Publications

TitleAbstractYear(sorted descending)
Filter
PMID
Filter
prediction of specific pathogens in patients with sepsis: evaluation of treat, a computerized decision support system.prediction of bacterial infections and their pathogens allows for early, directed investigation and treatment. we assessed the ability of treat, a computerized decision support system, to predict specific pathogens.200717449883
self-cutting to kill: new insights into the processing of clostridium difficile toxins.clostridium difficile toxins a and b are the major cause of antibiotic-associated diarrhea and pseudomembranous colitis. the toxins are one of the biggest protein toxins known, but only the n-terminal catalytic domains of the large proteins enter the cytosol. now, a new study shows that the toxins are processed by autocatalytic cleavage, which depends on the presence of inositol hexaphosphate.200717455899
a prospective, case control study evaluating the association between clostridium difficile toxins in the colon of neonatal swine and gross and microscopic lesions.clostridium difficile infection in swine has most often been described in suckling pigs, where it has been associated with mesocolonic edema and typhlocolitis. this prospective study was designed to assess the correlation between the presence of c. difficile toxins (tcd) in the colon contents of neonatal pigs and a number of parameters, including gross evidence of diarrhea, mesocoloninc edema, typhlitis, and colitis. c. difficile was isolated from 51% (66/129) of large intestines and tcd was det ...200717459832
clostridium difficile-associated diarrhea after living donor liver transplantation.to assess the incidence and analyze the risk factors for clostridium difficile-associated diarrhea (cdad) after living donor liver transplantation (ldlt) in adult.200717465450
no evidence for a clear link between active intestinal inflammation and autism based on analyses of faecal calprotectin and rectal nitric oxide.due to parental concern regarding the child's bowel habits and the ongoing discussion whether there might be an association between autism and intestinal inflammation, two inflammatory markers were analysed in a group of children with autism.200717465982
clostridium difficile small-bowel enteritis after total proctocolectomy: a rare but fatal, easily missed diagnosis. report of a case.clostridium difficile enteritis is a rare infection, with less than a dozen cases reported in the literature. we present a case of a patient with total proctocolectomy and ileostomy, developing clostridium difficile infection of small bowel. we discuss the role of clostridium difficile toxins and review previously reported cases of clostridium difficile enteritis after total colectomy.200717468989
natural and experimental infection of neonatal calves with clostridium difficile.clostridium difficile toxins were associated with calf diarrhea in a recent retrospective study; however, no causal relationship has been prospectively investigated. this infection study tested whether the oral inoculation of neonatal calves with a toxigenic strain of c. difficile (pcr-ribotype 077) results in enteric disease. fourteen 6-24 h old male colostrums-fed holstein calves, received either three doses of c. difficile (1.4 x 10(8) +/- 3.5 x 10(8) cfu) (n = 8) or sterile culture broth (n ...200717481830
implications of the changing face of clostridium difficile disease for health care practitioners.recent reported outbreaks of clostridium difficile-associated disease in canada have changed the profile of c difficile infections. historically, c difficile disease was thought of mainly as a nosocomial disease associated with broad-spectrum antibiotics, and the disease was usually not life threatening. the emergence of an epidemic strain, bi/nap1/027, which produces a binary toxin in addition to the 2 classic c difficile toxins a and b and is resistant to some fluoroquinolones, was associated ...200717482995
effect of metronidazole on growth and toxin production by epidemic clostridium difficile pcr ribotypes 001 and 027 in a human gut model.we compared the behaviour of clostridium difficile pcr ribotypes 001 and 027 in a human gut model, and compared the responses to metronidazole exposure.200717483547
case of the month. pseudomembranous colitis. 200717484335
hospitals to report c. difficile and mrsa. 200717485683
hypervirulent strains of clostridium difficile.north america has seen increasing numbers of hospitalised patients and others in nursing homes and the community, with more severe clostridium difficile associated diarrhoea. this is also described in northern europe and surveillance systems are being developed or improved to monitor the situation. one strain (ribotype o27) is described in detail and, like other emerging strains, is demonstrating increasing antimicrobial resistance, notably to quinolone antibiotics. however, its association with ...200717488855
[common errors in the management of the seriously ill patient with inflammatory bowel disease]. 200717493441
prevention of porcine clostridium difficile-associated disease by competitive exclusion with nontoxigenic organisms.clostridium difficile is widely known as a cause of disease in humans, and has emerged as an important problem in neonatal swine. no commercial product is available for immunoprophylaxis of c. difficile-associated disease, but success in preventing experimental infections in hamsters by use of nontoxigenic strains to competitively exclude toxigenic strains led us to try this method in neonatal pigs. spores were administered orally to newborn pigs or were sprayed onto perineum and teats of dams. ...200717493774
how long should we treat community-acquired pneumonia?the studies reviewed in this article suggest that a shorter duration of antibiotic therapy is comparable to standard therapy in the treatment of community-acquired pneumonia and promotes reduction of adverse events, microbial resistance, cost, and improved patient compliance.200717496577
the missing care bundle: antibiotic prescribing in hospitals.the care bundle involves grouping together key elements of care for procedures and the management of specific diagnoses in order to provide a systematic method to improve and monitor the delivery of clinical care processes. in short, care bundles aim to ensure that all patients consistently receive the best care or treatment, all of the time. this approach has been successfully applied to the management of various conditions, particularly in the critical care setting. the institute for healthcar ...200717499482
postoperative hirschsprung's enterocolitis after minimally invasive swenson's procedure.our preferred minimally invasive technique of swenson's procedure has evolved from laparoscopic (lapswen) to swenson's transanal pullthrough (swap). we studied the incidence of postoperative hirschsprung's enterocolitis (hec) over the past decade.200717502205
simvastatin inhibits ifn-gamma-induced cd40 gene expression by suppressing stat-1alpha.cd40, a member of the tnf receptor superfamily, is critical for productive immune responses. macrophages constitutively express cd40 at low levels, which are enhanced by ifn-gamma. ifn-gamma-induced cd40 expression involves activation of stat-1alpha as well as nf-kappab activation through an autocrine response to ifn-gamma-induced tnf-alpha production. statins are 3-hydroxy-3-methylglutaryl (hmg)-coa reductase inhibitors, which exert anti-inflammatory effects independent of their cholesterol-low ...200717507688
systematic review of the risk of enteric infection in patients taking acid suppression.proton pump inhibitors (ppis) and h(2) receptor antagonists (h(2)ras) have become the mainstay of therapy in acid-related upper gastrointestinal disorders. there have been concerns raised about the possible association of ppis with enteric infections.200717509031
antimicrobial phenotypes and molecular basis in clinical strains of clostridium difficile.clostridium difficile remains the leading cause of nosocomial-acquired diarrhea. this study investigated antimicrobial susceptibility patterns of c. difficile over a 3-year period. three hundred seventeen c. difficile isolates recovered between 2002 and 2004 were analyzed for their susceptibility to erythromycin (ery), clindamycin (cli), moxifloxacin (mxf), doxycycline (dox), vancomycin (van), and metronidazole (mtr) by etest. the molecular basis for resistance was investigated using polymerase ...200717509804
etiologic agents of diarrhea in solid organ recipients.after transplantation, diarrhea may be caused by infectious agents, drug-specific effects, metabolic conditions, or mechanical complications of surgery. determining the cause helps to determine whether to initiate antimicrobial therapy and the duration of treatment. in this study we aimed to determine the causes of diarrhea in kidney or liver recipients. fifty-two diarrhea episodes among 43 solid organ recipients were evaluated. the cause of diarrhea was detected in 43 patients (82.6%). infectio ...200717511817
rac1, rhoa, and cdc42 participate in hela cell invasion by group b streptococcus.the group b streptococcus (gbs) is an important human pathogen with the ability to cause invasive disease. to do so, the bacteria must invade host cells. it has been well documented that gbs are able to invade a variety of nonphagocytic host cell types, and this process is thought to involve a number of pathogen-host cell interactions. while some of the molecular aspects of the gbs-host cell invasion process have been characterized, many events still remain unclear. the objective of this investi ...200717517067
hospital-acquired clostridium difficile-associated disease in the intensive care unit setting: epidemiology, clinical course and outcome.clostridium difficile-associated disease (cdad) is a serious nosocomial infection, however few studies have assessed cdad outcome in the intensive care unit (icu). we evaluated the epidemiology, clinical course and outcome of hospital-acquired cdad in the critical care setting.200717517130
in vitro activities of 15 antimicrobial agents against 110 toxigenic clostridium difficile clinical isolates collected from 1983 to 2004.the incidence and severity of clostridium difficile-associated disease (cdad) is increasing, and standard treatment is not always effective. therefore, more-effective antimicrobial agents and treatment strategies are needed. we used the agar dilution method to determine the in vitro susceptibility of the following antimicrobials against 110 toxigenic clinical isolates of c. difficile from 1983 to 2004, primarily from the united states: doripenem, meropenem, gatifloxacin, levofloxacin, moxifloxac ...200717517836
the large clostridial toxins from clostridium sordellii and c. difficile repress glucocorticoid receptor activity.we have previously shown that bacillus anthracis lethal toxin represses glucocorticoid receptor (gr) transactivation. we now report that repression of gr activity also occurs with the large clostridial toxins produced by clostridium sordellii and c. difficile. this was demonstrated using a transient transfection assay system for gr transactivation. we also report that c. sordellii lethal toxin inhibited gr function in an ex vivo assay, where toxin reduced the dexamethasone suppression of the pro ...200717517870
clostridium difficile toxins a and b directly stimulate human mast cells.clostridium difficile toxins a and b (tcda and tcdb) are the causative agents of antibiotic-associated pseudomembranous colitis. mucosal mast cells play a crucial role in the inflammatory processes underlying this disease. we studied the direct effects of tcda and tcdb on the human mast cell line hmc-1 with respect to degranulation, cytokine release, and the activation of proinflammatory signal pathways. tcda and tcdb inactivate rho gtpases, the master regulators of the actin cytoskeleton. the i ...200717517880
genome sequence of a proteolytic (group i) clostridium botulinum strain hall a and comparative analysis of the clostridial genomes.clostridium botulinum is a heterogeneous gram-positive species that comprises four genetically and physiologically distinct groups of bacteria that share the ability to produce botulinum neurotoxin, the most poisonous toxin known to man, and the causative agent of botulism, a severe disease of humans and animals. we report here the complete genome sequence of a representative of group i (proteolytic) c. botulinum (strain hall a, atcc 3502). the genome consists of a chromosome (3,886,916 bp) and ...200717519437
clostridium difficile-associated diarrhoea: bovine anti-clostridium difficile whey protein to help aid the prevention of relapses. 200717519495
molecular characterization and antimicrobial susceptibilities of extra-intestinal clostridium difficile isolates.amongst 25 extra-intestinal clinical isolates of clostridium difficile, a(+)b(+) (72%) and a(-)b(+) (4%) toxigenic phenotypes, as well as the non-toxigenic phenotype (a(-)b(-)) (24%), were identified. the a(-)b(-) isolates did not express toxin, yet carried part of the tcda and tcdb gene and are of a previously unreported toxinotype. six a(+)b(+) isolates also carried binary toxin genes. resistance to erythromycin (20%), clindamycin (48%), tetracycline (16%), moxifloxacin (16%) and imipenem (11% ...200717531516
evaluation of clostridium difficile-associated disease pressure as a risk factor for c difficile-associated disease.colonization pressure has been identified as an important risk factor in the transmission of methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococcus species, but the role of colonization pressure in the transmission of clostridium difficile-associated disease (cdad) is unclear. the purpose of this study was to evaluate cdad pressure, a modified form of colonization pressure based on symptomatic cdad cases, as a risk factor for cdad.200717533213
increasing incidence of clostridium difficile-associated diarrhea in african-american and hispanic patients: association with the use of proton pump inhibitor therapy.clostridium difficile-associated diarrhea (cdad) has been increasingly diagnosed in hospitalized patients. the number of prescriptions for proton pump inhibitors (ppis) has also increased significantly over time. few studies have reported an association between cdad and ppi use; however, the results are inconclusive.200717534007
surveillance of prescription drug-related mortality using death certificate data.the prescription drugs or drug classes that are most frequently associated with death in the us might be identifiable from death certificate data.200717536879
beating the bug. 200717539395
environmental contamination makes an important contribution to hospital infection.meticillin-resistant staphylococcus aureus (mrsa) and vancomycin-resistant enterococci (vre) are capable of surviving for days to weeks on environmental surfaces in healthcare facilities. environmental surfaces frequently touched by healthcare workers are commonly contaminated in the rooms of patients colonized or infected with mrsa or vre. a number of studies have documented that healthcare workers may contaminate their hands or gloves by touching contaminated environmental surfaces, and that h ...200717540242
clostridium difficile toxin expression is inhibited by the novel regulator tcdc.clostridium difficile, an emerging nosocomial pathogen of increasing clinical significance, produces two large protein toxins that are responsible for the cellular damage associated with the disease. the precise mechanisms by which toxin synthesis is regulated in response to environmental change have yet to be discovered. the toxin genes (tcda and tcdb) are located in a pathogenicity locus (paloc), along with tcdr and tcdc. tcdr is an alternative rna polymerase sigma factor that directly activat ...200717542920
recurrent clostridium difficile infection: an immunodeficiency state? 200717544993
association between igg2 and igg3 subclass responses to toxin a and recurrent clostridium difficile-associated disease.individuals who mount a significant serum immunoglobulin (ig)g response to toxin a are protected against recurrent clostridium difficile-associated disease (cdad). we investigated whether humoral immune deficiencies and/or specific igg subclass responses are associated with recurrent cdad.200717544998
no-touch taps help combat c. diff spread.dart valley's mike allen explains how no-touch taps can assist in the fight against an organism which continues to attract much attention.200717549948
clostridium difficile in retail ground meat, canada.clostridium difficile was isolated from 12 (20%) of 60 retail ground meat samples purchased over a 10-month period in 2005 in canada. eleven isolates were toxigenic, and 8 (67%) were classified as toxinotype iii. the human health implications of this finding are unclear, but with the virulence of toxinotype iii strains further studies are required.200717552108
clostridium difficile-associated disease in new jersey hospitals, 2000-2004.recent emergence of a virulent strain of clostridium difficile demonstrates the importance of tracking c. difficile incidence locally. our survey of new jersey hospitals documented increases in the rates of c. difficile disease (by 2-fold), c. difficile-associated complications (by 7-fold), and c. difficile outbreaks (by 12-fold) during 2000-2004.200717552112
gyra mutations in fluoroquinolone-resistant clostridium difficile pcr-027. 200717552115
antimicrobial drugs and community-acquired clostridium difficile-associated disease, uk.in a population-based case-control study of community acquired clostridium difficile-associated disease (cdad), we matched 1,233 cases to 12,330 controls. cdad risk increased 3-fold with use of any antimicrobial agent and 6-fold with use of fluoroquinolones. prior use of antimicrobial agents did not affect risk for cdad after 6 months.200717553260
acute colonic pseudo-obstruction.acute colonic pseudo-obstruction (acpo) is a syndrome of massive dilation of the colon without mechanical obstruction that develops in hospitalized patients with serious underlying medical and surgical conditions. increasing age, cecal diameter, delay in decompression, and status of the bowel significantly influence mortality, which is approximately 40% when ischemia or perforation is present. evaluation of the markedly distended colon involves excluding mechanical obstruction and other causes o ...200717556152
identification, optimal management, and infection control measures for clostridium difficile-associated disease in long-term care.residents of long-term care facilities are at an increased risk of exposure to clostridium difficile and become more susceptible to infection after receiving antimicrobial therapy. an increasing number and more severe cases of c. difficile-associated disease (cdad) have been reported over the last few years and have been linked to the emergence of a new, more virulent strain of c. difficile. these serious cases of disease have also been associated with a more atypical clinical presentation and h ...200717561015
vegetative clostridium difficile survives in room air on moist surfaces and in gastric contents with reduced acidity: a potential mechanism to explain the association between proton pump inhibitors and c. difficile-associated diarrhea?proton pump inhibitors (ppis) have been identified as a risk factor for clostridium difficile-associated diarrhea (cdad), though the mechanism is unclear because gastric acid does not kill c. difficile spores. we hypothesized that the vegetative form of c. difficile, which is killed by acid, could contribute to disease pathogenesis if it survives in room air and in gastric contents with elevated ph. we compared the numbers of c. difficile spores and vegetative cells in stools of patients prior t ...200717562803
effect of fluoroquinolone treatment on growth of and toxin production by epidemic and nonepidemic clostridium difficile strains in the cecal contents of mice.several recent outbreaks of clostridium difficile-associated disease (cdad) have been attributed to the emergence of an epidemic strain with increased resistance to fluoroquinolone antibiotics. some clinical studies have suggested that fluoroquinolones with enhanced antianaerobic activity (i.e., gatifloxacin and moxifloxacin) may have a greater propensity to induce cdad than ciprofloxacin and levofloxacin do. we examined the effects of subcutaneous fluoroquinolone treatment on in vitro growth of ...200717562807
three novel highly charged copper-based biocides: safety and efficacy against healthcare-associated organisms.we investigated three novel highly charged copper-based inorganic biocidal formulations for their activity against organisms highly relevant to healthcare-associated infection.200717567632
detection of clostridium difficile toxin: comparison of enzyme immunoassay results with results obtained by cytotoxicity assay.several kinds of laboratory techniques are available to detect clostridium difficile toxin in fecal samples. because questions have been raised about the reliability of immunoassays compared to the accepted standard, cytotoxicity assay, we studied three enzyme immunoassays (eias) and one rapid eia, which demonstrated relatively good sensitivities and specificities compared to cytotoxicity assay.200717567791
protease-activated receptor 2, dipeptidyl peptidase i, and proteases mediate clostridium difficile toxin a enteritis.we studied the role of protease-activated receptor 2 (par(2)) and its activating enzymes, trypsins and tryptase, in clostridium difficile toxin a (txa)-induced enteritis.200717570216
protease-activated receptor 2 in the intestinal inflammatory response induced by clostridium difficile toxin a. 200717570231
clostridium difficile in the long-term care setting.the incidence of clostridium difficile-associated disease (cdad) has increased over the past few years and more severe cases of cdad have been reported. this changing epidemiology is possibly a result of the emergence of a more virulent strain of c difficile that is more resistant to fluoroquinolones and is associated with increased morbidity and mortality. because of advanced age and frequent courses of antibiotic therapy, patients in long-term care facilities are at increased risk of c diffici ...200717570307
analysis of 30-day mortality for clostridium difficile-associated disease in the icu setting.to examine the 30-day mortality rate among patients with clostridium difficile-associated disease (cdad) requiring intensive care.200717573523
a case of pseudomembranous colitis presenting with massive ascites.clostridium difficile-associated disease seems to be increasing worldwide. a wide spectrum of clinical manifestations, ranging from asymptomatic to life-threatening disease, has been described. a case of pseudomembranous colitis with massive ascites as the main presenting manifestation is described in order to illustrate the changing clinical pattern of antibiotic-associated colitis.200717574110
point prevalence survey for healthcare-associated infections within canadian adult acute-care hospitals.a survey of adult patients 19 years of age and older was conducted in february 2002 in hospitals across canada to estimate the prevalence of healthcare-associated infections (hais). a total of 5750 adults were surveyed; 601 of these had 667 hais, giving a prevalence of 10.5% infected patients and 11.6% hais. urinary tract infections (uti) were the most frequent hai, shown by 194 (3.4%) of the patients surveyed. pneumonia was found in 175 (3.0%) of the patients, surgical site infections (ssi) in ...200717574304
molecular characterization and antimicrobial susceptibility patterns of clostridium difficile strains isolated from hospitals in south-east scotland.clostridium difficile isolates (n=149) collected in south-east scotland between august and october 2005 were typed by four different methods and their susceptibility to seven different antibiotics was determined. the aims were to define the types of strain occurring in this region and to determine whether there were any clonal relationships among them with respect to genotype and antibiotic resistance pattern. ribotyping revealed that 001 was the most common type (n=113, 75.8 %), followed by rib ...200717577057
antimicrobial activity of lacticin 3,147 against clinical clostridium difficile strains.clostridium difficile-associated diarrhoea (cdad) is the most common hospital-acquired diarrhoea, and is a major type of gastroenteritis infection in nursing homes and facilities for the elderly. in this study the antimicrobial activity of the two-component lantibiotic, lacticin 3,147, against a range of genetically distinct c. difficile isolates was studied. the bacteriocin exhibited an mic(50) of 3.6 microg ml(-1) for 10 genetically distinct c. difficile strains isolated from healthy subjects, ...200717577060
designing a protocol that eliminates clostridium difficile: a collaborative venture.clostridium difficile is a health care-associated pathogen that is difficult to eradicate in the health care environment through the use of common hospital disinfectants. many of these disinfectants fail to inactivate c difficile spores, which can result in patient-to-patient transmission. this study demonstrates that the use of 10% hypochlorite solution, along with interventions, reduced the incidence of health care-associated c. difficile infection.200717577477
prevalence of clostridium difficile environmental contamination and strain variability in multiple health care facilities.clostridium difficile spores can contaminate the hospital environment. little is known about the prevalence and strain variability of c. difficile environmental contamination in health care facilities. the objective of this study was to assess c. difficile environmental contamination at various health care facilities in a metropolitan area and determine if the north american pulsed field gel electrophoresis type 1 (nap1) strain was present.200717577478
the challenges posed by reemerging clostridium difficile infection.there have been recent, marked increases in the incidence and severity of clostridium difficile-associated disease (cdad). these may be attributable to the emergence of a hypervirulent strain of c. difficile that produces increased levels of toxins a and b, as well as an extra toxin known as "binary toxin." this previously uncommon strain has become epidemic, coincident with its development of increased resistance to fluoroquinolones, the use of which is increasingly associated with cdad outbrea ...200717578783
reduction of clostridium difficile and vancomycin-resistant enterococcus contamination of environmental surfaces after an intervention to improve cleaning methods.contaminated environmental surfaces may play an important role in transmission of some healthcare-associated pathogens. in this study, we assessed the adequacy of cleaning practices in rooms of patients with clostridium difficile-associated diarrhea (cdad) and vancomycin-resistant enterococcus (vre) colonization or infection and examined whether an intervention would result in improved decontamination of surfaces.200717584935
auto-catalytic cleavage of clostridium difficile toxins a and b depends on cysteine protease activity.the action of clostridium difficile toxins a and b depends on processing and translocation of the catalytic glucosyltransferase domain into the cytosol of target cells where rho gtpases are modified. here we studied the processing of the toxins. dithiothreitol and beta-mercaptoethanol induced auto-cleavage of purified native toxin a and toxin b into approximately 250/210- and approximately 63-kda fragments. the 63-kda fragment was identified by mass spectrometric analysis as the n-terminal gluco ...200717591770
stress ulcer prophylaxis in hospitalized patients not in intensive care units.a review is presented of the evidence behind the current use of therapies for the prevention of stress-related mucosal disease and bleeding in the nonintensive care unit (icu), general medicine population.200717592004
clostridium difficile: recent epidemiologic findings and advances in therapy.clostridium difficile-associated disease (cdad) has become an important public health problem. the causative organism is acquired by the oral route from an environmental source or by contact with an infected person or a health care worker who serves as a vector. disruption of the bowel microflora, generally by antibiotics, creates an environment that allows c. difficile to proliferate. organisms produce toxins a and b, which cause intense inflammation of the colonic mucosa. the syndrome that res ...200717594209
probiotics for clostridium difficile diarrhea: putting it into perspective.clostridium difficile diarrhea is an expensive, life-threatening infection associated with serious morbidity and mortality, even among previously healthy individuals. relapses from the infection are common following standard antibiotic treatments, with 3-5% of patients who contract c. difficile diarrhea unable to discontinue vancomycin due to continual relapses. such patients may have a focal immunodeficiency in which they fail to mount an immune response against c. difficile. for these individu ...200717595302
probiotics for clostridium difficile-associated diarrhea: focus on lactobacillus rhamnosus gg and saccharomyces boulardii.to review the literature on the use of probiotics to treat or prevent recurrences of clostridium difficile-associated diarrhea (cdad) by replacing normal gastric flora.200717595306
pharmacodynamic studies of vancomycin, metronidazole and fusidic acid against clostridium difficile.pharmacodynamic studies of antibiotics have attracted great interest in recent years. however, studies on the pharmacodynamics of different antibiotics against clostridium difficile are scarce.200717595541
hcais: statutory code of practice in england and wales.healthcare-associated infections (hcais) such as meticillin resistant staphylococcus aureus (mrsa) and clostridium difficile (c. dif) are never far from the media headlines. in january 2006 a leaked memo identified the government's concerns that its target of halving mrsa infection rates by april 2008 may not be met (boseley 2007). during 2004-5, 30 people died following two outbreaks of c. dif at stoke mandeville (boseley 2007). in this article the author will focus on and discuss in detail key ...200717598676
changing trends in bacterial infections: staphylococcus aureus, bacterial pneumonia, clostridium difficile.changing bacterial diseases in the general population of which hiv practitioners should be aware include: new staphylococcal syndromes caused by community-acquired methicillin-resistant staphylococcus aureus usa300 strains (eg, necrotizing skin infections, pneumonia, fasciitis); continued high rates of community-acquired pneumonia in the potent antiretroviral therapy era; increase rates and severity of clostridium difficile-associated disease due to the fluoroquinolone-resistant nap1 strain, and ...200717598928
fulminant clostridium difficile colitis.clostridium difficile is the most common cause of nosocomial infectious diarrhea in adults. the purpose of this review is to increase awareness that infection from c. difficile is not always indolent, but with fulminant colitis, it can be lethal. the epidemiology, pathogenesis and treatment of c. difficile infection are discussed, with special emphasis on management of fulminant colitis.200717599017
a comparison of vancomycin and metronidazole for the treatment of clostridium difficile-associated diarrhea, stratified by disease severity.the incidence and severity of clostridium difficile-associated diarrhea (cdad) has been increasing, and there have been recent reports of metronidazole treatment failure. metronidazole is still commonly used as first-line treatment for cdad but has never been compared with vancomycin in a prospective, randomized, double-blind, placebo-controlled trial. we conducted such a trial, stratifying patients according to disease severity, to investigate whether one agent was superior for treating either ...200717599306
value of repeat stool testing for clostridium difficile. 200717602913
use of probiotic lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial.to determine the efficacy of a probiotic drink containing lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by clostridium difficile.200717604300
hand hygiene and clostridium difficile. 200717606966
use of intravenous immunoglobulin for the treatment of severe clostridium difficile colitis.clostridium difficile is a gram-positive, anaerobic, spore-forming, rod-shaped bacterium responsible for most of the hospital-acquired diarrhea in developed countries. the organism received its name because it was difficult to isolate and grow in culture. infections in the elderly have been associated with significant morbidity and mortality as well as prolonged hospitalization.200717608247
clostridium difficile: changing epidemiology and new treatment options.the review summarizes changes in the epidemiology and treatment of clostridium difficile-associated disease.200717609596
association of interleukin-8 polymorphism and immunoglobulin g anti-toxin a in patients with clostridium difficile-associated diarrhea.previous studies have shown that failure to produce serum antibodies to c. difficile (cd) toxin a is associated with more severe and recurrent c. difficile-associated diarrhea (cdad); and that presence of aa genotype in the interleukin (il)-8 gene promoter -251 position is associated with increased susceptibility to cdad. this study examined the relationship between serum immunoglobulin g antibodies to cd toxin a and the presence of il-8 aa genotype in hospitalized patients with cdad.200717618838
salmonella pseudomembranous colitis.pseudomembranous colitis is most often associated with antibiotic use and caused most often by clostridium difficile. aclinical syndrome and pathology that is identical can be caused rarely by other organisms. we report a case of salmonella enterica pseudomembranous colitis and briefly review the literature regarding rare causes of this syndrome.200717619469
efficacy of hospital cleaning agents and germicides against epidemic clostridium difficile strains.to compare the effects of hospital cleaning agents and germicides on the survival of epidemic clostridium difficile strains.200717620238
onset of symptoms and time to diagnosis of clostridium difficile-associated disease following discharge from an acute care hospital.to identify patients with a diagnosis of clostridium difficile-associated disease (cdad) in the ambulatory care setting and determine the relationship of symptom onset and diagnosis to prior hospitalization and exposure to antimicrobials.200717620239
emergence and control of fluoroquinolone-resistant, toxin a-negative, toxin b-positive clostridium difficile.clostridium difficile is a major cause of infectious diarrhea in hospitalized patients. between august 2003 and january 2004, we experienced an increase in the incidence of c. difficile-associated disease. we describe the investigation into and management of the outbreak in this article.200717620240
longitudinal trends in antibiotic resistance in us nursing homes, 2000-2004.we evaluated antibiotic resistance trends in us nursing homes using the minimum data set. significant increases in the number and proportion of infections caused by antibiotic-resistant bacteria were documented over the 5-year study. further research on antibiotic resistance in nursing homes is urgently needed.200717620252
probiotics for preventing and treating nosocomial infections: review of current evidence and recommendations.objective: to review the available clinical data supporting the use of probiotics in preventing and treating serious nosocomial infections. data source: a medline database from 1996 to july 2006 and references from identified articles were used to perform a literature search relating to the clinical applications of probiotics in preventing and treating clostridium difficile-associated diarrhea (cdd) and prevention of hospital-associated pneumonia (hap). conclusion: nosocomial infections like hap ...200717625089
acute appendicitis in the setting of clostridium difficile colitis: case report and review of the literature.a 72-year-old man was hospitalized for exacerbation of chronic obstructive pulmonary disease and was treated with oral prednisone and 7 days of moxifloxacin. five days after completing the antibiotic course, he developed watery diarrhea and diffuse, crampy abdominal pain. on presentation he was afebrile, and abdominal examination revealed diffuse tenderness without peritoneal signs. stool tested positive for clostridium difficile toxin a by enzyme-linked immunosorbent assay. despite starting ora ...200717625978
diarrhoea associated with antibiotic use. 200717626915
toxin a-negative, toxin b-positive clostridium difficile.clostridium difficile is a major cause of infectious diarrhea in hospitalized patients. many pathogenic strains of clostridium difficile produce two toxins tcda and tcdb, both of which are pro-inflammatory and enterotoxic in human intestine. clinically relevant toxin a-negative, toxin b-positive (a(-)b(+)) strains of clostridium difficile that cause diarrhea and colitis in humans have been isolated with increasing frequency worldwide. this perspective describes these important toxin variant stra ...200716857405
tcdc genotypes associated with severe tcdc truncation in an epidemic clone and other strains of clostridium difficile.severe clostridium difficile associated disease is associated with outbreaks of the recently described bi/nap1 epidemic clone. this clone is characterized by an 18-bp deletion in the tcdc gene and increased production of toxins a and b in vitro. tcdc is a putative negative regulator of toxin a&b production. we characterized tcdc genotypes from a collection of c. difficile isolates from a hospital that experienced an outbreak caused by the bi/nap1 epidemic clone. sequence analysis of tcdc was per ...200717035492
has the severity of clostridium difficile infections increased? 200717055114
production of xylitol by metabolically engineered strains of bacillus subtilis.xylitol-phosphate dehydrogenase (xpdh) genes from several gram-positive bacteria were isolated and expressed in bacillus subtilis. the substrate specificities of the recombinant xpdh enzymes were compared and it was found that the xpdh enzymes of lactobacillus rhamnosus and clostridium difficile had the highest selectivity towards d-xylulose 5-phosphate. expression of these two xpdh enzymes in d-ribulose and d-xylulose producing b. subtilis strain resulted in strains of b. subtilis capable of co ...200717079043
gut microbiota composition and development of atopic manifestations in infancy: the koala birth cohort study.perturbations in intestinal microbiota composition due to lifestyle changes may be involved in the development of atopic diseases. we examined gut microbiota composition in early infancy and the subsequent development of atopic manifestations and sensitisation.200717047098
molecular analysis of clostridium difficile isolates recovered from horses with diarrhea.clostridium difficile is an important cause of diarrhea in horses, causing sporadic and epidemic disease of varying severity. this study evaluated the molecular characteristics of 48 c. difficile isolates recovered from diarrheic horses admitted to a veterinary hospital by using pcr-ribotyping and toxin gene profile. additionally, feces were tested for the presence of c. difficile toxin a/b via enzyme immunosorbant assay (eia) in 38 horses. the toxin genes tcda, tcdb and cdtb were present in 27 ...200717112686
signaling pathways involved in oxpapc-induced pulmonary endothelial barrier protection.increased tissue or serum levels of oxidized phospholipids have been detected in a variety of chronic and acute pathological conditions such as hyperlipidemia, atherosclerosis, heart attack, cell apoptosis, acute inflammation and injury. we have recently described signaling cascades activated by oxidized 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (oxpapc)in the human pulmonary artery endothelial cells (ec) and reported potent barrier-protective effects of oxpapc, which were mediated ...200717292425
the safety of whey protein concentrate derived from the milk of cows immunized against clostridium difficile.a whey protein concentrate prepared from the milk of cows that have been immunized against clostridium difficile (c. difficile) and its toxins, toxin a and toxin b, is produced for use as a medical food for the dietary management of patients with c. difficile-associated diarrhea (cdad) to prevent a relapse of the infection. the safety of anti-c. difficile whey protein concentrate (anti-cd wpc) is supported by analytical data comparing the composition of raw milk from immunized cows versus that f ...200717293018
laboratory diagnosis of antibiotic-associated diarrhea: a polish pilot study into the clinical relevance of clostridium difficile and clostridium perfringens toxins.in the present study, we investigated the prevalence of the clostridium perfringens enterotoxin (cpent) in stool samples originally submitted for detection of clostridium difficile toxins. fifty-two fecal samples from inpatients were screened simultaneously for c. difficile and c. perfringens toxins: 75% of the specimens were positive for tcda/tcdb toxins, 40% were positive for cpent, and 31% gave positive test results for both. it is interesting to note that only a relatively small number of c. ...200717300901
interruption of recurrent clostridium difficile-associated diarrhea episodes by serial therapy with vancomycin and rifaximin.eight women who each experienced 4-8 episodes of clostridium difficile-associated diarrhea were given a 2-week course of rifaximin therapy when they were asymptomatic, immediately after completing their last course of vancomycin therapy. seven of the 8 patients experienced no further diarrhea recurrence. the patient who had a recurrence responded to a second course of rifaximin therapy, but rifaximin-resistant c. difficile was recovered after treatment. a controlled trial for treating recurrent ...200717304459
mutations in fusa associated with posttherapy fusidic acid resistance in clostridium difficile.in silico, we identified fusa (2,067 bp) in clostridium difficile 630. sequencing of fusa in posttherapy fusidic acid-resistant c. difficile isolates from 12 patients with c. difficile-associated diarrhea (cdad) identified fusa mutations, one or two nonsynonymous substitutions, or in one case a deletion of one codon associated with resistance. five of these mutations have previously been described in fusa of fusidic acid-resistant staphylococcus aureus, but seven were novel fusa mutations. fusid ...200717307985
volatile organic compounds from feces and their potential for diagnosis of gastrointestinal disease.little is known about the volatile organic compounds (vocs) in feces and their potential health consequences. patients and healthcare professionals have observed that feces often smell abnormal during gastrointestinal disease. the aim of this work was to define the volatiles emitted from the feces of healthy donors and patients with gastrointestinal disease. our hypotheses were that i) vocs would be shared in health; ii) vocs would be constant in individuals; and iii) specific changes in vocs wo ...200717314143
toxin profiles and resistances to macrolides and newer fluoroquinolones as epidemicity determinants of clinical isolates of clostridium difficile from warsaw, poland.amplified fragment length polymorphism genotypes, antibiotic resistance profiles, and toxin profiles of clostridium difficile strains from warsaw were determined. the isolates segregate in six major genotypes, coinciding with toxin profiles. most of the toxin a-negative toxin b-positive toxin cdt-negative strains possess ermb, and several strains were resistant to fluoroquinolones. resistograms and toxin types of c. difficile strains are epidemicity determinants.200717314219
variant forms of the binary toxin cdt locus and tcdc gene in clostridium difficile strains.variability in the genes for toxin a, toxin b and other pathogenicity locus regions is well known and is the basis for the distribution of clostridium difficile strains into variant toxinotypes. previous data have indicated that some c. difficile strains have a non-functional truncated form of the binary toxin (cdt) locus. this study analysed variability in the cdt locus and the presence of deleted tcdc genes in c. difficile strains. a total of 146 strains were screened, including known variant ...200717314362
saccharomyces cerevisiae strain 905 reduces the translocation of salmonella enterica serotype typhimurium and stimulates the immune system in gnotobiotic and conventional mice.previous results in the laboratory of the authors showed that saccharomyces cerevisiae strain 905, isolated during 'cachaça' production, was able to colonize and survive in the gastrointestinal tract of germ-free and conventional mice, and to protect these animals against oral challenge with salmonella enterica serotype typhimurium or clostridium difficile. in the present work, the effects of s. cerevisiae 905 on the translocation of salm. typhimurium (mesenteric lymph nodes, peyer's patches, sp ...200717314366
molecular characterization of clostridium difficile clinical isolates in a geriatric hospital.the discriminatory potential of a combination of various typing methods was evaluated on a set of 21 clostridium difficile isolates obtained from symptomatic patients hospitalized in a geriatric unit and 7 non-toxigenic isolates from the same hospital. isolates were firstly serotyped and toxinotyped. of the 28 isolates, 19 belonged to serogroup a. pcr-ribotyping and pcr-rflp on the flic and slpa genes were then applied to these 19 isolates. the results suggest that the combination of pcr-ribotyp ...200717314371
Displaying items 7701 - 7800 of 12134