| differential stress transcriptome landscape of historic and recently emerged hypervirulent strains of clostridium difficile strains determined using rna-seq. | c. difficile is the most common cause of nosocomial diarrhea in north america and europe. genomes of individual strains of c. difficile are highly divergent. to determine how divergent strains respond to environmental changes, the transcriptomes of two historic and two recently isolated hypervirulent strains were analyzed following nutrient shift and osmotic shock. illumina based rna-seq was used to sequence these transcriptomes. our results reveal that although c. difficile strains contain a la ... | 2013 | 24244315 |
| fecal microbiota transplantation: facts and controversies. | to review the current evidence on fecal microbiota transplantations (fmts) for recurrent clostridium difficile infections (cdis), metabolic syndrome and inflammatory bowel disease. | 2014 | 24241245 |
| progress in the discovery of treatments for c. difficile infection: a clinical and medicinal chemistry review. | clostridium difficile is an anaerobic, gram-positive pathogen that causes c. difficile infection, which results in significant morbidity and mortality. the incidence of c. difficile infection in developed countries has become increasingly high due to the emergence of newer epidemic strains, a growing elderly population, extensive use of broad spectrum antibiotics, and limited therapies for this diarrheal disease. because treatment options currently available for c. difficile infection have some ... | 2014 | 24236721 |
| discrepancies among three laboratory methods for clostridium difficile detection and a proposal for their optimal use. | clostridium difficile is the major cause of nosocomial diarrhoea. several detection methods are available for the laboratory diagnosis of c. difficile, but these vary in terms of sensitivity and specificity. in this study, we compared the performance of three following laboratory tests to detect c. difficile: in-house real-time pcr aiming for toxin b gene (tcdb), eia for detection of toxins a and b (premier toxins a & b) and c. difficile culture in selective medium (biomerieux). our results were ... | 2014 | 24236508 |
| spo0a differentially regulates toxin production in evolutionarily diverse strains of clostridium difficile. | clostridium difficile is an important pathogen of humans and animals, representing a significant global healthcare problem. the last decade has seen the emergence of epidemic bi/nap1/027 and ribotype 078 isolates, associated with the onset of more severe disease and higher rates of morbidity and mortality. however, little is known about these isolates at the molecular level, partly due to difficulties in the genetic manipulation of these strains. here we report the development of an optimised tn ... | 2013 | 24236153 |
| all-cause mortality in hospitalized patients with infectious diarrhea: clostridium difficile versus other enteric pathogens in austria from 2008 to 2010. | clostridium difficile infection is the leading cause of gastroenteritis-associated deaths in the industrialized world, followed by infection with norovirus. | 2016 | 24231157 |
| role of lactobacillus in the prevention of clostridium difficile-associated diarrhea: a meta-analysis of randomized controlled trials. | clostridium difficile-associated diarrhea (cdad) is a major public health problem because of significant morbidity and mortality, and many clinicians pay attention to lactobacillus as a potentially effective treatment. the purpose of this meta-analysis was to evaluate the efficacy of lactobacillus in the prevention of cdad. | 2013 | 24229690 |
| comparison of simplexa universal direct pcr with cytotoxicity assay for diagnosis of clostridium difficile infection: performance, cost, and correlation with disease. | simplexa clostridium difficile universal direct pcr, a real-time pcr assay for the detection of the c. difficile toxin b (tcdb) gene using the 3m integrated cycler, was compared with a two-step algorithm which includes the c. diff chek-60 glutamate dehydrogenase (gdh) antigen assay followed by cytotoxin neutralization. three hundred forty-two liquid or semisolid stools submitted for diagnostic c. difficile testing, 171 gdh antigen positive and 171 gdh antigen negative, were selected for the stud ... | 2014 | 24226924 |
| histologic findings and clinical characteristics in acutely symptomatic ulcerative colitis patients with superimposed clostridium difficile infection. | to examine biopsy specimens for histologic features suggestive of clostridium difficile infection in patients with ulcerative colitis (uc). | 2013 | 24225751 |
| clostridium difficile 027 emerging outbreak in marseille, france. | | 2013 | 24225631 |
| the impact of observation units on the rate of hospital-acquired infection. | using clostridium difficile as an example, we calculated the impact that reduced inpatient-day denominators resulting from implementation of hospital observation units would have on hospital-acquired infection rates. using proposed scenarios of reduced inpatient-days, we estimated an increase in the hospital-acquired c. difficile infection rate of up to 12%. | 2013 | 24225619 |
| constructing identities in the media: newspaper coverage analysis of a major uk clostridium difficile outbreak. | to examine how a major clostridium difficile outbreak in the uk was represented in the media. | 2014 | 24224760 |
| whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with clostridium difficile. | whole-genome sequencing was used to determine whether the reductions in recurrence of clostridium difficile infection observed with fidaxomicin in pivotal phase 3 trials occurred by preventing relapse of the same infection, by preventing reinfection with a new strain, or by preventing both outcomes. paired isolates of c. difficile were available from 93 of 199 participants with recurrences (28 were treated with fidaxomicin, and 65 were treated with vancomycin). given c. difficile evolutionary ra ... | 2014 | 24218500 |
| accuracy of administrative code data for the surveillance of healthcare-associated infections: a systematic review and meta-analysis. | administrative code data (acd), such as international classifications of diseases, ninth revision, clinical modification codes, are widely used in surveillance and public reporting programs that seek to identify healthcare-associated infections (hais); however, little is known about their accuracy. this systematic review summarizes evidence for the accuracy of acd for the detection of selected hais, including catheter-associated urinary tract infection, clostridium difficile infection (cdi), cen ... | 2014 | 24218103 |
| clostridium difficile infection in children hospitalized due to diarrhea. | the frequency of clostridium difficile infection (cdi)-related hospitalizations is increasing. the aim of this study was to determine the extent of cdi among children hospitalized with diarrhea, risk factors or predictors for severe cdi, the prevalence of nap1, and to compare the course of cdi depending on bacteria toxicity profile. a retrospective analysis of case records of 64 children (age range 3 months-16 years, median age 2.12 years) with cdi as defined by diarrheal disease and positive po ... | 2014 | 24213847 |
| clinical comparison of simplexa universal direct and bd geneohm tests for detection of toxigenic clostridium difficile in stool samples. | we compared the performance characteristics of the simplexa universal direct (focus diagnostics, cypress, ca) and bd geneohm (bd diagnostics/geneohm sciences, san diego, ca) tests for detection of toxigenic clostridium difficile in 459 stool samples (9.4% positive). the observed agreement for the results of the two tests with 452 samples with valid test results was 98.2% (kappa, 0.9; p value of 0.73 by the mcnemar test). when samples with discordant or invalid results were retested, the agreemen ... | 2014 | 24197886 |
| more nutritional research needed to prevent and treat clostridium difficile infections. | | 2013 | 24192962 |
| editorial: ppis and recurrent c. difficile infection: no association? | a rigorously conducted cohort study published in this edition of the american journal of gastroenterology shows that the use of a proton-pump inhibitor is not associated with recurrent clostridium difficile infection among hospitalized patients. this contradicts the findings of previous studies that, however, were at a high risk of bias. where does the truth lie? regardless of the answer, it is important that proton-pump inhibitors, not dissimilar to any other drug, are used appropriately. | 2013 | 24192949 |
| gastrointestinal infections, active component, u.s. armed forces, 2002-2012. | acute gastroenteritis and other infectious disorders of the gastrointestinal system are common in civilian and military populations. during the years 2002 through 2012, there were 286,305 cases of gastrointestinal infection (gi) diagnosed among members of the active component of the u.s. armed forces. the distribution of presumed causes of these illnesses (as reported in administrative medical records) was bacterial (29%), viral (68%), and parasitic (3%). most recorded diagnoses did not specify ... | 2013 | 24191767 |
| health care use and serious infection prevalence associated with penicillin "allergy" in hospitalized patients: a cohort study. | penicillin is the most common drug "allergy" noted at hospital admission, although it is often inaccurate. | 2014 | 24188976 |
| possible association between obesity and clostridium difficile infection. | | 2013 | 24188730 |
| predicting a complicated course of clostridium difficile infection at the bedside. | clostridium difficile infections (cdis) are a common cause of antibiotic-associated diarrhoea and associated with cdi-related mortality in c. 10%. to date, there is no prediction model in use that guides clinicians to identify patients at high risk for complicated cdi. from 2006 to 2009, nine dutch hospitals included hospitalized cdi patients in a prospective cohort. potential predictors of a complicated course (icu admission, colectomy or death due to cdi) were evaluated in uni- and multivariat ... | 2014 | 24188103 |
| clostridium difficile infection in the community: are proton pump inhibitors to blame? | once a nosocomial disease, clostridium difficile infection (cdi) now appears frequently in the community in the absence of exposure to antibiotics. prior studies have shown that patients with community-acquired cdi are younger, more likely to be female, and have fewer comorbidities compared to patients with hospital-associated cdi. because most studies of cdi are hospital-based, comparatively little is known about community-acquired cdi. the recent study by chitnis has received widespread attent ... | 2013 | 24187445 |
| incidence and mortality associated with clostridium difficile infection at a japanese tertiary care center. | although increases in clostridium difficile infection (cdi) incidence and severity have been observed in numerous countries, the incidence of cdi in japan remains unclear. the goal of this study was to determine the incidence and outcomes of cdi at a japanese tertiary care center. | 2014 | 24184291 |
| bacterial counts from five over-the-counter probiotics: are you getting what you paid for? | there is concern that the bacterial colony counts present at the time of manufacture and listed on the probiotic package may not be reflective of the numbers viable colonies at the time of purchase and patient consumption thereby diminishing efficacy. we performed a colony count study of three separate samples of five different probiotics purchased from three different stores: bifidobacterium infantis (align(®)); lactobacillus acidophilus cl1285(®) and lactobacillus casei lbc80r(®) (bio-k+(®)); ... | 2014 | 24184290 |
| bacteremia as an adverse event of fecal microbiota transplantation in a patient with crohn's disease and recurrent clostridium difficile infection. | | 2014 | 24184170 |
| evolution of interventional vancomycin trials in light of new antibiotic development in the usa, 1999-2012. | use of vancomycin has increased following the emergence of resistant gram-positive bacterial infections. investigation into recent vancomycin clinical studies provides insight into the optimal use of vancomycin and the development of novel antibiotics for the treatment of resistant infections. interventional vancomycin trials registered in clinicaltrials.gov from january 1999 to december 2012 were identified. trial trends and characteristics were evaluated in the context of vancomycin use and ne ... | 2014 | 24183801 |
| acute oxalate nephropathy associated with clostridium difficile colitis. | we report the case of a 69-year-old man who presented with acute kidney injury in the setting of community-acquired clostridium difficile-associated diarrhea and biopsy-proven acute oxalate nephropathy. we discuss potential mechanisms, including increased colonic permeability to oxalate. we conclude that c difficile-associated diarrhea is a potential cause of acute oxalate nephropathy. | 2014 | 24183111 |
| clostridium difficile infection in children with inflammatory bowel disease: current evidence. | inflammatory bowel disease (ibd) is a chronic, immune-mediated disease of the gastrointestinal tract that develops in genetically susceptible individuals. questions about the role of infections in the development and exacerbations of inflammatory bowel disease remain unanswered. among numerous bacteria that have been linked to ibd, the most frequently associated is clostridium difficile. clinical symptoms of c. difficile infection and an exacerbation of inflammatory bowel disease are often indis ... | 2014 | 24180405 |
| [the use of molecular methods in the diagnosis of clostridium difficile infections]. | the aim of this study was to use molecular methods to identify selected strains of c. difficile isolated from patients hospitalized at independent public central teaching hospital [sp csk] between 2008 and 2011 in order to demonstrate their toxicgenic character and to determine their epidemic potential, including the incidence of a suspected c. difficile strain 027/nap1/b1. | 2013 | 24180138 |
| clostridium difficile: epidemiology, diagnostic and therapeutic possibilities-a systematic review. | this literature review looks at the epidemiology, clinical manifestations, diagnostics and current medical and surgical management of clostridium difficile (c. difficile) infection. a literature search of pubmed and cochrane database regarding c. difficile infection was performed. information was extracted from 43 published articles from 2000 to the present day which met inclusion criteria. c. difficile is a gram-positive, anaerobic bacillus, which is widely found in the environment, especially ... | 2014 | 24178946 |
| hypersensitivity reactions associated with fidaxomicin use. | we report hypersensitivity reactions associated with fidaxomicin, an antibacterial drug approved for the treatment of clostridium difficile-associated diarrhea. these reactions are viewed as significant because of severity and unexpected because fidaxomicin is minimally absorbed. the fidaxomicin labeling was revised to include information about the possibility of hypersensitivity reactions. | 2014 | 24178248 |
| antibiotic-associated complications following lower limb arthroplasty: a comparison of two prophylactic regimes. | as part of a wider drive to reduce clostridium difficile rates (cdad), our trust switched from cefuroxime to gentamicin and flucloxacillin prophylaxis for joint replacement surgery. anecdotal evidence suggested that we were seeing an increased incidence of acute kidney injury (aki) following elective total hip replacement (thr) and total knee replacement (tkr) since this change. the aim of this study was to compare rates of aki and post-operative infection between the two antibiotic regimes. | 2014 | 24178085 |
| genetic analysis of tn916-like elements conferring tetracycline resistance in clinical isolates of clostridium difficile. | as an important clinically relevant pathogen, clostridium difficile has a high multidrug resistance rate. conjugative transposons play a vital role in its resistance phenotype. in the present study, 34 tetracycline-resistant clinical isolates of c. difficile were studied to detect tetracycline resistance genes and the presence of transposons. thirty-two isolates were found to harbour tn916-like elements carrying the tet(m) resistance gene, of which only one copy existed in the genome by southern ... | 2014 | 24176599 |
| fever in the postoperative patient. | postprocedure fevers vary in the timing of their occurrence, duration, and severity. such fevers do not all have an infectious cause, but they all require thorough investigation to rule out life-threatening conditions. this article summarizes the principles of diagnosis and management of postprocedure fevers for the emergency care provider. | 2013 | 24176478 |
| quality focus: clostridium difficile. | | 2013 | 24175503 |
| validation of a clinical prediction scale for hospital-onset clostridium difficile infection. | the aim of this study was to validate a clinical prediction scale for hospital-onset clostridium difficile infection (cdi). | 2015 | 24172178 |
| toxin-producing clostridium difficile strains as long-term gut colonizers in healthy infants. | clostridium difficile is a colonizer of the human gut, and toxin-producing strains may cause diarrhea if the infectious burden is heavy. infants are more frequently colonized than adults, but they rarely develop c. difficile disease. it is not known whether strains of c. difficile differ in the capacity to colonize and persist in the human gut microbiota. here, we strain typed isolates of c. difficile that had colonized 42 healthy infants followed from birth to ≥12 months of age by using pcr rib ... | 2014 | 24172156 |
| predictors of first recurrence of clostridium difficile infections in children. | little is known regarding the risk of recurrence of clostridium difficile infection (cdi) in children. in a 9-year cohort, 12% of hospitalized children with cdi had recurrent disease. receipt of concomitant antibiotics and community-associated cdi were independently associated with recurrent disease in children hospitalized with cdi. antibiotics administered for reasons other than treatment of cdi should be discontinued whenever possible. | 2014 | 24168983 |
| clostridium difficile infection in hospitalized patients at university clinical center tuzla, bosnia and herzegovina: a 4 year experience. | clostridium difficile (c. difficile) is currently the leading cause of healthcare-associated diarrhea, but almost nothing is known about the extent of c. difficile infection (cdi) in bosnia and herzegovina. | 2013 | 24167425 |
| clostridium difficile toxin b-induced necrosis is mediated by the host epithelial cell nadph oxidase complex. | clostridium difficile infection (cdi) is a leading cause of health care-associated diarrhea and has increased in incidence and severity over the last decade. pathogenesis is mediated by two toxins, tcda and tcdb, which cause fluid secretion, inflammation, and necrosis of the colonic mucosa. tcdb is a potent cytotoxin capable of inducing enzyme-independent necrosis in both cells and tissue. in this study, we show that tcdb-induced cell death depends on assembly of the host epithelial cell nadph o ... | 2013 | 24167244 |
| role of leptin-mediated colonic inflammation in defense against clostridium difficile colitis. | the role of leptin in the mucosal immune response to clostridium difficile colitis, a leading cause of nosocomial infection, was studied in humans and in a murine model. previously, a mutation in the receptor for leptin (lepr) was shown to be associated with susceptibility to infectious colitis and liver abscess due to entamoeba histolytica as well as to bacterial peritonitis. here we discovered that european americans homozygous for the same lepr q223r mutation (rs1137101), known to result in d ... | 2014 | 24166957 |
| is fidaxomicin the drug of choice for treating clostridium difficile-associated diarrhea in patients with cancer? | | 2013 | 24166524 |
| an antibiotic-altered microbiota provides fuel for the enteric foe. | antibiotic therapies disrupt the intestinal microbiota and render the host susceptible to enteric infections. a recent report by ng et al. explores the ability of two intestinal pathogens (salmonella enterica serovar typhimurium and clostridium difficile) to use this disruption to their advantage and consume host carbohydrates that would otherwise be unavailable in the presence of a normal gut microbiota. | 2014 | 24165893 |
| fulminant colitis. | fulminant colitis is an ill-defined entity that is usually viewed as the most severe form of uncomplicated acute colitis. it usually occurs in the course of ulcerative colitis and infectious colitis, but can also be seen in other forms of colitis. every patient with clinical criteria for severe or fulminant colitis should be approached in a systematic way, based on two premises - intense medical treatment and early surgery in non-responders. | 2013 | 24160933 |
| detection of toxins a/b and isolation of clostridium difficile and clostridium perfringens from dogs in minas gerais, brazil. | the objective of this study was to detect c. difficile a/b toxins and to isolate strains of c. perfringens and c. difficile from diarrheic and non-diarrheic dogs in brazil. stool samples were collected from 57 dogs, 35 of which were apparently healthy, and 22 of which were diarrheic. c. difficile a/b toxins were detected by elisa, and c. perfringens and c. difficile were identified by multiplex pcr. c. difficile a/b toxins were detected in 21 samples (36.8%). of these, 16 (76.2%) were from diarr ... | 2013 | 24159295 |
| epidemiology of clostridium difficile-associated disease (cdad): a shift from hospital-acquired infection to long-term care facility-based infection. | previous epidemiological studies on clostridium-difficile-associated diarrhea (cdad) have focused on hospitalized patients with nosocomial transmission. however, increasing numbers of patients with cdad are being admitted to acute-care hospitals from long-term care facilities (ltcfs) and the local community. the purpose of our study was to study the changing epidemiological trends of cdad patients admitted to an acute-care hospital and examine factors contributing to this shift in epidemiology. | 2013 | 24154638 |
| utility of a commercial pcr assay and a clinical prediction rule for detection of toxigenic clostridium difficile in asymptomatic carriers. | a commercial pcr assay of perirectal swab specimens detected 17 (68%) of 25 asymptomatic carriers of toxigenic clostridium difficile, including 93% with skin and/or environmental contamination. a clinical prediction rule, followed by pcr screening, could be used to identify carriers at high risk of c. difficile shedding. | 2014 | 24153132 |
| surveillance cultures in pediatric allogeneic hematopoietic stem cell transplantation. | the value of surveillance cultures in predicting systemic infections and in guiding antimicrobial treatment is controversial. we investigated 57 pediatric allo-scts between 2007 and 2009. all (34), aml (5), and severe aplastic anemia (4) were the largest patient groups. conditioning was tbi-based in 87% and 54% developed gvhd (21% grade iii-iv). of the 2594 weekly colonization samples, 24% were positive (fecal bacteria 86%, fecal fungi 16%, clostridium difficile 16%; throat bacteria 17% and thro ... | 2014 | 24152015 |
| clostridium difficile surveillance: harnessing new technologies to control transmission. | clostridium difficile surveillance allows outbreaks of cases clustered in time and space to be identified and further transmission prevented. traditionally, manual detection of groups of cases diagnosed in the same ward or hospital, often followed by retrospective reference laboratory genotyping, has been used to identify outbreaks. however, integrated healthcare databases offer the prospect of automated real-time outbreak detection based on statistically robust methods, and accounting for conta ... | 2013 | 24151834 |
| quality of care delivered to hospitalized inflammatory bowel disease patients. | hospitalized patients with inflammatory bowel disease (ibd) are at high risk for morbidity, mortality, and health care utilization costs. while the literature on trends in hospitalization rates for this disease is conflicting, there does appear to be significant variation in the delivery of care to this complex group, which may be a marker of suboptimal quality of care. there is a need for improvement in identifying patients at risk for hospitalization in an effort to reduce admissions. moreover ... | 2013 | 24151354 |
| what is the value of a food and drug administration investigational new drug application for fecal microbiota transplantation to treat clostridium difficile infection? | | 2014 | 24148361 |
| clostridium difficile carriage and serum antitoxin responses in children with inflammatory bowel disease. | adults with inflammatory bowel disease (ibd) have a high prevalence of clostridium difficile carriage, but little data exist regarding pediatric patients with ibd. serum antibody responses to c. difficile toxins in correlation with organism carriage are not described in ibd. this study determines the prevalence of c. difficile carriage and compares serum antibody responses to c. difficile toxins in pediatric outpatients with ibd and controls. | 2013 | 24145927 |
| simple approach for ultrasensitive electrochemical immunoassay of clostridium difficile toxin b detection. | clostridium difficile toxin b (tcd b), as one of the primary contributing factors to the pathogenesis of c. difficile-associated diseases, has raised serious public concerns due to its virulence, spore-forming ability and persistence with major types of infectious diarrhea diseases, and been used as a potential biomarker in clinical diagnoses. thus, a simple method for the determination of tcd b was developed based on a sandwich-type electrochemical immunosensor. greatly enhanced sensitivity was ... | 2014 | 24141113 |
| functional analysis of slec from clostridium difficile: an essential lytic transglycosylase involved in spore germination. | clostridium difficile is the most common cause of enteric disease and presents a major burden on healthcare systems globally due in part to the observed rapid rise in antibiotic resistance. the ability of c. difficile to form endospores is a key feature in the organism's pathogenesis and transmission, and contributes greatly to its resilient nature. endospores are highly resistant to disinfection, allowing them to persist on hospital surfaces. in order for the organism to cause disease, the spor ... | 2014 | 24140647 |
| the impact of cefepime as first line therapy for neutropenic fever on clostridium difficile rates among hematology and oncology patients. | after changing empiric treatment of febrile neutropenia from meropenem to cefepime, the effect on clostridium difficile infection (cdi) was investigated. the change was assessed using an autoregressive model. a significant increase in cdi rates occurred following the introduction of cefepime. there may be an association between increased cefepime usage and cdi. | 2013 | 24140078 |
| a polymorphic, mucocutaneous eruption in a patient with end-stage renal disease. | an 81-year-old man is presented who developed cryptococcal infection after treatment for clostridium difficile infection. | 2013 | 24139366 |
| linking clostridium difficile infection with depression. | | 2013 | 24137729 |
| fidaxomicin: a review of its use in patients with clostridium difficile infection. | oral fidaxomicin (dificid(®); dificlir(®)) is a first-in-class macrocyclic antibacterial that is approved in several countries for the treatment of adult patients with clostridium difficile-associated diarrhoea. fidaxomicin 200 mg twice daily for 10 days was an effective and generally well tolerated treatment in adult patients with a first episode or first recurrence of c. difficile infection. in two multinational phase iii trials, fidaxomicin treatment was noninferior to vancomycin treatment wi ... | 2013 | 24136090 |
| colonic decompression and direct intraluminal medical therapy for clostridium difficile-associated megacolon using a tube placed endoscopically in the proximal colon. | urgent colectomy for severe clostridium difficile infection can be associated with increased morbidity and mortality. we aimed to use endoscopic methods for treatment. | 2014 | 24134562 |
| [clostridium difficile infection (cdi) in the course of time - an issue only for the internist?]. | toxigenic strains of clostridium (c.) difficile are the most prevalent pathogens of antibiotic associated intestinal disease and nosocomial diarrhoea. during the last 10 years, incidences of c. difficile infection (cdi) have increased worldwide. | 2014 | 24132675 |
| fecal transplantation therapy for clostridium difficile-associated pouchitis. | | 2014 | 24132529 |
| horizontal gene transfer converts non-toxigenic clostridium difficile strains into toxin producers. | clostridium difficile is a major nosocomial pathogen and the main causative agent of antibiotic-associated diarrhoea. the organism produces two potent toxins, a and b, which are its major virulence factors. these are chromosomally encoded on a region termed the pathogenicity locus (paloc), which also contains regulatory genes, and is absent in non-toxigenic strains. here we show that the paloc can be transferred from the toxin-producing strain, 630δerm, to three non-toxigenic strains of differen ... | 2013 | 24131955 |
| added value of multiplex luminex gastrointestinal pathogen panel (xtag® gpp) testing in the diagnosis of infectious gastroenteritis. | the luminex gastrointestinal pathogen panel (xtag(®) gpp) detects in one assay the most common gastroenteritis-causing pathogens and toxins, namely adenovirus 40/41, norovirus genogroup (ng) i/ii, rotavirus a, clostridium difficile toxin a/b, campylobacter sp., escherichia coli o157, enterotoxigenic e. coli heat-labile enterotoxin/heat-stable enterotoxin, salmonella sp., shiga-toxin producing e. coli, shiga-like toxin (stx)1/2, shigella sp., vibrio cholerae, yersinia enterocolitica, cryptosporid ... | 2014 | 24131399 |
| a quantitative method for assessment of prescribing patterns using electronic health records. | most available quality indicators for hospitals are represented by simple ratios or proportions, and are limited to specific events. a generalized method that can be applied to diverse clinical events has not been developed. the aim of this study was to develop a simple method of evaluating physicians' prescription patterns for diverse events and their level of awareness of clinical practice guidelines. | 2013 | 24130689 |
| [challenges of clostridium difficile infection]. | clostridium difficile infections remain a problem especially for patients in the intensive care unit. the fact that c. difficile infections are strongly associated with antibiotic therapy calls for more caution in the use of antibiotics, especially in patients with a high risk of developing c. difficle infections. severe infections and recurrent episodes are usually difficult to manage and therapeutic options are often limited. the method of stool transplantation, though not new, has received mo ... | 2013 | 24129852 |
| severe clostridium difficile infection in new zealand associated with an emerging strain, pcr-ribotype 244. | to compare disease severity and clinical outcome of clostridium difficile infection (cdi) due to pcr-ribotype (rt) 244 with cdi due to other strains present in auckland. | 2013 | 24126745 |
| common gastrointestinal symptoms: risks of long-term proton pump inhibitor therapy. | more than 11 million individuals receive proton pump inhibitor (ppi) prescriptions each year in the united states. although ppis are effective treatment for peptic ulcers and esophagitis and provide symptom relief for many other conditions, their use carries risks. they decrease gastric acid and can lower blood levels of drugs whose absorption is acid dependent, including several antiretroviral and cancer therapy drugs. other drugs, such as digoxin, may be absorbed more extensively when gastric ... | 2013 | 24124705 |
| a retrospective study on the etiological diagnoses of diarrhea in neonatal piglets in ontario, canada, between 2001 and 2010. | laboratory surveillance data from the animal health laboratory, university of guelph, on the etiological diagnoses of neonatal diarrhea in piglets were analyzed to determine the relative importance and trends of different enteric pathogens in ontario. a total of 237 cases, including live and dead 1- to 7-day-old piglets, were submitted for diagnosis of gastrointestinal illness between 2001 and 2010. the combined frequencies for cases of gastrointestinal illness involving escherichia coli, clostr ... | 2013 | 24124267 |
| ultrastructure of clostridium difficile colonies. | the ultrastructural colony architecture of six clostridium difficile strains belonging to four different ribotypes (001, 027, 078/126 and 036) was studied by scanning electron microscopy (sem). in 2-day-old colonies several microareas differing in cell length and organization could be differentiated. some cells at colony edges were extremely long and exhibited invasiveness into the agar. the ultrastructure of 5-day-old colonies is more homogenous and characterized by presence of sporulating cell ... | 2013 | 24120350 |
| microbiological, pathological and histological findings in four danish pig herds affected by a new neonatal diarrhoea syndrome. | neonatal diarrhoea is a frequent clinical condition in commercial swine herds, previously regarded to be uncomplicated to treat. however, since 2008 it seems that a new neonatal diarrhoeic syndrome unresponsive to antibiotics and common management practices has emerged. routine laboratory examinations have not detected any pathogen related to this syndrome. the primary purpose of this study was to evaluate if well-known enteric pathogens could be associated with outbreaks of neonatal diarrhoea, ... | 2013 | 24119974 |
| a new plant-derived antibacterial is an inhibitor of efflux pumps in staphylococcus aureus. | an in-depth evaluation was undertaken of a new antibacterial natural product (1) recently isolated and characterised from the plant hypericum olympicum l. cf. uniflorum. minimum inhibitory concentrations (mics) were determined for a panel of bacteria, including: meticillin-resistant and -susceptible strains of staphylococcus aureus, staphylococcus epidermidis and staphylococcus haemolyticus; vancomycin-resistant and -susceptible enterococcus faecalis and enterococcus faecium; penicillin-resistan ... | 2013 | 24119569 |
| european society of clinical microbiology and infectious diseases: update of the treatment guidance document for clostridium difficile infection. | in 2009 the first european society of clinical microbiology and infection (escmid) treatment guidance document for clostridium difficile infection (cdi) was published. the guideline has been applied widely in clinical practice. in this document an update and review on the comparative effectiveness of the currently available treatment modalities of cdi is given, thereby providing evidence-based recommendations on this issue. a computerized literature search was carried out to investigate randomiz ... | 2014 | 24118601 |
| molecular epidemiology of clostridium difficile at a medical center in taiwan: persistence of genetically clustering of a⁻b⁺ isolates and increase of a⁺b⁺ isolates. | we investigated the changing trend of various toxigenic clostridium difficile isolates at a 3 500-bed hospital in taiwan. genetic relatedness and antimicrobial susceptibility of toxigenic c. difficile isolates were also examined. | 2013 | 24116048 |
| sensitivity to antibiotics of clostridium difficile toxigenic nosocomial strains. | clostridium difficile is the etiological agent of diarrhoea and colitis, especially in elderly patients. the incidence of these diseases has increased during the last 10 years. emergence of so-called hypervirulent strains is considered as one of the main factors responsible for the more severe disease and changed profile of sensitivity to antimicrobial agents. the aim of this work was to determine the sensitivity profile of toxigenic strains of c. difficile in the czech republic in 2011-2012 to ... | 2014 | 24114414 |
| metabolic engineering of escherichia coli for biosynthesis of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) from glucose. | the escherichia coli xl1-blue strain was metabolically engineered to synthesize poly(3-hydroxybutyrate-co-3-hydroxyvalerate) [p(3hb-co-3hv)] through 2-ketobutyrate, which is generated via citramalate pathway, as a precursor for propionyl-coa. two different metabolic pathways were examined for the synthesis of propionyl-coa from 2-ketobutyrate. the first pathway is composed of the dickeya dadantii 3937 2-ketobutyrate oxidase or the e. coli pyruvate oxidase mutant (poxb l253f v380a) for the conver ... | 2014 | 24113828 |
| a clostridium difficile infection (cdi) stewardship initiative improves adherence to practice guidelines for management of cdi. | a clostridium difficile infection (cdi) stewardship initiative reduced inappropriate prescription of empirical cdi therapy and improved timeliness of treatment and adherence to clinical practice guidelines for management of cdi. the initiative required minimal resources and could easily be incorporated into traditional antimicrobial stewardship programs. | 2013 | 24113611 |
| occurrence of zoonotic clostridia and yersinia in healthy cattle. | zoonotic pathogens are a frequent cause of disease worldwide. this study was designed to determine the occurrence of clostridium difficile, clostridium botulinum, and yersinia enterocolitica in cattle in southern bavaria, germany. the study population included 49 farms; 34 were dairy farms (30 also fattening beef cattle) and 15 were solely beef cattle farms. fecal and dust samples were collected from summer 2011 to summer 2012 and analyzed using a combination of enrichment procedures and real-ti ... | 2013 | 24112568 |
| trends in orthopaedic antimicrobial prophylaxis in the uk between 2005 and 2011. | antimicrobial prophylaxis remains the most powerful tool used to reduce infection rates in orthopaedics but the choice of antibiotic is complex. the aim of this study was to examine trends in antimicrobial prophylaxis in orthopaedic surgery involving the insertion of metalwork between 2005 and 2011. | 2013 | 24112496 |
| clostridium difficile bacteremia. | | 2013 | 24111758 |
| comparison of multilocus variable-number tandem-repeat analysis and whole-genome sequencing for investigation of clostridium difficile transmission. | no study to date has compared multilocus variable-number tandem-repeat analysis (mlva) and whole-genome sequencing (wgs) in an investigation of the transmission of clostridium difficile infection. isolates from 61 adults with ongoing and/or recurrent c. difficile infections and 17 asymptomatic carriage episodes in children (201 samples), as well as from 61 suspected outbreaks affecting 2 to 41 patients in 31 hospitals in the united kingdom (300 samples), underwent 7-locus mlva and wgs in paralle ... | 2013 | 24108611 |
| guidance on preparing an investigational new drug application for fecal microbiota transplantation studies. | fecal microbiota transplantation (fmt) is an effective treatment for clostridium difficile infections that are refractory to antibiotic therapy. because of the important roles of the microbiota in the function of the gastrointestinal tract and other aspects of human physiology, there is a growing interest in studying fmt for other clinical indications. the us food and drug administration regulates clinical studies to evaluate the safety and efficacy of fmt. studies of fmt for recurrent clostridi ... | 2014 | 24107393 |
| clinical differences in clostridium difficile infection based on age: a multicenter study. | advancing age is a well-known risk factor for clostridium difficile infection (cdi). however, age-specific clinical differences in cdi are uncertain. a retrospective comparative analysis was performed based on age in 1367 patients with cdi in korea. most clinical features were similar in the two age groups studied, however malignancy was more common in the older group (age ≥ 65 y) (p < 0.001), while chemotherapy and transplantation were more common in the younger group (age < 65 y) (p < 0.001). ... | 2014 | 24106984 |
| cadazolid, a novel antibiotic with potent activity against clostridium difficile: safety, tolerability and pharmacokinetics in healthy subjects following single and multiple oral doses. | current treatment options for clostridium difficile-associated diarrhoea (cdad) leave a high unmet medical need for new therapies. cadazolid is a new antibiotic in development for the treatment of cdad. the objectives of this study were to evaluate its tolerability and pharmacokinetics following single ascending doses (ac-061-101) and multiple ascending doses (ac-061-102). | 2014 | 24106141 |
| effect of vancomycin dose on treatment outcomes in severe clostridium difficile infection. | current guidelines recommend vancomycin 125 mg four times daily for the treatment of severe clostridium difficile infection (cdi). however, the optimal dose of vancomycin has not been elucidated. this study was conducted to evaluate outcome differences in patients with severe cdi treated with either low-dose (≤500 mg daily) or high-dose (>500 mg daily) oral vancomycin. the medical records of 78 patients with severe cdi were evaluated retrospectively. the primary outcome was time to clinical cure ... | 2013 | 24103633 |
| faecal microbiota transplantation for the treatment of recurrent clostridium difficile infection: current promise and future needs. | the use of faecal microbiota transplantation (fmt) as treatment for recurrent clostridium difficile infection (cdi) has increased rapidly over the past few years. in this review, we highlight clinical studies of fmt for treatment of recurrent cdi and discuss the safety, standardization and future of this treatment option. the major risk factor for cdi is prior antibiotic use, which results in an altered state of the gut microbiota characterized by decreased microbial diversity. this altered gut ... | 2013 | 24100717 |
| defining the vulnerable period for re-establishment of clostridium difficile colonization after treatment of c. difficile infection with oral vancomycin or metronidazole. | clostridium difficile is an anaerobic, spore-forming bacterium that is the most common cause of healthcare-associated diarrhea in developed countries. a significant proportion of patients receiving oral vancomycin or metronidazole for treatment of clostridium difficile infection (cdi) develop recurrences. however, the period of vulnerability to re-establishment of colonization by c. difficile after therapy is not well defined. | 2013 | 24098459 |
| microbiota-mediated colonization resistance against intestinal pathogens. | commensal bacteria inhabit mucosal and epidermal surfaces in mice and humans, and have effects on metabolic and immune pathways in their hosts. recent studies indicate that the commensal microbiota can be manipulated to prevent and even to cure infections that are caused by pathogenic bacteria, particularly pathogens that are broadly resistant to antibiotics, such as vancomycin-resistant enterococcus faecium, gram-negative enterobacteriaceae and clostridium difficile. in this review, we discuss ... | 2013 | 24096337 |
| abdominal catastrophes in the intensive care unit setting. | patients in the setting of the intensive care unit can develop intra-abdominal complications that may worsen outcome. clinical suspicion of such complications coupled with early diagnosis and treatment may reduce morbidity and mortality associated with these processes. this article addresses the diagnosis and management of some of the common causes of intra-abdominal catastrophes. | 2013 | 24094389 |
| overview of severe clostridium difficile infection. | clostridium difficile is an anaerobic, spore-forming, gram-positive bacillus that can produce severe colitis resulting in death. there has been an overall increase in the incidence of clostridium difficile-associated disease and, particularly, an increase in the more virulent forms of the disease. treatment of severe c difficile infection includes management of severe sepsis and shock, pathogen-directed antibiotic therapy, and, in selected cases, surgical intervention. ultimately, prevention is ... | 2013 | 24094379 |
| depression and clostridium difficile infection. | | 2013 | 24093925 |
| physician outlook toward fecal microbiota transplantation in the treatment of clostridium difficile infection. | | 2013 | 24091517 |
| how do university education and clinical experience influence pre-registration nursing students' infection control practice? a descriptive, cross sectional survey. | this study aims to explore nursing students' knowledge of infection control and investigate how university education and clinical experience influence their infection control practice. | 2014 | 24090618 |
| prevalence of clostridium difficile colonization among healthcare workers. | clostridium difficile infection (cdi) has increased to epidemic proportions in recent years. the carriage of c. difficile among healthy adults and hospital inpatients has been established. we sought to determine whether c. difficile colonization exists among healthcare workers (hcws) in our setting. | 2013 | 24090343 |
| multicenter evaluation of the verigene clostridium difficile nucleic acid assay. | the verigene clostridium difficile nucleic acid test (verigene cdf test) (nanosphere, northbrook, il) is a multiplex qualitative pcr assay that utilizes a nanoparticle-based array hybridization method to detect c. difficile tcda and tcdb in fecal specimens. in addition, the assay detects binary toxin gene sequences and the single base pair deletion at nucleotide 117 (δ 117) in tcdc to provide a presumptive identification of the epidemic strain 027/nap1/bi (referred to here as ribotype 027). this ... | 2013 | 24088862 |
| the role of flagella in clostridium difficile pathogenesis: comparison between a non-epidemic and an epidemic strain. | clostridium difficile is a major cause of healthcare-associated infection and inflicts a considerable financial burden on healthcare systems worldwide. disease symptoms range from self-limiting diarrhoea to fatal pseudomembranous colitis. whilst c. difficile has two major virulence factors, toxin a and b, it is generally accepted that other virulence components of the bacterium contribute to disease. c. difficile colonises the gut of humans and animals and hence the processes of adherence and co ... | 2013 | 24086268 |
| culturing and maintaining clostridium difficile in an anaerobic environment. | clostridium difficile is a gram-positive, anaerobic, sporogenic bacterium that is primarily responsible for antibiotic associated diarrhea (aad) and is a significant nosocomial pathogen. c. difficile is notoriously difficult to isolate and cultivate and is extremely sensitive to even low levels of oxygen in the environment. here, methods for isolating c. difficile from fecal samples and subsequently culturing c. difficile for preparation of glycerol stocks for long-term storage are presented. te ... | 2013 | 24084491 |
| poor functional status as a risk factor for severe clostridium difficile infection in hospitalized older adults. | to determine the role of impaired functional status as a risk factor for severe clostridium difficile infection (cdi) in older adults. | 2013 | 24083842 |
| molecular epidemiology of clostridium difficile strains from nosocomial-acquired infections. | the purpose of this study is to analyze isolates of clostridium difficile from patients with nosocomial acquired infection in respect to their molecular type and antimicrobial susceptibility. fifty-nine randomly selected clinical isolates were characterized. molecular typing was performed by rep-pcr (diversilab). isolates were tested by disk diffusion towards 11 different antibiotics. all isolates were susceptible to metronidazole and vancomycin. fifty five (93 %) isolates were resistant to eryt ... | 2014 | 24081935 |
| the situation and management of clostridium difficile infection in spain: an opinion document. | | 2013 | 24080894 |