| oral vancomycin desensitisation to treat clostridium difficile infection in a vancomycin allergic patient. | the prevalence of clostridium difficile infection (cdi) is increasing worldwide. oral vancomycin is an effective and frequently used treatment. however, patients with cdi who are allergic to intravenous vancomycin cannot receive oral vancomycin due to the risk of anaphylaxis if given the oral form.we present a case where oral vancomycin desensitisation was used to successfully treat a vancomycin allergic patient with recurrent cdi. | 2013 | 24079362 |
| murine models to study clostridium difficile infection and transmission. | clostridium difficile is the leading cause of antibiotic-associated diarrhea in healthcare facilities worldwide. c. difficile infections are difficult to treat because of the high rate of disease recurrence after antibiotic therapy, leaving few treatment options for patients. c. difficile is also difficult to contain within a healthcare setting due to a highly-transmissible, resistant spore form that challenges standard infection control measures. the recent development of murine infection model ... | 2013 | 24076318 |
| first case of autochthonous clostridium difficile pcr ribotype 027 detected in spain. | clostridium difficile ribotype 027 (cd027) has caused outbreaks in the united states, canada, and europe since 2001. in spain, the importance of cd027 is still unknown. in 2007, we began active surveillance of cd027 to determine its incidence in our hospital. | 2014 | 24074903 |
| risk factors for clostridium difficile infection in the community: a case-control study in patients in general practice, denmark, 2009-2011. | to identify risk factors for clostridium difficile infection (cdi) in danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (n = 259) had positive cultures for toxigenic c. difficile and controls (n = 455) negative cultures. data were analysed by conditional logistic regression. in patients aged ⩾2 years (138 cases), hospitalization [odds ratio (or) 8·4, 95% confidence interval (ci) 3·1-23], consumption of beef ( ... | 2014 | 24073613 |
| [epidemiological characteristics of nosocomial diarrhea caused by clostridium difficile in a tertiary level hospital in serbia]. | among the most important causes of diarrhea in modern hospitals is clostridium difficile (c. difficile). a wide spectrum of diseases caused by this bacterium is now known as c. difficile associated disease (cdad). the development of cdad is usually preceded by the administration of antimicrobial therapy and fecal-oral infections with c. difficile. over the last years epidemiology of cdad has significantly changed. recently, a hypervirulent bi/nap1/027 strain, the cause of severe epidemics in nor ... | 2013 | 24073554 |
| proton pump inhibitors and clostridium difficile infection: are we propagating an already rapidly growing healthcare problem? | proton pump inhibitors (ppis) have been associated with clostridium difficile infection (cdi) in several recent studies. the exact mechanism through which ppis may cause clostridium difficile infection is not well understood. one potential mechanism to explain this association may be that elevated gastric ph levels facilitate the growth of potentially pathogenic upper and lower gastrointestinal tract flora. although clostridium difficile spores are acid resistant, vegetative forms are susceptibl ... | 2013 | 27785249 |
| cervical spine fractures in the elderly: morbidity and mortality after operative treatment. | although there are currently many different strategies and recommendations in the therapy of cervical spine fractures in elderly patients, there are still no generally accepted treatment algorithms. the aim of the present study was to analyze the morbidity, mortality, and outcome of operated cervical spine injuries in the elderly. | 2013 | 26815442 |
| investigating clostridium difficile. | clostridium difficile is one of the leading health-care-associated infections in the uk and has a significant clinical and economic impact. optimal laboratory testing for this pathogen is controversial and interpretation of results can lead to confusion. in the context of the clinical syndrome of c. difficile infection, this article reviews disease presentation, the diagnostic tests available, and their translation into information that can assist clinical management at the bedside. | 2013 | 24145598 |
| alteration of the intestinal microbiome: fecal microbiota transplant and probiotics for clostridium difficile and beyond. | clostridium difficile infection is increasingly common with a high risk of recurrence despite antibiotic treatment. in cases of recurrent c. difficile infection, fecal microbiota transplant (fmt) is a highly effective treatment option promoting the restoration of normal gut microbiota. furthermore, preliminary uncontrolled evidence demonstrates possible benefit of fmt in the management of some cases of inflammatory bowel disease and chronic constipation. in addition to presenting an overview of ... | 2013 | 24070153 |
| a review of ischemic colitis: is our clinical recognition and management adequate? | ischemic colitis is a common cause of hospital admissions; however it is frequently confused intellectually with mesenteric ischemia and often misdiagnosed as infectious diarrhea or clostridium difficile colitis. ischemic colitis is caused by non-occlusive insult to the small vessels supplying the colon without a clear precipitating factor. it is more common in females and in patients above 60 years of age. the classic presentation includes sudden onset of lower abdominal pain followed by the ur ... | 2013 | 24070152 |
| [fulminant clostridium difficile colitis]. | clostridium difficile is a common cause of nosocomial diarrhea and it's most difficult fulminant form is increasing in prevalence and severity in hospitalized patients. the early diagnostics and intensive conservative therapy are essential in the treatment of this ominous disease. the physicians must be aware of the possibility of this disease, when treating patients, who have received preceding antibiotic therapy. these patients have to be followed up in the surgical units. if the general condi ... | 2013 | 24069637 |
| [fecal transfusion as treatment of clostridium difficile infection]. | clostridium difficile is the major identified cause of antibiotic-associated diarrhea. metronidazole has been applied as the first-line treatment, while vancomycin has been used in recurring cases of the disease. fecal transfusion has already long been applied as experimental therapy in the treatment of recurring c. difficile infection. the aim of fecal transfusion is normalization of the intestinal microbial flora. an only recently published extensive finnish patient series and a randomized stu ... | 2013 | 24069636 |
| concurrent infections of giardia duodenalis, enterocytozoon bieneusi, and clostridium difficile in children during a cryptosporidiosis outbreak in a pediatric hospital in china. | over 200 cryptosporidiosis outbreaks have been reported, but little is known if other enteric pathogens were also involved in some of these outbreaks. recently, an outbreak of cryptosporidiosis linked to poor hygiene by two cryptosporidium hominis subtypes occurred in a pediatric hospital ward (ward a) in china, lasting for more than 14 months. in this study, the concurrence during the outbreak of three other enteric pathogens with a similar transmission route, giardia duodenalis, enterocytozoon ... | 2013 | 24069491 |
| emerging clinical role of pivmecillinam in the treatment of urinary tract infection in the context of multidrug-resistant bacteria. | the continuing spread of resistant gram-negative bacteria is a therapeutic challenge and prudent use of antimicrobials is therefore essential. urinary tract infections (utis), usually due to gram-negative bacteria, are among the most common infections seen in the community. moreover, bacterial strains producing extended-spectrum β-lactamases (esbls) that are resistant not only to cephalosporins and penicillins, but also to fluoroquinolones and trimethoprim, are becoming more prevalent in the com ... | 2014 | 24068280 |
| clostridium difficile--beyond the usual suspects. | | 2013 | 24066748 |
| diverse sources of c. difficile infection identified on whole-genome sequencing. | it has been thought that clostridium difficile infection is transmitted predominantly within health care settings. however, endemic spread has hampered identification of precise sources of infection and the assessment of the efficacy of interventions. | 2013 | 24066741 |
| proteomic analysis and label-free quantification of the large clostridium difficile toxins. | clostridium difficile is the leading cause of antibiotic-associated diarrhea in hospitals worldwide, due to hypervirulent epidemic strains with the ability to produce increased quantities of the large toxins tcda and tcdb. unfortunately, accurate quantification of tcda and tcdb from different toxinotypes using small samples has not yet been reported. in the present study, we quantify c. difficile toxins in <0.1 ml of culture filtrate by quantitative label-free mass spectrometry (ms) using data-i ... | 2013 | 24066231 |
| dna detection of clostridium difficile infection based on real-time resistance measurement. | we used a newly developed electrochemical method, real-time resistance measurement, based on loop-mediated isothermal amplification (lamp), with real-time resistance monitoring and derivative analysis. dna extracted from specimens was amplified through lamp reaction. the 2 products of lamp, dna and pyrophosphate, both are negative ions; they combine with positive dye (crystal violet) and positive ions (mg(2+)), which leads to an increase in the resistivity of the reaction liquid. the changes of ... | 2013 | 24065671 |
| role of fidaxomicin for the treatment of clostridium difficile infection. | clostridium difficile is a gram-negative, anaerobic, spore-forming emerging pathogen within health care systems and community-based populations that has a high associated morbidity and mortality as well as cost for the health care system. recent studies reported high rates of recurrence thus a need for new pharmacological agents to treat c difficile infections (cdis). fidaxomicin is a novel macrocyclic antibiotic, originally isolated from fermentation broth of dactylosporangium aurantiacum spp h ... | 2013 | 24064437 |
| antibiotic-associated diarrhea: a refresher on causes and possible prevention with probiotics--continuing education article. | antibiotic-associated diarrhea (aad) describes any unexplained diarrhea associated with the use of an antibiotic. aad also includes infection caused by clostridium difficile, however this organism only accounts for a small percentage of diarrhea caused by antibiotics. aad can be caused by multiple other organisms including c perfringens, s aureus, and candida. some antibiotics are more likely to cause non-c difficile aad, such as erythromycin and the penicillin class. aad develops through the lo ... | 2013 | 24064436 |
| epidemiology of clostridium difficile infection. | there has been dramatic change in the epidemiology of clostridium difficile infection (cdi) since the turn of the 21st century noted by a marked increase in incidence and severity, occurring at a disproportionately higher frequency in older patients. historically considered a nosocomial infection associated with antibiotic exposure, cdi has now also emerged in the community in populations previously considered low risk. emerging risk factors and disease recurrence represent continued challenges ... | 2013 | 24064435 |
| clostridium difficile-associated diarrhea: role of the pharmacist in the health system. | | 2013 | 24064434 |
| risk factors for clostridium difficile-associated diarrhea among hospitalized adults with fecal toxigenic c. difficile colonization. | patients with toxigenic clostridium difficile colonization (tcdc) are at risk of developing c. difficile-associated diarrhea (cdad). however, the risk factors of hospitalized patients with tcdc developing cdad are not clear. | 2015 | 24064285 |
| molecular methods in the diagnosis of clostridium difficile infections: an update. | nucleic acid amplification techniques (naats) represent a major advance in the diagnosis of clostridium difficile (c. difficile) infection. this review analyzes the different options available for a molecular diagnosis of c. difficile infection, as well as the strengths and weaknesses of naats. the performances of seven commercials naats are compared (bd geneohm cdiff, illumigene c. difficile, xpert c. difficile, bd max cdiff, portrait toxigenic c. difficile, progastro cd, seeplex diarrhea ace). ... | 2013 | 24063396 |
| hype or hypervirulence: a reflection on problematic c. difficile strains. | clostridium difficile infections (cdi) have emerged as a major cause of healthcare associated disease, and recent epidemiological evidence also suggests an important role in community-acquired diarrhea. this increase is associated with specific types, especially pcr ribotypes 027 and 078, which are sometimes referred to as "hypervirulent". over the past years major advances have been made in our understanding of c. difficile pathogenicity, with the identification and characterization of the majo ... | 2013 | 24060961 |
| proton pump inhibitors and risk for recurrent clostridium difficile infection among inpatients. | observational studies suggest that proton pump inhibitors (ppis) are a risk factor for incident clostridium difficile infection (cdi). data also suggest an association between ppis and recurrent cdi, although large-scale studies focusing solely on hospitalized patients are lacking. we therefore performed a retrospective cohort analysis of inpatients with incident cdi to assess receipt of ppis as a risk factor for cdi recurrence in this population. | 2013 | 24060760 |
| enterotoxigenic clostridium perfringens infection and pediatric patients with inflammatory bowel disease. | clostridium difficile is the major cause of antibiotic-associated diarrhea and is the most well known bacterial pathogen associated with inflammatory bowel disease (ibd). enterotoxigenic clostridium perfringens has also been detected in up to 15% of antibiotic-associated diarrhea cases, and it has not been found in healthy people. the aim of this study was to investigate the prevalence of c. perfringens infection in pediatric patients with ibd. | 2014 | 24060617 |
| human vaccines & immunotherapeutics: news. | infant rotavirus vaccination provides for herd immunity nonreplicating sporozoite vaccine protects humans against malaria personalized brain cancer vaccine enters phase 2 trial novel implantable therapeutic cancer vaccine to be tested in humans clostridium difficile vaccine candidate successful in phase 1 cdc reports strong uptake of hpv vaccine in boys whooping cough outbreak in texas. | 2013 | 24056006 |
| therapy of clostridium difficile infection: perspectives on a changing paradigm. | clostridium difficile disease (cdi) have increased in frequency and severity over the past decade and are a leading cause of hospital acquired infections, contributing to increased hospital length of stay and costs, as well as associated increased mortality, especially amongst the elderly. standard therapy has been associated with 20 - 30% relapse rates. consequently, new cdi therapeutic approaches have emerged. | 2013 | 24053182 |
| a tool to assess student performance in a clostridium difficile infection simulation scenario. | to develop and validate an evaluation tool to assess student pharmacists' performance in a simulation scenario involving a patient with clostridium difficile infection (cdi). | 2013 | 24052652 |
| opportunistic infections due to inflammatory bowel disease therapy. | the use of biological agents and immunomodulators for inflammatory bowel disease (ibd) has remarkably improved disease management in the current era but at the same time has increased the risk of infectious complications. patients with ibd on corticosteroids, immunomodulators, and biological agents are considered immunocompromised and are at risk for opportunistic infections. these are infections caused by organisms that take advantage of a weakened immune system, and cause disease, when they or ... | 2014 | 24051931 |
| structures of a bifunctional cell wall hydrolase cwlt containing a novel bacterial lysozyme and an nlpc/p60 dl-endopeptidase. | tn916-like conjugative transposons carrying antibiotic resistance genes are found in a diverse range of bacteria. orf14 within the conjugation module encodes a bifunctional cell wall hydrolase cwlt that consists of an n-terminal bacterial lysozyme domain (n-acetylmuramidase, blysg) and a c-terminal nlpc/p60 domain (γ-d-glutamyl-l-diamino acid endopeptidase) and is expected to play an important role in the spread of the transposons. we determined the crystal structures of cwlt from two pathogens, ... | 2014 | 24051416 |
| reprint of new opportunities for improved ribotyping of c. difficile clinical isolates by exploring their genomes. | clostridium difficile causes outbreaks of infectious diarrhoea, most commonly occurring in healthcare institutions. recently, concern has been raised with reports of c. difficile disease in those traditionally thought to be at low risk i.e. community acquired rather than healthcare acquired. this has increased awareness for the need to track outbreaks and pcr-ribotyping has found widespread use to elucidate epidemiologically linked isolates. pcr-ribotyping uses conserved regions of the 16s rrna ... | 2013 | 24050948 |
| fecal microbiota transplantation: an innovative approach to treating clostridium difficile disease. | normal gut flora or microbiota, which is key to a healthy digestive tract, can be disrupted by antibiotic therapy, potentially leading to clostridium difficile-associated disease (cdad). fecal microbiota transplant has shown promise in quickly and safely eradicating cdad at low cost. | 2013 | 24049940 |
| solution nmr structure of cd1104b from pathogenic clostridium difficile reveals a distinct α-helical architecture and provides first structural representative of protein domain family pf14203. | a high-quality structure of the 68-residue protein cd1104b from clostridium difficile strain 630 exhibits a distinct all α-helical fold. the structure presented here is the first representative of bacterial protein domain family pf14203 (currently 180 members) of unknown function (duf4319) and reveals that the side-chains of the only two strictly conserved residues (glu 8 and lys 48) form a salt bridge. moreover, these two residues are located in the vicinity of the largest surface cleft which i ... | 2013 | 24048810 |
| clostridium difficile infection in lung cancer patients. | clostridium difficile infection (cdi) is a common nosocomial infection. lung cancer patients have a high risk of developing cdi because of continuous antibiotic treatment or chemotherapy, prolonged hospitalization, and general weakness. this study aimed to analyze predisposing or associated risk factors for cdi in lung cancer patients receiving chemotherapy. this study was a retrospective review of 188 lung cancer patients who were admitted to the wonkwang university hospital between 2008 and 20 ... | 2013 | 24047734 |
| distinguishing community-associated from hospital-associated clostridium difficile infections in children: implications for public health surveillance. | children are increasingly recognized as being at risk for c. difficile infection (cdi), even without prior exposure to antibiotics or the healthcare environment. we aimed to distinguish risk factors, clinical course, and outcomes between healthcare facility-associated (ha) and community-associated (ca) cdi. | 2013 | 24046303 |
| editorial commentary: community-associated clostridium difficile infection in children. | | 2013 | 24046300 |
| clostridium difficile infection: how safe are the household contacts? | | 2013 | 24045053 |
| a lactobacillus casei shirota probiotic drink reduces antibiotic-associated diarrhoea in patients with spinal cord injuries: a randomised controlled trial. | certain probiotics may prevent the development of antibiotic-associated diarrhoea (aad) and clostridium difficile-associated diarrhoea (cdad), but their effectiveness depends on both strain and dose. there are few data on nutritional interventions to control aad/cdad in the spinal cord injury (sci) population. the present study aimed to assess (1) the efficacy of consuming a commercially produced probiotic containing at least 6·5 × 10⁹ live lactobacillus casei shirota (lcs) in reducing the incid ... | 2014 | 24044687 |
| muricholic acids inhibit clostridium difficile spore germination and growth. | infections caused by clostridium difficile have increased steadily over the past several years. while studies on c. difficile virulence and physiology have been hindered, in the past, by lack of genetic approaches and suitable animal models, newly developed technologies and animal models allow these processes to be studied in detail. one such advance is the generation of a mouse-model of c. difficile infection. the development of this system is a major step forward in analyzing the genetic requi ... | 2013 | 24040011 |
| appendectomy and clostridium difficile colitis: relationships revealed by clinical observations and immunology. | advances in understanding the interaction between the human immune system and the microbiome have led to an improved understanding of the function of the vermiform appendix as a safe-house for beneficial bacteria in the colon. these advances have been made despite long standing clinical observations that the appendectomy is a safe and effective procedure. however, more recent clinical data show that an appendectomy puts patients at increased risk for recurrent clostridium difficile (c. difficile ... | 2013 | 24039352 |
| the second messenger cyclic di-gmp regulates clostridium difficile toxin production by controlling expression of sigd. | the gram-positive obligate anaerobe clostridium difficile causes potentially fatal intestinal diseases. how this organism regulates virulence gene expression is poorly understood. in many bacterial species, the second messenger cyclic di-gmp (c-di-gmp) negatively regulates flagellar motility and, in some cases, virulence. c-di-gmp was previously shown to repress motility of c. difficile. recent evidence indicates that flagellar gene expression is tightly linked with expression of the genes encod ... | 2013 | 24039264 |
| short versus long course of antibiotics for catheter-associated urinary tract infections in patients with spinal cord injury: a randomized controlled noninferiority trial. | to assess the applicability of a short-course regimen of antibiotics for managing catheter-associated urinary tract infection (ca-uti) in patients with spinal cord injury (sci). | 2014 | 24035770 |
| increase in reported clostridium difficile cases as unintended consequence of enhanced norovirus testing. | | 2013 | 24035257 |
| creating the right evidence for system change. | most evaluative research is focused on assessing new technologies at the patient level. comparatively little is focused on assessing how system changes could improve the delivery of healthcare. in this article, the authors describe an opportunity to conduct evaluative trials of system changes affordably and efficiently by using a cluster randomized design and mandatory reporting data, using the prevention of clostridium difficile infection as an example. they then describe what must be done to m ... | 2013 | 24034773 |
| risk factors, preemptive therapy, and antiperistaltic agents for clostridium difficile infection in cancer patients. | clostridium difficile infection (cdi) is a serious complication of chemotherapy including high-dose regimens with autologous stem cell transplantation (asct). antiperistaltic agents are contraindicated in cdi and preemptive cdi therapy is not recommended. we assessed the incidence, risk factors, and outcomes of cdi in patients with newly diagnosed multiple myeloma (mm) receiving similar antineoplastic therapy and supportive care including antiperistaltic agents and preemptive cdi antibiotics for ... | 2013 | 24034141 |
| use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated clostridium difficile infection. | clostridium difficile infection (cdi) is an important health care-associated infection that leads to increased morbidity and mortality. antibacterial medications used in hospitals serve as targets for antibacterial stewardship programs to reduce c difficile. the objective was to create a benchmark strategy targeting high-risk antibacterials for c difficile. this was a retrospective cross-sectional study using claims data from 58 hospitals. the data envelopment analysis technique was used to iden ... | 2014 | 24031081 |
| probiotics for the prevention of clostridium difficile. | | 2013 | 24029510 |
| clostridium difficile genotypes in piglet populations in germany. | clostridium difficile was isolated from 147 of 201 (73%) rectal swabs of piglets from 15 farms of lower saxony and north rhine-westphalia. in 14 farms, 14 to 100% (mean, 78%) of the animals tested were culture positive. the rate of isolation was 68% postpartum, increased to 94% in animals 2 to 14 days of age, and declined to 0% for animals 49 days of age and older. there was no link between isolation and antibiotic treatment or diarrhea of piglets. strains were assigned to 10 pcr ribotypes, and ... | 2013 | 24025903 |
| fate of ingested clostridium difficile spores in mice. | clostridium difficile infection (cdi) is a leading cause of antibiotic-associated diarrhea, a major nosocomial complication. the infective form of c. difficile is the spore, a dormant and resistant structure that forms under stress. although spore germination is the first committed step in cdi onset, the temporal and spatial distribution of ingested c. difficile spores is not clearly understood. we recently reported that camsa, a synthetic bile salt analog, inhibits c. difficile spore germinatio ... | 2013 | 24023628 |
| risk factors for clostridium difficile-associated diarrhea and the effectiveness of prophylactic probiotic therapy. | measures for prevention of clostridium difficile-associated diarrhea, a common nosocomial infection, in hospital settings are urgently needed. this study was conducted to identify the risk factors contributing to c. difficile-associated diarrhea and to evaluate the clinical benefit of probiotics in its prevention. the study included 2716 patients at least 20 years old who received an injected antibiotic at any time between february 2010 and february 2011; a total of 2687 patients (98.9%) were as ... | 2013 | 24020129 |
| does organic material on hospital surfaces reduce the effectiveness of hypochlorite and uv radiation for disinfection of clostridium difficile? | an organic load of 5%-10% fetal calf serum significantly reduced hypochlorite and uv radiation killing of clostridium difficile spores, but organic material collected from hospital surfaces did not affect hypochlorite and only modestly affected uv killing of spores. hypochlorite reduced aerobic microorganisms on unclean surfaces with no wiping. | 2013 | 24018930 |
| a systematic literature review and meta-analysis of factors associated with methicillin-resistant staphylococcus aureus colonization at time of hospital or intensive care unit admission. | screening for methicillin-resistant staphylococcus aureus (mrsa) in high-risk patients is a legislative mandate in 9 us states and has been adopted by many hospitals. definitions of high risk differ among hospitals and state laws. a systematic evaluation of factors associated with colonization is lacking. we performed a systematic review of the literature to assess factors associated with mrsa colonization at hospital admission. | 2013 | 24018925 |
| bed occupancy rates and hospital-acquired clostridium difficile infection: a cohort study. | an emergent strain (ribotype 027) of clostridium difficile infection (cdi) has been implicated in epidemics worldwide. organizational factors such as bed occupancy have been associated with an increased incidence of cdi; however, the data are sparse, and the association has not been widely demonstrated. we investigated the association of bed occupancy and cdi within a large hospital organization in the united kingdom. | 2013 | 24018923 |
| impact of change to molecular testing for clostridium difficile infection on healthcare facility-associated incidence rates. | change from nonmolecular to molecular testing techniques is thought to contribute to the increasing trend in incidence of clostridium difficile infection (cdi); however the degree of effect attributed to this versus other time-related epidemiologic factors is unclear. | 2013 | 24018922 |
| multiplex pcr targeting slpa: a rapid screening method to predict common clostridium difficile ribotypes among fluoroquinolone resistant clinical strains. | based on the relationship between clostridium difficile surface layer protein a (slpa) sequence types (sts) and pcr-ribotypes (rts), a multiplex polymerase chain reaction (mpcr) assay was developed to rapidly confirm c. difficile toxigenicity and, simultaneously, to identify any of five slpa sts, gr, hr, fr, gc8 and 078, that usually correspond with globally distributed rts, 001, 014, 017, 027 and 078, respectively. | 2013 | 24018815 |
| therapeutic potential of fecal microbiota transplantation. | there has been growing interest in the use of fecal microbiota for the treatment of patients with chronic gastrointestinal infections and inflammatory bowel diseases. lately, there has also been interest in its therapeutic potential for cardiometabolic, autoimmune, and other extraintestinal conditions that were not previously considered to be associated with the intestinal microbiota. although it is not clear if changes in the microbiota cause these conditions, we review the most current and bes ... | 2013 | 24018052 |
| detection of clostridium sordellii strains expressing hemorrhagic toxin (tcsh) and implications for diagnostics and regulation of veterinary vaccines. | clostridium sordellii is a gram positive anaerobic bacterium that causes multiple disease syndromes in both humans and animals. as with many clostridial pathogens, toxins contribute to the virulence of c. sordellii. two large toxins have been identified: a lethal toxin (tcsl) and a hemorrhagic toxin (tcsh) which are similar in structure and function to clostridium difficile toxin b (tcdb) and toxin a (tcda), respectively. while tcda, tcdb, and tcsl have been extensively studied, relatively littl ... | 2013 | 24016805 |
| treatment approaches including fecal microbiota transplantation for recurrent clostridium difficile infection (rcdi) among infectious disease physicians. | clostridium difficile infection (cdi) was the most common nosocomial infection in the u.s. in 2010. most cases of cdi respond to a standard course of antibiotics, but recurrent c. difficile infections (rcdi) are increasingly common. given the lack of randomized clinical trials, it is important to understand how infectious disease physicians are managing rcdi to inform future clinical research. | 2013 | 24012687 |
| proton pump inhibitors and the risk for hospital-acquired clostridium difficile infection. | to examine the relationship between proton pump inhibitor (ppi) usage and nosocomial clostridium difficile infection (cdi) and determine the duration of therapy at which cdi risk increases. | 2013 | 24012413 |
| fecal microbiota transplantation and donor standardization. | clostridium difficile diarrhea is a common and severe infectious disease. antibiotics, which are standard initial treatment, are less effective for treating refractory or recurrent infection. fecal microbiota transplantation, where healthy donor stool is transplanted into a patient, is an alternative to antibiotic therapy that requires standardization for donors and patients. | 2013 | 24012274 |
| transmission of clostridium difficile in foods. | clostridium difficile is a human intestinal pathogen most frequently involved in diarrheal illnesses following the administration of antibiotics. there is growing concern that some c difficile infections (cdi) may be acquired from ingestion of c difficile spores in contaminated foods. the number of cdi cases is increasing with a heightening in the severity of disease symptoms and an increasing number of community-associated infections not connected to health care-associated risk. this article pr ... | 2013 | 24011836 |
| intestinal inflammatory biomarkers and outcome in pediatric clostridium difficile infections. | to identify specific fecal biomarkers for symptomatic clostridium difficile infection and predictors of poor outcomes. | 2013 | 24011765 |
| clostridium difficile colitis in the united states: a decade of trends, outcomes, risk factors for colectomy, and mortality after colectomy. | clostridium difficile colitis (cdc) is a major health concern in the united states (us), with earlier reports demonstrating a rising incidence. studies analyzing predictors for total colectomy and mortality after colectomy are limited by small numbers. | 2013 | 24011436 |
| clostridium difficile colitis induced by long-term low-dosage erythromycin. | | 2013 | 24008746 |
| laboratory diagnosis of clostridium difficile. | | 2013 | 24007916 |
| differences in outcome according to clostridium difficile testing method: a prospective multicentre diagnostic validation study of c difficile infection. | diagnosis of clostridium difficile infection is controversial because of many laboratory methods, compounded by two reference methods. cytotoxigenic culture detects toxigenic c difficile and gives a positive result more frequently (eg, because of colonisation, which means that individuals can have the bacterium but no free toxin) than does the cytotoxin assay, which detects preformed toxin in faeces. we aimed to validate the reference methods according to clinical outcomes and to derive an optim ... | 2013 | 24007915 |
| [colitis precipitated by clostridium difficile - a serious current problem]. | clostridium difficile is currently considered a significant cause of nosocomial infection. the probability of a colonisation of hospitalised patients rises with the length of their stay in hospital and depends on the local epidemiologic situation. interdisciplinary collaboration is the foundation of the effort to limit the development of this very serious, often fatal disease. the basic element is a rational antibiotic therapy which builds on the knowledge that the administration of antibiotics, ... | 2013 | 24007234 |
| successful treatment of simulated clostridium difficile infection in a human gut model by fidaxomicin first line and after vancomycin or metronidazole failure. | fidaxomicin reduces the risk of recurrent clostridium difficile infection (cdi) compared with vancomycin. we investigated fidaxomicin primary or secondary treatment efficacy using a gut model. | 2014 | 24003182 |
| multifocal clinical performance improvement across 21 hospitals. | improving quality and safety across an entire healthcare system in multiple clinical areas within a short time frame is challenging. we describe our experience with improving inpatient quality and safety at kaiser permanente northern california. the foundations of performance improvement are a "four-wheel drive" approach and a comprehensive driver diagram linking improvement goals to focal areas. by the end of 2011, substantial improvements occurred in hospital-acquired infections (central-line- ... | 2013 | 24001267 |
| health care-associated infections: a meta-analysis of costs and financial impact on the us health care system. | health care-associated infections (hais) account for a large proportion of the harms caused by health care and are associated with high costs. better evaluation of the costs of these infections could help providers and payers to justify investing in prevention. | 2014 | 23999949 |
| fecal transplantation: re-discovering the value of stool. | for over 1000 years, stool in various forms has been used to treat disease. within the past few decades, fecal infusion either rectally or via a nasogastric tube has become a viable option for the treatment of refractory clostridium difficile infection (cdi), and, more recently, it has shown promise in treating inflammatory bowel disease (ibd) and metabolic disease. the purpose of this article is to review the use of feces as a treatment option in pediatric disease. | 2013 | 23995428 |
| leukemoid reaction: spectrum and prognosis of 173 adult patients. | the prognosis of patients with leukemoid reaction (lr) depends mainly on their underlying illness. our aim was to investigate the etiologies and prognosis of a mixed group of patients with lr. | 2013 | 23994818 |
| complicated clostridium difficile colitis in children with cystic fibrosis: association with gastric acid suppression? | patients with cystic fibrosis (cf) have several risk factors for clostridium difficile colonization such as frequent hospitalization and exposure to a broad array of antibiotics utilized for the control, eradication, and prophylaxis of respiratory pathogens. however, despite this high rate of colonization, the occurrence of c. difficile infection (cdi) in cf is rare. we report three children with cf who presented with severe community-associated cdi. all three children had complicated courses an ... | 2014 | 23993432 |
| analysis of metabolic evolution in bacteria using whole-genome metabolic models. | recent advances in the automation of metabolic model reconstruction have led to the availability of draft-quality metabolic models (predicted reaction complements) for multiple bacterial species. these reaction complements can be considered as trait representations and can be used for ancestral state reconstruction to infer the most likely metabolic complements of common ancestors of all bacteria with generated metabolic models. we present here an ancestral state reconstruction for 141 extant ba ... | 2013 | 23992299 |
| clostridium difficile infection in the twenty-first century. | clostridium difficile is a spore-forming gram-positive bacillus, and the leading cause of antibiotic-associated nosocomial diarrhea and colitis in the industrialized world. with the emergence of a hypervirulent strain of c. difficile (bi/nap1/027), the epidemiology of c. difficile infection has rapidly changed in the last decade. c. difficile infection, once thought to be an easy to treat bacterial infection, has evolved into an epidemic that is associated with a high rate of mortality, causing ... | 2013 | 26038491 |
| effects of nitric oxide and reactive oxygen species on hif-1α stabilization following clostridium difficile toxin exposure of the caco-2 epithelial cell line. | stabilization of the hypoxia-inducible factor (hif-1α) is proposed to provide a protective host-response to c. difficile intoxication. here, we aimed to elucidate whether nitric oxide and/or reactive oxygen species produced during c. difficile toxin exposure could influence hif-1α stability and initiate protection against epithelial cell damage. | 2013 | 23988581 |
| [include representations of caregivers coping with nosocomial clostridium difficile in quebec to promote better health]. | | 2013 | 23986384 |
| alerting physicians during electronic order entry effectively reduces unnecessary repeat pcr testing for clostridium difficile. | hospital information systems (his) alerts restricting repeat clostridium difficile pcr ordering by physicians in patients with a prior result within 7 days eliminated 91% of repeat tests, from 14.5% (282/1,949) repeats preintervention to 1.3% (135/10,285) postintervention. his alerting is an effective, targeted, patient-specific tool for improving the quality and utilization of c. difficile results. | 2013 | 23985918 |
| fulminant clostridium difficile infection: an association with prior appendectomy? | to examine if fulminant clostridium difficile infections (cdi) resulting in colectomy was associated with a prior appendectomy and whether any association affected the severity of the disease. | 2013 | 23983904 |
| overlapping roles for toxins in clostridium difficile infection. | | 2014 | 23983214 |
| therapy: probiotics do not reduce antibiotic-associated or clostridium difficile diarrhoea in older hospitalized patients. | | 2013 | 23982682 |
| new developments in chemotherapeutic options for clostridium difficile colitis. | clostridium difficile infections (cdis) are of increasing concern in healthcare due to increasing incidence as well as suboptimal response to standard therapies. this review focuses on current updates in chemotherapeutic treatment options for primary cdi as well as for relapse. | 2013 | 23982237 |
| clostridium difficile: biological therapies. | biological therapies for clostridium difficile infection (cdi) include probiotics and faecal microbiota transplant (fmt). there is significant interest in their use in treating refractory/recurrent cdi. this review summarizes the latest evidence for these approaches. | 2013 | 23982236 |
| recent insights into clostridium difficile pathogenesis. | clostridium difficile infection (cdi) is the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis in the healthcare setting. an emerging consensus suggests that cdi is caused by pathogenic toxin production, gut microbial dysbiosis and altered host inflammatory responses. the aim of this review is to summarize and highlight recent advances focused on cdi pathogenic mechanisms. | 2013 | 23982235 |
| [the intestinal microbiota and human disease]. | advances in sequencing technology and the development of metagenomics have opened up new ways to investigate the microorganisms inhabiting the human gut. the intestinal microbiota confer protection against pathogens, contribute to the maturation of the immune system, and regulate host metabolism. the composition of gut microbiota in early life is influenced by mode of birth, diet, and antibiotics. decreased biodiversity and alterations in the composition of the intestinal microbiota have been ob ... | 2013 | 23981941 |
| moving fecal microbiota transplantation into the mainstream. | in recent years, fecal microbiota transplantation (aka fecal transplantation, fecal bacteriotherapy, fmt) has become increasing utilized to treat recurrent and refractory clostridium difficile infection (cdi). almost 600,000 cases of cdi occur each year in the united states. of these, an estimated 15,000 patients have a recurrence. the management of recurrent disease has been challenging for patients and clinicians. increasingly, fmt has been recognized as an effective option for these patients. ... | 2013 | 23979974 |
| a statewide colectomy experience: the role of full bowel preparation in preventing surgical site infection. | to assess the utility of full bowel preparation with oral nonabsorbable antibiotics in preventing infectious complications after elective colectomy. | 2014 | 23979289 |
| clinical manifestations of clostridium difficile infection in a medical center in taiwan. | to investigate the clinical characteristics of clostridium difficile infection (cdi) at a medical center in taiwan. | 2014 | 23978490 |
| clostridium difficile antibodies: a patent evaluation (wo2013028810). | incidence and severity of clostridium difficile infection (cdi) are increasing worldwide. toxins a (tcda) and b (tcdb) and host immune response are the major determinates of cd pathogenesis and represent a new, stimulating therapeutic target to control cdi. | 2013 | 23978053 |
| fidaxomicin: a minimally absorbed macrocyclic antibiotic for the treatment of clostridium difficile infections. | fidaxomicin was approved for the treatment of clostridium difficile infections in 2011. it has a novel mechanism of action and narrow spectrum of activity that makes it unique among the currently used therapies for this disease. phase iii clinical studies demonstrated a benefit of fidaxomicin over vancomycin for the outcomes of recurrence and global cure or sustained clinical response. this observation was confirmed within specific populations, including those of older age, immunocompromised due ... | 2013 | 23977933 |
| clostridium difficile infection caused by binary toxin-positive strains. | | 2013 | 23977836 |
| current status of surgical treatment for fulminant clostridium difficile colitis. | mortality rates attributable to fulminant clostridium difficile (c. difficile) colitis remain high and are reported to be 38%-80%. historically, the threshold for surgical intervention has been judged empirically because level i evidence to guide decision making is lacking. studies of the surgical management of c. difficile infection have been limited by small sample size and the lack of a standard definition of fulminancy. multiple small and medium-sized series have examined the surgical manage ... | 2013 | 23977418 |
| [drug therapy of infectious diarrhea: part 1: acute diarrhea]. | diarrhea is one of the most commonly occurring diseases. | 2013 | 23974914 |
| investigating the candidacy of a lipoteichoic acid-based glycoconjugate as a vaccine to combat clostridium difficile infection. | a lipoteichoic acid has recently been shown to be conserved in the majority of strains from clostridium difficile and as such is being considered as a possible vaccine antigen. in this study we examine the candidacy of the conserved lipoteichoic acid by demonstrating that it is possible to elicit antibodies against c. difficile strains following immunisation of rabbits and mice with glycoconjugates elaborating the conserved lipoteichoic acid antigen. the present study describes a conjugation str ... | 2013 | 23974722 |
| presence of clostridium difficile in pigs and cattle intestinal contents and carcass contamination at the slaughterhouse in belgium. | the objective of this study was to evaluate the presence of clostridium difficile in intestinal and carcass samples collected from pigs and cattle at a single slaughterhouse. c. difficile was isolated in 1% and 9.9% of the pig and cattle intestinal contents and in 7.9% and 7% of cattle and pig carcass samples respectively. a total of 19 different pcr-ribotypes were identified, among them types 078 and 014. seven of 19 ribotypes correlated with the pcr-ribotypes involved in human c. difficile inf ... | 2013 | 23973837 |
| [clostridium difficile infection: epidemiology, risk factors, pathogenesis, clinical features, diagnosis and therapy]. | clostridium difficile is a gram-positive, spore-forming anaerobic bacterium. c.difficile is the leading cause of antibiotic associated diarrhea and colitis. the clinical spectrum of c.difficile infection (cdi) is highly variable, ranging from mild diarrhea to severe forms of intestinal illness including toxic megacolon, ileus, bowel perforation, and pseudomembranous colitis. advanced age, long duration of hospitalization, and exposure to certain antimicrobial agents are the most common risk fact ... | 2013 | 23971935 |
| fecal transplant for recurrent clostridium difficile infection. | clostridium difficile infection (cdi) results in clinical manifestations ranging from mild diarrhea to life-threatening pseudomembranous colitis. infection is most often initiated by antimicrobial therapy which causes an imbalance in normal colonic microflora. the pathogenesis of c. difficile is predominantly controlled by the production of its two cytotoxins, a and b, which damage the intestinal mucosa. in recent years a nationwide increase in the rate of cdi has been noted as well as an increa ... | 2013 | 23967542 |
| one-day point prevalence of emerging bacterial pathogens in a nationwide sample of 62 german hospitals in 2012 and comparison with the results of the one-day point prevalence of 2010. | antibiotic resistance of bacterial pathogens is an emerging problem worldwide. to combat multidrug resistant organisms (mrdos) networks of care providers have been established in all states in germany. the hicare-network, a project to combat mrdos, founded by the federal ministry of education and research, has published data from 2010 of a voluntary, german-wide, multicenter point-prevalence survey in 2011 conducted in collaboration with the german society of hospital hygiene. the aim of the pre ... | 2013 | 23967398 |