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clostridium difficile infection following hip fracture. 200818353494
laboratory diagnosis of clostridium difficile-associated disease in the republic of ireland: a survey of irish microbiology laboratories.the health protection surveillance centre (hpsc) established a group to produce national guidelines for clostridium difficile in ireland in 2006. a laboratory questionnaire was distributed to determine current c. difficile diagnostic practices. twenty-nine out of 44 laboratories providing c. difficile diagnostic services to 34 hospitals responded. twenty-five out of 29 (86%) laboratories processed specimens for c. difficile and four (13.8%) forwarded specimens to another laboratory. sixteen labo ...200818353502
infection in solid-organ transplant recipients. 200818354113
comparative genomic analysis of t-box regulatory systems in bacteria.t-box antitermination is one of the main mechanisms of regulation of genes involved in amino acid metabolism in gram-positive bacteria. t-box regulatory sites consist of conserved sequence and rna secondary structure elements. using a set of known t-box sites, we constructed the common pattern and used it to scan available bacterial genomes. new t-boxes were found in various gram-positive bacteria, some gram-negative bacteria (delta-proteobacteria), and some other bacterial groups (deinococcales ...200818359782
treatment of clostridium difficile colitis in the critical care setting.clostridium difficile colitis is a debilitating infection with a remarkably high associated mortality. infection is contagious and spreads especially rapidly in an intensive care setting because patients who are there have all the associated risk factors, including major underlying illnesses, prior antibiotic therapy, and use of agents that suppress gastric acidity. prevention of disease is the responsibility of every health care provider in the critical care setting. this article emphasizes tre ...200818361946
antibiotic-associated diarrhea: candidate organisms other than clostridium difficile.the direct toxic effects of antibiotics on the intestine can alter digestive functions and cause pathogenic bacterial overgrowth leading to antibiotic-associated diarrhea (aad). clostridium difficile (c. difficile) is widely known to be responsible for 10 approximately 20% of aad cases. however, klebsiella oxytoca, clostridium perfringens, staphylococcus aureus, and candida species might also contribute to aad.200818363274
opt-80, a macrocyclic antimicrobial agent for the treatment of clostridium difficile infections: a review.clostridium difficile-associated diarrhoea has become a major problem over the last years. increasing incidence and more severe clinical cases initiated the search for new treatment options.200818363518
a probiotic drink prevented diarrhoea and clostridium difficile-associated diarrhoea in older patients taking antibiotics. 200818364427
ageing and the gut. 200818372803
a probiotic drink prevented diarrhoea and clostridium difficile infection in older patients taking antibiotics. 200818375699
antimicrobial stewardship programs: interventions and associated outcomes.guidelines regarding antimicrobial stewardship programs recommend an infectious diseases-trained physician and an infectious diseases-trained pharmacist as core members. inclusion of clinical microbiologists, infection-control practitioners, information systems experts and hospital epidemiologists is considered optimal. recommended stewardship interventions include prospective audit and intervention, formulary restriction, education, guideline development, clinical pathway development, antimicro ...200818380603
clostridium difficile enteritis: a cause for high ileostomy output. 200818380751
role of phospholipase a2 and tyrosine kinase in clostridium difficile toxin a-induced disruption of epithelial integrity, histologic inflammatory damage and intestinal secretion.clostridium difficile-associated disease causes diarrhea to fulminant colitis and death. we investigated the role of phospholipase a2 (pla2) inhibitors, aristolochic acid (aa), bromophenacyl bromide (bpb) and quinacrine (quin) on the c. difficile toxin a-induced disruption of epithelial integrity, histologic inflammatory damage and intestinal secretion. toxin a caused severe hemorrhagic and inflammatory fluid secretion at 6-8 h in rabbit ileal segments, an effect that was significantly inhibited ...200818381687
pcr detection of clostridium difficile triose phosphate isomerase (tpi), toxin a (tcda), toxin b (tcdb), binary toxin (cdta, cdtb), and tcdc genes in vhembe district, south africa.specific polymerase chain reaction (pcr) protocols were used to determine the prevalence of toxigenic clostridium difficile in vhembe, south africa. of 322 stool samples collected, toxigenic c. difficile was found in 23 (7.1%) cases and was significantly associated with diarrhea 20 (11.4%) compared with 3 (2%) in non-diarrheal samples (chi(2) = 426, p = 0.001), intestinal inflammation in 18 (12.1%) compared with 5 (2.9%) in lactoferrin-negative samples (chi(2) = 10.194, p = 0.001), and occult bl ...200818385352
risk of clostridium difficile diarrhoea in critically ill patients treated with erythromycin-based prokinetic therapy for feed intolerance.to determine the incidence of clostridium difficile (cd) diarrhoea in feed-intolerant, critically ill patients who received erythromycin-based prokinetic therapy.200817701160
the epidemiology and treatment of infections in cancer patients.significant changes in the epidemiology of infectious complications in cancer patients have emerged during the past decade. among blood culture isolates from febrile neutropenic patients, gram-positive pathogens have become predominant, and an increasing spread of methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococci must be taken into consideration. risk factors such as indwelling venous catheters or chemotherapy-induced mucosal damage are associated with an increased ...200817703922
predictors of clostridium difficile colitis infections in hospitals.hospital-level predictors of high rates of 'clostridium difficile-associated disease' (cdad) were evaluated in over 2300 hospitals across california, arizona, and minnesota. american hospital association data were used to determine hospital characteristics associated with high rates of cdad. significant correlations were found between hospital rates of cdad, common infections and other identified pathogens. hospitals in urban areas had higher average rates of cdad; yet, irrespective of geographi ...200817686193
fucoidin prevents clostridium difficile toxin-a-induced ileal enteritis in mice.recent reports suggest increased incidence and severity of clostridium difficile-associated diseases. these facts have raised the need for additional clarification of pathogenesis and for a search for new therapeutic strategies. this study evaluated the effects of the polysaccharide fucoidin, an l-selectin blocker, on toxin-a-induced mouse enteritis. fucoidin (25 mg/kg) or saline (0.1 ml) were injected systemically (ocular plexus) 5 min prior to local challenge with toxin a (5 microg/ileal loop) ...200817805968
excess hospitalisation burden associated with clostridium difficile in patients with inflammatory bowel disease.clostridium difficile is an important cause of diarrhoea in hospitalised patients. an increasing number of cases of c difficile colitis occur in patients with inflammatory bowel disease (ibd)-crohn's disease (cd), ulcerative colitis (uc).200817905821
statins enhance toll-like receptor 4-mediated cytokine gene expression in astrocytes: implication of rho proteins in negative feedback regulation.toll-like receptors (tlrs) are sentinels of innate immunity that recognize pathogenic molecules and trigger inflammatory response. because inflammatory mediators are detrimental to the host, the tlr response is regulated by feedback inhibition. statins, the inhibitors of isoprenoid biosynthesis, have been shown to be potent modulators of tlr activity, and this modulation may provide insight regarding mechanisms of the feedback inhibition. in the present study, we examined feedback mechanisms tha ...200817896797
the effect of a multispecies probiotic on the intestinal microbiota and bowel movements in healthy volunteers taking the antibiotic amoxycillin.one of the side effects of antimicrobial therapy is a disturbance of the intestinal microbiota potentially resulting in antibiotic-associated diarrhea (aad). in this placebo-controlled double-blind study, the effect of a multispecies probiotic on the composition and metabolic activity of the intestinal microbiota and bowel habits was studied in healthy volunteers taking amoxycillin.200817900321
clostridium difficile: an under-recognized cause of reactive arthritis?reactive arthritis usually presents as a sterile, inflammatory, asymmetric oligoarthritis, affecting large lower extremity joints. extra-articular features (conjunctivitis, uveitis, enthesopathy, urethritis, balanitis, keratoderma blenorrhagicum) may occur. common causes of enteric reactive arthritis are preceding infections attributable to salmonella, shigella, campylobacter, and yersinia. in contrast, clostridium difficile is an uncommon cause of reactive arthritis, with only approximately 40 ...200817902012
small bowel evisceration: a rare complication of laparoscopic ileostomy. 200817944971
in vitro and in vivo antibacterial activities of dc-159a, a new fluoroquinolone.dc-159a is a new 8-methoxy fluoroquinolone that possesses a broad spectrum of antibacterial activity, with extended activity against gram-positive pathogens, especially streptococci and staphylococci from patients with community-acquired infections. dc-159a showed activity against streptococcus spp. (mic(90), 0.12 microg/ml) and inhibited the growth of 90% of levofloxacin-intermediate and -resistant strains at 1 microg/ml. the mic 90s of dc-159a against staphylococcus spp. were 0.5 microg/ml or ...200817938194
a possible role for clostridium difficile in the etiology of calf enteritis.clostridium difficile was investigated as a possible cause of enteritis in calves. the organism and its toxins (tcda and tcdb), respectively, were found in 25.3% and 22.9% of stool samples from diarrheic calves. culture positive samples were more likely than culture negative samples to be toxin positive. however, toxin positive stools were more common among nondiarrheic calves, but diarrheic calves were nearly twice as likely to be culture positive. ribotype 078 was dominant among isolates. salm ...200817964088
importance of the environment in meticillin-resistant staphylococcus aureus acquisition: the case for hospital cleaning.in the uk, we continue to debate the importance of hospital cleaning in relation to increasing numbers of patients acquiring meticillin-resistant staphylococcus aureus (mrsa). however, there is little direct evidence for the effectiveness of cleaning because it has never been afforded scientific status. hospital hygiene is usually assessed visually, but this does not necessarily correlate with microbiological risk. a more robust case for hospital cleaning can be presented by considering the evid ...200817974481
evaluation of two rapid immunochromatography tests for the detection of clostridium difficile toxins.the aim of the study was to evaluate the performance of two rapid immunochromatography tests, the tox a/b quick chek (techlab) and the immunocard toxins a&b test (meridian), in addition to the older tox a/b elisa, against pcr detection of the tcdb gene. two hundred patient-unique stool specimens were tested. in comparison to the polymerase chain reaction results, the sensitivity and specificity of the two rapid tests were 94.7% and 97.2%, respectively; corresponding values for the elisa were 93. ...200817990108
laparoscopic parastomal hernia repair.management of the parastomal hernia represents a common clinical dilemma for both the surgeon and patient. once established, these defects are notoriously difficult to treat. although most parastomal hernias can be managed nonoperatively, approximately 30% will require intervention secondary to complications such as obstruction, pain, bleeding, poorly fitting appliances, or leakage. overall complication rates of up to 88%, combined with a growing body of literature citing decreased patient morbi ...200817999128
evaluation of two enzyme immunoassays for detection of clostridium difficile toxins a and b in swine.diagnosis of clostridium difficile-associated disease (cdad) in neonatal pigs is accomplished, in part, by detection of toxins a (tcda) and b (tcdb) in feces or colonic contents. samples (n=115) were tested simultaneously with two toxin assays (clostridium difficile tox a/b ii, techlab, blacksburg, va; gastro-tect clostridium difficile toxin a+b, medical chemical corporation). previous comparison of the tox a/b ii assay to the reference method (toxicity in cho cell monolayers) revealed an overal ...200818006252
a rare and unsuspected complication of clostridium difficile infection.to report the occurrence of abdominal compartment syndrome (acs) due to infection with clostridium difficile.200818026931
rapid and reliable diagnostic algorithm for detection of clostridium difficile.we evaluated a two-step algorithm for detection of clostridium difficile in 1,468 stool specimens. first, specimens were screened by an immunoassay for c. difficile glutamate dehydrogenase antigen (c.diff chek-60). second, screen-positive specimens underwent toxin testing by a rapid toxin a/b assay (tox a/b quik chek); toxin-negative specimens were subjected to stool culture. this algorithm allowed final results for 92% of specimens with a turnaround time of 4 h.200818032627
clostridium difficile-associated disease: update and focus on non-antibiotic strategies.clostridium difficile-associated disease (cdad) is a problem of especially the frail elderly. changes in virulence of prevalent strains in the early years of the new century saw mortality and morbidity increase from historical levels. this article explores non-antibiotic strategies including the use of probiotics. a number of avenues of ongoing research appear to have potential future clinical application. evidence exists linking acid-inhibiting drugs to an increased risk of cdad, and the adjunc ...200818033775
comparison of seven techniques for typing international epidemic strains of clostridium difficile: restriction endonuclease analysis, pulsed-field gel electrophoresis, pcr-ribotyping, multilocus sequence typing, multilocus variable-number tandem-repeat analysis, amplified fragment length polymorphism, and surface layer protein a gene sequence typing.using 42 isolates contributed by laboratories in canada, the netherlands, the united kingdom, and the united states, we compared the results of analyses done with seven clostridium difficile typing techniques: multilocus variable-number tandem-repeat analysis (mlva), amplified fragment length polymorphism (aflp), surface layer protein a gene sequence typing (slpast), pcr-ribotyping, restriction endonuclease analysis (rea), multilocus sequence typing (mlst), and pulsed-field gel electrophoresis ( ...200818039796
ileal smooth muscle motility depression on rabbit induced by toxin a from clostridium difficile.this study is aimed at elucidating with in vitro experiments the time course of alteration of ileal motility caused by in vivo exposure of ligated loops of ileum to toxin a (1 microg/ligated loop) of clostridium difficile. in the sham-operated animals no significant alteration of motility was observed. in ligated loops directly injected with toxin a and in loops neighboring those administered with this toxin, a biphasic time course of motility alterations was observed. there was initially (2 h a ...200817987387
[update on clostridium difficile infections].purpose: clostridium difficile is an anaerobic gram positive, spore-forming bacterium which is responsible for 15-25% of antibiotic-associated diarrhea and for more than 95% of pseudomembranous colitis (pmc). this paper will review the main knowledge on c. difficile-associated infections and their recent evolution. current knowledge and key points: since 2003, outbreaks of severe c. difficile-associated diarrhea (cdad) have been increasingly reported in canada and the united states. this trend i ...200818023937
sphingosine-1-phosphate and endothelin-1 induce the expression of rgs16 protein in cardiac myocytes by transcriptional activation of the rgs16 gene.the expression of the negative regulator of g protein signaling 16 (rgs16) is rapidly induced in cardiomyocytes by various stimuli. to identify the promoter of the mouse rgs16 gene, a 1.8-kb deoxyribonucleic acid fragment 5' of the rgs16-coding region was subcloned into a firefly-luciferase reporter vector and four overlapping fragments were analyzed. the luciferase production was quantified in neonatal rat cardiac myocytes (nrcm). a 0.6-kb fragment that induced a tenfold increase in luciferase ...200818046543
catastrophic clostridium difficile enteritis in a pelvic pouch patient: report of a case.in recent years, clostridium difficile-associated infection has emerged as an increasingly problematic entity. more virulent strains have been isolated and new manifestations of the infection have been described.200818071831
do fluoroquinolones predispose patients to clostridium difficile associated disease? a review of the evidence.clostridium difficile associated diarrhea (cdad) is an important cause of hospital-acquired diarrhea, and increasingly of community-acquired diarrhea. the occurrence of cdad in the hospitalized patient is associated with increased length of stay, morbidity, mortality, and healthcare costs. exposure to antimicrobials is the single most important predisposing factor for acquiring cdad. the data suggesting that fluoroquinolones are an important risk factor for cdad is becoming stronger. also, diffe ...200818067688
tetracycline resistance gene tet(w) in the pathogenic bacterium clostridium difficile.in this study, the tet(w) gene region of a human clinical isolate of clostridium difficile resistant to tetracycline was characterized. this gene was a new allele showing 99% sequence identity to the gene found in the human strain bifidobacterium longum f8, and it is not transferable by "in vitro" mating experiments.200818070963
clostridium difficile, ethnicity and religion. 200818079020
aldosterone induces superoxide generation via rac1 activation in endothelial cells.currently, aldosterone is believed to be involved in the development of cardiovascular injury as a potential cardiovascular risk hormone. however, its exact cellular mechanisms remain obscure. this study was undertaken to examine the effect of aldosterone on superoxide production in cultured rat aortic endothelial cells with possible involvement of the small gtp-binding (g) protein rac1. the aldosterone levels showed a time-dependent (6-24 h) and dose-dependent (10(-8) to 10(-6) m) increase in s ...200818079208
randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia.to compare a strategy of combination therapy with a strategy of monotherapy with broad-spectrum antibiotics for suspected late ventilator-associated pneumonia.200818091545
active immunization of hamsters against clostridium difficile infection using surface-layer protein.clostridium difficile is the leading cause of infectious antibiotic-associated diarrhoea, particularly among the elderly. its surface-layer protein (slp) was tested as a vaccine component in a series of immunization and challenge experiments with golden syrian hamsters, combined with different systemic and mucosal adjuvants. some regimens were also tested in a nonchallenge balb/c mouse model, enabling closer monitoring of the immune response. none of the regimens conferred complete protection in ...200818093141
fulminant clostridium difficile colitis. 200818094201
prospective, controlled, cross-over trial of alcohol-based hand gel in critical care units .there are limited data from prospective studies to indicate whether improvement in hand hygiene associated with the use of alcohol-based hand hygiene products results in improved patient outcomes.200818171181
case-control study of antibiotic use and subsequent clostridium difficile-associated diarrhea in hospitalized patients.to determine which antibiotics increase or decrease the risk of clostridium difficile-associated diarrhea (cdad).200818171186
update on the changing epidemiology of clostridium difficile-associated disease.in the past, clostridium difficile-associated disease (cdad) was thought of mainly as a nosocomial disease associated with the use of broad-spectrum antibiotics, but its epidemiology seems to be changing. since 2002, outbreaks of severe cdad associated with increased mortality and reduced effectiveness of treatment with metronidazole have focused attention on this challenging pathogen. a fluoroquinolone-resistant strain of c. difficile (bi/nap1/027) has been predominantly associated with these o ...200818174906
comparison of the premier toxin a and b assay and the tox a/b ii assay for diagnosis of clostridium difficile infection.clostridium difficile causes nosocomial diarrhea and is responsible for complications such as pseudomembranous colitis, megacolon, and perforation. using 442 stool specimens, we compared the sensitivities and specificities of the premier toxin a and b (meridian bioscience, inc.) and c. difficile tox a/b ii (techlab, inc., blacksburg, va) immunoassays in the virology department of the kaiser permanente regional reference laboratories. the premier toxin a and b assay demonstrated a higher sensitiv ...200818175802
clinical recognition and diagnosis of clostridium difficile infection.prompt and precise diagnosis is an important aspect of effective management of clostridium difficile infection (cdi). cdi causes 15%-25% of all cases of antibiotic-associated diarrhea, the severity of which ranges from mild diarrhea to fulminant pseudomembranous colitis. several factors, especially advanced age and hospitalization, should be considered in the diagnosis of cdi. in particular, nosocomial diarrhea arising >72 hours after admission among patients receiving antibiotics is highly like ...200818177217
antimicrobial-associated risk factors for clostridium difficile infection.antimicrobial therapy plays a central role in the pathogenesis of clostridium difficile infection (cdi), presumably through disruption of indigenous intestinal microflora, thereby allowing c. difficile to grow and produce toxin. investigations involving animal models and studies performed in vitro suggest that inhibitory activity against c. difficile and differences in the propensity to stimulate toxin production may also influence the likelihood that particular drugs may cause cdi. although nea ...200818177218
treatment of clostridium difficile infection.recent outbreaks of clostridium difficile infection (cdi) in north america have been due to a more virulent, possibly more resistant strain that causes more-severe disease, making prompt recognition of cases and optimal management of infection essential for a successful therapeutic outcome. treatment algorithms are presented to help guide the management of patients with cdi. metronidazole has been recommended as initial therapy since the late 1990s and continues to be the first choice for all bu ...200818177219
historical perspectives on studies of clostridium difficile and c. difficile infection.the initial period of studies on clostridium difficile (published during 1978-1980) appeared to provide a nearly complete portfolio of criteria for diagnosing and treating c. difficile infection (cdi). the putative pathogenic role of c. difficile was established using koch's postulates, risk factors were well-defined, use of a cell cytotoxicity assay as the diagnostic test provided accurate results, and treatment with oral vancomycin was highly effective and rapidly incorporated into practice. d ...200818177220
measures to control and prevent clostridium difficile infection.control of clostridium difficile infection (cdi) outbreaks in health care facilities presents significant challenges to infection control specialists and other health care workers. c. difficile spores survive routine environmental cleaning with detergents and hand hygiene with alcohol-based gels. enhanced cleaning of all potentially contaminated surfaces with 10% sodium hypochlorite reduces the environmental burden of c. difficile, and use of barrier precautions reduces c. difficile transmission ...200818177221
[clostridium difficile infections: an unexpected re-emergence]. 200818178330
is diarrhea enough to assess the severity of clostridium difficile-associated disease? 200818179377
efficacy of sodium hypochlorite-based disinfectants against clostridium difficile spores. 200818179379
clinical indications for probiotics: an overview.probiotic bacteria are used to treat or prevent a broad range of human diseases, conditions, and syndromes. in addition, there are areas of medical use that have been proposed for future probiotic applications. randomized double-blind studies have provided evidence of probiotic effectiveness for the treatment and prevention of acute diarrhea and antibiotic-induced diarrhea, as well as for the prevention of cow milk-induced food allergy in infants and young children. research studies have also pr ...200818181732
clostridium difficile skin contamination in patients with c. difficile-associated disease.in a prospective study of 27 patients with clostridium difficile-associated disease, we found that c. difficile frequently contaminated multiple skin sites, including groin, chest, abdomen, forearms, and hands, and was easily acquired on investigators' hands. skin contamination often persisted on patients' chest and abdomen after resolution of diarrhea.200818181742
clostridium difficile colitis in cystic fibrosis patients with and without lung transplantation.despite a large carriage rate of clostridium difficile among cystic fibrosis (cf) patients, c. difficile-associated disease (cdad) is rather rare. in case of lung transplantation, the incidence and clinical aspects of cdad in this patient population are not well known.200817630999
new advances in the treatment of clostridium difficile infection (cdi).clostridium difficile infections (cdi) have increased in frequency throughout the world. in addition to an increase in frequency, recent cdi epidemics have been linked to a hypervirulent c. difficile strain resulting in greater severity of disease. although most mild to moderate cases of cdi continue to respond to metronidazole or vancomycin, refractory and recurrent cases of cdi may require alternative therapies. this review provides a brief overview of cdi and summarizes studies involving alte ...200819209277
feasibility and tolerability of probiotics for prevention of antibiotic-associated diarrhoea in hospitalized us military veterans.probiotics may be efficacious for the prevention of antibiotic-associated diarrhoea. the tolerability and acceptability of probiotics in an elderly us veteran population has not been assessed.200819138244
[diagnostics and therapy of chronic diarrhea in elderly people]. 200819130728
management of clostridium difficile infection--medical or surgical? 200819110818
physical and chemical factors influencing the germination of clostridium difficile spores.to investigate the influence of chemical and physical factors on the rate and extent of germination of clostridium difficile spores.200819120667
infectious disease. vancomycin should be the drug of choice for severe clostridium difficile-associated diarrhea. 200819107100
clostridium difficile. 200819093359
increased number of clostridium difficile infections and prevalence of clostridium difficile pcr ribotype 001 in southern germany.in recent years, clostridium difficile infection (cdi) has emerged as an increasing problem, both in in- and outpatients. in a rural region of southern germany, the annual number of c. difficile toxin (tcd)-positive patients has increased from 95 to 796 in the period from 2000 to 2007. simultaneously, the proportion of positive tests among all tcd examinations has risen from 7.0% to 12.8%, indicating that the higher number of affected patients was not solely due to an increase in the number of a ...200819081002
a prospective study of risk factors and historical trends in metronidazole failure for clostridium difficile infection.recent studies of clostridium difficile infection (cdi) have indicated a dramatic increase in metronidazole failure. the aims of this study were to compare current and historical rates of metronidazole failure and to identify risk factors for metronidazole failure.200819081526
a randomized, double-blind study comparing clostridium difficile immune whey and metronidazole for recurrent clostridium difficile-associated diarrhoea: efficacy and safety data of a prematurely interrupted trial.a prospective, randomized, double-blind study was designed to compare clostridium difficile immune whey (cdiw) with metronidazole for treatment of laboratory-confirmed, recurrent, mild to moderate episodes of clostridium difficile-associated diarrhoea (cdad). cdiw was manufactured by immunization of cows in their gestation period with inactivated c. difficile vaccine. the resulting colostrum was processed, immunoglubulins were concentrated and the end-product containing high titres of c. diffici ...200819086244
clostridium difficile-associated diarrhea with hematochezia is associated with ulcer formation.clostridium difficile-associated diarrhea (cdad) is a well-known iatrogenic infection with typical endoscopic features including pseudomembranes and intervening normal mucosa. clinically, diarrhea frequently occurs, but occurrence of hematochezia is rare. the objective of this study was to investigate the background and endoscopic features of cdad patients with hematochezia.200819086279
an unusual case of acute abdomen -? is it c. difficile infection. 200819086365
alpha-defensins and clostridium difficile recent growing concerns in inflammatory bowel disease. 200819086982
mucin dynamics in intestinal bacterial infection.bacterial gastroenteritis causes morbidity and mortality in humans worldwide. murine citrobacter rodentium infection is a model for gastroenteritis caused by the human pathogens enteropathogenic escherichia coli and enterohaemorrhagic e. coli. mucin glycoproteins are the main component of the first barrier that bacteria encounter in the intestinal tract.200819088856
could clostridium difficile delay dental treatment for geriatric patients? 200819068062
increase in clostridium difficile-related hospitalizations among infants in the united states, 2000-2005.virulence and mortality of clostridium difficile-associated disease (cdad) are increasing in the united states. infant cdad hospitalization incidence nearly doubled from 2.8 to 5.1 cases per 10,000 hospitalizations between 2000 and 2005. because incidence of hospitalizations with other infectious enteritides has remained essentially stable, this growth in cdad cannot be explained by a gastroenteritis reporting bias.200819068517
clostridium difficile infection in solid organ transplant recipients.to provide a general understanding of clostridium difficile infection with a focus on recent publications that evaluate the disease in solid organ transplant recipients.200819060548
c. difficile: a dangerous threat. 200819065929
measuring the severity of clostridium difficile infection: implications for management and drug development.the appropriate management of clostridium difficile infection (cdi) has become a growing clinical and economic issue, as a new epidemic strain with enhanced virulence is causing increased morbidity and mortality. presently, only two antibiotics (metronidazole and vancomycin) are routinely used to treat cdi. both increasing disease severity and recurrent infections have been an impetus not only to develop new agents, but also to better recognize which patients are at highest risk for treatment fa ...200819053902
pain and palliative care pharmacotherapy literature summaries and analyses.timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. symptoms, interventions, mechanisms of action, and treatment-related adverse events addressed in this issue are: analgesia in the management of the acute abdomen; comparative antibiotic treatment of clostridium difficile; impact of weather on joint pain; treatment of constipation; and, risk of increased mortality with antipsychotics in dementia patients.200819042839
epidemiological features of clostridium difficile-associated disease among inpatients at children's hospitals in the united states, 2001-2006.clostridium difficile is the main cause of nosocomial and antibiotic-associated diarrhea in adults. recently, the incidence and severity of c difficile-associated disease in adults have been increasing. whether similar phenomena are occurring among children remains unknown. our study describes the epidemiological features of c difficile-associated disease in hospitalized children.200819047244
clostridium difficile colitis: a silent epidemic in the united states. 200819047985
[unexpected cause of acute renal failure in an 85-year-old woman].acute postinfectious glomerulonephritis (apign) is usually diagnosed in young people, while in elderly people rapidly progressive forms appear to be the most important glomerular disease causing acute renal failure. we report on a 85-year-old woman with acute renal failure due to apign. an 85-year-old woman with a history of hypertension and cerebrovascular disease was hospitalized because of diarrhea and syncope associated with atrial fibrillation. she was found to have left lower lobe pneumoni ...200819048577
new multiplex pcr method for the detection of clostridium difficile toxin a (tcda) and toxin b (tcdb) and the binary toxin (cdta/cdtb) genes applied to a danish strain collection.isolates of clostridium difficile from 159 hospitalized danish patients (2005) were analysed by a new 5-plex pcr method targeting the toxin genes tcda, tcdb, cdta and cdtb, and 16s rdna as an internal positive control. additionally, the toxin-regulating gene tcdc was partially sequenced by a new sequencing-based method that revealed genetic changes that may render the gene product inactive. finally tcda was analysed using a previously published method for the detection of internal deletions. the ...200819040478
mobility and other predictors of hospitalization for urinary tract infection: a retrospective cohort study.many hospitalizations for residents of skilled nursing facilities are potentially avoidable. factors that could prevent hospitalization for urinary tract infection (uti) were investigated, with focus on patient mobility.200819032784
fairness of financial penalties to improve control of clostridium difficile. 200819022838
[hospital-acquired clostridium difficile-associated diarrhea].clostridium difficile-associated diarrhea (cdad) is common among hospital-acquired bacterial diarrhea, its mortality and morbidity show an increasing trend in recent years. improper antimicrobial drug use is one of the key reasons. adequate hand hygiene of healthcare workers, thorough disinfection of hospital environment, and appropriate isolation of patients are effective measures to prevent the outbreak of hospital-aquired cdad.200819024399
molecular and clinical characteristics of clostridium difficile infection in a university hospital in shanghai, china. 200819025371
prospective multicenter study evaluating fecal calprotectin in adult acute bacterial diarrhea.every year, about 2.2 million deaths occur worldwide due to diarrhea. reliable diagnosis of patients with acute infectious diarrhea remains a formidable challenge to the clinicians. this is the first study reporting use of fecal calprotectin in diagnosing acute diarrhea. the aim was to compare the diagnostic accuracy of fecal calprotectin, fecal lactoferrin, and guaiac-based fecal occult blood test in a diverse group of consecutive patients with acute diarrhea in which routine bacterial stool cu ...200819028207
the success of nhs goals will depend on the professional development of nurses. 200819014125
high diversity of clostridium difficile genotypes isolated from a single poultry farm producing replacement laying hens.clostridium difficile is well established as a pathogen of horses, calves, and pigs, but little is known about its prevalence in poultry. in this study, chicken fecal samples were collected on four occasions from two populations being raised as layer replacements. samples were examined by an enrichment culture method, and 38 of 61 (62.3%) were culture positive. the rate of colonization seemed to be age dependent: 100% of fecal samples from 2-week- old birds were culture positive, and the coloniz ...200819022388
first isolation of clostridium difficile pcr-ribotype 027/toxinotype iii in poland.of 175 clostridium difficile strains isolated from patient hospitalized in one academic hospital in warsaw between 2005-2006, one isolate belonged to pcr-ribotype 027/toxinotype iii. this isolate had tcda, tcdb, binary toxin genes (cdta and cdtb), a 18-bp deletion and a 1 bp deletion at 117 position in the tcdc gene. antimicrobial susceptibility tests revealed high level resistance to erythromycin, moxifloxacin and gatifloxacin. this is a first report of the 027 strain of c. difficile in poland.200819004250
advances in epidemiology and diagnosis of inflammatory bowel diseases.the etiology of chronic inflammatory bowel diseases (ibd) remains unknown. understanding ibd epidemiology helps to identify at-risk individuals, to appreciate the changing demographic profile of ibd, and to interpret theories of ibd pathogenesis. this article reviews recent advances in epidemiology and diagnostics. the importance of clostridium difficile is highlighted. state-of-the-art ibd diagnostic modalities include serology, fecal markers, and advanced radiologic or endoscopic techniques. t ...200819006614
the acquisition and outcome of icu-acquired clostridium difficile infection in a single centre in the uk.the clinical course and outcome of clostridium difficile infection (cdi) in the intensive care unit (icu) setting have been reported in a small number of studies in the us and canada. however, no such study has been reported in the uk. therefore, we aimed to study the acquisition rate and outcome of icu-acquired cdis in our unit.200819013649
laboratory-acquired clostridium difficile polymerase chain reaction ribotype 027: a new risk for laboratory workers? 200818986267
[infections in coloproctology from a microbiologist's view]. 200818988479
[clostridium difficile colitis].the authors present a detailed study of clostridium difficile-induced conditions and desribe their pathogenesis, diagnostics, and treatment. considering the extensive use of antibiotics and increasing numbers of immunocompromized patients, it can be expected that surgeons will face this infection, which was practically unknown a few years ago, more often in future. based on the above facts, the authors consider important to inform the surgical profession about the problematics.200818988483
expression of recombinant clostridium difficile toxin a and b in bacillus megaterium.major clostridium difficile virulence factors are the exotoxins tcda and tcdb. due to the large size and poor stability of the proteins, the active recombinant tcda and tcdb have been difficult to produce.200818990232
constructing a multimedia resource for managing clostridium difficile: feedback on effectiveness. 200818991997
keeping watch over the staphylococcus. 200818952322
revolutionizing the practice of medicine through rapid (< 1h) dna-based diagnostics.twenty years ago, i dreamed of using dna detection for speeding the microbiological identification of microorganisms from two days to less than one hour. this dream is slowly becoming a reality as we were the first to develop and put on the market real-time pcr assays, approved by the united states food and drug administration and health canada, for the detection of several pathogens including group b streptococci, methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococci and ...200818980716
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