Publications
| Title | Abstract | Year(sorted descending) Filter | PMID Filter |
|---|
| low colonization rates of clostridium difficile among patients and healthcare workers at örebro university hospital in sweden. | the aim of this study was to investigate the rate of asymptomatic colonization rate of clostridium difficile among both healthcare workers (hcws) and patients in a hospital ward in sweden. in a prospective observational study, asymptomatic hcws (n = 22) (22/60; 37%) attending patients in an infectious disease ward in sweden participated and were screened once for c. difficile. at the same time, 58 consecutive patients (58/227; 26%) admitted to the same ward were screened for c. difficile, first ... | 2015 | 25627981 |
| low incidence of clostridium difficile infection (cdi) in patients treated with outpatient parenteral antimicrobial therapy (opat). | 2015 | 25627769 | |
| postoperative burden of hospital-acquired clostridium difficile infection. | objective clostridium difficile infection (cdi) is a common hospital-acquired infection. previous reports on the incidence, risk factors, and impact of cdi on resources in the surgical population are limited. in this context, we study cdi across diverse surgical settings. methods we prospectively identified patients with laboratory-confirmed postoperative cdi after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between july 2012 and september 2013 ... | 2015 | 25627760 |
| clostridium difficile the hospital plague. | clostridium difficile infection (cdi) has become one of the major public health threats in the last two decades. an increase has been observed not only in the rate of cdi, but also in its severity and mortality. symptoms caused by this pathogen are accompanied by intense local and systemic inflammation. we confirmed that raman microspectroscopy can help us in understanding cdi pathogenesis. a single erythrocyte of patients with cdi shows a difference, approximately 10 times, in the intensity of ... | 2015 | 25627751 |
| non-inferiority of pulsed xenon uv light versus bleach for reducing environmental clostridium difficile contamination on high-touch surfaces in clostridium difficile infection isolation rooms. | the standard for clostridium difficile surface decontamination is bleach solution at a concentration of 10 % of sodium hypochlorite. pulsed xenon uv light (px-uv) is a means of quickly producing germicidal uv that has been shown to be effective in reducing environmental contamination by c. difficile spores. the purpose of this study was to investigate whether px-uv was equivalent to bleach for decontamination of surfaces in c. difficile infection isolation rooms. high-touch surfaces in rooms pre ... | 2015 | 25627208 |
| acute gastroenteritis due to co-infection by salmonella and clostridium difficile. | 2015 | 25626957 | |
| inflammasome activation contributes to interleukin-23 production in response to clostridium difficile. | clostridium difficile is the most common hospital-acquired pathogen, causing antibiotic-associated diarrhea in over 250,000 patients annually in the united states. disease is primarily mediated by toxins a and b, which induce potent proinflammatory signaling in host cells and can activate an asc-containing inflammasome. recent findings suggest that the intensity of the host response to infection correlates with disease severity. our lab has identified the proinflammatory cytokine interleukin-23 ... | 2015 | 25626905 |
| risk factors for recurrent clostridium difficile infection: a systematic review and meta-analysis. | an estimated 20-30% of patients with primary clostridium difficile infection (cdi) develop recurrent cdi (rcdi) within 2 weeks of completion of therapy. while the actual mechanism of recurrence remains unknown, a variety of risk factors have been suggested and studied. the aim of this systematic review and meta-analysis was to evaluate current evidence on the risk factors for rcdi. | 2015 | 25626326 |
| diagnosis and treatment of clostridium difficile in adults: a systematic review. | since 2000, the incidence and severity of clostridium difficile infection (cdi) have increased. | 2015 | 25626036 |
| tigecycline exhibits inhibitory activity against clostridium difficile in the intestinal tract of hospitalised patients. | no new acquisition of clostridium difficile occurred among 12 hospitalised patients receiving tigecycline, and pre-existing colonisation was reduced to undetectable levels in 2 patients. moreover, 91% of stool suspensions obtained during tigecycline therapy exhibited inhibitory activity against c. difficile. these results suggest that tigecycline achieves sufficient concentrations to inhibit intestinal colonisation by c. difficile. | 2015 | 25623897 |
| meropenem versus piperacillin-tazobactam for definitive treatment of bloodstream infections due to ceftriaxone non-susceptible escherichia coli and klebsiella spp (the merino trial): study protocol for a randomised controlled trial. | gram-negative bacteria such as escherichia coli or klebsiella spp. frequently cause bloodstream infections. there has been a worldwide increase in resistance in these species to antibiotics such as third generation cephalosporins, largely driven by the acquisition of extended-spectrum beta-lactamase or plasmid-mediated ampc enzymes. carbapenems have been considered the most effective therapy for serious infections caused by such resistant bacteria; however, increased use creates selection pressu ... | 2015 | 25623485 |
| typhlocolitis associated with clostridium difficile ribotypes 078 and 110 in neonatal piglets from a commercial irish pig herd. | clostridium difficile is a recognised cause of typhlocolitis and diarrhoea in neonatal pigs but has never been confirmed in association with pathology and disease in irish pigs. | 2015 | 27547375 |
| the epidemiological and clinical analysis of clostridium difficile infections in patients hospitalized due to the infection at the department of infectious diseases in bytom. | clostridium difficile infections are becoming a more serious problem as hospital-acquired infections and the consequence of common antibiotic therapy, also on an out-patient basis. | 2015 | 27139349 |
| fecal microbiota transplantation: a review of emerging indications beyond relapsing clostridium difficile toxin colitis. | the symbiotic relationship between gut microbiota and humans has been forged over many millennia. this relationship has evolved to establish an intimate partnership that we are only beginning to understand. gut microbiota were once considered pathogenic, but the concept of gut microbiota and their influence in human health is undergoing a major paradigm shift, as there is mounting evidence of their impact in the homeostasis of intestinal development, metabolic activities, and the immune system. ... | 2015 | 27099570 |
| implementation of a clinical decision support alert for the management of clostridium difficile infection. | clostridium difficile infections are common in hospitalized patients and can result in significant morbidity and mortality. it is imperative to optimize the management of c. difficile infections to help minimize disease complications. antimicrobial stewardship techniques including guidelines, order sets and other clinical decision support functionalities may be utilized to assist with therapy optimization. we implemented a novel alert within our electronic medical record to direct providers to t ... | 2015 | 27025646 |
| a review of management of clostridium difficile infection: primary and recurrence. | clostridium difficile infection (cdi) is a potentially fatal illness, especially in the elderly and hospitalized individuals. the recurrence and rates of cdi are increasing. in addition, some cases of cdi are refractory to the currently available antibiotics. the search for improved modalities for the management of primary and recurrent cdi is underway. this review discusses the current antibiotics, fecal microbiota transplantation (fmt) and other options such as immunotherapy and administration ... | 2015 | 27025632 |
| antimicrobial resistance and reduced susceptibility in clostridium difficile: potential consequences for induction, treatment, and recurrence of c. difficile infection. | clostridium difficile infection (cdi) remains a substantial burden on healthcare systems and is likely to remain so given our reliance on antimicrobial therapies to treat bacterial infections, especially in an aging population in whom multiple co-morbidities are common. antimicrobial agents are a key component in the aetiology of cdi, both in the establishment of the infection and also in its treatment. the purpose of this review is to summarise the role of antimicrobial agents in primary and re ... | 2015 | 27025625 |
| fecal microbiota transplantation: expanding horizons for clostridium difficile infections and beyond. | fecal microbiota transplantation (fmt) methodology has been progressively refined over the past several years. the procedure has an extensive track record of success curing clostridium difficile infection (cdi) with remarkably few adverse effects. it achieves similar levels of success whether the cdi occurs in the young or elderly, previously normal or profoundly ill patients, or those with cdi in inflammatory bowel disease (ibd). while using fmt to treat cdi, however, we learned that using the ... | 2015 | 27025624 |
| antimicrobial use, human gut microbiota and clostridium difficile colonization and infection. | clostridium difficile infection (cdi) is the most important cause of nosocomial diarrhea. broad-spectrum antimicrobials have profound detrimental effects on the structure and diversity of the indigenous intestinal microbiota. these alterations often impair colonization resistance, allowing the establishment and proliferation of c. difficile in the gut. studies involving animal models have begun to decipher the precise mechanisms by which the intestinal microbiota mediates colonization resistance ... | 2015 | 27025623 |
| doxycycline and tigecycline: two friendly drugs with a low association with clostridium difficile infection. | clostridium difficile infection (cdi) is known to be associated with prior exposure to many classes of antibiotics. standard therapy for cdi (i.e., metronidazole and vancomycin) is associated with high recurrence rates. although tetracycline derivatives such as tetracycline, doxycycline or tigecycline are not the standard therapeutic choices for cdi, they may serve as an alternative or a component of combination therapy. previous tetracycline or doxycycline usage had been shown to have less asso ... | 2015 | 27025622 |
| the antimicrobial stewardship approach to combating clostridium difficile. | clostridium difficile remains a major public health threat and continues to contribute to excess morbidity, mortality and healthcare costs. antimicrobial stewardship programs have demonstrated success in combating c. difficile, primarily through antibiotic restrictive strategies. as the incidence and prevalence of c. difficile associate disease continues to increase both in the hospital and community setting, additional stewardship approaches are needed. this manuscript reviews stewardship inter ... | 2015 | 27025621 |
| [intestinal microbiota transplantation for the treatment of clostridium difficile infection]. | the infections caused by c. difficile, responsible for the antibiotic-associated diarrhea and pseudomembranous colitis, are the growing health problem. an increasing number of c. difficile infection (cdi) cases and the phenomenon of multidrug-resistance of bacteria forces to find new, effective therapeutic methods. intestinal microbiota transplantation ("fecal bacteriotherapy") is a promising remedy for patients suffering from recurrent, severe, not susceptible to standard treatments intestinal ... | 2015 | 27019915 |
| clostridium difficile infection: risk factors, diagnosis and management. | clostridium difficile infection (cdi) is the leading cause of death due to gastrointestinal infections in the us and is the most common cause of nosocomial diarrhea. the emergence of a hypervirulent strain in the early 2000s has been associated with a dramatic increase in the number and severity of cases in the us, canada, and several other countries. most cases are related to antibiotic use, but sporadic cases occur in otherwise healthy individuals with no risk factors. morbidity and mortality ... | 2015 | 25567105 |
| the gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. | rapid environmental transition and modern lifestyles are likely driving changes in the biodiversity of the human gut microbiota. with clear effects on physiologic, immunologic, and metabolic processes in human health, aberrations in the gut microbiome and intestinal homeostasis have the capacity for multisystem effects. changes in microbial composition are implicated in the increasing propensity for a broad range of inflammatory diseases, such as allergic disease, asthma, inflammatory bowel dise ... | 2015 | 25567038 |
| dysfunctional families: clostridium scindens and secondary bile acids inhibit the growth of clostridium difficile. | c. difficile infection is a deadly disease that is influenced by the microbiome. in a recent article in nature, buffie et al. (2014) demonstrate that the ability of c. scindens to synthesize secondary bile acids is crucial to providing resistance to c. difficile infection. | 2015 | 25565200 |
| the intestinal microbiota: its role in health and disease. | the intestinal microbiota (previously referred to as "intestinal flora") has entered the focus of research interest not only in microbiology but also in medicine. huge progress has been made with respect to the analysis of composition and functions of the human microbiota. an "imbalance" of the microbiota, frequently also called a "dysbiosis," has been associated with different diseases in recent years. crohn's disease and ulcerative colitis as two major forms of inflammatory bowel disease, irri ... | 2015 | 25563215 |
| seek and you shall find: prevalence of clostridium difficile in wuhan, china. | clostridium difficile infection (cdi) is one of the leading health care acquired-infections in the united states, but much of the epidemiology and burden of disease is unknown in china. the aim of this study was to determine the prevalence and possible risk factors of cdi among hospitalized patients with diarrhea in wuhan, china. the overall prevalence of cdi was 28% (31/111). the findings of this study suggest the prevalence of cdi in hospitalized patients with diarrhea is higher then what has ... | 2015 | 25557771 |
| clostridium difficile infection among kidney transplant recipients: frequency, clinical presentation, and outcome. | the objective of this study was to evaluate the frequency of clostridium difficile infection (cdi) among kidney transplant recipients and describe the clinical picture in correlation with the presence of certain risk factors. we included kidney transplant recipients with a functioning graft, who were admitted during the period 1/2012-12/2013, and patients with esrd who were admitted to undergo kidney transplantation (ktx) from a deceased or a living donor in the same period. patients were screen ... | 2015 | 25556694 |
| long-term effects of an antimicrobial stewardship programme at a tertiary-care teaching hospital. | antimicrobial stewardship has been shown to reduce unnecessary antibiotic use, but there are few data on the long-term benefits of such a programme. antimicrobial use over a 13-year period since implementing an antimicrobial stewardship programme (asp) at our institution was examined. nosocomial rates of clostridium difficile infection (cdi) and antimicrobial susceptibility patterns of common nosocomial micro-organisms over the same period were also reviewed. total antimicrobial use decreased by ... | 2015 | 25554468 |
| evaluation of the bd max cdiff assay for the detection of toxigenic clostridium difficile in human stool specimens. | the becton dickinson (bd) pcr-based geneohm cdiff assay has demonstrated a high sensitivity and specificity for detecting clostridium difficile. recently, the bd max platform, using the same principles as bd geneohm, has become available in australia. this study aimed to investigate the sensitivity and specificity of bd max cdiff assay for the detection of toxigenic c. difficile in an australian setting. between december 2013 and january 2014, 406 stool specimens from 349 patients were analysed ... | 2015 | 25551308 |
| overview of management of acute renal failure and its evaluation; a case analysis. | the annual incidence is about 150 per million in the uk, but this figure is six times greater in the >80 years old group. prerenal azotemia is considered as the most serious reason in community or hospital acquired acute renal failure (arf). a 67-year-old middle age male was admitted to the hospital with a chief complaint of generalized weakness, volume depletion and dysuria. he has treated with metronidazole for diarrhoea caused by clostridium difficile considered as the precipitating factor fo ... | 2015 | 28197469 |
| clostridium difficile infection, a descriptive analysis of solid organ transplant recipients at a single center. | clostridium difficile is a bacterial enteric pathogen, which causes clinical disease among solid organ transplant (sot) recipients. this large, single-center, retrospective study describes incidence, demographics, and impact of c. difficile infection (cdi) among adult sot recipients, cardiac (n=5), lung (n=14), liver (n=9), renal (n=26), and multiorgan (n=9) patients transplanted and diagnosed with cdi (geneb pcr) between 9/2009 and 12/2012. the overall incidence of cdi in our population during ... | 2015 | 25586932 |
| government introduces action plan to reduce deaths from sepsis. | tackling sepsis - the potentially fatal over-reaction of the immune system to infection - must be given the same priority as reducing clostridium difficile and mrsa infections, the government has said. | 2015 | 25585729 |
| the epidemiology of clostridium difficile infection inside and outside health care institutions. | this article describes the global changes in clostridium difficile epidemiology since the late twentieth century and into the twenty-first century when the new epidemic strain bi/nap1/027 emerged. the article provides an overview of how understanding of c difficile epidemiology has rapidly evolved since its initial association with colitis in 1974. it also discusses how c difficile has spread across the globe, the role of asymptomatic carriers in disease transmission, the increased recognition o ... | 2015 | 25582647 |
| potential sources of clostridium difficile in human infection. | the view of clostridium difficile infection as a hospital-acquired infection transmitted only by symptomatic patients is changing. although c difficile is present in food for human consumption, food-borne infection caused by c difficile has never been confirmed. more information on the infective dose and the level of contamination is needed to determine the risk for food-borne exposure to c difficile in humans. the emergence of c difficile polymerase chain reaction (pcr) ribotype 078 in humans i ... | 2015 | 25582646 |
| the contribution of strains and hosts to outcomes in clostridium difficile infection. | acquisition of clostridium difficile spores can be followed by a spectrum of clinical outcomes ranging from asymptomatic transit through the bowel to severe colitis and death. this clinical variability is a product of bacterial virulence and host susceptibility to the pathogen. it is important to identify patients at high risk of poor outcome so that increased monitoring and optimal treatment strategies can be instigated. this article discusses the evidence linking strain type to clinical outcom ... | 2015 | 25582645 |
| predictive values of models of clostridium difficile infection. | in vivo and in vitro models are widely used to simulate clostridium difficile infection (cdi). they have made considerable contributions in the study of c difficile pathogenesis, antibiotic predisposition to cdi, and population dynamics as well as the evaluation of new antimicrobial and immunologic therapeutics. although cdi models have greatly increased understanding of this complicated pathogen, all have limitations in reproducing human disease, notably their inability to generate a truly refl ... | 2015 | 25582644 |
| testing for clostridium difficile in patients newly diagnosed with inflammatory bowel disease in a community setting. | the incidence of clostridium difficile infection (cdi) in inflammatory bowel disease (ibd) is increasing, and cdi has a negative impact on ibd outcomes with both increased morbidity and mortality. data are lacking regarding the rate of appropriate testing for cdi at the time of diagnosis. | 2015 | 25581825 |
| [fecal microbiota transplantation: review]. | fecal microbiota transplantation (fmt) has gained an increasing medical interest, since the recognition of the role of disturbed microbiota in the development of various diseases. to date, fmt is an established treatment modality for multiple recurrent clostridium difficile infection (rcdi), despite lack of standardization of the procedure. persisting normalization of the disturbed colonic microbiota associated with rcdi seems to be responsible for the therapeutic effect of fmt. for other diseas ... | 2015 | 25577013 |
| mobile genetic elements in clostridium difficile and their role in genome function. | approximately 11% the clostridium difficile genome is made up of mobile genetic elements which have a profound effect on the biology of the organism. this includes transfer of antibiotic resistance and other factors that allow the organism to survive challenging environments, modulation of toxin gene expression, transfer of the toxin genes themselves and the conversion of non-toxigenic strains to toxin producers. mobile genetic elements have also been adapted by investigators to probe the biolog ... | 2015 | 25576774 |
| an alkaline phosphatase reporter for use in clostridium difficile. | clostridium difficile is an anaerobic, gram-positive pathogen that causes severe gastrointestinal disease in humans and other mammals. c. difficile is notoriously difficult to work with and, until recently, few tools were available for genetic manipulation and molecular analyses. despite the recent advances in the field, there is no simple or cost-effective technique for measuring gene transcription in c. difficile other than direct transcriptional analyses (e.g., quantitative real-time pcr and ... | 2015 | 25576237 |
| clostridium difficile infection targets. | 2015 | 25575770 | |
| fidaxomicin use and clinical outcomes for clostridium difficile-associated diarrhea. | fidaxomicin has been scrutinized because of its high acquisition cost. real-world experience is needed to determine whether fidaxomicin has value in patients with clostridium difficile-associated diarrhea (cdad) and certain risk factors. | 2015 | 25574116 |
| fecal microbiota transplantation broadening its application beyond intestinal disorders. | intestinal dysbiosis is now known to be a complication in a myriad of diseases. fecal microbiota transplantation (fmt), as a microbiota-target therapy, is arguably very effective for curing clostridium difficile infection and has good outcomes in other intestinal diseases. new insights have raised an interest in fmt for the management of extra-intestinal disorders associated with gut microbiota. this review shows that it is an exciting time in the burgeoning science of fmt application in previou ... | 2015 | 25574083 |
| fecal transplant policy and legislation. | fecal microbiota transplantation (fmt) has garnered significant attention in recent years in the face of a reemerging clostridium difficile (c. difficile) epidemic. positive results from the first randomized control trial evaluating fmt have encouraged the medical community to explore the process further and expand its application beyond c. difficile infections and even the gastrointestinal domain. however promising and numerous the prospects of fmt appear, the method remains limited in scope to ... | 2015 | 25574076 |
| treatment of clostridium difficile infections. | vancomycin and metronidazole were historically considered equivalent therapies for the management of clostridium difficile infections (cdi); however, recent data confirm more favorable outcomes with vancomycin. fidaxomicin is a narrow spectrum antibiotic that has an advantage in reducing recurrence rates compared with vancomycin, possibly owing to its sparing effect on normal colonic microbiota. data are limited for guiding management of cdi recurrences, particularly multiple recurrences. severa ... | 2015 | 25573676 |
| environmental interventions to control clostridium difficile. | the control of clostridium difficile infection is paramount. c difficile spores are difficult to eradicate and can survive on surfaces for prolonged periods of time. hand washing with either plain or antimicrobial soap is effective in removing c difficile spores from hands. patients should be placed in private rooms and under contact precautions to prevent transmission to other patients. regular hospital germicides are not sporicidal and hypochlorite solutions are required for surface disinfecti ... | 2015 | 25573675 |
| new perspectives in clostridium difficile disease pathogenesis. | clostridium difficile is associated with a spectrum of clinical manifestations ranging from asymptomatic carriage to severe life-threatening pseudomembranous colitis. current perspectives indicate that c difficile pathogenesis is a multifactorial disease process dictated by pathogenic toxin production, gut microbial dysbiosis, and altered host inflammatory responses. this article summarizes recent findings underpinning the cellular and molecular mechanisms regulating bacterial virulence and shed ... | 2015 | 25573674 |
| costs associated with health care-associated infections in cardiac surgery. | health care-associated infections (hais) are the most common noncardiac complications after cardiac surgery and are associated with increased morbidity and mortality. current information about their economic burden is limited. | 2015 | 25572505 |
| clostridium difficile from food and surface samples in a belgian nursing home: an unlikely source of contamination. | this study investigates the contamination of foods and surfaces with clostridium difficile in a single nursing home. c. difficile pcr-ribotype 078 was found in one food sample and in none of the tested surfaces. these results indicate that food and surfaces are an unlikely source of c. difficile infection in this setting. | 2015 | 25571851 |
| novel receptors for bacterial protein toxins. | while bacterial effectors are often directly introduced into eukaryotic target cells by various types of injection machines, toxins enter the cytosol of host cells from endosomal compartments or after retrograde transport via golgi from the er. a first crucial step of toxin-host interaction is receptor binding. using optimized protocols and new methods novel toxin receptors have been identified, including metalloprotease adam 10 for staphylococcus aureus α-toxin, laminin receptor lu/bcam for esc ... | 2015 | 25461573 |
| single domain antibody coated gold nanoparticles as enhancer for clostridium difficile toxin detection by electrochemical impedance immunosensors. | this work presents a sandwich-type electrochemical impedance immunosensor for detecting clostridium difficile toxin a (tcda) and toxin b (tcdb). single domain antibody conjugated gold nanoparticles were applied to amplify the detection signal. gold nanoparticles (au nps) were characterized by transmission electron microscopy and uv–vis spectra. the electron transfer resistance (ret) of the working electrode surface was used as a parameter in the measurement of the biosensor. with the increase of ... | 2015 | 25460611 |
| development of fecal microbiota transplantation suitable for mainstream medicine. | fecal microbiota transplantation has emerged as an increasingly common treatment for patients with refractory clostridium difficile infection. although it can be relatively simple to perform, a number of challenges need to be overcome before this procedure is widely accepted in mainstream clinical practice. most of the solutions to these challenges already exist, but some need further optimization and testing. standardized fecal microbiota is being developed as a therapeutic agent, although it c ... | 2015 | 25460566 |
| [fecal microbiota transplantation]. | bacteria can no longer be seen as an enemy. nowadays, there is enough evidence to place the microbiota as a key element in human homeostasis. despite initial skepticism, fecal microbiota transplantation (fmt) is a real therapeutic alternative for patients with recurrent clostridium difficile infection. moreover, this procedure has shown promising results in ulcerative colitis and other non-gastrointestinal disorders. there is still a lack of knowledge and clinical trials with long- term follow-u ... | 2015 | 25454597 |
| missed diagnosis of clostridium difficile infection; a prospective evaluation of unselected stool samples. | clostridium difficile infection (cdi) is the leading cause of hospital-acquired diarrhoea in developed countries, however a high proportion of cdi episodes go undiagnosed, either because physicians do not request identification of toxigenic c. difficile or microbiologists do not perform the appropriate tests. | 2015 | 25452039 |
| broad coverage of genetically diverse strains of clostridium difficile by actoxumab and bezlotoxumab predicted by in vitro neutralization and epitope modeling. | clostridium difficile infections (cdis) are the leading cause of hospital-acquired infectious diarrhea and primarily involve two exotoxins, tcda and tcdb. actoxumab and bezlotoxumab are human monoclonal antibodies that neutralize the cytotoxic/cytopathic effects of tcda and tcdb, respectively. in a phase ii clinical study, the actoxumab-bezlotoxumab combination reduced the rate of cdi recurrence in patients who were also treated with standard-of-care antibiotics. however, it is not known whether ... | 2015 | 25451052 |
| development of antimicrobial resistance in the normal anaerobic microbiota during one year after administration of clindamycin or ciprofloxacin. | thirty healthy subjects (15 males and 15 females) were randomly assigned in three groups and clindamycin (150 mg qid) or ciprofloxacin (500 mg bid) or placebo was given for a 10-day period. skin, nasal, saliva, faeces samples were collected at day - 1, day 11, 1 month, 2 months, 4 months and 12 months post administration for microbiological analysis. ciprofloxacin or clindamycin had no impact on the anaerobic skin microbiota and the proportions of antibiotic resistant anaerobic bacteria were sim ... | 2015 | 25445201 |
| sporicides for clostridium difficile—do they do what it says on the tin? | 2015 | 25443502 | |
| practice parameters for the management of clostridium difficile infection. | 2015 | 25489690 | |
| prevalence of clostridium difficile infection presenting to us eds. | the objective of the study is to determine the prevalence of clostridium difficile infection (cdi) presenting to emergency departments (eds) in the united states. secondary objectives included defining the burden of cdi. | 2015 | 25488337 |
| mechanisms of protection against clostridium difficile infection by the monoclonal antitoxin antibodies actoxumab and bezlotoxumab. | clostridium difficile infection (cdi) represents the most prevalent cause of antibiotic-associated gastrointestinal infections in health care facilities in the developed world. disease symptoms are caused by the two homologous exotoxins, tcda and tcdb. standard therapy for cdi involves administration of antibiotics that are associated with a high rate of disease recurrence, highlighting the need for novel treatment paradigms that target the toxins rather than the organism itself. a combination o ... | 2015 | 25486992 |
| faecal shedding of antimicrobial-resistant clostridium difficile strains by dogs. | to longitudinally assess the shedding of antimicrobial resistant clostridium difficile strains by clinically healthy dogs raised at breeding facilities. | 2015 | 25483272 |
| influence of sequence mismatches on the specificity of recombinase polymerase amplification technology. | recombinase polymerase amplification (rpa) technology relies on three major proteins, recombinase proteins, single-strand binding proteins, and polymerases, to specifically amplify nucleic acid sequences in an isothermal format. the performance of rpa with respect to sequence mismatches of closely-related non-target molecules is not well documented and the influence of the number and distribution of mismatches in dna sequences on rpa amplification reaction is not well understood. we investigated ... | 2015 | 25481659 |
| detection of clostridium difficile toxin genes by pcr: sequence variation may cause false-negative results. | 2015 | 25480881 | |
| analysis of interventions to reduce the incidence of clostridium difficile infection at a london teaching hospital trust, 2003-2011. | since 2008 there has been a substantial fall in the incidence of clostridium difficile infection (cdi) in the uk, though it is unclear what contribution local and governmental interventions have made to this reduction. | 2015 | 25480022 |
| low vitamin d level and impact on severity and recurrence of clostridium difficile infections. | clostridium difficile infection (cdi) has recently markedly increased, incurring greater health care-associated costs and hospitalizations especially in vitamin d deficient patients. accordingly, the aim of this study was to evaluate the relationship between low vitamin d levels and the severity and recurrence of cdi. | 2015 | 25479065 |
| adult vaccination. | vaccination of children has had a major impact on the morbidity and mortality of many infectious diseases globally. however, with age, immune responses to vaccines can be less robust, which can be further enhanced by underlying diseases that are common in the older adult. in many countries around the globe booster vaccinations against diphtheria, tetanus, and pertussis are recommended for adults. for the older adult, vaccination against pneumococcal diseases, influenza and herpes zoster are also ... | 2015 | 25483533 |
| the importance of considering different healthcare settings when estimating the burden of clostridium difficile. | traditional surveillance methods may underestimate the true burden of clostridium difficile infection (cdi) because they fail to capture cases brought to medical attention in outpatient settings or diagnosed during non-face-to-face patient-provider interactions. | 2015 | 25477426 |
| development of a sporicidal test method for clostridium difficile. | disinfectants with claimed activity against clostridium difficile must be evaluated to ensure efficacy against the spores that comprise an environmental source of patient infection. unfortunately there is, at present, no generally accepted method for evaluating these disinfectants. in the absence of such a method, laboratories have to adapt protocols that were not designed for products used in medical environments and consequently may use inappropriate test organisms, exposure times, and pass cr ... | 2015 | 25477061 |
| survival of clostridium difficile spores at low temperatures. | clostridium difficile's presence has been reported in meat products stored typically at low temperatures. this study evaluated the viability in phosphate buffer saline (pbs) of spores from epidemic c. difficile strain r20291 (4.6 log cfu/ml) and m120 (7.8 log cfu/ml). viability was assessed during 4 months at -80 °c, -20 °c, 4 °c (refrigeration), and 23 °c (room temperature), and after 10 freeze (-20 °c)/thaw (+23 °c) cycles. although spore viability decreased, significant viability was still ob ... | 2015 | 25475288 |
| molecular epidemiology and antimicrobial susceptibility of clostridium difficile isolated from a university teaching hospital in japan. | clostridium difficile infection control strategies require an understanding of its epidemiology. in this study, we analysed the toxin genotypes of 130 non-duplicate clinical isolates of c. difficile from a university hospital in tokyo, japan. multilocus sequence typing (mlst) and eburst analysis were performed for these isolates and nine strains previously analysed by polymerase chain reaction (pcr) ribotyping. minimum inhibitory concentrations (mics) were determined for six antibiotics, and the ... | 2015 | 25471195 |
| clostridium perfringens enterotoxin and clostridium difficile toxin a/b do not play a role in acute haemorrhagic diarrhoea syndrome in dogs. | although an association between clostridial pathogens and canine idiopathic acute haemorrhagic diarrhoea syndrome (ahds) has been described, the relevance of those bacteria and their toxins remains unclear. the aim of this study was to evaluate the association between severity of clinical signs and presence of clostridium perfringens enterotoxin (cpe) and clostridium difficile toxin a/b (cdt a/b) in faeces of dogs with ahds. faecal samples of 54 dogs with idiopathic ahds were tested by qualitati ... | 2015 | 25467148 |
| antibiotic policies in acute english nhs trusts: implementation of 'start smart-then focus' and relationship with clostridium difficile infection rates. | the objective of this study was to establish how antibiotic prescribing policies at national health service (nhs) hospitals match the england department of health 'start smart-then focus' recommendations and relate to clostridium difficile infection (cdi) rates. | 2015 | 25538165 |
| clostridium difficile infection in thailand. | clostridium difficile is the aetiological agent in ca. 20% of cases of antimicrobial-associated diarrhoea in hospitalised adults. diseases caused by this organism range from mild diarrhoea to occasional fatal pseudomembranous colitis. the epidemiology of c. difficile infection (cdi) has changed notably in the past decade, following epidemics in the early 2000s of pcr ribotype (rt) 027 infection in north america and europe, where there was an increase in disease severity and mortality. another ma ... | 2015 | 25537687 |
| dynamics and establishment of clostridium difficile infection in the murine gastrointestinal tract. | clostridium difficile infection (cdi) following antibiotic therapy is a major public health threat. while antibiotic disruption of the indigenous microbiota underlies the majority of cases of cdi, the early dynamics of infection in the disturbed intestinal ecosystem are poorly characterized. this study defines the dynamics of infection with c. difficile strain vpi 10463 throughout the gastrointestinal (gi) tract using a murine model of infection. after inducing susceptibility to c. difficile col ... | 2015 | 25534943 |
| antisecretory factor peptide af-16 inhibits the secreted autotransporter toxin-stimulated transcellular and paracellular passages of fluid in cultured human enterocyte-like cells. | both the endogenous antisecretory factor (af) protein and peptide af-16, which has a sequence that matches that of the active n-terminal region of af, inhibit the increase in the epithelial transport of fluid and electrolytes induced by bacterial toxins in animal and ex vivo models. we conducted a study to investigate the inhibitory effect of peptide af-16 against the increase of transcellular passage and paracellular permeability promoted by the secreted autotransporter toxin (sat) in a culture ... | 2015 | 25534938 |
| fluoroquinolone resistance does not impose a cost on the fitness of clostridium difficile in vitro. | point mutations conferring resistance to fluoroquinolones were introduced in the gyr genes of the reference strain clostridium difficile 630. only mutants with the substitution thr-82→ile in gyra, which characterizes the hypervirulent epidemic clone iii/027/nap1, were resistant to all fluoroquinolones tested. the absence of a fitness cost in vitro for the most frequent mutations detected in resistant clinical isolates suggests that resistance will be maintained even in the absence of antibiotic ... | 2015 | 25534738 |
| multicenter, randomized clinical trial to compare the safety and efficacy of lff571 and vancomycin for clostridium difficile infections. | clostridium difficile infection causes serious diarrheal disease. although several drugs are available for treatment, including vancomycin, recurrences remain a problem. lff571 is a semisynthetic thiopeptide with potency against c. difficile in vitro. in this phase 2 exploratory study, we compared the safety and efficacy (based on a noninferiority analysis) of lff571 to those of vancomycin used in adults with primary episodes or first recurrences of moderate c. difficile infection. patients were ... | 2015 | 25534727 |
| pharmacokinetics of lff571 and vancomycin in patients with moderate clostridium difficile infections. | clostridium difficile infection causes diarrheal disease with potentially fatal complications. although treatments are available, including vancomycin, metronidazole, and fidaxomicin, the recurrence of disease after therapy remains a problem. lff571 is a novel thiopeptide antibacterial that shows in vitro potency against c. difficile that is comparable to or greater than that of other clinically used antibiotics. here, we compare the pharmacokinetics (pk) of lff571 and vancomycin in patients wit ... | 2015 | 25534724 |
| fidaxomicin therapy in critically ill patients with clostridium difficile infection. | fidaxomicin use to treat proven clostridium difficile infection (cdi) was compared between 20 patients receiving care in critical care units (ccus) and 30 patients treated on general medical floors. at baseline, the ccu patients had more initial cdi episodes, more severe and complicated disease, and more concurrent broad-spectrum antibiotic coverage. on multivariate analysis, the response to fidaxomicin therapy among the critically ill patients was comparable to that among patients in the genera ... | 2015 | 25534722 |
| use of a daily disinfectant cleaner instead of a daily cleaner reduced hospital-acquired infection rates. | documenting effective approaches to eliminate environmental reservoirs and reduce the spread of hospital-acquired infections (hais) has been difficult. this was a prospective study to determine if hospital-wide implementation of a disinfectant cleaner in a disposable wipe system to replace a cleaner alone could reduce hais over 1 year when housekeeping compliance was ≥80%. | 2015 | 25534117 |
| [clostridium difficile infections in internal medicine departments. addendum]. | 2015 | 25533745 | |
| clostridium difficile infection and inflammatory bowel disease: what gastroenterologists and surgeons should know. | over the past two decades there has been a dramatic increase worldwide in both incidence and severity of clostridium difficile infection (cdi). paralleling the rising incidence of cdi in the general population, there has been an even higher increase in the incidence of cdi among patients with inflammatory bowel disease (ibd). cdi may mimic a flare of ibd as symptoms and laboratory parameters are often similar, and therefore, screening for cdi is recommended at every flare in such patients. enzym ... | 2015 | 25532244 |
| new role for human α-defensin 5 in the fight against hypervirulent clostridium difficile strains. | clostridium difficile infection (cdi), one of the most common hospital-acquired infections, is increasing in incidence and severity with the emergence and diffusion of hypervirulent strains. cdi is precipitated by antibiotic treatment that destroys the equilibrium of the gut microbiota. human α-defensin 5 (hd5), the most abundant enteric antimicrobial peptide, is a key regulator of gut microbiota homeostasis, yet it is still unknown if c. difficile, which successfully evades killing by other hos ... | 2015 | 25547793 |
| effects of tigecycline and vancomycin administration on established clostridium difficile infection. | the glycylcycline antibiotic tigecycline was approved in 2005 for the treatment of complicated skin and soft tissue infections and complicated intra-abdominal infections. tigecycline is broadly active against both gram-negative and gram-positive microorganisms, including clostridium difficile. tigecycline has a low mic against c. difficile in vitro and thus may represent an alternate treatment for c. difficile infection (cdi). to assess the use of tigecycline for treatment of established cdi, 5- ... | 2015 | 25547352 |
| chondroitin sulfate proteoglycan 4 functions as the cellular receptor for clostridium difficile toxin b. | as a gram-positive, spore-forming anaerobic bacillus, clostridium difficile (c. difficile) is responsible for severe and fatal pseudomembranous colitis, and poses the most urgent antibiotic resistance threat worldwide. epidemic c. difficile is the leading cause of antibiotic-associated diarrhoea globally, especially diarrhoea due to the emergence of hypervirulent strains associated with high mortality and morbidity. tcdb, one of the key virulence factors secreted by this bacterium, enters host c ... | 2015 | 25547119 |
| fecal microbiota transplantation for recurrent clostridium difficile infection in pediatric patients: encouragement wrapped in caution. | 2015 | 25546336 | |
| emergency department visits related to clostridium difficile infection: results from the nationwide emergency department sample, 2006 through 2010. | the objective was to estimate emergency department (ed) visits for clostridium difficile infection in the united states for the years 2006 through 2010. | 2015 | 25545404 |
| human neutrophils are activated by a peptide fragment of clostridium difficile toxin b presumably via formyl peptide receptor. | clostridium difficile may induce antibiotic-associated diarrhoea and, in severe cases, pseudomembranous colitis characterized by tremendous neutrophil infiltration. all symptoms are caused by two exotoxins: tcda and tcdb. we describe here the activation of isolated human blood neutrophils by tcdb and, moreover, by toxin fragments generated by limited proteolytical digestion. kinetics and profiles of tcdb-induced rise in intracellular-free ca(2+) and reactive oxygen species production were simila ... | 2015 | 25529763 |
| use of mcherry red fluorescent protein for studies of protein localization and gene expression in clostridium difficile. | fluorescent proteins are powerful reporters in biology, but most require o2 for chromophore maturation, making them inherently difficult to use in anaerobic bacteria. clostridium difficile, a strict anaerobe with a genomic gc content of only 29%, is the leading cause of hospital-acquired diarrhea in developed countries, and new methods for studying this pathogen are sorely needed. we recently demonstrated that a cyan fluorescent protein called cfpopt that has been codon optimized for production ... | 2015 | 25527559 |
| effect of airborne hydrogen peroxide on spores of clostridium difficile. | contamination of surfaces by spores of clostridium difficile is a major factor influencing the spread of healthcare-associated c. difficile infection. the aim of this study was to test the effect of an automated room disinfection system that provides an aerosol of 7.5 % hydrogen peroxide (h2o2) disinfectant, on spores of two different strains of c. difficile, and to evaluate the impact of biological soiling on the efficacy of h2o2 disinfection. | 2015 | 25527140 |
| characterization of drug-product-related impurities and variants of a therapeutic monoclonal antibody by higher energy c-trap dissociation mass spectrometry. | mass spectrometry (ms) characterization of recombinant monoclonal antibody (mab) drugs and their degraded and/or post-translationally modified counterparts, drug-product-related impurities and variants, is critical for successful development of biotherapeutics. specifically in this study, drug-product-related impurities of an anti-clostridium difficile igg1 mab drug substance were profiled by cation-exchange liquid chromatography (cex) followed by the cex peaks being fraction-collected for ms ch ... | 2015 | 25513708 |
| subinhibitory concentrations of lff571 reduce toxin production by clostridium difficile. | lff571 is a novel semisynthetic thiopeptide antibacterial that is undergoing investigation for safety and efficacy in patients with moderate clostridium difficile infections. lff571 inhibits bacterial protein synthesis by interacting with elongation factor tu (ef-tu) and interrupting complex formation between ef-tu and aminoacyl-trna. given this mechanism of action, we hypothesized that concentrations of lff571 below those necessary to inhibit bacterial growth would reduce steady-state toxin lev ... | 2015 | 25512411 |
| letter: clinical predictors of clostridium difficile infection - advanced age and residential status are important factors for prediction and prevention - authors' reply. | 2015 | 25511771 | |
| letter: clinical predictors of clostridium difficile infection - advanced age and residential status are important factors for prediction and prevention. | 2015 | 25511770 | |
| prospective audit and feedback in antimicrobial stewardship: is there value in early reviewing within 48 h of antibiotic prescription? | antimicrobial stewardship programme (asp) methodologies are not well defined, with most preferring to wait ≥72-96 h following antibiotic prescription before reviewing patients. however, we hypothesise that early asp reviews and interventions are beneficial and do not adversely impact patient safety. this study aimed to evaluate the impact of early asp interventions within 48 h of antibiotic prescription on patient outcomes and safety. a prospective review of asp interventions made within 48 h of ... | 2015 | 25511192 |
| total synthesis of the tiacumicin b (lipiarmycin a3/fidaxomicin) aglycone. | tiacumicin b (lipiarmycin a3, fidaxomicin) is an atypical macrolide antibiotic which is used for the treatment of clostridium difficile infections. tiacumicin b is also a potent inhibitor of mycobacterium tuberculosis, but due to its limited oral bioavailability is unsuitable for systemic therapy. to provide a basis for structure-activity studies that might eventually lead to improved variants of tiacumicin b, we have developed an efficient approach to the synthesis of the tiacumicin b aglycone. ... | 2015 | 25510439 |
| real-time cell analysis for monitoring cholera toxin-induced human intestinal epithelial cell response. | the pathogenic mechanism of vibrio cholerae manifests as diarrhea and causes life-threatening dehydration. here, we observe the human intestinal epithelial cells (hiec) response to cholera toxin (ct) by a real-time cell analysis (rtca) platform, and disclose the difference from ct-induced cytotoxicity and others in hiec. an hiec cell of 1.0 × 10(5) cells/ml was characterized as the suitable concentration for each well. for experimentation, the assay requires an inoculation of ct dissolved in dul ... | 2015 | 25510171 |
| evaluation of the cepheid xpert c. difficile/epi and meridian bioscience illumigene c. difficile assays for detecting clostridium difficile ribotype 033 strains. | clostridium difficile pcr ribotype 033 (rt033) is found in the gastrointestinal tracts of production animals and, occasionally, humans. the illumigene c. difficile assay (meridian bioscience, inc.) failed to detect any of 52 c. difficile rt033 isolates, while all strains signaled positive for the binary toxin genes but were reported as negative for c. difficile by the xpert c. difficile/epi assay (cepheid). | 2015 | 25520452 |
| global transcriptional response of clostridium difficile carrying the cd38 prophage. | clostridium difficile is one of the most dangerous pathogens in hospital settings. most strains of c. difficile carry one or more prophages, and some of them, like cd38-2 and cd119, can influence the expression of toxin genes. however, little is known about the global host response in the presence of a given prophage. in order to fill this knowledge gap, we used high-throughput rna sequencing (rna-seq) to conduct a genome-wide transcriptomic analysis of the epidemic c. difficile strain r20291 ca ... | 2015 | 25501487 |