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clostridium difficile. monoclonal antibody treatment. 201020360229
do not sit on the bed. for these good reasons. 201020360232
actin re-organization induced by chlamydia trachomatis serovar d--evidence for a critical role of the effector protein ct166 targeting rac.the intracellular bacterium chlamydia trachomatis causes infections of urogenital tract, eyes or lungs. alignment reveals homology of ct166, a putative effector protein of urogenital c. trachomatis serovars, with the n-terminal glucosyltransferase domain of clostridial glucosylating toxins (cgts). cgts contain an essential dxd-motif and mono-glucosylate gtp-binding proteins of the rho/ras families, the master regulators of the actin cytoskeleton. ct166 is preformed in elementary bodies of c. tra ...201020360858
a review of mortality due to clostridium difficile infection.summary: in this review we examine published literature to ascertain mortality in relation to clostridium difficile infection (cdi) and the factors associated with mortality. in the 27 studies that had sufficient data, there were 10975 cases of cdi with great heterogeneity in the methods for reporting mortality. we calculated the overall associated mortality to be at least 5.99% within 3 months of diagnosis. the most important finding is that higher mortality is associated with advanced age, bei ...201020361997
human coronaviruses are uncommon in patients with gastrointestinal illness.coronaviruses infect numerous animal species causing a variety of illnesses including respiratory, neurologic and enteric disease. human coronaviruses (hcov) are mainly associated with respiratory tract disease but have been implicated in enteric disease.201020362494
evolutionary dynamics of clostridium difficile over short and long time scales.clostridium difficile has rapidly emerged as the leading cause of antibiotic-associated diarrheal disease, with the transcontinental spread of various pcr ribotypes, including 001, 017, 027 and 078. however, the genetic basis for the emergence of c. difficile as a human pathogen is unclear. whole genome sequencing was used to analyze genetic variation and virulence of a diverse collection of thirty c. difficile isolates, to determine both macro and microevolution of the species. horizontal gene ...201020368420
does stress ulcer prophylaxis explain the association between clostridium difficile-associated disease and mechanical ventilation? 201020371539
a 10% false-negative rate for clostridium difficile infections is too high. 201020372142
clostridium difficile enteritis 9 years after total proctocolectomy: a rare case report. 201020372147
evaluation of the c.diff quik chek complete assay, a new glutamate dehydrogenase and a/b toxin combination lateral flow assay for use in rapid, simple diagnosis of clostridium difficile disease.the diagnosis of clostridium difficile infection continues to be a challenge for many clinical microbiology laboratories. a new lateral flow assay, the c.diff quik chek complete assay, which tests for the presence of both glutamate dehydrogenase (gdh) and c. difficile toxins a and b, was evaluated for its ability to diagnose c. difficile disease. the results of this assay were compared to those of both pcr and toxigenic culture. the results showed that this assay allows 88% of specimens to be ac ...201020375230
what has made the difference? 201020381899
infection probability score, apache ii and karnofsky scoring systems as predictors of infection onset in haematology-oncology patients.to assess the predictive power of three systems: infection probability score, apache ii and karnofsky score to the onset of healthcare-associated infections in haematology-oncology patients.201020384664
validation of a commercial enzyme immunoassay for detection of clostridium difficile toxins in feces of horses with acute diarrhea.clostridium difficile infection (cdi) is a recognized cause of colitis in the horse. identification of its toxins is important for management of individual cases and for prevention of transmission and zoonosis. in humans, cdi diagnosis is performed with enzyme immunoassays, none of which have been validated for horses.201020384955
gtpases rhoa and rac1 are important for amelogenin and dspp expression during differentiation of ameloblasts and odontoblasts.morphogenesis and cytodifferentiation are distinct processes in tooth development. cell proliferation predominates in morphogenesis; differentiation involves changes in form and gene expression. the cytoskeleton is essential for both processes, being regulated by rho gtpases. the aim of this study was to verify the expression, distribution, and role of rho gtpases in ameloblasts and odontoblasts during tooth development in correlation with actin and tubulin arrangements and amelogenin and dentin ...201020387077
glucocorticoids are associated with increased risk of short-term mortality in hospitalized patients with clostridium difficile-associated disease.glucocorticoids are commonly used to treat various illnesses in patients at risk for clostridium difficile-associated disease (cdad), but the effect of such immunosuppression on outcome has not been studied. we hypothesized that glucocorticoid use increases the risk of 30-day mortality in patients with cdad.201020389295
clostridium difficile colitis: a retrospective study of incidence and severity before and after institution of an alcohol-based hand rub policy.clostridium difficile-associated diarrhea is a leading cause of hospital-acquired diarrhea. we sought to determine whether the institution of a hospital-wide alcohol-based hand rub (abhr) policy was associated with an increase in the incidence and/or severity of health care facility-onset, health care facility-associated c difficile diarrhea (cdad).201020392538
treatment with monoclonal antibodies against clostridium difficile toxins. 201020393181
treatment with monoclonal antibodies against clostridium difficile toxins. 201020397289
treatment with monoclonal antibodies against clostridium difficile toxins. 201020397290
clostridium difficile toxin-induced inflammation and intestinal injury are mediated by the inflammasome.clostridium difficile-associated disease (cdad) is the leading cause of nosocomial diarrhea in the united states. c difficile toxins tcda and tcdb breach the intestinal barrier and trigger mucosal inflammation and intestinal damage. the inflammasome is an intracellular danger sensor of the innate immune system. in the present study, we hypothesize that tcda and tcdb trigger inflammasome-dependent interleukin (il)-1beta production, which contributes to the pathogenesis of cdad.201020398664
pseudomembranes in a patient with flare-up of inflammatory bowel disease (ibd): is it only clostridium difficile or is it still an ibd exacerbation? 201020405379
multihospital outbreak of clostridium difficile infection, cleveland, ohio, usa.to determine whether a multihospital clostridium difficile outbreak was associated with epidemic strains and whether use of particular fluoroquinolones was associated with increased infection rates, we cultured feces from c. difficile-infected patients. use of fluoroquionolones with enhanced antianaerobic activity was not associated with increased infection rates.201020409374
surgical aspects of fulminant clostridium difficile colitis.clostridium difficile-associated disease (cdad) is responsible for the majority of nosocomial diarrhea, and fulminant c difficile colitis can have mortality upwards of 80%. early identification and treatment of fulminant c difficile colitis is critical to patient care, but timing of surgical intervention remains difficult. this review summarizes the epidemiology, predictors of development, and management of fulminant c difficile colitis.201020409527
clostridium difficile toxinotype xi (a-b-) exhibits unique arrangement of paloc and its upstream region.clostridium difficile toxinotype xi strains do not produce toxins a (tcda) or b (tcdb) but do possess a nonfunctional remnant of the pathogenicity locus (paloc), bearing part of the sequence for tcda. this is the first report of a type with absent upstream terminal paloc sequences and major genetic rearrangements of the paloc region.201020412866
a real-time quantitative pcr assay for evaluating clostridium difficile adherence to differentiated intestinal caco-2 cells.herein we describe a real-time quantitative pcr assay for evaluating the adherence of clostridium difficile to differentiated human intestinal caco-2 cells. our investigations demonstrated that the method, employing the c. difficile-specific triose-phosphate isomerase gene, is as reliable but less time-consuming than counting c.f.u. we conclude that the method will be useful for evaluating the role of host cell adherence in the pathogenesis of c. difficile infection.201020413620
preventing transmission of clostridium difficile: is the answer blowing in the wind? 201020415566
the potential for airborne dispersal of clostridium difficile from symptomatic patients.background. the high transmissibility and widespread environmental contamination by clostridium difficile suggests the possibility of airborne dissemination of spores. we measured airborne and environmental c. difficile adjacent to patients with symptomatic c. difficile infection (cdi). methods. we conducted air sampling adjacent to 63 patients with cdi for 180 h in total and for 101 h in control settings. environmental samples were obtained from surfaces adjacent to the patient and from communa ...201020415567
[rapid-tests detection evaluation of clostridium difficile toxins and microbiological investigation].we evaluated two rapid toxin tests for c. difficile combined with stool specimen cultures used from january 2006 to march 2009. stool specimens numbered 877, 102 among which were from the cases of diagnosed clinical c. difficile-associated diarrhea (cdad). rapid toxin a 'uniquick' detection kits were used until october 2007 and toxin a&b 'tox a/b' detection kits thereafter. clinical cdad was considered the detection gold standard. uniquick sensitivity, specificity, and positive and negative pred ...201020420157
colectomy for fulminant clostridium difficile colitis: predictors of mortality.the purpose of this study was to define clinical and radiographic variables associated with postoperative mortality after urgent colectomy for fulminant clostridium difficile colitis. data were obtained regarding patients undergoing colectomy for fulminant c. difficile colitis at two institutions (1997-2005). univariate analysis of factors predicting 30-day mortality was performed using chi2 and student's t tests. multivariable logistic regression was done to include all variables whose p value ...201020420254
increased urinary excretion of a 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (hphpa), an abnormal phenylalanine metabolite of clostridia spp. in the gastrointestinal tract, in urine samples from patients with autism and schizophrenia.a compound identified as 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (hphpa) was found in higher concentrations in urine samples of children with autism compared to age and sex appropriate controls and in an adult with recurrent diarrhea due to clostridium difficile infections. the highest value measured in urine samples was 7500 mmol/mol creatinine, a value 300 times the median normal adult value, in a patient with acute schizophrenia during an acute psychotic episode. the psychosis remitted af ...201020423563
toxic megacolon secondary to clostridium difficile colitis. case report.the incidence and severity of clostridium difficile colitis has markedly increased in recent years. the spectrum of clostridium difficile infection ranges from asymptomatic colonization to fulminant colitis requiring immediate surgery. medical therapy failure and the presence of toxic megacolon dictate urgent surgical treatment with unfortunate high mortality rates (35% to 57%). we broach herein a case of toxic megacolon secondary to colitis due to clostridium difficile infection in which early ...201020423791
clinical spectrum & pathogenesis of clostridium difficile associated diseases.clostridium difficile is the major aetiological agent of antibiotic associated diarrhoea and colitis. the majority of hospitalized patients infected by c. difficile are asymptomatic carriers who serve as silent reservoirs for continued c. difficile contamination of the hospital environment. c. difficile associated disease (cdad) is a serious condition with mortality up to 25 per cent in frail elderly people. c. difficile infection may present itself in several forms with both colonic and extraco ...201020424299
clostridium difficile infection in the intensive care unit.clostridium difficile infection (cdi) is an increasing nosocomial problem in north america and western europe, where outbreaks caused by a more virulent, toxin-hyperproducing strain have been recently reported. clostridium difficile infection is now characterized by a higher incidence, more frequent relapses, and a higher case-fatality ratio. as a consequence, fulminant cases requiring admission to the intensive care unit (icu) are much more common than previously. in recent years, metronidazole ...201020034951
piglet models of acute or chronic clostridium difficile illness.we examined the piglet model of clostridium difficile illness (cdi) in humans, because swine are naturally susceptible to c. difficile. the piglet is a reproducible model of acute or chronic cdi with characteristic pseudomembranous colitis. germ-free piglets were consistently and extensively colonized after oral challenge with the human strain 027/bi/nap1, establishing an infectious dose-age relationship. this allowed a demarcation between acute fatal and chronic models. the clinical manifestati ...201020039803
the effects of substituted cyclodextrins on the colloidal and conformational stability of selected proteins.the effects of various types of substituted and nonsubstituted cyclodextrins (cds) on the physical and colloidal stability of three different proteins were studied to further ascertain the mechanism by which cyclodextrins stabilize proteins. the three proteins examined in this study are the clostridium difficile toxoid a, yersinia pestis low-calcium-response v or v antigen (lcrv), and fibroblast growth factor 10 (fgf-10). these three pharmaceutically relevant proteins differ in molecular weight, ...201020049940
editorial: clostridium difficile infection: yet another predictor of poor outcome in cirrhosis.the development of clostridium difficile infection in cirrhosis is predictive of death, independent of severity of liver disease. the main risk factors are the use of antibiotics and proton-pump inhibitors (ppis). this is further evidence that supports the wise and cautious use of antibiotics in cirrhosis and suggests avoiding the use of ppis in these patients except for indications of proven benefit.201020054307
prevalence of diverticulosis in recurrent clostridium difficile infection.to re-evaluate the theory that colonic diverticulosis is associated with relapse of clostridium difficile associated disease (cdad) in light of data suggesting increasing rates of cdad infection and relapse.201020082480
treatment with monoclonal antibodies against clostridium difficile toxins.new therapies are needed to manage the increasing incidence, severity, and high rate of recurrence of clostridium difficile infection.201020089970
clostridium difficile--beyond antibiotics. 201020089977
metabolism of bile salts in mice influences spore germination in clostridium difficile.clostridium difficile, a spore-forming bacterium, causes antibiotic-associated diarrhea. in order to produce toxins and cause disease, c. difficile spores must germinate and grow out as vegetative cells in the host. although a few compounds capable of germinating c. difficile spores in vitro have been identified, the in vivo signal(s) to which the spores respond were not previously known. examination of intestinal and cecal extracts from untreated and antibiotic-treated mice revealed that extrac ...201020090901
disease transmission model for community-associated clostridium difficile infection.participating researchers and public health personnel at a canadian workshop in 2007, noted considerable gaps in current understanding of community-associated clostridium difficile infection (ca-cdi), specifically infection sources and risk factors. a disease transmission model for ca-cdi was requested as an initial step towards a risk assessment, to analyse infection sources and risk factors, addressing priority research areas. the developed model contains eight infection states (susceptible, g ...201020092667
is high consumption of antibiotics associated with clostridium difficile polymerase chain reaction-ribotype 027 infections in france?we compared antibiotic consumption between hospitals affected by a strain of clostridium difficile designated as polymerase chain reaction-ribotype 027 (cd-027) and those unaffected during an outbreak in northern france. the mean consumption of several beta-lactams, amikacin, and fluoroquinolones was high in affected hospitals (p < .05). however, only levofloxacin and imipenem remained associated with emerging cd-027 in the multivariate analysis, suggesting that those antibiotics should be bette ...201020100084
multicenter study of surveillance for hospital-onset clostridium difficile infection by the use of icd-9-cm diagnosis codes.to compare incidence of hospital-onset clostridium difficile infection (cdi) measured by the use of international classification of diseases, ninth revision, clinical modification (icd-9-cm) discharge diagnosis codes with rates measured by the use of electronically available c. difficile toxin assay results.201020100085
identification of risk factors for the development of clostridium difficile-associated diarrhea following treatment of polymicrobial surgical infections.to identify risk factors for clostridium difficile-associated diarrhea (cdad) in surgical patients following treatment of polymicrobial infections.201020101175
detection and characterization of clostridium difficile in retail chicken.this study was designed to evaluate the prevalence of clostridium difficile contamination of retail chicken.201020102510
incidence of clostridium difficile infection in patients with acute leukemia and lymphoma after allogeneic hematopoietic stem cell transplantation. 201020109075
adverse drug events among hospitalized medicare patients: epidemiology and national estimates from a new approach to surveillance.although adverse drug events (ades) are a well-recognized problem among hospitalized patients, there is no system for monitoring them. six high-alert medications and associated adverse events were selected for inclusion in the medicare patient safety monitoring system (mpsms), a national surveillance system designed to identify and track over time inpatient adverse events within the hospitalized fee-for-service medicare population.201020112660
real-time multiplex polymerase chain reaction assay for rapid detection of clostridium difficile toxin-encoding strains.clostridium difficile is considered an important emerging pathogen capable of causing disease in humans and animal species. in our study, we developed and evaluated a multiplex real-time polymerase chain reaction (pcr) assay for the detection of c. difficile genes encoding toxin a (tcda), toxin b (tcdb), and binary toxin (cdta and cdtb). the standardized real-time pcr assay for toxin genes of c. difficile was used to screen for toxigenic c. difficile in fecal samples from 71 preweaned calves, 53 ...201020113206
risk factors for and estimated incidence of community-associated clostridium difficile infection, north carolina, usa.we determined estimated incidence of and risk factors for community-associated clostridium difficile infection (ca-cdi) among patients treated at 6 north carolina hospitals. ca-cdi case-patients were defined as adults (>18 years of age) with a positive stool test result for c. difficile toxin and no hospitalization within the prior 8 weeks. ca-cdi incidence was 21 and 46 per 100,000 person-years in veterans affairs (va) outpatients and durham county populations, respectively. va case-patients we ...201020113547
postoperative clostridium difficile-associated diarrhea.abdominal surgery is thought to be a risk factor for clostridium difficile-associated diarrhea (cdad). the aims of this study were to discern pre-operative factors associated with postoperative cdad, examine outcomes after postoperative cdad, and compare outcomes of postoperative versus medical cdad.201020116817
success of self-administered home fecal transplantation for chronic clostridium difficile infection.clostridium difficile infection (cdi) can relapse in patients with significant comorbidities. a subset of these patients becomes dependent on oral vancomycin therapy for prolonged periods with only temporary clinical improvement. these patients incur significant morbidity from recurrent diarrhea and financial costs from chronic antibiotic therapy.201020117243
reevaluation of the premier clostridium difficile toxin a and b immunoassay with comparison to glutamate dehydrogenase common antigen testing evaluating bartels cytotoxin and prodesse progastro cd polymerase chain reaction as confirmatory procedures.enzyme immunoassays are currently the most common tests used in the clinical laboratory for the detection of clostridium difficile toxins; however, significant problems with their performance have recently been described. we prospectively reevaluated the meridian premier c. difficile toxin a/b assay with direct comparison to a 2-step algorithm that screened for c. difficile common antigen and compared cytotoxin and real-time polymerase chain reaction (pcr) as confirmatory procedures. the premier ...201020117349
significant impact of terminal room cleaning with bleach on reducing nosocomial clostridium difficile.we were alerted to increased rates of clostridium difficile-positive tests at all 3 hospitals in our health care system by medmined data mining surveillance service, carefusion (san diego, ca). in response, an intervention of terminal room cleaning with dilute bleach was instituted to decrease the amount of c difficile environmental spore contamination from patients with c difficile infection (cdi).201020123150
typing of clostridium difficile isolates endemic in japan by sequencing of slpa and its application to direct typing.a typing system for clostridium difficile using sequencing of the surface-layer protein a encoding gene (slpa) was evaluated and used to analyse clinical isolates in japan. a total of 160 stool specimens from symptomatic patients in japan was examined and 87 c. difficile isolates were recovered. slpa sequence typing was found to have reliable typability and discriminatory power in comparison with pcr ribotyping, and the typing results were highly reproducible and comparable. slpa sequence typing ...201020133413
diagnosing of clostridium difficile colitis. 201020134370
trichomonas vaginalis vast bspa-like gene family: evidence for functional diversity from structural organisation and transcriptomics.trichomonas vaginalis is the most common non-viral human sexually transmitted pathogen and importantly, contributes to facilitating the spread of hiv. yet very little is known about its surface and secreted proteins mediating interactions with, and permitting the invasion and colonisation of, the host mucosa. initial annotations of t. vaginalis genome identified a plethora of candidate extracellular proteins.201020144183
association of ciprofloxacin prescriptions to outpatients to clostridium difficile infections.to study if antibiotic treatment of outpatients had triggered clostridium difficile infections (cdi), prescription numbers were compared with cdi-affected patient numbers. a strong correlation was observed for ciprofloxacin (r=0.917), suggesting that increased use of ciprofloxacin by outpatients contributed to increased numbers of cdi. these findings deserve further investigation as they may have an impact on future decisions regarding antibiotic prescribing.201020144444
evaluation of the risk of transmission of bacterial biofilms and clostridium difficile during gastrointestinal endoscopy.recent attention has focused on the potential for the transmission of bacterial biofilms, clostridium difficile, and other types of pathogenic spore-forming bacteria during gastrointestinal (gi) endoscopy. this study investigates whether gi endoscopy is a risk factor for the transmission of bacterial biofilms and the endospores or vegetative cells of pathogenic spore-forming bacteria including c. difficile. the medical literature was reviewed to evaluate the risk of the transmission of these inf ...201020145448
dose-response efficacy of a proprietary probiotic formula of lactobacillus acidophilus cl1285 and lactobacillus casei lbc80r for antibiotic-associated diarrhea and clostridium difficile-associated diarrhea prophylaxis in adult patients.standard therapies for antibiotic-associated diarrhea (aad) and clostridium difficile-associated diarrhea (cdad) have limited efficacy. probiotic prophylaxis is a promising alternative for reduction of aad and cdad incidence.201020145608
a complex of 2-hydroxyisocaproyl-coenzyme a dehydratase and its activator from clostridium difficile stabilized by aluminium tetrafluoride-adenosine diphosphate.the dehydration of 2-hydroxyisocaproyl-coa to isocaprenoyl-coa is the chemically most demanding step in the reduction of leucine to isocaproate by clostridium difficile, because the beta-hydrogen of the substrate is not acidic (pk(a) ca. 40). a two-component system, composed of a homodimeric activator and an heterodimeric dehydratase, catalyses this unusual alpha,beta-elimination of water. the reduced activator transfers an electron from its [4fe-4s](+) cluster to that of the dehydratase in an a ...201020146278
increasing incidence of community-associated atypical clostridium difficile disease in children.forty-one children with a variety of gastrointestinal complaints were diagnosed with clostridium difficile infections as part of a routine screen over 3 years. the infection had not been suspected prior to the screen. each child responded to treatment with metronidazole with resolution of their symptoms. these data suggest that community-associated c difficile is increasing and may produce atypical disease and lead to misdiagnosis.201020150212
the antimicrobial compound reuterin (3-hydroxypropionaldehyde) induces oxidative stress via interaction with thiol groups.reuterin is an antimicrobial compound produced by lactobacillus reuteri, and has been proposed to mediate, in part, the probiotic health benefits ascribed to this micro-organism. despite 20 years of investigation, the mechanism of action by which reuterin exerts its antimicrobial effects has remained elusive. here we provide evidence that reuterin induces oxidative stress in cells, most likely by modifying thiol groups in proteins and small molecules. escherichia coli cells subjected to subletha ...201020150236
neutralization of clostridium difficile toxin a using antibody combinations.the pathogenicity of clostridium difficile (c. difficile) is mediated by the release of two toxins, a and b. both toxins contain large clusters of repeats known as cell wall binding (cwb) domains responsible for binding epithelial cell surfaces. several murine monoclonal antibodies were generated against the cwb domain of toxin a and screened for their ability to neutralize the toxin individually and in combination. three antibodies capable of neutralizing toxin a all recognized multiple sites o ...201020150758
continuing diarrhoea after ten days of oral metronidazole or oral vancomycin for presumed, hospital-acquired clostridium difficile colitis in elderly hospital patients. 201020153080
economic healthcare costs of clostridium difficile infection: a systematic review.clostridium difficile infection (cdi) is the leading cause of infectious diarrhoea in hospitalised patients. cdi increases patient healthcare costs due to extended hospitalisation, re-hospitalisation, laboratory tests and medications. however, the economic costs of cdi on healthcare systems remain uncertain. the purpose of this study was to perform a systematic review to summarise available studies aimed at defining the economic healthcare costs of cdi. we conducted a literature search for peer- ...201020153547
four country healthcare-associated infection prevalence survey: pneumonia and lower respiratory tract infections.in 2006, the hospital infection society was funded by the respective health services in england, wales, northern ireland and the republic of ireland to conduct a prevalence survey of healthcare-associated infection (hcai). here, we report the prevalence of pneumonia and lower respiratory tract infection other than pneumonia (lrtiop) in these four countries. the prevalence of all hcais was 7.59% (5743 out of 75 694). nine hundred (15.7%) of these infections were pneumonia, and 402 (7.0%) were lrt ...201020153552
substrate specificity of ribose-5-phosphate isomerases from clostridium difficile and thermotoga maritima.the activity of ribose-5-phosphate isomerases (rpib) from clostridium difficile for d-ribose isomerization was optimal at ph 7.5 and 40 degrees c, while that from thermotoga maritima for l-talose isomerization was optimal at ph 8.0 and 70 degrees c. c. difficile rpib exhibited activity only with aldose substrates possessing hydroxyl groups oriented in the right-handed configuration (fischer projections) at the c2 and c3 positions, such as d-ribose, d-allose, l-talose, l-lyxose, d-gulose, and l-m ...201020155483
3 bad bugs. 201020164710
should probiotics be routine therapy for the prevention of antibiotic-associated diarrhea? 201020099380
reactive arthritis due to clostridium difficile. 201020171133
a time-series analysis of clostridium difficile and its seasonal association with influenza.to characterize the temporal progression of the monthly incidence of clostridium difficile infections (cdis) and to determine whether the incidence of cdi is related to the incidence of seasonal influenza.201020175682
how to avoid treating irritable bowel syndrome with biologic therapy for inflammatory bowel disease.some patients with an established diagnosis of crohn's disease and symptoms compatible with a disease flare do not have evidence of active crohn's disease by laboratory, endoscopic or radiographic criteria. in clinical trials, approximately 18% of patients with crohn's disease and moderate to severe clinical symptoms have no evidence of ulceration at colonoscopy. there are multiple other causes of symptoms in patients with crohn's disease, including the presence of disease complications (strictu ...201020203501
prevalence and diversity of toxigenic clostridium perfringens and clostridium difficile among swine herds in the midwest.clostridium perfringens and clostridium difficile are associated with scours in the neonatal piglet and are an economic concern in swine production. the objective of this study was to characterize the prevalence and diversity of c. perfringens and c. difficile isolates obtained from scouring neonatal piglets in a large integrated production system, as well as in smaller independently owned regional farms. rectal swabs were collected from 333 pigs at 11 sites in an integrated swine production sys ...201020208029
probiotics.the pharmacology, uses, dosages, safety, drug interactions, and contraindications of probiotics are reviewed.201020208051
safety considerations of fluoroquinolones in the elderly: an update.the fluoroquinolones ciprofloxacin, levofloxacin, moxifloxacin and gemifloxacin are widely used for the treatment of various types of bacterial infections. overall, these antibacterial agents can be considered safe and well tolerated drugs. comparative studies have evaluated the use of quinolones in elderly and younger populations. although age per se does not seem to decrease their tolerability, specific adverse effects of the quinolones must be considered when they are chosen for antibacterial ...201020210367
pleiotropic role of rac in mast cell activation revealed by a cell permeable bordetella dermonecrotic fusion toxin.to activate the gtpase rac in rat basophilic leukemia (rbl) cells and mouse bone marrow-derived mast cells (bmmc) a tat fusion toxin of bordetella dermonecrotic toxin (dnt-tat) was constructed. the fusion toxin activated rac1 and rhoa in vitro but only rac in rbl cells and bmmc. dnt-tat caused an increase in inositol phosphate formation, calcium mobilization, erk activation and degranulation of mast cells. all these effects were inhibited by the rho gtpase-inactivating clostridium difficile toxi ...201020211724
appropriateness of urinary tract infection diagnosis and treatment duration. 201020212189
daily skin cleansing with chlorhexidine did not reduce the rate of central-line associated bloodstream infection in a surgical intensive care unit.cleansing the skin of intensive care unit (icu) patients daily with chlorhexidine gluconate (chg) has been associated with beneficial effects, including a reduction in central-line-associated bacteremias (clabsis). most studies have been done in medical icus. in this study, we evaluated the effectiveness of daily chlorhexidine skin cleansing on clabsi rates in a surgical icu.201020213074
probiotics as therapy in gastroenterology: a study of physician opinions and recommendations.the objective of this study was to determine how gastroenterologists perceive and use probiotic-based therapies in practice.201020216432
a novel risk score to stratify severity of crohn's disease hospitalizations.crohn's disease (cd) is a lifelong relapsing-remitting disease often requiring health-care contact, hospitalization, or surgery. general comorbidity indices were developed to predict mortality, which is rare in this population. there are limited tools to stratify these hospitalizations by severity.201020216534
potential benefits of probiotics--main findings of an in-depth review.media reports on probiotics have been conflicting which has led to increased confusion among the general population and also among health professionals. to disentangle myths and reality, the british nutrition foundation has carried out a review on probiotics and health. there is good evidence that probiotics are effective in preventing antibiotic-associated diarrhoea and, although only few studies have been carried out so far, probiotic microorganisms also seem to have the potential to prevent t ...201020220625
cinderella service to health service priority: infection control in the uk.reducing the morbidity, mortality and economic burden of healthcare-associated infection has become an nhs priority. however, this has not always been the case. the problems associated with hospital infection have been well known for some considerable time but historically the topic has been afforded scant resources, and relegated to 'cinderella' status. this began to change when seminal epidemiological studies of the 1970s and 1980s identified the scale of the problem, and accelerated when adju ...201020220651
changes in laboratory and clinical workload for clostridium difficile infection from 2003 to 2007 in hospitals in edinburgh.clostridium difficile infection (cdi) is a growing concern with regard to increases in incidence and its associated financial burden. a retrospective analysis of patients admitted to hospitals in edinburgh from 2003 to 2007 and tested for c. difficile toxins was performed. a total of 45 412 faecal samples were tested and 6286 (13.8%) were positive. overall cdi was identified in 1.7 cases/1000 in-patient occupied bed days (obd). the incidence of cdi fell from 1.98 cases/1000 obd in 2006 to 1.48 c ...201020222891
the enteropathogenic escherichia coli effector nleh inhibits apoptosis induced by clostridium difficile toxin b.clostridium difficile is a leading cause of nosocomial infections, causing a spectrum of diseases ranging from diarrhoea to pseudomembranous colitis triggered by a range of virulence factors including c. difficile toxins a (tcda) and b (tcdb). tcda and tcdb are monoglucosyltransferases that irreversibly glycosylate small rho gtpases, inhibiting their ability to interact with their effectors, guanine nucleotide exchange factors, and membrane partners, leading to disruption of downstream signallin ...201020223805
clinical predictors and risk factors for relapsing clostridium difficile infection.clostridium difficile infection (cdi) is a common cause of morbidity among hospitalized patients. multiple factors have been associated with primary cdi, but risk factors for cdi relapses are less well described.201020224312
optimum timing of blood tests for monitoring patients with clostridium difficile-associated diarrhea.this study aimed to identify optimum timing of blood tests and suitable cutoff values when managing patients with clostridium difficile-associated diarrhea (cdad), in relation to early mortality.201020224434
[prevalence of clostridium difficile in swine thought to have clostridium difficile infections (cdi) in eleven swine operations in the netherlands]. 201020225480
molecular characterization of moxifloxacin resistance from canadian clostridium difficile clinical isolates.fluoroquinolone resistance in clostridium difficile has been implicated in recent outbreaks of c. difficile infection. the purpose of this report was to characterize the molecular mechanism conferring resistance to moxifloxacin among c. difficile clinical isolates. eighty-four c. difficile clinical isolates (collected as part of the canadian nosocomial infection surveillance program) were evaluated in the current study. pulsed-field gel electrophoresis was used to type the isolates. susceptibili ...201020226332
reducing clostridium difficile through early identification of clusters and the use of a standardised set of interventions.in recent years the rates of clostridium difficile infection (cdi) have increased worldwide with several large outbreaks occurring within the uk. new guidance from the uk department of health describes measures to investigate periods of increased incidence (pii) of cdi which include informing staff, ribotyping isolates, enhanced cleaning, audits and monitoring of antibiotic prescribing. this study aimed to determine whether a standardised set of measures could be used to control the incidence of ...201020227140
glutamate dehydrogenase as confirmatory test for clostridium difficile toxin a/b-positive stools. 201020227790
prevention and medical management of clostridium difficile infection. 201020228142
co-culture with potentially probiotic microorganisms antagonises virulence factors of clostridium difficile in vitro.toxigenic strains of clostridium difficile were co-cultured with different strains of bifidobacteria and lactobacilli. spent culture supernatants were tested for biological activity on cultured vero cells. co-culture of c. difficile with some potentially probiotic strains lead to a reduction of the biological activity of spent culture supernatants. the observed effects cannot be ascribed either to secreted factors from the probiotic strains or to toxin adsorption by bacterial cells. immunologica ...201020232250
multiple peracute deaths in a colony of syrian hamsters (mesocricetus auratus). 201020305630
clinical practice guidelines for clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of america (shea) and the infectious diseases society of america (idsa).since publication of the society for healthcare epidemiology of america position paper on clostridium difficile infection in 1995, significant changes have occurred in the epidemiology and treatment of this infection. c. difficile remains the most important cause of healthcare-associated diarrhea and is increasingly important as a community pathogen. a more virulent strain of c. difficile has been identified and has been responsible for more-severe cases of disease worldwide. data reporting the ...201020307191
effects of inoculum, ph, and cations on the in vitro activity of fidaxomicin (opt-80, par-101) against clostridium difficile.the effects of the inoculum, ph, cation concentrations, and different lots of commercial media on the in vitro susceptibility of clostridium difficile to fidaxomicin were examined. of the factors evaluated, only ph alterations influenced the activity of fidaxomicin against c. difficile, noticeably reducing its activity at higher ph (> or =7.9).201020308366
prevalence of diarrhea and enteropathogens in racing sled dogs.diarrhea is highly prevalent in racing sled dogs, although the underlying causes are poorly understood. hypothesis: clostridium perfringens enterotoxin (cpe) and clostridium difficile toxin a and b are associated with diarrhea in racing sled dogs.201019925573
characterization of the pccdc42 small g protein from pneumocystis carinii, which interacts with the pcste20 life cycle regulatory kinase.pneumocystis carinii (pc) causes severe pneumonia in immunocompromised hosts. the binding of pc trophic forms to alveolar epithelial cells is a central feature of infection, inducing the expression and activation of pcste20, a gene participating in mating, proliferation, and pseudohyphal growth. in related fungi, ste20 proteins are generally activated by immediate upstream small g proteins of the cdc42-like family. pccdc42 has not been previously described in pneumocystis. to address the potenti ...201019915161
development of a dna microarray to detect antimicrobial resistance genes identified in the national center for biotechnology information database.to understand the mechanisms and epidemiology of antimicrobial resistance (ar), the genetic elements responsible must be identified. due to the myriad of possible genes, a high-density genotyping technique is needed for initial screening. to achieve this, ar genes in the national center for biotechnology information genbank database were identified by their annotations and compiled into a nonredundant list of 775 genes. a dna microarray was constructed of 70mer oligonucelotide probes designed to ...201019916789
anti-clostridium difficile potential of tetramic acid derivatives from pseudomonas aeruginosa quorum-sensing autoinducers.we have examined the potential bactericidal activities of several tetramic acids derived from pseudomonas autoinducers against clostridium difficile, a cause of antibiotic-associated pseudomembranous colitis. clinical isolates of c. difficile (n=4) were incubated in broth with a chemically synthesized pseudomonas autoinducer and its tetramic acid derivatives. the structure-activity relationship and the mechanisms of action were examined by a time-killing assay and by determination of the morphol ...201019917748
evaluation of tcdb real-time pcr in a three-step diagnostic algorithm for detection of toxigenic clostridium difficile.clostridium difficile is the most common infectious cause of diarrhea in hospitalized patients. the optimal approach for the detection of toxigenic c. difficile remains controversial because no single test is sensitive, specific, and affordable. we have developed a real-time pcr method (direct stool pcr [dpcr]) to detect the tcdb gene encoding toxin b directly from stool specimens and have combined it with enzyme immunoassays (eias) in a three-step protocol. dpcr was performed on 699 specimens t ...201019923482
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