Publications

long-term follow-up of patients with fulminant clostridium difficile colitis.	the purpose of this study was to determine the long-term survival rate, rate of gastrointestinal continuity restoration, and rate of recurrence following an attack of fulminant clostridium difficile colitis.	2009	19224298
management of severe clostridium difficile-associated diarrhea.		2009	19225882
necessary but not sufficient: a comparison of surveillance definitions of clostridium difficile-associated diarrhea.	in this article, we describe our comparison of the cleveland clinic surveillance definition of clostridium difficile-associated diarrhea and the definition mandated by the ohio department of health. we found the definitions to be concordant only 71% of the time; the ohio department of health definition identified 278 of the 391 cases identified by the cleveland clinic definition. surveillance definitions mandated by the ohio department of health overrepresented the number of cases attributable t ...	2009	19228111
impact of clostridium difficile infection on pediatric inflammatory bowel disease.	to determine the prevalence of and explore possible differences in the risk for and symptoms of clostridium difficile infection between patients with and without inflammatory bowel disease (ibd).	2009	19230908
laboratory maintenance of clostridium difficile.	clostridium difficile is a gram-positive, spore-forming, anaerobe and is the leading cause of antibiotic-associated diarrhea, pseudomembranous colitis, and toxic megacolon. essential to the lifestyle of c. difficile is the ability to form a metabolically dormant spore, germinate, and grow out upon appropriate signals and elicit disease with the secretion of two toxins. to aid in the study of this organism, this unit describes the growth and maintenance of c. difficile. included are methods to is ...	2009	19235151
two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant staphylococcus aureus infection and clostridium difficile infection.	to determine the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant staphylococcus aureus (mrsa) infection and clostridium difficile infection (cdi).	2009	19236282
hospital-associated clostridium difficile infection: is it necessary to track community-onset disease?	to compare clostridium difficile infection (cdi) rates determined with use of a traditional definition (ie, with healthcare-onset cdi defined as diagnosis of cdi more than 48 hours after hospital admission) with rates determined with use of expanded definitions, including both healthcare-onset cdi and community-onset cdi, diagnosed within 48 hours after hospital admission in patients who were hospitalized in the previous 30 or 60 days, and to determine whether differences exist between patients ...	2009	19239377
management of clostridium difficile infection: survey of practices and compliance with national guidelines among primary care physicians.		2009	19239379
clinical risk factors for severe clostridium difficile-associated disease.	identifying patients who are at high risk for severe clostridium difficile-associated disease (cdad) early in the course of their infection may help clinicians improve outcomes. therefore, we compared clinical features associated with severe versus nonsevere cdad by retrospectively reviewing records of hospitalized patients whose fecal assays were positive for c. difficile toxin. of 336 patients, 12.2% had severe disease and 10.1% died from all causes. regression modeling showed the following to ...	2009	19239754
in vitro effect of metronidazole and vancomycin in combination on clostridium difficile.		2009	19240074
comparative in vitro activity of rep3123 against clostridium difficile and other anaerobic intestinal bacteria.	the aim of this study was to determine the anaerobic spectrum of activity of rep3123, a novel diaryldiamine that inhibits bacterial methionyl-trna synthetases in gram-positive bacteria.	2009	19240076
[collateral damage of cephalosporins and quinolones and possibilities for control].	background: the occurrence of multidrug-resistant microorganisms is associated with an extended and long-term use of broad-spectrum antibiotics. indeed, this may lead to a colonization and even to an infection of the patient, which is called collateral damage. moreover, the risk for collateral damage can be assessed for different antibiotic classes. occurrence of multidrug-resistant microorganisms: the use of cephalosporins may induce a subsequent infection with vancomycin-resistant enterococci, ...	2009	19242662
analysis of an outbreak of clostridium difficile infection controlled with enhanced infection control measures.	in october 2004, our clostridium difficile infection (cdi) rate increased (relative risk, 3.51; 95% confidence interval: 2.96-4.16) from a baseline rate of 1.35 per 1000 patient-days. we describe the outbreak, the relationship between antibiotic use and cdi, and the effect of enhanced infection control measures (eicm) on cdi.	2009	19243859
is there a future for probiotics in preventing clostridium difficile-associated disease and treatment of recurrent episodes?	due to morbidity, mortality, and high costs associated with eradicating clostridium difficile once this organism causes colitis, this bacterium has been termed one of the most ecologically relevant microorganisms of the present day. symptoms associated with c. difficile diarrhea often first present during or shortly after a course of antibiotic therapy. during the past 5 years, the virulence of this organism has increased. c. difficile-associated disease (cdad) has reached epidemic proportions i ...	2009	19244145
the use of probiotics in the prevention and treatment of antibiotic-associated diarrhea with special interest in clostridium difficile-associated diarrhea.	antimicrobials are effective agents used to combat virulent bacterial, yeast, and fungal infections that may otherwise cause rampant disease leading to skyrocketing social/economic costs and possible epidemic morbidity and mortality rates. antibiotics are designed to attack specific bacterial pathogens but, in the process, indiscreetly reduce the number of beneficial human microbiota that is part of the gut-associated lymphatic tissue. broad-spectrum antibiotics can upset this uniquely balanced ...	2009	19244146
rapid detection of toxigenic strains of clostridium difficile in diarrheal stools by real-time pcr.		2009	19244461
a nosocomial outbreak of norovirus infection masquerading as clostridium difficile infection.	noroviruses (novs) are increasingly being recognized as important enteric pathogens. at a university-based hospital, we investigated a nosocomial outbreak of nov infection that was originally attributed to clostridium difficile. we describe here the unique challenges of the identification of novs as the true etiologic pathogen in an outbreak occurring in a health care setting, where c. difficile infection is endemic, as well as the important lessons learned.	2009	19245344
early colectomy may be associated with improved survival in fulminant clostridium difficile colitis: an 8-year experience.	we hypothesized that colectomy for fulminant clostridium difficile colitis (cdc) before organ failure would be associated with decreased mortality.	2009	19245905
diagnosis of clostridium difficile infection by toxin detection kits.		2009	19246016
activity of a novel carbapenem, doripenem, against anaerobic pathogens.	doripenem, a synthetic 1-beta-methyl carbapenem, has a broad-spectrum of activity against almost all species of anaerobic bacteria, including all bacteroides fragilis group species, most with mic(90) results at <or=1 microg/ml (with the exception of sutterella wadsworthensis). against clostridium difficile strains, it has a narrow range of inhibitory concentrations (1-4 microg/ml) that "may be achievable in the colon", potentially resulting in lower disease rates. it has been shown to be active ...	2009	19249176
reining in recurrent clostridium difficile infection--who's at risk?		2009	19250653
inhibitory effect of rep3123 on toxin and spore formation in clostridium difficile, and in vivo efficacy in a hamster gastrointestinal infection model.	rep3123 is a fully synthetic methionyl-trna synthetase inhibitor in pre-clinical development as a novel agent to treat clostridium difficile infection (cdi). this novel agent was investigated for its ability to block the production of toxins and spores, and was tested for efficacy in vivo in a hamster model.	2009	19251726
pseudomembranes on colostomy.		2009	19252106
toxin b is essential for virulence of clostridium difficile.	clostridium difficile is the leading cause of infectious diarrhoea in hospitals worldwide, because of its virulence, spore-forming ability and persistence. c. difficile-associated diseases are induced by antibiotic treatment or disruption of the normal gastrointestinal flora. recently, morbidity and mortality resulting from c. difficile-associated diseases have increased significantly due to changes in the virulence of the causative strains and antibiotic usage patterns. since 2002, epidemic tox ...	2009	19252482
infection control in long-term care facilities: the need for engagement.		2009	19278407
national point prevalence of clostridium difficile in us health care facility inpatients, 2008.	recent published estimates of clostridium difficile infection (cdi) incidence have been based on small numbers of hospitals or national hospital discharge data. these data suggest that cdi incidence is increasing.	2009	19278754
clostridium difficile: a new zoonotic agent?	clostridium difficile is mainly considered a nosocomial pathogen associated with diarrhea and pseudomembranous colitis in hospitalized patients. austrian hospitals reported 2761 cases of c. difficile infection (including 277 lethal outcomes) in 2007, compared with 777 cases (including 54 lethal outcomes) in 2003. the occurrence of community-acquired c. difficile infection is also increasingly reported. recent studies have shown the occurrence of c. difficile in food and animals. the aim of the p ...	2009	19280132
clostridium difficile colitis.	clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. its effects are mediated by c difficile toxins a and b. recent outbreaks of severe colitis have been associated with a new strain of the bacterium that produces large amounts of the toxins. although oral metronidazole and oral vancomycin can be used to treat c difficile-associated disease, intraluminal vancomycin is preferable for more severe c difficile colitis. early surgical intervention can improv ...	2009	19281896
assessing staff knowledge about clostridium difficile diarrhoea.		2009	19282050
public perception of clostridium difficile.		2009	19282054
comparison of clinical, microbiologic, and clinicopathologic findings in horses positive and negative for clostridium difficile infection.	to compare clinical, microbiologic, and clinicopathologic findings among horses infected with clostridium difficile that had toxin a in their feces, horses with evidence of c difficile infection that were negative for toxin a in their feces, and horses with diarrhea that were negative for c difficile infection.	2009	19284345
quasiexperimental study of the effects of antibiotic use, gastric acid-suppressive agents, and infection control practices on the incidence of clostridium difficile-associated diarrhea in hospitalized patients.	the objective of this study was to evaluate the effects of antimicrobial drug use, gastric acid-suppressive agent use, and infection control practices on the incidence of clostridium difficile-associated diarrhea (cdad) in a 426-bed general teaching hospital in northern ireland. the study was retrospective and ecological in design. a multivariate autoregressive integrated moving average (time-series analysis) model was built to relate cdad incidence with antibiotic use, gastric acid-suppressive ...	2009	19289520
hospital infection control strategies for vancomycin-resistant enterococcus, methicillin-resistant staphylococcus aureus and clostridium difficile.		2009	19289807
vapour-phase activities of essential oils against antibiotic sensitive and resistant bacteria including mrsa.	to determine whether essential oil (eo) vapours could reduce surface and airborne levels of bacteria including methicillin-resistant staphylococcus aureus (mrsa).	2009	19292822
investigation and prediction of enteral nutrition problems after percutaneous endoscopic gastrostomy.	to investigate and predict enteral nutrition problems after percutaneous endoscopic gastrostomy (peg).	2009	19294767
probiotics in the intensive care unit.	to examine current knowledge regarding the utility of probiotics in a variety of medical conditions afflicting critically ill patients in the intensive care unit (icu).	2009	19300087
clostridium difficile infections: emerging epidemiology and new treatments.	clostridium difficile infections (cdis) are increasingly a cause of morbidity and mortality. although the pathogenicity of c difficile is based on toxin a and b expression, new hypervirulent strains express novel virulence factors. the etiology of recent increases in prevalence and severity of disease is not clearly explained by known mechanisms. new at-risk groups include children (without prior antibiotic exposure) and patients with inflammatory bowel disease. vancomycin has an important role ...	2009	19300129
new views on clostridium difficile infections: introduction.		2009	19303561
characterisation of clostridium difficile isolates by slpa and tcdc gene sequencing.	the genotyping of clostridium difficile is generally performed by the analysis of fragment- or amplification-length polymorphism by pulsed field gel electrophoresis (pfge) or polymerase chain reaction (pcr) ribotyping. however, sequence-based methods allow typing technique standardisation and data comparison. in the present study 100 c. difficile isolates, obtained from various institutions in the state of saarland, germany, were prospectively analyzed by surface layer protein a single locus seq ...	2009	19303562
surveillance of clostridium difficile-associated diarrhoea with the german nosocomial infection surveillance system kiss (cdad-kiss).	a study of 2856 clostridium difficile -associated diarrhoea (cdad) patients from 34 hospitals in germany was carried out over a period of 12 months in 2007. the overall incidence of cdad cases was 46.5 per 10,000 admitted patients, or 6.6 cases per 10,000 patient-days. seventy-three percent of cases were considered to be nosocomial and 8.4% were classified as severe. there was a wide range in the incidence of cdad between the hospitals (interquartile range [iqr] 3.2-9.2 cases per 10,000 patient- ...	2009	19303563
clostridium difficile 30 years on: what has, or has not, changed and why?	the report of clindamycin-associated colitis in 1974 by tedesco et al. [ann intern med 81: 429-33] stimulated an intense search for the cause of this severe complication of antibiotic use. the search culminated in early 1978 in the publication of a series of papers within 3 months that identified the causative agent as clostridium difficile and its accompanying toxins. thirty years later we are in the midst of a resurgence of c. difficile infection (cdi) in north america and europe that is great ...	2009	19303564
new trends in clostridium difficile virulence and pathogenesis.	the disease spectrum caused by clostridium difficile infection ranges from antibiotic-associated diarrhoea to life-threatening clinical manifestations such as pseudomembranous colitis. c. difficile infection is precipitated by antimicrobial therapy that causes a disruption of the normal colonic microbiota, predisposing to c. difficile intestinal colonisation. the pathogenicity of c. difficile is mediated by two exotoxins, tcda and tcdb, both of which damage the human colonic mucosa and are poten ...	2009	19303565
clostridium difficile and fluoroquinolones: is there a link?	clostridium difficile infection has become one of the most significant threats to hospitalised patients and represents an increasingly important issue in terms of morbidity and mortality within our institutions. the arrival of a new, more virulent strain coincided with the introduction of several new respiratory fluoroquinolones, and several studies have reported a potential link between the use of fluoroquinolones and the occurrence of c. difficile infection. after reviewing the available publi ...	2009	19303566
recurrent clostridium difficile infection: causality and therapeutic approaches.	recurrent diarrhoea after successful treatment of the primary episode is a common complication of clostridium difficile infection (cdi) and may be increasing in frequency. evidence suggests that persistent alterations in the indigenous bowel flora and failure to mount an effective antibody response to c. difficile toxins are the main mechanisms whereby recurrent cdis occur. treatment of the first recurrence with the same agent used for the treatment of the primary episode is reasonable, but a di ...	2009	19303567
nosocomial and antibiotic-associated diarrhoea caused by organisms other than clostridium difficile.	most cases of nosocomial and antibiotic-associated diarrhoea are caused by alteration of the physiological gut microflora. this alteration leads to reduced microbial metabolism of carbohydrates and primary bile acids, resulting in osmotic or secretory forms of diarrhoea. moreover, facultative enteropathogens may experience a growth advantage due to the antibiotic-induced microflora alteration that, in turn, can harm the gut mucosa by the toxins they produce. clostridium difficile is the major in ...	2009	19303568
clostridium difficile is no longer just a nosocomial infection or an infection of adults.	clostridium difficile is the main cause of nosocomial gastrointestinal disorders. historically, c. difficile has usually affected older patients, hospital inpatients, and long-term care facility residents. recent reports suggest that the occurrence and severity of c. difficile-associated disease (cdad) is increasing in populations previously considered to be at low risk of the infection, and increasing numbers of community-acquired cases of cdad are being reported. risk factors for cdad in paedi ...	2009	19303569
new approach to the management of clostridium difficile infection: colonisation with non-toxigenic c. difficile during daily ampicillin or ceftriaxone administration.	non-toxigenic strains of clostridium difficile are highly effective in preventing toxigenic c. difficile infection in hamsters when given following a single dose of an antimicrobial agent. the goal of this study was to determine the ability of non-toxigenic c. difficile to colonise hamsters during administration of an antibiotic to which the organisms are resistant - ceftriaxone - and an antibiotic to which they are susceptible - ampicillin - and to determine if non-toxigenic colonisation is pro ...	2009	19303570
alternative strategies for clostridium difficile infection.	although antibiotics are generally effective in achieving symptomatic recovery from clostridium difficile infection, the disease frequently relapses, partly because antibiotics not only kill c. difficile, but also disrupt colonisation resistance of the gut microflora. non-antibiotic strategies for the prevention and treatment of the infection include probiotics, deliberate colonisation by non-toxigenic c. difficile strains, toxin-binding agents, active immunisation, passive immunotherapy with in ...	2009	19303571
what is the role of antimicrobial resistance in the new epidemic of clostridium difficile?	the epidemiology of clostridium difficile infection (cdi) has changed in recent years, with the occurrence of large outbreaks of infection associated with the emergence of 'hypervirulent' strains, particularly pcr ribotype 027. there has been much speculation as to the nature of the factors responsible for driving the new epidemic of cdi, and various hypotheses have been proposed. these include increases in the size of the population at risk of cdi and/or their susceptibility to infection, incre ...	2009	19303572
antibody-enhanced, fc gamma receptor-mediated endocytosis of clostridium difficile toxin a.	toxin a (tcda) and toxin b (tcdb) are major virulence factors of clostridium difficile. these two toxins intoxicate cultured cells by similar mechanisms, and tcdb generally is more potent than tcda in cultured cells. the exact reason for this difference is unclear. here, we report that the cellular effects of tcda can be substantially enhanced via an opsonizing antibody through fc gamma receptor i (fcgammari)-mediated endocytosis. a tcda-specific monoclonal antibody, a1h3, was found to significa ...	2009	19307220
cpdadh: a new peptidase family homologous to the cysteine protease domain in bacterial martx toxins.	a cysteine protease domain (cpd) has been recently discovered in a group of multifunctional, autoprocessing rtx toxins (martx) and clostridium difficile toxins a and b. these cpds (referred to as cpdmartx) autocleave the toxins to release domains with toxic effects inside host cells. we report identification and computational analysis of cpdadh, a new cysteine peptidase family homologous to cpdmartx. cpdadh and cpdmartx share a rossmann-like structural core and conserved catalytic residues. in b ...	2009	19309740
late endocytic dysfunction as a putative cause of amyloid fibril formation in alzheimer's disease.	the assembly of amyloid beta-protein to amyloid fibrils is a critical event in alzheimer's disease. evidence exists that endocytic pathway abnormalities, including the enlargement of early endosomes, precede the extraneuronal amyloid fibril deposition in the brain. we determined whether endocytic dysfunction potently promotes the assembly of amyloid beta-protein on the surface of cultured cells. blocking the early endocytic pathway by clathrin suppression, inactivation of small gtpases, removal ...	2009	19317854
the vexed relationship between clostridium difficile and inflammatory bowel disease: an assessment of carriage in an outpatient setting among patients in remission.	comorbidity with clostridium difficile may cause diagnostic delay in newly presenting inflammatory bowel disease (ibd) patients, trigger relapse in established disease, confound therapies, and serve as an indicator of an underlying defect in innate immunity. retrospective analyses have suggested community acquisition; to address this we conducted a prospective analysis of c. difficile carriage in ibd patients using molecular methods specifically in an outpatient setting.	2009	19319128
essential role of the glucosyltransferase activity in clostridium difficile toxin-induced secretion of tnf-alpha by macrophages.	clostridium difficile causes serious and potentially fatal inflammatory diseases of the colon. two large protein toxins, tcda and tcdb, have been clearly implicated in pathogenesis. the goal of this study was to determine whether the glucosyltransferase activity of the toxins is critical for the induction of tumor necrosis factor-alpha (tnf-alpha), an important cytokine mediating both local and systematic inflammatory response. a dose-dependent tnf-alpha secretion was demonstrated in murine macr ...	2009	19324080
presence of the epidemic north american pulsed field type 1 clostridium difficile strain in hospitalized children.	a hypervirulent strain of clostridium difficile-labeled north american pulsed field type 1 causes severe disease in adults. to determine the prevalence of nap1 c. difficile in children, organisms from consecutive c. difficile toxin-positive stool samples at 2 children's hospitals microbiology laboratories were characterized. we found that 19.4% of these samples were nap1.	2009	19324222
the mechanisms and efficacy of probiotics in the prevention of clostridium difficile-associated diarrhoea.	the proportion and severity of clostridium difficile-associated diarrhoea (cdad) is increasing in health-care settings. antibiotics remain the most important risk factor for cdad, due to their limiting the ability of the gastrointestinal flora to inhibit c difficile colonisation. probiotics have therefore been investigated for primary and secondary prophylaxis against cdad, with varying success. this review looks at the current literature for in-vitro and clinical evidence for probiotic use in t ...	2009	19324296
increasing seroprevalence of clostridium difficile in an adult danish general population.	the incidence of clostridium difficile-associated infections is increasing, but it remains to be defined whether any change in the seroprevalence of c. difficile has also occurred. in a population-based study of the general adult population, 734 subjects, aged 15-69 years, were examined on two occasions 8 years apart (1990 and 1998) for the presence of antibodies against c. difficile in serum. the overall seroprevalence of c. difficile increased significantly from 19% in 1990 to 27% in 1998 (p<0 ...	2009	18503728
mechanisms of action of probiotics: recent advances.	the intestinal microbiota plays a fundamental role in maintaining immune homeostasis. in controlled clinical trials probiotic bacteria have demonstrated a benefit in treating gastrointestinal diseases, including infectious diarrhea in children, recurrent clostridium difficile-induced infection, and some inflammatory bowel diseases. this evidence has led to the proof of principle that probiotic bacteria can be used as a therapeutic strategy to ameliorate human diseases. the precise mechanisms inf ...	2009	18626975
clostridium difficile colitis in a health care worker: case report and review of the literature.		2009	18594979
effects of exposure of clostridium difficile pcr ribotypes 027 and 001 to fluoroquinolones in a human gut model.	the incidence of clostridium difficile infection is increasing, with reports implicating fluoroquinolone use. a three-stage chemostat gut model was used to study the effects of three fluoroquinolones (ciprofloxacin, levofloxacin, and moxifloxacin) on the gut microbiota and two epidemic c. difficile strains, strains of pcr ribotypes 027 and 001, in separate experiments. c. difficile total viable counts, spore counts, and cytotoxin titers were determined. the emergence of c. difficile isolates wit ...	2009	18710908
[a recurrent diarrhea].		2009	18572277
emergency laparoscopic surgery for complicated diverticular disease.	the aim of this study was to analyse the outcome of emergency laparoscopic surgical management of complicated diverticular disease.	2009	18616737
clostridium difficile-associated disease in children with solid tumors.	the goal of this study was to describe the incidence of clostridium difficile-associated disease (cdad) in children with solid tumours.	2009	18802726
toxin-binding treatment for clostridium difficile: a review including reports of studies with tolevamer.	clostridium difficile represents an increasing threat to patients, mainly as a hospital-acquired infection causing antibiotic-associated colitis (aac). the emergence of a new more virulent strain in north america and europe has been linked to increased morbidity and mortality. for a long period of time the only available therapeutic options were oral vancomycin and metronidazole. however, both of these antibiotics have limitations either in terms of efficacy, cost, formulation, side effects or t ...	2009	18804351
more bad news on clostridium difficile in inflammatory bowel disease.		2009	18785624
absence of pseudomembranes in clostridium difficile-associated diarrhea in patients using immunosuppression agents.	clostridium difficile is a major cause of diarrhea in hospitalized patients. although pseudomembranes are crucial evidence for diagnosis of c. difficile-associated diarrhea (cdad), some cases do not show any pseudomembranes. the aim of this study was to verify the hypothesis that pseudomembranes are not generated in immunosuppressed patients because of the absence of immunoreactions.	2009	18781540
melanin-concentrating hormone (mch) modulates c difficile toxin a-mediated enteritis in mice.	melanin-concentrating hormone (mch) is a hypothalamic orexigenic neuropeptide that regulates energy balance. however, the distribution of mch and its receptor mchr1 in tissues other than brain suggested additional, as yet unappreciated, roles for this neuropeptide. based on previous paradigms and the presence of mch in the intestine as well as in immune cells, its potential role in gut innate immune responses was examined.	2009	18824554
reduction in infection risk through treatment of microbially contaminated surfaces with a novel, portable, saturated steam vapor disinfection system.	surface-mediated infectious disease transmission is a major concern in various settings, including schools, hospitals, and food-processing facilities. chemical disinfectants are frequently used to reduce contamination, but many pose significant risks to humans, surfaces, and the environment, and all must be properly applied in strict accordance with label instructions to be effective. this study set out to determine the capability of a novel chemical-free, saturated steam vapor disinfection syst ...	2009	18834748
community acquired clostridium difficile infection due to a moxifloxacin susceptible ribotype 027 strain.		2009	18846478
mass spectrometric analysis of the s-layer proteins from clostridium difficile demonstrates the absence of glycosylation.	like many other bacterial cell surfaces, the cell wall of clostridium difficile is also encapsulated by a proteinaceous paracrystalline layer, the surface (s)-layer. in many bacterial species, the s-layer proteins (slps) have been shown to be glycosylated, whereas in other species glycosylation is absent. unusually, the s-layer of c. difficile is composed of two distinct proteins, the high-molecular weight (hmw) and low-molecular-weight (lmw) slps. previous investigations have reported that one ...	2009	18932172
regulation of kir2.1 channels by the rho-gtpase, rac1.	mutations in kir2.1 inwardly rectifying potassium channels are associated with andersen syndrome, a disease characterized by potentially fatal cardiac arrhythmias. while several andersen-associated mutations affect membrane expression, the cytoplasmic signals that regulate kir2.1 trafficking are poorly understood. here, we investigated whether the rho-family of small gtpases regulates trafficking of kir2.1 channels expressed in hek-293 cells. treatment with clostridium difficile toxin b, an inhi ...	2009	18932198
seasonal variation of enteric infections and inflammatory bowel disease.		2009	18942760
fulminant small bowel enteritis: a rare complication of clostridium difficile-associated disease.		2009	18942764
isolation and analysis of bacteria with antimicrobial activities from the marine sponge haliclona simulans collected from irish waters.	samples of the marine sponge haliclona simulans were collected from irish coastal waters, and bacteria were isolated from these samples. phylogenetic analyses of the cultured isolates showed that four different bacterial phyla were represented; bacteriodetes, actinobacteria, proteobacteria, and firmicutes. the sponge bacterial isolates were assayed for the production of antimicrobial substances, and biological activities against gram-positive and gram-negative bacteria and fungi were demonstrate ...	2009	18953608
characterization of tet(32) genes from the oral metagenome.	tet(32) was identified in three bacterial isolates and in metagenomic dna from the human oral cavity. the regions immediately flanking the gene were found to have similarities to the mobile elements tnb1230 from butyrivibrio fibrisolvens, ate-3 from arcanobacterium pyogenes, and ctn5 from clostridium difficile.	2009	18955517
opt-80 eliminates clostridium difficile and is sparing of bacteroides species during treatment of c. difficile infection.	during a 10-day treatment for clostridium difficile infection, opt-80 and vancomycin were comparably effective in reducing c. difficile counts. bacteroides fragilis group counts appeared unaffected with increasing dosages of opt-80, whereas vancomycin was markedly suppressive. retention of components of the normal microflora might lower the risk of recurrent disease.	2009	18955523
clinical outcomes, safety, and pharmacokinetics of opt-80 in a phase 2 trial with patients with clostridium difficile infection.	opt-80, a novel, minimally absorbed macrocycle, is a candidate treatment option for clostridium difficile infection (cdi) based on cure without recurrence of cdi in the hamster challenge model, good in vitro activity against c. difficile, and relative sparing of commensal gram-negative anaerobes. in this open-label, dose-ranging clinical trial, 48 evaluable subjects were randomized to receive either 50, 100, or 200 mg of opt-80 orally every 12 h for 10 days as treatment for mild to moderately se ...	2009	18955525
idiopathic pseudomembranous colitis limited to the right colon: a change from clostridium difficile.		2009	18830611
porcine circovirus 2 infection of epithelial cells is clathrin-, caveolae- and dynamin-independent, actin and rho-gtpase-mediated, and enhanced by cholesterol depletion.	epithelial cells are the major in vivo target cells for porcine circovirus type 2 (pcv2). although these cells are used for most studies of pcv2 gene expression and, little is known on pcv2 entry, attachment and internalization, in epithelial cells. pcv2 attachment to epithelial cells occurred rapidly and in a time-dependent manner. in contrast to attachment, internalization was slow. immunofluorescent stainings revealed that during internalization, pcv2 co-localized with clathrin, but not caveo ...	2009	18952130
an outbreak of clostridium difficile-associated disease (cdad) in a german university hospital.		2009	18982365
clostridium difficile toxin a promotes dendritic cell maturation and chemokine cxcl2 expression through p38, ikk, and the nf-kappab signaling pathway.	clostridium difficile toxin a causes acute colitis associated with intense infiltrating neutrophils. although dendritic cells (dcs) play an important role in the regulation of inflammation, little is known about the effects of toxin a on the maturation and neutrophil-attracting chemokine expression in dcs. this study investigated whether c. difficile toxin a could influence the maturation of mouse bone-marrow-derived dcs and chemokine cxcl2 expression. toxin a increased the dc maturation which w ...	2009	18985311
survey of wastewater indicators and human pathogen genomes in biosolids produced by class a and class b stabilization treatments.	accurate modeling of the infectious aerosol risk associated with the land application of biosolids requires an in-depth knowledge of the magnitudes and changes in pathogen concentrations for a variety of class a and class b stabilization methods. the following survey used quantitative pcr (qpcr) and culture assays to detect environmentally resistant bacterial and viral pathogens and biosolid indicator organisms for 36 biosolid grab samples. biosolids were collected from 14 u.s. states and includ ...	2009	18997022
risk indices for c. difficile infection are unlikely to be generalisable between organisations.		2009	19013667
spatio-temporal stochastic modelling of clostridium difficile.	clostridium difficile-associated diarrhoea (cdad) occurs sporadically or in small discrete outbreaks. stochastic models may help to inform hospital infection control strategies. bayesian framework using data augmentation and markov chain monte carlo methods were applied to a spatio-temporal model of cdad. model simulations were validated against 17 months of observed data from two 30-bedded medical wards for the elderly. simulating the halving of transmission rates of c. difficile from other pat ...	2009	19013677
urinary tract infection in hospitalized elderly patients in the united kingdom: the importance of making an accurate diagnosis in the post broad-spectrum antibiotic era.	the increasing prevalence of clostridium difficile infection (cdi) has prompted many hospitals in the uk to recommend the use of narrow-spectrum antibiotics targeted at the likely bacteria at the clinical site of infection instead of broad-spectrum antibiotics. an underpinning requirement of such a strategy is the need to make an accurate diagnosis. in elderly patients, diagnosis of urinary tract infection can be challenging due to the frequent presence of respiratory signs and difficulties in t ...	2009	19022779
what have we learned about antimicrobial use and the risks for clostridium difficile-associated diarrhoea?	clostridium difficile is recognized as a major cause of antibiotic-associated diarrhoea and colitis. antimicrobial agents have been repeatedly recognized as a causative risk for c. difficile-associated diarrhoea (cdad) and more recently fluoroquinolones have been particularly implicated. unfortunately, not all reports of antimicrobial associations with cdad have excluded variables other than antimicrobial use. prevention of cdad usually involves infection control interventions and antimicrobial ...	2009	19028718
fas death receptor enhances endocytic membrane traffic converging into the golgi region.	the death receptor fas/cd95 initiates apoptosis by engaging diverse cellular organelles including endosomes. the link between fas signaling and membrane traffic has remained unclear, in part because it may differ in diverse cell types. after a systematic investigation of all known pathways of endocytosis, we have clarified that fas activation opens clathrin-independent portals in mature t cells. these portals drive rapid internalization of surface proteins such as cd59 and depend upon actin-regu ...	2009	19037097
cranberry or trimethoprim for the prevention of recurrent urinary tract infections? a randomized controlled trial in older women.	to compare the effectiveness of cranberry extract with low-dose trimethoprim in the prevention of recurrent urinary tract infections (utis) in older women.	2009	19042940
skin and environmental contamination with vancomycin-resistant enterococci in patients receiving oral metronidazole or oral vancomycin treatment for clostridium difficile-associated disease.	oral metronidazole has been recommended for treatment of mild-to-moderate clostridium difficile-associated disease (cdad), in part because of concern that use of vancomycin may be more likely to promote colonization and transmission of vancomycin-resistant enterococci (vre). the objective of our study was to compare the frequency of skin and environmental vre contamination associated with metronidazole treatment for cdad with such frequency associated with vancomycin treatment for cdad.	2009	19046063
autocatalytic processing of clostridium difficile toxin b. binding of inositol hexakisphosphate.	clostridium difficile toxins a and b are major virulence factors responsible for induction of pseudomembranous colitis and antibiotic-associated diarrhea in men. the toxins possess a multidomain structure and only the n-terminal glucosyltransferase domain, which inactivates rho gtpases by glucosylation, is translocated into the cytosol of target cells. processing of the toxin occurs by autocatalytic cleavage and is activated by inositol hexakisphosphate (insp6). here we studied the inherent prot ...	2009	19047051
ruwa scoring system: a novel predictive tool for the identification of patients at high risk for complications from clostridium difficile infection.		2009	19041159
quantitative detection of clostridium difficile in hospital environmental samples by real-time polymerase chain reaction.	c. difficile-associated diarrhoea occurs commonly in hospitals and is a significant cause of morbidity and mortality. hospital surfaces are often contaminated with nosocomial pathogens and may be responsible for cross-transmission, especially if hardy gram-positive and spore-forming organisms are involved. the aim of this study was to quantify c. difficile in the hospital environment near c. difficile-positive and -negative patients using a quantitative real-time polymerase chain reaction. a tot ...	2009	19041162
review of current literature on the economic burden of clostridium difficile infection.	clostridium difficile is well recognized as the most common infectious cause of healthcare-associated diarrhea. since 2000, this pathogen has demonstrated an increased propensity to cause more frequent and virulent illness that is often refractory to treatment. an analysis by the centers for disease control and prevention revealed that, in the united states, the number of patients discharged from hospitals who received the international classification of diseases, ninth revision discharge diagno ...	2009	19049438
diagnosis and management of urinary tract infection in hospitalized older people.	to compare the diagnosis and management of urinary tract infection (uti) in hospitalized older people with clinical criteria and therapeutic guidelines.	2009	19054190
chenodeoxycholate is an inhibitor of clostridium difficile spore germination.	some cholate derivatives that are normal components of bile can act with glycine to induce the germination of clostridium difficile spores, but at least one bile component, chenodeoxycholate, does not induce germination. here we show that chenodeoxycholate inhibits the germination of c. difficile spores in response to cholate and taurocholate.	2009	19060152
severe pseudomembranous colitis after moxifloxacin use: a case series.	to describe the illnesses of 4 patients who developed severe pseudomembranous colitis after receiving moxifloxacin.	2009	19066322
outcomes following colectomy for clostridium difficile colitis.	clostridium difficile associated diarrhoea has become an important health problem in uk hospitals but surgical intervention is rarely required. there is little evidence regarding best practice for patients requiring surgical intervention. the aim of this multicentre study was to review our experience in patients requiring surgery for c. difficile colitis.	2009	19070558
effective and reduced-cost modified selective medium for isolation of clostridium difficile.	both for epidemiologic studies and for diagnostic testing, there is a need for effective, economical, and readily available selective media for the culture of clostridium difficile. we have developed a reduced-cost substitute for cycloserine-cefoxitin-fructose agar (ccfa), which is an effective but expensive selective medium for c. difficile. the modified medium, called c. difficile brucella agar (cdba), includes an enriched brucella base as a substitute for proteose peptone no. 2, and the conce ...	2009	19073869
comparison of a commercial real-time pcr assay for tcdb detection to a cell culture cytotoxicity assay and toxigenic culture for direct detection of toxin-producing clostridium difficile in clinical samples.	rapid detection of toxin-producing strains of clostridium difficile is essential for optimal management of patients with c. difficile infection. the bd geneohm (san diego, ca) cdiff assay, a real-time pcr assay that amplifies tcdb, was compared to a cell culture neutralization assay (wampole c. difficile toxin b [tox-b] test; techlab, blacksburg, va) and to toxigenic culture. using liquid (n = 273) and soft (n = 131) stool specimens from 377 symptomatic patients, all testing was performed on the ...	2009	19073875
predictors of serious complications due to clostridium difficile infection.	identifying individuals with severe clostridium difficile infection (cdi) at risk for major complications has become an important objective. presence of clinical variables that predict complications from cdi would have the potential to strongly influence management.	2009	19077106