Publications

[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
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
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
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
clostridium difficile relapse secondary to medication access issue.		2015	26119615
metronidazole-triazole conjugates: activity against clostridium difficile and parasites.	metronidazole has been used clinically for over 50 years as an antiparasitic and broad-spectrum antibacterial agent effective against anaerobic bacteria. however resistance to metronidazole in parasites and bacteria has been reported, and improved second-generation metronidazole analogues are needed. the copper catalysed huigsen azide-alkyne 1,3-dipolar cycloaddition offers a way to efficiently assemble new libraries of metronidazole analogues. several new metronidazole-triazole conjugates (mtz- ...	2015	26117821
postoperative diarrhea and high ostomy output impact postoperative outcomes after elective colon and rectal operations regardless of clostridium difficile infection.	we aimed to review and compare outcomes of patients with and without clostridium difficile infection (cdi) after elective colorectal operations.	2015	26117432
application of the atlas score for evaluating the severity of clostridium difficile infection in teaching hospitals in mexico.	for clinicians, a practical bedside tool for severity assessment and prognosis of patients with clostridium difficile infection is a highly desirable unmet medical need.	2015	26117213
laboratory and clinical features of eia toxin-positive and eia toxin-negative community-acquired clostridium difficile infection.	studies have described the clinical course of patients with clostridium difficile infection (cdi) with positive enzyme immunoassay (eia) for toxins a and b. limited information is available for the patients with negative eia but positive for the toxin b gene (tcdb) by the pcr. the aim of our study is to determine if there are any differences that exist among the clinical and laboratory parameters in the patients tested to be positive by eia for toxin and those who were negative. this is a retros ...	2015	26116599
a national survey of the molecular epidemiology of clostridium difficile in israel: the dissemination of the ribotype 027 strain with reduced susceptibility to vancomycin and metronidazole.	our goals were to study the molecular epidemiology and antimicrobial susceptibilities of c. difficile strains in israel. microbiology laboratories serving 6 general hospitals (gh) and 10 long-term care facilities (ltcf) were asked to submit all stool samples in january-february 2014 that tested positive for c. difficile. toxigenic c. difficile isolates were recovered in 208 out of 217 samples (95.8%), of which 50 (23.6%) were from ltcfs. ribotype 027 was the most common type overall, identified ...	2015	26116225
controversies around epidemiology, diagnosis and treatment of clostridium difficile infection.	clostridium difficile infection is a major public health problem. however, in recent years the epidemiology, risk factors, diagnosis, and treatment of c. difficile infection have undergone a significant change. the incidence of c. difficile has increased, not only in the healthcare sector but also in the community. hospital-acquired infection and community-acquired disease have different risk factors, with the latter occurring in children and younger individuals without a history of antibiotic u ...	2015	26113167
fidaxomicin--the new drug for clostridium difficile infection.	clostridium difficile is one of the many aetiological agents of antibiotic associated diarrhoea and is implicated in 15-25 per cent of the cases. the organism is also involved in the exacearbation of inflammatory bowel disease and extracolonic manifestations. due to increase in the incidence of c. difficile infection (cdi), emergence of hypervirulent strains, and increased frequency of recurrence, the clinical management of the disease has become important. the management of cdi is based on dise ...	2015	26112840
clostridium difficile infection.		2015	26111124
candidemia, and infections by clostridium difficile and carbapenemase-producing enterobacteriaceae: new enteropathogenetic opportunistic syndromes?	in this paper we analyze three enteropathogenetic opportunistic infections represented by candida spp., c. difficile and carbapenemase-producing k. pneumoniae. the common pathogenetic pathway is based on an alteration of the intestinal flora, now mainly referred as the human microbiome, with secondary opportunism for infections caused by candida, c. difficile and carbapenemase-producing enterobacteriaceae ("ccc"). we highlight the epidemiology, risk factors, clinical syndromes associated with th ...	2015	26110290
longitudinal trends in all healthcare-associated infections through comprehensive hospital-wide surveillance and infection control measures over the past 12 years: substantial burden of healthcare-associated infections outside of intensive care units and "other" types of infection.	targeted surveillance has focused on device-associated infections and surgical site infections (ssis) and is often limited to healthcare-associated infections (hais) in high-risk areas. longitudinal trends in all hais, including other types of hais, and hais outside of intensive care units (icus) remain unclear. we examined the incidences of all hais using comprehensive hospital-wide surveillance over a 12-year period (2001-2012).	2015	26108686
risk factors, clinical characteristics, and treatment differences between residents with and without nursing home- and non-nursing home-acquired clostridium difficile infection.	the incidence of clostridium difficile infection (cdi) in nursing home residents is believed to be high because of the prevalence of predisposing factors such as decreased immune response, multiple comorbidities, medications, increased risk of infection, close proximity of residents, and recent hospitalization. yet, specific information on cdi in this population is scarce.	2015	26108383
antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents.	the risk factors for and frequency of antibiotic prescription and antibiotic-associated diarrhoea (aad) among care home residents are unknown.	2015	26104506
inference of network dynamics and metabolic interactions in the gut microbiome.	we present a novel methodology to construct a boolean dynamic model from time series metagenomic information and integrate this modeling with genome-scale metabolic network reconstructions to identify metabolic underpinnings for microbial interactions. we apply this in the context of a critical health issue: clindamycin antibiotic treatment and opportunistic clostridium difficile infection. our model recapitulates known dynamics of clindamycin antibiotic treatment and c. difficile infection and ...	2015	26102287
outcomes and risk factors associated with clostridium difficile diarrhea in hospitalized adult patients.	background. the epidemiology of clostridium difficile infection has changed over time. therefore, it is essential to monitor the characteristics of patients at risk of infection and factors associated with poor prognosis. objective. to evaluate factors associated with c. difficile infection and with poor prognosis in those with documented c. difficile colitis. methods. a retrospective case-control study of 75 patients with documented c. difficile colitis and 75 controls with hospital-acquired di ...	2015	26101522
[diagnosis of infections caused by clostridium difficile in the czech republic: availability, possibilities, and interpretation of laboratory results].	to assess the availability of the laboratory diagnosis of infections caused by c. difficile in the czech republic (cr), including the range of tests used, possible combinations, and adequate interpretation of model results.	2015	26099613
diarrhea in solid organ transplant recipients.	diarrhea is a common complaint in the solid organ transplant recipient. unlike the immune-competent patient, diarrhea in an organ transplant recipient may result in dehydration, increased toxicity of medications, and rejection. there is a wide range of causes for diarrhea in transplant recipients, but the most common causes are clostridium difficile infection, cytomegalovirus, and norovirus. this review will focus on new epidemiology data as to the cause of diarrhea in the transplant population.	2015	26098506
faecal microbiota transplantation plus selected use of vancomycin for severe-complicated clostridium difficile infection: description of a protocol with high success rate.	severe and severe/complicated clostridium difficile infection (cdi) can result in icu admission, sepsis, toxic megacolon and death. in this setting, colectomy is the standard of care but it is associated with a 50% mortality.	2015	26096320
fecal-free toxin detection remains the best way to detect clostridium difficile infection.		2015	26092488
the stethoscope and healthcare-associated infection: a snake in the grass or innocent bystander?	there is a concern that stethoscopes may transmit infectious agents which could result in healthcare-associated infection (hcai). the aim of this review was to evaluate the available literature as to the role of the stethoscope in the development of hcai. a literature search was conducted across several databases for relevant studies and reports. stethoscopes were consistently shown to harbour bacteria. the mean rate of stethoscope contamination across 28 studies was 85% (range: 47-100%). the ma ...	2015	26092471
emergence of community-acquired clostridium difficile infection: the experience of a french hospital and review of the literature.	clostridium difficile infection (cdi) is a common cause of nosocomial diarrhoea. people in the general community are not usually considered to be at risk of cdi. cdi is associated with a high risk of morbidity and mortality. the risk of severity is defined by the clostridium severity index (csi).	2015	26092300
faecal microbiota transplantation as salvage therapy for fulminant clostridium difficile infections.		2015	26092095
flooding and clostridium difficile infection: a case-crossover analysis.	clostridium difficile is a bacterium that can spread by water. it often causes acute gastrointestinal illness in older adults who are hospitalized and/or receiving antibiotics; however, community-associated infections affecting otherwise healthy individuals have become more commonly reported. a case-crossover study was used to assess emergency room (er) and outpatient visits for c. difficile infection following flood events in massachusetts from 2003 through 2007. exposure status was based on wh ...	2015	26090609
multiple recurrences of clostridium difficile infection treated with crushed fidaxomicin administered through a percutaneous endoscopic gastrostomy tube.		2015	26089544
detection of adp ribosylation in parp-1 and bacterial toxins using a capillary-based western system.	both poly and mono adp-ribosylation are common posttranslational protein modifications. for example, poly adp-ribosylation is involved in dna repair mechanisms through the poly (adp-ribose) polymerase (parp) family of enzymes. while mono adp-ribosylation has been known to trigger cell death exhibited by many bacterial toxins. because of the wide role of adp-ribosylation, the detection and analysis are very important for further understanding of the parp family of enzymes and the molecular mechan ...	2015	26084776
[evaluation of growth of clinical clostridium difficile strains belonging to different pcr-ribotypes on chromid c. difficile agar].	clostridium difficile is main reason of antibiotic-associated diarrhea in hospitalized patients. diagnostic method for detection of clostridium difficile infection (cdi) are limited to an enzyme immunoassays (eias), while the culture of toxigenic strains is still seen as the gold standard for the laboratory diagnosis. the aim of this study was to compare growth of c. difficile strains belonging to different polymerase chain reaction (pcr) ribotypes on new chromid c. difficile agar (cdiff, biomér ...	2015	26084070
[presence of lactoferrin in faeces as the indicator of clostridium difficile in pediatric patients].	number of infection caused by clostridium difficile in hospitalized children is increasing. even though children unlike adults seldom develop complications after being ill, cases of persistent diarrhoea triggered by this pathogen and mortality from this origin have been reported. at present the important problem constitute differentiation between the colonization and infection limiting the proper diagnosis of c. difficile infections (cdi) in this age group. the aim of this study was to evaluate ...	2015	26084069
evaluation of 3 automated real-time pcr (xpert c. difficile assay, bd max cdiff, and imdx c. difficile for abbott m2000 assay) for detecting clostridium difficile toxin gene compared to toxigenic culture in stool specimens.	we evaluated the performance of the 3 automated systems (cepheid xpert, bd max, and imdx c. difficile for abbott m2000) detecting clostridium difficile toxin gene compared to toxigenic culture. of the 254 stool specimens tested, 87 (48 slight, 35 moderate, and 4 heavy growth) were toxigenic culture positive. the overall sensitivities and specificities were 82.8% and 98.8% for xpert, 81.6% and 95.8% for bd max, and 62.1% and 99.4% for imdx, respectively. the specificity was significantly higher i ...	2015	26081240
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
anti-infective vaccination in the 21st century-new horizons for personal and public health.	the 21st century has seen the licensure of new anti-infective vaccines that have demonstrated their benefit for both individual and population (herd) protection. despite this there are still many human pathogens for which no vaccine is available. as we learn more about these pathogens, and as technologies advance, more opportunities for vaccine development have become available. this review will address these advances and highlight the paradigm shift from vaccines that are used on a population b ...	2015	26344360
prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (stroke-inf): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial.	post-stroke pneumonia is associated with increased mortality and poor functional outcomes. this study assessed the effectiveness of antibiotic prophylaxis for reducing pneumonia in patients with dysphagia after acute stroke.	2015	26343840
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
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
economic burden of clostridium difficile associated diarrhoea: a cost-of-illness study from a german tertiary care hospital.	clostridium difficile associated diarrhoea (cdad) is the most common cause of health-care-associated infectious diarrhoea. in the context of the german health-care system, direct and indirect costs of an initial episode of cdad and of cdad recurrence are currently unknown.	2015	26123227
variability in antibiotic use across nursing homes and the risk of antibiotic-related adverse outcomes for individual residents.	antibiotics are frequently and often inappropriately prescribed to patients in nursing homes. these antibiotics pose direct risks to recipients and indirect risks to others residing in the home.	2015	26121537
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 are the effects of proton pump inhibitors on the small intestine?	generally, proton-pump inhibitors (ppis) have great benefit for patients with acid related disease with less frequently occurring side effects. according to a recent report, ppis provoke dysbiosis of the small intestinal bacterial flora, exacerbating nonsteroidal anti-inflammatory drug-induced small intestinal injury. several meta-analyses and systematic reviews have reported that patients treated with ppis, as well as post-gastrectomy patients, have a higher frequency of small intestinal bacter ...	2015	26078557
efficacy of alternative fidaxomicin dosing regimens for treatment of simulated clostridium difficile infection in an in vitro human gut model.	fidaxomicin treatment reduces the risk of recurrent clostridium difficile infection (cdi) compared with vancomycin. extending duration of fidaxomicin therapy may further reduce recurrence. we compared the efficacy of four extended fidaxomicin regimens in an in vitro model of cdi.	2015	26078392
burden of clostridium difficile infection between 2010 and 2013: trends and outcomes from an academic center in eastern europe.	to analyze the incidence and possible risk factors in hospitalized patients treated with clostridium difficile infection (cdi).	2015	26074711
continuous administration of vancomycin through a long intestinal tube for clostridium difficile infection.	a 76-year-old previously healthy japanese man experienced severe diarrhea (8,000 ml per day) after undergoing laparotomy for small bowel obstruction and was diagnosed with clostridium difficile infection. although he developed a maculopapular rash secondary to the systemic absorption of enteral vancomycin (vcm), the patient was successfully treated with the continuous administration of vcm through a long intestinal tube placed in the terminal ileum. this method ensured the reliable delivery of v ...	2015	26073250
hospital transfer network structure as a risk factor for clostridium difficile infection.	to determine the effect of interhospital patient sharing via transfers on the rate of clostridium difficile infections in a hospital.	2015	26072907
monomicrobial vs polymicrobial clostridium difficile bacteremia: a case report and review of the literature.		2015	26071832
antibiotic regimen after a total abdominal colectomy with ileostomy for fulminant clostridium difficile colitis: a multi-institutional study.	fulminant clostridium difficile colitis (fcdc) is a highly lethal disease with mortality rates ranging between 12% and 80%. although often these patients require a total abdominal colectomy (tac) with ileostomy, there is no established management protocol for post-operative antibiotics. in this study we aim to make some recommendations for post-operative antibiotic usage, while describing the practice across different institutions.	2015	26069992
increasing numbers of hospitalizations and deaths with mention of clostridium difficile infection, north-eastern italy, 2008-2013.		2015	26068651
recombinant lipoproteins as novel vaccines with intrinsic adjuvant.	a core platform technology for high production of recombinant lipoproteins with built-in immunostimulator for novel subunit vaccine development has been established. this platform technology has the following advantages: (1) easily convert antigen into lipidated recombinant protein using a fusion sequence containing lipobox and express high level (50-150mg/l) in escherichia coli; (2) a robust high-yield up- and downstream bioprocess for lipoprotein production is successfully developed to devoid ...	2015	26067816
the gut microbiome: a clinically significant player in transplantation?	the intestinal microbiome is critical to digestion, metabolism and protection from pathogenic organisms. dysbiosis, or alteration of this microbiome, can result in clostridium difficile infection and may play a role in other conditions. patients undergoing solid organ transplantation (e.g., kidney, lung, liver, small bowel) and hematopoietic stem cell transplantation have a shift in the gut microbiome with a decrease in predominant organisms, a loss of bacterial diversity and emergence of a new ...	2015	26065325
reducing unnecessary and duplicate ordering for ovum and parasite examinations and clostridium difficile pcr in immunocompromised patients by using an alert at the time of request in the order management system.	we implemented hospital information system (his) alerts to deter unnecessary test orders for ovum and parasite (o&p) exams and clostridium difficile pcr. the his alerts decreased noncompliant o&p orders (orders after >72 h of hospitalization) from 49.8% to 30.9%, an overall decrease of 19%, and reduced noncompliant c. difficile pcr orders (orders <7 days after a previous positive result) from 30.6% to 19.2%, an overall decrease of 31.9%.	2015	26063860
fecal microbiota transplantation for clostridium difficile infection: back to the future.	clostridium difficile infection (cdi) is a leading cause of diarrhea in the industrialized world. the estimated costs of this infection are impressive: over 3.2 billion dollars annually in the us. the introduction of fecal microbiota transplantation (fmt) to clinical practice can be considered a copernican revolution. the rationale of this approach consists of correcting the imbalance of the organisms dwelling in the gut by reintroducing a normal flora.	2015	26063385
emergence of a novel binary toxin-positive strain of clostridium difficile associated with severe diarrhea that was not ribotype 027 and 078 in china.		2015	26062650
burden of clostridium difficile infection in the united states.		2015	26061852
burden of clostridium difficile infection in the united states.		2015	26061851
burden of clostridium difficile infection in the united states.		2015	26061850
use of acid suppression medication is associated with risk for c. difficile infection in infants and children: a population-based study.	acid suppression medication is associated with clostridium difficile infection (cdi) in adults and is increasingly prescribed to children. this study evaluated the relationship between acid suppression medication and incident cdi in children.	2015	26060292
comparative genomic and phenomic analysis of clostridium difficile and clostridium sordellii, two related pathogens with differing host tissue preference.	clostridium difficile and c. sordellii are two anaerobic, spore forming, gram positive pathogens with a broad host range and the ability to cause lethal infections. despite strong similarities between the two clostridial strains, differences in their host tissue preference place c. difficile infections in the gastrointestinal tract and c. sordellii infections in soft tissues.	2015	26059449
risk factors for surgical site infection in laryngeal cancer surgery.	surgical site infection (ssi) is a significant factor of morbidity and mortality in patients surgically treated for laryngeal carcinoma. the aim of this prospective study in 277 patients was to determine the incidence of ssi in patients surgically treated for laryngeal squamous cell carcinoma and to identify risk factors for development of ssi. patients with previous chemotherapy and/or radiotherapy were excluded. all patients had tracheostomy postoperatively and received antibiotic prophylaxis ...	2015	26058244
clinical and epidemiologic considerations of clostridium difficile in harbor seals (phoca vitulina) at a marine mammal rehabilitation center.	between 1998 and 2008, 15 cases of segmental to diffuse hemorrhagic to necrohemorrhagic enterocolitis were diagnosed in neonatal and weaned juvenile harbor seals (phoca vitulina) presented from the vancouver aquarium marine mammal rescue centre for rehabilitation. based on a combination of gross pathology, histopathology, bacterial isolation, and toxin testing, clostridium difficile enterocolitis was diagnosed. most pups were anorexic or inappetant and died acutely with few other premonitory sig ...	2015	26056868
impact of vancomycin faecal concentrations on clinical and microbiological outcomes in clostridium difficile infection.	to assess the impact of faecal vancomycin concentrations on clinical and microbiological outcomes in patients with clostridium difficile infection (cdi) and whether these concentrations vary with stool consistency and frequency, faecal concentrations of vancomycin were measured in stools collected at various times from patients initiated on 125mg every 6h (q6h) for 10 days. stool consistency and frequency were determined over the course of therapy. clinical and microbiological outcomes were asse ...	2015	26055927
mode of action and bactericidal properties of surotomycin against growing and nongrowing clostridium difficile.	surotomycin (cb-183,315), a cyclic lipopeptide, is in phase 3 clinical development for the treatment of clostridium difficile infection. we report here the further characterization of the in vitro mode of action of surotomycin, including its activity against growing and nongrowing c. difficile. this was assessed through time-kill kinetics, allowing a determination of the effects on the membrane potential and permeability and macromolecular synthesis in c. difficile. against representative strain ...	2015	26055381
[a sensitive method for detection of clostridium difficile in diarrheal patients].		2015	26049196
association of tcda+/tcdb+ clostridium difficile genotype with emergence of multidrug-resistant strains conferring metronidazole resistant phenotype.	reduced susceptibility of clostridium difficile to antibiotics is problematic in clinical settings. there is new evidence indicating the cotransfer of toxin-encoding genes and conjugative transposons encoding resistance to antibiotics among different c. difficile strains. to analyze this association, in the current study, we evaluated the frequency of toxigenic c. difficile among the strains with different multidrug-resistant (mdr) profiles in iran.	2015	26048022
clostridium difficile infection among veterans health administration patients.	to report on the prevalence and incidence of clostridium difficile infection (cdi) from 2009 to 2013 among veterans healthcare administration patients	2015	26047207
microbiology for radiologists: how to minimize infection transmission in the radiology department.	the implementation of standardized infection control and prevention practices is increasingly relevant as modern radiology practice evolves into its more clinical role. current centers for disease control and prevention, national institutes of health, and world health organization guidelines for the proper use of personal protective equipment, decontamination of reusable medical equipment, and appropriate management of bloodborne pathogen exposures will be reviewed. standard precautions apply to ...	2015	26046943
epidemiology of clostridium difficile infection.		2015	26043422
identification of an epithelial cell receptor responsible for clostridium difficile tcdb-induced cytotoxicity.	clostridium difficile is the leading cause of hospital-acquired diarrhea in the united states. the two main virulence factors of c. difficile are the large toxins, tcda and tcdb, which enter colonic epithelial cells and cause fluid secretion, inflammation, and cell death. using a gene-trap insertional mutagenesis screen, we identified poliovirus receptor-like 3 (pvrl3) as a cellular factor necessary for tcdb-mediated cytotoxicity. disruption of pvrl3 expression by gene-trap mutagenesis, shrna, o ...	2015	26038560
erratum to: clostridium difficile infection from a surgical perspective.		2015	26037139
defining the roles of tcda and tcdb in localized gastrointestinal disease, systemic organ damage, and the host response during clostridium difficile infections.	clostridium difficile is a leading cause of antibiotic-associated diarrhea, a significant animal pathogen, and a worldwide public health burden. most disease-causing strains secrete two exotoxins, tcda and tcdb, which are considered to be the primary virulence factors. understanding the role that these toxins play in disease is essential for the rational design of urgently needed new therapeutics. however, their relative contributions to disease remain contentious. using three different animal m ...	2015	26037121
hand hygiene and clostridium difficile infections.		2015	26034828
weight gain after fecal microbiota transplantation.	fecal microbiota transplantation (fmt) is a promising treatment for recurrent clostridium difficile infection. we report a case of a woman successfully treated with fmt who developed new-onset obesity after receiving stool from a healthy but overweight donor. this case may stimulate further studies on the mechanisms of the nutritional-neural-microbiota axis and reports of outcomes in patients who have used nonideal donors for fmt.	2015	26034755