risk factors for complications of cdi (ccdi). | 2015 | 26338788 |
| recombinant lipoprotein-based vaccine candidates against c. difficile infections. | opportunistically nosocomial infections in hospitalized patients are often related to clostridium difficile infections (cdi) due to disruption of the intestinal micro-flora by antibiotic therapies during hospitalization. clostridial exotoxins a and b (tcda and tcdb) specifically bind to unknown glycoprotein(s) in the host intestine, disrupt the intestinal barrier leading to acute inflammation and diarrhea. the c-terminal receptor binding domain of tcda (a-rrbd) has been shown to elicit antibody ... | 2015 | 26245825 |
| dna-microarray-based genotyping of clostridium difficile. | clostridium difficile can cause antibiotic-associated diarrhea and a possibility of outbreaks in hospital settings warrants molecular typing. a microarray was designed that included toxin genes (tcda/b, cdta/b), genes related to antimicrobial resistance, the slpa gene and additional variable genes. | 2015 | 26242247 |
| ulcerated tophaceous gout. | gout is an inflammatory arthritis characterised by hyperuricemia, which, if poorly controlled, can lead to the development of tophi. we report the case of a 60-year-old caucasian man with poorly controlled polyarticular tophaceous gout with multiple comorbidities (including renal failure) who presented with tophaceous ulcers of the upper extremity. these ulcers caused extreme pain, requiring chronic opiate medications, and were associated with decreased sensation and reduced ability to move the ... | 2015 | 26240104 |
| u.s.-based national sentinel surveillance study for the epidemiology of clostridium difficile-associated diarrheal isolates and their susceptibility to fidaxomicin. | in 2011 a surveillance study for the susceptibility to fidaxomicin and epidemiology of clostridium difficile isolates in the united states was undertaken in seven geographically dispersed medical centers. this report encompasses baseline surveillance in 2011 and 2012 on 925 isolates. a convenience sample of c. difficile isolates or toxin positive stools from patients were referred to a central laboratory. antimicrobial susceptibility was determined by agar dilution (clsi m11-a8). clinical and la ... | 2015 | 26239985 |
| the importance of colonization with clostridium difficile on infection and transmission. | clostridium difficile infections (cdi) are the most common cause of healthcare-associated infections (hai) in the usa, accounting for 12 % of all hais [1]. reasons for such an increase are unknown but may relate to antibiotic use and evolution of a new, pathogenic strain, nap1/bi/027. the centers for disease control and prevention (cdc) identifies c. difficile as one of only three organisms to be assigned a designation of an "urgent" threat level. asymptomatic colonization with c. difficile is m ... | 2015 | 26239132 |
| predominance of pcr-ribotypes, 018 (smz) and 369 (trf) of clostridium difficile in japan: a potential relationship with other global circulating strains? | global spread and evolutionary links of an epidemic clostridium difficile strain (pcr-ribotype 027) have been noted in recent decades. however, in japan, no outbreaks caused by type 027 have been reported to date. a total of 120 c. difficile isolates from patients at 15 hospitals during non-outbreak seasons between 2011 and 2013 as well as 18 and 21 isolates collected from two hospitals in 2010 and 2009, respectively, in outbreak periods in japan, were examined. among these 120 isolates, japan-r ... | 2015 | 26238868 |
| incorrect diagnosis of clostridium difficile infection in a university hospital in japan. | physicians often fail to suspect clostridium difficile infection (cdi) and many microbiology laboratories use suboptimal diagnostic techniques. to estimate the extent of and reasons for incorrect diagnosis of cdi in japan, we investigated toxigenic c. difficile isolated from all stool culture samples and clinical course. over a 12-month period in 2010, all stool culture samples (n = 975) submitted from inpatients in a university hospital in japan were cultured for c. difficile and routine microb ... | 2015 | 26238001 |
| clostridium difficile diarrhea in the elderly: current issues and management options. | clostridium difficile infection (cdi) is the most common cause of infectious diarrhea in healthcare settings. along with antimicrobial exposure, advanced age has been shown to be a significant risk factor for the development and recurrence of, and mortality from, cdi. the substantial burden of cdi in the elderly may be related to frequent healthcare exposure, the necessity for more medications, altered intestinal microbiota, and complicated comorbidities. a diagnosis of cdi is based on evidence ... | 2015 | 26233437 |
| recommendations for the management of symptomatic clostridium difficile infection (cdi). | 2015 | 26233089 | |
| low sensitivity of fecal toxin a/b enzyme immunoassay for diagnosis of clostridium difficile infection in immunocompromised patients. | the optimal approach in laboratory diagnosis of clostridium difficile infection (cdi) is still not well defined. toxigenic culture (tc) or alternatively fecal toxin assay by cell cytotoxicity neutralization assay are considered to be the reference standard, but these methods are time-consuming and labor intensive. in many medical centers, diagnosis of cdi is therefore still based on fecal toxin a/b enzyme immunoassay (eia) directly from stool alone, balancing cost and speed against limited diagn ... | 2015 | 26232535 |
| relationship between sharps disposal containers and clostridium difficile infections in acute care hospitals. | sharps disposal containers are ubiquitous in health care facilities; however, there is paucity of data on their potential role in pathogen transmission. this study assessed the relationship between use of single-use versus reusable sharps containers and rates of clostridium difficile infections in a national sample of hospitals. | 2015 | 26231552 |
| industrial food animal production and community health. | industrial food animal production (ifap) is a source of environmental microbial and chemical hazards. a growing body of literature suggests that populations living near these operations and manure-applied crop fields are at elevated risk for several health outcomes. we reviewed the literature published since 2000 and identified four health outcomes consistently and positively associated with living near ifap: respiratory outcomes, methicillin-resistant staphylococcus aureus (mrsa), q fever, and ... | 2015 | 26231503 |
| a primer on on-demand polymerase chain reaction technology. | efforts to reduce health care-associated infections (hais) have grown in both scale and sophistication over the past few decades; however, the increasing threat of antimicrobial resistance and the impact of new legislation regarding hais on health care economics make the fight against them all the more urgent. on-demand polymerase chain reaction (pcr) technology has proven to be a highly effective weapon in this fight, offering the ability to accurately and efficiently identify disease-causing p ... | 2015 | 26198577 |
| microbiome changes associated with sustained eradication of clostridium difficile after single faecal microbiota transplantation in children with and without inflammatory bowel disease. | little data are available regarding the effectiveness and associated microbiome changes of faecal microbiota transplantation (fmt) for clostridium difficile infection (cdi) in children, especially in those with inflammatory bowel disease (ibd) with presumed underlying dysbiosis. | 2015 | 26198180 |
| fate of clostridium botulinum and incidence of pathogenic clostridia in biogas processes. | this study aimed to assess the sanitary situation in agricultural biogas plants (bp) regarding pathogenic clostridium spp. | 2015 | 26198084 |
| age-stratified treatment response rates in hospitalized patients with clostridium difficile infection treated with metronidazole. | consensus on the optimal treatment of clostridium difficile infection (cdi) is rapidly changing. treatment with metronidazole has been associated with increased clinical failure rates; however, the reasons for this are unclear. the purpose of this study was to assess age-related treatment response rates in hospitalized patients with cdi treated with metronidazole. this was a retrospective, multicenter cohort study of hospitalized patients with cdi. patients were assessed for refractory cdi, defi ... | 2015 | 26195522 |
| robot-assisted laparoscopic repair of vesicovaginal fistula: a single-center experience. | to describe our surgical technique and outcomes with robot-assisted laparoscopic repair of vesicovaginal fistula (vvf) in 10 patients. | 2015 | 26194296 |
| incidence and costs of clostridium difficile infections in canada. | background. limited data are available on direct medical costs and lost productivity due to clostridium difficile infection (cdi) in canada. methods. we developed an economic model to estimate the costs of managing hospitalized and community-dwelling patients with cdi in canada. the number of episodes was projected based on publicly available national rates of hospital-associated cdi and the estimate that 64% of all cdi is hospital-associated. clostridium difficile infection recurrences were c ... | 2015 | 26191534 |
| horizontal infection prevention measures and a risk-managed approach to vancomycin-resistant enterococci: an evaluation. | the use of infection control measures in the management of vancomycin-resistant enterococci (vre) is hotly debated. a risk-managed approach to vre control after the introduction of 2 horizontal infection prevention measures-an environmental cleaning (ec) and an antimicrobial stewardship (ams) program-was assessed. | 2015 | 26190379 |
| use of intravenous immunoglobulin in severe clostridium difficile-associated diarrhea. | clostridium difficile infection is an increasingly common cause of healthcare-acquired diarrhea. there remains substantial morbidity and mortality, even with current modalities of treatment. the aim of our study was to investigate the role of intravenous immunoglobulin (ivig) on mortality in patients with severe clostridium difficile-associated diarrhea (cdad). | 2015 | 26189489 |
| pitfalls in diagnosis of pediatric clostridium difficile infection. | the incidence of clostridium difficile infection (cdi) has risen among children and c difficile is increasingly recognized as an important cause of healthcare-associated diarrhea among pediatric patients. still, increased identification of cdi in healthy children in the community and increased testing among infants requires cautious interpretation, given the high prevalence of asymptomatic colonization in young infants and frequent detection of viruses and other co-pathogens in stool specimens i ... | 2015 | 26188603 |
| bacterial infections in hematopoietic stem cell transplant recipients. | bacterial infections are major complications after hematopoietic stem cell transplant (hsct). they consist mainly of bloodstream infections (bsi), followed by pneumonia and gastrointestinal infections, including typhlitis and clostridium difficile infection. microbiological data come mostly from bsi. coagulase negative staphylococci and enterobacteriaceae are the most frequent pathogens causing approximately 25% of bsi each, followed by enterococci, p. aeruginosa and viridans streptococci. bacte ... | 2015 | 26185610 |
| [cystic fibrosis: toward a genetic treatment; clostridium difficile versus clostridium difficile]. | 2015 | 26182641 | |
| defined nutrient diets alter susceptibility to clostridium difficile associated disease in a murine model. | clostridium difficile is a major identifiable and treatable cause of antibiotic-associated diarrhea. poor nutritional status contributes to mortality through weakened host defenses against various pathogens. the primary goal of this study was to assess the contribution of a reduced protein diet to the outcomes of c. difficile infection in a murine model. | 2015 | 26181795 |
| loss of vancomycin-resistant enterococcus fecal dominance in an organ transplant patient with clostridium difficile colitis after fecal microbiota transplant. | we report the use of fecal microbiota transplantation in a single heart-kidney transplant recipient with recurrent clostridium difficile, vancomycin-resistant enterococcus (vre) fecal dominance, and recurrent vre infections. fecal microbiota transplantation resulted in the reconstruction of a diverse microbiota with (1) reduced relative abundance of c difficile and vre and (2) positive clinical outcome. | 2015 | 26180828 |
| genomic epidemiology of a protracted hospital outbreak caused by a toxin a-negative clostridium difficile sublineage pcr ribotype 017 strain in london, england. | clostridium difficile remains the leading cause of nosocomial diarrhea worldwide, which is largely considered to be due to the production of two potent toxins: tcda and tcdb. however, pcr ribotype (rt) 017, one of five clonal lineages of human virulent c. difficile, lacks tcda expression but causes widespread disease. whole-genome sequencing was applied to 35 isolates from hospitalized patients with c. difficile infection (cdi) and two environmental ward isolates in london, england. the phylogen ... | 2015 | 26179308 |
| the clostridium difficile cell wall protein cwpv confers phase-variable phage resistance. | bacteriophages are present in virtually all ecosystems, and bacteria have developed multiple antiphage strategies to counter their attacks. clostridium difficile is an important pathogen causing severe intestinal infections in humans and animals. here we show that the conserved cell-surface protein cwpv provides antiphage protection in c. difficile. this protein, for which the expression is phase-variable, is classified into five types, each differing in their repeat-containing c-terminal domain ... | 2015 | 26179020 |
| clostridium difficile infection. | 2015 | 26176399 | |
| clostridium difficile infection. | 2015 | 26176398 | |
| clostridium difficile infection. | 2015 | 26176397 | |
| clostridium difficile infection. | 2015 | 26176396 | |
| antibiotic-induced alterations of the murine gut microbiota and subsequent effects on colonization resistance against clostridium difficile. | perturbations to the gut microbiota can result in a loss of colonization resistance against gastrointestinal pathogens such as clostridium difficile. although c. difficile infection is commonly associated with antibiotic use, the precise alterations to the microbiota associated with this loss in function are unknown. we used a variety of antibiotic perturbations to generate a diverse array of gut microbiota structures, which were then challenged with c. difficile spores. across these treatments ... | 2015 | 26173701 |
| ultrasound diagnosis of clostridium difficile-associated diarrhea. | clostridium difficile colitis is diagnosed using an immunoassay or polymerase chain reaction (pcr) assay for toxins a/b. since ultrasound is frequently used as a screening test for hospitalized patients suffering from different abdominal morbidities, we searched for sonographic indicators of c. difficile infection (cdi). in a prospective and blinded case-control study, abdominal ultrasound was performed on hospitalized patients for whom stool samples were sent for c. difficile toxin immunoassay. ... | 2015 | 26173691 |
| effects of fluoroquinolone restriction (from 2007 to 2012) on clostridium difficile infections: interrupted time-series analysis. | antimicrobial stewardship is a key component in the reduction of healthcare-associated infections, particularly clostridium difficile infection (cdi). we successfully restricted the use of cephalosporins and, subsequently, fluoroquinolones. from an endemically high level of >280 cases per year in 2007-08, the number of cdis reduced to 72 cases in 2011-12. | 2015 | 26169793 |
| novel riboswitch-binding flavin analog that protects mice against clostridium difficile infection without inhibiting cecal flora. | novel mechanisms of action and new chemical scaffolds are needed to rejuvenate antibacterial drug discovery, and riboswitch regulators of bacterial gene expression are a promising class of targets for the discovery of new leads. herein, we report the characterization of 5-(3-(4-fluorophenyl)butyl)-7,8-dimethylpyrido[3,4-b]quinoxaline-1,3(2h,5h)-dione (5fdqd)-an analog of riboflavin that was designed to bind riboswitches that naturally recognize the essential coenzyme flavin mononucleotide (fmn) ... | 2015 | 26169403 |
| fecal microbiota transplantation eliminates clostridium difficile in a murine model of relapsing disease. | recurrent clostridium difficile infection (cdi) is of particular concern among health care-associated infections. the role of the microbiota in disease recovery is apparent given the success of fecal microbiota transplantation (fmt) for recurrent cdi. here, we present a murine model of cdi relapse to further define the microbiota recovery following fmt. cefoperazone-treated mice were infected with c. difficile 630 spores and treated with vancomycin after development of clinical disease. vancomyc ... | 2015 | 26169276 |
| methods to prevent or treat refractory diseases by focusing on intestinal microbes using lps and macrophages. | intestinal microbes are known to influence host homeostasis by producing various substances. recently, the presence of a diverse range of intestinal microbiota has been shown to play a key role in the maintenance of health, along with influencing the host's innate immunity towards various diseases. for example, fecal microbiota transplantation (fmt) from healthy individuals was remarkably effective in cases of refractory clostridium difficile colitis. conversely, decreased number of intestinal m ... | 2015 | 26168477 |
| [analysis of clostridium difficile associated diarrhea in pediatric patients with antibiotic-associated diarrhea]. | to analyze the incidence and treatment of clostridium difficile infection (cdi) in pediatric patients with antibiotic-associated diarrhea (aad). | 2015 | 26165021 |
| risk factors for community-associated clostridium difficile-associated diarrhea in children. | clostridium difficile-associated diarrhea (cdad) is increasingly diagnosed in children in community settings. this study aims to assess recent antibiotic use and other risk factors in children with community-associated (ca-) cdad compared with children with other diarrheal illnesses in a tertiary care setting. | 2015 | 26164847 |
| proton pump inhibitors alter specific taxa in the human gastrointestinal microbiome: a crossover trial. | we conducted an open-label crossover trial to test whether proton pump inhibitors (ppis) affect the gastrointestinal microbiome to facilitate clostridium difficile infection (cdi). twelve healthy volunteers each donated 2 baseline fecal samples, 4 weeks apart (at weeks 0 and 4). they then took ppis for 4 weeks (40 mg omeprazole, twice daily) and fecal samples were collected at week 8. six individuals took the ppis for an additional 4 weeks (from week 8 to 12) and fecal samples were collected fro ... | 2015 | 26164495 |
| first implementation of frozen, capsulized faecal microbiota transplantation for recurrent clostridium difficile infection into clinical practice in europe. | 2015 | 26163107 | |
| innate immune defenses mediated by two ilc subsets are critical for protection against acute clostridium difficile infection. | infection with the opportunistic enteric pathogen clostridium difficile is an increasingly common clinical complication that follows antibiotic treatment-induced gut microbiota perturbation. innate lymphoid cells (ilcs) are early responders to enteric pathogens; however, their role during c. difficile infection is undefined. to identify immune pathways that mediate recovery from c. difficile infection, we challenged c57bl/6, rag1(-/-) (which lack t and b cells), and rag2(-/-)il2rg(-/-) (ragγc(-/ ... | 2015 | 26159718 |
| the bug stops here: innate lymphoid cells in clostridium difficile infection. | the contribution of the innate immune response to the resolution of clostridium difficile infection (cdi) remains incompletely defined. in this issue of cell host & microbe, abt et al. demonstrated that innate lymphoid cells and the effector cytokine ifn-γ are important for recovery from the acute phase of cdi. | 2015 | 26159713 |
| clostridium difficile infections before and during use of ultraviolet disinfection. | we previously reported a significant decrease in hospital-acquired (ha) clostridium difficile infection (cdi) coincident with the introduction of pulsed xenon ultraviolet light for room disinfection (uvd). the purpose of this study was to evaluate cdi cases in greater detail to understand the effect of uvd. | 2015 | 26159499 |
| c. difficile infection: changing epidemiology and management paradigms. | the incidence of clostridium difficile infection (cdi) has been rising in hospitals, long-term care facilities, and within the community. cases have been more severe with more complications, deaths, and higher healthcare-associated costs. with the emergence of a hypervirulent strain of c. difficile and the increasing prevalence of community-acquired cdi among healthy patients without traditional risk factors, the epidemiology of c. difficile has been evolving. this changing epidemiology requires ... | 2015 | 26158611 |
| clostridium difficile ribotypes in austria: a multicenter, hospital-based survey. | a prospective, noninterventional survey was conducted among clostridium difficile positive patients identified in the time period of july until october 2012 in 18 hospitals distributed across all nine austrian provinces. participating hospitals were asked to send stool samples or isolates from ten successive patients with c.difficile infection to the national clostridium difficile reference laboratory at the austrian agency for health and food safety for pcr-ribotyping and in vitro susceptibilit ... | 2015 | 26156942 |
| [research progress of fecal microbiota transplantation]. | intestinal microbial ecosystem is the most complex and the largest micro-ecosystem of the mammals. the use of antibiotics can lead to a lot of major changes of the flora, making the intestinal flora damaged and impacted, even developing clostridium difficile infection. fecal microbiota transplantation (fmt) as a special organ transplant therapy, which can rebuild the intestinal flora, has raised the clinical concerns. it has been used in the refractory clostridium difficile, inflammatory bowel d ... | 2015 | 26211780 |
| probiotics for clostridium difficile infection in adults (pico): study protocol for a double-blind, randomized controlled trial. | clostridium difficile is a pathogen of rapidly increasing public health importance. an estimated quarter of a million clostridium difficile infections (cdi) occur in the united states annually, at a resultant cost of 14,000 deaths and 1 billion dollars. clostridium difficile related deaths have risen 400% over the last decade, and current standard antibiotic treatments are only 75 to 85% successful. besides increasing the risk of antibiotic resistance and side effects, these treatments are very ... | 2015 | 26210512 |
| clostridium difficile infections after blunt trauma: a different patient population? | the epidemiology of clostridium difficile-associated infection (cdi) has changed, and it is evident that susceptibility is related not only to exposures and bacterial potency, but host factors as well. several small studies have suggested that cdi after trauma is associated with a different patient phenotype. the purpose of this study was to examine and describe the epidemiologic factors associated with c. difficile in blunt trauma patients without traumatic brain injury using the trauma-related ... | 2015 | 26207402 |
| [fecal microbiota transplantation in recurrent clostridium difficile infection. report of one case]. | fecal microbiota transplantation (fmt) has an incomparable efficacy to treat recurrent clostridium difficile infection, with near 90% of success. we report a 57 years old woman who developed an antibiotic associated diarrhea with a positive polymerase chain reaction test for clostridium difficile toxin. she was successfully treated with vancomycin trice but diarrhea recurred. therefore a fecal microbiota transplant was performed using solid stools from a relative, diluted in saline and instilled ... | 2015 | 26204547 |
| [treatment of a severe clostridium difficile infection with colonic lavages. report of one case]. | a loop ileostomy with intraoperative anterograde colonic lavage has been described as an alternative to colectomy in the management of cases of clostridium difficile infection refractory to medical treatment. we report a 69 years old diabetic women admitted with a septic shock. an abdominal cat scan showed a pan-colitis that seemed to be infectious. a polymerase chain reaction was positive for clostridium difficile. due to the failure to improve after full medical treatment, a derivative loop il ... | 2015 | 26203580 |
| risk factors for recurrent hospital-acquired clostridium difficile infection in a japanese university hospital. | clostridium difficile infection (cdi) is a highly prevalent hospital-associated infection. although most patients respond well to discontinuation of antibiotics, 20%-30% of patients relapse. to initiate early therapeutic measures, the risk factors for recurrent cdi must be identified, although very few japanese studies have used standard surveillance definitions to identify these risk factors. | 2015 | 26203270 |
| development and validation of digital enzyme-linked immunosorbent assays for ultrasensitive detection and quantification of clostridium difficile toxins in stool. | the currently available diagnostics for clostridium difficile infection (cdi) have major limitations. despite mounting evidence that toxin detection is paramount for diagnosis, conventional toxin immunoassays are insufficiently sensitive and cytotoxicity assays too complex; assays that detect toxigenic organisms (toxigenic culture [tc] and nucleic acid amplification testing [naat]) are confounded by asymptomatic colonization by toxigenic c. difficile. we developed ultrasensitive digital enzyme-l ... | 2015 | 26202120 |
| ipilimumab-associated colitis or refractory clostridium difficile infection? | we present a case of a patient with a diagnostic dilemma who was referred for possible faecal microbiota transplantation (fmt) for refractory diarrhoea secondary to clostridium difficile infection (cdi). on detailed history, the patient was exposed to ipilimumab concomitantly while being treated for cdi, and was instead diagnosed with diarrhoea secondary to superimposed ipilimumab-associated colitis. ipilimumab is an anti-ctla4 monoclonal antibody approved for use in metastatic melanoma and unde ... | 2015 | 26153295 |
| pathogenesis of clostridium difficile infection and its potential role in inflammatory bowel disease. | colonization with toxigenic clostridium difficile may be associated with a wide spectrum of clinical presentation ranging from asymptomatic carriage to mild diarrhea to life-threatening colitis. over the last 15 years, there has been a marked increase in the incidence of c. difficile infection, which predominantly affects elderly patients on antibiotics. more recently, there has been significant interest in the association between inflammatory bowel disease (ibd) and c. difficile infection. this ... | 2015 | 26199993 |
| homozygosity for the e526v mutation in fibrinogen a alpha-chain amyloidosis: the first report. | systemic hereditary amyloidoses are autosomal dominant diseases associated with mutations in genes encoding ten different proteins. the clinical phenotype has implications on therapeutic approach, but it is commonly variable and largely dependent on the type of mutation. except for rare cases involving gelsolin or transthyretin, patients are heterozygous for the amyloidogenic variants. here we describe the first patient identified worldwide as homozygous for a nephropathic amyloidosis, involving ... | 2015 | 26199771 |
| impact of toxigenic clostridium difficile colonization on the risk of subsequent c. difficile infection in intensive care unit patients. | clostridium difficile infection (cdi) in hospitalized patients is generally attributed to the current stay, but recent studies reveal high c. difficile colonization rates on admission. | 2015 | 26223207 |
| a curiously rare case of septic shock from clostridium difficile colitis. | this case provides the first report of a young healthy child presenting in septic shock from clostridium difficile colitis. this child had no identifiable risk factors for c. difficile, raising the suspicion for a hypervirulent strain. once infection was recognized and treated appropriately, the child made a full recovery. this case presentation highlights the need to consider c. difficile colitis in the differential diagnosis of severely ill patients, even in the absence of traditional risk fac ... | 2015 | 26221790 |
| correction: molecular epidemiology of clostridium difficile infection in a large teaching hospital in thailand. | 2015 | 26221729 | |
| surveillance for antimicrobial resistance in australian isolates of clostridium difficile, 2013-14. | the objective of this study was to determine the activity of fidaxomicin and comparator antimicrobials against clostridium difficile isolated from patients with c. difficile infection (cdi) in australian hospitals and in the community. | 2015 | 26221017 |
| mechanisms of hypervirulent clostridium difficile ribotype 027 displacement of endemic strains: an epidemiological model. | following rapid, global clonal dominance of hypervirulent ribotypes, clostridium difficile now constitutes the primary infectious cause of nosocomial diarrhoea. evidence indicates at least three possible mechanisms of hypervirulence that facilitates the successful invasion of these atypical strains: 1) increased infectiousness relative to endemic strains; 2) increased symptomatic disease rate relative to endemic strains; and 3) an ability to outcompete endemic strains in the host's gut. stochast ... | 2015 | 26218654 |
| systematic review with meta-analysis: saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. | antibiotic-associated diarrhoea is a common complication of antibiotic use, but it can be prevented with administration of probiotics. | 2015 | 26216624 |
| clostridium difficile infection after ileostomy closure mimicking anastomotic leak. | clostridium difficile infection is linked to antibiotic exposure, with elderly and immunocompromised hospitalised patients being particularly at risk. the symptoms range from mild diarrhoea to life-threatening fulminant colitis. we describe an unusual presentation of c. difficile infection after closure of ileostomy in a healthy 60-year-old man with a history of low anterior resection and defunctioning ileostomy for rectal tumour. on the third day postoperatively, the patient developed left lowe ... | 2015 | 26150639 |
| a cfr-like gene from clostridium difficile confers multiple antibiotic resistance by the same mechanism as the cfr gene. | the cfr rna methyltransferase causes multiple resistances to peptidyl transferase inhibitors by methylation of a2503 23s rrna. many cfr-like gene sequences in the databases code for unknown functions. this study confirms that a cfr-like protein from a peptoclostridium difficile (formerly clostridium difficile) strain does function as a cfr protein. the enzyme is expressed in escherichia coli and shows elevated mics for five classes of antibiotics. a primer extension stop indicates a modification ... | 2015 | 26149991 |
| effective sequestration of clostridium difficile protein toxins by calcium aluminosilicate. | clostridium difficile is a leading cause of antibiotic-associated diarrhea and the etiologic agent responsible for c. difficile infection. toxin a (tcda) and toxin b (tcdb) are nearly indispensable virulence factors for clostridium difficile pathogenesis. given the toxin-centric mechanism by which c. difficile pathogenesis occurs, the selective sequestration with neutralization of tcda and tcdb by nonantibiotic agents represents a novel mode of action to prevent or treat c. difficile-associated ... | 2015 | 26149988 |
| chronic kidney disease and end-stage renal disease are risk factors for poor outcomes of clostridium difficile infection: a systematic review and meta-analysis. | the objective of this systematic review and meta-analysis was to assess the clinical outcomes of clostridium difficile infection (cdi) in patients with chronic kidney diseases (ckd) and end-stage renal disease (esrd). | 2015 | 26147121 |
| the yield of stool testing in hospital-onset diarrhea: has evidence changed practice? | aside from examination for clostridium difficile, the yield of stool testing in hospital-onset diarrhea is poor. clinical practice guidelines discourage overzealous stool testing in patients with diarrhea that develops after the third hospital day. however, the adoption of this recommendation into clinical practice is limited. furthermore, the effect of microbiology laboratory improvements on hospital-onset diarrhea testing is largely unknown. | 2015 | 26145180 |
| a prospective study of community-associated clostridium difficile infection in kuwait: epidemiology and ribotypes. | clostridium difficile infection (cdi) is increasingly recognized as a significant community acquired pathogen that causes disease in the community. the aim of the study was to investigate prospectively the incidence of community-acquired-cdi (ca-cdi) in kuwait. of the 2584 patients with diarrhea, 16 (0.62%) were confirmed cases of ca-cdi. the other notable pathogens were salmonella spp. (0.39%) and campylobacter spp. (0.23%). the mean age was 39 years and the cdi was mild. exposure to antibiotic ... | 2015 | 26144314 |
| ensuring the safe and effective fda regulation of fecal microbiota transplantation. | scientists, policymakers, and medical professionals alike have become increasingly worried about the rise of antibiotic resistance, and the growing number of infections due to bacteria like clostridium difficile, which cause a significant number of deaths and are imposing increasing costs on our health care system. however, in the last few years, fecal microbiota transplantation (fmt), the transplantation of stool from a healthy donor into the bowel of a patient, has emerged as a startlingly eff ... | 2015 | 27774199 |
| community-acquired clostridium difficile infection in children: a retrospective study. | community acquired-clostridium difficile infection (cdi) has increased also in children in the last years. | 2015 | 26141927 |
| initial experience with fecal microbiota transplantation in clostridium difficile infection - transplant protocol and preliminary results. | clostridium difficile infection (cdi) constitutes an important cause of antibiotic-associated diarrhea. recurrence after first-line treatment with antibiotics is high and fecal microbiota transplantation (fmt) may be effective for refractory and recurrent cdi. this series aims to describe the efficacy of fmt in the treatment of refractory and recurrent cdi. | 2015 | 26140631 |
| therapeutic targeting of bile acids. | the first objectives of this article are to review the structure, chemistry, and physiology of bile acids and the types of bile acid malabsorption observed in clinical practice. the second major theme addresses the classical or known properties of bile acids, such as the role of bile acid sequestration in the treatment of hyperlipidemia; the use of ursodeoxycholic acid in therapeutics, from traditional oriental medicine to being, until recently, the drug of choice in cholestatic liver diseases; ... | 2015 | 26138466 |
| fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup o91 entero hemorrhagic escherichia coli associated with a clostridium difficile infection. more than meets the eye. | hemolytic-uremic syndrome due to enterohemorrhagic escherichia coli, belonging to serogroup o91 has rarely been described. we report here a case of post-diarrheal hus due to ehec o91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed c. difficile infection. this case highlights the usefulness of shiga-toxin detection. | 2015 | 26135847 |
| risk factors for in-hospital mortality among a cohort of children with clostridium difficile infection. | the incidence of clostridium difficile infection (cdi) has increased and has been associated with poor outcomes among hospitalized children, including increased risk of death. the purpose of this study was to identify risk factors for all-cause in-hospital mortality among children with cdi. | 2015 | 26135055 |
| isolation and identification of clostridium difficile using chromid c. difficile medium combined with gram staining and pro disc testing: a proposal for a simple culture process. | chromid c. difficile agar (cdif; biomérieux, france), a chromogenic medium, allows for the isolation and identification of clostridium difficile strains within 24 hr regardless of pretreatment of stool specimens with heat or alcohol shock. in the present study, we designed and evaluated a simple procedure for the implementation c. difficile cultures using cdif medium in a tertiary hospital setting. | 2015 | 26131411 |
| impact of clostridium difficile infection among pneumonia and urinary tract infection hospitalizations: an analysis of the nationwide inpatient sample. | clostridium difficile infection (cdi) remains one of the major hospital acquired infections in the nation, often attributable to increased antibiotic use. little research, however, exists on the prevalence and impact of cdi on patient and hospital outcomes among populations requiring such treatment. as such, the goal of this study was to examine the prevalence, risk factors, and impact of cdi among pneumonia and urinary tract infection (uti) hospitalizations. | 2015 | 26126606 |
| total synthesis of the glycosylated macrolide antibiotic fidaxomicin. | the first enantioselective total synthesis of fidaxomicin, also known as tiacumicin b or lipiarmycin a3, is reported. this novel glycosylated macrolide antibiotic is used in the clinic for the treatment of clostridium difficile infections. key features of the synthesis involve a rapid and high-yielding access to the noviose, rhamnose, and orsellinic acid precursors; the first example of a β-selective noviosylation; an effective suzuki coupling of highly functionalized substrates; and a ring-clos ... | 2015 | 26125969 |
| how do clostridium difficile infections affect nurses' everyday hospital work: a qualitative study. | this qualitative study explored the impact of clostridium difficile infections on nurses' everyday work in the hospital. twelve nurses (six in france and six in the united states) were interviewed in depth using a semi-structured interview guide. thematic analysis of the interviews was performed. managing diarrhoea and taking precautionary measures for infection control were the two most inconvenient aspects nurses reported with c. difficile patient management. precautions included contact isola ... | 2015 | 26125573 |
| what's the clinical features of colitis in elderly people in long-term care facilities? | as life expectancy has increased, the number of elderly patients who need long-term care has grown rapidly. mortality in patients with colitis in long-term care facilities (ltcfs) is increasing. we intend to investigate the main causes of colitis in ltcfs compared to those of colitis in local communities, and to identify the clinical features and risk factors of patients with colitis in ltcfs. | 2015 | 25931997 |
| recurrent clostridium difficile infection: from colonization to cure. | clostridium difficile infection (cdi) is increasingly prevalent, dangerous and challenging to prevent and manage. despite intense national and international attention the incidence of primary and of recurrent cdi (pcdi and rcdi, respectively) have risen rapidly throughout the past decade. of major concern is the increase in cases of rcdi resulting in substantial morbidity, morality and economic burden. rcdi management remains challenging as there is no uniformly effective therapy, no firm consen ... | 2015 | 25930686 |
| extrachromosomal and integrated genetic elements in clostridium difficile. | clostridium difficile is a major nosocomial pathogen, causing gastrointestinal disease in patients undergoing antibiotic therapy. this bacterium contains many extrachromosomal and integrated genetic elements, with recent genomic work giving new insights into their variability and distribution. this review summarises research conducted in this area over the last 30 years and includes a discussion on the functional contributions of these elements to host cell phenotypes, as well as encompassing re ... | 2015 | 25929174 |
| co-infection as a confounder for the role of clostridium difficile infection in children with diarrhoea: a summary of the literature. | although clostridium difficile is a major cause of antibiotic-associated diarrhoea in adults, the incidence and severity of c. difficile infection (cdi) in children is unclear. one complicating factor in assessing the role of cdi in children is the possibility of co-infection with other gastrointestinal pathogens. in this review, we summarise the literature concerning c. difficile co-infections in young children, in an attempt to discuss the rate of co-infections and their potential role in the ... | 2015 | 25926302 |
| recurrence of dual-strain clostridium difficile infection in an in vitro human gut model. | clostridium difficile infection (cdi) is still a major challenge to healthcare facilities. the detection of multiple c. difficile strains has been reported in some patient samples during initial and recurrent cdi episodes. however, the behaviour of individual strains and their contribution to symptomatic disease is unclear. | 2015 | 25925596 |
| incidence and nature of adverse reactions to antibiotics used as endocarditis prophylaxis. | antibiotic prophylaxis (ap) administration prior to invasive dental procedures has been a leading focus of infective endocarditis prevention. however, there have been long-standing concerns about the risk of adverse drug reactions as a result of this practice. the objective of this study was to identify the incidence and nature of adverse reactions to amoxicillin and clindamycin prophylaxis to prevent infective endocarditis. | 2015 | 25925595 |
| a combination of three fully human toxin a- and toxin b-specific monoclonal antibodies protects against challenge with highly virulent epidemic strains of clostridium difficile in the hamster model. | clostridium difficile infection (cdi) is the principal cause of nosocomial diarrhea and pseudomembranous colitis associated with antibiotic therapy. recent increases in the number of outbreaks attributed to highly virulent antibiotic-resistant strains underscore the importance of identifying efficacious alternatives to antibiotics to control this infection. cdi is mediated by two large exotoxins, toxins a and b. strong humoral toxin-specific immune responses are associated with recovery and a la ... | 2015 | 25924765 |
| identification of recurrent clostridium difficile infection using administrative codes: accuracy and implications for surveillance. | to develop an algorithm using administrative codes, laboratory data, and medication data to identify recurrent clostridium difficile infection (cdi) and to examine the sensitivity, specificity, positive and negative predictive values, and performance of this algorithm. | 2015 | 25924718 |
| high molecular weight typing with maldi-tof ms - a novel method for rapid typing of clostridium difficile. | clostridium difficile strains were typed by a newly developed maldi-tof method, high molecular weight typing, and compared to pcr ribotyping. among 500 isolates representing 59 pcr ribotypes a total of 35 high molecular weight types could be resolved. although less discriminatory than pcr ribotyping, the method is extremely fast and simple, and supports for cost-effective screening of isolates during outbreak situations. | 2015 | 25923527 |
| infectious disease outbreaks and increased complexity of care. | this study examined the effects of healthcare-associated infectious disease outbreaks on nurses' work in a large acute care hospital in ontario, canada. | 2015 | 25922983 |
| the clostridium difficile protease cwp84 modulates both biofilm formation and cell-surface properties. | clostridium difficile is responsible for 15-20% of antibiotic-associated diarrheas, and nearly all cases of pseudomembranous colitis. among the cell wall proteins involved in the colonization process, cwp84 is a protease that cleaves the s-layer protein slpa into two subunits. a cwp84 mutant was previously shown to be affected for in vitro growth but not in its virulence in a hamster model. in this study, the cwp84 mutant elaborated biofilms with increased biomass compared with the parental stra ... | 2015 | 25922949 |
| surveillance of clostridium difficile infections in a long-term care psychogeriatric facility: outbreak analysis and policy improvement. | following an exceptionally high clostridium difficile infections (cdi) incidence (spring 2011) in a psychogeriatric long-term care facility, a bidirectional study (2009-2012) was initiated to identify determinants (retrospectively) and to assess intervention measures taken (prospectively). | 2015 | 25922669 |