Publications

extraintestinal clostridium difficile infections: a single-center experience.	to evaluate the clinical burden of extraintestinal clostridium difficile infection (cdi) seen at a single institution and to characterize the management and outcomes of these rare infections.	2014	25245597
a survey of prescriber perceptions about the prevention of stress-related mucosal bleeding in the intensive care unit.	practices vary between institutions and amongst prescribers regarding when to initiate stress ulcer prophylaxis (sup), which agent to choose (including doses and frequencies) and rationale, and decisions about escalation or discontinuation of therapy. the purpose of this survey is to evaluate the perceptions of prescribers about risk assessment of stress-related mucosal bleeding (srmb) and practice patterns of sup.	2014	25243327
hand hygiene is crucial to combat clostridium difficile.	patients with clostridium difficile infection (cdi) can contaminate the environment with spores that are able to survive for months. a previous room occupant with cdi is a significant risk factor for developing the infection. room cleaning with commonly used disinfectants will not kill spores. sodium hypochlorite and hydrogen peroxide are effective but correct concentration and contact time are important. hand hygiene is a crucial element in preventing infection. in the uk, there is a clear reco ...	2014	25258234
a case of clostridium difficile infection complicated by acute respiratory distress syndrome treated with fecal microbiota transplantation.	acute respiratory distress syndrome is a life-threatening disorder caused mainly by pneumonia. clostridium difficile infection (cdi) is a common nosocomial diarrheal disease. disruption of normal intestinal flora by antibiotics is the main risk factor for cdi. the use of broad-spectrum antibiotics for serious medical conditions can make it difficult to treat cdi complicated by acute respiratory distress syndrome. fecal microbiota transplantation is a highly effective treatment in patients with r ...	2014	25253977
gastrointestinal microbiota-mediated control of enteric pathogens.	the gastrointestinal (gi) microbiota is a complex community of microorganisms residing within the mammalian gastrointestinal tract. the gi microbiota is vital to the development of the host immune system and plays a crucial role in human health and disease. the composition of the gi microbiota differs immensely among individuals yet specific shifts in composition and diversity have been linked to inflammatory bowel disease, obesity, atopy, and susceptibility to infection. in this review, we desc ...	2014	25251855
prevention of health care-associated infections.	health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. over the past decade, a downward trend in health care-associated infections has occurred nationwide. basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic techniqu ...	2014	25251230
enterococci, clostridium difficile and esbl-producing bacteria: epidemiology, clinical impact and prevention in icu patients.	most hospital-acquired infections arise from colonising bacteria. intensive care patients and immunocompromised individuals are at highest risk for microbial invasion and subsequent infection due to multiple invasive procedures in addition to frequent application of chemotherapeutics and presence of poor microperfusion leading to mucosal disruption. in this narrative review, we summarise the literature on bacterial colonisation in intensive care patients, in particular the epidemiology, the clin ...	2014	25250957
exogenous phosphatidylcholine supplementation improves intestinal barrier defense against clostridium difficile toxin.	the incidence and severity of clostridium difficile colitis have increased dramatically in the last decade. disease severity is related to c. difficile virulence factors, including toxins a and b, as well as the patient's immune status. the intestinal mucus is an important component of innate barrier function in the intestine. phosphatidylcholine (pc) is a key constituent of the intestinal mucus barrier, and exogenous pc administration has had therapeutic efficacy in patients with ulcerative col ...	2014	25250596
core elements of hospital antibiotic stewardship programs from the centers for disease control and prevention.	the proven benefits of antibiotic stewardship programs (asps) for optimizing antibiotic use and minimizing adverse events, such as clostridium difficile and antibiotic resistance, have prompted the centers for disease control and prevention (cdc) to recommend that all hospitals have an asp. this article summarizes core elements of hospital antibiotic stewardship programs, a recently released cdc document focused on defining the infrastructure and practices of coordinated multidisciplinary progra ...	2014	25261548
investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with clostridium difficile infection.	antimicrobial exposure remains an important risk factor for developing clostridium difficile infection (cdi). efficient method to identify antibiotics associated with cdi is important for formulating strategies to curtail their use. as a prelude to a more extensive agency for healthcare research and quality-funded project (evaluation & research on antimicrobial stewardship's effect on clostridium difficile), we undertook an exploratory evaluation to determine a resource-efficient method for iden ...	2014	25239720
an interleukin-4 polymorphism is associated with susceptibility to clostridium difficile infection in patients with inflammatory bowel disease: results of a retrospective cohort study.	clinical studies have suggested that patients with inflammatory bowel disease (ibd) are at greater risk for developing clostridium difficile infection (cdi). the purpose of this study was to identify single-nucleotide polymorphisms (snps) associated with cdi among ibd patients.	2014	25239315
stimulation of innate immunity by in vivo cyclic di-gmp synthesis using adenovirus.	the bacterial second messenger cyclic di-gmp (c-di-gmp) stimulates inflammation by initiating innate immune cell recruitment and triggering the release of proinflammatory cytokines and chemokines. these properties make c-di-gmp a promising candidate for use as a vaccine adjuvant, and numerous studies have demonstrated that administration of purified c-di-gmp with different antigens increases protection against infection in animal models. here, we have developed a novel approach to produce c-di-g ...	2014	25230938
antimicrobial stewardship-qualitative and quantitative outcomes: the role of measurement.	overuse and misuse of antibiotics have contributed to the growing problem of antimicrobial resistance and serious side effects including clostridium difficile infection. the centers for disease control and prevention estimates that more than 2 million people are infected by multidrug-resistant organisms every year. they propose that promoting antimicrobial stewardship programs (asp) is an essential component to combat this growing threat. one of the major barriers in implementing effective asp i ...	2014	25230602
clostridium difficile-induced colitis in mice is independent of leukotrienes.	clostridium difficile is the major cause of antibiotic-associated diarrhea and pseudomembranous colitis in healthcare settings. however, the host factors involved in the intestinal inflammatory response and pathogenesis of c. difficile infection (cdi) are largely unknown. here we investigated the role of leukotrienes (lts), a group of pro-inflammatory lipid mediators, in cdi. notably, the neutrophil chemoattractant ltb4, but not cysteinyl (cys) lts, was induced in the intestine of c57bl/6 mice i ...	2014	25230329
[pharmaceutical intervention in duration of antimicrobial treatment at hospital ambit].	to estimate the acceptance of the pharmaceutical intervention in controlling duration of antimicrobial therapy and to evaluate their impact on optimizing the treatment.	2014	25229371
evaluation of three enzyme immunoassays and a nucleic acid amplification test for the diagnosis of clostridium difficile-associated diarrhea at a university hospital in brazil.	despite the known importance of clostridium difficile as a nosocomial pathogen, few studies regarding clostridium difficile infection (cdi) in brazil have been conducted. to date, the diagnostic tests that are available on the brazilian market for the diagnosis of cdi have not been evaluated. the aim of this study was to compare the performances of four commercial methods for the diagnosis of cdi in patients from a university hospital in brazil.	2014	25229284
clostridium difficile ribotype 027 is most prevalent among inpatients admitted from long-term care facilities.	intestinal inflammation was evaluated using faecal lactoferrin and ribotype in 196 hospitalized adults with clostridium difficile infection to determine the impact of ribotype 027 in long-term care facilities (ltcfs). ltcf residents (n=28) had greater antibiotic use (p=0.049) and more ribotype 027 infection [odds ratio (or): 4.87; 95% confidence interval (ci): 2.02-11.74; p<0.01], compared to those admitted from home. patients infected with ribotype 027 strains had worse six-month mortality (or: ...	2014	25228227
fecal microbiota transplantation: an interest in ibd?	fecal microbiota transplantation (fmt) is a targeted microbiome-based therapy that has garnered a great deal of attention from the scientific, clinical, and lay communities. an increasing number of studies have demonstrated that fmt is a highly effective therapy for recurrent/refractory clostridium difficile infection and appears safe in the short term. uncontrolled reports suggest the possibility of benefit in a select group of ibd patients, but there is quite limited information so far. fmt fo ...	2014	25227298
host immunity to clostridium difficile pcr ribotype 017 strains.	clostridium difficile is an important nosocomial pathogen and the leading cause of antibiotic-associated diarrhea. multilocus sequence typing indicates that c. difficile strains belong to five distinct genetic clades encompassing several pcr ribotypes (rt). since their emergence in 2003, hypervirulent rt027 strains have been a major focus of research; in contrast, our current understanding of rt017-mediated disease pathogenesis lags far behind. in this study, we aimed to characterize host immuni ...	2014	25225246
clostridium difficile infection induced by pregabalin-associated agranulocytosis.	a 33-year-old man who had recently undergone surgery for cervical spondylotic myelopathy was prescribed pregabalin for neuralgia, and the dose was increased to 600 mg/day during hospitalization. however, the patient was diagnosed with a clostridium difficile infection on day 34 after admission. a complete blood count showed agranulocytosis (neutrophil count: 105/μl). we did not observe any changes in vital signs, a relative increase in band cells, or intestinal edema. the patient's agranulocytos ...	2014	25224205
polymerase chain reaction ribotyping of clostridium difficile isolates in qatar: a hospital-based study.	clostridium difficile infection (cdi) is not generally reported to public health authorities in the middle east and its true prevalence remains largely unknown. the aims of this study were to determine the prevalence of cdi and its associated ribotypes among c. difficile isolates in qatar. influence of age and correlation with other risk factors e.g. proton pump inhibitor use, antibiotic use, existence of chronic conditions, etc was also investigated for cdi positive patients.	2014	25223337
host recognition of clostridium difficile and the innate immune response.	clostridium difficile is a gram-positive, spore forming bacillus and the most common cause of antibiotic-associated diarrhea in the united states. clinical outcomes of c. difficile infection (cdi) range from asymptomatic colonization to pseudomembranous colitis, sepsis and death. disease is primarily mediated by the action of the rho-glucosylating toxins a and b, which induce potent pro-inflammatory signaling within the host. the role of this inflammatory response during infection is just beginn ...	2014	25223264
pseudomembranous colitis due to clostridium difficile.		2014	25223126
lessons learned from implementing clostridium difficile-focused antibiotic stewardship interventions.	to determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset clostridium difficile infection (cdi) rates.	2014	25222903
racial and ethnic disparities in healthcare-associated infections in the united states, 2009-2011.	little is known about racial and ethnic disparities in the occurrence of healthcare-associated infections (hais) in hospitalized patients.	2014	25222888
risk factors and management of refractory or recurrent clostridium difficile infection in ileal pouch patients.	clostridium difficile infection (cdi) is increasingly recognized in patients with ulcerative colitis with ileal pouch-anal anastomosis (ipaa). the aim of this study was to identify clinical risk factors for treatment-refractory or recurrent cdi in patients with ipaa.	2014	25222656
recombination drives evolution of the clostridium difficile 16s-23s rrna intergenic spacer region.	pcr-ribotyping, a typing method based on size variation in 16s-23s rrna intergenic spacer region (isr), has been used widely for molecular epidemiological investigations of c. difficile infections. in the present study, we describe the sequence diversity of isrs from 43 c. difficile strains, representing different pcr-ribotypes and suggest homologous recombination as a possible mechanism driving the evolution of 16s-23s rrna isrs. isrs of 45 different lengths (ranging from 185 bp to 564 bp) were ...	2014	25222120
[faecal microbiota transplantation in france: what applicable law?].	the transplantation of gut microbiota addresses a critical gap in the treatment of recurrent severe clostridium difficile infection, and clinical trials are ongoing throughout the world for other potential broader clinical indications. as the fecal flora inoculum has currently no legal status under european law, we consider it provisionally a sui generis biological drug rather than a human tissue transplantation, with major implications in terms of legal liability in france. the inoculum obeys a ...	2014	25220232
risk factors of clostridium difficile infections among patients in a university hospital in shanghai, china.	clostridium difficile infection (cdi) is an increasing concern in china. however, the risk factors of cdi are rarely reported in the chinese population. a prospective observational study was therefore conducted among patients with hospital-acquired c. difficile diarrhoea and the risk factors of cdi in a retrospective case-control study. the cdi patients were compared with the non-cdi diarrhoeal patients and those without diarrhoea, respectively. the recurrent cdi patients were compared with the ...	2014	25219941
hand-hygiene compliance does not predict rates of resistant infections in critically ill surgical patients.	our institution had a major outbreak of multi-drug-resistant acinetobacter (mdra) in its general surgical and trauma intensive care units (icus) in 2011, requiring implementation of an aggressive infection-control response. we hypothesized that poor hand-hygiene compliance (hhc) may have contributed to the outbreak of mdra. a response to the outbreak including aggressive environmental cleaning, cohorting, and increased hand hygiene compliance monitoring may have led to an increase in hhc after t ...	2014	25215463
pseudomembranous colitis: not always caused by clostridium difficile.	although classically pseudomembranous colitis is caused by clostridium difficile, it can result from several etiologies. certain medications, chemical injury, collagenous colitis, inflammatory bowel disease, ischemia, and other infectious pathogens can reportedly cause mucosal injury and subsequent pseudomembrane formation. we present the case of a middle-aged woman with vascular disease who was incorrectly diagnosed with refractory c. difficile infection due to the presence of pseudomembranes. ...	2014	25214850
diagnosis and management of common gastrointestinal tract infectious diseases in ulcerative colitis and crohn's disease patients.	management of inflammatory bowel disease (ibd), including ulcerative colitis and crohn's disease, stretches beyond control of flares. some infections of the gastrointestinal tract are more commonly seen in patients with ibd. work from the human microbiome project has been instrumental in our understanding of the interplay between the vast gut microbiota and host immune responses. patients with ibd may be more prone to infectious complications based on their underlying inflammatory disease and va ...	2014	25208106
molecular epidemiology of clostridium difficile for clinical practice.	during the last decade, the world has witnessed numerous outbreaks of clostridium difficile infections (cdi) in healthcare settings. increasing incidence rates of cdi have been mainly attributed to the successful global spread of a more virulent strain of c. difficile - namely pcr-ribotype 027. more recent studies, however, point to the emergence of other ribotypes as the main cause of the continuing epidemic. this review summarises the current literature on the molecular epidemiology of c. diff ...	2014	25207831
impact of clostridium difficile infection on inflammatory bowel disease outcome: a review.	although a considerable number of studies support a substantial increase in incidence, severity, and healthcare costs for clostridium difficile infection (cdi) in inflammatory bowel disease (ibd), only few evaluate its impact on ibd outcome. medline and several other electronic databases from january 1993 to october 2013 were searched in order to identify potentially relevant literature. most of the studies showed that ibd patients with cdi present a greater proportion of worse outcomes than tho ...	2014	25206277
point-of-care testing for clostridium difficile infection: a real-world feasibility study of a rapid molecular test in two hospital settings.	in the developed world, clostridium difficile infection (cdi) is the most important cause of nosocomial infectious diarrhea. in addition to providing epidemiological data and helping to indicate that a local outbreak may be occurring, laboratory tests are used to augment clinical decisions on individual patients. very rarely do diagnostic tests provide results at the point of decision making; in the intervening period between requesting investigations on a patient with suspected cdi and return o ...	2014	25205503
fidaxomicin: a novel macrolide antibiotic for clostridium difficile infection.	to review the chemistry, pharmacology, microbiology, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, drug interactions, dosing, and administration of fidaxomicin (fdx).	2014	25203410
shared hoppers: a novel risk factor for the transmission of clostridium difficile.		2014	25203194
clinical and molecular characteristics of an outbreak caused by the pandemic (bi/nap1/027) clostridium difficile clone in a single center in israel.		2014	25203189
antimicrobial stewardship programs in inpatient hospital settings: a systematic review.	evaluate the evidence for effects of inpatient antimicrobial stewardship programs (asps) on patient, prescribing, and microbial outcomes.	2014	25203174
commentary on "high frequency of nonadherence to clostridium difficile treatment guidelines".		2014	25188628
high frequency of nonadherence to clostridium difficile treatment guidelines.	the 2010 infectious diseases society of america/society for healthcare epidemiology of america treatment guidelines for clostridium difficile infections (cdi) recommend oral metronidazole for mild-to-moderate disease and oral vancomycin for severe disease. given that disease severity is easily determined by the peripheral white blood cell count and serum creatinine level, a computerized decision support (cds) pathway to guide treatment is inherently appealing. because providers often override or ...	2014	25188627
performance of chromid clostridium difficile agar compared with bbl c. difficile selective agar for detection of c. difficile in stool specimens.	we evaluated the performance of a new chromogenic medium for detection of clostridium difficile, chromid c. difficile agar (cdif; biomérieux, france), by comparison with bbl c. difficile selective agar (cdsa; becton dickinson and company, usa). after heat pre-treatment (80℃, 5 min), 185 diarrheal stool samples were inoculated onto the two media types and incubated anaerobically for 24 hr and 48 hr for cdif and for 48 hr and 72 hr for cdsa. all typical colonies on each medium were examined by gra ...	2014	25187891
epidemiology and clinical features of toxigenic culture-confirmed hospital-onset clostridium difficile infection: a multicentre prospective study in tertiary hospitals of south korea.	hypervirulent clostridium difficile strains, most notably bi/nap1/027, have been increasingly emerging in western countries as local epidemics. we performed a prospective multicentre observational study from december 2011 to may 2012 to identify recent incidences of toxigenic culture-confirmed hospital-onset c. difficile infections (cdi) and their associated clinical characteristics in south korea. patients suspected of having been suffering from cdi more than 48 h after admission and aged ≥20 y ...	2014	25187603
multi-institution case-control and cohort study of risk factors for the development and mortality of clostridium difficile infections in japan.	to examine risk factors for clostridium difficile infection (cdi) morbidity and mortality in japan.	2014	25186155
inflammatory bowel disease cause-specific mortality: a primer for clinicians.	inflammatory bowel disease (ibd), including crohn's disease (cd) and ulcerative colitis (uc) is perceived to harbor significant morbidity but limited excess mortality, thought to be driven by colon cancer, compared with the general population. recent studies suggest mortality rates seem higher than previously understood, and there are emerging threats to mortality. clinicians must be up to date and able to clearly convey the causes of mortality to arm individual patients with information to mean ...	2014	25185685
evaluation of six pcr assays in combination with patient related data for the diagnosis of clostridium difficile-associated infections.	the aim of this multicenter study was to establish a diagnostic algorithm using molecular methods for the diagnosis of c. difficile-associated infection (cdi). in addition patient specific data were taken into consideration for the interpretation of the results.	2014	25185420
clostridium difficile has a single sortase, srtb, that can be inhibited by small-molecule inhibitors.	bacterial sortases are transpeptidases that covalently anchor surface proteins to the peptidoglycan of the gram-positive cell wall. sortase protein anchoring is mediated by a conserved cell wall sorting signal on the anchored protein, comprising of a c-terminal recognition sequence containing an "lpxtg-like" motif, followed by a hydrophobic domain and a positively charged tail.	2014	25183427
cost and impact on patient length of stay of rapid molecular testing for clostridium difficile.	a study was performed to assess the cost of a rapid molecular assay (pcr) for diagnosis of clostridium difficile infection (cdi) and the impact of its routine use on patient length of stay (los) in comparison with cell culture cytotoxin neutralization assay (ccna).	2014	25183400
ramoplanin at bactericidal concentrations induces bacterial membrane depolarization in staphylococcus aureus.	ramoplanin is an actinomycetes-derived antibiotic with broad-spectrum activity against gram-positive bacteria that has been evaluated in clinical trials for the treatment of gastrointestinal vancomycin-resistant enterococci (vre) and clostridium difficile infections. recent studies have proposed that ramoplanin binds to bacterial membranes as a c2 symmetrical dimer that can sequester lipid ii, which causes inhibition of cell wall peptidoglycan biosynthesis and cell death. in this study, ramoplan ...	2014	25182650
biofilm formation of clostridium difficile and susceptibility to manuka honey.	biofilm bacteria are relatively more resistant to antibiotics. the escalating trend of antibiotic resistance higlights the need for evaluating alternative potential therapeutic agents with antibacterial properties. the use of honey for treating microbial infections dates back to ancient times, though antimicrobial properties of manuka honey was discovered recently. the aim of this study was to demonstrate biofilm formation of specific clostridium difficile strains and evaluate susceptibility of ...	2014	25181951
the potential for emerging therapeutic options for clostridium difficile infection.	clostridium difficile is mainly a nosocomial pathogen and is a significant cause of antibiotic-associated diarrhea. it is also implicated in the majority of cases of pseudomembranous colitis. recently, advancements in next generation sequencing technology (ngs) have highlighted the extent of damage to the gut microbiota caused by broad-spectrum antibiotics, often resulting in c. difficile infection (cdi). currently the treatment of choice for cdi involves the use of metronidazole and vancomycin. ...	2014	25564777
[risk factors for clostridium difficile-associated diarrhea among cancer patients].	the aim of this study was to investigate the prevalence of clostridium difficile (c. difficile) infection and the risk factors for acquisition of c. difficile-associated diarrhea (cdad) among cancer patients who received chemotherapy or radiation therapy.	2014	25567310
does gastrointestinal dysmotility predispose to recurrent or severe forms of clostridium difficile infections?	clostridium difficile infection (cdi) is the most common cause of hospital-acquired diarrhea. a limited number of studies have looked at the risk factors for recurrent cdi. mitochondrial neurogastrointestinal encephalopathy (mngie) is a rare multisystemic disorder that causes gastrointestinal dysmotility. herein we present a patient with mngie who suffered recurrent and severe c. difficile infection despite appropriate treatment. we aim to bring the gastroenterologist's attention to gastrointest ...	2014	25580313
clostridium difficile with moxifloxacin/clindamycin resistance in vegetables in ohio, usa, and prevalence meta-analysis.	we (i) determined the prevalence of clostridium difficile and their antimicrobial resistance to six antimicrobial classes, in a variety of fresh vegetables sold in retail in ohio, usa, and (ii) conducted cumulative meta-analysis of reported prevalence in vegetables since the 1990s. six antimicrobial classes were tested for their relevance as risk factors for c. difficile infections (cdis) (clindamycin, moxifloxacin) or their clinical priority as exhaustive therapeutic options (metronidazole, van ...	2014	25580297
clinical characteristics of symptomatic clostridium difficile infection in children: conditions as infection risks and whether probiotics is effective.	this study investigated the clinical presentations of symptomatic clostridium difficile infection (cdi) in children.	2014	25587523
international patents granted for clostridium difficile program.		2014	25507269
characterization of comorbid factors in hip fracture related in-hospital mortality.	it is important to delineate factors which influence in-hospital mortality rates following a hip fracture. the current study aimed to identify the nature and frequency of comorbidities prevalent in this patient cohort. a retrospective chart review of cases of in-patient mortality following admission for a hip fracture was performed. these cases (n=127) were characterized for comorbidities, complications, medical status indicators, and other contributory factors. cardiovascular 104 (81.9%), respi ...	2014	25507116
faecal microbiota transplantation.	the use of faeces for the treatment of gastrointestinal diseases was described in 4th century chinese medicine for the treatment of severe diarrhoea.1 more recently there has been renewed interest in this unconventional biological therapy, particularly for the treatment of recurrent clostridium difficile infection (cdi) and to a lesser extent inflammatory bowel diseases (ibd). faecal microbiota transplantation† (fmt) involves the introduction of enteric bacteria from the faeces of healthy donors ...	2014	25505015
microbial bile acid metabolic clusters: the bouncers at the bar.	colonization resistance refers to the ability of the colonic microbiota to prevent invasion by pathogens including clostridium difficile. in a recent article, buffie et al. (2014) have demonstrated that a single metabolic cluster present in the normal, colonic microflora is responsible for preventing c. difficile invasion of healthy hosts.	2014	25525784
draft genome sequence of clostridium butyricum strain nor 33234, isolated from an elderly patient with diarrhea.	clostridium butyricum is one of the species frequently present in patients' stool samples. however, the identification of this species is sometimes difficult. here, we present the draft genome of clostridium butyricum nor 33234, which was isolated from a patient with suspected clostridium difficile infection-associated diarrhea and resembles clostridium clostridioforme in biochemical tests.	2014	25540356
proton pump inhibitors increase the risk for hospital-acquired clostridium difficile infection in critically ill patients.	proton pump inhibitors (ppi) have been linked to clostridium difficile infection (cdi) but there are few data specific to icu patients. we evaluated duration of ppi exposure as a potential risk factor for hospital-acquired cdi in the icu.	2014	25540023
epidemiology and predictors of recurrence of clostridium difficile infection in a north italian tertiary care hospital.		2014	25532010
rheological properties of erythrocytes in patients infected with clostridium difficile.	clostridium difficile infection (cdi) is a bacterial infection of the digestive tract. acute infections are accompanied by increased risk for venous thromboembolism (vte). to date, there have been no studies of the rheological properties of blood during the course of digestive tract infections. the aim of our study was to examine the effects of cdi on red blood cell (rbc) rheology, specifically rbc deformability, rbc aggregation, and plasma viscosity. in addition, the activity of glucose 6 phosp ...	2014	25531703
fecal transplantation treatment of antibiotic-induced, noninfectious colitis and long-term microbiota follow-up.	fecal microbiota transplantation (fmt) is an effective treatment for recurrent clostridium difficile infection (cdi) and is considered as a treatment for other gastrointestinal (gi) diseases. we followed up the relief of symptoms and long-term, over-a-year microbiota stabilization in a 46-year-old man, who underwent fmt for antibiotic-induced, non-cdi colitis nine months after being treated for cdi by fmt. fecal and mucosal microbiota was analyzed before the second fmt and during 14 months after ...	2014	25548572
probiotics for antibiotic-associated diarrhea: do we have a verdict?	probiotics use has increased tremendously over the past ten years. this was coupled with a surge of data relating their importance in clinical practice. antibiotic-associated diarrhea, whose frequency has risen recently, was one of the earliest targets with data published more than ten years ago. unfortunately, available trials suffer from severe discrepancies associated with variability and heterogeneity of several factors. most published randomized controlled trials and subsequent meta-analyse ...	2014	25548477
surveillance snapshot of clostridium difficile infection in hospitals across queensland detects binary toxin producing ribotype uk 244.	in north america and europe, the binary toxin positive clostridium difficile strains of the ribotypes 027 and 078 have been associated with death, toxic megacolon and other adverse outcomes. following an increase in c. difficile infections (cdis) in queensland, a prevalence study involving 175 hospitals was undertaken in early 2012, identifying 168 cases of cdi over a 2 month period. patient demographics and clinical characteristics were recorded, and c. difficile isolates were ribotyped and tes ...	2014	25631588
antibiotic therapy for acute uncomplicated pyelonephritis in women. take resistance into account.	acute uncomplicated pyelonephritis is a bacterial infection of the renal parenchyma, common in women. the bacterium responsible is usually escherichia coli. empirical antibiotic therapy should be initiated promptly to prevent serious complications. as of 2014, which empirical antibiotic regimen should be offered to non-pregnant adult women with acute uncomplicated pyelonephritis, while awaiting the results of antimicrobial susceptibility testing? we reviewed the available evidence using the stan ...	2014	25629148
immune-based treatment and prevention of clostridium difficile infection.	clostridium difficile (c. difficile) causes over 500,000 infections per year in the us, with an estimated 15,000 deaths and an estimated cost of $1-3 billion. moreover, a continual rise in the incidence of severe c. difficile infection (cdi) has been observed worldwide. currently, standard treatment for cdi is the administration of antibiotics. while effective, these treatments do not prevent and may contribute to a disease recurrence rate of 15-35%. prevention of recurrence is one of the most c ...	2014	25668664
fecal microbiota transplantation for clostridium difficile infection: the ochsner experience.	clostridium difficile infection (cdi) accounts for 20%-30% of cases of antibiotic-associated diarrhea and is the most commonly recognized cause of infectious diarrhea in healthcare settings. the incidence of cdi is rising, while the effectiveness of antibiotics for treatment decreases with recurrent episodes. the use of fecal microbiota transplantation (fmt) for cure of cdi has been reported since 1958, and the worldwide cure rate is reported to be 93%. we report our experience with fmt for the ...	2014	25598718
the role of bifidobacterium lactis b94 plus inulin in the treatment of acute infectious diarrhea in children.	in contrast to many other studies of probiotic species, the number of publications evaluating bifidobacterium lactis and its combinations with prebiotics as treatments for acute infectious diarrhea is limited. we investigated the synbiotic effects of b. lactis b94 plus inulin on acute infectious diarrhea.	2014	25599772
clostridium difficile infection and inflammatory bowel disease.	over the past 15 years, clostridium difficile infection (cdi) in patients with inflammatory bowel disease (ibd) has increased both in incidence and severity. traditional risk factors for cdi are similar in ibd and non-ibd populations, but there is a significant proportion of ibd patients which have distinctive characteristics. patients with ulcerative colitis (uc) are more susceptible to cdi and have more severe outcomes than those with crohn's disease (cd). cdi may be difficult to distinguish f ...	2014	25599768
antimicrobial peptide resistance mechanisms of gram-positive bacteria.	antimicrobial peptides, or amps, play a significant role in many environments as a tool to remove competing organisms. in response, many bacteria have evolved mechanisms to resist these peptides and prevent amp-mediated killing. the development of amp resistance mechanisms is driven by direct competition between bacterial species, as well as host and pathogen interactions. akin to the number of different amps found in nature, resistance mechanisms that have evolved are just as varied and may con ...	2014	25419466
characterization of comorbid factors in hip fracture related in-hospital mortality.	it is important to delineate factors which influence in-hospital mortality rates following a hip fracture. the current study aimed to identify the nature and frequency of comorbidities prevalent in this patient cohort. a retrospective chart review of cases of in-patient mortality following admission for a hip fracture was performed. these cases (n=127) were characterized for comorbidities, complications, medical status indicators, and other contributory factors. cardiovascular 104 (81.9%), respi ...	2014	25417388
report into clostridium difficile deaths at vale of leven reveals poor care and lack of leadership.	an inquiry into the deaths of patients from clostridium difficile at the vale of leven hospital in scotland has criticised nurses for providing substandard care.	2014	26982537
visual detection of bacterial pathogens via pna-based padlock probe assembly and isothermal amplification of dnazymes.	we have developed a self-reporting isothermal system for visual bacterial pathogen detection with single base resolution. the new dna diagnostic is based on combination of peptide nucleic acid (pna) technology, rolling circle amplification (rca) and dnazymes. pnas are used as exceedingly selective chemical tools that bind genomic dna at a predetermined sequence under nondenaturing conditions. after assembly of the pna-dna construct a padlock probe is circularized on the free strand. the probe in ...	2014	25415469
whole genome sequencing reveals potential spread of clostridium difficile between humans and farm animals in the netherlands, 2002 to 2011.	farm animals are a potential reservoir for human clostridium difficile infection (cdi), particularly pcr ribotype 078 which is frequently found in animals and humans. here, whole genome single-nucleotide polymorphism (snp) analysis was used to study the evolutionary relatedness of c. difficile 078 isolated from humans and animals on dutch pig farms. all sequenced genomes were surveyed for potential antimicrobial resistance determinants and linked to an antimicrobial resistance phenotype. we sequ ...	2014	25411691
prolonged use of a proton pump inhibitor reduces microbial diversity: implications for clostridium difficile susceptibility.	the role of the gut microbiome in arresting pathogen colonization and growth is important for protection against clostridium difficile infection (cdi). observational studies associate proton pump inhibitor (ppi) use and cdi incidence. we hypothesized that ppi use affected the distal gut microbiome over time, an effect that would be best explored by time-longitudinal study of healthy subjects on ppi in comparison to treatment-naïve cdi subjects. this study enrolled nine healthy human subjects and ...	2014	25426290
antibiotic stewardship in orthopaedic surgery: principles and practice.	a thorough knowledge of the principles of antibiotic stewardship is a crucial part of high-quality orthopaedic surgical care. these principles include (1) determining appropriate indications for antibiotic administration, (2) choosing the correct antibiotic based on known or expected pathogens, (3) determining the correct dosage, and (4) determining the appropriate duration of treatment. antibiotic stewardship programs have a multidisciplinary staff that can help guide antibiotic selection and d ...	2014	25425612
antibiotic susceptibility of clostridium difficile is similar worldwide over two decades despite widespread use of broad-spectrum antibiotics: an analysis done at the university hospital of zurich.	clostridium difficile infection (cdi) remains a major health problem worldwide. antibiotic use, in general, and clindamycin and ciprofloxacin, in particular, have been implicated in the pathogenesis of cdi. here, we hypothesized that antibiotics that are highly active in vitro against c. difficile are less frequently associated with cdi than others. the primary goals of our study were to determine if antibiotic susceptibility and cdi are associated and whether the antimicrobial susceptibility of ...	2014	25425433
occurrence of clostridium difficile in seasoned hamburgers and seven processing plants in iran.	the recent increment of the incidence of community associated clostridium difficile infection (ca)-cdi has led to speculation that this disease is associated to foodborne transmission. therefore it is critical to establish the community sources of cdi in order to implement the appropriate interventions. the present study was conducted to evaluate the prevalence of c. difficile in seasoned hamburger and examine the sources of c. difficile dispersal in hamburger processing plants. a total of 211 s ...	2014	25420512
international patents granted for clostridium difficile program.		2014	25420285
clostridium difficile infection in hospitalized patients with cystic fibrosis.		2014	25419780
recurrent clostridium difficile infection treated with home fecal transplantation: a case report.	clostridium difficile infection causes severe diarrhea, abdominal pain and weight loss. a course of metronidazole is the initial treatment; however up to 40% of patients have at least one recurrence. some patients have recurrent infections requiring further treatment with vancomycin, others need multiple courses of expensive treatment. fecal transplantation has been proposed as an effective treatment option for patients with recurrences. we report the case of a patient with recurrent clostridium ...	2014	25430511
right hemicolectomy in a severely anemic jehovah's witness patient with an extremely low preoperative hemoglobin level and the decision to operate.	severe anemia is associated with high mortality, and patients with this condition are typically treated with packed blood red cells. patients of jehovah's witness faith, however, do not accept blood transfusion therapy. the authors report the case of a jehovah's witness patient who presented with lower gastrointestinal bleeding secondary to clostridium difficile colitis. because the patient refused blood transfusion therapy, he underwent a right hemicolectomy with a preoperative hemoglobin level ...	2014	25429083
clostridium difficile infection: prevention, treatment, and surgical management.	clostridium difficile is increasing in both incidence and severity. although metronidazole and vancomycin remain the gold standard for medical management, and surgical colectomy the gold standard for surgical management, new treatment alternatives, including the creation of a diverting loop ileostomy along with colonic lavage and vancomycin enemas, are being investigated that may lead to changes in the current treatment algorithms. the most exciting development in the treatment options for c dif ...	2014	25440127
review of the emerging treatment of clostridium difficile infection with fecal microbiota transplantation and insights into future challenges.	clostridium difficile infection (cdi) is one of the most common health care-associated infections in the united states. currently, there are no standardized methods to prepare or deliver the fecal microbiota transplantation (fmt). various methods are used to prepare the fmt, which is usually administered via nasogastric tube, colonoscopy, or by enema. several clinical trials are underway to assess the true efficacy and safety of fmt for cdi. these trials include cdi studies assessing fmt via col ...	2014	25439277
the impact of proton pump inhibitors on the human gastrointestinal microbiome.	potent gastric acid suppression using proton pump inhibitors (ppis) is common in clinical practice but may have important effects on human health that are mediated through changes in the gastrointestinal microbiome. in the esophagus, ppis change the normal bacterial milieu to decrease distal esophageal exposure to inflammatory gram-negative bacteria. in the stomach, ppis alter the abundance and location of gastric helicobacter pylori and other bacteria. in the small bowel, ppis cause polymicrobi ...	2014	25439276
invited commentary on clostridium difficile increases the risk for venous thromboembolism.		2014	25441599
excess length of stay and mortality due to clostridium difficile infection: a multi-state modelling approach.	the burden of healthcare-associated infections, such as healthcare-acquired clostridium difficile (ha-cdi), can be expressed in terms of additional length of stay (los) and mortality. however, previous estimates have varied widely. although some have considered time of infection onset (time-dependent bias), none considered the impact of severity of ha-cdi; this was the primary aim of this study.	2014	25441017
long-term efficacy of a self-disinfecting coating in an intensive care unit.	cleaning and disinfecting fomites can effectively remove/kill pathogens on surfaces, but studies have shown that more than one-half the time, surfaces are not adequately cleaned or are recontaminated within minutes. this study evaluated a product designed to create a long-lasting surface coating that provides continuous disinfecting action.	2014	25444265
severity and frequency of community-onset clostridium difficile infection on an australian tertiary referral hospital campus.	clostridium difficile infection (cdi) is increasingly being found in populations without traditional risk factors. we compared the relative frequency, risk factors, severity, and outcomes of community-onset cdi with hospital-acquired infection.	2014	25449250
outbreak of clostridium difficile ribotype 027 in a residential home.	this article reports a significant outbreak of clostridium difficile ribotype 027 infection in a residential care home in the uk. five of six affected residents died within one month of diagnosis. investigation of the facility revealed problems with hand hygiene and environmental cleaning. affected residents had received a mean of 2.7 antibiotic courses in the two months preceding diagnosis. it is important to recognize that c. difficile outbreaks can occur in residential homes. there is a need ...	2014	25447200
implementation of polymerase chain reaction to rule out clostridium difficile infection is associated with reduced empiric antibiotic duration of therapy.	the polymerase chain reaction (pcr) test has higher sensitivity and a faster turnaround time than the enzyme immunoassay (eia) for identification of clostridium difficile, although the clinical implications of these variables are not well described.	2014	25477583
prevalence and characterization of clostridium difficile in beef and mutton meats of isfahan region, iran.	clostridium difficile (c. difficile) is a frequent cause of nosocomial infections. during last few years, the mortality rate of c. difficile infection (cdi) increased in healthcare facilities. this organism has become a major public health concern in developed nations. because of the increasing incidence of acquired-cdi (ca-cdi) and notable genetic overlap between c. difficile isolates from animals and humans, meat has defined as one of the probable transmission route of c. diffiicle to humans.	2014	25485054
clostridium difficile infection aggravates colitis in interleukin 10-deficient mice.	to investigate the effect of clostridium difficile (c. difficile) infection in an interleukin 10-deficient (il-10(-/-)) mouse model of inflammatory bowel disease.	2014	25493020
europe-wide call to combat c. difficile.	experts from across europe gathered last week to discuss ways to control and improve diagnosis and treatment of clostridium difficile, after research found an estimated 40,000 cases are missed annually.	2014	25492752
impacts of infection with different toxigenic clostridium difficile strains on faecal microbiota in children.	increasing evidence suggests that altered intestinal microbial composition and function result in an increased risk of clostridium difficile-associated diarrhoea (cdad); however, the specific changes of intestinal microbiota in children suffering from cdad and their associations with c. difficile strain toxigenicity are poorly understood. high-throughput pyrosequencing showed that reduced faecal bacterial diversity and dramatic shifts of microbial composition were found in children with cdad. th ...	2014	25501371
fecal microbiota transplantation for gastrointestinal diseases.	fecal microbiota transplantation (fmt) is a treatment to restore the normal microbial composition of the gut by introducing fecal microbiota obtained from a healthy donor into a diseased individual. there has been a growing interest in the use of fmt as a treatment of various diseases including clostridium difficile infection (cdi), inflammatory bowel disease, and irritable bowel syndrome. despite the increasing application of fmt, there are no standard protocols. many aspects of fmt procedures ...	2014	25500625
emphysematous cystitis due to recurrent clostridium difficile infection.	a 78-year-old woman with long-standing obstipation presented herself to the hospital with diarrhoea and progressive abdominal cramping since 2 days. acute abdomen developed and an emergency exploratory laparotomy was indicated, which showed no signs of bowel ischaemia. after admission to the internal ward, stool clostridium difficile pcr was tested positive. hence the diagnosis of pseudomembranous colitis became apparent. abdominal imaging demonstrated multiple gas foci in the wall of the bladde ...	2014	25519862
changes to clinician attire have done more harm than good.	the introduction of 'bare below the elbows' policies to facilitate handwashing led to the disappearance of the white coat from medical and surgical wards. while rates of key healthcare acquired infections in hospitals, e.g. clostridium difficile and methicillin-resistant staphylococcus aureus bacteraemia, have fallen, argument continues around the contribution of hand hygiene and dress codes to these changes. conversely, the number of complaints against clinicians continues to rise, and respect ...	2014	25516900