| ulcerative colitis worsened after clostridium difficile infection: efficacy of infliximab. | the incidence of clostridium difficile (c. difficile) infection (cdi) is 1.8%-5.7% in admitted patients with ulcerative colitis (uc). cdi can worsen uc and increase the risk for colectomy or even death, thus necessitating therapy escalation, such as increasing the corticoid therapy or starting a biologic treatment. several reported cases with infliximab therapy have provided favorable outcomes in uc patients with cdi, suggesting that infliximab treatment may be protective; however, the optimal i ... | 2014 | 24803831 |
| microbiome data distinguish patients with clostridium difficile infection and non-c. difficile-associated diarrhea from healthy controls. | antibiotic usage is the most commonly cited risk factor for hospital-acquired clostridium difficile infections (cdi). the increased risk is due to disruption of the indigenous microbiome and a subsequent decrease in colonization resistance by the perturbed bacterial community; however, the specific changes in the microbiome that lead to increased risk are poorly understood. we developed statistical models that incorporated microbiome data with clinical and demographic data to better understand w ... | 2014 | 24803517 |
| urinary tract infections: leading initiatives in selecting empiric outpatient treatment (utilise). | overuse of fluoroquinolone antibiotics is associated with outbreaks of methicillin-resistant staphylococcus aureus and of clostridium difficile-associated diarrhea and increasing resistance in gram-negative organisms. over the past decade, resistance of escherichia coli to ciprofloxacin has increased in the regina qu'appelle health region. in august 2011, an exploratory audit of the regina general hospital (rgh) emergency department showed that 20% of new antibiotic orders were for fluoroquinolo ... | 2014 | 24799721 |
| real-time polymerase chain reaction detection of asymptomatic clostridium difficile colonization and rising c. difficile-associated disease rates. | to evaluate the accuracy of real-time polymerase chain reaction (pcr) for clostridium difficile-associated disease (cdad) detection, after hospital cdad rates significantly increased following real-time pcr initiation for cdad diagnosis. | 2014 | 24799643 |
| strategies to prevent clostridium difficile infections in acute care hospitals: 2014 update. | | 2014 | 24799639 |
| occurrence of clostridium difficile pcr-ribotype 027 and it's closely related pcr-ribotype 176 in hospitals in poland in 2008-2010. | since 2003, a rising incidence of clostridium difficile infection (cdi) in north america and europe has coincided with outbreaks of c. difficile pcr ribotype 027. this ribotype was not observed in poland until 2008. in the period 2008-2010, outbreaks of antibiotic-associated diarrhoea occurred in three different hospitals in poland. of 30 c. difficile isolates available for microbiological characterisation, 17 (56%) were positive for binary toxin genes and belonged to pcr ribotype 027 (n = 7) an ... | 2014 | 24799338 |
| vancomycin, metronidazole, or tolevamer for clostridium difficile infection: results from two multinational, randomized, controlled trials. | clostridium difficile infection (cdi) is a common complication of antibiotic therapy that is treated with antibiotics, contributing to ongoing disruption of the colonic microbiota and cdi recurrence. two multinational trials were conducted to compare the efficacy of tolevamer, a nonantibiotic, toxin-binding polymer, with vancomycin and metronidazole. | 2014 | 24799326 |
| editorial commentary: the trials and tribulations of treating clostridium difficile infection-one step backward, one step forward, but still progress. | | 2014 | 24799325 |
| surotomycin demonstrates low in vitro frequency of resistance and rapid bactericidal activity in clostridium difficile, enterococcus faecalis, and enterococcus faecium. | surotomycin (cb-183,315) is an orally administered, minimally absorbed, selective bactericidal cyclic lipopeptide in phase 3 development for the treatment of clostridium difficile-associated diarrhea. the aim of this study was to evaluate the emergence of resistance in c. difficile (atcc 700057 and three recent clinical isolates from the restriction endonuclease analysis groups bi, bk, and k), vancomycin-susceptible (vs) enterococcus faecalis (atcc 49452), vancomycin-resistant (vr) e. faecalis ( ... | 2014 | 24798273 |
| impact of a change in antibacterial prophylaxis on bacteremia and hospitalization rates following outpatient autologous peripheral blood stem cell transplantation for multiple myeloma. | levofloxacin is routinely used for the prevention of invasive bacterial infections during autologous peripheral blood stem cell transplantation (apbsct). however, increasing rates of bacterial sepsis were noted at our institution among multiple myeloma (mm) patients undergoing outpatient apbsct with melphalan-based chemotherapy and levofloxacin prophylaxis. we assessed the impact of a change in antibacterial prophylaxis from oral levofloxacin (period 1) to sequential oral levofloxacin followed b ... | 2014 | 24797543 |
| practical approaches to probiotics use. | probiotics are microorganisms exerting beneficial effects on the host. they can be ingested through foods or supplements and their inclusion in these products is regulated in canada by the health canada health products and food branch. the aim of this article is to summarize current evidence from randomized controlled trials and guidelines from health canada, the world health organization, and internationally recognized expert committees in the hope that it will help practitioners and profession ... | 2014 | 24797031 |
| fecal microbial therapy: promises and pitfalls. | a rapidly expanding range of diverse human diseases is now associated with perturbations to the gastrointestinal microbiome. fecal microbial transplant (fmt) has been used with high rates of efficacy to treat gastrointestinal microbiome perturbation associated with recurrent clostridium difficile infection, and is now being considered for other indications. here we discuss the gut microbiome, review published and ongoing studies using fmt as a treatment modality for human disease, consider the r ... | 2014 | 24796803 |
| real-time polymerase chain reaction correlates well with clinical diagnosis of clostridium difficile infection. | to determine the clinical utility of a rapid molecular assay for clostridium difficile infection (cdi) in an acute hospital setting. | 2014 | 24795170 |
| clostridium difficile colonization and disease in patients undergoing hematopoietic stem cell transplantation. | there was an increase in the clostridium difficile infection (cdi) rate in our bone marrow transplantation unit. to evaluate the role of unit-based transmission, c. difficile screening was performed on adult patients admitted for hematopoietic stem cell transplantation (hsct) over a 2-year period, and c. difficile isolates were typed. c. difficile testing was performed using a 2-step c. difficile glutamate dehydrogenase antigen plus toxin a/b enzyme immunoassay (eia) and cytotoxin assay (or mole ... | 2014 | 24792871 |
| fecal transplant for recurrent clostridium difficile infection in children with and without inflammatory bowel disease. | ten children at our institution received single-infusion fecal microbiome transplant (fmt) using healthy, related screened donor stool to treat recurrent clostridium difficile infection (rcdi) via nasogastric tube (2 patients) or colonoscopic delivery. nine of the 10 (90%) children had resolution of their symptoms after a single-infusion fmt with follow-up of 1 month to 4 years. no concerning related adverse events were recognized during short- or long-term follow-up. three of these children had ... | 2014 | 24792627 |
| clinical and microbiological characterization of clostridium difficile infection in a tertiary care hospital in shanghai, china. | over the last decade, clostridium difficile infection (cdi) has emerged as a significant nosocomial infection, yet little has been reported from china. this study aimed to characterize the clinical and microbiological features of cdi from a hospital in shanghai. | 2014 | 24791861 |
| evaluation of a rapid membrane enzyme immunoassay for the simultaneous detection of glutamate dehydrogenase and toxin for the diagnosis of clostridium difficile infection. | we evaluated the new c. diff quik chek complete (cd complete; techlab, usa), which is a rapid membrane enzyme immunoassay that uses a combination of glutamate dehydrogenase (gdh) antigen and toxin a and b detection. a total of 608 consecutive loose stool specimens collected from the patients with suspected clostridium difficile infection (cdi) from august to december 2012 were subjected to the cd complete and vidas clostridium difficile a & b (vidas cdab; biomérieux, france). their performances ... | 2014 | 24790912 |
| antibodies for treatment of clostridium difficile infection. | antibodies for the treatment of clostridium difficile infection (cdi) have been demonstrated to be effective in the research and clinical environments. early uncertainties about molecular and treatment modalities now appear to have converged upon the systemic dosing of mixtures of human igg1. although multiple examples of high-potency monoclonal antibodies (mabs) exist, significant difficulties were initially encountered in their discovery. this minireview describes historical and contemporary m ... | 2014 | 24789799 |
| comparison of planktonic and biofilm-associated communities of clostridium difficile and indigenous gut microbiota in a triple-stage chemostat gut model. | biofilms are characteristic of some chronic or recurrent infections and this mode of growth tends to reduce treatment efficacy. clostridium difficile infection (cdi) is associated with a high rate of recurrent symptomatic disease. the presence and behaviour of c. difficile within intestinal biofilms remains largely unexplored, but may factor in recurrent infection. | 2014 | 24788662 |
| the prevalence of clostridium difficile infection in pediatric and adult patients with inflammatory bowel disease. | adults with inflammatory bowel disease (ibd) have a high prevalence of clostridium difficile infection (cdi). cdi in children with ibd may differ from adults. we aim to compare the prevalence of cdi in hospitalized pediatric and adult ibd patients and patients without ibd. | 2014 | 24788321 |
| high colonization rate and prolonged shedding of clostridium difficile in pediatric oncology patients. | surveillance testing for clostridium difficile among pediatric oncology patients identified stool colonization in 29% of patients without gastrointestinal symptoms and in 55% of patients with prior c. difficile infection (cdi). a high prevalence of c. difficile colonization and diarrhea complicates the diagnosis of cdi in this population. | 2014 | 24785235 |
| editorial commentary: clostridium difficile in pediatric oncology patients: more questions than answers. | | 2014 | 24785232 |
| clostridium difficile infection diagnosis in a paediatric population: comparison of methodologies. | the increasing incidence of clostridium difficile infection (cdi) in paediatric hospitalised populations, combined with the emergence of hypervirulent strains, community-acquired cdi and the need for prompt treatment and infection control, makes the rapid, accurate diagnosis of cdi crucial. we validated commonly used c. difficile diagnostic tests in a paediatric hospital population. from october 2011 to january 2012, 150 consecutive stools were collected from 75 patients at a tertiary paediatric ... | 2014 | 24781004 |
| a prospective study of community-associated clostridium difficile infections: the role of antibiotics and co-infections. | this prospective study was performed to determine the incidence, risk factors, severity and outcomes of community-associated clostridium difficile infection (ca-cdi) in the se of scotland. | 2014 | 24780765 |
| surgical management of toxic megacolon. | toxic megacolon carries still a substantial mortality and the decision when to per form emergent colectomy needs precise predictors outcome. | 2014 | 26176049 |
| the role and influence of gut microbiota in pathogenesis and management of obesity and metabolic syndrome. | the obesity epidemic has drastically impacted the state of health care in the united states. aside from poor diet hygiene and genetics, there are many other factors thought to play a role in the emergence of obesity and the metabolic syndrome. there has been a paradigm shift toward further investigating the gut microbiota and its implications in the pathogenesis of a variety of disease states, including inflammatory bowel disease, clostridium difficile, and most recently obesity and the metaboli ... | 2014 | 24778627 |
| changes in the incidence of health care-associated pathogens at a university hospital from 2005 to 2011. | data on health care-associated infections (hais) outside of intensive care units (icu) are scarce. we assessed hospital-wide changes in the incidence of health care-associated pathogens by infection site and by service between 2005 and 2011. | 2014 | 24775560 |
| outcomes of a ventilator-associated pneumonia bundle on rates of ventilator-associated pneumonia and other health care-associated infections in a long-term acute care hospital setting. | long-term trends in ventilator-associated pneumonia (vap) rates, and other health care-associated infections, were examined prior to, during, and after introduction of a vap bundle in a long-term acute care hospital setting. vap incidence rate declined in a step-wise fashion and reached a null value. incidence rates of bacteremia from any cause declined in a similar fashion. the incidence rates of vancomycin-resistant enterococci and methicillin-resistant staphylococcus aureus colonization or in ... | 2014 | 24773791 |
| environmental cleaning resources and activities in canadian acute care hospitals. | environmental cleaning interventions have increased cleaning effectiveness and reduced antibiotic-resistant organisms in hospitals. this study examined cleaning in canadian acute care hospitals with the goal of developing strategies to improve cleaning and reduce antibiotic-resistant organism rates. | 2014 | 24773787 |
| international typing study of clostridium difficile. | we report the results of an international clostridium difficile typing study to cross reference strain designations for seven typing methodologies and facilitate inter-laboratory communication. four genotypic and three phenotypic methods were used to type 100 isolates and compare the results to 39 pcr ribotypes identified among the collection. | 2014 | 24768986 |
| chemoprophylaxis of clostridium difficile infections in high-risk hospitalized patients. | | 2014 | 24768812 |
| challenges in the diagnosis of clostridium difficile infection. | | 2014 | 24768590 |
| findings of a hospital surveillance-based outcome evaluation study for clostridium difficile-associated colitis. | we completed a prospective study of 164 patients involved in a clostridium difficile surveillance programme, evaluating a range of variables such as disease severity, treatment regimen and known clinical risk factors, for their effect on case lethality. the aim of this study was to determine if there are any additional clinical variables worth considering for inclusion in the therapeutic decision-making process. beyond common risk factors, secondary immunodeficiencies such as diabetes mellitus, ... | 2014 | 24766614 |
| transplant related outcomes in patients with hematopoietic stem cell transplant with clostridium difficile associated diarrhea. | | 2015 | 24766526 |
| overview of clostridium difficile infection: implications for china. | the incidence and severity of clostridium difficile infection (cdi) have dramatically increased in the western world in recent years. in contrast, cdi is rarely reported in china, possibly due to under-diagnosis. this article briefly summarizes cdi incidence, management and preventive strategies. the authors intend to raise awareness of this disease among chinese physicians and health workers, in order to minimize the medical and economic burden of a potential epidemic in the future. | 2013 | 24759960 |
| prevalence and duration of asymptomatic clostridium difficile carriage among healthy subjects in pittsburgh, pennsylvania. | previous studies suggested that 7 to 15% of healthy adults are colonized with toxigenic clostridium difficile. to investigate the epidemiology, genetic diversity, and duration of c. difficile colonization in asymptomatic persons, we recruited healthy adults from the general population in allegheny county, pennsylvania. participants provided epidemiological and dietary intake data and submitted stool specimens. the presence of c. difficile in stool specimens was determined by anaerobic culture. s ... | 2014 | 24759727 |
| molecular test based on isothermal helicase-dependent amplification for detection of the clostridium difficile toxin a gene. | the amplivue clostridium difficile assay and a glutamate dehydrogenase (gdh)-illumigene algorithm were evaluated using 308 diarrheal stool specimens of patients suspected of having c. difficile infection. compared to the enriched toxigenic culture method, the sensitivities, specificities, and positive and negative predictive values of the amplivue c. difficile assay and the gdh-illumigene-based algorithm were 91.7% (95% confidence interval [ci], 76.4 to 97.8), 100% (95% ci, 98.3 to 100), 100% (9 ... | 2014 | 24759714 |
| recombinant clostridium difficile toxin fragments as carrier protein for psii surface polysaccharide preserve their neutralizing activity. | clostridium difficile is a gram-positive bacterium and is the most commonly diagnosed cause of hospital-associated and antimicrobial-associated diarrhea. despite the emergence of epidemic c. difficile strains having led to an increase in the incidence of the disease, a vaccine against this pathogen is not currently available. c. difficile strains produce two main toxins (tcda and tcdb) and express three highly complex cell-surface polysaccharides (psi, psii and psiii). psii is the more abundantl ... | 2014 | 24759173 |
| epidemiological surveillance of bacterial nosocomial infections in the surgical intensive care unit. | intensive care units (icus) are associated with a greater risk of developing nosocomial infections (nis) than other departments. | 2014 | 24757393 |
| prevalence and risk factors for asymptomatic clostridium difficile carriage. | clostridium difficile infection (cdi) incidence has increased dramatically over the last decade. recent studies suggest that asymptomatic carriers may be an important reservoir of c. difficile in healthcare settings. we sought to identify the prevalence and risk factors for asymptomatic c. difficile carriage on admission to the hospital. | 2014 | 24755858 |
| epidemiology and outcomes of community-acquired clostridium difficile infections in medicare beneficiaries. | the incidence of community-acquired clostridium difficile (cacd) is increasing in the united states. many cacd infections occur in the elderly, who are predisposed to poor outcomes. we aimed to describe the epidemiology and outcomes of cacd in a nationally representative sample of medicare beneficiaries. | 2014 | 24755188 |
| the effect of new neonatal porcine diarrhoea syndrome (nnpds) on average daily gain and mortality in 4 danish pig herds. | the study evaluated the effect of new neonatal porcine diarrhoea syndrome (nnpds) on average daily gain (adg) and mortality and described the clinical manifestations in four herds suffering from the syndrome. nnpds is a diarrhoeic syndrome affecting piglets within the first week of life, which is not caused by enterotoxigenic escherichia coli (etec), clostridium perfringens (c. perfringens) type a/c, clostridium difficile (c. difficile), rotavirus a, coronavirus, cystoisospora suis, strongyloide ... | 2014 | 24755093 |
| strain types and antimicrobial resistance patterns of clostridium difficile isolates from the united states, 2011 to 2013. | we determined the pcr ribotypes and antimicrobial susceptibility patterns of 508 toxigenic clostridium difficile isolates collected between 2011 and 2013 from 32 u.s. hospitals. of the 29 pcr ribotypes identified, the 027 strain type was the most common (28.1%), although the rates varied by geographic region. ribotype 014/020 isolates appear to be emerging. clindamycin and moxifloxacin resistances (36.8% and 35.8%, respectively) were the most frequent resistance phenotypes observed. reduced susc ... | 2014 | 24752264 |
| characteristics of clostridium difficile colonization in japanese children. | in children, asymptomatic colonization with clostridium difficile is well known, but its prevalence in japanese children is not fully understood. the objective of this study was to determine the colonization rate of c. difficile and to identify the risk factors for c. difficile colonization in japanese children. single fecal samples were prospectively collected from children hospitalized in saitama city hospital between august 1, 2012, and march 31, 2013. samples were obtained from neonates, at ... | 2014 | 24751233 |
| clostridium difficile in a children's hospital: assessment of environmental contamination. | clostridium difficile infection (cdi) is the most frequent infectious cause of health care-associated diarrhea. three cases of cdi, in children age 2, 3, and 14 years, occurred in the hematology/oncology ward of our children's hospital over 48 hours. we aimed to assess environmental contamination with c difficile in the shared areas of this unit, and to determine whether person-to-person transmission occurred. c difficile was recovered from 5 of 18 samples (28%). we compared c difficile isolated ... | 2014 | 24751141 |
| fecal microbiota transplantation for management of clostridium difficile infection. | the widespread use of antibiotics has led clostridium difficile infection (cdi) to become a common problem with pronounced medical and economic effects. the recurrence of cdi after treatment with standard antibiotics is becoming more common with the emergence of more resistant strains of c. difficile. as cdi is an antibiotic-associated disease, further treatment with antibiotic is best avoided. as the gut flora is severely disturbed in cdi, approaches that restore the gut microbiota may become g ... | 2014 | 24748025 |
| disinfecting the ipad: evaluating effective methods. | tablet computers are increasingly used in healthcare, but they may carry nosocomial pathogens. there are few data available on how to clean an ipad effectively for use in the clinical setting. | 2014 | 24746231 |
| effectiveness of deep cleaning followed by hydrogen peroxide decontamination during high clostridium difficile infection incidence. | clostridium difficile infection (cdi) remains an infection control challenge, especially when environmental spore contamination and suboptimal cleaning may increase transmission risk. | 2014 | 24746230 |
| [a case of severe enteritis induced by adjuvant chemotherapy for colon cancer]. | a 77-year-old man underwent surgery for sigmoid colon cancer. he was diagnosed with stage iiia colon cancer; there- fore, we initiated oral administration of adjuvant chemotherapy comprising uracil/tegafur(uft)plus leucovorin(lv). however, chemotherapy was stopped after 21 days because of fatigue and diarrhea. he recovered after 3 weeks, and we administered the same regimen with a dose reduction. however, he again experienced fatigue and diarrhea after 20 days; therefore, chemotherapy was discon ... | 2014 | 24743369 |
| donor fecal transfer for recurrent clostridium difficile-associated diarrhea in heart transplantation. | | 2014 | 24742697 |
| clostridium difficile epidemic outbreak in an oncology unit. | contributions to the knowledge of some peculiarities of c. difficile involvement in human pathology, nosocomial infections (ni) included. | 2014 | 24741794 |
| outbreak of clostridium difficile pcr ribotype 027--the recent experience of a regional hospital. | clostridium difficile infection (cdi) is the leading cause of healthcare-associated diarrhea, and several outbreaks with increased severity and mortality have been reported. in this study we report a c. difficile pcr ribotype 027 outbreak in portugal, aiming to contribute to a better knowledge of the epidemiology of this agent in europe. | 2014 | 24739945 |
| lrp1 is a receptor for clostridium perfringens tpel toxin indicating a two-receptor model of clostridial glycosylating toxins. | large glycosylating toxins are major virulence factors of various species of pathogenic clostridia. prototypes are clostridium difficile toxins a and b, which cause antibiotics-associated diarrhea and pseudomembranous colitis. the current model of the toxins' action suggests that receptor binding is mediated by a c-terminal domain of combined repetitive oligopeptides (crop). this model is challenged by the glycosylating clostridium perfringens large cytotoxin (tpel toxin) that is devoid of the c ... | 2014 | 24737893 |
| managing clostridium difficile infection in hospitalised patients. | checklists are not a new phenomenon and have been used in the aviation industry for some time as a means of ensuring safety and minimising harm. checklists are now used commonly in health care to improve patient safety. this article describes the development and integration of a daily review checklist process to support the care and management of patients with clostridium difficile infection in one nhs trust hospital. the aim of the checklist is to assist staff in early recognition of disease se ... | 2016 | 24734836 |
| epidemic clostridium difficile strains demonstrate increased competitive fitness compared to nonepidemic isolates. | clostridium difficile infection is the most common cause of severe cases of antibiotic-associated diarrhea (aad) and is a significant health burden. recent increases in the rate of c. difficile infection have paralleled the emergence of a specific phylogenetic clade of c. difficile strains (ribotype 027; north american pulsed-field electrophoresis 1 [nap1]; restriction endonuclease analysis [rea] group bi). initial reports indicated that ribotype 027 strains were associated with increased morbid ... | 2014 | 24733099 |
| epidemiological factors influencing the development of relapsing and severe clostridium difficile infection. | clostridium difficile infection (cdi) is currently the most frequent cause of nosocomial infectious diarrhea in adults in the developed countries. the goal of the study was to evaluate risk factors for relapsing and severe cdi in a set of patients hospitalized at the clinic of infectious diseases at the university hospital brno. | 2014 | 24730991 |
| clinical update for the diagnosis and treatment of clostridium difficile infection. | clostridium difficile infection (cdi) presents a rapidly evolving challenge in the battle against hospital-acquired infections. recent advances in cdi diagnosis and management include rapid changes in diagnostic approach with the introduction of newer tests, such as detection of glutamate dehydrogenase in stool and polymerase chain reaction to detect the gene for toxin production, which will soon revolutionize the diagnostic approach to cdi. new medications and multiple medical society guideline ... | 2014 | 24729930 |
| identification and characterization of a gene cluster required for proper rod shape, cell division, and pathogenesis in clostridium difficile. | little is known about cell division in clostridium difficile, a strict anaerobe that causes serious diarrheal diseases in people whose normal intestinal microbiome has been perturbed by treatment with broad-spectrum antibiotics. here we identify and characterize a gene cluster encoding three cell division proteins found only in c. difficile and a small number of closely related bacteria. these proteins were named mlda, mldb, and mldc, for midcell localizing division proteins. mlda is predicted t ... | 2014 | 24727226 |
| fulminant colitis from clostridium difficile infection, the epidemic strain ribotype 027, in japan. | in december 2012, a 32-year-old woman with no previous medical history and no previous antibiotic treatment had a fever and diarrhea 2 days after a cesarean section in which cefazolin was used as a prophylactic antimicrobial agent. she was transferred to our hospital 5 days after the cesarean for severe colitis. a rapid test of stool for clostridium difficile toxin a and b was positive. although oral vancomycin (0.5-2.0 g/day) and intravenous immunoglobulin (5 g/day) were administered after her ... | 2014 | 24726377 |
| the spore-associated protein bcla1 affects the susceptibility of animals to colonization and infection by clostridium difficile. | the bcla protein is a major component of the outermost layer of spores of a number of bacterial species and clostridium difficile carries three bcla genes. using insertional mutagenesis each gene was characterized and spores devoid of these proteins had surface aberrations, reduced hydrophobicity and germinated faster than wild-type spores. therefore the bcla proteins were likely major components of the spore surface and when absent impaired the protective shield effect of this outermost layer. ... | 2014 | 24720767 |
| physician attitudes toward the use of fecal microbiota transplantation for the treatment of recurrent clostridium difficile infection. | fecal microbiota transplantation (fmt) is a safe and effective, yet infrequently used therapy for recurrent clostridium difficile infection (cdi). | 2014 | 24719899 |
| oral absorption of enteral vancomycin in a child with clostridium difficile colitis and renal impairment. | vancomycin is a glycopeptide antibiotic that is used by the enteral route for the treatment of clostridium difficile infections and is not thought to be absorbed into the systemic circulation. we report on a 2-year-old, 12.5-kg patient with confirmed c difficile colitis and renal insufficiency that was treated with 125 mg of enteral vancomycin (10 mg/kg); the patient developed measurable systemic concentrations as high as 17.8 mg/l. however, as the patient's colitis began to improve, the serial ... | 2013 | 24719593 |
| the impact of hospital-onset clostridium difficile infection on outcomes of hospitalized patients with sepsis. | to examine the impact of hospital-onset clostridium difficile infection (hocdi) on the outcomes of patients with sepsis. | 2014 | 24715578 |
| incidence and outcomes of clostridium difficile-associated disease in hematopoietic cell transplant recipients. | hematopoietic stem cell transplant (hsct) recipients are at a high risk of clostridium difficile-associated disease (cdad) given frequent hospitalizations, prolonged antibiotic usage and altered integrity of intestinal mucosa. the prevalence and trends of cdad in hsct patients have not been extensively studied. in this study, the international classification of diseases, ninth revision, clinical modification (icd-9-cm) codes were used to identify cdad in hsct patients using a nationwide inpatien ... | 2014 | 24715522 |
| the lexa regulated genes of the clostridium difficile. | the sos response including two main proteins lexa and reca, maintains the integrity of bacterial genomes after dna damage due to metabolic or environmental assaults. additionally, derepression of lexa-regulated genes can result in mutations, genetic exchange and expression of virulence factors. here we describe the first comprehensive description of the in silico lexa regulon in clostridium difficile, an important human pathogen. | 2014 | 24713082 |
| clostridium difficile toxin a attenuates wnt/β-catenin signaling in intestinal epithelial cells. | clostridium difficile toxins a and b (tcda and tcdb) are homologous glycosyltransferases that inhibit a group of small gtpases within host cells, but several mechanisms underlying their pathogenic activity remain unclear. in this study, we evaluated the effects of tcda on the wnt/β-catenin pathway, the major driving force behind the proliferation of epithelial cells in colonic crypts. iec-6 and rko cells stimulated with wnt3a-conditioned medium were incubated with 10, 50, and 100 ng/ml of tcda f ... | 2014 | 24711571 |
| time-resolved cellular effects induced by tcda from clostridium difficile. | the anaerobe clostridium difficile is a common pathogen that causes infection of the colon leading to diarrhea or pseudomembranous colitis. its major virulence factors are toxin a (tcda) and toxin b (tcdb), which specifically inactivate small gtpases by glucosylation leading to reorganization of the cytoskeleton and finally to cell death. in the present work a quantitative proteome analysis using the isotope-coded protein label (icpl) approach was conducted to investigate proteome changes in the ... | 2014 | 24711272 |
| reduction in clostridium difficile infections among neurosurgical patients associated with discontinuation of antimicrobial prophylaxis for the duration of external ventricular drain placement. | | 2014 | 24709732 |
| community-associated clostridium difficile infection among veterans with spinal cord injury and disorder. | the impact of community-associated clostridium difficile infection (ca-cdi) on patients with spinal cord injuries and disorders (sci/ds) is not fully understood. we examined ca-cdi cases among veterans with sci/d, comparing them with community-onset, healthcare facility-associated (co-hcfa) cases. generally, patients with ca-cdi had less comorbidity, less severe cdi, and lower likelihood of antibiotic exposure. | 2014 | 24709729 |
| the role of the humoral immune response to clostridium difficile toxins a and b in susceptibility to c. difficile infection: a case-control study. | antibody levels to clostridium difficile toxin a (tcda), but not toxin b (tcdb), have been found to determine risk of c. difficile infection (cdi). historically, tcda was thought to be the key virulence factor; however the importance of tcdb in disease is now established. we re-evaluated the role of antibodies to tcda and tcdb in determining patient susceptibility to cdi in two separate patient cohorts. in contrast to earlier studies, we find that cdi patients have lower pre-existing iga titres ... | 2014 | 24708941 |
| restoring the gut microbiome for the treatment of inflammatory bowel diseases. | fecal microbiota transplantation (fmt) is considered to be a highly successful therapy for recurrent and refractory clostridium difficile infection (cdi) based on recent clinical trials. the pathogenesis of inflammatory bowel diseases (ibd) is thought to be due in part to perturbations in the gut microflora that disrupt homeostasis. fmt restores essential components of the microflora which could reverse the inflammatory processes observed in ibd. case reports and series for the treatment of ibd ... | 2014 | 24707129 |
| enteric infections. | cancer patients, particularly those with neutropenia, are at risk for enteric and intra-abdominal infections. specific infections and infectious syndromes in this setting include neutropenic enterocolitis, bacterial infections such as clostridium difficile infection (cdi), viral infections such as cmv colitis, and parasitic infections such as strongyloidiasis. diagnosing and gauging the severity of cdi presents challenges, as chemotherapy may produce symptoms that mimic cdi and laboratory findin ... | 2014 | 24706227 |
| early infection of hip joint prosthesis by clostridium difficile in an hiv-1 infected patient. | anaerobes are less frequently described as causative pathogen of prosthetic joint infection (pji). we report the first case of early pji after hip arthroplasty due to clostridium difficile in a diabetic and hiv-1 infected patient with bacteremia. our patient was successfully treated through surgical debridement and prosthesis retention combined with targeted antibiotic therapy. | 2014 | 24705255 |
| editorial commentary: changing epidemiology of clostridium difficile and emergence of new virulent strains. | | 2014 | 24704726 |
| emergence of a ribotype 244 strain of clostridium difficile associated with severe disease and related to the epidemic ribotype 027 strain. | we identified 12 patients with clostridium difficile infection between july 2011 and march 2012 from whom an unusual c. difficile strain was isolated. this strain had a single-nucleotide deletion of the tcdc gene at position 117 and binary toxin genes, which are characteristic of the hypervirulent ribotype (rt) 027 strain. | 2014 | 24704722 |
| [clostridium colitis at a surgical department]. | the aim of our study was to identify risk factors associated with the development of clostridium difficile colitis and determining the severity of clostridial colitis in a group of surgical patients. identification of its predispositions is necessary for preventive interventions and effective treatment. | 2014 | 24702290 |
| development and validation of a recurrent clostridium difficile risk-prediction model. | recurrent clostridium difficile infection (rcdi) affects 10% to 25% of patients with initial cdi (icdi). initiation of new therapies that reduce recurrences rests on identifying patients at high risk for rcdi at icdi onset. | 2014 | 24700708 |
| re: proton pump inhibitors and risk for recurrent clostridium difficile infection among inpatients. | | 2014 | 24698870 |
| safety and tolerability of rifaximin for the treatment of irritable bowel syndrome without constipation: a pooled analysis of randomised, double-blind, placebo-controlled trials. | the efficacy of rifaximin, a nonsystemic, gut-targeted antibiotic for reducing non-constipation-predominant irritable bowel syndrome (non-c ibs) symptoms, has been demonstrated in one phase 2b and two phase 3 randomised, double-blind, placebo-controlled trials, but detailed data about rifaximin safety and tolerability during treatment and subsequent follow-up periods are lacking. | 2014 | 24697851 |
| the changes of pcr ribotype and antimicrobial resistance of clostridium difficile in a tertiary care hospital over 10 years. | the aims of this study were to investigate any change in pcr ribotypes and to determine the antimicrobial resistance of common pcr ribotypes over a 10-year period in a tertiary care hospital. we conducted pcr ribotyping, antimicrobial susceptibility testing and dna gyrase sequencing to identify changes in 1407 clostridium difficile non-duplicated isolates obtained between 2000 and 2009. a total of 74 different ribotypes were found. the most prevalent ribotype was ribotype 001 (26.1 %). the preva ... | 2014 | 24696516 |
| common questions about clostridium difficile infection. | clostridium difficile infection is a common cause of antibiotic-associated diarrhea. it causes no symptoms in more than one-half of infected patients, but can also cause a wide spectrum of illnesses and death. the incidence and severity have increased in recent years. the most important modifiable risk factor for c. difficile infection is antibiotic exposure; this risk is dose-related and higher with longer courses and combination therapy. c. difficile infection is also associated with older age ... | 2014 | 24695562 |
| comparison of sensitivity of enzyme immunoassays for toxin a and b in different c. difficile pcr ribotypes. | enzyme immunoassays (eias) for toxins a and b are the most common assays for the diagnosis of clostridium difficile infection due to their rapidity and ease of use. however, the sensitivity of different kits varies greatly. the predominant pcr ribotypes of c. difficile vary according to the region or country studied, and it was recently reported that the sensitivity of eias can be affected by the strain type. the aim of this study was to assess the sensitivity of eias in different pcr ribotypes ... | 2014 | 24695472 |
| temporal changes in serum albumin and total protein in patients with hospital-acquired clostridium difficile infection. | studies have demonstrated low serum levels of total protein (tp) and albumin (alb) in patients with clostridium difficile infection (cdi), especially with refractory and recurrent disease. however, it is not known whether low tp and/or alb levels are a risk factor for cdi or merely a result of diarrheal loss. the aim of this study is to determine if low tp and/or alb level is an antecedent or sequela of cdi, which would be useful in risk stratification of hospitalized or nursing home patients. a ... | 2014 | 24695471 |
| comparison of two molecular methods for detecting toxigenic clostridium difficile. | clostridium difficile is one of the most common causes of nosocomial diarrhea, and diagnostic methods for detecting c. difficile infection have shifted from conventional to more recent molecular techniques. this study aimed to compare the performance of two molecular assays (meridian illumigene™ and advansure cd real-time pcr) in detecting c. difficile using a toxigenic culture as a reference standard. | 2014 | 24695470 |
| the clostridium difficile proline racemase is not essential for early logarithmic growth and infection. | proline racemase (prdf), which is important for energy metabolism via the stickland pathway and is unique to certain clostridia, was investigated as a potential anti-clostridium difficile target by examining its effects on the growth and virulence of c. difficile. inactivation of prdf by insertional mutagenesis did not affect early logarithmic growth but only attenuated growth in the mid- and late logarithmic phases. there was no effect on virulence in vivo, suggesting that prdf is also not requ ... | 2014 | 24693984 |
| cost-effectiveness of competing strategies for management of recurrent clostridium difficile infection: a decision analysis. | clostridium difficile infection (cdi) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. the cost-effectiveness of newer treatments for recurrent cdi has not been examined, yet would be important to inform clinical practice. the aim of this study was to analyze the cost effectiveness of competing strategies for recurrent cdi. | 2014 | 24692533 |
| rho gtpases control ciliary epithelium cells proliferation and progenitor profile induction in vivo. | rho gtpases play a central role in actin-based cytoskeleton reorganization and regulate multiple signaling pathways that control gene transcription, cell survival, and proliferation. we investigated the effect of rho gtpases on cell cycle regulation and progenitor genes expression on mouse ciliary epithelium (ce), a potential source of progenitor/stem cells in the adult retina. | 2014 | 24692128 |
| drug-safety alerts issued by regulatory authorities: usefulness of meta-analysis in predicting risks earlier. | the purpose of this study was to evaluate how risk estimates generated from cumulative meta-analysis performs over time for drugs having their benefit/risk ratio re-evaluated due to safety issues and, additionally, assess whether results are consistent with regulatory authorities' conclusions. | 2014 | 24691786 |
| treatment of recurrent clostridium difficile infection with fecal transplantation. | clostridium difficile infection is an increasingly common clinical challenge in hospitals and healthcare facilities. the infection often results in severe complications for the infected individual including relentless diarrhea, abdominal pain, dehydration, and mortality. currently, there is a significant gap between research and practice in the management of recurrent clostridium difficile infection, and treatment guidelines are limited. numerous attempts at treating this infection have been mad ... | 2014 | 24691086 |
| investigation of a clostridium difficile cluster by multilocus sequence typing in a bone marrow transplant unit. | | 2014 | 24690456 |
| the epidemiology of clostridium difficile infection in romania: what we know, or do not know and why? | | 2014 | 24689105 |
| improving hospital staff compliance with environmental cleaning behavior. | reducing the incidence of healthcare-associated infections requires proper environmental cleanliness of frequently touched objects within the hospital environment. an intervention was launched in june 2012 and repeated in february 2013 and august 2013 to increase hospital room cleanliness with repeated education and training of nursing and environmental services staff to reduce healthcare-associated infections at cook children's medical center. random rooms were tested, staff were trained about ... | 2014 | 24688183 |
| national trends and in-hospital outcomes of adult patients with inflammatory bowel disease receiving parenteral nutrition support. | patients with inflammatory bowel disease (ibd), including crohn's disease (cd) and ulcerative colitis (uc), are susceptible to protein-calorie malnutrition secondary to decreased oral intake, malabsorption, and increased metabolic expenditure. in this study, we seek to assess the national frequencies of parenteral nutrition (pn) use among hospitalized patients with ibd and to determine their in-hospital outcomes. | 2016 | 24687967 |
| mathematical modelling reveals properties of tcdc required for it to be a negative regulator of toxin production in clostridium difficile. | the role of the protein tcdc in pathogenicity of the bacterium clostridium difficile is currently unclear: conflicting reports suggest it is either a negative regulator of toxin production or, on the other hand, has no effect on virulence at all. we exploit a theoretical approach by taking what is known about the network of proteins surrounding toxin production by c. difficile and translating this into a mathematical model. from there it is possible to investigate a range of possible interaction ... | 2015 | 24687436 |
| [diarrhea associated with clostridium difficile in the elderly: new perspectives]. | infection due to clostridium difficile is currently the main cause of hospital acquired gastrointestinal disease. its prevalence in the elderly population is higher due to there being many associated risk factors in this age group, such as comorbidity, frequent exposure to the healthcare or residential home setting, immunosenescence, greater consumption of antibiotics, and antiacids. the diagnostic techniques have notably improved in the last few years, which could also account for an increase i ... | 2014 | 24685366 |
| fever notions of the misinformed: a quality improvement project. | tracking temperatures graphically, recognizing their normal quotidian variations, and acknowledging that fever may be a beneficial physiological response to infection, have been lost in modern hospital care. further, injudicious use of antibiotics for "low-grade fever" contributes to the multiple drug resistant organism and clostridium difficile epidemics. this essay discusses these issues and proposes changing common misperceptions of fever as a quality improvement project. | 2014 | 24683931 |
| a novel multivalent, single-domain antibody targeting tcda and tcdb prevents fulminant clostridium difficile infection in mice. | the incidence of clostridium difficile infection (cdi) and associated mortality have increased rapidly worldwide in recent years. therefore, it is critical to develop new therapies for cdi. in this study, we generated a novel, potently neutralizing, tetravalent, and bispecific antibody composed of 2 heavy-chain-only vh (vhh) binding domains against both tcda and tcdb (designated "aba") that reverses fulminant cdi in mice infected with an epidemic 027 strain after a single injection of the antibo ... | 2014 | 24683195 |
| role of doxycycline in clostridium difficile infection acquisition. | to evaluate and review the literature surrounding the potential protective benefit of tetracyclines, particularly doxycycline, in reducing clostridium difficile infection (cdi) acquisition. | 2014 | 24682682 |
| utility of the clostridial site-specific recombinase tnpx to clone toxic-product-encoding genes and selectively remove genomic dna fragments. | tnpx is a site-specific recombinase responsible for the excision and insertion of the transposons tn4451 and tn4453 in clostridium perfringens and clostridium difficile, respectively. here, we exploit phenotypic features of tnpx to facilitate genetic mutagenesis and complementation studies. genetic manipulation of bacteria often relies on the use of antibiotic resistance genes; however, a limited number are available for use in the clostridia. the ability of tnpx to recognize and excise specific ... | 2014 | 24682304 |
| effects of clostridium difficile infection in patients with alcoholic hepatitis. | infection increases mortality in patients with alcoholic hepatitis (ah). little is known about the association between clostridium difficile infection (cdi) and ah. we examined the prevalence and effects of cdi in patients with ah, compared with those of other infections. | 2014 | 24681081 |