Publications

[recommendations for the use of faecal microbiota transplantation "stool transplantation": consensus of the austrian society of gastroenterology and hepatology (öggh) in cooperation with the austrian society of infectious diseases and tropical medicine].	the intestinal microbiota has a pivotal role in the maintenance of health of the human organism, especially in the defense against pathogenic microorganisms. alterations in the microbiota, also termed dysbiosis, seem to be involved in the pathogenesis of a variety of intestinal and extraintestinal diseases. fecal microbiota transplantation (fmt), also known as stool transplantation, is a therapeutic procedure aiming at restoring an altered intestinal microbiota by administration of stool microor ...	2014	25474284
vitamin d deficiency is associated with community-acquired clostridium difficile infection: a case-control study.	clostridium difficile infection (cdi) is increasingly recognized as an important community acquired pathogen causing disease (ca-cdi). vitamin d [25(oh)d] has immune modulatory effects and plays an important role in intestinal immunity. the role of vitamin d in ca-cdi has not been examined previously.	2014	25471926
the impact of horizontal gene transfer on the biology of clostridium difficile.	clostridium difficile infection (cdi) is now recognised as the main cause of healthcare associated diarrhoea. over the recent years there has been a change in the epidemiology of cdi with certain related strains dominating infection. these strains have been termed hyper-virulent and have successfully spread across the globe. many c. difficile strains have had their genomes completely sequenced allowing researchers to build up a very detailed picture of the contribution of horizontal gene transfe ...	2014	25476764
clostridium difficile virulence factors: insights into an anaerobic spore-forming pathogen.	the worldwide emergence of epidemic strains of clostridium difficile linked to increased disease severity and mortality has resulted in greater research efforts toward determining the virulence factors and pathogenesis mechanisms used by this organism to cause disease. c. difficile is an opportunist pathogen that employs many factors to infect and damage the host, often with devastating consequences. this review will focus on the role of the 2 major virulence factors, toxin a (tcda) and toxin b ...	2014	25483328
underdiagnosis of clostridium difficile across europe: the european, multicentre, prospective, biannual, point-prevalence study of clostridium difficile infection in hospitalised patients with diarrhoea (euclid).	variations in testing for clostridium difficile infection can hinder patients' care, increase the risk of transmission, and skew epidemiological data. we aimed to measure the underdiagnosis of c difficile infection across europe.	2014	25455988
hidden burden of undiagnosed clostridium difficile infection.		2014	25455970
tigecycline for the treatment of severe and severe complicated clostridium difficile infection.	clostridium difficile infection (cdi) is a common cause of nosocomial diarrhea. metronidazole and vancomycin are the primary treatment options for cdi, but increasing rates of antimicrobial resistance and severe, refractory disease have prompted the need for alternative agents. tigecycline has previously demonstrated favorable in vitro activity against c. difficile isolates, but clinical data on its use in the treatment of cdi are severely lacking. the objective of this study was to describe our ...	2014	25466443
portable uv light as an alternative for decontamination.	we evaluated the capability of a commercially available hand-held device that emits ultraviolet (uv) light to disinfect plain surfaces. eight bacterial species were tested, including clostridium difficile ribotype 027 and 3 other spore-forming species. even bacterial spores could be successfully inactivated within a few seconds of irradiation. uv light may provide an alternative for the decontamination of medical products, such as mobile phones or tablet computers, that cannot be treated otherwi ...	2014	25465267
comparative performance of the genexpert c. difficile pcr assay and c. diff quik chek complete kit assay for detection of clostridium difficile antigen and toxins in symptomatic community-onset infections.	to evaluate the performance of the genexpert c. difficile assay and c. diff quik chek complete (qcc) kit for the detection of toxins from fecal specimens and cooked meat broth (cmb) culture using toxigenic stool culture as reference method, for the diagnosis of c. difficile infection (cdi) in a community setting.	2014	25462186
factors affecting treatment and recurrence of clostridium difficile infections.	the antimicrobial agents vancomycin and metronidazole have been used to treat clostridium difficile infections (cdis). however, it remains unclear why patients are at risk of treatment failure and recurrence. therefore, this study retrospectively examined 98 patients with cdis who were diagnosed based on the detection of toxin-positive c. difficile to determine the risk factors affecting drug treatment responses and the recurrence of cdi. no significant difference was observed in the cure rate o ...	2014	25366486
cost-effectiveness analysis of treatment strategies for initial clostridium difficile infection.	clostridium difficile infection (cdi) is costly. current guidelines recommend metronidazole as first-line therapy and vancomycin as an alternative. recurrence is common. faecal microbiota transplantation (fmt) is an effective therapy for recurrent cdi (rcdi). this study explores the cost-effectiveness of fmt, vancomycin and metronidazole for initial cdi. we constructed a decision-analytic computer simulation using inputs from published literature to compare fmt with a 10-14-day course of oral me ...	2014	25366338
a hospital-based study of the clinical characteristics of clostridium difficile infection in children.	clostridium difficile infection (cdi) is an increasingly important cause of morbidity in hospitalized children. we describe the recent epidemiology of pediatric cdi at a children's hospital, compare community-associated (ca) and hospital-associated (ha) infections and identify risk factors for severe disease.	2014	25361022
development of taqman-based quantitative pcr for sensitive and selective detection of toxigenic clostridium difficile in human stools.	clostridium difficile is the main cause of nosocomial diarrhea, but is also found in asymptomatic subjects that are potentially involved in transmission of c. difficile infection. a sensitive and accurate detection method of c. difficile, especially toxigenic strains is indispensable for the epidemiological investigation.	2014	25360662
cost-effectiveness of fecal microbiota transplant in treating clostridium difficile infection in canada.		2014	27202489
cost-effectiveness of fidaxomicin therapy for clostridium difficile infection in hungary.		2014	27202484
economic evaluation of fidaxomicin for the treatment of clostridium difficile infections (cdi) also known as clostridium difficile-associated diarrhoea (cdad) in spain.		2014	27202478
cost-effectiveness of fidaxomicin for the treatment of clostridium difficile infection (cdi) in sweden.		2014	27202472
the burden of clostridium difficile (cdi) infection in hospitals, in denmark, finland, norway and sweden.		2014	27202459
fidaxomicin therapy for patients with clostridium difficile infection: a systematic literature review and meta-analysis.		2014	27202426
cdad-daysyms™: a new patient-reported outcome tool for clostridium difficile-associated diarrhoea.		2014	27201895
cost-utility analysis of fidaxomicin compared to vancomycin in the management of severe clostridium difficile infection in poland.		2014	27200779
epidemiology of clostridium difficile infection in two tertiary-care hospitals in perth, western australia: a cross-sectional study.	the epidemiology of clostridium difficile infection (cdi) has changed over time and between countries. it is therefore essential to monitor the characteristics of patients at risk of infection and the circulating strains to recognize local and global trends, and improve patient management. from december 2011 to may 2012 we conducted a prospective, observational epidemiological study of patients with laboratory-confirmed cdi at two tertiary teaching hospitals in perth, western australia to determ ...	2014	25356346
the role of local and systemic cytokines in patients infected with clostridium difficile.	it is widely accepted that the pathogenesis of clostridium difficile infection (cdi) is multifactorial, dependent on pathogen virulence factors produced by the organism as well as disorders of the gastrointestinal tract, the alteration in intestinal flora and the immune response of the host. in particular, the immune response in the course of cdi and the involvement of cytokines in the pathogenesis of cdi is not fully understood. the aim of our study was to evaluate the relationship between proi ...	2014	25371529
jama patient page. clostridium difficile infection.		2014	25369506
[sensory aphasia during therapy with metronidazole--an important differential diagnosis of acute cerebral ischemia].	a 74-year old man was admitted after neurosurgical treatment of a lumbar vertebral fracture. he had a slight paresis of the right leg in combination with bladder dysfunction.	2014	25369045
comparison of supplemented brucella agar and modified clostridium difficile agar for antimicrobial susceptibility testing of clostridium difficile.	antimicrobial susceptibility testing (ast) of clostridium difficile is increasingly important because of the rise in resistant strains. the standard medium for the ast of c. difficile is supplemented brucella agar (sba), but we found that the growth of c. difficile on sba was not optimal. because active growth is critical for reliable ast, we developed a new, modified c. difficile (mcd) agar. c. difficile grew better on mcd agar than on sba.	2014	25368819
strategies to prevent clostridium difficile infections in acute care hospitals: 2014 update.		2014	25376069
long-term clinical outcome of clostridium difficile infection in hospitalized patients: a single center study.	antibiotic usage and increasingly aging populations have led to increased incidence of clostridium difficile infection (cdi) in worldwide. recent studies in korea have also reported increasing cdi incidence; however, there have been no reports on the long-term outcomes of cdi. we therefore investigated the long-term clinical outcomes of patients with cdi, including delayed recurrence, associated risk factors and mortality.	2014	25374496
risk factors for delayed recurrence of clostridium difficile infection.		2014	25374490
icu-onset clostridium difficile infection in a university hospital in china: a prospective cohort study.	a prospective study was conducted to investigate the incidence, clinical profiles and outcome of icu-onset cdi in a 50-bed medical icu at a university hospital in china. stools were collected from patients who developed icu-onset diarrhea and was screened for tcda (toxin a gene) and tcdb (toxin b gene) by pcr. cdi cases were compared with the icu-onset non-cdi diarrhea cases for demographics, comorbidities, potential risk factors, major laboratory findings and outcomes. stool samples from cdi ca ...	2014	25372033
the complexity and diversity of the pathogenicity locus in clostridium difficile clade 5.	the symptoms of clostridium difficile infection are caused by two closely related toxins, tcda and tcdb, which are encoded by the 19.6 kb pathogenicity locus (paloc). the paloc is variably present among strains, and in this respect it resembles a mobile genetic element. the c. difficile population structure consists mainly of five phylogenetic clades designated 1-5. certain genotypes of clade 5 are associated with recently emergent highly pathogenic strains causing human disease and animal infec ...	2014	25381663
alert microorganisms isolated from patients hospitalized in małopolskie province in 2010-2012.	healthcare centers undertake supervisory activities to control health care-associated infections (hcais) by elaborating procedures, identifying alert microorganisms and analyzing data collected. the aim of the study was to analyze the prevalence of alert microorganisms in hospital wards in 2010-2012.	2014	25391008
factors associated with clostridium difficile diarrhea in a hospital in beijing, china.	clostridium difficile is the most common cause of hospital-acquired diarrhea in patients treated with antibiotics, chemotherapeutic agents, and other drugs that alter the normal equilibrium of the intestinal flora. a better understanding of the risk factors for c. difficile-associated disease (cdad) could be used to reduce the incidence of cdad and the costs associated with its treatment. the aim of this study was to identify the risk factors for cdad in a cohort of chinese patients in a beijing ...	2014	25387676
intestinal microbiota in health and disease: role of bifidobacteria in gut homeostasis.	the pool of microbes inhabiting our body is known as "microbiota" and their collective genomes as "microbiome". the colon is the most densely populated organ in the human body, although other parts, such as the skin, vaginal mucosa, or respiratory tract, also harbour specific microbiota. this microbial community regulates some important metabolic and physiological functions of the host, and drives the maturation of the immune system in early life, contributing to its homeostasis during life. alt ...	2014	25386066
antibiotic self-stewardship: trainee-led structured antibiotic time-outs to improve antimicrobial use.	antibiotic use is an important quality improvement target. nearly 50% of antibiotic use is unnecessary or inappropriate. to combat overuse, the centers for disease control and prevention (cdc) proposed "time-outs" to reevaluate antibiotics.	2014	25402404
clostridium difficile infection: guideline-based diagnosis and treatment.	clostridium difficile (c. difficile) is the pathogen that most commonly causes nosocomial and antibiotic-associated diarrheal disease. optimized algorithms for diagnosis, treatment, and hygiene can help lower the incidence, morbidity, and mortality of c. difficile infection (cdi).	2014	25404529
electrical injuries. biological values measurements as a prediction factor of local evolution in electrocutions lesions.	taking into account the incidence and the severity of electrocutions, we consider it extremely necessary to find effective, appropriate and particularized therapeutic solutions aimed at improving the survival, decreasing the mortality, ensuring a superior functional and aesthetic effect and facilitating the social reintegration. given the severity of the general condition of the electrically injured patient and the fact that any worsening of the lesions has a systemic echo, the selection of the ...	2014	25408731
stability and recovery of dificid(®) (fidaxomicin) 200-mg crushed tablet preparations from three delivery vehicles, and administration of an aqueous dispersion via nasogastric tube.	fidaxomicin is approved for the treatment of adults with clostridium difficile-associated diarrhea, many of whom have difficulty swallowing an intact tablet. the study objective was to evaluate the stability and recovery of crushed dificid(®) (fidaxomicin) 200-mg tablets dispersed in water, applesauce, or ensure(®) brand liquid nutritional supplement, and to determine the recovery of fidaxomicin from the administration of an aqueous dispersion of a crushed dificid(®) tablet through a nasogastric ...	2014	25424419
[fecal microbiota transplantation: first case report in chile and review].	clostridium difficile (cd) infection is increasing in frequency and severity in in-hospital and outpatient clinical settings, with a recurrence that can reach 30% after first episode. the recurrences are usually treated with longer courses of metronidazole or vancomycin. other treatments have been used, such as probiotics, fidaxomicin, rifaximin, immunoglobulins and monoclonal antibodies against toxins a and b. fecal microbiota transplantation (fmt) has emerged as a promising strategy in this gr ...	2014	25327204
clostridium difficile infection in the postcolectomy patient.	clostridium difficile infection (cdi) after total colectomy has been increasingly recognized over the past decade. c. difficile enteritis (cde) is a rare occurrence, whereas c. difficile pouchitis (cdp) has been reported in approximately 10% of symptomatic patients seen at a referral center for pouch dysfunction. similar to colonic cdi in the general population, antibiotic use and comorbid diseases may be risk factors for cde. in contrast, the postoperative use of antibiotics does not seem to be ...	2014	25401722
quantitative fecal lactoferrin as a biomarker for severe clostridium difficile infection in hospitalized patients.	the incidence and severity of clostridium difficile infection (cdi) have increased over the past decade, especially among hospitalized patients. in this study, we determined the value of published criteria for severe cdi in predicting 3 month mortality, as well as the utility of fecal lactoferrin as a biomarker for severe cdi.	2014	25401164
discrepancies between surveillance definition and the clinical incidence of clostridium difficile infection in a veterans affairs long-term care facility.		2014	25333446
differences in hospital-associated multidrug-resistant organisms and clostridium difficile rates using 2-day versus 3-day definitions.	we surveyed infection prevention programs in 16 hospitals for hospital-associated methicillin-resistant staphylococcus aureus (mrsa), vancomycin-resistant enterococci, extended-spectrum β-lactamase, and multidrug-resistant acinetobacter acquisition, as well as hospital-associated mrsa bacteremia and clostridium difficile infection based on defining events as occurring >2 days versus >3 days after admission. the former resulted in significantly higher median rates, ranging from 6.76% to 45.07% hi ...	2014	25333439
evaluation of a sporicidal peracetic acid/hydrogen peroxide-based daily disinfectant cleaner.	oxycide daily disinfectant cleaner, a novel peracetic acid/hydrogen peroxide-based sporicidal disinfectant, was as effective as sodium hypochlorite for in vitro killing of clostridium difficile spores, methicillin-resistant staphylococcus aureus, and vancomcyin-resistant enterococci. oxycide was minimally affected by organic load and was effective in reducing pathogen contamination in isolation rooms.	2014	25333438
attributable inpatient costs of recurrent clostridium difficile infections.	to determine the attributable inpatient costs of recurrent clostridium difficile infections (cdis).	2014	25333435
probiotics for antibiotic-associated diarrhoea (paad): a prospective observational study of antibiotic-associated diarrhoea (including clostridium difficile-associated diarrhoea) in care homes.	antibiotic prescribing rates in care homes are higher than in the general population. antibiotics disrupt the normal gut flora, sometimes causing antibiotic-associated diarrhoea (aad). clostridium difficile (hall and o'toole 1935) prévot 1938 is the most commonly identified cause of aad. little is known either about the frequency or type of antibiotics prescribed in care homes or about the incidence and aetiology of aad in this setting.	2014	25331573
acid suppression therapy does not predispose to clostridium difficile infection: the case of the potential bias.	an adverse effect of acid-suppression medications on the occurrence of clostridium difficile infection (cdi) has been a common finding of many, but not all studies. we hypothesized that association between acid-suppression medications and cdi is due to the residual confounding in comparison between patients with infection to those without, predominantly from non-tested and less sick subjects. we aimed to evaluate the effect of acid suppression therapy on incidence of cdi by comparing patients wi ...	2014	25343667
utility of clostridium difficile toxin b for inducing anti-tumor immunity.	clostridium difficile toxin b (tcdb) is a key virulence factor of bacterium and induces intestinal inflammatory disease. because of its potent cytotoxic and proinflammatory activities, we investigated the utility of tcdb in developing anti-tumor immunity. tcdb induced cell death in mouse colorectal cancer ct26 cells, and the intoxicated cells stimulated the activation of mouse bone marrow-derived dendritic cells and subsequent t cell activation in vitro. immunization of balb/c mice with toxin-tr ...	2014	25340750
fecal microbiota transplantation in inflammatory bowel disease: beyond the excitement.	the purpose of this article is to perform a systematic review of the literature on the use of fecal microbiota transplantation (fmt) in inflammatory bowel disease (ibd).there is an increasing interest of both physicians and patients in assessing the possible role of the fmt in the treatment of ibd.electronic and manual bibliographic searches were performed to identify original reports in which subjects with ibd were treated with fmt. because of the scarcity of studies with adequate sample size, ...	2014	25340496
development and validation of a clostridium difficile risk assessment tool.	the incidence of clostridium difficile infection has increased rapidly during the past decade, increasing lengths of stays in the hospital, costs, and mortality rates. to address this increased incidence, we performed a retrospective case-control study using known risk factors to develop a tool to determine which patients are at risk for infection. multivariate analysis generated a combination of risk factors associated with development of infection including prior admission, endoscopy within 30 ...	2014	25340415
genetic relatedness between japanese and european isolates of clostridium difficile originating from piglets and their risk associated with human health.	clostridium difficile colonization in pig intestine has been a public health concern. we analyzed c. difficile prevalence among piglets in japan to clarify their origin and extent of the associated risk by using molecular and microbiological methods for both swine and human clinical isolates and foreign isolates. c. difficile was isolated from 120 neonatal piglet fecal samples. toxin gene profile, antimicrobial susceptibilities, pcr ribotype, and multiple-locus variable-number tandem-repeat anal ...	2014	25339943
clostridium difficile infection: current, forgotten and emerging treatment options.	clostridium difficile infection (cdi) has increased in incidence and severity, and is now among the most common nosocomial infections. several agents are available for the initial treatment of cdi, some of which are rarely used, and none of which is clearly superior for initial clinical cure. fidaxomicin appears to offer a benefit in terms of preventing recurrent disease, although the cost-benefit ratio is debated. recurrent cdi is a major challenge, occurring after 15-30% of initial episodes. t ...	2014	25350805
[high hospital standardized mortality ratio does not always indicate low quality].	hospital standardized mortality ratio (hsmr) is increasingly used to assess quality of care. at frederiksberg hospital hsmr increased significantly during the first and second quarter in 2012. we therefore reviewed records of all deceased, including patients deceased during the comparative period in 2011 (n = 413). information about cancer and infection with clostridium difficile was specifically noted. we found that the increasing hsmr reflected an increase in the number of terminal cancer pati ...	2014	25350706
significant publications on infectious diseases pharmacotherapy in 2013.	the most important articles on infectious diseases (id) pharmacotherapy published in the peer-reviewed literature in 2013, as nominated and selected by panels of pharmacists and others with id expertise, are summarized.	2014	25349243
update on the pathogenesis and management of pouchitis.	pouchitis is an inflammatory complication after restorative proctocolectomy and ileal pouch-anal anastomosis (ipaa). ipaa is the surgical treatment of choice in patients with ulcerative colitis (uc) who require colectomy. initial episodes of acute pouchitis generally respond to antibiotics but significant numbers of cases eventually become dependent on or refractory to antibiotics. management of chronic antibiotic refractory pouchitis is challenging and can ultimately lead to pouch failure. the ...	2014	25348740
systemically administered igg anti-toxin antibodies protect the colonic mucosa during infection with clostridium difficile in the piglet model.	the use of anti-toxin human monoclonal antibodies (hmab) as treatment for c. difficile infection has been investigated in animal models and human clinical trials as an alternative to or in combination with traditional antibiotic therapy. while hmab therapy appears to be a promising option, how systemically administered igg antibodies protect the colonic mucosa during clostridium difficile infection is unknown. using the gnotobiotic piglet model of clostridium difficile infection, we administered ...	2014	25347821
[experience with fecal transplantation in the treatment of clostridium difficile infection].	during the past years a dramatic change has been observed in the epidemiology of clostridium difficile infections.	2014	25344853
a case of imported clostridium difficile pcr-ribotype 027 infection within the czech republic which has a high prevalence of c. difficile ribotype 176.	the first case of clostridium difficile rt027 infection in the czech republic (cz) was identified. the patient had been hospitalised in germany prior to moving to cz. multiple-locus variable number tandem repeat analysis revealed a genetic relatedness between the patient's isolate and rt027 isolate collected in the german hospital.	2014	25300750
prevalence and risk factors of clostridium difficile infection in patients hospitalized for flare of inflammatory bowel disease: a retrospective assessment.	recent studies have identified a high frequency of clostridium difficile infections in patients with active inflammatory bowel disease.	2014	25294795
[developments in the treatment of inflammatory bowel disease: 2014 overview].	the way we treat inflammatory bowel disease is rapidly changing. biologics have accounted for the biggest change in recent years, and they are being used on a more regular basis, on more indications and at earlier stages. however, primary response failure and, above all, secondary response failure and cost represent serious limitations for their use. combination immunosuppressant therapy, individualization depending on levels and response, increasing compliance and a more suitable choice of case ...	2014	25294262
the past 10 years of gastroenterology and hepatology-reflections and predictions.	in november 2004, the very first issue of this journal featured articles on the pathogenesis of ulcerative colitis, mechanisms leading to chronic pancreatitis, and treatment of recurrent clostridium-difficile-associated diarrhoea. although those topics might seem familiar, much has changed in the intervening years in our understanding, diagnosis and treatment of many different diseases across the field of gastroenterology and hepatology. nonetheless, many challenges remain. here, we have asked f ...	2014	25291429
fecal microbiota transplantation: a new old kid on the block for the management of gut microbiota-related disease.	gut microbiota is deeply involved in the regulation of both health and disease within our body. the restoration of a healthy gut microbiota is, therefore, a main clinical target in the management of diseases associated with its disruption. fecal microbiota transplantation (fmt) is an old therapy that has recently been rediscovered, having proved a clear efficacy against recurrent clostridium difficile infection. by restoring the altered gut microbiota in a substantial and durable manner, fmt is ...	2014	25291136
giardia duodenalis infection reduces granulocyte infiltration in an in vivo model of bacterial toxin-induced colitis and attenuates inflammation in human intestinal tissue.	giardia duodenalis (syn. g. intestinalis, g. lamblia) is a predominant cause of waterborne diarrheal disease that may lead to post-infectious functional gastrointestinal disorders. although giardia-infected individuals could carry as much as 106 trophozoites per centimetre of gut, their intestinal mucosa is devoid of overt signs of inflammation. recent studies have shown that in endemic countries where bacterial infectious diseases are common, giardia infections can protect against the developme ...	2014	25289678
mini-review: epidemiology and zoonotic potential of multiresistant bacteria and clostridium difficile in livestock and food.	information on the epidemiology of multiresistant bacteria (mrb) with zoonotic potential is growing but still remains quite incomplete. this narrative mini-review provides a general overview of the epidemiology of the most important zoonotic mrb in cattle, swine and poultry in europe.	2014	25285265
clostridium difficile in the community: time to clean up?		2014	25284189
synthetic polymers active against clostridium difficile vegetative cell growth and spore outgrowth.	nylon-3 polymers (poly-β-peptides) have been investigated as synthetic mimics of host-defense peptides in recent years. these polymers are attractive because they are much easier to synthesize than are the peptides themselves, and the polymers resist proteolysis. here we describe in vitro analysis of selected nylon-3 copolymers against clostridium difficile, an important nosocomial pathogen that causes highly infectious diarrheal disease. the best polymers match the human host-defense peptide ll ...	2014	25279431
reply to "use of adenosine triphosphate bioluminescence assays to measure cleaning: the role of spores and clostridium difficile infection rates".		2014	25278414
hospital roommates and development of health care-onset clostridium difficile infection.	there is potential for person-to-person transmission in clostridium difficile outbreak settings. a limited number of studies have examined the role of hospital roommates in the development of nosocomial infections. this retrospective cohort study evaluated room cooccupancy and duration of exposure to roommates as predictors of health care-onset c difficile infection (cdi). among roommates of patients with cdi, duration of room cooccupancy was significantly longer in those developing cdi.	2014	25278404
the rise in clostridium difficile infection incidence among hospitalized adults in the united states: 2001-2010.	clostridium difficile infection (cdi) incidence is a growing concern. this study provides national estimates of cdi over 10 years and identifies trends in mortality and hospital length of stay (los) among hospitalized adults with cdi.	2014	25278388
phenotypic and genotypic analysis of clostridium difficile isolates: a single-center study.	clostridium difficile infections (cdi) are a growing concern in north america, because of their increasing incidence and severity. using integrated approaches, we correlated pathogen genotypes and host clinical characteristics for 46 c. difficile infections in a tertiary care medical center during a 6-month interval from january to june 2010. multilocus sequence typing (mlst) demonstrated 21 known and 2 novel sequence types (sts), suggesting that the institution's c. difficile strains are geneti ...	2014	25275005
faecal transplantation and infectious diseases practitioners.		2014	25274397
recombinant clostridium difficile toxin b induces endoplasmic reticulum stress in mouse colonal carcinoma cells.	clostridium difficile is the main cause of antibiotic-associated diarrhea and pseudomembranous colitis in humans and animals. its pathogenicity is primarily linked to the secretion of two exotoxins (tcda and tcdb). although great progress in the toxic mechanism of tcda and tcdb has been achieved, there are many conflicting reports about the apoptotic mechanism. more importantly, apoptotic endoplasmic reticulum (er) stress has been reported in cells treated with shiga toxins-another kind of cytot ...	2014	25274332
faecal microbiota transplantation--the austrian approach.	the intestinal microbiome is essential for maintaining human health and defending against intestinal pathogens. alterations of the intestinal microbiota, also termed dysbiosis, play a pivotal role in the pathogenesis of various human diseases. faecal microbiota transplantation (fmt) is aimed at correcting these alterations by delivering faecal microorganisms from a healthy person to the intestines of a patient. at present, recurrent clostridium difficile infection is the only indication supporte ...	2014	25274251
[clostridium difficile spores and its relevance in the persistence and transmission of the infection].	c. difficile is an anaerobic spore former pathogen and the most important etiologic agent of nosocomial and community acquired antibiotics associated diarrheas. c. difficile infections (cdi) are responsible for an elevated rate of morbidity in developed and developing countries. although the major virulence factors responsible for clinical symptoms of cdi are the two toxins tcda and tcdb, c. difficile spores are the main vehicle of infection, persistence and transmission of cdi. recent work has ...	2014	25679927
[performance of prognostic index in severe clostridium difficile-associated infection: retrospective analysis in a university hospital].	by consensus severe, clostridium difficile-associated infection (cdai) is one that results in hospitalization in icu, colectomy or death within 30 days. multiple prognostic indices (ip) attempt to predict these adverse events.	2014	25679920
urinary tract infections in male veterans with human immunodeficiency virus.	treatment duration for men with urinary tract infection (uti) and human immunodeficiency virus (hiv) infection is unknown. fiscal year 2009 veterans affairs administrative data were used to compare men with hiv and uti with non-hiv men with uti. antimicrobial selection and duration were similar. shorter treatment (≤7 days) did not affect recurrence, suggesting that treatment beyond 7 days may be unnecessary.	2014	25734168
novel fidaxomicin treatment regimens for patients with multiple clostridium difficile infection recurrences that are refractory to standard therapies.	reports of fidaxomicin treatment for patients with multiple recurrent clostridium difficile infections ([mrcdi] ie, more than 2 cdi episodes) indicate symptomatic response to this agent, but 50% have subsequent mrcdi episodes. in an effort to improve outcomes in patients with mrcdi we used novel regimens of fidaxomicin based on strategies used with vancomycin. of 8 patients who received a 10-day chaser of fidaxomicin given twice daily after a course of vancomycin, 3 (38%) experienced a subsequen ...	2014	25734139
determinants of clostridium difficile infection incidence across diverse united states geographic locations.	clostridium difficile infection (cdi) is no longer restricted to hospital settings, and population-based incidence measures are needed. understanding the determinants of cdi incidence will allow for more meaningful comparisons of rates and accurate national estimates.	2014	25734120
learning data-driven patient risk stratification models for clostridium difficile.	although many risk factors are well known, clostridium difficile infection (cdi) continues to be a significant problem throughout the world. the purpose of this study was to develop and validate a data-driven, hospital-specific risk stratification procedure for estimating the probability that an inpatient will test positive for c difficile.	2014	25734117
id learning unit: understanding and interpreting testing for clostridium difficile.	understanding and interpreting the molecular tests for clostridium difficile is challenging because there are several different types of assays and most laboratories combine multiple tests in order to assess for presence of disease. this learning unit demonstrates the basic principles of each test along with its strengths and weaknesses, and illustrates how the tests are used in clinical practice.	2014	25734081
assessing control bundles for clostridium difficile: a review and mathematical model.	clostridium difficile is the leading cause of infectious diarrhea in hospitalized patients. integrating several infection control and prevention methods is a burgeoning strategy for reducing disease incidence in healthcare settings. we present an up-to-date review of the literature on 'control bundles' used to mitigate the transmission of this pathogen. all clinical studies of control bundles reported substantial reductions in disease rates, in the order of 33%-61%. using a biologically realisti ...	2014	26038744
rational therapy of clostridium difficile infections.	clostridium difficile infections (cdi) are increasingly important in patients with antibiotic treatments, ranging from mild, self-limiting to severe, life-threatening disease. currently, diagnostic algorithms and treatment guidelines are being adapted to novel tests and therapeutic options for recurrent cdi.	2014	26288096
variation in risk of hospital-onset clostridium difficile infection across β-lactam antibiotics in children with new-onset acute lymphoblastic leukemia.	antibiotic exposure is common among children with leukemia. however, limited data exist regarding the risk of clostridium difficile infection (cdi) across anti-pseudomonal β-lactam antibiotics commonly used for fever and neutropenia.	2014	26625453
use of rifamycin drugs and development of infection by rifamycin-resistant strains of clostridium difficile.	the relationship between rifamycin drug use and the development of resistant strains of clostridium difficile was studied at a large university hospital in houston, tx, between may 2007 and september 2011. in 49 of 283 (17.3%) patients with c. difficile infection (cdi), a rifamycin-resistant strain of c. difficile was identified that compares to a rate of 8% using the same definitions in 2006-2007 (p = 0.59). the 49 patients infected by a resistant organism were matched by date of admission to 9 ...	2013	23545528
sequencing of bacterial genomes: principles and insights into pathogenesis and development of antibiotics.	the impact of bacterial diseases on public health has become enormous, and is partly due to the increasing trend of antibiotic resistance displayed by bacterial pathogens. sequencing of bacterial genomes has significantly improved our understanding about the biology of many bacterial pathogens as well as identification of novel antibiotic targets. since the advent of genome sequencing two decades ago, about 1,800 bacterial genomes have been fully sequenced and these include important aetiologica ...	2013	24705262
novel strategies for enhanced removal of persistent bacillus anthracis surrogates and clostridium difficile spores from skin.	removing spores of clostridium difficile and bacillus anthracis from skin is challenging because they are resistant to commonly used antimicrobials and soap and water washing provides only modest efficacy. we hypothesized that hygiene interventions incorporating a sporicidal electrochemically generated hypochlorous acid solution (vashe(®)) would reduce the burden of spores on skin.	2013	23844234
clinical approach to fever in the neurosurgical intensive care unit: focus on drug fever.	as fever is one of the cardinal signs of infection, the presence of fever in a patient in the neurosurgical intensive care unit (nsicu) raises the question of whether it is infectious in etiology. infectious and noninfectious causes of fever in the nsicu may be determined based upon assessment of clinical signs and symptoms, the degree of temperature elevation, the relationship of the pulse to the fever (e.g., an infectious process resulting in hyperpyrexia and bradycardia), and when the fever o ...	2013	23878765
recent advances in antibacterial drugs.	the incidence of antimicrobial resistance is on continued rise with a threat to return to the "pre-antibiotic" era. this has led to emergence of such bacterial infections which are essentially untreatable by the current armamentarium of available treatment options. various efforts have been made to develop the newer antimicrobials with novel modes of action which can act against these multi-drug resistant strains. this review aims to focus on these newly available and investigational antibacteri ...	2013	23776832
structure of clostridium difficile pilj exhibits unprecedented divergence from known type iv pilins.	type iv pili are produced by many pathogenic gram-negative bacteria and are important for processes as diverse as twitching motility, cellular adhesion, and colonization. recently, there has been an increased appreciation of the ability of gram-positive species, including clostridium difficile, to produce type iv pili. here we report the first three-dimensional structure of a gram-positive type iv pilin, pilj, demonstrate its incorporation into type iv pili, and offer insights into how the type ...	2013	24362261
biological evaluation of benzothiazole ethyl urea inhibitors of bacterial type ii topoisomerases.	the type ii topoisomerases dna gyrase (gyra/gyrb) and topoisomerase iv (parc/pare) are well-validated targets for antibacterial drug discovery. because of their structural and functional homology, these enzymes are amenable to dual targeting by a single ligand. in this study, two novel benzothiazole ethyl urea-based small molecules, designated compound a and compound b, were evaluated for their biochemical, antibacterial, and pharmacokinetic properties. the two compounds inhibited the atpase act ...	2013	24041906
bacterial complications of respiratory tract viral illness: a comprehensive evaluation.	respiratory tract infection is one of the most common reasons for hospitalization among adults, and recent evidence suggests that many of these illnesses are associated with viruses. although bacterial infection is known to complicate viral infections, the frequency and impact of mixed viral-bacterial infections has not been well studied.	2013	23661797
discovery of a cyclic phosphodiesterase that catalyzes the sequential hydrolysis of both ester bonds to phosphorus.	the bacterial c-p lyase pathway is responsible for the metabolism of unactivated organophosphonates under conditions of phosphate starvation. the cleavage of the c-p bond within ribose-1-methylphosphonate-5-phosphate to form methane and 5-phospho-ribose-1,2-cyclic phosphate (prcp) is catalyzed by the radical sam enzyme phnj. in escherichia coli the cyclic phosphate product is hydrolyzed to ribose-1,5-bisphosphate by phnp. in this study, we describe the discovery and characterization of an enzyme ...	2013	24147537
evaluation of luminex xtag gastrointestinal pathogen analyte-specific reagents for high-throughput, simultaneous detection of bacteria, viruses, and parasites of clinical and public health importance.	acute diarrheal disease (add) can be caused by a range of pathogens, including bacteria, viruses, and parasites. conventional diagnostic methods, such as culture, microscopy, biochemical assays, and enzyme-linked immunosorbent assays (elisa), are laborious and time-consuming and lack sensitivity. combined, the array of tests performed on a single specimen can increase the turnaround time (tat) significantly. we validated a 19plex laboratory-developed gastrointestinal pathogen panel (gpp) using l ...	2013	23850948
pang, a new ketopantoate reductase involved in pantothenate synthesis.	pantothenate, commonly referred to as vitamin b(5), is an essential molecule in the metabolism of living organisms and forms the core of coenzyme a. unlike humans, some bacteria and plants are capable of de novo biosynthesis of pantothenate, making this pathway a potential target for drug development. francisella tularensis subsp. tularensis schu s4 is a zoonotic bacterial pathogen that is able to synthesize pantothenate but is lacking the known ketopantoate reductase (kpr) genes, pane and ilvc, ...	2013	23243306
the protective effect of recombinant lactococcus lactis oral vaccine on a clostridium difficile-infected animal model.	oral immunization with vaccines may be an effective strategy for prevention of clostridium difficile infection (cdi). however, application of previously developed vaccines for preventing cdi has been limited due to various reasons. here, we developed a recombinant lactococcus lactis oral vaccine and evaluated its effect on a c. difficile-infected animal model established in golden hamsters in attempt to provide an alternative strategy for cdi prevention.	2013	23865596
inhaled colistin for treatment of pneumonia due to colistin-only-susceptible acinetobacter baumannii.	colistin is used for the treatment of pneumonia associated with multidrug- resistant acinetobacter baumannii and pseudomonas aeruginosa. however, the best route of administration and dosage is not known. we report our experience with aerosolized colistin in twelve patients with pneumonia caused by colistin-only-susceptible (cos) a. baumannii.	2013	24339296
development of novel sugar isomerases by optimization of active sites in phosphosugar isomerases for monosaccharides.	phosphosugar isomerases can catalyze the isomerization of not only phosphosugar but also of monosaccharides, suggesting that the phosphosugar isomerases can be used as sugar isomerases that do not exist in nature. determination of active-site residues of phosphosugar isomerases, including ribose-5-phosphate isomerase from clostridium difficile (cdrpi), mannose-6-phosphate isomerase from bacillus subtilis (bsmpi), and glucose-6-phosphate isomerase from pyrococcus furiosus (pfgpi), was accomplishe ...	2013	23204422
a rare case intractable diarrhea secondary to clostridium difficile and cytomegalovirus coinfection.	male, 63 final diagnosis: cytomegalo virus (cmv) infection symptoms: diarrhea medication:- clinical procedure:- specialty: infectious diseases.	2013	24298304
clostridium difficile and inflammatory bowel disease: role in pathogenesis and implications in treatment.	clostridium difficile (c. difficile) is the leading cause of antibiotic associated colitis and nosocomial diarrhea. patients with inflammatory bowel disease (ibd) are at increased risk of developing c. difficile infection (cdi), have worse outcomes of cdi-including higher rates of colectomy and death, and experience higher rates of recurrence. however, it is still not clear whether c. difficile is a cause of ibd or a consequence of the inflammatory state in the intestinal environment. the burden ...	2013	24282348
the role of the bacterial flagellum in adhesion and virulence.	the bacterial flagellum is a complex apparatus assembled of more than 20 different proteins. the flagellar basal body traverses the cell wall, whereas the curved hook connects the basal body to the whip-like flagellar filament that protrudes several µm from the bacterial cell. the flagellum has traditionally been regarded only as a motility organelle, but more recently it has become evident that flagella have a number of other biological functions. the major subunit, flagellin or flic, of the fl ...	2013	24833223