| correlation between clostridium difficile bacterial load, commercial real-time pcr cycle thresholds, and results of diagnostic tests based on enzyme immunoassay and cell culture cytotoxicity assay. | the impact of clostridium difficile fecal loads on diagnostic test results is poorly understood, but it may have clinical importance. in this study, we investigated the relationship between c. difficile fecal load and the results of four assays: a glutamate dehydrogenase (gdh) enzyme immunoassay (eia), a toxin a/b antigen eia (toxab), a cell culture cytotoxicity assay (cca), and pcr targeting the tcdb gene. we also compared the pcr cycle threshold (ct) with the results of quantitative culture us ... | 2013 | 23966497 |
| fecal microbiota transplantation and emerging treatments for clostridium difficile infection. | due to the increased incidence and recurrence of clostridium difficile infection, health care providers are seeking new and alternative treatments to the standard antibiotic therapy. the objective of this article is to present a review on the background, microbiologic efficacy, clinical efficacy, and safety of fecal microbiota transplantation and to provide an overview of emerging treatment options currently under investigation. emerging treatment options discussed include the use of monoclonal ... | 2013 | 23966282 |
| acute gastroenteritis. | acute gastroenteritis is a common infectious disease syndrome, causing a combination of nausea, vomiting, diarrhea, and abdominal pain. there are more than 350 million cases of acute gastroenteritis in the united states annually and 48 million of these cases are caused by foodborne bacteria. traveler's diarrhea affects more than half of people traveling from developed countries to developing countries. in adult and pediatric patients, the prevalence of clostridium difficile is increasing. contac ... | 2013 | 23958366 |
| asymptomatic carriage of toxigenic clostridium difficile by hospitalized patients. | asymptomatic carriage of clostridium difficile is common in hospitals, but the risk for transmission by carriers is unclear. in this point prevalence culture survey of asymptomatic hospitalized patients, 18 of 149 (12%) were carriers of toxigenic c. difficile. by comparison with c. difficile infection (cdi) patients, the prevalence of skin and/or environmental contamination was significantly lower in asymptomatic carriers (3/18, 17% versus 5/6, 83%; p = 0.007), but carriers outnumbered cdi patie ... | 2013 | 23954113 |
| clostridium difficile infection after lung transplantation: are we really doing everything possible? | | 2013 | 23953917 |
| is clostridium difficile infection influenced by antimicrobial use density in wards? | this study was performed to elucidate the relationship between antimicrobial use density (aud) and clostridium difficile infection (cdi) manifesting as antimicrobial-associated diarrhea (aad) in hospital wards during a 4-year period. case definition of cdi was an adult exhibiting aad with a daily stool frequency of three or more, arising at least 48 hours after ward admission, and fecal samples testing positive for toxin (a and/or b). metronidazole or vancomycin was orally administered as treatm ... | 2013 | 23951727 |
| clostridium difficile--special collection. | | 2013 | 23950217 |
| clostridium difficile exposure as an insidious source of infection in healthcare settings: an epidemiological model. | clostridium difficile is the leading cause of infectious diarrhea in hospitalized patients. its epidemiology has shifted in recent years from almost exclusively infecting elderly patients in whom the gut microbiota has been disturbed by antimicrobials, to now also infecting individuals of all age groups with no recent antimicrobial use. | 2013 | 23947736 |
| severe hemorrhagic colitis in a patient with chronic myeloid leukemia in the blastic phase after dasatinib use. | dasatinib is a second-line tyrosine kinase inhibitor used in patients with imatinib resistant or intolerant chronic myeloid leukemia (cml) and philadelphia chromosome-positive acute leukemia. gastrointestinal bleeding may occur in up to 7% of patients using dasatinib, although, severe dasatinib-related acute colitis had rarely been reported. here, we present the case of a 36-year-old female who progressed to acute myeloid leukemia after fourteen months of receiving imatinib for cml in the chroni ... | 2013 | 23946889 |
| antimicrobial stewardship and clostridium difficile-associated diarrhea. | antimicrobial stewardship programs are essential to health care institutions to promote the appropriate use of antibiotics not only to decrease antimicrobial resistance but to prevent the spread and infection of clostridium difficile. clostridium difficile-associated diarrhea is increasing rapidly in the united states and is now considered a major public health problem that poses an immediate threat to the health of patients prescribed antibiotics, more so than antimicrobial resistance. clostrid ... | 2013 | 23946208 |
| [severe eosinophilia in a patient with clostridium colitis and gastric cancer]. | a case of a 77-year-old male repeatedly hospitalized with the diagnosis of clostridium difficile colitis associated with eosinophilia is presented. the percentage and number of eosinophils achieved maximal values (54 %, 5.4 times 1.000.000.000/l) during repeated treatment with metronidazole. eosinophilia was accompanied by significant elevation of serum ige and presence of charcot-leyden crystals in stool. helminth infections and hemoblastosis were ruled out as the cause and a working diagnosis ... | 2013 | 23945831 |
| evaluation of a new immunochromatography test for rapid and simultaneous detection of clostridium difficile antigen and toxins. | clostridium difficile infection is considered the most common cause of nosocomial infectious diarrhea among adults in the developed world. it is responsible for virtually all cases of pseudomembranous colitis. the tox a/b enzyme immunoassay (eia) is the most widely used test for the detection of c. difficile toxins a and b. however, it is associated with poor sensitivity and an unacceptable high rate of false-negative results. | 2013 | 23943984 |
| recurrent clostridium difficile infection. | | 2013 | 23943969 |
| antimicrobial selection and its impact on the incidence of clostridium difficile-associated diarrhea. | the study objective was to determine which antimicrobials place patients at a higher risk for clostridium difficile-associated diarrhea (cdad) and which interventions can reduce their risk. all patients with diarrhea and a positive toxin assay for clostridium difficile for 3 months were included in the study. patients were broken down into either community-acquired infection or health care-associated infection based on symptom onset, antibiotic usage prior to admission, and where the patient was ... | 2013 | 23940122 |
| the role of vancomycin and metronidazole for the treatment of clostridium difficile-associated diarrhea. | for the treatment of clostridium difficile-associated diarrhea (cdad), metronidazole and vancomycin remain the most commonly used agents. the major advantage of metronidazole is its low cost, while the advantage of oral vancomycin is a more favorable pharmacokinetic profile. the epidemiology and clinical severity of cdad have changed due to the emergence of a hypervirulent strain (bi/nap1/027). in 2010, the infectious diseases society of america/society for health care epidemiology of america ex ... | 2013 | 23940121 |
| nontoxigenic clostridium difficile protects hamsters against challenge with historic and epidemic strains of toxigenic bi/nap1/027 c. difficile. | nontoxigenic clostridium difficile (ntcd) has been shown to prevent fatal c. difficile infection in the hamster model when hamsters are challenged with standard toxigenic c. difficile strains. the purpose of this study was to determine if ntcd can prevent c. difficile infection in the hamster model when hamsters are challenged with restriction endonuclease analysis group bi c. difficile strains. groups of 10 hamsters were given oral clindamycin, followed on day 2 by 10(6) cfu of spores of ntcd s ... | 2013 | 23939887 |
| depression and use of antidepressants is associated with increased risk of clostridium difficile infection. | | 2013 | 23939678 |
| risk factors of fecal toxigenic or non-toxigenic clostridium difficile colonization: impact of toll-like receptor polymorphisms and prior antibiotic exposure. | this study is to investigate the significance and risk factors of fecal toxigenic (tcdc) or non-toxigenic clostridium difficile colonization (ntcdc) among hospitalized patients. | 2013 | 23936050 |
| clostridium difficile 027/bi/nap1 encodes a hypertoxic and antigenically variable form of tcdb. | the clostridium difficile exotoxin, tcdb, which is a major virulence factor, varies between strains of this pathogen. herein, we show that tcdb from the epidemic bi/nap1/027 strain of c. difficile is more lethal, causes more extensive brain hemorrhage, and is antigenically variable from tcdb produced by previously studied strains of this pathogen (tcdb003). in mouse intoxication assays, tcdb from a ribotype 027 strain (tcdb027) was at least four fold more lethal than tcdb003. tcdb027 caused a pr ... | 2013 | 23935501 |
| importance of toxin a, toxin b, and cdt in virulence of an epidemic clostridium difficile strain. | clostridium difficile infection is the main cause of healthcare-acquired diarrhea in the developed world. in addition to the main virulence factors toxin a and b, epidemic, pcr ribotype 027 strains, such as r20291, produce a third toxin, cdt. to develop effective medical countermeasures, it is important to understand the importance of each toxin. accordingly, we created all possible combinations of isogenic toxin mutants of r20291 and assessed their virulence. we demonstrated that either toxin a ... | 2014 | 23935202 |
| inappropriate use of antibiotics and clostridium difficile infection. | we assessed appropriateness of preceding and concurrent antibiotics in 126 consecutive patients with hospital-associated clostridium difficile infection. in 93 (73.8%) episodes, at least 1 preceding course of antibiotics was inappropriate. we provided feedback on concurrent antibiotics on the day of diagnosis during the final 8 months: 17 of 74 (23.0%) patients were on inappropriate antibiotics. our recommendations were well received. reviewing c difficile-infected patients allowed for identific ... | 2013 | 23932828 |
| lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and clostridium difficile diarrhoea in older inpatients (placide): a randomised, double-blind, placebo-controlled, multicentre trial. | antibiotic-associated diarrhoea (aad) occurs most frequently in older (≥65 years) inpatients exposed to broad-spectrum antibiotics. when caused by clostridium difficile, aad can result in life-threatening illness. although underlying disease mechanisms are not well understood, microbial preparations have been assessed in the prevention of aad. however, studies have been mostly small single-centre trials with varying quality, providing insufficient data to reliably assess effectiveness. we aimed ... | 2013 | 23932219 |
| advanced techniques for detection and identification of microbial agents of gastroenteritis. | gastroenteritis persists as a worldwide problem, responsible for approximately 2 million deaths annually. traditional diagnostic methods used in the clinical microbiology laboratory include a myriad of tests, such as culture, microscopy, and immunodiagnostics, which can be labor intensive and suffer from long turnaround times and, in some cases, poor sensitivity. [corrected]. this article reviews recent advances in genomic and proteomic technologies that have been applied to the detection and id ... | 2013 | 23931837 |
| impact of adding prophylactic probiotics to a bundle of standard preventative measures for clostridium difficile infections: enhanced and sustained decrease in the incidence and severity of infection at a community hospital. | in 2003, hospitals in quebec, canada experienced an increase of nap1/027 clostridium difficile infections following antibiotic administration (cdiaa). at pierre-le gardeur hospital (plgh), the incidence increased from 10 to over 25 cases per 1000 patient admissions. | 2013 | 23931498 |
| treatment of an initial infection with clostridium difficile in patients with inflammatory bowel disease. | : although the incidence of clostridium difficile-associated diarrhea in the general population has increased dramatically over the past decade, an even greater rate of infection exists in patients with inflammatory bowel disease. susceptibility in this population is likely inherent to the pathophysiology and treatment of these diseases. c. difficile infection can cause serious complications and death. consequently, early diagnosis and initiation of effective antibacterial therapy is imperative. ... | 2013 | 23929262 |
| healthcare-associated infections studies project: an american journal of infection control and national healthcare safety network data quality collaboration-labid clostridium difficile event 2013. | this is the first in a series of case studies that will be published in american journal of infection control following the centers for disease control and prevention/national healthcare safety network (nhsn) surveillance definition update of 2013. these cases reflect some of the complex patient scenarios infection professionals encounter during daily surveillance of health care-associated infections using nhsn definitions. answers to the questions posed and immediate feedback in the form of ans ... | 2013 | 23928030 |
| perils and pitfalls of long-term effects of proton pump inhibitors. | this review summarizes the literature regarding long-term adverse effects of proton pump inhibitors (ppis). a pubmed search (1966 to february 2013) for english language studies was conducted using key terms ppi: omeprazole, esomeprazole, pantoprazole, lansoprazole, dexlansoprazole, rabeprazole, pneumonia, clostridium difficile, osteoporosis, risk of fractures, thrombocytopenia, rhabdomyolysis, anemia, iron deficiency, hypomagnesemia, vitamin b₁₂ and nephritis. the risk of pneumonia was increased ... | 2013 | 23927671 |
| clostridium difficile pcr ribotype 046 is common among neonatal pigs and humans in sweden. | clostridium difficile pcr ribotype 046 was found in 67% of neonatal piglets (45/67) sampled from three separate pig-breeding farms in sweden. sows from the same farms were tested and 50% were colonized in faeces and 30% were colonized on skin. an environmental source was suggested because identical pcr ribotypes were isolated from faeces as well as externally. human c. difficile infection outbreaks in southern sweden by the identical pcr ribotype 046 indicate its zoonotic potential. | 2014 | 23927574 |
| comparison of perirectal versus rectal swabs for detection of asymptomatic carriers of toxigenic clostridium difficile. | for long-term care and spinal cord injury patients, the sensitivity, specificity, and positive and negative predictive values of perirectal versus rectal cultures for detection of asymptomatic carriers of clostridium difficile were 95%, 100%, 100%, and 97%, respectively. perirectal cultures provide an accurate method to detect asymptomatic carriers of c. difficile. | 2013 | 23926162 |
| fecal transplantation for the treatment of recurrent clostridium difficile infection. | clostridium difficile infection (cdi) is currently a leading cause of antibiotic and health care-related diarrhea. the incidence and the severity of cdi-related diarrhea have increased dramatically in the usa and europe in the past few decades. the emergence of multidrug-resistant hypervirulent strains of c. difficile has led to an increase in mortality. fecal microbiota transplantation (fmt) (also known as fecal bacteriotherapy) has been utilized sporadically since the 1950s; and currently, the ... | 2013 | 23923106 |
| clostridium difficile modulates host innate immunity via toxin-independent and dependent mechanism(s). | clostridium difficile infection (cdi) is the leading cause of hospital and community-acquired antibiotic-associated diarrhoea and currently represents a significant health burden. although the role and contribution of c. difficile toxins to disease pathogenesis is being increasingly understood, at present other facets of c. difficile-host interactions, in particular, bacterial-driven effects on host immunity remain less studied. using an ex-vivo model of infection, we report that the human gastr ... | 2013 | 23922820 |
| stool therapy may become a preferred treatment of recurrent clostridium difficile? | fecal enemas were first reported to successfully treat life threatening enterocolitis in 1958, but fecal therapy to treat clostridium difficile (c. difficile) infection has remained esoteric and not well investigated until recently. in the past few years, systematic reviews of case series and case reports of fecal microbiota transplant for recurrent c. difficile infection have become available and validate use of fecal transplant for c. difficile enterocolitis. methods of fecal transplant report ... | 2013 | 23922461 |
| antidepressant drugs and infectious disease. | clostridium difficile (c.difficile) infection (cdi) is a common and clinically significant cause of diarrhea associated with the use of antibiotic drugs. two observational studies have suggested that antidepressant drug use is associated with an increased risk of developing cdi. because of the potential public health significance of this finding, this article critically evaluates the methodology of these studies and provides evidence to question the plausibility and validity of this finding. the ... | 2013 | 23919230 |
| detection of mixed populations of clostridium difficile from symptomatic patients using capillary-based polymerase chain reaction ribotyping. | to investigate the simultaneous occurrence of more than 1 clostridium difficile ribotype in patients' stool samples at the time of diagnostic testing. | 2013 | 23917911 |
| evaluation of a commercial real-time polymerase chain reaction assay for detection of environmental contamination with clostridium difficile. | contaminated environmental surfaces are an important source for transmission of clostridium difficile. however, there are no efficient and easy methods to assess contamination. the performance of a commercial real-time polymerase chain reaction (pcr) assay was evaluated for detection of environmental toxigenic c. difficile in comparison with anaerobic culture followed by toxin testing of isolates. for 66 sites sampled, pcr had a sensitivity of 17.39%, specificity 100%, positive predictive value ... | 2013 | 23916890 |
| clostridium difficile infection after adult autologous stem cell transplantation: a multicenter study of epidemiology and risk factors. | we sought to describe the epidemiology of clostridium difficile infection (cdi) among adult recipients of autologous hematopoietic stem cell transplantation (auto-hsct) within the first year after hsct in centers with variable epidemiology of hypertoxigenic strains. a multicenter, retrospective nested case-control study was conducted among 873 auto-hsct recipients at johns hopkins hospital (jhh) and hôpital maisonneuve-rosemont (hmr) between january 2003 and december 2008. despite center differe ... | 2013 | 23916741 |
| is the prevalence of clostridium difficile in animals underestimated? | reported prevalence rates of clostridium difficile infection in animals differ considerably depending on the nature of the study and the population surveyed. the methods used to recover this organism from faecal samples may account for some of the prevalence variation. the objective of this study was to assess the performance of two different methods of detecting c. difficile in animal faeces in comparison with a conventional isolation procedure ('ethanol shock' of faecal samples followed by cul ... | 2013 | 23911042 |
| fecal microbiota transplant for recurrent clostridium difficile infection: mayo clinic in arizona experience. | to report the initial experience of treating recurrent clostridium difficile infection (cdi) with fecal microbiota transplant (fmt) at mayo clinic in arizona. | 2013 | 23910407 |
| influence of cohorting patients with clostridium difficile infection on risk of symptomatic recurrence. | cohorting of patients with clostridium difficile infection (cdi) is recommended when single side-rooms are unavailable. although patients may remain infectious after cessation of diarrhoea, continued cohorting may place them at increased risk of reinfection. | 2013 | 23910403 |
| temporal phenome analysis of a large electronic health record cohort enables identification of hospital-acquired complications. | to develop methods for visual analysis of temporal phenotype data available through electronic health records (ehr). | 2013 | 23907284 |
| [laboratory diagnosis of clostridium difficile infection]. | for the diagnosis of clostridium difficile infection (cdi), it is necessary to obtain microbiological evidence of toxigenic c. difficile with a compatible clinical picture (diarrhoea or ileus). two gold standards exist: cell culture cytotoxicity neutralization assay (specific, but less sensitive than previously acknowledged) and toxigenic culture (very sensitive but less specific because it also detects asymptomatic colonization). these gold standards are not used routinely because at least 2 or ... | 2013 | 23906566 |
| molecular epidemiology of clostridium difficile infection in a major chinese hospital: an underrecognized problem in asia? | clostridium difficile infection is almost unrecognized in mainland china. we have undertaken a study in a large chinese teaching hospital in changsha, hunan, china, to identify cases of c. difficile, record patient characteristics, and define the molecular epidemiology with respect to ribotype distribution and cross-infection. between april 2009 and february 2010, we examined fecal samples from 70 hospitalized patients with diarrhea who were receiving or had received antibiotics within the previ ... | 2013 | 23903542 |
| [largest eu prevalence studies of clostridium difficile infection reveals that perhaps more than one-fifth of the patient are wrongly diagnosed]. | | 2013 | 23901614 |
| establishment of the intestinal microbiota and its role for atopic dermatitis in early childhood. | perturbations in the intestinal microbiota may disrupt mechanisms involved in the development of immunologic tolerance. the present study aimed to examine the establishment of the infant microbiota and its association to the development of atopic dermatitis (ad). | 2013 | 23900058 |
| effect of nucleic acid amplification testing on population-based incidence rates of clostridium difficile infection. | nucleic acid amplification testing (naat) is increasingly being adopted for diagnosis of clostridium difficile infection (cdi). data from 3 states conducting population-based cdi surveillance showed increases ranging from 43% to 67% in cdi incidence attributable to changing from toxin enzyme immunoassays to naat. cdi surveillance requires adjustment for testing methods. | 2013 | 23899677 |
| alteration of intestinal dysbiosis by fecal microbiota transplantation does not induce remission in patients with chronic active ulcerative colitis. | in patients with ulcerative colitis (uc), alterations of the intestinal microbiota, termed dysbiosis, have been postulated to contribute to intestinal inflammation. fecal microbiota transplantation (fmt) has been used as effective therapy for recurrent clostridium difficile colitis also caused by dysbiosis. the aims of the present study were to investigate if patients with uc benefit from fmt and if dysbiosis can be reversed. | 2013 | 23899544 |
| in vivo physiological and transcriptional profiling reveals host responses to clostridium difficile toxin a and toxin b. | toxin a (tcda) and toxin b (tcdb) of clostridium difficile cause gross pathological changes (e.g., inflammation, secretion, and diarrhea) in the infected host, yet the molecular and cellular pathways leading to observed host responses are poorly understood. to address this gap, we evaluated the effects of single doses of tcda and/or tcdb injected into the ceca of mice, and several endpoints were analyzed, including tissue pathology, neutrophil infiltration, epithelial-layer gene expression, chem ... | 2013 | 23897615 |
| clostridium difficile colitis: is severity increased with previous appendectomy? | | 2013 | 23896227 |
| outpatient healthcare settings and transmission of clostridium difficile. | recent reports suggest that community-associated clostridium difficile infection (cdi) (i.e., no healthcare facility admission within 90 days) may be increasing in frequency. we hypothesized that outpatient clinics could be an important source for acquisition of community-associated cdi. | 2013 | 23894609 |
| biofilm formation by clostridium difficile. | clostridium difficile infection (cdi) is a major healthcare-associated disease worldwide. recurring infections and increasing antibiotic resistance have complicated treatment of cdi. while c. difficile spores are important for transmission and persistence of cdi, other factors such as gut colonization and formation of bacterial communities in the gut may also contribute to pathogenesis and persistence, but have not been well investigated. recently, we reported that important clinical c. difficil ... | 2015 | 23892245 |
| clostridium difficile infection increases mortality risk in lung transplant recipients. | clostridium difficile infection (cdi) and associated mortality in solid organ transplant recipients is rising, but data are scarce in lung transplant recipients. we aimed to characterize cdi and its effect on mortality in a large cohort of lung transplant recipients. | 2013 | 23891145 |
| risk factors associated with clostridium difficile infection after kidney and pancreas transplantation. | clostridium difficile infection (cdi) is a common cause of nosocomial antibiotic-associated diarrhea with an increased incidence reported in solid organ transplant recipients. we sought to determine if kidney and/or pancreas transplant recipients possess unique risk factors for cdi. | 2013 | 23890202 |
| the effects of statins on the clinical outcomes of clostridium difficile infection in hospitalised patients. | an association between exposure to statin drugs and favourable treatment outcomes for various types of infections has been established. | 2013 | 23888883 |
| the anticancer drug tirapazamine has antimicrobial activity against escherichia coli, staphylococcus aureus and clostridium difficile. | rapidly increasing bacterial resistance to existing therapies creates an urgent need for the development of new antibacterials. tirapazamine (tpz, 3-amino-1,2,4-benzotriazine 1,4 dioxide) is a prodrug undergoing clinical trials for various types of cancers. in this study, we showed that tpz has antibacterial activity, particularly at low oxygen levels. with escherichia coli, tpz was bactericidal under both aerobic and anaerobic conditions. escherichia coli mutants deficient in homologous recombi ... | 2013 | 23888874 |
| reducing clostridium difficile incidence, colectomies, and mortality in the hospital setting: a successful multidisciplinary approach. | health care associated clostridium difficile infections are a major cause of morbidity and mortality in hospitals. in the united states, from 2000 through 2009, discharge diagnoses from hospitals in the united states that included c. difficile increased from 139,000 to 336,600, and the yearly national excess hospital cost associated with hospital-onset c. difficile is estimated to be upwards of $1.3 billion. | 2013 | 23888639 |
| molecular test to determine toxigenic capabilities in gdh-positive, toxin-negative samples: evaluation of the portrait toxigenic c. difficile assay. | new recommendations for testing and reporting of clostridium difficile were introduced in the nhs in 2012. these guidelines have improved identification of potential c. difficile infection (cdi) cases, but questions remain around the management of glutamate dehydrogenase (gdh)-positive, toxin-negative patients. this study aims to assess the introduction of the portrait c. difficile assay as the third step to identify the presence of the toxigenic c. difficile b (tcdb) gene and thus determine tox ... | 2013 | 23888607 |
| presumably hospital-transmitted clostridium difficile infections based on epidemiological linkage. | given the traditionally low cdad (clostridium difficile associated diarrhoea) prevalence in switzerland, cdad patients are not routinely contact-isolated in our institution. in light of the globally changing c. difficile epidemiology, we sought to determine our institutional cdad rate and to detect possible hospital transmission by means of epidemiological linkage. | 2013 | 23888435 |
| in vitro selection, via serial passage, of clostridium difficile mutants with reduced susceptibility to fidaxomicin or vancomycin. | current treatments for clostridium difficile infection include vancomycin, metronidazole and fidaxomicin. lff571 is an experimental agent undergoing evaluation in humans for the treatment of moderate c. difficile infection. reduced susceptibility of c. difficile to fidaxomicin or lff571 in vitro can be mediated by single point mutations in genes encoding the targets, whereas the mechanism(s) mediating reduced susceptibility to vancomycin in vitro remains elusive. to further characterize mechanis ... | 2014 | 23887866 |
| diarrhoea in the icu: respective contribution of feeding and antibiotics. | diarrhoea is frequently reported in the icu. little is known about diarrhoea incidence and the role of the different risk factors alone or in combination. this prospective observational study aims at determining diarrhoea incidence and risk factors in the first 2 weeks of icu stay, focusing on the respective contribution of feeding, antibiotics, and antifungal drugs. | 2013 | 23883438 |
| the identification and epidemiology of meticillin-resistant staphylococcus aureus and clostridium difficile in patient rooms and the ward environment. | research has indicated that the environment may play an important role in the transmission of meticillin-resistant staphylococcus aureus (mrsa) and clostridium difficile in healthcare facilities. despite the significance of this finding, few data exist from longitudinal studies investigating mrsa and c. difficile contamination, concurrently, in both patient rooms and the general ward environment. the objectives of this study were to determine the prevalence of mrsa and c. difficile contamination ... | 2013 | 23883171 |
| editorial commentary: looking to the future: vertical vs horizontal prevention of clostridium difficile infections. | | 2013 | 23881152 |
| use of multilocus variable number of tandem repeats analysis genotyping to determine the role of asymptomatic carriers in clostridium difficile transmission. | previous studies have suggested that asymptomatic carriers of toxigenic clostridium difficile are a source of hospital-associated (ha) infections. multilocus variable number of tandem repeats analysis (mlva) is a highly discriminatory molecular subtyping tool that helps to determine possible transmission sources. | 2013 | 23881150 |
| a surview of recent patents on anti-infective therapy for clostridium difficile. | clostridium difficile has become the most common infectious cause of healthcare-associated diarrhea, with serious morbidity, prolonged hospitalization and even death. treatment of the disease utilizing today's therapies does not guarantee a successful outcome. in the past decade, many new ideas and inventions have surfaced exploring different treatment strategies of clostridium difficile associated diarrhea (cdad). these treatments include antitoxins, novel antimicrobials, immunoglobulins and la ... | 2013 | 23879822 |
| [infections caused by clostridium difficile. addendum]. | | 2013 | 23876975 |
| comparison of treatment outcomes with vancomycin alone versus combination therapy in severe clostridium difficile infection. | the recommended treatment for severe clostridium difficile infection (cdi) is oral vancomycin alone. combination therapy with metronidazole is only recommended in cases complicated by shock, ileus, or toxic megacolon. however, patients with severe infection are often treated with combination therapy despite a lack of data supporting this practice. | 2013 | 23876778 |
| [clostridium difficile infection: epidemiology, disease burden and therapy]. | c. difficile causes 25 percent of the antibiotic associated infectious nosocomial diarrhoeas. c. difficile infection is a high-priority problem of public health in each country. the available literature of c. difficile infection's epidemiology and disease burden is limited. | 2013 | 23876616 |
| high prevalence of the epidemic clostridium difficile pcr ribotype 078 in iberian free-range pigs. | previous studies in intensively raised piglets have detected a high prevalence of the epidemic clostridium difficile pcr ribotype 078. in this article we present a longitudinal survey of c. difficile colonisation in a population of iberian pigs reared under a free-range system. a total of 160 faecal samples from 20 piglets belonging to different litters were obtained by weekly sampling. c. difficile was recovered from samples collected at different times throughout the survey from a 90% of pigle ... | 2013 | 23876331 |
| infections and inflammatory bowel disease: challenges in asia. | the diagnosis and management of inflammatory bowel disease (ibd) in asia can be challenging as certain infections can mimic ibd and lead to a misdiagnosis. colitis can be caused by bacterial infections, ileitis can result from yersinia and salmonella infections and ileocolonic ulcers can be seen in intestinal tuberculosis and amebiasis. in addition, cytomegalovirus and clostridium difficile infection may mimic a flare of ibd and their presence is associated with an increased risk of colectomy an ... | 2013 | 23875824 |
| the complex dynamics of antimicrobial activity in the human gastrointestinal tract. | the human gastrointestinal tract is a complex environment of mutualistic associations. as bacteria form a major component of fecal content, the natural balance of the colon can be significantly altered by exposure to antimicrobial agents. however, the effects of antimicrobial therapy on fecal content are difficult to predict and can at times be quite surprising. the emergence and spread of vancomycin-resistant enterococci are cases in point. resistance to the glycopeptide vancomycin emerged in e ... | 2013 | 23874016 |
| identification and characterization of clostridium sordellii toxin gene regulator. | toxigenic clostridium sordellii causes uncommon but highly lethal infections in humans and animals. recently, an increased incidence of c. sordellii infections has been reported in women undergoing obstetric interventions. pathogenic strains of c. sordellii produce numerous virulence factors, including sordellilysin, phospholipase, neuraminidase, and two large clostridial glucosylating toxins, tcsl and tcsh. recent studies have demonstrated that tcsl toxin is an essential virulence factor for th ... | 2013 | 23873908 |
| fulminant clostridium difficile colitis: a complication of perioperative antibiotic prophylaxis. | antibiotic prophylaxis for maxillofacial surgical wounds remains common practice. surgeons must weigh the risks (e.g., clostridium difficile colitis) against the benefits before administering antibiotics for any reason and the relative risk and morbidity of c difficile colitis against those of a potential postoperative wound infection. in addition, the possibility of c difficile infection as a complication of perioperative antibiotic prophylaxis should be discussed with patients before surgery, ... | 2013 | 23871314 |
| reducing health care-associated infections: patients want to be engaged and learn about infection prevention. | multidrug-resistant organisms (mdros) are common in health care-associated infection (hai). the aim of this study was to examine patient's willingness to learn about mdros and hais and their preferred ways of education about mdro hais. | 2013 | 23870794 |
| disruption of intrinsic motions as a mechanism for enzyme inhibition. | clostridium difficile (c. diff) is one of the most common and most severe hospital-acquired infections; its consequences range from lengthened hospital stay to outright lethality. c. diff causes cellular damage through the action of two large toxins tcda and tcdb. recently, there has been increased effort toward developing antitoxin therapies, rather than antibacterial treatments, in hopes of mitigating the acquisition of drug resistance. to date, no analysis of the recognition mechanism of tcda ... | 2013 | 23870270 |
| fecal transplantation for recurrent clostridium difficile infection in older adults: a review. | recurrent clostridium difficile infection (cdi) is a common nosocomial infection that has a large effect on morbidity and quality of life in older adults in hospitals and long-term care facilities. because antibiotics are often unsuccessful in curing this disease, fecal transplantation has emerged as a second-line therapy for treatment of recurrent cdi. a comprehensive literature search of pubmed, embase, and web of science regarding fecal transplantation for cdi was performed to further evaluat ... | 2013 | 23869970 |
| indeterminate tcdb using a clostridium difficile pcr assay: a retrospective cohort study. | c. difficile (cd) real-time polymerase chain reaction (pcr) for toxin b gene (tcdb) is more sensitive, and reduces turnaround time when compared to toxin immunoassay. we noted typical amplification curves with high tcdb cycle thresholds (ct) and low endpoints (ept) that are labeled negative by the xpert(®) c. difficile assay (cepheid) and undertook this study to determine their significance. | 2013 | 23865713 |
| clostridium difficile infection: a multicenter study of epidemiology and outcomes in mechanically ventilated patients. | clostridium difficile is a leading cause of hospital-associated infection in the united states. the purpose of this study is to assess the prevalence of c. difficile infection among mechanically ventilated patients within the icus of three academic hospitals and secondarily describe the influence of c. difficile infection on the outcomes of these patients. | 2013 | 23863229 |
| horizontal gene transfer in human pathogens. | horizontal gene transfer has a tremendous impact on the genome plasticity, adaptation and evolution of bacteria. horizontally transferred mobile genetic elements are involved in the dissemination of antibiotic resistance and virulence genes, thus contributing to the emergence of novel "superbugs". this review provides update on various mechanisms of horizontal gene transfer and examines how horizontal gene transfer contributes to the evolution of pathogenic bacteria. special focus is paid to the ... | 2015 | 23862575 |
| antimicrobial susceptibility of animal and human isolates of clostridium difficile by broth microdilution. | a total of 188 human (n = 92) and animal (n = 96) isolates of clostridium difficile of different pcr ribotypes were screened for susceptibility to 30 antimicrobials using broth microdilution. when comparing the prevalence of antimicrobial resistance, the isolates of animal origin were significantly more often resistant to oxacillin, gentamicin and trimethoprim/sulfamethoxazole (p<0.01). the most significant difference between the animal and human populations (p = 0.0006) was found in the level o ... | 2013 | 23861298 |
| antimicrobial stewardship in pediatrics: how every pediatrician can be a steward. | antimicrobial stewardship (as) programs are effective in improving clinical outcomes associated with antimicrobial therapies while improving patient safety by reducing adverse events and development of bacterial resistance. understanding the basic principles of as is essential to the successful development and implementation of as strategies. identifying and developing strategies to address barriers and challenges to as can facilitate the establishment of financial, administrative, and organizat ... | 2013 | 23857121 |
| major infection events over 5 years: how is media coverage influencing online information needs of health care professionals and the public? | the last decade witnessed turbulent events in public health. emerging infections, increase of antimicrobial resistance, deliberately released threats and ongoing battles with common illnesses were amplified by the spread of disease through increased international travel. the internet has dramatically changed the availability of information about outbreaks; however, little research has been done in comparing the online behavior of public and professionals around the same events and the effect of ... | 2013 | 23856364 |
| fecal microbiota transplantation: indications, methods, evidence, and future directions. | fecal microbiota transplantation (fmt) has attracted great interest in recent years, largely due to the global clostridium difficile infection (cdi) epidemic and major advances in metagenomic sequencing of the gastrointestinal (gi) microbiota, with growing understanding of its structure and function. fmt is now recommended as the most effective therapy for relapsing cdi and, with further refinement, may even be used in "first-time" cdi. there is interest also in other conditions related to gi dy ... | 2013 | 23852569 |
| potent monoclonal antibodies against clostridium difficile toxin a elicited by dna immunization. | recent studies have demonstrated that dna immunization is effective in eliciting antigen-specific antibody responses against a wide range of infectious disease targets. the polyclonal antibodies elicited by dna vaccination exhibit high sensitivity to conformational epitopes and high avidity. however, there have been limited reports in literature on the production of monoclonal antibodies (mab) by dna immunization. here, by using clostridium difficile (c. diff) toxin a as a model antigen, we demo ... | 2013 | 23851482 |
| prevalence of gastrointestinal clostridium difficile carriage in australian sheep and lambs. | recently, clostridium difficile has been isolated from a wide variety of animals, particularly production animals, mainly cattle and pigs. concurrently, the incidence of c. difficile infection (cdi) in humans has increased in the community, with some suggestions that food-borne transmission of c. difficile is occurring. interestingly, sheep and lambs appear not to have been investigated for carriage/colonization with c. difficile. the aim of this project was to determine the prevalence of carria ... | 2013 | 23851101 |
| efficacy and safety of paromomycin for treating amebiasis in japan. | the clinical management of amebiasis is a growing concern, particularly among human immunodeficiency virus (hiv)-infected individuals who are predisposed to severe illness. treatment with a luminal amebicide is strongly recommended following acute-stage treatment with a nitroimidazole. in 2004, the japanese research group on chemotherapy of tropical diseases introduced paromomycin, which was not nationally licensed, and offered it to a number of patients. from 2004 to 2011, 143 case records of a ... | 2013 | 23850836 |
| epidemiology of adverse events and clostridium difficile-associated diarrhea during long-term antibiotic therapy for osteoarticular infections. | osteoarticular infections require several weeks of antibiotic therapy, but little is known about the epidemiology of adverse events (ae) including symptomatic clostridium difficile-associated diarrhea during treatment in these patients. | 2013 | 23850617 |
| derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with clostridium difficile infection. | clostridium difficile infection poses a significant healthcare burden. however, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described. | 2013 | 23849267 |
| genetic risk factors for clostridium difficile infection in ulcerative colitis. | patients with inflammatory bowel disease (ibd) are at higher risk for clostridium difficile infection (cdi). disruption of gut microbiome and interaction with the intestinal immune system are essential mechanisms for pathogenesis of both cdi and ibd. whether genetic polymorphisms associated with susceptibility to ibd are also associated with risk of cdi is unknown. | 2013 | 23848254 |
| clostridium difficile associated disease in a neurointensive care unit. | critically ill patients are at high risk for acquiring clostridium difficile infection. the aim of this study was to investigate the prevalence, severity, and outcome of neurointensive care unit (nicu) acquired clostridium difficile associated disease (cdad). | 2013 | 23847584 |
| comparison of chromid c. difficile agar and cycloserine-cefoxitin-fructose agar for the recovery of clostridium difficile. | the rapidly changing epidemiology of clostridium difficile infection highlights the need for improved and continuing surveillance involving stool culturing to enable molecular tracking. culture of c. difficile can be difficult and time consuming. in this report chromid c. difficile agar (cdif) was compared to cycloserine-cefoxitin-fructose-egg-yolk agar which contained 0.1% sodium taurocholate (tccfa) as a germinant. | 2013 | 23846295 |
| the adoptive transfer of behavioral phenotype via the intestinal microbiota: experimental evidence and clinical implications. | there is growing interest in the ability of the intestinal microbiome to influence host function within and beyond the gastrointestinal tract. here we review evidence of microbiome-brain interactions in mice and focus on the ability to transfer behavioral traits between mouse strains using fecal microbiota transplantation (fmt). transplantation alters brain chemistry and behavior in recipient ex-germ free mice, raising the possibility of using fmt for disorders of the central nervous system, and ... | 2013 | 23845749 |
| [harnessing nature for treating infectious and autoimmune diseases: good and bad bacteria]. | clostridium difficile is the etiologic agent of nosocomial and community-acquired diarrhea associated with exposure to antibiotics that disrupt the normal colonic flora. as antibacterials currently used for primary c. difficile infections favor recurrences, new methods able to neutralize the bacterium without affecting the gut microbiota are badly needed. complementary treatment with probiotic agents to reconstitute the physiological intestinal flora does not yield any consistent benefit. in rec ... | 2013 | 23844515 |
| emerging therapies for clostridium difficile infection - focus on fidaxomicin. | the epidemiology of clostridium difficile infections (cdi) has evolved during the last decades, with an increase in the reported incidence, severity of cases, and rate of mortality and relapses. these increases have primarily affected some special populations including the elderly, patients requiring concomitant antibiotic therapy, patients with renal failure, and patients with cancer. until recently, the treatment of cdi was limited to either metronidazole or vancomycin. new therapeutic options ... | 2013 | 23843696 |
| clostridium difficile in a hiv-infected cohort: incidence, risk factors, and clinical outcomes. | clostridium difficile is the most commonly reported infectious diarrhoea in hiv-infected patients in the united states. we set out to determine the incidence, risk factors and clinical presentation of c. difficile infections (cdis) in a cohort of hiv-infected individuals. | 2013 | 23842125 |
| fecal microbiota transplantation for treating recurrent clostridium difficile infection. | | 2013 | 23841136 |
| excess risk of clostridium difficile infection in ovarian cancer is related to exposure to broad-spectrum antibiotics. | the purpose of the study was to determine if a diagnosis of ovarian cancer is independently associated with an increased risk of clostridium difficile infection (cdi). | 2013 | 23839499 |
| treatment of recurrent clostridium difficile infection: a systematic review. | clostridium difficile infection (cdi) recurs in nearly one-third of patients who develop an initial infection. recurrent cdi (rcdi) is associated with considerable morbidity, mortality, and cost. treatment for rcdi has not been not well examined. | 2014 | 23839210 |
| viral co-infections are common and are associated with higher bacterial burden in children with clostridium difficile infection. | clostridium difficile infections in children are increasing. in this cohort study, we enrolled 62 children with diarrhea and c difficile. we performed polymerase chain reaction assays to detect viral agents of gastroenteritis and quantify c difficile burden. fifteen (24%) children diagnosed as having c difficile infection had a concomitant viral co-infection. these patients tended to be younger and had a higher c difficile bacterial burden than children with no viral co-infections (median differ ... | 2013 | 23838821 |
| clostridium difficile infection in pediatric acute myeloid leukemia: from the canadian infections in acute myeloid leukemia research group. | the prevalence and severity of clostridium difficile infection (cdi) has increased over time in adult patients, but little is known about cdi in pediatric cancer. the primary objectives were to describe the incidence and characteristics of cdi in children with de novo acute myeloid leukemia (aml). the secondary objective was to describe factors associated with cdi. | 2013 | 23838731 |
| utility of an adenosine triphosphate bioluminescence assay to evaluate disinfection of clostridium difficile isolation rooms. | | 2013 | 23838235 |
| discontinuation of reflex testing of stool samples for vancomycin-resistant enterococci resulted in increased prevalence. | discontinuation of reflex testing of stool submitted for clostridium difficile testing for vancomycin-resistant enterococci (vre) led to an increase in the number of patients with healthcare-associated vre bacteremia and bacteriuria (0.21 vs 0.36 cases per 1,000 patient-days; p<.01). cost-benefit analysis showed reflex screening and isolation of vre reduced hospital costs. | 2013 | 23838226 |