Publications

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primary human polarized small intestinal epithelial barriers respond differently to a hazardous and an innocuous protein.an experimental platform employing human derived intestinal epithelial cell (iec) line monolayers grown on permeable transwell(®) filters was previously investigated to differentiate between hazardous and innocuous proteins. this approach was effective at distinguishing these types of proteins and perturbation of monolayer integrity, particularly transepithelial electrical resistance (teer), was the most sensitive indicator. in the current report, in vitro indicators of monolayer integrity, cyto ...201728533127
clinical, immunological and microbiological predictors of poor outcome in clostridium difficile infection.clostridium difficile infection (cdi) causes increased morbidity and mortality. clinical data cannot clearly predict poor cdi outcome. data on the value of microbiological predictors is scarce.201728533000
methods and reporting studies assessing fecal microbiota transplantation: a systematic review.fecal microbiota transplantation (fmt) could be a novel treatment option for several chronic diseases associated with altered gut microbiota.201728531908
management of bacteriuria in veterans affairs hospitals.bacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (asb) and long durations of therapy for symptomatic urinary tract infections (utis), yet large-scale evaluations of bacteriuria management among inpatients are lacking.201728531289
how to: establish and run a stool bank.since 2013, several stool banks have been developed following publications reporting on clinical success of 'faecal microbiota transplantation' (fmt) for recurrent clostridium difficile infections (cdi). however, protocols for donor screening, faecal suspension preparation, and transfer of the faecal suspension differ between countries and institutions. moreover, no european consensus exists regarding the legislative aspects of the faecal suspension product. internationally standardized recommen ...201728529025
antimicrobial activity of fidaxomicin against clostridium difficile clinical isolates in aichi area in japan.we evaluated the susceptibility of 100 japanese clostridium difficile isolates to fidaxomicin, a new macrocyclic antibiotic. the minimum inhibitory concentration (mic) range of fidaxomicin was 0.03-0.5 μg/ml, with a mic for inhibition of 50% (mic50) of 0.12 μg/ml, and for inhibition of 90% (mic90) of 0.25 μg/ml. we also evaluated the susceptibilities of the same 100 c. difficile isolates to vancomycin, metronidazole, moxifloxacin, clindamycin, meropenem, and ampicillin. of all the antibiotics te ...201728527649
[clinical and demographic profile and risk factors for clostridium difficile infection].clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. the increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease.201728527248
efficacy of the world health organization-recommended handwashing technique and a modified washing technique to remove clostridium difficile from hands.the efficacy of the world health organization (who)-recommended handwashing technique against clostridium difficile is uncertain, and whether it could be improved remains unknown. also, the benefit of using a structured technique instead of an unstructured technique remains unclear.201728526314
dramatic effects of a new antimicrobial stewardship program in a rural community hospital.new joint commission antimicrobial stewardship requirements took effect on january 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and clostridium difficile infection. our objective was to measure the effects of a new antimicrobial stewardship program (asp) in a rural community hospital with no prior asp, in the context of having a new infectious disease specialist on staff.201728526311
antimicrobial stewardship for hospitalized patients with viral respiratory tract infections.the purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection.201728526309
draft genome sequences of five enterococcus species isolated from the gut of patients with suspected clostridium difficile infection.we present draft genome sequences of five enterococcus species from patients suspected of clostridium difficile infection. genome completeness was confirmed by presence of bacterial orthologs (97%). gene searches using hidden-markov models revealed that the isolates harbor between seven and 11 genes involved in antibiotic resistance to tetracyclines, beta-lactams, and vancomycin.201728522725
gut microbiota-mediated protection against diarrheal infections.the mammalian gut microbiota is a highly abundant and diverse microbial community that resides in the gastrointestinal tract. one major benefit that the gut microbiota provides to its host is colonization resistance-the ability to prevent colonization by foreign microbes, including diarrheal pathogens such as clostridium difficile , salmonella enterica serovar typhimurium and diarrheagenic escherichia coli .201728520994
effects of short- and long-course antibiotics on the lower intestinal microbiome as they relate to traveller's diarrhea.antibiotics have profound and lasting effects on the lower intestinal (gut) microbiome that can both promote resistance and increase susceptibility to colonization and infection; knowledge of these changes is important to the prevention and treatment of traveler's diarrhea.201728520993
evolving insights into the epidemiology and control of clostridium difficile in hospitals.typing studies suggest most cases of hospital-onset clostridium difficile infection are unrelated to other cases of active disease in the hospital. new cases may instead be due to transmissions from asymptomatic carriers or progression of latent c.difficile present-on-admission to active infection. direct exposure to antibiotics remains the primary risk factor for c.difficile infection but ward-level antibiotic use, antibiotic exposure of the prior room occupant, and c.difficile status of the pr ...201728520953
determination of the in vitro sporulation frequency of clostridium difficile.the anaerobic, gastrointestinal pathogen, clostridium difficile, persists within the environment and spreads from host-to-host via its infectious form, the spore. to effectively study spore formation, the physical differentiation of vegetative cells from spores is required to determine the proportion of spores within a population of c. difficile. this protocol describes a method to accurately enumerate both viable vegetative cells and spores separately and subsequently calculate a sporulation fr ...201728516125
serum-derived bovine immunoglobulin as novel adjunct in complicated clostridium difficile colitis treatment.clostridium difficile infection (cdi) is a well-known complication of antibiotic therapy. it is associated with significant morbidity, mortality, and cost in the hospital setting. the main symptoms include watery diarrhea, abdominal pain, and distension, but cdi can also present as toxic megacolon, bowel perforation with peritonitis, sepsis and renal failure. therapy includes metronidazole and oral vancomycin, with rectal vancomycin and fecal transplant reserved for more complicated cases. adjun ...201728516109
fecal microbiota transplantation outcomes in immunocompetent and immunocompromised patients: a single-center experience.clostridium difficile infection (cdi) is a major infectious disease focus for which fecal microbiota transplantation (fmt) has been used with success in various patient populations.201728513974
can procalcitonin contribute to the diagnosis of clostridium difficile colitis?it is a challenge to diagnosis clostridium difficile colitis.201728513121
intrinsic toxin-derived peptides destabilize and inactivate clostridium difficile tcdb.clostridium difficile infection (cdi) is a major cause of hospital-associated, antibiotic-induced diarrhea, which is largely mediated by the production of two large multidomain clostridial toxins, tcda and tcdb. both toxins coordinate the action of specific domains to bind receptors, enter cells, and deliver a catalytic fragment into the cytosol. this results in gtpase inactivation, actin disassembly, and cytotoxicity. tcdb in particular has been shown to encode a region covering amino acids 175 ...201728512094
emergence of microbial diversity due to cross-feeding interactions in a spatial model of gut microbial metabolism.the human gut contains approximately 10(14) bacteria, belonging to hundreds of different species. together, these microbial species form a complex food web that can break down nutrient sources that our own digestive enzymes cannot handle, including complex polysaccharides, producing short chain fatty acids and additional metabolites, e.g., vitamin k. microbial diversity is important for colonic health: changes in the composition of the microbiota have been associated with inflammatory bowel dise ...201728511646
enteric infection in relapse of inflammatory bowel disease: the utility of stool microbial pcr testing.the similar presentations in relapse of inflammatory bowel disease (ibd) and enteric infection pose substantial barriers to diagnosis and treatment. the objective of this study was to investigate the incidence, etiology, predictors, and treatment of enteric infection in patients with ibd.201728511200
identification of novel risk factors for community-acquired clostridium difficile infection using spatial statistics and geographic information system analyses.the rate of community-acquired clostridium difficile infection (ca-cdi) is increasing. while receipt of antibiotics remains an important risk factor for cdi, studies related to acquisition of c. difficile outside of hospitals are lacking. as a result, risk factors for exposure to c. difficile in community settings have been inadequately studied.201728510584
changes in microbial ecology after fecal microbiota transplantation for recurrent c. difficile infection affected by underlying inflammatory bowel disease.gut microbiota play a key role in maintaining homeostasis in the human gut. alterations in the gut microbial ecosystem predispose to clostridium difficile infection (cdi) and gut inflammatory disorders such as inflammatory bowel disease (ibd). fecal microbiota transplantation (fmt) from a healthy donor can restore gut microbial diversity and pathogen colonization resistance; consequently, it is now being investigated for its ability to improve inflammatory gut conditions such as ibd. in this stu ...201728506317
fecal microbiota transplantation in recurrent clostridium difficile infection in a patient with concomitant inflammatory bowel disease.the use of fecal microbiota transplantation in recurrent clostridium difficile infection and coexistent inflammatory bowel disease remains unclear. a 61-year-old man with ulcerative pancolitis was diagnosed with a third recurrence of clostridium difficile infection, previously treated with metronidazole, vancomycin and fidaxomicin. fecal microbiota transplantation of an unrelated healthy donor was performed by the lower route. after a twelve month follow-up, the patient remains asymptomatic with ...201728506071
comparison of the hospital-acquired clostridium difficile infection risk of using proton pump inhibitors versus histamine-2 receptor antagonists for prophylaxis and treatment of stress ulcers: a systematic review and meta-analysis.although proton pump inhibitors (ppis) have been widely used for the prevention and treatment of stress gastric ulcers in hospital settings, there are concerns that ppis increase the risk of clostridium difficile infection (cdi). however, little is known about the risk of cdi following ppi and histamine-2 receptor antagonist (h2ra) use. we evaluated the comparative hospital-acquired cdi occurrence risk associated with the concurrent use of ppis versus h2ras.201728506028
predictors of failure after single faecal microbiota transplantation in patients with recurrent clostridium difficile infection: results from a 3-year cohort study: authors' reply. 201728502839
an outbreak of clostridium difficile pcr ribotype 027 in spain: risk factors for recurrence and a novel treatment strategy.an outbreak of clostridium difficile infection (cdi) caused by ribotype 027 (b1/nap1) began in our hospital in november 2014, and produced 141 episodes in the following months. the aim of this study is to describe this outbreak, assess risk factors for recurrence of cdi-027 and to analyze the implementation of a novel treatment strategy. this is a prospective study of all patients with cdi-027, from november 2014 to november 2015. the epidemiological data were collected daily for each patient. w ...201728501926
molecular typing of clostridium difficile isolates cultured from patient stool samples and gastroenterological medical devices in a single iranian hospital.this study aimed to characterize clostridium difficile isolates cultured from stool samples of patients with c. difficile infection (cdi) and swabs from a medical environment in a gastroenterology center in tehran, iran. a total of 158 samples (105 stool samples from hospitalized patients and 53 swabs from medical devices and the environment) were collected from january 2011 to august 2011 and investigated for the presence of c. difficile by direct anaerobic culture on a selective media for c. d ...201728501554
comparative effectiveness of faecal microbiota transplant by route of administration.the optimal route of delivery for faecal microbiota transplant (fmt) is unknown. this observational single-centre study analysed the two-week cure rates for all patients who received fmt from 2013 to 2016 according to route of delivery. overall, nasogastric delivery of fmt was less effective than lower endoscopic delivery. when patients were stratified by illness severity, nasogastric delivery achieved similar cure rates in healthier individuals, whereas lower endoscopic delivery was preferred f ...201728501333
carboxyl analogue of mutacin 1140, a scaffold for lead antibacterial discovery.mutacin 1140 belongs to the epidermin group of lantibiotics. epidermin class lantibiotics are ribosomally synthesized and posttranslationally modified antibiotics with potent activity against gram-positive bacteria. in particular, this class is effective at targeting drug-resistant streptococcus pneumoniae, methicillin-resistant staphylococcus aureus (mrsa), mycobacterium tuberculosis, and clostridium difficile a c-terminal s-[(z)-2-aminovinyl]-d-cysteine (avicys) residue is derived from a decar ...201728500042
protective factors in the intestinal microbiome against clostridium difficile infection in recipients of allogeneic hematopoietic stem cell transplantation.clostridium difficile infection (cdi) is a frequent complication in recipients of allogeneic hematopoietic stem cell transplantation (allo-hsct), who receive intensive treatments that significantly disrupt the intestinal microbiota. in this study, we examined the microbiota composition of allo-hsct recipients to identify bacterial colonizers that confer protection against cdi after engraftment.201728498996
assessing the risk and disease burden of clostridium difficile infection among patients with hospital-acquired pneumonia at a university hospital in central china.hospital-acquired pneumonia (hap) remains one of the major hospital-acquired infections in china. antibiotic treatment of hap may lead to subsequent clostridium difficile infection (cdi). baseline data on the occurrence of cdi among hap patients in china are currently unavailable. this study examines the risk and disease burden of cdi among hap hospitalized patients (hap-cdi).201728497295
inhibition of clostridium difficile in mice using a mixture of potential probiotic strains enterococcus faecalis nm815, e. faecalis nm915, and e. faecium nm1015: novel candidates to control c. difficile infection (cdi).this study is aimed at the isolation, identification, and characterization of potential probiotic strains capable of inhibiting clostridium difficile in vitro and in vivo. twenty isolates were isolated from infant fecal samples and screened against c. difficile using their cell-free supernatant. only three isolates showed maximum inhibition from 56.05 to 60.60%, thus they were characterized for probiotic properties and safety. the results obtained approved their tolerance to the gastrointestinal ...201728497217
lack of association between the clinical outcome of clostridium difficile infection and current steroids use.the purpose of this study was to compare the outcome of clostridium difficile infection (cdi) in patients on systemic steroids for various indications to patients not on steroids in term of disease severity, and associated morbidity and mortality.201728496532
comparison of two environmental sampling tools for the detection of clostridium difficile spores on hard bathroom surfaces in the hospital setting. 201728495188
filmarray™ gi panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea.acute gastroenteritis is a common cause of morbidity and mortality in humans worldwide. the rapid and specific identification of infectious agents is crucial for correct patient management. however, diagnosis of acute gastroenteritis is usually performed with diagnostic panels that include only a few pathogens. in the present bicentric study, the diagnostic value of filmarray™ gi panels was assessed in unformed stool samples of patients with acute gastroenteritis and in a series of samples colle ...201728494766
rapid synthesis of bicyclic lactones via palladium-catalyzed aminocarbonylative lactonizations.a novel and efficient palladium-catalyzed aminocarbonylative lactonization of amino propargylic alcohols has been developed to provide rapid access to various bicyclic lactones especially dihydropyrrole-fused furanones, which are novel structures and have not been explored in biological and medicinal settings. this method can also be used to access β-lactone products such as 16. preliminary biological evaluations revealed that compounds 13h and 13s demonstrated promising activity against clostri ...201728492641
infections in hematopoietic cell transplant recipients: results from the organ transplant infection project, a multicenter, prospective, cohort study.infection is a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (hct). our object was to better define the epidemiology and outcomes of infections after hct.201728491889
current challenges in the treatment of severe clostridium difficile infection: early treatment potential of fecal microbiota transplantation.fecal microbiota transplantation (fmt) is a very effective treatment for recurrent clostridium difficile infection (cdi). less is known about the application of fmt as a curative treatment of severe or complicated cdi. in this review, we present and discuss evidence supporting the curative use of fmt in severe or complicated cdi. we performed a literature search in pubmed and embase for studies on the curative use of fmt in severe or complicated cdi. in addition, we describe a patient with sever ...201728491142
antimicrobial activity of natural products against clostridium difficile in vitro.to investigate the antimicrobial activity of various natural products against clostridium difficile in vitro.201728489336
a clostridium difficile alanine racemase affects spore germination and accommodates serine as a substrate.clostridium difficile has become one of the most common bacterial pathogens in hospital-acquired infections in the united states. although c. difficile is strictly anaerobic, it survives in aerobic environments and transmits between hosts via spores. c. difficile spore germination is triggered in response to certain bile acids and glycine. although glycine is the most effective co-germinant, other amino acids can substitute with varying efficiencies. of these, l-alanine is an effective co-germin ...201728487371
thirty-day readmissions after hospitalization for clostridium difficile enteritis measures and predictors: a nationwide analysis. 201728486996
optimal control of vaccination rate in an epidemiological model of clostridium difficile transmission.the spore-forming, gram-negative bacteria clostridium difficile can cause severe intestinal illness. a striking increase in the number of cases of c. difficile infection (cdi) among hospitals has highlighted the need to better understand how to prevent the spread of cdi. in our paper, we modify and update a compartmental model of nosocomial c. difficile transmission to include vaccination. we then apply optimal control theory to determine the time-varying optimal vaccination rate that minimizes ...201728484801
intraluminal administration of resiniferatoxin protects against clostridium difficile toxin a-induced colitis.clostridium difficile toxin a is a colonic inflammatory agent that acts partially by activation of trpv1 (transient receptor potential vanilloid type 1). resiniferatoxin (rtx) is an excitotoxin that activates trpv1 at low concentrations and defunctionalizes trpv1 at high concentrations. rtx at various doses was injected intraluminally into isolated ileal segments in anesthetized rats. after 3 hours, the treated segments were removed and inflammation was assessed. this acute treatment with rtx re ...201728484490
protective effect of carvacrol against gut dysbiosis and clostridium difficile associated disease in a mouse model.this study investigated the effect of carvacrol (cr), a phytophenolic compound on antibiotic-associated gut dysbiosis and c. difficile infection in a mouse model. five to six-week-old c57bl/6 mice were randomly divided into seven treatment groups (challenge and control) of eight mice each. mice were fed with irradiated feed supplemented with cr (0, 0.05, and 0.1%); the challenge groups were made susceptible to c. difficile by orally administering an antibiotic cocktail in water and an intra-peri ...201728484429
bezlotoxumab: could this be the answer for clostridium difficile recurrence?to review the pharmacology, pharmacokinetics, efficacy, safety, and place in therapy of bezlotoxumab (bez), a novel monoclonal antibody against clostridium difficile toxin b.201728480750
community environmental contamination of toxigenic clostridium difficile.clostridium difficile infection is often considered to result from recent acquisition of a c difficile isolate in a healthcare setting. however, c difficile spores can persist for long periods of time, suggesting a potentially large community environmental reservoir. the objectives of this study were to assess community environmental contamination of toxigenic c difficile and to assess strain distribution in environmental versus clinical isolates.201728480289
primary outcomes from a phase 3, randomized, double-blind, active-controlled trial of surotomycin in subjects with clostridium difficile infection.although the incidence of clostridium difficile infection (cdi) is increasing, available cdi treatment options are limited in terms of sustained response after treatment. this phase 3 trial assessed the efficacy and safety of surotomycin, a novel bactericidal cyclic lipopeptide, versus oral vancomycin in subjects with cdi.201728480267
does adjunctive tigecycline improve outcomes in severe-complicated, nonoperative clostridium difficile infection?severe clostridium difficile infection is associated with a high rate of mortality; however, the optimal treatment for severe- complicated infection remains uncertain for patients who are not candidates for surgical intervention. thus, we sought to evaluate the benefit of adjunctive tigecycline in this patient population using a retrospective cohort adjusted for propensity to receive tigecycline. we found that patients who received tigecycline had similar outcomes to those who did not, although ...201728480257
outcomes associated with antimicrobial de-escalation of treatment for pneumonia within the veterans healthcare administration.de-escalation, an antimicrobial stewardship concept, involves narrowing broad-spectrum empiric antimicrobial therapy based on clinical data. current health outcomes evidence is lacking to support de-escalation. studying veterans healthcare administration pneumonia patients, de-escalation was associated with improved length of stay without affecting 30-day readmission or 30-day clostridium difficile infection rates.201728480242
higher incidence of clostridium difficile infection among individuals with inflammatory bowel disease.studies of clostridium difficile infections (cdis) among individuals with inflammatory bowel disease (ibd) have used data from single centers or cdi administrative data codes of limited diagnostic accuracy. we determined the incidence, risk factors, and outcomes after cdi in a population-based cohort of patients with ibd and laboratory confirmation diagnoses of cdi.201728479377
promoting appropriate urine culture management to improve health care outcomes and the accuracy of catheter-associated urinary tract infections.published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and clostri ...201728476493
tracking microbial colonization in fecal microbiota transplantation experiments via genome-resolved metagenomics.fecal microbiota transplantation (fmt) is an effective treatment for recurrent clostridium difficile infection and shows promise for treating other medical conditions associated with intestinal dysbioses. however, we lack a sufficient understanding of which microbial populations successfully colonize the recipient gut, and the widely used approaches to study the microbial ecology of fmt experiments fail to provide enough resolution to identify populations that are likely responsible for fmt-deri ...201728473000
microbicidal effects of weakly acidified chlorous acid water against feline calicivirus and clostridium difficile spores under protein-rich conditions.sanitation of environmental surfaces with chlorine based-disinfectants is a principal measure to control outbreaks of norovirus or clostridium difficile. the microbicidal activity of chlorine-based disinfectants depends on the free available chlorine (fac), but their oxidative potential is rapidly eliminated by organic matter. in this study, the microbicidal activities of weakly acidified chlorous acid water (wacaw) and sodium hypochlorite solution (naclo) against feline calcivirus (fcv) and c. ...201728472060
[bezlotoxumab for the secondary prevention of clostridium difficile infection : modify i and modify ii studies]. 201728470456
proton pump inhibitors and clostridium difficile infection. 201728469228
a combination of the probiotic and prebiotic product can prevent the germination of clostridium difficile spores and infection.clostridium difficile infection (cdi) is one of the most prevalent healthcare associated infections in hospitals and nursing homes. different approaches are used for prevention of cdi. absence of intestinal lactobacilli and bifidobacteria has been associated with c. difficile colonization in hospitalized patients. our aim was to test a) the susceptibility of c. difficile strains of different origin and the intestinal probiotic lactobacillus plantarum inducia (dsm 21379) to various antimicrobial ...201728465256
the emergence of clostridium difficile infection in asia: a systematic review and meta-analysis of incidence and impact.clostridium difficile infection (cdi) is the most common healthcare associated infection and is highly prevalent in europe and north america. limited data is available on the prevalence of cdi in asia. however, secular increases in prevalence of risk factors for cdi suggest that it may be emerging as a major cause of morbidity, highlighting the urgent need for a systematic study of the prevalence of cdi in asia.201728463987
a multicenter randomized trial to determine the effect of an environmental disinfection intervention on the incidence of healthcare-associated clostridium difficile infection.objective to determine the impact of an environmental disinfection intervention on the incidence of healthcare-associated clostridium difficile infection (cdi). design a multicenter randomized trial. setting in total,16 acute-care hospitals in northeastern ohio participated in the study. intervention we conducted a 12-month randomized trial to compare standard cleaning to enhanced cleaning that included monitoring of environmental services (evs) personnel performance with feedback to evs and inf ...201728462761
second generation cephalosporin antibiotic prophylaxis and clostridium difficile infection in hip and knee arthroplasty.introduction the use of broad spectrum cephalosporin antibiotics has been discouraged by the department of health in england because of the link to increased clostridium difficile infection rates. the aim of this study was to evaluate whether a local protocol that included the use of second generation cephalosporin (cefuroxime) antibiotics as a prophylactic agent was associated with increased risk of c difficile in elective hip and knee arthroplasty patients. methods a retrospective intention-to ...201728462657
expanding the armamentarium for the treatment of clostridium difficile infection. 201728461208
efficacy and safety of ridinilazole compared with vancomycin for the treatment of clostridium difficile infection: a phase 2, randomised, double-blind, active-controlled, non-inferiority study.clostridium difficile infection is the most common health-care-associated infection in the usa. we assessed the safety and efficacy of ridinilazole versus vancomycin for treatment of c difficile infection.201728461207
probiotics for prevention of clostridium difficile infection in hospitalized patients: is the jury still out? 201728461190
withholding pantoprazole for stress ulcer prophylaxis in critically ill patients: a pilot randomized clinical trial and meta-analysis.a decreased frequency of upper gastrointestinal bleeding and a possible association of proton pump inhibitor use with clostridium difficile and ventilator-associated pneumonia have raised concerns recently. the reevaluating the inhibition of stress erosions pilot trial determined the feasibility of undertaking a larger trial investigating the efficacy and safety of withholding proton pump inhibitors in critically ill patients.201728459708
effect of liberal blood transfusion on clinical outcomes and cost in spine surgery patients.blood transfusions in spine surgery are shown to be associated with increased patient morbidity. the association between transfusion performed using a liberal hemoglobin (hb) trigger-defined as an intraoperative hb level of ≥10 g/dl, a postoperative level of ≥8 g/dl, or a whole hospital nadir between 8 and 10 g/dl-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study.201728458067
clostridium difficile.clostridium difficile infections (cdis) have emerged as one of the principal threats to the health of hospitalized and immunocompromised patients. the importance of c difficile colonization is increasingly recognized not only as a source for false-positive clinical testing but also as a source of new infections within hospitals and other health care environments. in the last five years, several new treatment strategies that capitalize on the increasing understanding of the altered microbiome and ...201728457354
comparison of the rates of clostridium difficile and bacteremia after delaying fluoroquinolone prophylaxis from day 0 to day +3 post autologous stem cell transplantation.prophylactic fluoroquinolones are routinely administered after stem cell transplantation (sct) to prevent bacterial infection; however, fluoroquinolones may increase the risk of clostridium difficile infection, particularly in immunocompromised patients. this study is designed to evaluate the effect of a delay by 3 days in fluoroquinolone prophylaxis after autologous sct (asct) on the rates of c. difficile infection and bacteremia. a single-center retrospective cohort study was performed in 118 ...201728456140
collateral damage during antibiotic treatment of c. difficile infection in the aged host: insights into why recurrent disease happens.clostridium difficile infection (cdi) is one of the most common causes of healthcare-associated infections but an even bigger problem for the aging population. advanced age leads to higher incidence, higher mortality, and higher recurrences. in our study, recently published in the journal of infectious diseases, we investigated the effect of aging on cdi using a mouse model. we were able to demonstrate that aging leads to worse clinical outcomes, as well as lead to changes in microbiota composit ...201728453386
leapfrog hospital safety score, magnet designation, and healthcare-associated infections in united states hospitals.healthcare-associated infections (hais) pose a challenge to patient safety. although studies have explored individual level, few have focused on organizational factors such as a hospital's safety infrastructure (indicated by leapfrog hospital safety score) or workplace quality (magnet recognition). the aim of the study was to determine whether magnet and hospitals with better leapfrog hospital safety scores have fewer hais.201728452915
efficacy and factors associated with treatment response of intravenous immunoglobulin in inpatients with refractory inflammatory bowel diseases.the administration of intravenous immunoglobulin (ivig) has demonstrated promise in the treatment of medically refractory inflammatory bowel diseases (ibd). we aimed to identify factors associated with ivig failures in the treatment of refractory ibd.201728452863
outcomes of fecal microbiota transplantation for clostridium difficile infection in patients with inflammatory bowel disease.fecal microbiota transplantation (fmt) has recently been shown to be a promising therapy for recurrent and refractory clostridium difficile infections (cdi) despite lack of protocol standardization. patients with inflammatory bowel disease (ibd) present a particular challenge to cdi therapy as they are reported to have worse clinical outcomes, including higher colectomy rates and increased mortality. we aimed to assess the outcomes of fmt for recurrent cdi in patients with ibd at our healthcare ...201728451916
fecal microbiota transplantation for refractory and recurrent clostridium difficile infection: a case series of nine patients.fecal microbiota transplantation (fmt) is a highly effective therapy for refractory and recurrent clostridium difficile infection (cdi). despite its excellent efficacy and recent widespread use, fmt has not been widely used in south korea thus far. we describe our experience with fmt to treat refractory/recurrent cdi.201728449424
clostridium difficile in england: can we stop washing our hands? 201728447950
clostridium difficile in england: can we stop washing our hands? - authors' reply. 201728447949
clostridium difficile: a bad bug goes into defensive mode. 201728447375
the effect of a piperacillin/tazobactam shortage on antimicrobial prescribing and clostridium difficile risk in 88 u.s. medical centers.anti-infective shortages are a pervasive problem in the u.s. the objective of this study was to identify any associations between changes in antibiotic prescribing during a piperacillin/tazobactam (pip/tazo) shortage and hospital-onset clostridium difficile infection (ho-cdi) risk in 88 u.s medical centers.201728444166
"predictors of failure after single faecal microbiota transplantation in patients with recurrent clostridium difficile infection: results from a three-year cohort study"; methodological issues. 201728442436
[colonization rate of clostridium difficile in healthy children].objective: to learn the colonization of clostridium difficile in local healthy children and to investigate the colonization rate and toxin types of clostridium difficile at different ages. method: from september 2014 to january 2015 in a case observational study, healthy children's fecal specimens from the health care department of beijing children's hospital were collected. the children were divided into four groups according to age: <1 year old(n=53), 1-<3 years old(n=50), 3-<6 years old(n=50) ...201728441827
toxigenic clostridium difficile colonization among hospitalised adults; risk factors and impact on survival.to establish risk factors for clostridium difficile colonization among hospitalized patients in england.201728435086
ribotypes associated with clostridium difficile outbreaks in brazil display distinct surface protein profiles.clostridium difficile is a spore-forming anaerobic intestinal pathogen that causes clostridium difficile infection (cdi). c. difficile is the leading cause of toxin-mediated nosocomial antibiotic-associated diarrhea. the pathogenesis of cdi is attributed to two major virulence factors, tcda and tcdb toxins, that cause the symptomatic infection. c. difficile also expresses a number of key proteins, including cell wall proteins (cwps). s-layer proteins (slps) are cwps that form a paracrystalline s ...201728435010
clostridium difficile toxin glucosyltransferase domains in complex with a non-hydrolyzable udp-glucose analogue.clostridium difficile is the leading cause of hospital-acquired diarrhea and pseudomembranous colitis worldwide. the organism produces two homologous toxins, tcda and tcdb, which enter and disrupt host cell function by glucosylating and thereby inactivating key signalling molecules within the host. as a toxin-mediated disease, there has been a significant interest in identifying small molecule inhibitors of the toxins' glucosyltransferase activities. this study was initiated as part of an effort ...201728433497
results of the implementation of a multidisciplinary programme of faecal microbiota transplantation by colonoscopy for the treatment of recurrent clostridium difficile infection.recurrent clostridium difficile infection (cdi) is common and often difficult to manage. faecal microbiota transplant (fmt) is an effective therapeutic tool in these cases, although its applicability and effectiveness in spain is currently unknown.201728433406
how well does transfer of bacterial pathogens by culture swabs correlate with transfer by hands?in laboratory testing and in isolation rooms, pickup and transfer of health care-associated pathogens by premoistened rayon swabs correlated well with pickup and transfer by bare hands or moistened gloves. these results suggest that swab cultures provide a useful surrogate indicator of the risk for pathogen pickup and transfer by hands.201728431852
prospective cluster controlled crossover trial to compare the impact of an improved hydrogen peroxide disinfectant and a quaternary ammonium-based disinfectant on surface contamination and health care outcomes.quaternary ammonium-based (quat) disinfectants are widely used, but they have disadvantages.201728431849
reducing recurrence of c. difficile infection.clostridium difficile infection (cdi) is facilitated by alteration of the microbiome following antibiotic administration. antimicrobial therapy directed against the pathogen can treat cdi. unfortunately, ∼20% of successfully treated patients will suffer recurrence. bezlotoxumab, a human monoclonal antibody, binds to c. difficile toxin b (tcdb), reducing recurrence presumably by limiting epithelial damage and facilitating microbiome recovery.201728431238
ethical issues in fecal microbiota transplantation in practice.fecal microbiota transplantation (fmt) has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent clostridium difficile infection. despite a lack of high-quality trials to provide more information on the long-term effects of fmt, there has been great enthusiasm about the potential for expanding its applications. however, fmt presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. in t ...201728430065
a review of the novel application and potential adverse effects of proton pump inhibitors.proton pump inhibitors (ppis) are known as a class of pharmaceutical agents that target h(+)/k(+)-atpase, which is located in gastric parietal cells. ppis are widely used in the treatment of gastric acid-related diseases including peptic ulcer disease, erosive esophagitis and gastroesophageal reflux disease, and so on. these drugs present an excellent safety profile and have become one of the most commonly prescribed drugs in primary and specialty care. except for gastric acid-related diseases, ...201728429247
detection of gastrointestinal pathogens in oncology patients by highly multiplexed molecular panels.we compared the frequency of gastrointestinal (gi) pathogen detection in an oncology patient population by two multiplexed molecular assays, the luminex xtag® gastrointestinal pathogen panel (gpp, which identifies 14 gi pathogens) and the biofire gastrointestinal panel (bfgp, which identifies 22 gi pathogens). we additionally reviewed the clinical characteristics of patients tested with both panels. a total of 200 prospectively collected and 81 archived stool samples were tested by both panels. ...201728429164
loop ileostomy versus total colectomy as surgical treatment for clostridium difficile-associated disease: an eastern association for the surgery of trauma multicenter trial.the mortality of patients with clostridium difficile-associated disease (cdad) requiring surgery continues to be very high. loop ileostomy (li) was introduced as an alternative procedure to total colectomy (tc) for cdad by a single-center study. to date, no reproducible results have been published. the objective of this study was to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need.201728426557
quality of care and outcomes among hospitalized inflammatory bowel disease patients: a multicenter retrospective study.half of patients with inflammatory bowel disease (ibd) require hospitalization. we sought to characterize inpatient quality indicators of care and outcomes during ibd-related hospitalizations at 4 major ibd referral centers in canada.201728426451
bezlotoxumab and recurrent clostridium difficile infection. 201728425276
bezlotoxumab and recurrent clostridium difficile infection. 201728423300
bezlotoxumab and recurrent clostridium difficile infection. 201728423299
bezlotoxumab and recurrent clostridium difficile infection. 201728423298
changes in composition of the gut bacterial microbiome after fecal microbiota transplantation for recurrent clostridium difficile infection in a pediatric heart transplant patient.the microbiome is increasingly recognized as an important influence on human health and many of the comorbidities that affect patients after solid organ transplantation (sot) have been shown to involve changes in gut bacterial populations. thus, microbiome changes in an individual patient may have important health implications after sot but this area remains understudied. we describe changes in the composition of the fecal microbiome from a pediatric heart transplant recipient before and >2.5 ye ...201728421185
the influence of maternal vaginal flora on the intestinal colonization in newborns and 3-month-old infants.the role of maternal vaginal bacteria on the colonization of neonatal gut is still a matter of discussion. our aim was to estimate the role of maternal vaginal flora on the development of intestinal flora in neonates and 3-month-old infants.201728420276
editorial: clostridium difficile and inflammatory bowel disease - is it always a bad combination? 201728417498
antimicrobial effects of manuka honey on in vitro biofilm formation by clostridium difficile.clostridium difficile is the cause of the nosocomial c. difficile infection (cdi). the conventional antibiotics used in cdi therapy are often unsuccessful, and recurrent infections may occur. biofilm formation by c. difficile is associated with chronic or recurrent infections; biofilms may contribute to virulence and impaired antimicrobial efficacy. manuka honey, derived from the manuka tree (leptospermum scoparium), is known to exhibit antimicrobial properties that are associated with its signi ...201728417271
clostridium difficile bacteremia: report of two cases in french hospitals and comprehensive review of the literature.we report two cases of bacteremia due to clostridium difficile from two french hospitals. the first patient with previously diagnosed rectal carcinoma underwent courses of chemotherapy, and antimicrobial treatment, and survived the c. difficile bacteremia. the second patient with colon perforation and newly diagnosed lung cancer underwent antimicrobial treatment in an icu but died shortly after the episode of c. difficile bacteremia. a review of the literature allowed the identification of 137 c ...201728417069
clostridium difficile infection.preventing clostridium difficile, the most common cause of health care-associated infections in hospitals and infectious disease death in the united states, is a national priority. increased rates of infection among low-risk individuals in the community call for community-based prevention efforts to halt the increasing spread of this highly contagious opportunistic infection.201728414622
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