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environmental control critical for controlling clostridium difficile infections. 200818606597
in vitro susceptibility of genotypically distinct and clonal clostridium difficile strains to oritavancin.clostridium difficile infection is a nosocomial disease of increasing importance. first-line treatment is limited to metronidazole or vancomycin. oritavancin is a lipoglycopeptide with activity against gram-positive bacteria, including drug-resistant pathogens. mics of oritavancin, metronidazole and vancomycin for genotypically distinct c. difficile strains, including epidemic c. difficile pcr ribotypes 001 and 027, were determined by agar incorporation and broth macrodilution methods. in agar i ...200818606787
safety, tolerance, and pharmacokinetic studies of opt-80 in healthy volunteers following single and multiple oral doses.current therapies for clostridium difficile infection (cdi) are encumbered by treatment failures and recurrences. due to its high in vitro activity against c. difficile but low activity against the typical intestinal flora, minimal absorption, and durable cure in the hamster model of c. difficile infection, opt-80 was considered for clinical development as a therapy for cdi. this trial consisted of two phases. four single oral doses of opt-80 (100, 200, 300, and 450 mg) were administered in a cr ...200818268081
early surgical intervention for fulminant pseudomembranous colitis.the objective of this study of a retrospective case series was to determine factors associated with survival after surgical intervention in pseudomembranous colitis (pmc). the study was conducted at a tertiary care medical center and comprised 36 patients who underwent colectomy for fulminant pmc from 1995 to 2006. patients including 21 females ranged from 40 to 89 years of age (mean, 70 years). comorbidities included diabetes (39%), cardiovascular disease (77%), chronic obstructive pulmonary di ...200818274423
defining surgical therapy for pseudomembranous colitis with toxic megacolon.pseudomembranous colitis has increased in incidence and severity over the past 10 years. toxic megacolon is a rare but reported presentation of severe pseudomembranous colitis. this article reviews the reported cases of clostridium difficile with toxic megacolon in the literature and introduces an additional case that underscores the importance of early diagnosis in guiding appropriate therapy.200818277885
bench-to-bedside review: clostridium difficile colitis.in recent years, the incidence and severity of clostridium difficile-associated disease (cdad) have increased dramatically. beginning in 2000, widespread regional outbreaks associated with a previously uncommon hypervirulent strain of c. difficile have occurred in north america and europe. most likely because of increased toxin production as well as other virulence factors, this epidemic strain has caused more severe and refractory disease leading to complications, including intensive care unit ...200818279531
predictors of mortality after colectomy for fulminant clostridium difficile colitis.to present, to our knowledge, the largest experience with colectomy for fulminant clostridium difficile colitis and to propose factors significant in predicting mortality.200818283139
clostridium difficile infection: emerging concepts and treatments.clostridium difficile infection has become one of the most common causes of diarrhea in patients frequenting hospitals, skilled nursing facilities, and physicians' offices. although the pathogenesis and clinical description were well elucidated three decades ago, cure during the initial episode now occurs in fewer than two thirds of patients exhibiting clinical illness. the past decade has brought a new strain with more toxin. frequent relapses in elderly patients are now the norm rather than a ...200818627654
clostridium difficile infection and inflammatory bowel disease: a marker for disease extent? 200818628389
collateral damage. the rise of resistant c. difficile. 200818635789
riboswitches in eubacteria sense the second messenger cyclic di-gmp.cyclic di-guanosine monophosphate (di-gmp) is a circular rna dinucleotide that functions as a second messenger in diverse species of bacteria to trigger wide-ranging physiological changes, including cell differentiation, conversion between motile and biofilm lifestyles, and virulence gene expression. however, the mechanisms by which cyclic di-gmp regulates gene expression have remained a mystery. we found that cyclic di-gmp in many bacterial species is sensed by a riboswitch class in messenger r ...200818635805
impact of hydrogen peroxide vapor room decontamination on clostridium difficile environmental contamination and transmission in a healthcare setting.to determine whether hydrogen peroxide vapor (hpv) decontamination can reduce environmental contamination with and nosocomial transmission of clostridium difficile.200818636950
peripartum clostridium difficile infection: case series and review of the literature.clostridium difficile infection (cdi) in nonhospitalized patients has been reported with increased frequency. an association between cdi and pregnancy has not been stressed. this review will report 4 cases of peripartum cdi with characterization of the infecting strain and a literature review. a pubmed search identified 24 recorded cases of peripartum cdi; information was available for 14 cases. most patients (91%) received prophylactic antibiotics during delivery or for treatment of bacterial i ...200818639213
continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in the postoperative period of major heart surgery.aspiration of endotracheal secretions is a major step in the prevention of ventilator-associated pneumonia (vap). we compared conventional and continuous aspiration of subglottic secretions (cass) procedures in ventilated patients after major heart surgery (mhs).200818641114
use of a rifaximin "chaser" in the treatment of recurrent clostridium difficile-associated diarrhea. 200818641597
rising economic impact of clostridium difficile-associated disease in adult hospitalized patient population.clostridium difficile-associated disease (cdad) is responsible for increased morbidity and a substantial economic burden. incidences of cdad, including those with a severe course of illness, have been increasing rapidly.200818643746
commentary: preventing clostridium difficile-associated disease: is it time to pay the piper? 200818643747
metronidazole resistance in clostridium difficile is heterogeneous.at our institution, the prevalence of clinical isolates of clostridium difficile with resistance to metronidazole is 6.3%. we observed that initial metronidazole mics of 16 to 64 mg/liter against toxigenic, primary fresh c. difficile isolates, as determined by agar dilution, decreased to 0.125 mg/liter after the isolates were thawed. in this study, we examined the possibility of heterogeneous or inducible resistance. totals of 14 metronidazole-resistant and 10 metronidazole-susceptible clinical ...200818650353
characterization of clostridium difficile strains isolated from patients in ontario, canada, from 2004 to 2006.clostridium difficile is the bacterium most commonly surmised to cause antimicrobial- and hospital-associated diarrhea in developed countries worldwide, and such infections are thought to be increasing in frequency and severity. a laboratory-based study was carried out to characterize c. difficile strains isolated from persons in ontario, canada, during 2004 to 2006 according to toxin type (enterotoxin a, cytotoxin b, and binary toxin [cdt]), tcdc gene characterization, ribotyping, pulsed-field ...200818650360
estimation of faecal carriage of clostridium difficile in patients with ulcerative colitis using real time polymerase chain reaction.ulcerative colitis (uc) is a disease of unknown aetiology in which exacerbations are sometimes linked to intestinal colonization by toxin-producing clostridium difficile. we undertook this study to detect and quantitatively assess c. difficile in the stool of patients with uc using real time polymerase chain reaction (rt-pcr), and to compare it with healthy individuals.200818653911
proceedings from the 2nd international clostridium difficile symposium, maribor, slovenia, june 2007. 200818655255
can the superbugs ever be beaten?"cluttered, dirty and overcrowded" wards, "sloppy hygiene" practices among nurses and clinicians, including use of commodes and bedpans that had already been "condemned", and board and management-level failure to respond to repeated requests for more nursing staff, were among the major contributors to the 90 elderly patient clostridium difficile deaths at three large west kent nhs hospitals between april 2004 and september 2006, a recent bbc 1 panorama programme suggested. health estate journal ...200818655658
cdc42 protein acts upstream of iqgap1 and regulates cytokinesis in mouse oocytes and embryos.cdc42 and rac1 rho family gtpases, and their interacting protein iqgap1 are the key regulators of cell polarity. we examined the role of cdc42 and iqgap1 in establishing the polarity of mouse oocyte and regulation of meiotic and mitotic divisions. we showed that cdc42 was localized on the microtubules of meiotic and mitotic spindle and in the cortex of mouse oocytes and cleaving embryos. iqgap1 was present in the cytoplasm and cortex of growing and fully-grown oocytes. during maturation it disap ...200818662680
tolevamer, an orally administered, toxin-binding polymer for clostridium difficile-associated diarrhea.genzyme corp is developing tolevamer, an anionic toxin-binding polymer that binds and neutralizes the clostridium difficile a and b toxins, for the potential treatment of c difficile-associated diarrhea (cdad). two phase iii clinical trials of tolevamer in patients with cdad have been completed and results from the second trial are expected to be released imminently.200818666039
univariate and multivariate analysis of risk factors for severe clostridium difficile-associated diarrhoea: importance of co-morbidity and serum c-reactive protein.to investigate risk factors for severe clostridium difficile associated diarrhoea (cdad) in hospitalised patients.200818666322
germination of spores of clostridium difficile strains, including isolates from a hospital outbreak of clostridium difficile-associated disease (cdad).clostridium difficile is an emerging nosocomial pathogen and one of the major causes of antibiotic-associated diarrhoea. cases of clostridium difficile-associated disease (cdad) are likely initiated by the ingestion of dormant c. difficile spores, which then germinate, outgrow and rapidly proliferate to cause gastrointestinal (gi) infections. to understand the initial stages of cdad pathogenesis, we have characterized the germination of spores from a collection of c. difficile strains, including ...200818667557
application of isothermal helicase-dependent amplification with a disposable detection device in a simple sensitive stool test for toxigenic clostridium difficile.enzyme immunoassays (eias) are commonly used for the diagnosis of cases of clostridium difficile-associated diarrhea (cdad). however, these eias have high false-negative rates, even in patients with severe clinical disease. we have developed an isoamp cdad test using a simple and user-friendly procedure to identify toxigenic c. difficile in feces. after dna extraction from fecal samples, both the conserved sequence of the 5'-end fragment of the c. difficile tcda toxin gene and competitive amplif ...200818669881
epidemiology of clostridium species bacteremia in calgary, canada, 2000-2006.to define the incidence, risk factors for acquisition, and outcomes associated with clostridial bacteremia in a large canadian health region.200818672296
how to cut clostridium difficile infection.this article provides an update on clostridium difficile and highlights the appropriate infection-control measures that need to be in place to reduce the infection.200818672843
high levels of resistance to fluoroquinolones among clostridium difficile isolates in a spanish hospital. 200818680418
assessment of reporting bias for clostridium difficile hospitalizations, united states. 200818680680
rates of clostridium difficile infection in patients discharged from spanish hospitals, 1997-2005.we analyzed the spanish hospital discharges registered from 1997 to 2005 with patient diagnoses of "intestinal infection due to clostridium difficile." the mean annual incidence rate was 41.2 diagnoses per 100,000 discharges. a significant increase was found from 1997 to 2005 (slope of the regression line [b], 5.12; p < .001). overall rates were 2.5 times as high in the group of patients aged at least 65 years as in the group aged 45-64 years.200818681812
[results of the application of a prevention protocol for clostridium difficile infection in an acute geriatric unit]. 200818682125
smart approaches for reducing nosocomial infections in the icu.nosocomial infections are problematic in the icu because of their frequency, morbidity, and mortality. the most common icu infections are pneumonia, bloodstream infection, and urinary tract infection, most of which are device related. surgical site infection is common in surgical icus, and clostridium difficile-associated diarrhea is occurring with increasing frequency. prospective observational studies confirm that use of evidence-based guidelines can reduce the rate of these icu infections, es ...200818682466
european centre warns of need for better surveillance of c difficile. 200818682480
aurintricarboxylic acid upregulates the thrombomodulin expression of endothelial cells and peripheral blood monocytes.thrombomodulin has a central role in the regulation of coagulation through its ability to promote generation of the potent anticoagulant, activated protein c. aurintricarboxylic acid (ata) has been reported to inhibit platelet function by blocking von willebrand factor binding to platelet glycoprotein ib and to impede thrombosis development in vivo. in the present study, we demonstrated a novel antithrombotic effect of ata. the surface thrombomodulin expression of endothelial cells and periphera ...200818685431
clostridium difficile infection in critically injured trauma patients.clostridium difficile infection (cdi) is an increasing problem worldwide. to our knowledge, there are no studies evaluating specifically the incidence of cdi in the critically injured trauma population.200818687049
emphysematous cholecystitis: a case report.abstract: a 65-year-old greek man with a history of diabetes mellitus and hypertension was admitted because of right upper quadrant pain, nausea and palpable right quadrant mass. on admission the patient was febrile (38.8 degrees c) with a total bilirubin level of 1.99 mg/dl (direct 0.59 mg/dl); sgot 1.26 mg/dl; na 135 mmol/l and k 2.9 mmol/l. the white blood count was 15200/mul with 92.2% neutrophiles. axial sections of single slice ct imaging (section thickness 10 mm), revealed emphysematous c ...200818687128
[acute infectious diarrhea in adults].acute infectious diarrhoea are common and usually self-limited but their management is often inadequate due to over-prescriptions of stool cultures and antibiotics. from a clinical point of view, the most important point is to promptly identify presentations at risk of complications (severe dehydration, septic shock, surgical complications) such as elderly patients, co-morbidity, diabetes, renal or heart deficiency, immune deficiency...). when the epidemiological context is suggestive, physician ...200818689113
[antibiotic-associated diarrhea].most of the cases of antibiotic-associated diarrhea are benign, self-limited and presumably related to functional consequences of the alteration of gut microflora. in few cases, changes in the gut flora ecosystem allow pathogens to proliferate. clostridium difficile is responsible for approximately 10% of the cases of antibiotic-associated diarrhea in the community, most of the cases of antibiotic-associated colitis, and almost all the cases of pseudomembranous colitis. according to anatomoclini ...200818689117
clostridium difficile in adult patients with nosocomial diarrhea in a costa rican hospital.stool samples from 104 adult patients with nosocomial antibiotic-associated diarrhea were analyzed for clostridium difficile by cultivation, toxin a inmunoenzymatic detection, and toxin b cytotoxic detection. the isolates were additionally screened for the toxin genes by polymerase chain reaction. c. difficile was isolated from 26 samples, and the toxins were directly detected in another 5 samples. toxin a and b genes were detected in all toxigenic bacterial isolates. the detection rate of 30% i ...200818689617
amebic colitis in an antigenically and serologically negative patient: usefulness of a small-subunit ribosomal rna gene-based polymerase chain reaction in diagnosis.specific identification of entamoeba histolytica in clinical specimens is an essential confirmatory diagnostic step in the management of amebiasis. here, we report an unusual case of amebic colitis in a 20-year-old female immigrant from south china. the patient had experienced diarrhea, crampy abdominal pain, and fever for approximately 3 weeks prior to admission to hospital and had treated herself at home with metronidazole. on admission, stool microscopy and serology for e. histolytica were ne ...200818691843
[rectal prolapse in a 3-year-8-month-old child].starting from a recent clinical case, we present the different causes of rectal prolapse and their specific treatments. in this case, the relation to infectious colitis was questionable.200818693092
emergence of reduced susceptibility to metronidazole in clostridium difficile.antimicrobial treatment for clostridium difficile infection (cdi) has typically been metronidazole, although reports have questioned the efficacy of this option. we screened recently isolated c. difficile (2005-06) for susceptibility to metronidazole and compared results for historic isolates (1995-2001).200818693234
orally administered beta-lactamase enzymes represent a novel strategy to prevent colonization by clostridium difficile.antibiotics that are excreted into the intestinal tract and that disrupt the indigenous microbiota may promote infection by clostridium difficile. we previously demonstrated that oral administration of a proteolysis-resistant, recombinant class a beta-lactamase inactivates ampicillin or piperacillin excreted into the small intestine during parenteral treatment. we hypothesized that oral administration of this beta-lactamase in conjunction with parenteral ampicillin or piperacillin would preserve ...200818693236
inappropriate use of loperamide worsens clostridium difficile-associated diarrhoea. 200818694612
activity of a dry mist hydrogen peroxide system against environmental clostridium difficile contamination in elderly care wards.clostridium difficile causes serious healthcare-associated infections. infection control is difficult, due in part to environmental contamination with c. difficile spores. these spores are relatively resistant to cleaning and disinfection. the activity of a dry mist hydrogen peroxide decontamination system (sterinis) against environmental c. difficile contamination was assessed in three elderly care wards. initial sampling for c. difficile was performed in 16 rooms across a variety of wards and ...200818694613
gastric acid suppression by proton pump inhibitors as a risk factor for clostridium difficile-associated diarrhea in hospitalized patients.evidence for the association between clostridium difficile (c. difficile) and the use of proton pump inhibitor (ppi) is unclear. this study investigated the relationship between clostridium difficile-associated diarrhea (cdad) and exposure to acid suppressive therapy in hospitalized adult patients while controlling for the most common predisposing risk factors.200818702653
combination therapy with direct hemoperfusion using polymyxin b-immobilized fiber and oral vancomycin improves fulminant pseudomembranous colitis by reducing the elevated endogenous cannabinoids and inflammatory cytokines: report of a case.this paper reports a case of fulminant pseudo-membranous colitis which did not lead to septic shock. the case was improved by combination therapy with direct hemoperfusion using polymyxin b-immobilized fiber and oral vancomycin. direct hemoperfusion using polymyxin b-immobilized fiber has been demonstrated to have excellent therapeutic effects for the treatment of septic shock by removing circulating lipopolysaccharide. in the present case, the combination therapy dramatically improved clinical ...200818705306
benefit-risk assessment of linezolid for serious gram-positive bacterial infections.linezolid is an oxazolidinone, a new class of antibacterial with a unique mechanism of action, namely inhibition of the formation of a functional 70s initiation complex in the 50s bacterial ribosomal subunit. linezolid is highly active against multidrug-resistant gram-positive cocci, including meticillin-resistant staphylococcus aureus (mrsa), vancomycin-intermediate and vancomycin-resistant s. aureus, and vancomycin-resistant enterococci; its spectrum of activity also includes some anaerobic ba ...200818707190
molecular characterization of a clostridium difficile bacteriophage and its cloned biologically active endolysin.clostridium difficile infection is increasing in both frequency and severity, with the emergence of new highly virulent strains highlighting the need for more rapid and effective methods of control. here, we show that bacteriophage endolysin can be used to inhibit and kill c. difficile. the genome sequence of a novel bacteriophage that is active against c. difficile was determined, and the bacteriophage endolysin gene was subcloned and expressed in escherichia coli. the partially purified endoly ...200818708505
infection control and prevention in perioperative practice.the personal and financial consequences of avoidable infection are enormous in personal and global terms (dh 2003, stone, larson & kawar 2002). patients expect to be treated and cared for in clean conditions, and not be exposed to the risks of acquiring an infection by poor practice on the part of healthcare workers (dh 2005, health care commission 2005). infection control and prevention in perioperative settings assumes an even greater significance because of the vulnerability of patients who a ...200818710124
[clostridium difficile-associated diarrhea threatens the patient safety!]. 200818710154
an elderly woman with 'red man syndrome' in association with oral vancomycin therapy: a case report.abstract:200818710566
essential role of toxin a in c. difficile 027 and reference strain supernatant-mediated disruption of caco-2 intestinal epithelial barrier function.clostridium difficile induces mucosal inflammation via secreted toxins a and b and initial interactions between the toxins and intestinal epithelial cells (which lead to loss of barrier function) are believed to be important in disease pathogenesis. secreted toxin-specific antibodies may inhibit such interactions. using the caco-2 epithelial cell line, we have investigated the use of an anti-toxin a monoclonal antibody (ataa) in providing protection against toxin a-mediated disruption of epithel ...200818505424
comparative genomic analysis of the gut bacterium bifidobacterium longum reveals loci susceptible to deletion during pure culture growth.bifidobacteria are frequently proposed to be associated with good intestinal health primarily because of their overriding dominance in the feces of breast fed infants. however, clinical feeding studies with exogenous bifidobacteria show they don't remain in the intestine, suggesting they may lose competitive fitness when grown outside the gut.200818505588
inhibition of the glucosyltransferase activity of clostridial rho/ras-glucosylating toxins by castanospermine.castanospermine was identified as an inhibitor of the rho/ras-glucosylating clostridium sordellii lethal toxin and clostridium difficile toxin b. microinjection of castanospermine into embryonic bovine lung cells prevented the cytotoxic effects of toxins. the crystal structure of the glucosyltransferase domain of c. sordellii lethal toxin in complex with castanospermine, udp and a calcium ion was solved at a resolution of 2.3a. the inhibitor binds in a conformation that brings its four hydroxyl ...200818505687
absence of gastrointestinal infections in a cohort of patients with zollinger-ellison syndrome and other acid hypersecretors receiving long-term acid suppression with lansoprazole.the relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial.200818507843
increase in adult clostridium difficile-related hospitalizations and case-fatality rate, united states, 2000-2005.virulence of and deaths from clostridium difficile-associated disease (cdad) are on the rise in the united states. the incidence of adult cdad hospitalizations doubled from 5.5 cases per 10,000 population in 2000 to 11.2 in 2005, and the cdad-related age-adjusted case-fatality rate rose from 1.2% in 2000 to 2.2% in 2004.200818507904
functional properties of the carboxy-terminal host cell-binding domains of the two toxins, tcda and tcdb, expressed by clostridium difficile.the biological and ligand-binding properties of recombinant c-terminal cell-binding domains (cbds) and subdomains of the two large exotoxins, toxin a (tcda) and toxin b (tcdb) expressed by clostridium difficile were examined in the hemagglutination and verocytotoxicity neutralization assays and by qualitative affinity chromatography using sepharose-linked alpha gal(1,3)betagal(1,4)beta glc as well as the direct electrospray ionization mass spectrometry (es-ms) assay. these studies revealed that, ...200818509107
clinical microbiology and infectious diseases (eccmid)--18th european congress. new antimicrobial agents: selected poster presentations. 200818509778
clinical microbiology and infectious diseases (eccmid)--18th european congress. drug resistance among gram-negative and gram-positive bacteria. 200818509779
diagnostic value of five commercial tests for the rapid diagnosis of clostridium difficile-associated disease.we compared five commercial immunoassays (biostar oia cdtox ab, immunocard toxins a&b - meridian, xpect c. difficile toxin a/b -remel, c. difficile toxin a test- oxoid, and tox a/b quik chek- techlab) which allow a rapid diagnosis of c. difficile associated disease. the tests were performed directly on patient's stool specimen submitted for routine investigation of c. difficile infection from two university hospitals in brussels. the cell cytotoxicity assay was considered as the gold standard. o ...200818510038
clostridium difficile infection: a critical overview.clostridium difficile is a gram-positive, spore-forming, toxin-producing anaerobic bacillus identified as the causal agent of a variety of manifestations typically isolated to the colon, but in its severe form, it can lead to sepsis and death. c. difficile infection due to a toxin gene variant strain (bi/nap1) has been identified at the center of outbreaks and has resulted in increased mortality. many questions remain as to how this strain appeared so quickly and has harmed or killed so many pat ...200818510876
different ribotypes in community-acquired clostridium difficile. 200818511151
molecular analysis of the digestive microbiota in a gnotobiotic mouse model during antibiotic treatment: influence of saccharomyces boulardii.the probiotic saccharomyces boulardii is a non-pathogenic yeast that has been proven efficient in the prevention of antimicrobial-associated diarrhea and of clostridium difficile associated colitis. we evaluated the influence of the administration of s. boulardii on the composition of the fecal microbiota in a human microbiota-associated mouse model. this evaluation was run before, during and after a 7-day oral treatment with amoxicillin clavulanic acid. predominant groups of bacteria were quant ...200818511310
report names hospitals with highest proportions of deaths related to mrsa and c difficile. 200818511792
a national survey of the prevalence and impact of clostridium difficile infection among hospitalized inflammatory bowel disease patients.we sought to determine nationwide, population-based trends in rates of clostridium difficile (c. difficile) infection among hospitalized inflammatory bowel disease (ibd) patients in the united states, and to determine its mortality and economic impact.200818513271
effect of telephoned notification of positive clostridium difficile test results on the time to the ordering of antimicrobial therapy.the time between electronic-medical-record reporting of a positive result of a test for clostridium difficile toxin in stool and the ordering of antimicrobial therapy was compared during consecutive periods when results were not telephoned (n = 274) and when results were telephoned (n = 90) to the clinical service. the mean times to the ordering of antimicrobial therapy were 11.9 and 3.6 hours, respectively (p < .001).200818518668
outcome of colectomy for clostridium difficile colitis: a plea for early surgical management.fulminant clostridium difficile colitis is a common nosocomial infection that occurs with increasing frequency.200818519126
probiotics for children with diarrhea: an update.this review focuses on the efficacy of probiotics for diarrhea in children in different settings: day-care centers, diarrhea acquired in the hospital, antibiotic-associated diarrhea, and treatment of acute infectious diarrhea. for prevention of diarrhea acquired in day-care centers, 5 randomized and placebo-controlled trials have been published. probiotics tested were lactobacillus gg, bifidobacterium lactis (alone or in combination with streptococcus thermophilus), and lactobacillus reuteri. th ...200818520336
clostridium difficile enteritis following total colectomy. 200818524025
clostridium difficile infection after total joint arthroplasty: who is at risk?clostridium difficile-associated diarrhea is a recognized postoperative complication. however, the exact risk factors for this condition after total joint arthroplasty (tja) remain unknown. this case-controlled study intended to identify the predisposing factors for this condition. there were 16 cases of c difficile infections after 9880 tja (0.16% incidence) between january 2001 and may 2006 at our institution. the cases were matched with 32 controls for month/year of surgery and surgeon. this ...200818534454
antimicrobial efficacy of copper surfaces against spores and vegetative cells of clostridium difficile: the germination theory.persistent contamination of surfaces by spores of clostridium difficile is a major factor influencing the spread of c. difficile-associated diarrhoea (cdad) in the clinical setting. in recent years, the antimicrobial efficacy of metal surfaces has been investigated against microorganisms including methicillin-resistant staphylococcus aureus. this study compared the survival of c. difficile on stainless steel, a metal contact surface widely used in hospitals, and copper surfaces.200818544601
role of probiotics in antibiotic-associated diarrhea, clostridium difficile-associated diarrhea, and recurrent clostridium difficile-associated diarrhea.the role of probiotics in the prevention and treatment of antibiotic-associated diarrhea, clostridium difficile diarrhea, and recurrent c. difficile diarrhea is reviewed. various probiotics have variable efficacy. more studies are needed to define further their efficacies, roles, and indications.200818545161
hospital infection society prevalence survey of healthcare associated infection 2006: comparison of results between northern ireland and the republic of ireland.as part of the third healthcare associated infection (hcai) prevalence survey of the united kingdom and ireland, hcai point prevalence surveys were carried out in northern ireland (ni) and the republic of ireland (roi). here we explore the potential benefits of comparing results from two countries with different healthcare systems, which employed similar methodologies and identical hcai definitions. forty-four acute adult hospitals in the roi and 15 in ni participated with a total of 11 185 pati ...200818547678
intra-abdominal vagal blocking (vbloc therapy): clinical results with a new implantable medical device.a new medical device uses high-frequency electrical algorithms to create intermittent vagal blocking (vbloc therapy). the aim is to assess the effects of vagal blocking on excess weight loss (ewl), safety, dietary intake, and vagal function.200818549888
four country healthcare associated infection prevalence survey 2006: overview of the results.a survey of adult patients was conducted in february 2006 to may 2006 in acute hospitals across england, wales, northern ireland and the republic of ireland to estimate the prevalence of healthcare-associated infections (hcais). a total of 75 694 patients were surveyed; 5743 of these had hcais, giving a prevalence of 7.59% (95% confidence interval: 7.40-7.78). hcai prevalence in england was 8.19%, in wales 6.35%, in northern ireland 5.43% and in the republic of ireland 4.89%. the most common hca ...200818550218
toxigenic and non-toxigenic clostridium difficile: determinants of intestinal colonisation and role in childhood atopic manifestations. 200818559395
rifampin and rifaximin resistance in clinical isolates of clostridium difficile.rifaximin, a poorly absorbed rifamycin derivative, is a promising alternative for the treatment of clostridium difficile infections. resistance to this agent has been reported, but no commercial test for rifaximin resistance exists and the molecular basis of this resistance has not been previously studied in c. difficile. to evaluate whether the rifampin etest would be a suitable substitute for rifaximin susceptibility testing in the clinical setting, we analyzed the in vitro rifaximin susceptib ...200818559647
ontario's hospitals surpass those of quebec in c. difficile rates. 200818559796
epidemiology of clostridium difficile-associated disease at university hospital basel including molecular characterisation of the isolates 2006-2007.a prospective study was conducted during a one-year period between 2006 and 2007 to describe the epidemiology of clostridium difficile-associated disease (cdad) at university hospital basel, switzerland (uhbs) and to determine phenotypic and genotypic features of c. difficile strains isolated at the microbiology laboratory uhbs including strains from regional non-university hospitals. we prospectively identified 78 cdad cases at uhbs with an incidence of 2.65/1,000 hospitalised patients or 2.3/1 ...200818560909
clostridium difficile cell-surface polysaccharides composed of pentaglycosyl and hexaglycosyl phosphate repeating units.clostridium difficile is a gram-positive bacterium that is known to be a cause of enteric diseases in humans. it is the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis. recently, large outbreaks of c. difficile-associated diarrhea have been reported internationally, and there have been reports of increases in severe disease, mortality and relapse rates. at the moment, there is no vaccine against c. difficile, and the medical prevention of c. difficile infection is mo ...200818237724
clostridium difficile-associated disease: diagnosis, prevention, treatment, and nursing care. 200818238935
evaluation of clostridium difficile-associated diarrhea with a drug formulary change in preferred fluoroquinolones.recent publications report that gatifloxacin might be associated with a greater incidence of clostridium difficile-associated diarrhea (c. difficile, cdad) than are other fluoroquinolones. we performed a drug use evaluation to examine this issue after adding gatifloxacin to the formulary and changing from levofloxacin to gatifloxacin as the preferred oral fluoroquinolone in 10 department of veterans affairs (va) medical centers in the northeastern united states.200818240880
assessment of clostridium difficile-associated disease surveillance definitions, north carolina, 2005.to determine the timing of community-onset clostridium difficile-associated disease (cdad) relative to the patient's last healthcare facility discharge, the association of postdischarge cases with healthcare facility-onset cases, and the influence of postdischarge cases on overall rates and interhospital comparison of rates of cdad.200818241032
simulated-use testing of bedpan and urinal washer disinfectors: evaluation of clostridium difficile spore survival and cleaning efficacy.reusable bedpans and urinals are frequently cleaned and decontaminated using washer-disinfectors (wds) that may be located in the central processing department (cpd) or on the ward. the objective of this study was to determine how efficiently the wds provided cleaning and to evaluate the ability of such wds to kill clostridium difficile spores.200818241730
primary prophylaxis of sbp. 200818242238
regulation of dopamine-induced na+ current response by small g-protein rhob or c and phospholipase d in aplysia neurons.a family of gtp-binding proteins, rho, plays critical roles in cell migration, morphological change, cytokinesis, and smooth muscle contraction. furthermore, evidence has recently been accumulating for an involvement in regulation of receptor-operated ionic channels. we previously reported that stimulation of d1-like receptor by dopamine (da) induces a slow na+ current response in the identified neurons of aplysia under voltage-clamp. to further study a regulatory mechanism of the da-induced res ...200818242417
thiosemicarbazones active against clostridium difficile.a set of closely related furylidene thiosemicarbazones was prepared and screened against various clinically important gram-positive bacteria. one compound containing an ethylene spacer and a 5-nitrofuryl group was found to have promising activity against clostridium difficile.200818243694
bile salts and glycine as cogerminants for clostridium difficile spores.spore formation by clostridium difficile is a significant obstacle to overcoming hospital-acquired c. difficile-associated disease. spores are resistant to heat, radiation, chemicals, and antibiotics, making a contaminated environment difficult to clean. to cause disease, however, spores must germinate and grow out as vegetative cells. the germination of c. difficile spores has not been examined in detail. in an effort to understand the germination of c. difficile spores, we characterized the re ...200818245298
simultaneous control of norovirus and clostridium difficile outbreaks due to enhanced infection prevention and control measures. 200818192079
prognosis in clostridium difficile infection complicating inflammatory bowel disease. 200818192450
recent advances in clostridium difficile-associated disease.the main purpose of this article is to review recent developments in the management of acute and recurrent clostridium difficile-associated disease, with consideration of existing and new antibiotic and non-antibiotic agents for treatment. details of the current developmental stage of new agents are provided and the role of surgery in the management of severe disease is discussed. infection control measures considered comprise prudent use of antimicrobials, prevention of cross-infection and surv ...200818252748
probiotics for treatment of clostridium difficile-associated colitis in adults.probiotics are live microorganisms consisting of non-pathogenic yeast and bacteria that are believed to restore the microbial balance of the gastrointestinal tract altered by infection with clostridium difficile (c. difficile).200818254055
is a two-step glutamate dehyrogenase antigen-cytotoxicity neutralization assay algorithm superior to the premier toxin a and b enzyme immunoassay for laboratory detection of clostridium difficile?a two-step algorithm for the detection of clostridium difficile by the use of c. diff quik chek (techlab, blacksburg, va) and a tissue culture cytotoxicity neutralization assay was found to be more sensitive than the widely used solid-phase enzyme immunoassay (eia), the premier toxin a and b eia (meridian bioscience, cincinnati, oh), and a newly developed, rapid single-test eia for c. difficile toxins a and b (tox a/b quik chek; techlab).200818256226
physical characterization of clostridium difficile toxins and toxoids: effect of the formaldehyde crosslinking on thermal stability.nosocomial diarrhea and pseudomembranous colitis causing toxins a and b from clostridium difficile were studied at ph 5-8 and over the temperature range of 10-85 degrees c. the proteins were crosslinked with formaldehyde to inactivate them to toxoid forms and permit their use as vaccines. structural changes and aggregation behavior were monitored with circular dichroism, intrinsic and extrinsic (ans) fluorescence spectroscopy, turbidity measurements, high-resolution uv absorbance spectroscopy an ...200818257030
c. difficile rates in hospital higher than expected. 200819227581
[the frequency of clostridium difficile toxin in neutropenic and non-neutropenic patients with antibiotic-associated diarrhea and analysis of the risk factors].this study was carried out in order to investigate the frequency of clostridium difficile toxin in the stool samples of hospitalized 74 neutropenic (mean age: 41.78 +/- 14.3 years; 40 male) and 75 non-neutropenic patients (mean age: 44.09 +/- 15.6 years; 30 male) who developed antibiotic-associated diarrhea between january 2003-september 2004 in a university hospital and also to analyze the related risk factors. c. difficile toxin a and toxin a/b were searched by immunochromatographic method (to ...200819149078
[clinical importance of clostridium difficile finding in hospitalized patients].clostridium difficile infections predominatelly occur among hospitalized patients. the aim of this study was to evaluate the importance of finding the isolate of clostridium difficile cultured from the stool of hospitalized patients.200819368285
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