| the simple predictors of pseudomembranous colitis in patients with hospital-acquired diarrhea: a prospective observational study. | as the incidence rate of and mortality from pseudomembranous colitis (pmc) are increasing worldwide, it is important to study the simple predictive risk factors for pmc among patients with hospital-acquired diarrhea (had). this study focused on identifying the clinical risk factors that can easily predict pmc. | 2014 | 24516700 |
| clostridium difficile infection: a worldwide disease. | clostridium difficile, an anaerobic toxigenic bacterium, causes a severe infectious colitis that leads to significant morbidity and mortality worldwide. both enhanced bacterial toxins and diminished host immune response contribute to symptomatic disease. c. difficile has been a well-established pathogen in north america and europe for decades, but is just emerging in asia. this article reviews the epidemiology, microbiology, pathophysiology, and clinical management of c. difficile. prompt recogn ... | 2014 | 24516694 |
| development and validation of a chemostat gut model to study both planktonic and biofilm modes of growth of clostridium difficile and human microbiota. | the human gastrointestinal tract harbours a complex microbial community which exist in planktonic and sessile form. the degree to which composition and function of faecal and mucosal microbiota differ remains unclear. we describe the development and characterisation of an in vitro human gut model, which can be used to facilitate the formation and longitudinal analysis of mature mixed species biofilms. this enables the investigation of the role of biofilms in clostridium difficile infection (cdi) ... | 2014 | 24516647 |
| kibdelomycin is a potent and selective agent against toxigenic clostridium difficile. | clostridium difficile is the causative agent of c. difficile-associated diarrhea (cdad), with increased risk in elderly populations. kibdelomycin, a novel natural-product inhibitor of type ii topoisomerase enzymes, was evaluated for activity against c. difficile and gastrointestinal anaerobic organisms. toxigenic c. difficile isolates (n=168) from u.s. hospitals and anaerobic gram-positive and gram-negative organisms (n=598) from chicago-area hospitals were tested. kibdelomycin showed potent act ... | 2014 | 24514098 |
| therapeutic approaches for clostridium difficile infections. | metronidazole and vancomycin remain the front-line therapies for most clostridium difficile infections (cdi). however, recurrent cdi occurs in ∼ 25% of patients, causing significant morbidity and mortality and healthcare costs. for this population, traditional antibiotic therapies fail and new treatment options are greatly needed. the us food and drug administration recently approved fidaxomicin for cdi treatment. this narrow-spectrum antibiotic preserves the normal gut microbiota and shows prom ... | 2013 | 24510892 |
| prophylactic antibiotics for hemorrhoidectomy: are they really needed? | hemorrhoidectomy is considered by many to be a contaminated operation that requires antibiotic prophylaxis to lower the incidence of surgical site infection. in reality, little evidence exists to either support or refute the use of antibiotic prophylaxis in this setting. | 2014 | 24509461 |
| effect of antisera from clostridium difficile-infected mice on toxin-a-induced colonic epithelial cell death signaling. | clostridium difficile causes mucosal damage and diarrhea by releasing two exotoxins: toxin a and toxin b. c. difficile colitis is associated with alterations in bowel flora and the failure to mount an effective antibody response. the aim of the current study was to investigate whether antitoxin sera prevent toxin-a-induced apoptosis, cytoskeletal disaggregation, cell detachment, and tight junction loss in cultured colonic epithelial cells. serum samples were isolated from mice that survived a c. ... | 2014 | 24509250 |
| prevalence and molecular characterization of clostridium difficile isolated from european barn swallows (hirundo rustica) during migration. | clostridium difficile is an important bacterial pathogen of humans and a variety of animal species. birds, especially migratory passerine species, can play a role in the spread of many pathogens, including clostridium difficile. barn swallows (hirundo rustica) nest in close proximity to human habitats and their biology is closely associated with cattle farming. therefore, we hypothesized that barn swallows can be the reservoir of clostridium difficile. | 2014 | 24507706 |
| acute diarrhea. | acute diarrhea in adults is a common problem encountered by family physicians. the most common etiology is viral gastroenteritis, a self-limited disease. increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. a history and physical examination evaluating for risk factors and signs of inflammatory diarrhea and/or severe dehydration can direct any needed testing and treatment. most patients do not require laboratory workup, and routine stoo ... | 2014 | 24506120 |
| preoperative clostridium difficile infection is not associated with an increased risk for the infection in ileal pouch patients. | clostridium difficile infection (cdi) might contribute to a refractory course of pouchitis. however, the association between preoperative cdi and postoperative cdi in ileal pouch patients has not been investigated. | 2014 | 24504594 |
| epidemiological study of clostridium difficile infection in critical patients admitted to the intensive care unit. | data on the epidemiology of infections caused by clostridium difficile (cdi) in critically ill patients are scarce and center on studies with a limited time framework and/or epidemic outbreaks. | 2014 | 24503331 |
| role of the intestinal microbiota in resistance to colonization by clostridium difficile. | antibiotic-associated infection with the bacterial pathogen clostridium difficile is a major cause of morbidity and increased health care costs. c difficile infection follows disruption of the indigenous gut microbiota by antibiotics. antibiotics create an environment within the intestine that promotes c difficile spore germination, vegetative growth, and toxin production, leading to epithelial damage and colitis. studies of patients with c difficile infection and animal models have shown that t ... | 2014 | 24503131 |
| prevalence of clostridium difficile in raw beef, cow, sheep, goat, camel and buffalo meat in iran. | clostridium difficile has been shown to be a nosocomial pathogen associated with diarrhoea and pseudomembranous colitis in hospitalised patients and the infection is believed to be acquired nosocomially. recent studies have shown the occurrence of c. difficile in food animals which may act as a source of infection to humans.the aim of this study was to determine the occurrence of c. difficile in retail raw beef, cow, sheep, goat, camel and buffalo meat in iran. | 2014 | 24499381 |
| is clostridium difficile associated with the '4c' antibiotics? a retrospective observational study in diabetic foot ulcer patients. | clostridium difficile is an anaerobic cytotoxin-producing bacterium that can cause infectious diarrhoea, pseudomembranous colitis and toxic megacolon. the major risk factors for developing c. difficile infection include recent or current antimicrobial use, diabetes, age over 65, proton pump inhibitor use, immunosuppression and previous infection with c. difficile. most diabetic foot ulcers are polymicrobial. | 2014 | 24499256 |
| [insidious and widespread outbreak of clostridium difficile. changed cleaning procedures and frequent evaluations cut infection rates in half]. | | 2014 | 24498716 |
| spore formation and toxin production in clostridium difficile biofilms. | the ability to grow as a biofilm can facilitate survival of bacteria in the environment and promote infection. to better characterize biofilm formation in the pathogen clostridium difficile, we established a colony biofilm culture method for this organism on a polycarbonate filter, and analyzed the matrix and the cells in biofilms from a variety of clinical isolates over several days of biofilm culture. we found that biofilms readily formed in all strains analyzed, and that spores were abundant ... | 2014 | 24498186 |
| association between prehospital vitamin d status and hospital-acquired clostridium difficile infections. | to investigate whether preadmission 25-hydroxyvitamin d (25(oh)d) levels are associated with the risk of hospital-acquired clostridium difficile infection (hacdi). | 2015 | 24492311 |
| [the problem of clostridium dlfficile infection in children with inflammatory bowel disease]. | the last decade has seen a significant increase in the incidence of diseases related to infection by clostridium difficile (clostridium difficile-associated disease--cdad) in the u.s.a., canada and european countries, which is probably due to the widespread environmental hipervirulent c. difficile strain nap 1 / bi / 027. those particularly affected by cdad are patients with inflammatory bowel disease (ibd) who observed more severe infections, prolonged hospital stay, higher risk of complication ... | 2013 | 24490471 |
| [steroid-resistant nephrotic syndrome complicated with severe streptococcus pneumonlae peritonitis in a 10-year-old girl--case report]. | primary bacterial peritonitis is a rare complication of idiopathic nephrotic syndrome (ins) in children, found in 1.5-3.7% cases. the 10-year-old girl was admitted with ins relapse: generalized edema, proteinuria 630 mg/kg/24 h, hypoalbuminemia 1.8 g/dl, hypogammaglobulinemia 74.0 mg/dl (n: 618-1537 mg/dl), gfr 71.6 ml/min/1.73 m2. she was treated with prednisone 60 mg/24 h. on 5th day severe pain, fever, crp (15.5 mg/dl) and leukocytosis (19.5 tys/mm3) rise occurred. on 6th day due to suspicion ... | 2013 | 24490466 |
| recurrence of clostridium difficile infection among veterans with spinal cord injury and disorder. | recurrent clostridium difficile (cdi) infection is a growing concern; however, there are little data on impact of recurrent cdi on those with spinal cord injury and disorder (sci/d). therefore, the objective of this study was to identify risk factors associated with recurrence of cdi among veterans with sci/d. | 2014 | 24485372 |
| sequence similarity of clostridium difficile strains by analysis of conserved genes and genome content is reflected by their ribotype affiliation. | pcr-ribotyping is a broadly used method for the classification of isolates of clostridium difficile, an emerging intestinal pathogen, causing infections with increased disease severity and incidence in several european and north american countries. we have now carried out clustering analysis with selected genes of numerous c. difficile strains as well as gene content comparisons of their genomes in order to broaden our view of the relatedness of strains assigned to different ribotypes. we analyz ... | 2014 | 24482682 |
| lipoprotein cd0873 is a novel adhesin of clostridium difficile. | clostridium difficile is a cause of antibiotic-associated diarrhea and colitis, a healthcare-associated intestinal disease. colonization of the gut is a critical step in the course of infection. the c. difficile lipoprotein cd0873 was identified as a putative adhesin through a bioinformatics approach. surface exposure of cd0873 was confirmed and a cd0873 mutant was generated. the cd0873 mutant showed a significant reduction in adherence to caco-2 cells and wild-type bacteria preincubated with an ... | 2014 | 24482399 |
| a study in transfer learning: leveraging data from multiple hospitals to enhance hospital-specific predictions. | data-driven risk stratification models built using data from a single hospital often have a paucity of training data. however, leveraging data from other hospitals can be challenging owing to institutional differences with patients and with data coding and capture. | 2015 | 24481703 |
| [successful home-made fecal transplant for an elderly woman]. | recurrent clostridium difficile infection (cdi) is a challenge for infectious disease specialists. a third of first recurrences will fail antibiotic therapy. several mechanisms have been proposed to explain this, such as persistence of spores, inadequate antibody response, and altered gut microbiota. standard recommendations for cdi treatment include metronidazole and vancomycin. fecal transplant has proven to be an effective therapy for recurrent cdi. infusion of stools can be administered to t ... | 2014 | 24481438 |
| prospects for flavonoid and related phytochemicals as nature-inspired treatments for clostridium difficile infection. | there is a need for novel treatments for clostridium difficile infection(cdi). antibacterial flavonoids are part of a large family of polyphenol phytochemicals with a long history of use in ethnomedicine, but are unexamined against cl. difficile. we explored their anti-difficile properties. | 2014 | 24479135 |
| a cost-effective approach for detection of toxigenic clostridium difficile: toxigenic culture using chromid clostridium difficile agar. | we evaluated the performance and the cost of toxigenic culture using a commercial chromogenic medium (cdif) for 538 stool specimens. compared with real-time pcr, this method was found to detect an additional 9% of positive specimens and result in 61% reduction in material costs, with a trade-off increase in turnaround time of 1 day. | 2014 | 24478510 |
| impact of changes in clostridium difficile testing practices on stool rejection policies and c. difficile positivity rates across multiple laboratories in the united states. | we describe the adoption of nucleic acid amplification tests (naat) for clostridium difficile diagnosis and their impact on stool rejection policies and c. difficile positivity rates. of the laboratories with complete surveys, 51 (43%) reported using naat in 2011. laboratories using naat had stricter rejection policies and increased positivity rates. | 2014 | 24478500 |
| economic evaluation of laboratory testing strategies for hospital-associated clostridium difficile infection. | clostridium difficile infection (cdi) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have cdi, their isolation while awaiting laboratory results is costly. newer rapid tests for cdi may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. we used decision analysis from the hospital perspective to compare multiple cdi testing algorithms for adult inpatients with suspected cdi, assuming patient m ... | 2014 | 24478478 |
| protection from clostridium difficile infection in cd4 t cell- and polymeric immunoglobulin receptor-deficient mice. | clostridium difficile rivals methicillin-resistant staphylococcus aureus as the primary hospital-acquired infection. c. difficile infection (cdi) caused by toxins a and/or b can manifest as mild diarrhea to life-threatening pseudomembranous colitis. although most patients recover fully from cdi, ~20% undergo recurrent disease. several studies have demonstrated a correlation between anti-toxin antibody (ab) and decreased recurrence; however, the contributions of the systemic and mucosal ab respon ... | 2014 | 24478068 |
| colonic immunopathogenesis of clostridium difficile infections. | there are major gaps in our understanding of the immunopathogenesis of clostridium difficile infections (cdis). in this study, 36 different biomarkers were examined in the stools of cdi and non-cdi patients using the proteome profiler human cytokine array assay and quantitative enzyme-linked immunosorbent assay. diarrheal stools from patients with cdi (cdi-positive diarrheal stools) showed higher relative amounts of the following inflammatory markers than the diarrheal stools from cdi-negative p ... | 2014 | 24477852 |
| outcomes of clostridium difficile infection in recipients of solid abdominal organ transplants. | knowledge of outcomes of clostridium difficile infection (cdi) in solid organ transplant (sot) recipients is limited. to evaluate this population, we undertook a retrospective cohort study of all recipients of kidney and liver transplants diagnosed with cdi at a single center over 14 yr. data pertaining to all episodes of cdi were collected. multivariate analysis using logistic regression was performed to determine independent predictors of clinical cure. overall, 170 patients developed 215 epis ... | 2014 | 24476412 |
| transmission of clostridium difficile spores in isolation room environments and through hospital beds. | the aim of this study was to determine the dissemination of clostridium difficile (cd) spores in a hospital setting where the potassium monopersulfate-based disinfectant virkon™ was used for cleaning. in the initial part of the study, we sampled 16 areas of frequent patient contact in 10 patient rooms where a patient with cd infection (cdi) had been accommodated. in the second part of the study, we obtained samples from 10 patient beds after discharge of cdi patients, both before and after the b ... | 2014 | 24475890 |
| what does the talking?: quorum sensing signalling genes discovered in a bacteriophage genome. | the transfer of novel genetic material into the genomes of bacterial viruses (phages) has been widely documented in several host-phage systems. bacterial genes are incorporated into the phage genome and, if retained, subsequently evolve within them. the expression of these phage genes can subvert or bolster bacterial processes, including altering bacterial pathogenicity. the phage phicdhm1 infects clostridium difficile, a pathogenic bacterium that causes nosocomial infections and is associated w ... | 2014 | 24475037 |
| an interprofessional approach to reducing the overutilization of stress ulcer prophylaxis in adult medical and surgical intensive care units. | overutilization of stress ulcer prophylaxis (sup) in the intensive care unit (icu) is common. acid-suppressive therapies routinely used for sup are best reserved for patients with greatest risk of clinically important bleeding as they have been associated with nosocomial pneumonia, clostridium difficile infection and increased hospital cost. | 2014 | 24473490 |
| [screening for opportunistic infections and vaccination before introduction of biologic therapy]. | patients on anti-tnfalpha medications carry a higher risk for developing opportunistic infections. in order to introduce anti-tnfalpha therapy, screening for hepatitis viruses b and c, hiv, ebv, hpv, tbc, bacterial, fungal and parasitic infections should be performed. screening involves patient's history of earlier infectious diseases, vaccinations and traveling to parts of the world with endemic diseases. clinical examination should be supplemented with stomatologic and gynecologic exams. labor ... | 2013 | 24471299 |
| clostridium difficile toxin cdt hijacks microtubule organization and reroutes vesicle traffic to increase pathogen adherence. | clostridium difficile causes antibiotic-associated diarrhea and pseudomembranous colitis by the actions of rho-glucosylating toxins a and b. recently identified hypervirulent strains, which are associated with increased morbidity and mortality, additionally produce the actin-adp-ribosylating toxin c. difficile transferase (cdt). cdt depolymerizes actin, causes formation of microtubule-based protrusions, and increases pathogen adherence. here we show that cdt-induced protrusions allow vesicle tra ... | 2014 | 24469807 |
| stool substitute transplant therapy for the eradication of clostridium difficile infection: 'repoopulating' the gut. | fecal bacteriotherapy ('stool transplant') can be effective in treating recurrent clostridium difficile infection, but concerns of donor infection transmission and patient acceptance limit its use. here we describe the use of a stool substitute preparation, made from purified intestinal bacterial cultures derived from a single healthy donor, to treat recurrent c. difficile infection that had failed repeated standard antibiotics. thirty-three isolates were recovered from a healthy donor stool sam ... | 2013 | 24467987 |
| shedding of clostridium difficile pcr ribotype 078 by zoo animals, and report of an unstable metronidazole-resistant isolate from a zebra foal (equus quagga burchellii). | clostridium difficile is an emerging and potentially zoonotic pathogen, but its prevalence in most animal species, including exhibition animals, is currently unknown. in this study we assessed the prevalence of faecal shedding of c. difficile by zoo animals, and determined the ribotype, toxin profile and antimicrobial susceptibility of recovered isolates. a total of 200 samples from 40 animal species (36.5% of which came from plains zebra, equus quagga burchellii) were analysed. c. difficile was ... | 2014 | 24467928 |
| is there any value in measuring faecal calprotectin in clostridium difficile positive faecal samples? | markers of intestinal inflammation have been proposed for inclusion in clostridium difficile diagnostic algorithms. faecal calprotectin (f-cp), a sensitive marker of intestinal inflammation, was evaluated for utility in c. difficile diagnosis in the hospital setting. one hundred and twenty c. difficile positive and 99 c. difficile negative faecal samples of hospital-acquired diarrhoea were analysed for f-cp using a quantitative elisa. c. difficile positivity was confirmed using elisas for either ... | 2014 | 24464697 |
| clostridium difficile and cytomegalovirus colitis coinfection after bariatric surgery: case report. | | 2013 | 24463907 |
| [cloudy peritoneal effluent and diarrhoea due to clostridium difficile]. | | 2014 | 24463873 |
| severity assessment scores to guide empirical use of antibiotics in community acquired pneumonia. | severity assessment scores were first developed to predict the 30 day mortality in community acquired pneumonia; however, several guidelines have extended their use to guide empirical antibiotic prescription decisions. this approach has theoretical advantages because a decrease in broad-spectrum antibiotic treatment in low-risk patients might reduce antibiotic-related side-effects, and to give broad-spectrum therapy to patients at higher risk of death is intuitive. however, evidence in support o ... | 2013 | 24461668 |
| fulminant clostridium difficile colitis: prospective development of a risk scoring system. | of the patients with a clostridium difficile infection, 2% to 8% will progress to fulminant c. difficile colitis (fcdc), which carries high morbidity and mortality. no system exists to rapidly identify patients at risk for developing fcdc and possibly in need of surgical intervention. our aim was to design a simple and accurate risk scoring system (rss) for daily clinical practice. | 2014 | 24458048 |
| faecal transplantation for clostridium difficile infection. three cases treated in italy. | | 2014 | 24457126 |
| a case of an acquired factor viii inhibitor complicated by multiple treatment-related opportunistic infections and review of the literature. | this case report describes a patient with an idiopathic acquired factor viii inhibitor and severe bleeding. she was treated with rituximab after failing first-line treatment with steroids and cyclophosphamide. two months following rituximab treatment, our patient developed a succession of severe opportunistic infections requiring intensive care unit admission. over a period of 12 weeks she required treatment for pseudomonas aeruginosa septicaemia, herpes simplex gingivostomatitis and pharyngoton ... | 2013 | 24455336 |
| metronidazole induced liver injury: a rare immune mediated drug reaction. | drug induced liver injury (dili) can result either from dose-dependent direct hepatotoxicity or from an unpredictable dose-independent idiosyncratic reaction. incidence of idiosyncratic dili is estimated to be approximately 10-15 per 100,000 patient years. here we report an extremely rare case of metronidazole induced delayed immune-allergic hepatocellular liver injury masquerading as autoimmune hepatitis. a previously healthy 54-year-old caucasian male, who was treated with metronidazole for cl ... | 2013 | 24455335 |
| real-time cellular analysis coupled with a specimen enrichment accurately detects and quantifies clostridium difficile toxins in stool. | we describe here the use of an immunomagnetic separation enrichment process coupled with a modified real-time cellular analysis (rtca) system (rtca version 2) for the detection of c. difficile toxin (cdt) in stool. the limit of cdt detection by rtca version 2 was 0.12 ng/ml. among the consecutively collected 401 diarrheal stool specimens, 53 (13.2%) were toxin-producing c. difficile strains by quantitative toxigenic culture (qtc); bacterial loads ranged from 3.00 × 10(1) to 3.69 × 10(6) cfu/ml. ... | 2014 | 24452160 |
| reductions in intestinal clostridiales precede the development of nosocomial clostridium difficile infection. | antimicrobial use is thought to suppress the intestinal microbiota, thereby impairing colonization resistance and allowing clostridium difficile to infect the gut. additional risk factors such as proton-pump inhibitors may also alter the intestinal microbiota and predispose patients to clostridium difficile infection (cdi). this comparative metagenomic study investigates the relationship between epidemiologic exposures, intestinal bacterial populations and subsequent development of cdi in hospit ... | 2013 | 24450844 |
| detection of nosocomial clostridium difficile infections with toxigenic strains despite negative toxin a and b testing on stool samples. | a two-step diagnostic algorithm is recommended to detect clostridium difficile infections; however, samples are regularly found that are glutamate dehydrogenase (gdh) positive but stool toxin negative. in the present single-centre prospective study we focused on these 'difficult-to-interpret' samples and characterized them by anaerobic culture, toxigenic culture, slpa sequence typing and multiplex pcr (genotype cdiff). the majority of stool toxin a and b-negative samples have been caused by toxi ... | 2014 | 24450741 |
| ribotype 027 clostridium difficile infections with measurable stool toxin have increased lactoferrin and are associated with a higher mortality. | we evaluated clinical and diagnostic indicators of severe c. difficile infection (cdi) and their association with poor clinical outcome. a total of 210 patients positive according to pcr (toxin b: tcdb) were included, with patients having a median age of 62 years and a charlson co-morbidity index (ci) score of 5. ninety-one percent (n = 191) were positive by toxigenic culture and 61% (n = 129) had stool toxin. toxin-positive patients had significantly higher fecal lactoferrin (mean 316 μg/g vers ... | 2014 | 24449345 |
| a case study of a real-time evaluation of the risk of disease transmission associated with a failure to follow recommended sterilization procedures. | failures to follow recommendations for reprocessing of surgical instruments may place patients at risk for exposure to pathogenic microorganisms. when such failures occur, medical facilities often face considerable uncertainty and challenges in assessing the actual risks of disease transmission. | 2014 | 24447336 |
| comparative proteomic analysis of clostridium difficile isolates of varying virulence. | the soluble proteome of three clostridium difficile strains of varying pathogenic potential, designated b-1, tra 5/5 and 027 sm, were compared using differential in-gel electrophoresis in which the proteins of each strain were labelled with cydyes. this enabled visual inspection of the 2d profiles of strains and identification of differentially expressed proteins using image analysis software. unlabelled protein reference maps of the predominant proteins were then generated for each strain using ... | 2014 | 24445512 |
| antibiotic-induced shifts in the mouse gut microbiome and metabolome increase susceptibility to clostridium difficile infection. | antibiotics can have significant and long-lasting effects on the gastrointestinal tract microbiota, reducing colonization resistance against pathogens including clostridium difficile. here we show that antibiotic treatment induces substantial changes in the gut microbial community and in the metabolome of mice susceptible to c. difficile infection. levels of secondary bile acids, glucose, free fatty acids and dipeptides decrease, whereas those of primary bile acids and sugar alcohols increase, r ... | 2014 | 24445449 |
| a randomized trial of soap and water hand wash versus alcohol hand rub for removal of clostridium difficile spores from hands of patients. | | 2014 | 24442089 |
| comparison of 3 severity criteria for clostridium difficile infection. | effective severity criteria are needed to guide management of clostridium difficile infection (cdi). in this retrospective study, outcomes were compared between patients with mild-moderate versus severe cdi according to 3 different severity criteria: those included in the 2010 society for healthcare epidemiology of america/infectious diseases society of america guidelines, those from a recent clinical trial, and our hospital-specific guidelines. | 2014 | 24442086 |
| fecal microbiota transplantation for the treatment of clostridium difficile infection: a systematic review. | by systematic review, we assessed the impact of fecal microbiota transplantation (fmt) for the treatment of clostridium difficile (cd)-associated diarrhea. | 2014 | 24440934 |
| acidified nitrite: a host defence against colonization with c. difficile spores? | proton pump inhibitor (ppi) use increases the risk of clostridium difficile infection (cdi) despite c. difficile spores being acid resistant. swallowed saliva contains nitrite which reacts with gastric acid, producing bactericidal nitrogen oxides. with 5mm nitrite at ph 2 (reflecting normal gastric conditions) all c. difficile spores were killed within 15 min. no reduction in count was seen with the same nitrite concentration at ph 5, representing gastric conditions in patients taking ppis, even ... | 2014 | 24440371 |
| efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent clostridium difficile infection. | the prevalence of recurrent clostridium difficile infection (rcdi) is increasing; fecal microbiota transplantation (fmt) is an effective therapy. however, there have been no studies of the efficacy of a single session of combined enteral and colonic fmt or characterizations of changes in the microbiota between donors and recipients. we performed a study of 27 patients with rcdi who were given a fixed volume of processed fecal filtrate via enteroscopy and colonoscopy in a single session. patients ... | 2014 | 24440222 |
| a novel subtyping assay for detection of clostridium difficile virulence genes. | this proof-of-concept study demonstrates the application of a novel nucleic acid detection platform to detect clostridium difficile in subjects presenting with acute diarrheal symptoms. this method amplifies three genes associated with c. difficile infection, including genes and deletions (cdtb and tcdc) associated with hypervirulence attributed to the nap1/027/bi strain. amplification of dna from the tcdb, tcdc, and cdtb genes was performed using a droplet-based sandwich platform with quantitat ... | 2014 | 24434086 |
| fecal microbiota transplantation for refractory clostridium difficile colitis in solid organ transplant recipients. | fecal microbiota transplantation (fmt) has been shown to be safe and efficacious in individuals with refractory clostridium difficile. it has not been widely studied in individuals with immunosuppression due to concerns about infectious complications. we describe two solid organ transplant recipients, one lung and one renal, in this case report that both had resolution of their diarrhea caused by c. difficile after fmt. both recipients required two fmts to achieve resolution of their symptoms an ... | 2014 | 24433460 |
| an examination of longitudinal cauti, ssi, and cdi rates from key hhs data systems. | in response to the growing concern about healthcare-associated infections (hais), us department of health and human services (hhs) developed the national action plan to prevent healthcare-associated infections. a key focus of the action plan is the setting of hai metrics and targets and the enhancement and development of data systems to support hai surveillance. | 2014 | 24430270 |
| colonization with clostridium difficile in children with cancer. | clostridium difficile is a gram-positive, anaerobic, spore-forming bacillus. usually it does not cause disease unless a patient who is colonized with toxin-producing strains has been treated with antibiotics, particularly those that change the anaerobic flora of the large intestine. | 2013 | 24427503 |
| prevention of clostridium difficile spore formation by sub-inhibitory concentrations of tigecycline and piperacillin/tazobactam. | sporulation of clostridium difficile during infection and persistence of spores within the gut could partly explain treatment failures and recurrence. however, the influence of antibiotics on sporulation is unclear. the objective of our study was to evaluate the impact of ciprofloxacin, metronidazole, piperacillin/tazobactam, tigecycline, and vancomycin on c. difficile sporulation in vitro. | 2014 | 24422950 |
| comparison of chromid agar and clostridium difficile selective agar for effective isolation of c. difficile from stool specimens. | chromid clostridium difficile agar (idcd; biomérieux sa, france) is a recently developed chromogenic medium for rapid and specific isolation of c. difficile. we compared the performance of idcd with that of clostridium difficile selective agar (cdsa). | 2014 | 24422190 |
| combination of culture, antigen and toxin detection, and cytotoxin neutralization assay for optimal clostridium difficile diagnostic testing. | there has been a growing interest in developing an appropriate laboratory diagnostic algorithm for clostridium difficile, mainly as a result of increases in both the number and severity of cases of c difficile infection in the past decade. a c difficile diagnostic algorithm is necessary because diagnostic kits, mostly for the detection of toxins a and b or glutamate dehydrogenase (gdh) antigen, are not sufficient as stand-alone assays for optimal diagnosis of c difficile infection. in addition, ... | 2013 | 24421808 |
| treatment of relapsing clostridium difficile infection using fecal microbiota transplantation. | clostridium difficile infection (cdi) has become a global concern over the last decade. in the united states, cdi escalated in incidence from 1996 to 2005 from 31 to 64/100,000. in 2010, there were 500,000 cases of cdi with an estimated mortality up to 20,000 cases a year. the significance of this problem is evident from the hospital costs of over 3 billion dollars annually. fecal microbiota transplant (fmt) was first described in 1958 and since then about 500 cases have been published in litera ... | 2013 | 24421645 |
| antimicrobial stewardship program implementation in a medical intensive care unit at a tertiary care hospital in saudi arabia. | antimicrobial stewardship programs (asps) have shown to prevent the emergence of antimicrobial resistance associated with an inappropriate antimicrobial use. the primary objective of this study was to compare the prescribing appropriateness rate of the empirical antibiotic therapy before and after the asp implementation in a tertiary care hospital. secondary objectives include the rate of clostridium difficile-associated diarrhea (cdad), physicians' acceptance rate, patient's intensive care unit ... | 2015 | 24413857 |
| from stool transplants to next-generation microbiota therapeutics. | the epidemic of clostridium difficile infection fueled by new virulent strains of the organism has led to increased use of fecal microbiota transplantation (fmt). the procedure is effective for even the most desperate cases after failure of multiple courses of antibiotics. the approach recognizes microbiota to be integral to normal human physiology, and microbiota being used in fmt represents a new class of therapeutics. imbalance in the composition and altered activity of the microbiota are ass ... | 2014 | 24412527 |
| clostridium difficile infection: molecular pathogenesis and novel therapeutics. | the gram-positive anaerobic bacterium clostridium difficile produces toxins a and b, which can cause a spectrum of diseases from pseudomembranous colitis to c. difficile-associated diarrhea. a limited number of c. difficile strains also produce a binary toxin that exhibits adp ribosyltransferase activity. here, the structure and the mechanism of action of these toxins as well as their role in disease are reviewed. nosocomial c. difficile infection is often contracted in hospital when patients tr ... | 2014 | 24410618 |
| vitamin d status and severity of clostridium difficile infections: a prospective cohort study in hospitalized adults. | clostridium difficile is the most common cause of nosocomial diarrhea, affecting up to 10% of hospitalized patients. preliminary studies suggest an association between vitamin d status and c difficile infections (cdis). our goal was to investigate whether serum 25-hydroxyvitamin d (25(oh)d) levels are associated with cdi severity. | 2015 | 24408036 |
| prevention of clostridium difficile infection in rural hospitals. | prevention of clostridium difficile infection (cdi) remains challenging across the spectrum of health care. there are limited data on prevention practices for cdi in the rural health care setting. | 2014 | 24406257 |
| patients' experience and perception of hospital-treated clostridium difficile infections: a qualitative study. | clostridium difficile is the leading cause of antibiotic-associated diarrhea and an important source of nosocomial infection. clinical manifestations can range from mild diarrhea to lethal pseudomembranous colitis. little is known about the burden of c. difficile infections (cdi) in patients. | 2014 | 24403096 |
| proteomic analysis of a nap1 clostridium difficile clinical isolate resistant to metronidazole. | clostridium difficile is an anaerobic, gram-positive bacterium that has been implicated as the leading cause of antibiotic-associated diarrhea. metronidazole is currently the first-line treatment for mild to moderate c. difficile infections. our laboratory isolated a strain of c. difficile with a stable resistance phenotype to metronidazole. a shotgun proteomics approach was used to compare differences in the proteomes of metronidazole-resistant and -susceptible isolates. | 2014 | 24400070 |
| use of fidaxomicin through a nasogastric tube for the treatment of septic shock caused by clostridium difficile infection in a patient with oral cancer admitted to the surgical critical care unit. | | 2013 | 24399354 |
| fecal microbiota transplantation: effectiveness, complexities, and lingering concerns. | the mammalian colon is home to a microbial ecosystem that enhances resistance to infection, stimulates mucosal immune defenses, synthesizes essential vitamins, and promotes caloric uptake by hydrolyzing complex carbohydrates. the bacterial populations inhabiting the gut are complex and vary between different individuals. clinical and experimental studies reveal that the colonic microbiota can enhance or ameliorate intestinal and systemic inflammatory diseases. because of its potential to enhance ... | 2014 | 24399149 |
| characterization of clostridium perfringens in the feces of adult horses and foals with acute enterocolitis. | up to 60% of cases of equine colitis have no known cause. to improve understanding of the causes of acute colitis in horses, we hypothesized that clostridium perfringens producing enterotoxin (cpe) and/or beta2 toxin (cpb2) are common and important causes of severe colitis in horses and/or that c. perfringens producing an as-yet-undescribed cytotoxin may also cause colitis in horses. fecal samples from 55 horses (43 adults, 12 foals) with clinical evidence of colitis were evaluated by culture fo ... | 2014 | 24396174 |
| evaluation of the diagnostic performance of the xpert clostridium difficile assay and its comparison with the toxin a/b enzyme-linked fluorescent assay and in-house real-time pcr assay used for the detection of toxigenic c. difficile. | clostridium difficile genes or toxin can be detected using several laboratory techniques. in this study, we compared the performance of the xpert c. difficile assay with that of a toxin a/b enzyme-linked fluorescent immunoassay (elfa) and an in-house real-time pcr assay for the tcdb gene. | 2014 | 24395702 |
| the roles of toxin a and toxin b in clostridium difficile infection: insights from the gnotobiotic piglet model. | we recently published our findings indicating that anti-tcdb antibodies were effective as treatment for c. difficile infection, but that anti-tcda actually worsened prognosis in the gnotobiotic piglet model. to further investigate the roles of the two toxins, we administered purified toxins separately or together, systemically, to piglets and found that both toxins, either alone or together, are able to elicit severe lesions systemically and are also able to cross into the gut lumen and cause la ... | 2016 | 24394234 |
| clostridium difficile: deleterious impact on hematopoietic stem cell transplantation. | c. difficile infection (cdi), the most common cause of hospital-acquired diarrhea, is very frequent after hematopoietic stem cell transplantation (hsct). recent publications suggest it affects between 6 % and 20 % of hsct recipients during the first year and is more common following allogeneic transplant (allo-hsct). the best diagnostic strategy remains to be defined, but molecular testing for the toxin genes by polymerase chain reaction (pcr) seems to be replacing the traditional enzyme immunoa ... | 2014 | 24390550 |
| a clinician's primer on the role of the microbiome in human health and disease. | the importance of the commensal microbiota that colonizes the skin, gut, and mucosal surfaces of the human body is being increasingly recognized through a rapidly expanding body of science studying the human microbiome. although, at first glance, these discoveries may seem esoteric, the clinical implications of the microbiome in human health and disease are becoming clear. as such, it will soon be important for practicing clinicians to have an understanding of the basic concepts of the human mic ... | 2014 | 24388028 |
| new routes towards reutericyclin analogues. | a range of n-acylpyrrolo[3,4-c]isoxazoles and derived n-acyltetramides has been prepared via a nitrile oxide dipolar cycloaddition approach, as analogues of the acyltetramic acid metabolite reutericyclin, of interest for its antibiotic potential against gram-positive bacteria including hospital-acquired infections of resistant clostridium difficile. | 2014 | 24382380 |
| low vitamin d level is an independent predictor of poor outcomes in clostridium difficile-associated diarrhea. | the incidence, recurrence, and all-cause mortality rate for clostridium difficile-associated diarrhea (cdad) has increased markedly over the past 10 years despite treatment. low vitamin d levels are known to impair immune responses to infection and are associated with increased mortality. we compared the role of patient comorbidity measured by the charlson comorbidity index (cci) with vitamin d levels to ascertain whether vitamin d levels were an independent variable affecting the outcome of cda ... | 2014 | 24381644 |
| clostridium difficile-associated disease: adherence with current guidelines at a tertiary medical center. | to assess adherence with the the society for healthcare epidemiology of america (shea)/ the infectious diseases society of america (idsa) guidelines for management of clostridium difficile (c. difficile)-associated disease (cdad) at a tertiary medical center. | 2013 | 24379582 |
| parameters for the mathematical modelling of clostridium difficile acquisition and transmission: a systematic review. | mathematical modelling of clostridium difficile infection dynamics could contribute to the optimisation of strategies for its prevention and control. the objective of this systematic review was to summarise the available literature specifically identifying the quantitative parameters required for a compartmental mathematical model of clostridium difficile transmission. | 2013 | 24376797 |
| comparison of oral vancomycin capsule and solution for treatment of initial episode of severe clostridium difficile infection. | vancomycin is recommended as a first-line therapy for severe clostridium difficile infection (cdi). due to the high cost of commercially available vancomycin capsules, hospitals frequently compound oral solution despite a lack of data comparing outcomes. this study was conducted to determine treatment outcome differences based on oral vancomycin formulation. | 2015 | 24375999 |
| single nucleotide polymorphisms of the tcdc gene and presence of the binary toxin gene predict recurrent episodes of clostridium difficile infection. | to identify clostridium difficile genotypes, which are associated with recurrent c difficile infection (rcdi). | 2014 | 24374512 |
| epidemiology of clostridium difficile infection among active duty united states military personnel (1998-2010). | clostridium difficile associated disease (cdad) has risen in incidence and the experience in the us military has not been described. | 2013 | 24373384 |
| faecal microbiota transplantation for clostridium difficile infection. | to review the current clinical literature regarding the use of fecal microbiota transplantation (fmt) for severe and recurrent clostridium difficile disease (cdad). | 2014 | 24372725 |
| small animal models for the study of clostridium difficile disease pathogenesis. | clostridium difficile is the leading cause of bacterial antibiotic-associated diarrhoea in hospitals in the developed world. despite this notoriety, the complex mechanisms employed by this pathogen to overcome innate host defences and induce fulminant disease are poorly understood. various animal models have been used extensively for c. difficile research to study disease pathogenesis. until recently, the most commonly used c. difficile disease model has utilised hamsters; however, mouse and pig ... | 2014 | 24372713 |
| controversies surrounding clostridium difficile infection in infants and young children. | clostridium difficile is a frequent cause of antibiotic-associated diarrhea in adults and older children. however, as many as 80% of infants can be asymptomatically colonized. the reasons for this have not been well established but are believed to be due to differences in toxin receptors or toxin internalization. determining which children who test positive for c. difficile warrant treatment is exceedingly difficult, especially in the setting of increased rates of detection and the rising risk o ... | 2014 | 27417466 |
| false-positive clostridium difficile in negative-control reactions peak and then decrease with repetitive refrigeration of immunoassay. | aberrant false-positive reactions in negative-controls during elisa testing for clostridium difficile indicated the potential for false-diagnoses. experiments with 96-well products showed a maximum peak of false-positive immunoassay reactions with the provided negative-control reagents after 5 refrigeration-to-room temperature cycles (p < 0.001), decreasing thereafter with additional refrigeration cycles. because repetitive refrigeration causes a peak of false-positives, the use of single negati ... | 2014 | 27350964 |
| old and new glycopeptide antibiotics: action and resistance. | glycopeptides are considered antibiotics of last resort for the treatment of life-threatening infections caused by relevant gram-positive human pathogens, such as staphylococcus aureus, enterococcus spp. and clostridium difficile. the emergence of glycopeptide-resistant clinical isolates, first among enterococci and then in staphylococci, has prompted research for second generation glycopeptides and a flurry of activity aimed at understanding resistance mechanisms and their evolution. glycopepti ... | 2014 | 27025757 |
| ciprofloxacin affects host cells by suppressing expression of the endogenous antimicrobial peptides cathelicidins and beta-defensin-3 in colon epithelia. | antibiotics exert several effects on host cells including regulation of immune components. antimicrobial peptides (amps), e.g., cathelicidins and defensins display multiple functions in innate immunity. in colonic mucosa, cathelicidins are induced by butyrate, a bacterial fermentation product. here, we investigated the effect of antibiotics on butyrate-induced expression of cathelicidins and beta-defensins in colon epithelial cells. real-time pcr analysis revealed that ciprofloxacin and clindamy ... | 2014 | 27025750 |
| improving management of constipation in an inpatient setting using a care bundle. | constipation is a common occurrence on geriatric in-patient wards. it can result in delirium and other complications including bowel obstruction. over treatment with laxatives can result in iatrogenic diahorrea, which can lead to dehydration, delirium, and the false positive labeling and unnecessary treatment of clostridium difficile carriers. this can result in increased morbidity and mortality, and a longer stay in hospital. this means that improving the assessment and treatment of constipatio ... | 2014 | 26734278 |
| antimicrobial stewardship programs: appropriate measures and metrics to study their impact. | antimicrobial stewardship is a new field that struggles to find the right balance between meaningful and useful metrics to study the impact of antimicrobial stewardship programs (asps). asp metrics primarily measure antimicrobial use, although microbiological resistance and clinical outcomes are also important measures of the impact an asp has on a hospital and its patient population. antimicrobial measures looking at consumption are the most commonly used measures, and are focused on defined da ... | 2017 | 25999798 |
| [reccurent clostridium difficile infection in patient after kidney transplantation on rituximab therapy due to ptld (post-transplant lymphoprolipherative disorder). first experience with fidaxomicin use--case report]. | clostridium difficile infection (cdi) is an increasingly problem in everyday clinical practice. the most important risk factor of this infection is antibiotics use. the incidence of clostridium difficile associated diarrhea (cdad) in patients after renal transplantation is estimated to be about 6% in the early postoperative period. due to the applied immunosuppression and frequent infections requiring intensive, broad spectral antibiotics, the later prevalence of cdad may remain at a similar lev ... | 2014 | 25951705 |
| three-step diagnostic algorithm in diagnosing patients suspected of clostridium difficile-associated diarrhea. | clostridium difficile is a predominant etiological agent of healthcare-associated infectious diarrhea. immunoenzymatic tests for detecting toxins a/b from faecal samples are still used in routine diagnosis of clostridium difficile-associated diseases in a number of healthcare centers in poland. recently, however, new diagnostic tests were introduced which allow for detecting toxigenic strains of c. difficile in a more effective and precise manner. it is of importance, especially in the light of ... | 2014 | 25848788 |
| prevalence of gastrointestinal system infections acquired in provincial hospital in 2004-2013. | gastrointestinal system infection (gi) is an infection which is frequently acquired in health- care settings. in poland, there are limited data on the distribution of gastrointestinal system infections in the epidemiology of healthcare-associated infections (hais). therefore, a study was initiated with the objective to assess the prevalence and distribution of healthcare-associated gastrointestinal system infections in patients hospitalized in st. lukas provincial hospital in tarnów. | 2014 | 25848787 |
| predictors of first recurrence in clostridium difficile-associated disease. a study of 306 patients hospitalized in a romanian tertiary referral center. | clostridium difficile is recognized as the major cause of nosocomial gastroenteritis usually related to antibiotic treatment. although treatable, c. difficile--associated disease (cdad) tends to recur in many patients. the purpose of the study was to analyze the risk factors for recurrence in patients with cdad after the first treatment with vancomycin, metronidazole or both. | 2013 | 24369321 |
| fecal microbiota transplantation: a practical update for the infectious disease specialist. | fecal microbiota transplantation (fmt) has been shown to be a superior therapeutic modality for the treatment of recurrent clostridium difficile infection (rcdi). recently the us food and drug administration (fda) determined that human stool should be classified as a biological agent and its use should be regulated to ensure patient safety. consequently, the fda determined that prescribers of fmt must possess an approved investigational new drug (ind) permit to administer fmt for the purpose of ... | 2014 | 24368622 |