| impact of intensive infection control team activities on the acquisition of methicillin-resistant staphylococcus aureus, drug-resistant pseudomonas aeruginosa and the incidence of clostridium difficile-associated disease. | the transmission of multidrug-resistant organisms (mdros) is an emerging problem in acute healthcare facilities. to reduce this transmission, we introduced intensive infection control team (ict) activities and investigated the impact of their introduction. this study was conducted at a single teaching hospital from 1 april 2010 to 31 march 2012. during the intervention period, all carbapenem use was monitored by the ict, and doctors using carbapenems inappropriately were individually instructed. ... | 2013 | 23715827 |
| resolution of clostridium difficile-associated diarrhea in patients with cancer treated with fidaxomicin or vancomycin. | patients with cancer are at increased risk for clostridium difficile-associated diarrhea (cdad). little is known about treatment response. | 2013 | 23715579 |
| simultaneous detection of gastrointestinal pathogens with a multiplex luminex-based molecular assay in stool samples from diarrhoeic patients. | we have evaluated the multiplex molecular method xtag(®) gastrointestinal panel (gpp) for detecting pathogens in stool samples of diarrhoeic patients. we collected 440 samples from 329 patients (male:female ratio of 1.2:1), including 102 immunosuppressed adults, 50 immunosuppressed children, 56 children attending the neonatal unit and 121 children attending the emergency unit. of these, 176 samples from 162 patients were xtag(®) gpp positive (102 viruses, 61 bacteria and 13 parasites) and the as ... | 2013 | 23714194 |
| the impact of pseudomembrane formation on the outcome of clostridium difficile-associated disease. | although pseudomembranes are the hallmark manifestation of clostridium difficile-associated diarrhea (cdad), there are scant data specifically addressing their impact on the clinical outcome. we investigated whether the formation of pseudomembranes predicts a worse cdad outcome. | 2013 | 23709307 |
| genetic characteristics of toxigenic clostridia and toxin gene evolution. | clostridia comprise a heterogenous group of environmental bacteria containing 15 pathogenic species, which produce the most potent toxins. the origin of toxins is still enigmatic. it is hypothesized that toxins exhibiting an enzymatic activity have derived from hydrolytic enzymes, which are abundantly secreted by these bacteria, and that pore-forming toxins have evolved from an ancestor transmembrane protein. the presence of related toxin genes in distinct clostridium species and the variability ... | 2013 | 23707611 |
| susceptibility of hamsters to clostridium difficile isolates of differing toxinotype. | clostridium difficile is the most commonly associated cause of antibiotic associated disease (aad), which caused ∼21,000 cases of aad in 2011 in the u.k. alone. the golden syrian hamster model of cdi is an acute model displaying many of the clinical features of c. difficile disease. using this model we characterised three clinical strains of c. difficile, all differing in toxinotype; cd1342 (paloc negative), m68 (toxinotype viii) & bi-7 (toxinotype iii). the naturally occurring non-toxic strain ... | 2013 | 23704976 |
| is fidaxomicin worth the cost? an economic analysis. | in may 2011, the food and drug administration approved fidaxomicin for the treatment of clostridium difficile infection (cdi). it has been found to be noninferior to vancomycin; however, its cost-effectiveness for the treatment of cdi remains undetermined. | 2013 | 23704121 |
| polymerase chain reaction assay to detect clostridium difficile tcdc variants is valuable in characterizing hospital epidemiology. | the epidemiology of nosocomial clostridium difficile infection (cdi), acquired at two hospitals in vancouver over a one-year period, was reviewed. cases were analysed by tcdc polymerase chain reaction, with tcdc variants (18 base pair deletion) highly associated with the nap1 strain. of the 214 cases identified, 51.9% were caused by these tcdc variants; these cases occurred more frequently in older patients admitted to the community hospital where the strain was endemic. overall, at least five o ... | 2013 | 23702278 |
| clinical factors associated with development of severe-complicated clostridium difficile infection. | clostridium difficile infection (cdi) can cause life-threatening complications. severe-complicated cdi is characterized by hypotension, shock, sepsis, ileus, megacolon, and colon perforation. we created a model to identify clinical factors associated with severe-complicated cdi. | 2013 | 23702192 |
| gut solutions to a gut problem: bacteriocins, probiotics and bacteriophage for control of clostridium difficile infection. | clostridium difficile infection (cdi) is a major cause of morbidity and mortality among hospitalized patients and imposes a considerable financial burden on health service providers in both europe and the usa. the incidence of cdi has dramatically increased in recent years, partly due to the emergence of a number of hypervirulent strains. the most commonly documented risk factors associated with cdis are antibiotic usage leading to alterations of the gut microbiota, age >65 years and long-term h ... | 2013 | 23699066 |
| determination of the attp and attb sites of phage cd27 from clostridium difficile nctc 12727. | the attp region of the clostridium difficile phage cd27 was identified, located immediately downstream of the putative recombinase. the phage could integrate into two specific sites (attb) in the c. difficile genome, one of which was in an open reading frame encoding a putative atpase of an abc transporter and the other in an open reading frame encoding a putative atpase of the flagella protein export apparatus. the prophage was capable of excision and formation of a circular molecule and phages ... | 2013 | 23699063 |
| polymerase chain reaction test for clostridium difficile toxin b gene reveals similar prevalence rates in children with and without inflammatory bowel disease. | clinicians often evaluate for clostridium difficile infection (cdi) in patients with inflammatory bowel disease (ibd) presenting with exacerbations. a highly sensitive polymerase chain reaction (pcr) test for the toxin b gene of c difficile is increasingly used to diagnose cdi. the aim of this study was to determine the prevalence of positive c difficile pcr results in children and young adults with and without active ibd compared with patients with non-ibd gastrointestinal disease. | 2013 | 23698022 |
| novel molecular type of clostridium difficile in neonatal pigs, western australia. | clostridium difficile causes neonatal enteritis in piglets; strains of pcr ribotype 078 are most commonly identified. we investigated c. difficile prevalence in piglets in australia and isolated a novel strain with a unique pathogenicity locus. in a mouse infection model, this strain produced more weight loss than did a ribotype 078 strain. | 2013 | 23697508 |
| characterisation of the spoilage bacterial microbiota in oyster gills during storage at different temperatures. | the spoilage bacterial community in oyster gill was investigated during storage at 4, 10 and 20 °c. aerobic plate counts and ph values were determined. total bacterial dna was extracted from oyster gill and bulk cells of plate count media. the major bacterial species during fresh or different temperatures storage were determined by polymerase chain reaction-denaturing gradient gel electrophoresis (pcr-dgge). | 2013 | 23696433 |
| [immunosuppressive treatment as a risk factor for the occurrence of clostridium difficile infection (cdi)]. | toxigenic clostridium difficile strains are known as the most common infectious cause of antibiotic-associated intestinal disease and nosocomial diarrhoea. the increased incidence of hypervirulent strains gives rise to worldwide concern. in particular, courses with multiple recurrences are observed in the presence of immunosuppression. | 2013 | 23696115 |
| inflammatory bowel disease epidemiology. | the occurrence of inflammatory bowel disease (ibd) is increasing worldwide, yet the reasons remain unknown. new therapeutic approaches have been introduced in medical ibd therapy, but their impact on the natural history of ibd remains uncertain. this review will summarize the recent findings in the epidemiology of ibd. | 2013 | 23695429 |
| multidetector computed tomography features of positive endoscopic or toxin assay clostridium difficile colitis. | pancolonic colonic wall thickening is a common ctfeature in patients diagnosed with clostridium difficile colitis (cdc). | 2013 | 23691703 |
| transcriptional analysis of temporal gene expression in germinating clostridium difficile 630 endospores. | clostridium difficile is the leading cause of hospital acquired diarrhoea in industrialised countries. under conditions that are not favourable for growth, the pathogen produces metabolically dormant endospores via asymmetric cell division. these are extremely resistant to both chemical and physical stress and provide the mechanism by which c. difficile can evade the potentially fatal consequences of exposure to heat, oxygen, alcohol, and certain disinfectants. spores are the primary infective a ... | 2013 | 23691138 |
| short-term genome stability of serial clostridium difficile ribotype 027 isolates in an experimental gut model and recurrent human disease. | clostridium difficile whole genome sequencing has the potential to identify related isolates, even among otherwise indistinguishable strains, but interpretation depends on understanding genomic variation within isolates and individuals. | 2013 | 23691061 |
| upregulation of the host slc11a1 gene by clostridium difficile toxin b facilitates glucosylation of rho gtpases and enhances toxin lethality. | pseudomembranous enterocolitis associated with clostridium difficile infection is an important cause of morbidity and mortality in patients being treated with antibiotics. two closely related large protein toxins produced by c. difficile, tcda and tcdb, which act identically but at different efficiencies to glucosylate low-molecular-weight rho gtpases, underlie the microbe's pathogenicity. using antisense rna encoded by a library of human expressed sequence tags (ests), we randomly inactivated h ... | 2013 | 23690404 |
| interobserver variability and feasibility of polymerase chain reaction-based assay in distinguishing ischemic colitis from clostridium difficile colitis in endoscopic mucosal biopsies. | polymerase chain reaction (pcr)-based assays using stool samples are currently the most effective method of detecting clostridium difficile. this study examines the feasibility of this assay using mucosal biopsy samples and evaluates the interobserver reproducibility in diagnosing and distinguishing ischemic colitis from c difficile colitis. thirty-eight biopsy specimens were reviewed and classified by 3 observers into c difficile and ischemic colitis. the findings were correlated with clinical ... | 2013 | 23690114 |
| acp journal club. review: probiotics reduce clostridium difficile-associated diarrhea in patients receiving antibiotics. | | 2013 | 23689777 |
| fecal microbiota therapy for recurrent clostridium difficile infection in hiv-infected persons. | | 2013 | 23689775 |
| mbx-500 is effective for treatment of clostridium difficile infection in gnotobiotic piglets. | the novel antibiotic mbx-500, dosed at 100, 200, or 400 mg/kg twice daily for 7 days, was evaluated for the treatment of clostridium difficile infection (cdi) in the gnotobiotic pig model. mbx-500 increased survival at all doses and at high doses improved clinical signs and reduced lesion severity, similar to vancomycin. our results show that mbx-500 is an effective antibiotic for the treatment of diarrhea associated with cdi and prevents severe systemic disease. | 2013 | 23689716 |
| tcda as a diagnostic target in a loop-mediated amplification assay for detecting toxigenic clostridium difficile. | the illumigene® (meridian bioscience, inc., cincinnati, oh) and geneohm® (bd diagnostics, la jolla, ca) clostridium difficile assays target the tcda gene and tcdb gene, respectively. we assessed the use of tcda as the molecular target in the illumigene® c. difficile loop-mediated amplification assay in detecting a wide variety of c. difficile strains including those with tcda deletions. | 2013 | 23686774 |
| pathology and diagnostic criteria of clostridium difficile enteric infection in horses. | clostridium difficile is commonly associated with diarrhea and colitis in humans and other mammals, including horses. to this date, the epidemiologic, microbiologic, clinical, and diagnostic aspects of c. difficile-associated disease (cdad) in horses have been thoroughly described. however, reports describing the enteric pathology of this disease in horses are limited. this study presents a comprehensive description of the pathologic characteristics of cdad in 21 horses and discusses the criteri ... | 2013 | 23686768 |
| the effect of portable pulsed xenon ultraviolet light after terminal cleaning on hospital-associated clostridium difficile infection in a community hospital. | there is evidence that contamination of patient rooms from previous occupants is associated with hospital-associated clostridium difficile infection (ha-cdi). during january 2011, the use of 2 portable pulsed xenon ultraviolet light devices (ppx-uv) to disinfect patient rooms was added to routine hospital discharge cleaning in a community hospital. in 2010, the ha-cdi rate was 9.46 per 10,000 patient-days; in 2011, the ha-cdi rates was 4.45 per 10,000 patient-days (53% reduction, p = .01). the n ... | 2013 | 23685092 |
| evaluation of bacteriophage therapy to control clostridium difficile and toxin production in an in vitro human colon model system. | clostridium difficile is a leading cause of hospital-acquired diarrhoea and represents a major challenge for healthcare providers. due to the decreasing efficacy and associated problems of antibiotic therapy there is a need for synergistic and alternative treatments. in this study we investigated the use of a specific bacteriophage, φcd27, in a human colon model of c. difficile infection. our findings demonstrate a significant reduction in the burden of c. difficile cells and toxin production wi ... | 2013 | 23685029 |
| fidaxomicin for treatment of clostridium difficile-associated diarrhea and its potential role for prophylaxis. | clostridium difficile has become the most important healthcare-associated infection worldwide within the past decade. this is in part due to the emergence of a highly virulent epidemic strain of c. difficile as well as the relative ineffectiveness of current therapies at producing a sustained response. fidaxomicin is a novel antibiotic that demonstrates a greater sustained response for c. difficile-associated diarrhea (cdad) compared to existing drugs and its potential role as a prophylactic age ... | 2013 | 23683070 |
| detection of clostridium difficile toxins a, b and binary toxin with slow off-rate modified aptamers. | rapid and accurate diagnostic tests for clostridium difficile infections (cdi) are crucial for management of patients with suspected cdi and for infection control. enzyme immunoassays for detection of the toxins are routinely used but lack adequate sensitivity. we generated slow off-rate modified aptamers (somamer™ reagents) via in vitro selection (selex) that bind toxins a, b and binary toxin with high affinity and specificity. using somamers alone or in conjunction with antibodies, we have dev ... | 2013 | 23680240 |
| easily modified factors contribute to delays in diagnosis of clostridium difficile infection: a cohort study and intervention. | although rapid laboratory tests are available for diagnosis of clostridium difficile infection (cdi), delays in completion of cdi testing are common in clinical practice. we conducted a cohort study of 242 inpatients tested for cdi to determine the timing of different steps involved in diagnostic testing and to identify modifiable factors contributing to delays in diagnosis. the average time from test order to test result was 1.8 days (range, 0.2 to 10.6), with time from order to stool collectio ... | 2013 | 23678072 |
| [multidisciplinary approach of clostridium difficile infection]. | clostridium difficile is the most common cause of infectious diarrhea in adults healthcare institutions. recent studies have shown an increase in the incidence, severity and recurrence of c. difficile infection (cdi). factors associated with the patient and medical care provided contribute to establishing colonization and, in some cases, subsequent progression to symptomatic disease. the availability of new microbiological techniques has contributed greatly to improving care for these patients. ... | 2013 | 23677156 |
| genomic and expression analysis of the vang-like gene cluster of clostridium difficile. | primary antibiotic treatment of clostridium difficile intestinal diseases requires metronidazole or vancomycin therapy. a cluster of genes homologous to enterococcal glycopeptides resistance vang genes was found in the genome of c. difficile 630, although this strain remains sensitive to vancomycin. this vang-like gene cluster was found to consist of five orfs: the regulatory region consisting of vanr and vans and the effector region consisting of vang, vanxy and vant. we found that 57 out of 83 ... | 2013 | 23676437 |
| genome-wide identification of regulatory rnas in the human pathogen clostridium difficile. | clostridium difficile is an emergent pathogen, and the most common cause of nosocomial diarrhea. in an effort to understand the role of small noncoding rnas (srnas) in c. difficile physiology and pathogenesis, we used an in silico approach to identify 511 srna candidates in both intergenic and coding regions. in parallel, rna-seq and differential 5'-end rna-seq were used for global identification of c. difficile srnas and their transcriptional start sites at three different growth conditions (ex ... | 2013 | 23675309 |
| bile acid recognition by the clostridium difficile germinant receptor, cspc, is important for establishing infection. | clostridium difficile spores must germinate in vivo to become actively growing bacteria in order to produce the toxins that are necessary for disease. c. difficile spores germinate in vitro in response to certain bile acids and glycine. in other sporulating bacteria, proteins embedded within the inner membrane of the spore sense the presence of germinants and trigger the release of ca⁺⁺-dipicolinic acid (ca⁺⁺-dpa) from the spore core and subsequent hydrolysis of the spore cortex, a specialized p ... | 2013 | 23675301 |
| advances in the treatment of clostridium difficile with fidaxomicin: a narrow spectrum antibiotic. | clostridium difficile infection, also known as c. difficile-associated diarrhea (cdad), is the most common cause of nosocomial diarrhea, typically initiated by the use of broad-spectrum antibiotics that disrupt gut flora, thereby allowing c. difficile to proliferate. it is an increasing cause of morbidity and mortality, especially in hospitals and long-term care facilities. a particularly challenging aspect to treating cdad has been maintenance of clinical response: following initial treatment s ... | 2013 | 23672600 |
| transient flare of ulcerative colitis after fecal microbiota transplantation for recurrent clostridium difficile infection. | clostridium difficile infection (cdi) is a common cause of infectious diarrhea and is usually treated with metronidazole or vancomycin. cdi recurs in 15%-30% of patients after the initial episode and in up to 65% after a second episode. recurrent infections are a challenge to treat, and patients are usually managed with prolonged pulsed or tapered vancomycin. fecal microbiota transplantation is an alternative treatment that has a 91% rate of success worldwide, with no reported complications. we ... | 2013 | 23669309 |
| acute infection of mice with clostridium difficile leads to eif2α phosphorylation and pro-survival signalling as part of the mucosal inflammatory response. | the current study sought to delineate the gene expression profile of the host response in the caecum and colon during acute infection with clostridium difficile in a mouse model of infection, and to investigate the nature of the unfolded protein response in this process. the infected mice displayed a significant up-regulation in the expression of chemokines (cxcl1, cxcl2 and ccl2), numerous pro-inflammatory cytokines (ifng, il1b, il6, and il17f), as well as il22 and a number of anti-microbial pe ... | 2013 | 23668260 |
| [clostridium difficile infections - still a major challenge]. | | 2013 | 23668179 |
| a case of clostridium difficile bacteremia in a patient with loop ileostomy. | clostridium difficile, an anaerobic, spore-forming, gram-positive, rod-shaped bacterium, is the most common nosocomial pathogen causing pseudomembranous colitis. c. difficile is not intrinsically invasive and rarely infects extraintestinal sites. the bacterium, therefore, is not commonly detected in blood cultures. here, we report a case of c. difficile bacteremia in a patient who had underwent loop ileostomy because of rectal obstruction following metastatic colon cancer originated from prostat ... | 2013 | 23667848 |
| controversies in the management of the critically ill: the role of probiotics. | probiotics are commercially available, viable, non-pathogenic micro-organisms that, when ingested in sufficient quantities, exert a health benefit to the host derived through modification of the gut flora, local release of antimicrobial factors, maintenance of integrity of the gut barrier, competition for epithelial adherence, prevention of bacterial translocation, and modulation of the local immune response. in critically ill patients, probiotics appear to lead to decreased susceptibility to an ... | 2013 | 23664676 |
| clostridium difficile infections: do we know the real dimensions of the problem? | clostridium difficile infection (cdi) is the primary cause of nosocomial diarrhoea in industrialised countries, usually occurring as a complication of antibiotic therapy in elderly patients. landmark events contributed to boosting interest in cdi over the last 10 years, including the emergence of unusually severe and recurrent cdi due to the nap1/bi/027 strain, as well as reports suggesting that cdi is also significantly encountered in patients previously considered at no risk, such as community ... | 2013 | 23664578 |
| changes of poultry faecal microbiota associated with clostridium difficile colonisation. | bacterial, fungal and archaeal microbiota was analysed in 143 chicken faecal samples from a single poultry farm. after dhplc (denaturing high performance liquid chromatography) 15 bacterial groups, 10 fungal groups and a single archaeal species were differentiated. samples were grouped into two clusters with significantly different frequencies of c. difficile positive and negative samples in each cluster. acidaminococcus intestini, described here for the first time as a part of poultry faecal mi ... | 2013 | 23664184 |
| appropriateness of empiric therapy in patients with suspected clostridium difficile infection. | the objective of this study was to test the hypothesis that many patients with suspected clostridium difficile infection (cdi) receive inappropriate empiric therapy and/or receive continued therapy despite negative test results. | 2013 | 23663129 |
| the co-seasonality of pneumonia and influenza with clostridium difficile infection in the united states, 1993-2008. | seasonal variations in the incidence of pneumonia and influenza are associated with nosocomial clostridium difficile infection (cdi) incidence, but the reasons why remain unclear. our objective was to consider the impact of pneumonia and influenza timing and severity on cdi incidence. we conducted a retrospective cohort study using the us national hospital discharge survey sample. hospitalized patients with a diagnosis of cdi or pneumonia and influenza between 1993 and 2008 were identified from ... | 2013 | 23660799 |
| disinfection of ipad to reduce contamination with clostridium difficile and methicillin-resistant staphylococcus aureus. | | 2013 | 23660112 |
| clostridium difficile infection in children: a comprehensive review. | to provide a comprehensive review of the literature relating to clostridium difficile (c. difficile) infection (cdi) in the pediatric population. | 2013 | 23659563 |
| detection of mixed infection from bacterial whole genome sequence data allows assessment of its role in clostridium difficile transmission. | bacterial whole genome sequencing offers the prospect of rapid and high precision investigation of infectious disease outbreaks. close genetic relationships between microorganisms isolated from different infected cases suggest transmission is a strong possibility, whereas transmission between cases with genetically distinct bacterial isolates can be excluded. however, undetected mixed infections-infection with ≥2 unrelated strains of the same species where only one is sequenced-potentially impai ... | 2013 | 23658511 |
| understanding increased mortality in clostridium difficile-infected older adults. | | 2013 | 23658435 |
| clostridium difficile infection in patients with hiv/aids. | clostridium difficile infection (cdi) affects significant numbers of hospitalized patients and is an increasing problem in the community. it is also among the most commonly isolated pathogens in hiv patients with diarrheal illness and is ≥2 fold more common in hiv-seropositive individuals. this association is stronger in those with low absolute cd4 t cell counts or meeting clinical criteria for an aids diagnosis, and was most pronounced before the wide availability of highly active antiretrovira ... | 2013 | 23657793 |
| clostridium difficile in children: a review of existing and recently uncovered evidence. | the clinical significance of the presence of clostridium difficile in children's faeces remains uncertain using current diagnostic procedures. clostridium difficile is a relatively common finding in infants with no symptoms of gastrointestinal disease, suggesting it may be an incidental finding and form part of the normal gut micro-flora in this age group. on the other hand, particularly in older children or those with significant co-morbidity, there are examples where c. difficile causes diseas ... | 2013 | 23654056 |
| [antibiotic-associated diarrhea in clinical practice]. | antibiotic-associated diarrhea (aad) is considered to mean at least 3 shapeless stool episodes within 2 or more consecutive days when using antibacterial agents. due to the fact that antibiotics are used most commonly to treat many diseases, aad is one of the topical problems for different clinical specialists. there has recently been increased interest in this condition due to its higher morbidity and mortality rates and the emergence of novel treatment-resistant virulent strains of clostridium ... | 2013 | 23653946 |
| clostridium difficile surveillance: a multicenter comparison of labid events and use of standard definitions. | | 2013 | 23651906 |
| unnecessary antimicrobial use in the context of clostridium difficile infection: a call to arms for the veterans affairs antimicrobial stewardship task force. | | 2013 | 23651905 |
| has improved hand hygiene compliance reduced the risk of hospital-acquired infections among hospitalized patients in ontario? analysis of publicly reported patient safety data from 2008 to 2011. | prospective, observational, ecological, time series, cross-sectional study examining the association between hand hygiene compliance (hhc) rates and the incidence of hospital-acquired infections. | 2013 | 23651891 |
| attributable burden of hospital-onset clostridium difficile infection: a propensity score matching study. | to determine the attributable in-hospital mortality, length of stay (los), and cost of hospital-onset clostridium difficile infection (ho-cdi). | 2013 | 23651889 |
| antibacterial effect of manuka honey on clostridium difficile. | manuka honey originates from the manuka tree (leptospermum scoparium) and its antimicrobial effect has been attributed to a property referred to as unique manuka factor that is absent in other types of honey. antibacterial activity of manuka honey has been documented for several bacterial pathogens, however there is no information on clostridium difficile, an important nosocomial pathogen. in this study we investigated susceptibility of c. difficile to manuka honey and whether the activity is ba ... | 2013 | 23651562 |
| risks associated with the therapeutic use of fluoroquinolones. | quinolones are among the most often prescribed antimicrobial agents. some types of toxicity observed during therapy with these drugs have gained much attention. | 2013 | 23651367 |
| probiotics for the prevention of clostridium difficile-associated diarrhea. in response. | | 2013 | 23648957 |
| probiotics for the prevention of clostridium difficile-associated diarrhea. | | 2013 | 23648956 |
| probiotics for the prevention of clostridium difficile-associated diarrhea. | | 2013 | 23648955 |
| [anaerobic bacteria 150 years after their discovery by pasteur]. | in 2011 we celebrated the 150th anniversary of the discovery of anaerobic bacteria by louis pasteur. the interest of the biomedical community on such bacteria is still maintained, and is particularly focused on clostridium difficile. in the past few years important advances in taxonomy have been made due to the genetic, technological and computing developments. thus, a significant number of new species related to human infections have been characterised, and some already known have been reclassi ... | 2015 | 23648369 |
| depression, antidepressant medications, and risk of clostridium difficile infection. | an ancillary finding in previous research has suggested that the use of antidepressant medications increases the risk of developing clostridium difficile infection (cdi). our objective was to evaluate whether depression or the use of anti-depressants altered the risk of developing cdi, using two distinct datasets and study designs. | 2013 | 23647647 |
| indications and safety of proton pump inhibitor drug use in patients with cancer. | although the exact prevalence of proton pump inhibitor (ppi) use in cancer patients is not known, it is generally perceived to be widespread. ppis are generally well tolerated and carry an excellent safety profile. however, increasing and longer term ppi use has raised concerns about the risk of pneumonia, bone fractures and enteric infections, and a possible interaction with clopidogrel that could increase the risk of cardiovascular events. | 2013 | 23647006 |
| obesity as a risk factor for clostridium difficile infection. | obesity and clostridium difficile infection (cdi) are both related to an increased firmicutes/bacteroidetes ratio in the intestinal microbiota. however, an association between obesity and cdi is unknown. we aimed to assess the association between obesity and cdi in hospitalized patients. | 2013 | 23645850 |
| does empirical clostridium difficile infection (cdi) therapy result in false-negative cdi diagnostic test results? | patients with suspected clostridium difficile infection (cdi) often receive empirical therapy prior to collection of stool specimens for diagnostic testing. the likelihood that such empirical therapy might result in false-negative cdi test results is unknown. | 2013 | 23645849 |
| effects of clostridium difficile toxin a and b on human t lymphocyte migration. | bacterial products such as toxins can interfere with a variety of cellular processes, leading to severe human diseases. clostridium difficile toxins, tcda and tcdb are the primary contributing factors to the pathogenesis of c. difficile-associated diseases (cdad). while the mechanisms for tcda and tcdb mediated cellular responses are complex, it has been shown that these toxins can alter chemotactic responses of neutrophils and intestinal epithelial cells leading to innate immune responses and t ... | 2013 | 23645153 |
| effect of hospital disinfectants on spores of clinical brazilian clostridium difficile strains. | the aim of this study was to evaluate the sporicidal activity of hospital disinfectants against spores of two brazilian clostridium difficile ribotypes and the bi/nap1/027. our results showed that clororio(®) and cidex opa(®) were the most efficient agents for eliminating spores of c difficile. | 2013 | 23644034 |
| evaluation of the new ce-ivd marked bd max cdiff assay for the detection of toxigenic clostridium difficile harboring the tcdb gene from clinical stool samples. | the evaluation of the fully automated bd max cdiff assay on a panel of 100 stool samples characterized by the xpert c. difficile assay reported a high concordance between the two molecular assays (kappa coefficient of 0.96), which makes this new assay suitable for routine detection of toxigenic clostridium difficile. | 2013 | 23643507 |
| on the difficulties of isolating clostridium difficile from hospital environments. | spores of clostridium difficile were deposited on to a stainless steel surface and subsequently exposed to a chlorine-releasing disinfectant (dichloroisocyanurate). recovery of the spores was carried out using rodac plates containing a variety of selective and non-selective agars. the non-selective agar media yielded higher recoveries of both control and chlorine-stressed spores. our results show that the antibiotics used in selective media imposed an additional stress on both disinfectant-treat ... | 2013 | 23643391 |
| an overview of fecal microbiota transplantation: techniques, indications, and outcomes. | | 2013 | 23642791 |
| clostridium difficile infection in horses: a review. | clostridium difficile is considered one of the most important causes of diarrhea and enterocolitis in horses. foals and adult horses are equally susceptible to the infection. the highly resistant spore of c. difficile is the infectious unit of transmission, which occurs primarily via the fecal-oral route, with sources of infection including equine feces, contaminated soil, animal hospitals, and feces of other animals. two major risk factors for the development of c. difficile associated disease ... | 2013 | 23642413 |
| mycotic iliac artery aneurysm caused by clostridium difficile in a patient with axillobifemoral bypass for leriche syndrome. | a 74-year old man on hemodialysis developed a mycotic aneurysm caused by clostridium difficile. to the best of our knowledge, this is only the second case of such an aneurysm reported in the literature. he had previously undergone axillobifemoral bypass grafting because of symptomatic infrarenal aortic stenosis. although no blood flow was detected in his occluded right common iliac artery, it expanded rapidly despite intensive antibiotic therapy. as the blood supply to the lower limbs was alread ... | 2013 | 23641291 |
| presence of clostridium difficile pcr ribotype clusters related to 033, 078 and 045 in diarrhoeic calves in germany. | this study provides data on the distribution and relationship of c. difficile pcr ribotypes in diarrhoeic calves in germany. c. difficile was isolated from 176 of 999 (17.6 %) faecal samples or swabs of diarrhoeic calves from 603 farms collected between january 2010 and august 2012 by eight federal laboratories of six states. strains were assigned to 17 pcr ribotypes. pcr ribotypes 033 (57 %), 078 (17 %) and 045/fli01 (closest match to 045 in the webribo database; 9 %) were found the most freque ... | 2013 | 23639987 |
| reply to wiegand et al.: proton pump inhibitor over-use and the ongoing battle to control clostridium difficile infection in hospitals. | | 2013 | 23639818 |
| role of the environment in the transmission of clostridium difficile in health care facilities. | recent data demonstrate that the contaminated hospital surface environment plays a key role in the transmission of clostridium difficile. enhanced environmental cleaning of rooms housing clostridium difficile-infected patients is warranted, and, if additional studies demonstrate a benefit of "no-touch" methods (eg, ultraviolet irradiation, hydrogen peroxide systems), their routine use should be considered. | 2013 | 23622740 |
| interventions to improve antibiotic prescribing practices for hospital inpatients. | the first publication of this review in issue 3, 2005 included studies up to november 2003. this update adds studies to december 2006 and focuses on application of a new method for meta-analysis of interrupted time series studies and application of new cochrane effective practice and organisation of care (epoc) risk of bias criteria to all studies in the review, including those studies in the previously published version. the aim of the review is to evaluate the impact of interventions from the ... | 2013 | 23633313 |
| resolution of severe clostridium difficile infection following sequential fecal microbiota transplantation. | | 2013 | 23632358 |
| clostridium difficile binary toxin cdt induces clustering of the lipolysis-stimulated lipoprotein receptor into lipid rafts. | clostridium difficile is the leading cause of antibiotics-associated diarrhea and pseudomembranous colitis. hypervirulent c. difficile strains produce the binary actin-adp-ribosylating toxin cdt (c. difficile transferase), in addition to the rho-glucosylating toxins a and b. we recently identified the lipolysis-stimulated lipoprotein receptor (lsr) as the host receptor that mediates uptake of cdt into target cells. here we investigated in h1-hela cells, which ectopically express lsr, the influen ... | 2013 | 23631918 |
| a novel approach to generate a recombinant toxoid vaccine against clostridium difficile. | the clostridium difficile toxins a and b are primarily responsible for symptoms of c. difficile associated disease and are prime targets for vaccine development. we describe a plasmid-based system for the production of genetically modified toxins in a non-sporulating strain of c. difficile that lacks the toxin genes tcda and tcdb. tcda and tcdb mutations targeting established glucosyltransferase cytotoxicity determinants were introduced into recombinant plasmids and episomally expressed toxin mu ... | 2013 | 23629868 |
| human monoclonal antibodies against clostridium difficile toxins a and b inhibit inflammatory and histologic responses to the toxins in human colon and peripheral blood monocytes. | clostridium difficile infection (cdi) is a common and debilitating nosocomial infection with high morbidity and mortality. c. difficile mediates diarrhea and colitis by releasing two toxins, toxin a and toxin b. since both toxins stimulate proinflammatory signaling pathways in human colonocytes and both are involved in the pathophysiology of cdi, neutralization of toxin a and b activities may represent an important therapeutic approach against cdi. recent studies indicated that human monoclonal ... | 2013 | 23629713 |
| fecal microbiota transplantation: a new standard treatment option for clostridium difficile infection. | | 2013 | 23627849 |
| clostridium difficile is an autotrophic bacterial pathogen. | during the last decade, clostridium difficile infection showed a dramatic increase in incidence and virulence in the northern hemisphere. this incessantly challenging disease is the leading cause of antibiotic-associated and nosocomial infectious diarrhea and became life-threatening especially among elderly people. it is generally assumed that all human bacterial pathogens are heterotrophic organisms, being either saccharolytic or proteolytic. so far, this has not been questioned as colonization ... | 2013 | 23626782 |
| contemporary outcomes for ulcerative colitis inpatients admitted to pediatric hospitals in the united kingdom. | pediatric ulcerative colitis (uc) care is variable with a lack of appropriate guidelines to guide practice until recently. | 2013 | 23624885 |
| effect of age, dose and antibiotic therapy on the development of clostridium difficile infection in neonatal piglets. | piglet diarrhea is associated with increased pre-weaning mortality, poor growth rates, and variation in weight at weaning. clostridium difficile is a known cause of enteric disease in neonatal piglets, yet risk factors associated with c. difficile infection in piglets are unknown. the objectives of this study were (1) to evaluate the consistency and severity of lesions in piglets challenged with c. difficile at different bacterial doses (dosage experiment), (2) evaluate the use of antibiotics as ... | 2013 | 23624068 |
| asymptomatic clostridium difficile colonization in a tertiary care hospital: admission prevalence and risk factors. | the role of clostridium difficile (cd) carriers in health care-associated cd transmission has been identified as an area needing research. we investigated the prevalence of, and risk factors for, asymptomatic cd colonization at hospital admission. | 2013 | 23622704 |
| community-associated clostridium difficile infection and antibiotics: a meta-analysis. | antibiotic exposure is the most important risk factor for clostridium difficile infection (cdi). most evaluations of antimicrobial risk factors have been conducted in healthcare settings. the objective of this meta-analysis was to evaluate the association between antibiotic exposure and community-associated cdi (ca-cdi) (i.e. symptom onset in the community with no healthcare facility admission within 12 weeks) and to determine the classes of antibiotics posing the greatest risk. | 2013 | 23620467 |
| cytotoxicity of clostridium difficile toxin b does not require cysteine protease-mediated autocleavage and release of the glucosyltransferase domain into the host cell cytosol. | clostridium difficile virulence requires secretion of two exotoxins: tcda and tcdb. the precise mechanism of toxin uptake and delivery is undefined, but current models predict that the cysteine protease domain (cpd)-mediated autocleavage and release of glucosyltransferase domain (gtd) are crucial for intoxication. to determine the importance of cpd-mediated cleavage to tcdb cytotoxicity, we generated two mutant toxins--tcdb-c698s and tcdb-h653a--and assayed their abilities to intoxicate cells. t ... | 2013 | 23620115 |
| probiotic vsl#3 prevents antibiotic-associated diarrhoea in a double-blind, randomized, placebo-controlled clinical trial. | antibiotic-associated diarrhoea (aad) is a frequent complication of systemic antibiotic therapy and clostridium difficile-associated diarrhoea (cdad) is its most serious form due to associated morbidity and mortality. | 2013 | 23618760 |
| crofelemer, a novel antisecretory agent approved for the treatment of hiv-associated diarrhea. | secretory diarrhea has a significant impact on morbidity and mortality worldwide and may be a predominant or minor component of pathogenesis in diarrhea of various etiologies. crofelemer is a first-in-class antidiarrheal medication with unique inhibitory mechanisms at both the cystic fibrosis transmembrane conductance regulator and the calcium-activated chloride channels which are responsible for chloride secretion and subsequent luminal hydration. the efficacy of crofelemer has been investigate ... | 2013 | 23616951 |
| duodenal infusion of stool is more effective than vancomycin in patients with recurrent clostridium difficile. | | 2013 | 23616152 |
| the relationship between phenotype, ribotype, and clinical disease in human clostridium difficile isolates. | since 2000, clostridium difficile isolates of ribotype 027 have been linked to outbreaks in north america and europe and also an increased rate of colectomy and death among infected individuals. it has been proposed that enhanced sporulation and toxin production were associated with this apparent increase in virulence of 027 isolates. since only a limited number of isolates have been examined, the relationship of these phenotypes to a specific ribotype, and as well as to clinical disease severit ... | 2013 | 23608205 |
| the antimicrobial effects of helium and helium-air plasma on staphylococcus aureus and clostridium difficile. | healthcare-associated infections (hcai) affect 5-10% of acute hospital admissions. environmental decontamination is an important component of all strategies to prevent hcai as many bacterial causes survive and persist in the environment, which serve as ongoing reservoirs of infection. current approaches such as cleaning with detergents and the use of chemical disinfectant are suboptimal. we assessed the efficacy of helium and helium-air plasma in killing staphylococcus aureus and clostridium dif ... | 2013 | 23607860 |
| site-directed mutations in the lanthipeptide mutacin 1140. | the oral bacterium streptococcus mutans, strain jh1140, produces the antibiotic mutacin 1140. mutacin 1140 belongs to a group of antibiotics called lanthipeptides. more specifically, mutacin 1140 is related to the epidermin type a(i) lanthipeptides. mutagenesis experiments of this group of lanthipeptides have been primarily restricted to the posttranslationally modified meso-lanthionine and 3-methyllanthionine residues. site-directed mutagenesis of the core peptide of mutacin 1140 was performed ... | 2013 | 23603688 |
| diagnostic accuracy of a multiplex real-time pcr to predict clostridium difficile ribotype 027. | | 2013 | 23603384 |
| pouchitis: what every gastroenterologist needs to know. | pouchitis is the most common complication among patients with ulcerative colitis who have undergone restorative proctocolectomy with ileal pouch-anal anastomosis. pouchitis is actually a spectrum of diseases that vary in etiology, pathogenesis, phenotype, and clinical course. although initial acute episodes typically respond to antibiotic therapy, patients can become dependent on antibiotics or develop refractory disease. many factors contribute to the course of refractory pouchitis, such as the ... | 2013 | 23602818 |
| evaluation of the bd max cdiff assay for the detection of the toxin b gene of clostridium difficile out of faecal specimens. | in this evaluation study, 180 faecal specimens were tested in parallel with the new bd max™ cdiff assay, the premier™ toxins a&b, and toxigenic culture as reference method. bd max™ cdiff presented a high sensitivity (96.0%) and specificity (99.4%) with a negative predictive value of 99.4%. | 2013 | 23602785 |
| attenuation of clostridium difficile toxin-induced damage to epithelial barrier by ecto-5'-nucleotidase (cd73) and adenosine receptor signaling. | clostridium difficile (cdf) releases toxins (tcda and tcdb) that damage the intestinal epithelial barrier. ecto-5'-nucleotidase (cd73) is expressed on intestinal epithelial cells, and it is hypothesized to protect against toxin-induced epithelial damage through the cleavage of 5'-amp to adenosine (ado) and subsequent activation of adenosine receptors (adors). herein, we sought to assess the potential protective effects of cd73 and ador signaling on the injurious effects of cdf toxins. | 2013 | 23600886 |
| structural and functional investigation into acetyl-coenzyme a synthase and methyltransferase from human pathogen clostridium difficile. | methyltransferase (metrcd) and acetyl-coenzyme a synthase (acscd) are two key enzymes in the acetyl-coenzyme a synthesis pathway of the human pathogen clostridium difficile. the pathway is absent in humans and is essential for the survival of the pathogen. metrcd and acscd were cloned, expressed in e. coli, and characterized for the first time. structural and functional investigations of the two enzymes were performed using homology structure modeling, fluorescence spectroscopy, and steady state ... | 2013 | 23599026 |
| concomitant typhlitis and clostridium difficile colitis developed after first r-chop chemotherapy in a non-hodgkin lymphoma patient. | typhlitis or neutropenic enterocolitis (nec) is a life-threatening condition that occurs in neutropenic patients. early recognition is crucial owing to high death rate. we present a case of a 54-year-old man, diagnosed with non-hodgkin lymphoma who received a first cycle of rituximab, cyclophosphamide, hydroxydaunorubicin (doxorubicin), oncovin (vincristine), prednisolone (r-chop) chemotherapy 10 days prior presenting. he developed fever, mucositis, watery diarrhoea and right lower quadrant pain ... | 2013 | 23598937 |