Publications
| Title | Abstract | Year(sorted descending) Filter | PMID Filter |
|---|
| penicillin allergy as a public health measure. | 2014 | 24332220 | |
| faecal microbiota transplantation and bacteriotherapy for recurrent clostridium difficile infection: a retrospective evaluation of 31 patients. | recurrent clostridium difficile infection (cdi) is a significant problem due to its increased incidence and severity. failure rates for standard antibiotic therapies are high. in our hospital, faecal microbiota transplantation (fmt), or instillation of a culture mixture of known enteric bacteria in saline as rectal bacteriotherapy (rbt), has long been used as 'rescue therapy' in patients with recurrent disease, in whom repeated courses of standard antibiotic treatment have failed. we wanted to e ... | 2014 | 24354958 |
| comparison of illumigene, simplexa, and amplivue clostridium difficile molecular assays for diagnosis of c. difficile infection. | we compared the performance of the simplexa universal direct (focus diagnostics) and amplivue (quidel corporation) assays to that of the illumigene assay (meridian bioscience, inc.) for the diagnosis of clostridium difficile infection. two hundred deidentified remnant diarrheal stool specimens were tested by the simplexa, amplivue, and illumigene methods. specimens with discrepant results among the three assays and a representative number of concordant specimens were further evaluated by toxigen ... | 2014 | 24352999 |
| the incidence and clinical symptomatology of clostridium difficile infections in a community setting in a cohort of danish patients attending general practice. | clostridium difficile infection (cdi) is gradually being recognised as a cause of morbidity in the community. we investigated the incidence and clinical characteristics of cdi in a community setting and characterised the c. difficile strains by toxin gene profiling and polymerase chain reaction (pcr) ribotyping. patients included in the study had attended general practice, primarily because of diarrhoea; cdi patients (259 patients; 121 <2 years of age) had positive cultures for toxigenic c. diff ... | 2014 | 24352841 |
| cost-effectiveness of histamine receptor-2 antagonist versus proton pump inhibitor for stress ulcer prophylaxis in critically ill patients*. | to examine the cost-effectiveness of using histamine receptor-2 antagonist or proton pump inhibitor for stress ulcer prophylaxis. | 2014 | 24365863 |
| rifaximin is safe and well tolerated for long-term maintenance of remission from overt hepatic encephalopathy. | rifaximin is a gut-selective, oral antimicrobial agent shown to reduce the recurrence of overt hepatic encephalopathy (he) and he-related hospitalizations in a 6-month, randomized, controlled trial (rct). we performed a phase 3, open-label maintenance study to assess the safety and rate of hospitalization with long-term rifaximin use. | 2014 | 24365449 |
| mitogen-activated protein kinase/iκb kinase/nf-κb-dependent and ap-1-independent cx3cl1 expression in intestinal epithelial cells stimulated with clostridium difficile toxin a. | clostridium difficile toxin a causes acute colitis associated with inflammatory cell infiltration and increased production of proinflammatory mediators. although cx3cl1 (fractalkine) plays a role in chemoattracting monocytes/macrophages, nk cells, and t cells, little information is available on the regulated expression of cx3cl1 in response to toxin a stimulation. in this study, we investigated the role of c. difficile toxin a on cx3cl1 induction in intestinal epithelial cells. stimulation of mu ... | 2014 | 24362517 |
| [outbreak of clostridium difficile infection in a hematopoietic stem cell transplantation unit]. | 2014 | 24361148 | |
| diarylacylhydrazones: clostridium-selective antibacterials with activity against stationary-phase cells. | current antibiotics for treating clostridium difficile infections (cdi), that is, metronidazole, vancomycin and more recently fidaxomicin, are mostly effective but treatment failure and disease relapse remain as significant clinical problems. the shortcomings of these agents are attributed to their low selectivity for c. difficile over normal gut microflora and their ineffectiveness against c. difficile spores. this letter reports that certain diarylacylhydrazones identified during a high-throug ... | 2014 | 24360560 |
| [reccurent clostridium difficile infection in patient after kidney transplantation on rituximab therapy due to ptld (post-transplant lymphoprolipherative disorder). first experience with fidaxomicin use--case report]. | clostridium difficile infection (cdi) is an increasingly problem in everyday clinical practice. the most important risk factor of this infection is antibiotics use. the incidence of clostridium difficile associated diarrhea (cdad) in patients after renal transplantation is estimated to be about 6% in the early postoperative period. due to the applied immunosuppression and frequent infections requiring intensive, broad spectral antibiotics, the later prevalence of cdad may remain at a similar lev ... | 2014 | 25951705 |
| three-step diagnostic algorithm in diagnosing patients suspected of clostridium difficile-associated diarrhea. | clostridium difficile is a predominant etiological agent of healthcare-associated infectious diarrhea. immunoenzymatic tests for detecting toxins a/b from faecal samples are still used in routine diagnosis of clostridium difficile-associated diseases in a number of healthcare centers in poland. recently, however, new diagnostic tests were introduced which allow for detecting toxigenic strains of c. difficile in a more effective and precise manner. it is of importance, especially in the light of ... | 2014 | 25848788 |
| prevalence of gastrointestinal system infections acquired in provincial hospital in 2004-2013. | gastrointestinal system infection (gi) is an infection which is frequently acquired in health- care settings. in poland, there are limited data on the distribution of gastrointestinal system infections in the epidemiology of healthcare-associated infections (hais). therefore, a study was initiated with the objective to assess the prevalence and distribution of healthcare-associated gastrointestinal system infections in patients hospitalized in st. lukas provincial hospital in tarnów. | 2014 | 25848787 |
| faecal microbiota transplantation for clostridium difficile infection. | to review the current clinical literature regarding the use of fecal microbiota transplantation (fmt) for severe and recurrent clostridium difficile disease (cdad). | 2014 | 24372725 |
| small animal models for the study of clostridium difficile disease pathogenesis. | clostridium difficile is the leading cause of bacterial antibiotic-associated diarrhoea in hospitals in the developed world. despite this notoriety, the complex mechanisms employed by this pathogen to overcome innate host defences and induce fulminant disease are poorly understood. various animal models have been used extensively for c. difficile research to study disease pathogenesis. until recently, the most commonly used c. difficile disease model has utilised hamsters; however, mouse and pig ... | 2014 | 24372713 |
| controversies surrounding clostridium difficile infection in infants and young children. | clostridium difficile is a frequent cause of antibiotic-associated diarrhea in adults and older children. however, as many as 80% of infants can be asymptomatically colonized. the reasons for this have not been well established but are believed to be due to differences in toxin receptors or toxin internalization. determining which children who test positive for c. difficile warrant treatment is exceedingly difficult, especially in the setting of increased rates of detection and the rising risk o ... | 2014 | 27417466 |
| false-positive clostridium difficile in negative-control reactions peak and then decrease with repetitive refrigeration of immunoassay. | aberrant false-positive reactions in negative-controls during elisa testing for clostridium difficile indicated the potential for false-diagnoses. experiments with 96-well products showed a maximum peak of false-positive immunoassay reactions with the provided negative-control reagents after 5 refrigeration-to-room temperature cycles (p < 0.001), decreasing thereafter with additional refrigeration cycles. because repetitive refrigeration causes a peak of false-positives, the use of single negati ... | 2014 | 27350964 |
| old and new glycopeptide antibiotics: action and resistance. | glycopeptides are considered antibiotics of last resort for the treatment of life-threatening infections caused by relevant gram-positive human pathogens, such as staphylococcus aureus, enterococcus spp. and clostridium difficile. the emergence of glycopeptide-resistant clinical isolates, first among enterococci and then in staphylococci, has prompted research for second generation glycopeptides and a flurry of activity aimed at understanding resistance mechanisms and their evolution. glycopepti ... | 2014 | 27025757 |
| ciprofloxacin affects host cells by suppressing expression of the endogenous antimicrobial peptides cathelicidins and beta-defensin-3 in colon epithelia. | antibiotics exert several effects on host cells including regulation of immune components. antimicrobial peptides (amps), e.g., cathelicidins and defensins display multiple functions in innate immunity. in colonic mucosa, cathelicidins are induced by butyrate, a bacterial fermentation product. here, we investigated the effect of antibiotics on butyrate-induced expression of cathelicidins and beta-defensins in colon epithelial cells. real-time pcr analysis revealed that ciprofloxacin and clindamy ... | 2014 | 27025750 |
| improving management of constipation in an inpatient setting using a care bundle. | constipation is a common occurrence on geriatric in-patient wards. it can result in delirium and other complications including bowel obstruction. over treatment with laxatives can result in iatrogenic diahorrea, which can lead to dehydration, delirium, and the false positive labeling and unnecessary treatment of clostridium difficile carriers. this can result in increased morbidity and mortality, and a longer stay in hospital. this means that improving the assessment and treatment of constipatio ... | 2014 | 26734278 |
| how enteric pathogens know they hit the sweet spot. | ng km, ferreyra ja, higginbottom sk et al. microbiota-liberated host sugars facilitate post-antibiotic expansion of enteric pathogens. nature 502(7469), 96-99 (2013). the human gut microbiota is a complex system of commensal microorganisms required for normal host physiology. disruption of this protective barrier by antibiotics creates opportunities for enteric pathogens to establish infections. although the correlation between the use of antibiotics and enteric infections have been known for so ... | 2014 | 24328376 |
| could fecal microbiota transplantation cure all clostridium difficile infections? | 2014 | 24328373 | |
| medication risk factors associated with healthcare-associated clostridium difficile infection: a multilevel model case-control study among 64 us academic medical centres. | the main objective of this study was to determine patient- and hospital-level medication risk factors associated with clostridium difficile infection (cdi) occurrence among patients clustered within hospitals using a multilevel model. | 2014 | 24327619 |
| antibiotics and hospital-acquired clostridium difficile infection: update of systematic review and meta-analysis. | to update the evidence for associations between antibiotic classes and hospital-acquired clostridium difficile infection (ha-cdi). | 2014 | 24324224 |
| severe mucositis and clostridium difficile infection in adult autologous stem cell recipients: another question of the chicken or the egg? | 2014 | 24321748 | |
| comparison of antimicrobial susceptibility among clostridium difficile isolated from an integrated human and swine population in texas. | clostridium difficile can be a major problem in hospitals because the bacterium primarily affects individuals with an altered intestinal flora; this largely occurs through prolonged antibiotic use. proposed sources of increased community-acquired infections are food animals and retail meats. the objective of this study was to compare the antimicrobial resistance patterns of c. difficile isolated from a closed, integrated population of humans and swine to increase understanding of the bacterium i ... | 2014 | 24320797 |
| development of a novel method for detection of clostridium difficile using hs-spme-gc-ms. | a novel method has been developed that allows successful differentiation between clostridium difficile culture-positive and culture-negative stool samples based on volatile organic compound (voc) evolution and detection by headspace solid-phase microextraction coupled with gas chromatography mass spectrometry (hs-spme-gc-ms). | 2014 | 24320174 |
| histological damage of colonic epithelium is associated with clinical severity and outcome in colectomized critically ill patients. | severe intestinal mucosal damage and organ failure has been associated in experimental models. our purpose was to determine whether there is any association between histopathological findings and postoperative mortality among icu patients undergoing emergency colectomies for various illnesses. | 2014 | 24318408 |
| closure of a broncho-pleural fistula using an atrial septal defect occluder. | broncho-pleural fistulae (bpf) are recognised as a rare complication following pneumonectomy. we describe a patient, who after failing conservative treatment, underwent closure of a persistent fistula with an atrial septal defect (asd) occluder. additionally we review the literature regarding management of bpf and the emerging role of cardiac defect closure devices as a possible treatment option. | 2014 | 24315634 |
| structural basis for antibody recognition in the receptor-binding domains of toxins a and b from clostridium difficile. | clostridium difficile infection is a serious and highly prevalent nosocomial disease in which the two large, rho-glucosylating toxins tcda and tcdb are the main virulence factors. we report for the first time crystal structures revealing how neutralizing and non-neutralizing single-domain antibodies (sdabs) recognize the receptor-binding domains (rbds) of tcda and tcdb. surprisingly, the complexes formed by two neutralizing antibodies recognizing tcda do not show direct interference with the pre ... | 2014 | 24311789 |
| evolutionary history of the clostridium difficile pathogenicity locus. | the symptoms of clostridium difficile infection are caused by toxins expressed from its 19 kb pathogenicity locus (paloc). stable integration of the paloc is suggested by its single chromosomal location and the clade specificity of its different genetic variants. however, the paloc is variably present, even among closely related strains, and thus resembles a mobile genetic element. our aim was to explain these apparently conflicting observations by reconstructing the evolutionary history of the ... | 2014 | 24336451 |
| proton pump inhibitor therapy and potential long-term harm. | this review summarizes the recent literature on the potential side-effects of proton pump inhibitors (ppis) and known interactions with the metabolism/absorption of other drugs. | 2014 | 24310148 |
| portrait toxigenic clostridium difficile assay, an isothermal amplification assay detects toxigenic c. difficile in clinical stool specimens. | the portrait toxigenic clostridium difficile assay is a rapid, qualitative assay for the detection of the tcdb gene of c. difficile in stool specimens from patients suspected of c. difficile infections, and received 510(k) clearance by the us fda in march 2012. the portrait toxigenic c. difficile assay combines novel blocked-primer-mediated helicase-dependent multiplex amplification (bphda) technology and chip-based detection in an automated sample-to-result format. the assay requires minimal sa ... | 2014 | 24308336 |
| probiotics reduce symptoms of antibiotic use in a hospital setting: a randomized dose response study. | probiotics are known to reduce antibiotic associated diarrhea (aad) and clostridium difficile associated diarrhea (cdad) risk in a strain-specific manner. the aim of this study was to determine the dose-response effect of a four strain probiotic combination (howaru(®) restore) on the incidence of aad and cdad and severity of gastrointestinal symptoms in adult in-patients requiring antibiotic therapy. patients (n=503) were randomized among three study groups: howaru(®) restore probiotic 1.70×10(1 ... | 2014 | 24291194 |
| the emergence of community-onset clostridium difficile infection in a tertiary hospital in singapore: a cause for concern. | increasing rates of clostridium difficile infection (cdi) among those without traditional risk factors have been reported mainly in europe and north america. here we describe the epidemiology, clinical features and ribotypes of cdi at national university hospital (nuh), a 1000-bed tertiary care hospital in singapore, from december 2011 to may 2012. all laboratory-confirmed cdi cases ≥21 years old who gave informed consent were included. clinical data were collected prospectively and participants ... | 2014 | 24290727 |
| the prolongation of length of stay because of clostridium difficile infection. | clostridium difficile infection (cdi) possibly extends hospital length of stay (los); however, the current evidence does not account for the time-dependent bias, ie, when infection is incorrectly analyzed as a baseline covariate. the aim of this study was to determine whether cdi increases los after managing this bias. | 2014 | 24290226 |
| to the editor: molecular epidemiology of toxigenic clostridium difficile isolates in korea. | 2014 | 24290036 | |
| spread of epidemic clostridium difficile nap1/027 in latin america: case reports in panama. | the rate and severity of clostridium difficile infection (cdi) have been linked to the emergence and spread of the hypervirulent toxigenic strain nap1/027. this strain has been responsible for large outbreaks in healthcare facilities in north america and europe and most recently in latin america. this is the first report of the nap1 strain in panama. it suggests that the spread of c. difficile nap1 throughout latin america could be a possibility as evidenced in the following case reports. five i ... | 2014 | 24287669 |
| aptamer biosensor for sensitive detection of toxin a of clostridium difficile using gold nanoparticles synthesized by bacillus stearothermophilus. | a sensitive electrochemical biosensor was developed to detect toxin a (toa) of clostridium difficile based on an aptamer selected by the systematic evolution of ligands using exponential enrichment and gold nanoparticles (gnps) synthesized by bacillus stearothermophilus. the thiolated single-stranded dna used as the capture probe (cp) was first self-assembled on a nafion-thionine-gnps-modified screen-printed electrode (spe) through an au-thiol interaction. the horseradish peroxidase (hrp)-labele ... | 2014 | 24287407 |
| patients with cystic fibrosis have a high carriage rate of non-toxigenic clostridium difficile. | thirty-year-old observations report frequent asymptomatic clostridium difficile carriage among cystic fibrosis (cf) patients. in this case-control study, we found more carriers among cf patients than controls (47% versus 11%), but most strains carried by cf patients were non-toxigenic (77% versus 17%). among cf patients, carriers were younger, with more severe pulmonary disease than non-carriers. strains belonged to multiple pcr-ribotypes, suggesting that these cf patients did not acquire strain ... | 2014 | 24286342 |
| improved detection of gastrointestinal pathogens using generalised sample processing and amplification panels. | we aimed to streamline the diagnosis of gastrointestinal disease by producing multiplexed real time polymerase chain reaction (pcr) panels employing universal sample processing for dna and rna containing pathogens. a total of 487 stored, previously characterised stool samples comprising bacterial, viral, protozoan and clostridium difficile positive samples were tested using four multiplexed real time pcr panels. a further 81 pre-selected clinical samples from a teaching hospital were included to ... | 2014 | 24300711 |
| cost-effectiveness of fidaxomicin for clostridium difficile treatment. | 2014 | 24300043 | |
| the changing epidemiology of clostridium difficile infection. | clostridium difficile infection (cdi) is a growing concern and has a substantial impact on morbidity and mortality. epidemiology of cdi has dramatically changed over the last decade. diagnostic and treatment strategies are even more complicated given the wide variety of available diagnostic methods and the emergence of refractory or recurrent cdi. this review is intended to provide information on current cdi epidemiology and guidance for evidence-based diagnosis and management strategies. | 2014 | 24285002 |
| microbiota transplantation restores normal fecal bile acid composition in recurrent clostridium difficile infection. | fecal microbiota transplantation (fmt) has emerged as a highly effective therapy for refractory, recurrent clostridium difficile infection (cdi), which develops following antibiotic treatments. intestinal microbiota play a critical role in the metabolism of bile acids in the colon, which in turn have major effects on the lifecycle of c. difficile bacteria. we hypothesized that fecal bile acid composition is altered in patients with recurrent cdi and that fmt results in its normalization. general ... | 2014 | 24284963 |
| [successful home-made fecal transplant for an elderly woman]. | recurrent clostridium difficile infection (cdi) is a challenge for infectious disease specialists. a third of first recurrences will fail antibiotic therapy. several mechanisms have been proposed to explain this, such as persistence of spores, inadequate antibody response, and altered gut microbiota. standard recommendations for cdi treatment include metronidazole and vancomycin. fecal transplant has proven to be an effective therapy for recurrent cdi. infusion of stools can be administered to t ... | 2014 | 24481438 |
| prospects for flavonoid and related phytochemicals as nature-inspired treatments for clostridium difficile infection. | there is a need for novel treatments for clostridium difficile infection(cdi). antibacterial flavonoids are part of a large family of polyphenol phytochemicals with a long history of use in ethnomedicine, but are unexamined against cl. difficile. we explored their anti-difficile properties. | 2014 | 24479135 |
| a cost-effective approach for detection of toxigenic clostridium difficile: toxigenic culture using chromid clostridium difficile agar. | we evaluated the performance and the cost of toxigenic culture using a commercial chromogenic medium (cdif) for 538 stool specimens. compared with real-time pcr, this method was found to detect an additional 9% of positive specimens and result in 61% reduction in material costs, with a trade-off increase in turnaround time of 1 day. | 2014 | 24478510 |
| impact of changes in clostridium difficile testing practices on stool rejection policies and c. difficile positivity rates across multiple laboratories in the united states. | we describe the adoption of nucleic acid amplification tests (naat) for clostridium difficile diagnosis and their impact on stool rejection policies and c. difficile positivity rates. of the laboratories with complete surveys, 51 (43%) reported using naat in 2011. laboratories using naat had stricter rejection policies and increased positivity rates. | 2014 | 24478500 |
| economic evaluation of laboratory testing strategies for hospital-associated clostridium difficile infection. | clostridium difficile infection (cdi) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have cdi, their isolation while awaiting laboratory results is costly. newer rapid tests for cdi may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. we used decision analysis from the hospital perspective to compare multiple cdi testing algorithms for adult inpatients with suspected cdi, assuming patient m ... | 2014 | 24478478 |
| protection from clostridium difficile infection in cd4 t cell- and polymeric immunoglobulin receptor-deficient mice. | clostridium difficile rivals methicillin-resistant staphylococcus aureus as the primary hospital-acquired infection. c. difficile infection (cdi) caused by toxins a and/or b can manifest as mild diarrhea to life-threatening pseudomembranous colitis. although most patients recover fully from cdi, ~20% undergo recurrent disease. several studies have demonstrated a correlation between anti-toxin antibody (ab) and decreased recurrence; however, the contributions of the systemic and mucosal ab respon ... | 2014 | 24478068 |
| colonic immunopathogenesis of clostridium difficile infections. | there are major gaps in our understanding of the immunopathogenesis of clostridium difficile infections (cdis). in this study, 36 different biomarkers were examined in the stools of cdi and non-cdi patients using the proteome profiler human cytokine array assay and quantitative enzyme-linked immunosorbent assay. diarrheal stools from patients with cdi (cdi-positive diarrheal stools) showed higher relative amounts of the following inflammatory markers than the diarrheal stools from cdi-negative p ... | 2014 | 24477852 |
| outcomes of clostridium difficile infection in recipients of solid abdominal organ transplants. | knowledge of outcomes of clostridium difficile infection (cdi) in solid organ transplant (sot) recipients is limited. to evaluate this population, we undertook a retrospective cohort study of all recipients of kidney and liver transplants diagnosed with cdi at a single center over 14 yr. data pertaining to all episodes of cdi were collected. multivariate analysis using logistic regression was performed to determine independent predictors of clinical cure. overall, 170 patients developed 215 epis ... | 2014 | 24476412 |
| transmission of clostridium difficile spores in isolation room environments and through hospital beds. | the aim of this study was to determine the dissemination of clostridium difficile (cd) spores in a hospital setting where the potassium monopersulfate-based disinfectant virkon™ was used for cleaning. in the initial part of the study, we sampled 16 areas of frequent patient contact in 10 patient rooms where a patient with cd infection (cdi) had been accommodated. in the second part of the study, we obtained samples from 10 patient beds after discharge of cdi patients, both before and after the b ... | 2014 | 24475890 |
| what does the talking?: quorum sensing signalling genes discovered in a bacteriophage genome. | the transfer of novel genetic material into the genomes of bacterial viruses (phages) has been widely documented in several host-phage systems. bacterial genes are incorporated into the phage genome and, if retained, subsequently evolve within them. the expression of these phage genes can subvert or bolster bacterial processes, including altering bacterial pathogenicity. the phage phicdhm1 infects clostridium difficile, a pathogenic bacterium that causes nosocomial infections and is associated w ... | 2014 | 24475037 |
| an interprofessional approach to reducing the overutilization of stress ulcer prophylaxis in adult medical and surgical intensive care units. | overutilization of stress ulcer prophylaxis (sup) in the intensive care unit (icu) is common. acid-suppressive therapies routinely used for sup are best reserved for patients with greatest risk of clinically important bleeding as they have been associated with nosocomial pneumonia, clostridium difficile infection and increased hospital cost. | 2014 | 24473490 |
| recurrence of clostridium difficile infection among veterans with spinal cord injury and disorder. | recurrent clostridium difficile (cdi) infection is a growing concern; however, there are little data on impact of recurrent cdi on those with spinal cord injury and disorder (sci/d). therefore, the objective of this study was to identify risk factors associated with recurrence of cdi among veterans with sci/d. | 2014 | 24485372 |
| sequence similarity of clostridium difficile strains by analysis of conserved genes and genome content is reflected by their ribotype affiliation. | pcr-ribotyping is a broadly used method for the classification of isolates of clostridium difficile, an emerging intestinal pathogen, causing infections with increased disease severity and incidence in several european and north american countries. we have now carried out clustering analysis with selected genes of numerous c. difficile strains as well as gene content comparisons of their genomes in order to broaden our view of the relatedness of strains assigned to different ribotypes. we analyz ... | 2014 | 24482682 |
| lipoprotein cd0873 is a novel adhesin of clostridium difficile. | clostridium difficile is a cause of antibiotic-associated diarrhea and colitis, a healthcare-associated intestinal disease. colonization of the gut is a critical step in the course of infection. the c. difficile lipoprotein cd0873 was identified as a putative adhesin through a bioinformatics approach. surface exposure of cd0873 was confirmed and a cd0873 mutant was generated. the cd0873 mutant showed a significant reduction in adherence to caco-2 cells and wild-type bacteria preincubated with an ... | 2014 | 24482399 |
| clostridium difficile toxin cdt hijacks microtubule organization and reroutes vesicle traffic to increase pathogen adherence. | clostridium difficile causes antibiotic-associated diarrhea and pseudomembranous colitis by the actions of rho-glucosylating toxins a and b. recently identified hypervirulent strains, which are associated with increased morbidity and mortality, additionally produce the actin-adp-ribosylating toxin c. difficile transferase (cdt). cdt depolymerizes actin, causes formation of microtubule-based protrusions, and increases pathogen adherence. here we show that cdt-induced protrusions allow vesicle tra ... | 2014 | 24469807 |
| shedding of clostridium difficile pcr ribotype 078 by zoo animals, and report of an unstable metronidazole-resistant isolate from a zebra foal (equus quagga burchellii). | clostridium difficile is an emerging and potentially zoonotic pathogen, but its prevalence in most animal species, including exhibition animals, is currently unknown. in this study we assessed the prevalence of faecal shedding of c. difficile by zoo animals, and determined the ribotype, toxin profile and antimicrobial susceptibility of recovered isolates. a total of 200 samples from 40 animal species (36.5% of which came from plains zebra, equus quagga burchellii) were analysed. c. difficile was ... | 2014 | 24467928 |
| is there any value in measuring faecal calprotectin in clostridium difficile positive faecal samples? | markers of intestinal inflammation have been proposed for inclusion in clostridium difficile diagnostic algorithms. faecal calprotectin (f-cp), a sensitive marker of intestinal inflammation, was evaluated for utility in c. difficile diagnosis in the hospital setting. one hundred and twenty c. difficile positive and 99 c. difficile negative faecal samples of hospital-acquired diarrhoea were analysed for f-cp using a quantitative elisa. c. difficile positivity was confirmed using elisas for either ... | 2014 | 24464697 |
| [cloudy peritoneal effluent and diarrhoea due to clostridium difficile]. | 2014 | 24463873 | |
| a retrospective analysis of clinical characteristics, hospitalization, and functional outcomes in residents with and without clostridium difficile infection in us long-term care facilities. | patients in long-term care (ltc) are at increased risk for acquiring clostridium difficile infection (cdi). we compared the characteristics and outcomes of matched cohorts with and without cdi in the ltc setting. | 2014 | 24552133 |
| comparative microbiological studies of transcription inhibitors fidaxomicin and the rifamycins in clostridium difficile. | fidaxomicin (fdx) is a narrow-spectrum antibiotic for the treatment of clostridium difficile-associated diarrhea. while fdx and rifamycins share the same target (rna polymerase), fdx exhibits a unique mode of action distinct from that of rifamycins. in comparative microbiological studies with c. difficile, fdx interacted synergistically with rifamycins, demonstrated a lower propensity for the development of resistance to rifamycins, and exhibited no cross-resistance with rifamycins. these result ... | 2014 | 24550338 |
| histamine-2 receptor antagonists vs proton pump inhibitors on gastrointestinal tract hemorrhage and infectious complications in the intensive care unit. | importance histamine-2 receptor antagonists (h2ras) and proton pump inhibitors (ppis) are commonly used to prevent gastrointestinal tract (gi) hemorrhage in critically ill patients. the stronger acid suppression of ppis may reduce the rate of bleeding but enhance infectious complications, specifically pneumonia and clostridium difficile infection (cdi). objective to evaluate the occurrence and risk factors for gi hemorrhage, pneumonia, and cdi in critically ill patients. design, setting, and par ... | 2014 | 24535015 |
| characterization of temperate phages infecting clostridium difficile isolates of human and animal origins. | clostridium difficile is a gram-positive pathogen infecting humans and animals. recent studies suggest that animals could represent potential reservoirs of c. difficile that could then transfer to humans. temperate phages contribute to the evolution of most bacteria, for example, by promoting the transduction of virulence, fitness, and antibiotic resistance genes. in c. difficile, little is known about their role, mainly because suitable propagating hosts and conditions are lacking. here we repo ... | 2014 | 24532062 |
| clostridium difficile is common in patients with postoperative diarrhea after hip and knee arthroplasty. | clostridium difficile is an antibiotic-associated gastrointestinal infection that has detrimental consequences. we sought to determine the incidence of c. difficile in tja patients with postoperative diarrhea, to determine risk factors for c. difficile infection, and to establish the incidence of c. difficile-related complications. our institutional protocol includes screening for c. difficile in all patients with diarrhea after tja. we identified 121 such patients over four years with twenty-ei ... | 2014 | 24530206 |
| microbial composition analysis of clostridium difficile infections in an ulcerative colitis patient treated with multiple fecal microbiota transplantations. | fecal microbiota transplantation (fmt) is a promising therapy for clostridium difficile infection (cdi). however, questions remain regarding efficacy and safety in inflammatory bowel disease (ibd) patients, as well as longitudinal stability of donor stool composition. this report describes an ibd patient with two cdis 18 months apart, each successfully treated with fmt with no ibd flares or complications. microbiome composition analysis of patient samples during each infection revealed low-diver ... | 2014 | 24529606 |
| inpatient antibiotic consumption in a regional secondary hospital in new zealand. | reporting of antibiotic consumption in hospitals is a crucial component of antibiotic stewardship, but data from australasian secondary hospitals are scarce. the hypothesis of this audit is that antibiotic consumption in secondary hospitals would be lower than in tertiary centres. | 2014 | 24528814 |
| prophylactic antibiotics for hemorrhoidectomy: are they really needed? | hemorrhoidectomy is considered by many to be a contaminated operation that requires antibiotic prophylaxis to lower the incidence of surgical site infection. in reality, little evidence exists to either support or refute the use of antibiotic prophylaxis in this setting. | 2014 | 24509461 |
| effect of antisera from clostridium difficile-infected mice on toxin-a-induced colonic epithelial cell death signaling. | clostridium difficile causes mucosal damage and diarrhea by releasing two exotoxins: toxin a and toxin b. c. difficile colitis is associated with alterations in bowel flora and the failure to mount an effective antibody response. the aim of the current study was to investigate whether antitoxin sera prevent toxin-a-induced apoptosis, cytoskeletal disaggregation, cell detachment, and tight junction loss in cultured colonic epithelial cells. serum samples were isolated from mice that survived a c. ... | 2014 | 24509250 |
| prevalence and molecular characterization of clostridium difficile isolated from european barn swallows (hirundo rustica) during migration. | clostridium difficile is an important bacterial pathogen of humans and a variety of animal species. birds, especially migratory passerine species, can play a role in the spread of many pathogens, including clostridium difficile. barn swallows (hirundo rustica) nest in close proximity to human habitats and their biology is closely associated with cattle farming. therefore, we hypothesized that barn swallows can be the reservoir of clostridium difficile. | 2014 | 24507706 |
| acute diarrhea. | acute diarrhea in adults is a common problem encountered by family physicians. the most common etiology is viral gastroenteritis, a self-limited disease. increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. a history and physical examination evaluating for risk factors and signs of inflammatory diarrhea and/or severe dehydration can direct any needed testing and treatment. most patients do not require laboratory workup, and routine stoo ... | 2014 | 24506120 |
| preoperative clostridium difficile infection is not associated with an increased risk for the infection in ileal pouch patients. | clostridium difficile infection (cdi) might contribute to a refractory course of pouchitis. however, the association between preoperative cdi and postoperative cdi in ileal pouch patients has not been investigated. | 2014 | 24504594 |
| epidemiological study of clostridium difficile infection in critical patients admitted to the intensive care unit. | data on the epidemiology of infections caused by clostridium difficile (cdi) in critically ill patients are scarce and center on studies with a limited time framework and/or epidemic outbreaks. | 2014 | 24503331 |
| role of the intestinal microbiota in resistance to colonization by clostridium difficile. | antibiotic-associated infection with the bacterial pathogen clostridium difficile is a major cause of morbidity and increased health care costs. c difficile infection follows disruption of the indigenous gut microbiota by antibiotics. antibiotics create an environment within the intestine that promotes c difficile spore germination, vegetative growth, and toxin production, leading to epithelial damage and colitis. studies of patients with c difficile infection and animal models have shown that t ... | 2014 | 24503131 |
| prevalence of clostridium difficile in raw beef, cow, sheep, goat, camel and buffalo meat in iran. | clostridium difficile has been shown to be a nosocomial pathogen associated with diarrhoea and pseudomembranous colitis in hospitalised patients and the infection is believed to be acquired nosocomially. recent studies have shown the occurrence of c. difficile in food animals which may act as a source of infection to humans.the aim of this study was to determine the occurrence of c. difficile in retail raw beef, cow, sheep, goat, camel and buffalo meat in iran. | 2014 | 24499381 |
| is clostridium difficile associated with the '4c' antibiotics? a retrospective observational study in diabetic foot ulcer patients. | clostridium difficile is an anaerobic cytotoxin-producing bacterium that can cause infectious diarrhoea, pseudomembranous colitis and toxic megacolon. the major risk factors for developing c. difficile infection include recent or current antimicrobial use, diabetes, age over 65, proton pump inhibitor use, immunosuppression and previous infection with c. difficile. most diabetic foot ulcers are polymicrobial. | 2014 | 24499256 |
| [insidious and widespread outbreak of clostridium difficile. changed cleaning procedures and frequent evaluations cut infection rates in half]. | 2014 | 24498716 | |
| spore formation and toxin production in clostridium difficile biofilms. | the ability to grow as a biofilm can facilitate survival of bacteria in the environment and promote infection. to better characterize biofilm formation in the pathogen clostridium difficile, we established a colony biofilm culture method for this organism on a polycarbonate filter, and analyzed the matrix and the cells in biofilms from a variety of clinical isolates over several days of biofilm culture. we found that biofilms readily formed in all strains analyzed, and that spores were abundant ... | 2014 | 24498186 |
| prevention of clostridium difficile infection in rural hospitals. | prevention of clostridium difficile infection (cdi) remains challenging across the spectrum of health care. there are limited data on prevention practices for cdi in the rural health care setting. | 2014 | 24406257 |
| patients' experience and perception of hospital-treated clostridium difficile infections: a qualitative study. | clostridium difficile is the leading cause of antibiotic-associated diarrhea and an important source of nosocomial infection. clinical manifestations can range from mild diarrhea to lethal pseudomembranous colitis. little is known about the burden of c. difficile infections (cdi) in patients. | 2014 | 24403096 |
| proteomic analysis of a nap1 clostridium difficile clinical isolate resistant to metronidazole. | clostridium difficile is an anaerobic, gram-positive bacterium that has been implicated as the leading cause of antibiotic-associated diarrhea. metronidazole is currently the first-line treatment for mild to moderate c. difficile infections. our laboratory isolated a strain of c. difficile with a stable resistance phenotype to metronidazole. a shotgun proteomics approach was used to compare differences in the proteomes of metronidazole-resistant and -susceptible isolates. | 2014 | 24400070 |
| from stool transplants to next-generation microbiota therapeutics. | the epidemic of clostridium difficile infection fueled by new virulent strains of the organism has led to increased use of fecal microbiota transplantation (fmt). the procedure is effective for even the most desperate cases after failure of multiple courses of antibiotics. the approach recognizes microbiota to be integral to normal human physiology, and microbiota being used in fmt represents a new class of therapeutics. imbalance in the composition and altered activity of the microbiota are ass ... | 2014 | 24412527 |
| clostridium difficile infection: molecular pathogenesis and novel therapeutics. | the gram-positive anaerobic bacterium clostridium difficile produces toxins a and b, which can cause a spectrum of diseases from pseudomembranous colitis to c. difficile-associated diarrhea. a limited number of c. difficile strains also produce a binary toxin that exhibits adp ribosyltransferase activity. here, the structure and the mechanism of action of these toxins as well as their role in disease are reviewed. nosocomial c. difficile infection is often contracted in hospital when patients tr ... | 2014 | 24410618 |
| real-time cellular analysis coupled with a specimen enrichment accurately detects and quantifies clostridium difficile toxins in stool. | we describe here the use of an immunomagnetic separation enrichment process coupled with a modified real-time cellular analysis (rtca) system (rtca version 2) for the detection of c. difficile toxin (cdt) in stool. the limit of cdt detection by rtca version 2 was 0.12 ng/ml. among the consecutively collected 401 diarrheal stool specimens, 53 (13.2%) were toxin-producing c. difficile strains by quantitative toxigenic culture (qtc); bacterial loads ranged from 3.00 × 10(1) to 3.69 × 10(6) cfu/ml. ... | 2014 | 24452160 |
| single nucleotide polymorphisms of the tcdc gene and presence of the binary toxin gene predict recurrent episodes of clostridium difficile infection. | to identify clostridium difficile genotypes, which are associated with recurrent c difficile infection (rcdi). | 2014 | 24374512 |
| fecal microbiota transplantation: effectiveness, complexities, and lingering concerns. | the mammalian colon is home to a microbial ecosystem that enhances resistance to infection, stimulates mucosal immune defenses, synthesizes essential vitamins, and promotes caloric uptake by hydrolyzing complex carbohydrates. the bacterial populations inhabiting the gut are complex and vary between different individuals. clinical and experimental studies reveal that the colonic microbiota can enhance or ameliorate intestinal and systemic inflammatory diseases. because of its potential to enhance ... | 2014 | 24399149 |
| characterization of clostridium perfringens in the feces of adult horses and foals with acute enterocolitis. | up to 60% of cases of equine colitis have no known cause. to improve understanding of the causes of acute colitis in horses, we hypothesized that clostridium perfringens producing enterotoxin (cpe) and/or beta2 toxin (cpb2) are common and important causes of severe colitis in horses and/or that c. perfringens producing an as-yet-undescribed cytotoxin may also cause colitis in horses. fecal samples from 55 horses (43 adults, 12 foals) with clinical evidence of colitis were evaluated by culture fo ... | 2014 | 24396174 |
| evaluation of the diagnostic performance of the xpert clostridium difficile assay and its comparison with the toxin a/b enzyme-linked fluorescent assay and in-house real-time pcr assay used for the detection of toxigenic c. difficile. | clostridium difficile genes or toxin can be detected using several laboratory techniques. in this study, we compared the performance of the xpert c. difficile assay with that of a toxin a/b enzyme-linked fluorescent immunoassay (elfa) and an in-house real-time pcr assay for the tcdb gene. | 2014 | 24395702 |
| clostridium difficile: deleterious impact on hematopoietic stem cell transplantation. | c. difficile infection (cdi), the most common cause of hospital-acquired diarrhea, is very frequent after hematopoietic stem cell transplantation (hsct). recent publications suggest it affects between 6 % and 20 % of hsct recipients during the first year and is more common following allogeneic transplant (allo-hsct). the best diagnostic strategy remains to be defined, but molecular testing for the toxin genes by polymerase chain reaction (pcr) seems to be replacing the traditional enzyme immunoa ... | 2014 | 24390550 |
| a clinician's primer on the role of the microbiome in human health and disease. | the importance of the commensal microbiota that colonizes the skin, gut, and mucosal surfaces of the human body is being increasingly recognized through a rapidly expanding body of science studying the human microbiome. although, at first glance, these discoveries may seem esoteric, the clinical implications of the microbiome in human health and disease are becoming clear. as such, it will soon be important for practicing clinicians to have an understanding of the basic concepts of the human mic ... | 2014 | 24388028 |
| new routes towards reutericyclin analogues. | a range of n-acylpyrrolo[3,4-c]isoxazoles and derived n-acyltetramides has been prepared via a nitrile oxide dipolar cycloaddition approach, as analogues of the acyltetramic acid metabolite reutericyclin, of interest for its antibiotic potential against gram-positive bacteria including hospital-acquired infections of resistant clostridium difficile. | 2014 | 24382380 |
| low vitamin d level is an independent predictor of poor outcomes in clostridium difficile-associated diarrhea. | the incidence, recurrence, and all-cause mortality rate for clostridium difficile-associated diarrhea (cdad) has increased markedly over the past 10 years despite treatment. low vitamin d levels are known to impair immune responses to infection and are associated with increased mortality. we compared the role of patient comorbidity measured by the charlson comorbidity index (cci) with vitamin d levels to ascertain whether vitamin d levels were an independent variable affecting the outcome of cda ... | 2014 | 24381644 |
| detection of nosocomial clostridium difficile infections with toxigenic strains despite negative toxin a and b testing on stool samples. | a two-step diagnostic algorithm is recommended to detect clostridium difficile infections; however, samples are regularly found that are glutamate dehydrogenase (gdh) positive but stool toxin negative. in the present single-centre prospective study we focused on these 'difficult-to-interpret' samples and characterized them by anaerobic culture, toxigenic culture, slpa sequence typing and multiplex pcr (genotype cdiff). the majority of stool toxin a and b-negative samples have been caused by toxi ... | 2014 | 24450741 |
| ribotype 027 clostridium difficile infections with measurable stool toxin have increased lactoferrin and are associated with a higher mortality. | we evaluated clinical and diagnostic indicators of severe c. difficile infection (cdi) and their association with poor clinical outcome. a total of 210 patients positive according to pcr (toxin b: tcdb) were included, with patients having a median age of 62 years and a charlson co-morbidity index (ci) score of 5. ninety-one percent (n = 191) were positive by toxigenic culture and 61% (n = 129) had stool toxin. toxin-positive patients had significantly higher fecal lactoferrin (mean 316 μg/g vers ... | 2014 | 24449345 |
| a case study of a real-time evaluation of the risk of disease transmission associated with a failure to follow recommended sterilization procedures. | failures to follow recommendations for reprocessing of surgical instruments may place patients at risk for exposure to pathogenic microorganisms. when such failures occur, medical facilities often face considerable uncertainty and challenges in assessing the actual risks of disease transmission. | 2014 | 24447336 |
| comparative proteomic analysis of clostridium difficile isolates of varying virulence. | the soluble proteome of three clostridium difficile strains of varying pathogenic potential, designated b-1, tra 5/5 and 027 sm, were compared using differential in-gel electrophoresis in which the proteins of each strain were labelled with cydyes. this enabled visual inspection of the 2d profiles of strains and identification of differentially expressed proteins using image analysis software. unlabelled protein reference maps of the predominant proteins were then generated for each strain using ... | 2014 | 24445512 |
| antibiotic-induced shifts in the mouse gut microbiome and metabolome increase susceptibility to clostridium difficile infection. | antibiotics can have significant and long-lasting effects on the gastrointestinal tract microbiota, reducing colonization resistance against pathogens including clostridium difficile. here we show that antibiotic treatment induces substantial changes in the gut microbial community and in the metabolome of mice susceptible to c. difficile infection. levels of secondary bile acids, glucose, free fatty acids and dipeptides decrease, whereas those of primary bile acids and sugar alcohols increase, r ... | 2014 | 24445449 |
| a randomized trial of soap and water hand wash versus alcohol hand rub for removal of clostridium difficile spores from hands of patients. | 2014 | 24442089 | |
| comparison of 3 severity criteria for clostridium difficile infection. | effective severity criteria are needed to guide management of clostridium difficile infection (cdi). in this retrospective study, outcomes were compared between patients with mild-moderate versus severe cdi according to 3 different severity criteria: those included in the 2010 society for healthcare epidemiology of america/infectious diseases society of america guidelines, those from a recent clinical trial, and our hospital-specific guidelines. | 2014 | 24442086 |