| risk of clostridium difficile infection in hospitalized patients receiving metronidazole for a non-c difficile infection. | antibiotics often are given to prevent infections but also constitute a risk factor for clostridium difficile infection (cdi). metronidazole is an effective treatment for cdi. we investigated whether prophylactic administration of metronidazole to patients before they receive other antibiotics reduces the risk of cdi. | 2014 | 24681079 |
| the silver lining of disposable sporicidal privacy curtains in an intensive care unit. | the environment is a well-known source of health care-acquired infection. because of the known risk of contamination, patient privacy curtains require frequent changes to decrease the risk of spread from patients to curtain and visa versa. | 2014 | 24679561 |
| working relationships of infection prevention and control programs and environmental services and associations with antibiotic-resistant organisms in canadian acute care hospitals. | environmental contamination in hospitals with antibiotic-resistant organisms (aros) is associated with patient contraction of aros. this study examined the working relationship of infection prevention and control (ipac) and environmental services and the impact of that relationship on aro rates. | 2014 | 24679559 |
| [clostridium difficile infections in spanish internal medicine departments during the period 2005-2010: the burden of the disease]. | clostridium difficile infection (cdi) is increasing in spain. a review is presented of this infection in order to evaluate the burden of the disease in this country. | 2015 | 24679445 |
| synchronous cytomegalovirus and clostridium difficile infection of the pouch: a trigger for chronic pouchitis? | pouchitis occurs in up to one half of patients after restorative proctocolectomy with ileal pouch-anal anastomosis (ipaa). cytomegalovirus (cmv) and clostridium difficile are among the commonest secondary identifiable etiologies. a 17-year-old male with ulcerative colitis underwent ipaa due to refractory disease. nine months later he experienced bloody diarrhea and fever. laboratory testing and endoscopy confirmed pouch inflammation. testing for c. difficile toxins a and b was positive. histolog ... | 2014 | 26183628 |
| life after colectomy for fulminant clostridium difficile colitis: a 7-year follow up study. | the long-term prognosis of patients undergoing colectomy for fulminant clostridium difficile colitis has not been well studied. the authors present 7-year survival trends in such patients. | 2014 | 24674828 |
| administration of proton pump inhibitors in critically ill medical patients is associated with increased risk of developing clostridium difficile-associated diarrhea. | proton pump inhibitors (ppis) effectively prevent gastrointestinal bleedings in critically ill patients at the intensive care unit (icu). in non-icu hospitalized patients, ppi administration increases the risk of infectious complications, especially clostridium difficile-associated diarrhea (cdad); but no such data are available for the icu setting. | 2014 | 24674763 |
| saccharomyces cerevisiae fungemia, a possible consequence of the treatment of clostridium difficile colitis with a probioticum. | the yeast saccharomyces boulardii is a biotherapeutic agent used for the prevention and treatment of several gastrointestinal diseases, such as diarrhoea caused by clostridium difficile, in addition to the antibiotic therapy. in this study we report a case of saccharomyces cerevisiae fungemia in a patient with clostridium difficile-associated diarrhoea (cdad) treated orally with s. boulardii in association with vancomycin. the identification of the s. cerevisiae was confirmed by molecular techni ... | 2017 | 24674691 |
| trends and changes in clostridium difficile diagnostic policies and their impact on the proportion of positive samples: a national survey. | in june 2012, israeli guidelines for laboratories were published defining the recommended methods for diagnosis of clostridium difficile infection (cdi). we conducted this survey to examine the effects of the new recommendations on the proportions of rejected and positive samples by the different methods. a survey was mailed to the directors of all general hospital (gh) and health maintenance organization (hmo) clinical microbiology laboratories. the report was divided into two periods, before a ... | 2014 | 24674056 |
| multicenter evaluation of the quidel lyra direct c. difficile nucleic acid amplification assay. | clostridium difficile is a gram-positive bacterium commonly found in health care and long-term-care facilities and is the most common cause of antibiotic-associated diarrhea. rapid detection of this bacterium can assist physicians in implementing contact precautions and appropriate antibiotic therapy in a timely manner. the purpose of this study was to compare the clinical performance of the quidel lyra direct c. difficile assay (lyra assay) (quidel, san diego, ca) to that of a direct cell cultu ... | 2014 | 24671790 |
| community-acquired clostridium difficile infection: an increasing public health threat. | there has been a startling shift in the epidemiology of clostridium difficile infection over the last decade worldwide, and it is now increasingly recognized as a cause of diarrhea in the community. classically considered a hospital-acquired infection, it has now emerged in populations previously considered to be low-risk and lacking the traditional risk factors for c. difficile infection, such as increased age, hospitalization, and antibiotic exposure. recent studies have demonstrated great gen ... | 2014 | 24669194 |
| toxic megacolon after abdominoplasty: a case report. | after an accepted technique of abdominoplasty, a 66-year-old woman developed clostridium difficile-associated diarrhea, leading to toxic megacolon and subsequent subtotal colectomy. the presumed etiology is chronic use of a proton pump inhibitor. this was addressed in a 2012 "white paper" warning issued by the food and drug administration. this article presents the course of this case as well as a review of the pertinent literature. | 2014 | 24667886 |
| detection of clostridium difficile diarrhoea in harare, zimbabwe. | clostridium difficile is associated with nosocomial and community-acquired diarrhoea and pseudomembranous colitis in humans. little information is available on the importance of c. difficile as a causative agent of diarrhoea in developing countries such as zimbabwe. the current study was carried out to determine the prevalence of c. difficile in diarrhoeal stools of outpatients over 2 years of age presenting at healthcare centres in harare, zimbabwe, and to determine the antimicrobial susceptibi ... | 2014 | 24664819 |
| clostridium difficile extracytoplasmic function σ factor σv regulates lysozyme resistance and is necessary for pathogenesis in the hamster model of infection. | clostridium difficile is a clinically important pathogen and the most common cause of hospital-acquired infectious diarrhea. expression of the c. difficile gene csfv, which encodes σ(v), an extracytoplasmic function σ factor, is induced by lysozyme, which damages the peptidoglycan of bacteria. here we show that σ(v) is required for lysozyme resistance in c. difficile. using microarray analysis, we identified the c. difficile genes whose expression is dependent upon σ(v) and is induced by lysozym ... | 2014 | 24664503 |
| early clostridium difficile infection during allogeneic hematopoietic stem cell transplantation. | clostridium difficile infection (cdi) is frequently diagnosed in recipients of allogeneic hematopoietic stem cell transplantation (allo-hsct). we characterized early-transplant cdi and its associations, and analyzed serially-collected feces to determine intestinal carriage of toxigenic c. difficile. fecal specimens were collected longitudinally from 94 patients during allo-hsct hospitalization, from the start of pre-transplant conditioning until up to 35 days after stem cell infusion. presence o ... | 2014 | 24662889 |
| development of a recombinant toxin fragment vaccine for clostridium difficile infection. | clostridium difficile infection (cdi) is the major cause of antibiotic-associated diarrhea and pseudomembranous colitis, a disease associated with significant morbidity and mortality. the disease is mostly of nosocomial origin, with elderly patients undergoing anti-microbial therapy being particularly at risk. c. difficile produces two large toxins: toxin a (tcda) and toxin b (tcdb). the two toxins act synergistically to damage and impair the colonic epithelium, and are primarily responsible for ... | 2014 | 24662701 |
| investigation of potentially pathogenic clostridium difficile contamination in household environs. | as clostridium difficile spores are resistant to many household cleaning products, the potential for community household contamination is high. the purpose of this study was to assess the prevalence of toxigenic c. difficile from environmental sources from a large urban area. three to 5 household items or environmental dust was collected from 30 houses in houston, texas. a total of 127 environmental samples were collected from shoe bottoms (n = 63), bathroom surfaces (n = 15), house floor dusts ... | 2014 | 24657158 |
| evaluation of a multiplex pcr assay for simultaneous detection of bacterial and viral enteropathogens in stool samples of paediatric patients. | we evaluated a multiplex pcr assay, the seeplex diarrhoea ace detection, that simultaneously detects 15 enteric pathogens, including salmonella spp., shigella spp., vibrio spp., toxin b producer clostridium difficile, campylobacter spp., clostridium perfringens, yersinia enterocolitica, aeromonas spp., escherichia coli o157:h7, verocytotoxin-producing escherichia coli, adenovirus, group a rotavirus, norovirus gi and gii, and astrovirus. we compared this assay with clinical methods routinely used ... | 2014 | 24656922 |
| understanding new concepts: clostridium difficile infection in pouch patients. | | 2014 | 24652112 |
| [treating clostridium difficile infection with faecal transplantation: donor microbiological testing]. | clostridium difficile associated diseases (cdads) or c. difficile infections (cdis) are increasing in incidence, severity and mortality. among patients with cdis, those with recurrent disease are less responsive to traditional therapies with commonly used drugs, such as metronidazole and vancomycin. faecal microbiota transplantation is an old therapeutic procedure that has been recently proposed as a safe and effective treatment for cdi patients non-responsive to antibiotic therapy. in this pape ... | 2014 | 24651084 |
| increased incidence of clostridium difficile pcr ribotype 027 in hesse, germany, 2011 to 2013. | after the first outbreak of clostridium difficile pcr ribotype (rt) 027 in germany in 2007, no further outbreaks were reported until the recent re-emergence of rt 027 in hesse, a federal state with 6 million inhabitants located in south-west germany. we undertook a survey to determine the prevalence of rt 027 and other strains in a prospective study. from january 2011 to july 2013, we analysed 291 specimens from patients diagnosed with c. difficile infection (cdi) in 40 healthcare facilities in ... | 2014 | 24650866 |
| real-time cellular analysis for quantitative detection of functional clostridium difficile toxin in stool. | rapid and accurate diagnosis and monitoring of clostridium difficile infection (cdi) is critical for patient care and infection control. we will briefly review current laboratory techniques for the diagnosis of cdi and identify aspects needing improvement. we will also introduce a real-time cellular analysis (rtca) assay developed for the diagnosis and monitoring of cdi using electronic impedance to assess the cell status. the rtca assay uses impedance measurement to detect minute physiological ... | 2014 | 24649817 |
| [recurrent clostridium difficile infection. treatment with duodenal infusion of donor feces]. | | 2014 | 24647687 |
| the systemic inflammatory response to clostridium difficile infection. | the systemic inflammatory response to clostridium difficile infection (cdi) is incompletely defined, particularly for patients with severe disease. | 2014 | 24643077 |
| higher plasma vitamin d is associated with reduced risk of clostridium difficile infection in patients with inflammatory bowel diseases. | patients with inflammatory bowel diseases (ibd) have an increased risk of clostridium difficile infection (cdi). cathelicidins are anti-microbial peptides that attenuate colitis and inhibit the effect of clostridial toxins. plasma calcifediol [25(oh)d] stimulates production of cathelicidins. | 2014 | 24641590 |
| systematic review: faecal microbiota transplantation therapy for digestive and nondigestive disorders in adults and children. | there has been growing interest in the use of faecal microbiota transplantation (fmt) for the treatment of gastrointestinal and nongastrointestinal diseases. | 2014 | 24641570 |
| systematic selection of modified aptamer pairs for diagnostic sandwich assays. | protein diagnostic applications typically require pairs of analyte-specific reagents for capture and detection. we developed methods for the systematic isolation of slow off-rate modified aptamer (somamer) reagents that bind to different epitopes and allow efficient pair-wise screening of multiple ligands. somamers were generated via a second systematic evolution of ligands by exponential enrichment (selex), using complexes of target proteins with a primary, non-amplifiable somamer and employing ... | 2014 | 24641476 |
| increasing incidence of clostridium difficile infection, australia, 2011-2012. | to report the quarterly incidence of hospital-identified clostridium difficile infection (hi-cdi) in australia, and to estimate the burden ascribed to hospital-associated (ha) and community-associated (ca) infections. | 2014 | 24641152 |
| clostridium difficile - what is the australian story? | | 2014 | 24641129 |
| vaccines against clostridium difficile. | clostridium difficile infection (cdi) is recognized as a major cause of nosocomial diseases ranging from antibiotic related diarrhea to fulminant colitis. emergence during the last 2 decades of c. difficile strains associated with high incidence, severity and lethal outcomes has increased the challenges for cdi treatment. a limited number of drugs have proven to be effective against cdi and concerns about antibiotic resistance as well as recurring disease solicited the search for novel therapeut ... | 2014 | 24637887 |
| vaccination against clostridium difficile using toxin fragments: observations and analysis in animal models. | clostridium difficile is a major cause of antibiotic associated diarrhea. recently, we have shown that effective protection can be mediated in hamsters through the inclusion of specific recombinant fragments from toxin a and b in a systemically delivered vaccine. interestingly while neutralizing antibodies to the binding domains of both toxin a and b are moderately protective, enhanced survival is observed when fragments from the glucosyltransferase region of toxin b replace those from the bindi ... | 2015 | 24637800 |
| faecal transplantation for the treatment of clostridium difficile infection: a review. | clostridium difficile infection (cdi) remains a major healthcare burden despite recent global falls in its prevalence. the risk of recurrence is high when using antibiotics such as vancomycin, particularly in already recurrent disease. in light of this, new therapy options are being perused, including novel antibiotics such as fidaxomicin, probiotics, intravenous immunoglobulin and faecal transplantation. faecal transplantation, referred to here as human probiotic infusion (hpi), is attracting a ... | 2014 | 24636428 |
| probiotics, prebiotics and the gastrointestinal tract in health and disease. | the microbiome located in the human gastrointestinal tract (git) comprises the largest community (diverse and dense) of bacteria, and in conjunction with a conducive internal milieu, promotes the development of regulated pro- and anti-inflammatory signals within the git that promotes immunological and metabolic tolerance. in addition, host-microbial interactions govern git inflammation and provide cues for upholding metabolic regulation in both the host and microbes. failure to regulate inflamma ... | 2014 | 24633989 |
| is the interleukin 8 promoter polymorphism rs4073/-251t >a associated with clostridium difficile infection? | the interleukin 8 gene single-nucleotide polymorphism rs4073/-251t >a predisposes to clostridium difficile infection (cdi), but this association has not been independently validated. in this study, we were unable to replicate this association in either a white cohort or by meta-analysis, suggesting that rs4073/-251t >a is unlikely to constitute a major risk factor for cdi. | 2014 | 24633688 |
| effect of antibiotic stewardship programmes on clostridium difficile incidence: a systematic review and meta-analysis. | despite vigorous infection control measures, clostridium difficile continues to cause significant disease burden. antibiotic stewardship programmes (asps) may prevent c. difficile infections by limiting exposure to certain antibiotics. our objective was to perform a meta-analysis of published studies to assess the effect of asps on the risk of c. difficile infection in hospitalized adult patients. | 2014 | 24633207 |
| validation of the 3-day rule for stool bacterial tests in japan. | stool cultures are expensive and time consuming, and the positive rate of enteric pathogens in cases of nosocomial diarrhea is low. the 3-day rule, whereby clinicians order a clostridium difficile (cd) toxin test rather than a stool culture for inpatients developing diarrhea >3 days after admission, has been well studied in western countries. the present study sought to validate the 3-day rule in an acute care hospital setting in japan. | 2014 | 24633021 |
| of stewardship, motherhood and apple pie. | antibiotic stewardship is universally agreed to be desirable, but optimal models for stewardship remain uncertain. uk stewardship targets the particular antibiotic families-cephalosporins and fluoroquinolones-blamed for the selection of clostridium-difficile-associated disease. to balance this there have been dramatic increases in the use of penicillin-β-lactamase inhibitor combinations. by channelling selection pressure in this way, we hazard destroying the utility of these antibiotic classes i ... | 2014 | 24630303 |
| clostridium difficile in paediatric populations. | an increase in clostridium difficile infection incidence has been observed among hospitalized children in the united states. the present statement, targeted at clinicians caring for infants and children in community and institutional settings, summarizes the relevant information relating to the role of c difficile in childhood diarrhea and provides recommendations for diagnosis, prevention and treatment. significant differences between adult and paediatric risk factors and disease are discussed, ... | 2014 | 24627655 |
| the outcome and long-term follow-up of 94 patients with recurrent and refractory clostridium difficile infection using single to multiple fecal microbiota transplantation via retention enema. | clostridium difficile infection (cdi) is one of the most frequent causes of healthcare-associated infections, and its rates are also increasing in the community. the management of cdi has become a major challenge, given growing rates of recurrences and failures with standard antibiotic therapy. mounting evidence suggests that fecal microbiota transplantation (fmt) may be effective; however, as there is a paucity of data with regard to repeat fmt for primary non-response to this treatment, this s ... | 2014 | 24627239 |
| carvacrol and trans-cinnamaldehyde reduce clostridium difficile toxin production and cytotoxicity in vitro. | clostridium difficile is a nosocomial pathogen that causes a serious toxin-mediated enteric disease in humans. reducing c. difficile toxin production could significantly minimize its pathogenicity and improve disease outcomes in humans. this study investigated the efficacy of two, food-grade, plant-derived compounds, namely trans-cinnamaldehyde (tc) and carvacrol (cr) in reducing c. difficile toxin production and cytotoxicity in vitro. three hypervirulent c. difficile isolates were grown with or ... | 2014 | 24625665 |
| [general internal medicine in hospital practice: the year 2013 put into perspective by residents]. | 2013 was full of significant advances in all areas of medicine, which may have an impact on daily practice in general internal medicine. from salt and water restriction in heart failure to transfusion threshold in upper gastrointestinal bleeding and fecal infusion in clostridium difficile colitis; from new data in resuscitation and persistent questions in palliative care and intensive care medicine, through pneumology, nephrology and endocrinology, the literature has been rich in new considerati ... | 2014 | 24624733 |
| [2013 literature findings in internal general medicine]. | the prescribing of antibiotics for uncomplicated skin abscesses and diverticulitis has no benefit. some antibiotics are more at risk of causing a clostridium difficile infection. the tests used to exclude a history of a penicillin allergy are safe. a threshold of d-dimer adjusted for the age significantly improves the specificity of the test without affecting the sensitivity. the prescription of paraclinics tests is not an effective "treatment" for the patient's anxiety. in the sleep apnea syndr ... | 2014 | 24624732 |
| development and optimization of a high-throughput assay to measure neutralizing antibodies against clostridium difficile binary toxin. | clostridium difficile strains producing binary toxin, in addition to toxin a (tcda) and toxin b (tcdb), have been associated with more severe disease and increased recurrence of c. difficile infection in recent outbreaks. binary toxin comprises two subunits (cdta and cdtb) and catalyzes the adp-ribosylation of globular actin (g-actin), which leads to the depolymerization of filamentous actin (f-actin) filaments. a robust assay is highly desirable for detecting the cytotoxic effect of the toxin a ... | 2014 | 24623624 |
| the clostridium difficile pcr ribotype 027 lineage: a pathogen on the move. | clostridium difficile is a gram-positive, spore-forming, human and animal pathogen that is the major cause of antibiotic-associated diarrhoea worldwide. the past decade has seen the rapid emergence of the hypervirulent pcr ribotype (rt) 027 complex, which has been associated with increases in the incidence and severity of disease and mortality. in this review, we describe the potential virulence factors that have been reported in strains from the rt 027 complex. we review the emergence, populati ... | 2014 | 24621128 |
| international prevalence of adverse drug events in hospitals: an analysis of routine data from england, germany, and the usa. | adverse drug events (ades) are frequent in hospitals, occurring either in patients before admission or as a nosocomial event, and either as a drug reaction or as a consequence of a medication error. routine data primarily recorded for reimbursement purposes are increasingly being used on a national level both in pharmacoepidemiological studies and in trigger tools. the aim of this study was to compare the prevalence rates of coded ades in hospitals on a transnational level. | 2014 | 24620750 |
| clostridium difficile enteritis: a new role for an old foe. | small bowel involvement of clostridium difficile is increasingly encountered. data on many management aspects are lacking. | 2014 | 24618362 |
| clostridium difficile infection in patients with acute myelogenous leukemia and in patients undergoing allogeneic stem cell transplantation: epidemiology and risk factor analysis. | patients receiving treatment for acute myelogenous leukemia (aml) and recipients of allogeneic stem cell transplantation (asct) are at high risk of contracting clostridium difficile infection (cdi), the most frequently observed nosocomial diarrhea and enterocolitis. data were retrieved from the prospective cologne cohort of neutropenic patients. patients hospitalized for asct as well as patients receiving treatment for aml were included in the analysis. risk factor analysis for the occurrence of ... | 2014 | 24607558 |
| nap1 strain type predicts outcomes from clostridium difficile infection. | studies are conflicting regarding the importance of the fluoroquinolone-resistant north american pulsed-field gel electrophoresis type 1 (nap1) strain in clostridium difficile infection (cdi) outcome. we describe strain types causing cdi and evaluate their association with patient outcomes. | 2014 | 24604900 |
| editorial commentary: host-pathogen interactions in clostridium difficile infection: it takes two to tango. | | 2014 | 24604896 |
| harnessing microbiota to kill a pathogen: the sweet tooth of clostridium difficile. | | 2014 | 24603797 |
| harnessing microbiota to kill a pathogen: fixing the microbiota to treat clostridium difficile infections. | | 2014 | 24603796 |
| use and outcomes of extended antibiotic prophylaxis in urological cancer surgery. | although perioperative antibiotic prophylaxis prevents postoperative infectious complications, national guidelines recommend cessation of antibiotics within 24 hours after the procedure. extended antibiotic prophylaxis beyond 24 hours may contribute to hospital acquired infections such as clostridium difficile colitis. we evaluated practice patterns of antibiotic prophylaxis in genitourinary cancer surgery and assessed the impact of antibiotic prophylaxis on hospital acquired c. difficile infect ... | 2014 | 24603103 |
| development of team action projects in surgery (taps): a multilevel team-based approach to teaching quality improvement. | to meet the accreditation council for graduate medical education core competency in practice-based learning and improvement, educational curricula need to address training in quality improvement (qi). we sought to establish a program to train residents in the principles of qi and to provide practical experiences in developing and implementing improvement projects. | 2016 | 24602703 |
| risk estimation for recurrent clostridium difficile infection based on clinical factors. | the incidence of clostridium difficile infection (cdi) has risen dramatically during the last decade. although patients respond well to medical therapy such as vancomycin, 20%-30% of patients treated suffer a recurrence of cdi. | 2014 | 24599770 |
| vital signs: improving antibiotic use among hospitalized patients. | antibiotics are essential to effectively treat many hospitalized patients. however, when antibiotics are prescribed incorrectly, they offer little benefit to patients and potentially expose them to risks for complications, including clostridium difficile infection (cdi) and antibiotic-resistant infections. information is needed on the frequency of incorrect prescribing in hospitals and how improved prescribing will benefit patients. | 2014 | 24598596 |
| cost-benefit relation of diet and probiotics in iatrogenic bowel irregularity (ibi). | | 2014 | 24596557 |
| nutrition economic evaluation of a probiotic in the prevention of antibiotic-associated diarrhea. | antibiotic-associated diarrhea (aad) is common and frequently more severe in hospitalized elderly adults. it can lead to increased use of healthcare resources. we estimated the cost-effectiveness of a fermented milk (fm) with probiotic in preventing aad and in particular clostridium difficile-associated diarrhea (cdad). | 2014 | 24596556 |
| predictors of mortality attributable to clostridium difficile infection in patients with underlying malignancy. | this study aimed at evaluating the clinical severity and treatment outcomes of clostridium difficile infections (cdi) and identifying predictors associated with mortality in patients with malignancy. | 2014 | 24595407 |
| diversity in prevalent pcr ribotypes of clinical strains of c. difficile. | in 2009, a programme of clostridium difficile ribotyping was established in the north east. the aim of this project was to profile circulating ribotypes in the region, in all, 50 notified north east clostridium difficile cases were ribotyped. the majority of cases occurred in patients over 70 years and in hospital in-patients. the most common ribotype identified was 027 (n = 12, 24%) and 005 (n = 8, 16%). ribotype 078 was also detected (n = 5, 10%). comparison with a 2009 national ribotyping stu ... | 2014 | 24592641 |
| clostridium difficile infection among children across diverse us geographic locations. | little is known about the epidemiology of clostridium difficile infection (cdi) among children, particularly children ≤3 years of age in whom colonization is common but pathogenicity uncertain. we sought to describe pediatric cdi incidence, clinical presentation, and outcomes across age groups. | 2014 | 24590748 |
| alteration of the murine gastrointestinal microbiota by tigecycline leads to increased susceptibility to clostridium difficile infection. | antibiotics can play dual roles in clostridium difficile infection (cdi); antibiotic treatment increases the risk of cdi, and antibiotics are used to treat cdi. the glycylcycline antibiotic tigecycline has broad antimicrobial activity, yet it is rarely associated with the development of cdi, presumably due to its activity against c. difficile. in this study, we investigated how tigecycline treatment affects the structure of the gut microbiota and susceptibility to cdi by treating mice with tigec ... | 2014 | 24590475 |
| development of clostridium septicum gas gangrene as an adverse effect of clindamycin-induced clostridium difficile infection in a pediatric patient. | clostridium myonecrosis or gas gangrene is a life-threatening infection characterized by either traumatic or atraumatic etiology. it has been widely described in patients with traumatic open wounds and in immunocompromised patients, including malignancy. a third source can result from natural flora in the gastrointestinal tract after bowel ischemia. this is a rare occurrence and is even less commonly described in the pediatric population. we present a pediatric patient who developed clostridium ... | 2014 | 24590337 |
| fidaxomicin in clostridium difficile infection: latest evidence and clinical guidance. | the incidence of clostridium difficile infection (cdi) has risen 400% in the last decade. it currently ranks as the third most common nosocomial infection. cdi has now crossed over as a community-acquired infection. the major failing of current therapeutic options for the management of cdi is recurrence of disease after the completion of treatment. fidaxomicin has been proven to be superior to vancomycin in successful sustained clinical response to therapy. improved outcomes may be due to reduce ... | 2014 | 24587892 |
| clostridium difficile infection: management strategies for a difficult disease. | clostridium difficile was first described as a cause of diarrhea in 1978 and in the last three decades has reached an epidemic state with increasing incidence and severity in both healthcare and community settings. there also has been a rise in severe outcomes from c. difficile infection (cdi). there have been tremendous advancements in the field of cdi with the identification of newer risk factors, recognition of cdi in populations previously thought not at risk and development of better diagno ... | 2014 | 24587820 |
| effects of β-lactam antibiotics and fluoroquinolones on human gut microbiota in relation to clostridium difficile associated diarrhea. | clostridium difficile infections are an emerging health problem in the modern hospital environment. severe alterations of the gut microbiome with loss of resistance to colonization against c. difficile are thought to be the major trigger, but there is no clear concept of how c. difficile infection evolves and which microbiological factors are involved. we sequenced 16s rrna amplicons generated from dna and rna/cdna of fecal samples from three groups of individuals by flx technology: (i) healthy ... | 2014 | 24586762 |
| storage duration of red blood cell transfusion and clostridium difficile infection: a within person comparison. | randomized controlled trials demonstrated that red blood cell (rbc) transfusion elevates the risk of infection, and trials are underway to evaluate whether rbc storage affects outcomes. we previously reported that transfusion predicts clostridium difficile infection (cdi) and, therefore, planned an investigation to examine this further using a more robust design. | 2014 | 24586694 |
| reduction in the incidence of hospital-acquired clostridium difficile infection through infection control interventions other than the restriction of antimicrobial use. | a combination of infection control interventions, consisting of education, isolation, hand hygiene, contact precautions, and environmental disinfection, was implemented in the medical intensive care unit (micu). the strict restriction of the use of antimicrobial agents was not included in this study. following the interventions, the incidence of clostridium difficile infection (cdi) in the micu decreased significantly, by 67%, from 4.70 to 1.53 cases/1000 patient days (p = 0.012), while the hosp ... | 2014 | 24583565 |
| fecal microbiota transplantation in the treatment of clostridium difficile infections. | in recent years, clostridium difficile infections have become more frequent, more severe, more refractory to standard treatment, and more likely to recur. current antibiotic treatment regimens for clostridium difficile infection alter the normal gut flora, which provide colonization resistance against clostridium difficile. over the past few years, there has been a marked increase in the knowledge of the gut microbiota and its role in health maintenance and disease causation. this has, fortuitou ... | 2014 | 24582877 |
| what nurses need to know about fecal microbiota transplantation: education, assessment, and care for children and young adults. | fecal microbiota transplantation (fmt) is an emerging experimental therapy for treatment of recurrent clostridium difficile infection. in the future, fmt has the potential to be a treatment modality in other diseases that involve gut dysbiosis. as use of fmt is likely to expand, pediatric nurses need a clear understanding of fmt to provide appropriate education, assessment, and care for these patients. pediatric research and clinical nurses are a resource to help children and parents understand ... | 2014 | 24582649 |
| pharmacist participation in infection prevention: an innovative approach to monitoring compliance with the five moments for hand hygiene in a large academic medical center. | using pharmacy residents as covert observers, we evaluated compliance with hand hygiene and contact precautions among 101 unique health care workers on entrance, exit, and inside rooms of patients with known or suspected clostridium difficile infection. overall compliance rates with hand hygiene upon entering and exiting patient rooms were 63.4% and 69.3%, respectively. however, there was a lack of hand hygiene inside patient rooms for the observed opportunities. | 2014 | 24581023 |
| control of clostridium difficile infection in the hospital setting. | clostridium difficile infection (cdi) has emerged as a leading challenge in the control of healthcare-associated infection (hcai). the epidemiology of cdi has changed dramatically, this is associated with emergence of 'hypervirulent' strains, particularly pcr ribotype 027. despite the epidemic spread of these strains, there are recent reports of decreasing incidence from healthcare facilities where multi-facetted targeted control programs have been implemented. we consider these changes in epide ... | 2014 | 24579852 |
| [experience with laboratory diagnosis of clostridium difficile]. | clostridium difficile is currently a significant cause of nosocomial diarrhea. for several years, the number of infectious cases in the community has also been increasing. since the beginning of 2010, quite a large increase in the number of clostridium difficile infections (cdis) has been noted in pardubice regional hospital (prh). the objectives of this study were to describe and evaluate the methods used in the laboratory diagnosis of cdis in prh, and to describe the laboratory diagnostic algo ... | 2013 | 24579451 |
| antimicrobial susceptibility of clostridium difficile clinical isolates in iran. | clostridium difficile infection (cdi) is major growing problem in hospitals and its high incidence has been reported in recent years. | 2013 | 24578839 |
| reset of a critically disturbed microbial ecosystem: faecal transplant in recurrent clostridium difficile infection. | recurrent clostridium difficile infection (cdi) can be effectively treated by infusion of a healthy donor faeces suspension. however, it is unclear what factors determine treatment efficacy. by using a phylogenetic microarray platform, we assessed composition, diversity and dynamics of faecal microbiota before, after and during follow-up of the transplantation from a healthy donor to different patients, to elucidate the mechanism of action of faecal infusion. global composition and network analy ... | 2014 | 24577353 |
| antimicrobial stewardship in hospitals: does it work and can we do it? | selection of resistant pathogens by antimicrobial use is probably the most important cause of antimicrobial resistance. antimicrobial stewardship (ams) refers to a multifaceted approach to optimise prescribing. the benefits of ams programmes have been widely demonstrated in terms of reductions in antimicrobial use, mortality, clostridium difficile and other healthcare-associated infections, hospital length of stay and bacterial resistance. several kinds of interventions (i.e. restriction of drug ... | 2014 | 27873630 |
| diagnosis and management of clostridium difficile infection by pediatric infectious diseases physicians. | the incidence of c difficile infection (cdi) has risen among children; however, optimal management of cdi within a diverse pediatric population remains unclear. although adult guidelines recommend oral vancomycin for treatment of second recurrence or severe cdi, dedicated pediatric data to support pediatric specific management guidelines are lacking. our objective was to describe current cdi management practices by pediatric infectious diseases (id) physicians. | 2014 | 26624906 |
| clostridium difficile infection is on the rise. | the emergence of an epidemic strain makes prevention and early diagnosis critical. | 2014 | 24572541 |
| clinical outcomes associated with chronic antimicrobial suppression therapy in patients with continuous-flow left ventricular assist devices. | this retrospective cohort study evaluates the effect of chronic antimicrobial suppression (cas) therapy on clinical outcomes in patients with continuous-flow left ventricular assist devices (cf-lvads) and a history of device-related infection. patients with cf-lvad implantation between january 2008 and august 2011 who received systemic cas after index antibiotic treatment of a device-related infection were included. chronic suppression was defined as continuation of antibiotics for longer than 6 ... | 2014 | 24571683 |
| functional genomics reveals that clostridium difficile spo0a coordinates sporulation, virulence and metabolism. | clostridium difficile is an anaerobic, gram-positive bacterium that can reside as a commensal within the intestinal microbiota of healthy individuals or cause life-threatening antibiotic-associated diarrhea in immunocompromised hosts. c. difficile can also form highly resistant spores that are excreted facilitating host-to-host transmission. the c. difficile spo0a gene encodes a highly conserved transcriptional regulator of sporulation that is required for relapsing disease and transmission in m ... | 2014 | 24568651 |
| management of suspected infectious diarrhoea by english gps: are they right? | the criteria used when gps submit stool specimens for microbiological investigation are unknown. | 2014 | 24567579 |
| translocation domain mutations affecting cellular toxicity identify the clostridium difficile toxin b pore. | disease associated with clostridium difficile infection is caused by the actions of the homologous toxins tcda and tcdb on colonic epithelial cells. binding to target cells triggers toxin internalization into acidified vesicles, whereupon cryptic segments from within the 1,050-aa translocation domain unfurl and insert into the bounding membrane, creating a transmembrane passageway to the cytosol. our current understanding of the mechanisms underlying pore formation and the subsequent translocati ... | 2014 | 24567384 |
| the genome of clostridium difficile 5.3. | clostridium difficile is the leading cause of infectious diarrhea in humans and responsible for large outbreaks of enteritis in neonatal pigs in both north america and europe. disease caused by c. difficile typically occurs during antibiotic therapy and its emergence over the past 40 years is linked with the widespread use of broad-spectrum antibiotics in both human and veterinary medicine. | 2014 | 24565059 |
| surface layer proteins isolated from clostridium difficile induce clearance responses in macrophages. | clostridium difficile is the leading cause of hospital-acquired diarrhoea worldwide, and if the bacterium is not cleared effectively it can pose a risk of recurrent infections and complications such as colitis, sepsis and death. in this study we demonstrate that surface layer proteins from the one of the most frequently acquired strains of c. difficile, activate mechanisms in murine macrophage in vitro that are associated with clearance of bacterial infection. surface layer proteins (slps) isola ... | 2014 | 24560642 |
| clostridium difficile infection in brazil: a neglected problem? | the epidemiology of clostridium difficile infection is virtually unknown in brazil. in this prospective study, 8.3% of patients with nosocomial diarrhea were found to have toxigenic strains of c difficile in their feces. the relevant risk factors for clostridium difficile infection were receipt of solid organ transplantation and septic shock. | 2014 | 24559593 |
| premarket evaluations of the imdx c. difficile for abbott m2000 assay and the bd max cdiff assay. | clostridium difficile-associated diarrhea is a well-recognized complication of antibiotic use. historically, diagnosing c. difficile has been difficult, as antigen assays are insensitive and culture-based methods require several days to yield results. nucleic acid amplification tests (naats) are quickly becoming the standard of care. we compared the performance of two automated investigational/research use only (iuo/ruo) naats for the detection of c. difficile toxin genes, the imdx c. difficile ... | 2014 | 24554744 |
| why were molecular studies not considered to classify clostridium difficile isolates implicated in an outbreak? | | 2013 | 24553766 |
| why were molecular studies not considered to classify clostridium difficile isolates implicated in an outbreak? | | 2013 | 24553765 |
| a retrospective analysis of clinical characteristics, hospitalization, and functional outcomes in residents with and without clostridium difficile infection in us long-term care facilities. | patients in long-term care (ltc) are at increased risk for acquiring clostridium difficile infection (cdi). we compared the characteristics and outcomes of matched cohorts with and without cdi in the ltc setting. | 2014 | 24552133 |
| comparative microbiological studies of transcription inhibitors fidaxomicin and the rifamycins in clostridium difficile. | fidaxomicin (fdx) is a narrow-spectrum antibiotic for the treatment of clostridium difficile-associated diarrhea. while fdx and rifamycins share the same target (rna polymerase), fdx exhibits a unique mode of action distinct from that of rifamycins. in comparative microbiological studies with c. difficile, fdx interacted synergistically with rifamycins, demonstrated a lower propensity for the development of resistance to rifamycins, and exhibited no cross-resistance with rifamycins. these result ... | 2014 | 24550338 |
| histamine-2 receptor antagonists vs proton pump inhibitors on gastrointestinal tract hemorrhage and infectious complications in the intensive care unit. | importance histamine-2 receptor antagonists (h2ras) and proton pump inhibitors (ppis) are commonly used to prevent gastrointestinal tract (gi) hemorrhage in critically ill patients. the stronger acid suppression of ppis may reduce the rate of bleeding but enhance infectious complications, specifically pneumonia and clostridium difficile infection (cdi). objective to evaluate the occurrence and risk factors for gi hemorrhage, pneumonia, and cdi in critically ill patients. design, setting, and par ... | 2014 | 24535015 |
| characterization of temperate phages infecting clostridium difficile isolates of human and animal origins. | clostridium difficile is a gram-positive pathogen infecting humans and animals. recent studies suggest that animals could represent potential reservoirs of c. difficile that could then transfer to humans. temperate phages contribute to the evolution of most bacteria, for example, by promoting the transduction of virulence, fitness, and antibiotic resistance genes. in c. difficile, little is known about their role, mainly because suitable propagating hosts and conditions are lacking. here we repo ... | 2014 | 24532062 |
| clostridium difficile is common in patients with postoperative diarrhea after hip and knee arthroplasty. | clostridium difficile is an antibiotic-associated gastrointestinal infection that has detrimental consequences. we sought to determine the incidence of c. difficile in tja patients with postoperative diarrhea, to determine risk factors for c. difficile infection, and to establish the incidence of c. difficile-related complications. our institutional protocol includes screening for c. difficile in all patients with diarrhea after tja. we identified 121 such patients over four years with twenty-ei ... | 2014 | 24530206 |
| microbial composition analysis of clostridium difficile infections in an ulcerative colitis patient treated with multiple fecal microbiota transplantations. | fecal microbiota transplantation (fmt) is a promising therapy for clostridium difficile infection (cdi). however, questions remain regarding efficacy and safety in inflammatory bowel disease (ibd) patients, as well as longitudinal stability of donor stool composition. this report describes an ibd patient with two cdis 18 months apart, each successfully treated with fmt with no ibd flares or complications. microbiome composition analysis of patient samples during each infection revealed low-diver ... | 2014 | 24529606 |
| inpatient antibiotic consumption in a regional secondary hospital in new zealand. | reporting of antibiotic consumption in hospitals is a crucial component of antibiotic stewardship, but data from australasian secondary hospitals are scarce. the hypothesis of this audit is that antibiotic consumption in secondary hospitals would be lower than in tertiary centres. | 2014 | 24528814 |
| peritoneal dialysis-related peritonitis triggered by clostridium difficile-associated colitis. | | 2015 | 24525609 |
| comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: prospective randomized trial. | we have already reported that, for patients undergoing elective colon cancer operations, perioperative infection can be prevented by a single intravenous dose of an antibiotic given immediately beforehand if mechanical bowel preparation and the administration of oral antibiotics are implemented. synbiotics has been reported to reduce the rate of infection in patients after pancreatic cancer operations. the effectiveness of oral antibiotics and probiotics in preventing postoperative infection in ... | 2014 | 24524389 |
| survey of clostridium difficile in retail seafood in college station, texas. | the incidence and severity of disease associated with toxigenic clostridium difficile have increased in hospitals in north america with the emergence of newer, more virulent strains. toxigenic c. difficile has been isolated from food animals and retail meat with potential implications of transfer to humans. the objective of the present study was to investigate the prevalence of c. difficile in retail seafood from grocery stores in college station, texas. c. difficile was found in 4.5% (3/67) of ... | 2014 | 24524301 |
| estimating risk of c. difficile transmission from pcr positive but cytotoxin negative cases. | the use of molecular methods to diagnose clostridium difficile infection (cdi) has improved diagnostic yield compared to conventional methods. however, pcr testing can detect colonization and has introduced several practical challenges pertaining to need for treatment and isolation of cases. | 2014 | 24523882 |
| a cluster of fulminant clostridium difficile colitis in an intensive care unit in italy. | we describe, for the first time, a cluster of lethal fulminant health-care associated clostridium difficile (cd) colitis in italy, observed in the intensive care unit (icu) of an italian tertiary care hospital in rome. for all cases the cause of icu admission was cd-related septic shock. three out of seven patients were residents in a long-term care facility in rome, and the others had been transferred to the icu from different medical wards of the same hospital. five patients died within 96 h o ... | 2014 | 24523055 |
| variability of contact precaution policies in us emergency departments. | contact precautions policies in us emergency departments have not been studied. we surveyed a structured random sample and found wide variation; for example, 45% required contact precautions for stool incontinence or diarrhea, 84% for suspected clostridium difficile, and 79% for suspected methicillin-resistant staphylococcus aureus infection. emergency medicine departments and organizations should enact policies. | 2014 | 24521599 |