| clostridium difficile in foods and animals: history and measures to reduce exposure. | many articles have summarized the changing epidemiology of clostridium difficile infections (cdi) in humans, but the emerging presence of c. difficile in foods and animals and possible measures to reduce human exposure to this important pathogen have been infrequently addressed. cdis have traditionally been assumed to be restricted to health-care settings. however, recent molecular studies indicate that this is no longer the case; animals and foods might be involved in the changing epidemiology ... | 2013 | 23324529 |
| a mixture of functionally oligoclonal humanized monoclonal antibodies that neutralize clostridium difficile tcda and tcdb with high levels of in vitro potency shows in vivo protection in a hamster infection model. | clostridium difficile infections are a major cause of antibiotic-associated diarrhea in hospital and care facility patients. in spite of the availability of effective antibiotic treatments, c. difficile infection (cdi) is still a major cause of patient suffering, death, and substantial health care costs. clostridium difficile exerts its major pathological effects through the actions of two protein exotoxins, tcda and tcdb, which bind to and disrupt gut tissue. antibiotics target the infecting ba ... | 2013 | 23324518 |
| duodenal infusion of donor feces for recurrent clostridium difficile. | recurrent clostridium difficile infection is difficult to treat, and failure rates for antibiotic therapy are high. we studied the effect of duodenal infusion of donor feces in patients with recurrent c. difficile infection. | 2013 | 23323867 |
| hemolytic uremic syndrome associated with clostridium difficile infection. | we report 3 cases of clostridium difficile-associated hemolytic uremic syndrome (hus) with biopsy proven renal thrombotic microangiopathy. two patients with acute renal failure were kidney transplants recipients whereas the third patient developed renal failure in the native kidneys. the presentation was preceded by acute diarrhea and stool. clostridium difficile toxin was detected in all the 3 patients. stool studies were negative for escherichia coli, shigella dysenteriae and other enteric pat ... | 2014 | 23320969 |
| proton pump inhibitors versus histamine 2 receptor antagonists for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis. | critically ill patients may develop bleeding caused by stress ulceration. acid suppression is commonly prescribed for patients at risk of stress ulcer bleeding. whether proton pump inhibitors are more effective than histamine 2 receptor antagonists is unclear. | 2013 | 23318494 |
| american journal of gastroenterology lecture: intestinal microbiota and the role of fecal microbiota transplant (fmt) in treatment of c. difficile infection. | the vital roles that intestinal flora, now called microbiota, have in maintaining our health are being increasingly appreciated. starting with birth, exposure to the outside world begins the life-long intimate association our microbiota will have with our diet and environment, and initiates determination of the post-natal structural and functional maturation of the gut. moreover, vital interactions of the microbiota with our metabolic activities, as well as with the immunological apparatus that ... | 2013 | 23318479 |
| the rise of clostridium difficile infection in lung transplant recipients in the modern era. | clostridium difficile infection (cdi) rates have been rising in recent years. we aimed to characterize cdi in lung transplant recipients in the modern era and hypothesized that cdi would increase the mortality risk. | 2013 | 23316931 |
| unusual localization of clostridium difficile infection in an isolated segment of the descending colon in a critical care patient. | unrecognized severe pseudomembranous colitis may become life threatening. a typical clostridium difficile infection is associated with involvement of the colon; however, small bowel disease has also been described. here, we present a case of a 48-year-old man with clostridium difficile colitis of an isolated segment in the descending colon treated by a novel catheter intraluminal antibiotic irrigation. the intraluminal antibiotic irrigation was performed through a foley catheter inserted into th ... | 2012 | 23316409 |
| lack of clostridium difficile infection in patients treated with rifaximin for hepatic encephalopathy: a retrospective analysis. | the purpose of this study was to assess the incidence of clostridium difficile infection in patients who received rifaximin for the treatment of hepatic encephalopathy (he). | 2013 | 23314671 |
| incidence and risk factors for hospital-acquired clostridium difficile infection among inpatients in an orthopaedic tertiary care hospital. | the aim of this retrospective study was to identify risk factors for hospital-acquired clostridium difficile infection (ha-cdi) in orthopaedic patients. thirty-two ha-cdi cases were each matched with two controls. incidence rate was 0.33 cases per 1000 patient-days. univariate analyses showed that surgery >24 h after admission, antibiotics for treatment, and proton pump inhibitors were associated with ha-cdi. multivariate analyses revealed that surgery >24 h after admission was associated with h ... | 2013 | 23313026 |
| understanding gut-immune interactions in management of acute infectious diarrhoea. | this article discusses the role that immunity plays in the risk of diarrhoea and the potential role for probiotics in the management of acute infectious diarrhoea in older people, including antibiotic-associated diarrhoea and clostridium difficile-associated diarrhoea. | 2012 | 23311278 |
| characterization of continued antibacterial therapy after diagnosis of hospital-onset clostridium difficile infection: implications for antimicrobial stewardship. | to determine the proportion of hospitalized adults with hospital-onset clostridium difficile infection (cdi) who continued to receive concomitant non-cdi antibacterial agents, to characterize the antibacterial therapy that these patients received before and after the diagnosis of cdi, and to compare hospital outcomes between those patients who did and those who did not have their previous antibacterial therapy discontinued after cdi diagnosis. | 2012 | 23307522 |
| in recurrent c. difficile, the crp response to the primary c. difficile infection predicts whether the same strain or a different strain will cause a second infection. | clostridium difficile is the leading cause of antibiotic-associated diarrhoea and is associated with an increase in morbidity and mortality. there is a wide variance in disease severity with some patients suffering a single, self-limiting episode of diarrhoea while others suffer more intractable problems with recurrent attacks or toxic dilatation. numerous different c. difficile ribotypes exist, some of which are considered hypervirulent. the magnitude of toxin production alone is not sufficient ... | 2013 | 23306854 |
| phenome based analysis as a means for discovering context dependent clinical reference ranges. | robust electronic medical records (emr's) have made large-scale phenome-based analysis feasible. the context-dependent phenome of a large icu-based emr database (mimic ii) was explored, as a function of a clinical feature: white blood cell count (wbc). phenome visualization led to the discovery that peak wbc in the range 15-45 k/μl was highly associated with the diagnoses of clostridium difficile and bacterial sepsis; thus, it is conceivable that clinicians might delay ordering targeted antimicr ... | 2012 | 23304424 |
| clostridium difficile tcdc protein binds four-stranded g-quadruplex structures. | clostridium difficile infections are increasing worldwide due to emergence of virulent strains. infections can result in diarrhea and potentially fatal pseudomembranous colitis. the main virulence factors of c. difficile are clostridial toxins tcda and tcdb. transcription of the toxins is positively regulated by the sigma factor tcdr. negative regulation is believed to occur through tcdc, a proposed anti-sigma factor. here, we describe the biochemical properties of tcdc to understand the mechani ... | 2013 | 23303781 |
| five years experience of clostridium difficile infection in children at a uk tertiary hospital: proposed criteria for diagnosis and management. | clostridium difficile infection (cdi) is associated with significant morbidity and mortality in adults. there is increasing evidence of the pathogenic role of c. difficile in the paediatric population. we sought to ascertain the clinical presentation and severity of cdi in children at our institution and develop criteria to aid management. | 2012 | 23300561 |
| all-cause and disease-specific mortality in hospitalized patients with clostridium difficile infection: a multicenter cohort study. | mortality among patients with clostridium difficile infection (cdi) is high. because of high age and multiple underlying diseases, cdi-related mortality is difficult to estimate. we estimated cdi-related mortality in an endemic situation, not influenced by outbreaks and consequently certain patients and c. difficile strains. | 2013 | 23300235 |
| proteomic comparison of historic and recently emerged hypervirulent clostridium difficile strains. | clostridium difficile in recent years has undergone rapid evolution and has emerged as a serious human pathogen. proteomic approaches can improve the understanding of the diversity of this important pathogen, especially in comparing the adaptive ability of different c. difficile strains. in this study, tmt labeling and nanolc-ms/ms driven proteomics were used to investigate the responses of four c. difficile strains to nutrient shift and osmotic shock. we detected 126 and 67 differentially expre ... | 2013 | 23298230 |
| the changing faces of clostridium difficile: a personal reflection of the past 34 years. | late in 1978 my boss gave me a folder with "clostridium difficile (diffikilé)" written on it. inside were a few recent and now classic papers by bartlett, larson and co. it was suggested that this might be an interesting research topic. so began a continuing adventure which has resulted in at least 50 publications from my group. over the years we have made several important contributions to the field. beginning in 1982 we showed that c. difficile was a common cause of community-acquired infectio ... | 2013 | 23296302 |
| clostridium difficile infection and limitations of markers for severity in patients with hematologic malignancy. | to describe characteristics of clostridium difficile infection (cdi) and markers of severe cdi among patients with hematologic malignancies. | 2013 | 23295558 |
| unnecessary antimicrobial use in patients with current or recent clostridium difficile infection. | to determine the fraction of unnecessary antimicrobial use among patients with current and/or recent clostridium difficile infection (cdi). | 2013 | 23295554 |
| mortality and clostridium difficile infection in an australian setting. | to quantify the risk of death associated with clostridium difficile infection, in an australian tertiary hospital. | 2013 | 23294464 |
| prevention of hospital-onset clostridium difficile infection in the new york metropolitan region using a collaborative intervention model. | the incidence, severity, and associated costs of clostridium difficile (c. difficile) infection (cdi) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of c. difficile. this article describes a multifaceted collaborative approach to reduce hospital-onset cdi rates in 35 acute care hospitals in the new york metropolitan region. hospitals participated in a comprehensive cdi reduction intervention and formed interdiscipli ... | 2014 | 23294050 |
| clostridium difficile progress lags other infection-control goals. | | 2013 | 23292259 |
| the c-di-gmp recognition mechanism of the pilz domain of bacterial cellulose synthase subunit a. | in some proteobacteria and firmicutes such as pseudomonas aeruginosa, vibrio cholerae, xanthomonas campestris, and clostridium difficile, cyclic dimeric guanosine monophosphate (c-di-gmp) is known to regulate cellular processes, including motility, biofilm formation, and virulence, as a second messenger. cellulose production in acetobacter xylinum, a model organism of cellulose biosynthesis, also depends on by cellular c-di-gmp level. in cellulose-synthesizing bacteria, a terminal complex locali ... | 2013 | 23291177 |
| [assessment of the usefulness of chromogenic medium for the isolation of clostridium difficile from the gastrointestinal tract of children with diarrhoea]. | clostridium difficile is well known as an important cause of nosocomial infection. laboratory diagnostics have included bacterial culture or more commonly, direct detection of preformed toxin in stool samples using different assays. the aim of this study was to evaluate and compare two selecitve media to isolation of c. difficile from paediatric diarrhoeal stool samples. | 2012 | 23285773 |
| [report: clostridium difficile outbreak at the dr. alejandro del río emergency hospital in santiago, chile]. | | 2012 | 23282496 |
| an economic evaluation of clostridium difficile infection management in an italian hospital environment. | clostridium difficile infection (cdi) accounts for the majority of nosocomial cases of diarrhea, and with recent upsurge of multidrug-resistant strains, morbidity and mortality have increased. data on clinical impact of cdi come mostly from anglo-saxon countries, while in italy only two studies address the issue and no economic data exist on costs of cdi in the in hospital setting. a retrospective cross-sectional study with pharmacoeconomic analysis was performed on the cdi series of the policli ... | 2012 | 23280031 |
| infections following facial composite tissue allotransplantation--single center experience and review of the literature. | we reviewed medical records of all patients (n = 4) who underwent facial composite tissue allotransplantation (fcta) at our center between april 2009 and may 2011; data were censored in june 2012. we searched for fcta publications and reviewed them for infectious complications and prophylaxis strategies. three patients received full and one partial fcta at our institution. two recipients were cytomegalovirus (cmv) donor (d)+/recipient (r)- and two cmv d+/r+. perioperative prophylaxis included va ... | 2013 | 23279299 |
| clostridium difficile infection in travelers--a neglected pathogen? | until recently, clostridium difficile infection (cdi) has been mostly diagnosed in hospitalized elderly patients treated with antibacterial agents. the epidemiology of c difficile is changing as the ribotype 027 strain is spreading worldwide, and more infections are diagnosed in patients residing in the community. although only few data about the epidemiology of cdi in developing countries are available, a number of reports seem to indicate that the incidence of cdi may be high in some such coun ... | 2013 | 23279229 |
| clostridium difficile infection in infants and children. | infections caused by clostridium difficile in hospitalized children are increasing. the recent publication of clinical practice guidelines for c difficile infection in adults did not address issues that are specific to children. the purpose of this policy statement is to provide the pediatrician with updated information and recommendations about c difficile infections affecting pediatric patients. | 2013 | 23277317 |
| [detailed methodological recommendations for the treatment of clostridium difficile-associated diarrhea with faecal transplantation]. | the incidence of clostridium difficile associated enteral disease shows dramatic increase worldwide, with appallingly high treatment costs, mortality figures, recurrence rates and treatment refractoriness. it is not surprising, that there is significant interest in the development and introduction of alternative therapeutic strategies. among these only stool transplantation (or faecal bacteriotherapy) is gaining international acceptance due to its excellent cure rate (≈92%), low recurrence rate ... | 2013 | 23274229 |
| clostridium difficile outcomes difficult to generalize. authors' response. | | 2013 | 25237683 |
| [pseudomembranous colitis: pathogenesis, prevention, treatment]. | the article reviews a pathogenesis of pseudomembranous colitis. questions of prevention and treatment of clostridium difficile--associated diarrhea are shown by the evidence-based medicine. there is an accent on the rational prescription of antibiotics. | 2013 | 24933996 |
| [dynamics of contamination and persistence of clostridium difficile in intestinal microbiota in newborn infants during antibiotic therapy and use of probiotic strain enterococcus faecium l3]. | ninety four infants were observed as inpatients. thirty nine of them were mature neonates and 55 were premature infants with a very low body weight. the majority of the patients were treated with antibiotics. the mature infants were treated with penicillins, aminoglycosides, cephalosporins and the premature neonates were treated in addition with carbapenems, fluoroquinolones, glycopeptides. the mature infants were randomized into 2 groups: the control group (n=18) received the standard therapy a ... | 2013 | 24734423 |
| [the use of two-stage algorithm in the diagnosis of patients with low levels of clostridium difficile toxins a/b in feces confirmed by using enzyme immunoassay]. | clostridium difficile infection (cdi) is a serious problem in hospitalized patients. rapid and accurate laboratory diagnosis is the key to reducing of cdi. the suboptimal sensitivity and specificity of many commercial enzyme immunoassays have limited their utility. the aim of this study was analysis of faecal samples obtained from patients with clinical evidence of cdi, with non-detectable or questionable result of toxins a/b c. difficile recognized by toxins a/b eia test. | 2013 | 24730214 |
| uk renal registry 16th annual report: chapter 15 epidemiology of reported infections amongst patients receiving dialysis for established renal failure in england from may 2011 to april 2012: a joint report from public health england and the uk renal registry. | infection remains one of the leading causes of mortality in established renal failure patients receiving renal replacement therapy (rrt). since 2007, centres providing rrt in england have been asked to provide additional data on patients with methicillin resistant staphylococcus aureus (mrsa) bacteraemia. since 2011, the option to provide data on methicillin sensitive stapylococcus aureus (mssa) and escherichia coli bacteraemia, as well as clostridium difficile infection has also been available. | 2013 | 24662179 |
| a genomic analysis of clostridium difficile infections in blunt trauma patients. | evidence demonstrates that susceptibility to clostridium difficile infection is related to host risk factors as much as bacterial potency. using blood leukocyte genome-wide expression patterns of severe blunt trauma patients obtained by the national institute of general medical sciences-sponsored glue grant inflammation and the host response to injury, we examined leukocyte genomic profiles of patients with c. difficile infection to determine preinfection and postinfection gene expression change ... | 2013 | 23271108 |
| evaluation of the chromogenic agar chromid c. difficile. | three selective media (chromid c. difficile agar, taurocholate cycloserine cefoxitin agar [tcca; homemade], and clo medium) were compared from 406 stool samples of patients suspected of having clostridium difficile infection. the sensitivities of chromid c. difficile agar at 24 h and 48 h, clo medium, and tcca were 74.1%, 87%, 85.2%, and 70.4%, respectively. | 2013 | 23269743 |
| performance of clostridium difficile toxin enzyme immunoassay and nucleic acid amplification tests stratified by patient disease severity. | many clinical laboratories in the united states are transitioning from toxin enzyme immunoassays (eia) to nucleic acid amplification tests (naats) as the primary diagnostic test for clostridium difficile infection (cdi). while it is known that the analytical sensitivity of the toxin eia is poor, there are limited clinical data on the performance of these assays for patients with mild or severe cdi. two hundred ninety-six hospital inpatients with diarrhea and clinical suspicion for cdi were teste ... | 2013 | 23269736 |
| clostridium difficile healthcare-associated epidemics. | | 2013 | 23268129 |
| local injection of dsrna targeting calcitonin receptor-like receptor (clr) ameliorates clostridium difficile toxin a-induced ileitis. | enteritis caused by clostridium difficile toxin (tx) is a nosocomial disease of increasing clinical concern, but the local mediators of c. difficile txa inflammation are unknown. the potent vasodilator calcitonin gene-related peptide mediates neurogenic inflammation via the calcitonin receptor-like receptor (clr). here we examined the ileum-specific effects of reducing clr on txa ileitis by local preinjection of double-stranded rnas. treatment with clr dsrna for 7 d decreased clr immunoreactivit ... | 2013 | 23267070 |
| the membrane as a target for controlling hypervirulent clostridium difficile infections. | the stationary phase of clostridium difficile, which is primarily responsible for diarrhoeal symptoms, is refractory to antibiotic killing. we investigated whether disrupting the functions of the clostridial membrane is an approach to control c. difficile infections by promptly removing growing and non-growing cells. | 2013 | 23264511 |
| risk factors for recurrence of clostridium difficile-associated diarrhoea. | clostridium difficile associated disease (cdad) is one of the most common causes of hospital-acquired diarrhea. despite increasing incidence of clostridium difficile-associated diarrhea, there are few data on risk factors associated with its relapse. | 2013 | 23262313 |
| [successful treatment of life-threatening, treatment resistant clostridium difficile infection associated pseudomembranous colitis with faecal transplantation]. | due to world-wide spread of hypervirulent and antibiotic resistant clostridium difficile strains, the incidence of these infections are dramatically increasing in hungary with appalling mortality and recurrence rates. authors present a case of a 59-year-old patient who developed a severe, relapsing pseudomembranous colitis after antibiotic treatment. life-threatening symptoms of fulminant colitis were successfully treated with prolonged administration of metronidazole and vancomycin, careful sup ... | 2012 | 23261996 |
| clostridium difficile flagellin stimulates toll-like receptor 5, and toxin b promotes flagellin-induced chemokine production via tlr5. | clostridium difficile is an important pathogen in nosocomial infections. although c. difficile toxins are considered to be major virulence factors, pathogenesis of c. difficile associated diseases remains to be determined. in this study, we investigated whether c. difficile flagellin is involved in the pathogenesis of c. difficile-associated diseases. | 2013 | 23261530 |
| [when should request a stool culture?]. | a stool culture needs a medical prescription and is justified only in a case of clearly defined acute diarrhea. the clinical context must be suggestive of a bacterial etiology. the detection of the bacterial agents has to follow a well-defined strategy to optimize a rigorous prescription. standardized stool culture is for patients treated in medical community practice and for patients hospitalized for less than 3 days. clostridium difficile toxin testing is systematically performed in case of no ... | 2013 | 23260762 |
| clostridium difficile 027 infection in central italy. | clostridium difficile (cd) has increasingly become recognised as a significant international health burden, often associated with the healthcare environment. the upsurge in incidence of cd coincided with the emergence of a hypervirulent strain of cd characterized as 027. in 2010, 8 cases of cd 027 infections were identified in italy. since then, no further reports have been published. we describe 10 new cases of cd 027 infection occurring in italy. | 2012 | 23259814 |
| influence of environmental conditions on the expression and the maturation process of the clostridium difficile surface associated protease cwp84. | expression of the clostridium difficile protease gene, cwp84, was moderately up-regulated by decreasing ph due to glucose metabolism. purification under different ph conditions influenced the proteolytic process of cwp84. given this, acidic ph could favor the appearance of different forms of cwp84 that may have different roles during the infection. | 2013 | 23257307 |
| microbial ecosystems therapeutics: a new paradigm in medicine? | increasing evidence indicates that the complex microbial ecosystem of the human intestine plays a critical role in protecting the host against disease. this review discusses gut dysbiosis (here defined as a state of imbalance in the gut microbial ecosystem, including overgrowth of some organisms and loss of others) as the foundation for several diseases, and the applicability of refined microbial ecosystem replacement therapies as a future treatment modality. consistent with the concept of a 'co ... | 2013 | 23257018 |
| which are the antibodies to watch in 2013? | the start of the new year signals that it is time for mabs' annual review of the therapeutic monoclonal antibodies (mabs) in active phase 2/3 or phase 3 clinical studies. the entire clinical pipeline currently includes ~350 mabs, but most of these are in early development. as of the beginning of 2013, our "antibodies to watch" list includes 28 single mabs and one mab mixture that are undergoing evaluation in phase 3 studies for inflammatory or immunological disorders, cancers, high cholesterol, ... | 2016 | 23254906 |
| epidemiology, diagnosis and treatment of clostridium difficile infection. | clostridium difficile infection (cdi) is considered to be the main cause of bacterial infectious diarrhea in nosocomial settings. since the beginning of the new century a continuous rise in the incidence of severe cdi has been observed worldwide. even though some cdi cases are not associated with previous antibiotic exposure, this remains as the principal risk factor for the development of cdi. the rate of recurrences represents perhaps one the most challenging aspect on the management of cdi. t ... | 2012 | 23253319 |
| [acute infectious diarrhea in adults: epidemiology and management]. | acute diarrhea is defined as an abnormally frequent discharge of semisolid or fluid fecal matter from the bowel, lasting less than 14 days. more than three millions cases of acute diarrhea, presumably due to intestinal infections, are seen in general practice every year in france. most of the cases are benign and resolve under symptomatic treatment within 3 days, without need for biological tests or antibiotics. in special contexts (septicemic syndrome, visible blood in stools, severe dehydratio ... | 2013 | 23253255 |
| surveillance for clostridium difficile infection in nursing homes. | to define the time of onset of clostridium difficile infection (cdi) in the community nursing home setting. | 2013 | 23253029 |
| letter: clostridium difficile colitis in patients with ulcerative colitis. | | 2013 | 23252787 |
| a cohort study for derivation and validation of a clinical prediction scale for hospital-onset clostridium difficile infection. | to develop and validate a clinical prediction scale for hospital-onset clostridium difficile infection (cdi). | 2012 | 23248788 |
| infection: understanding how clostridium difficile infection in health-care settings spread around the world. | | 2013 | 23247509 |
| a systematic evaluation of methods to optimize culture-based recovery of clostridium difficile from stool specimens. | with the increasing prevalence of clostridium difficile infection among hospitalized patients, a clear understanding of c. difficile epidemiology is needed to evaluate current prevention policies, and to create new and effective policies. to determine the epidemiology of c. difficile, the most sensitive methods for detection of c. difficile are required. the purpose of this study was to systematically assess multiple methods to determine the most sensitive method to recover c. difficile from sto ... | 2013 | 23247066 |
| recent trends in the epidemiology and treatment of c. difficile infection in children. | clostridium difficile is the most common cause of healthcare-associated diarrhea among adults in western countries, and is increasingly recognized as an important pathogen in children. this review provides an update on the changing epidemiology of c. difficile infection (cdi) for pediatric providers and summarizes current knowledge regarding available therapies. | 2013 | 23241874 |
| using a dog's superior olfactory sensitivity to identify clostridium difficile in stools and patients: proof of principle study. | to investigate whether a dog's superior olfactory sensitivity can be used to detect clostridium difficile in stool samples and hospital patients. | 2012 | 23241268 |
| cd44 promotes intoxication by the clostridial iota-family toxins. | various pathogenic clostridia produce binary protein toxins associated with enteric diseases of humans and animals. separate binding/translocation (b) components bind to a protein receptor on the cell surface, assemble with enzymatic (a) component(s), and mediate endocytosis of the toxin complex. ultimately there is translocation of a component(s) from acidified endosomes into the cytosol, leading to destruction of the actin cytoskeleton. our results revealed that cd44, a multifunctional surface ... | 2012 | 23236484 |
| association between proton pump inhibitor therapy and clostridium difficile infection: a contemporary systematic review and meta-analysis. | emerging epidemiological evidence suggests that proton pump inhibitor (ppi) acid-suppression therapy is associated with an increased risk of clostridium difficile infection (cdi). | 2012 | 23236397 |
| characterisation of clostridium difficile biofilm formation, a role for spo0a. | clostridium difficile is a gram-positive anaerobic, spore-forming bacillus that is the leading cause of nosocomial diarrhoea worldwide. we demonstrate that c. difficile aggregates and forms biofilms in vitro on abiotic surfaces. these polymicrobial aggregates are attached to each other and to an abiotic surface by an extracellular polymeric substance (eps). the eps matrix provides the scaffold bonding together vegetative cells and spores, as well as forming a protective barrier for vegetative ce ... | 2012 | 23236376 |
| concomitant clostridium difficile colitis and cytomegalovirus colitis in an immunocompetent elderly female. | a 78-year-old japanese woman with diarrhoea and abdominal pain was admitted for pcr test (pcr)-proven clostridium difficile colitis. the patient's symptoms persisted despite multiple courses of antibiotics including intravenous metronidazole, oral vancomycin and oral fidaxomicin. she underwent a stool transplant without improvement. biopsies from a colonoscopy revealed concomitant cytomegalovirus (cmv) infection. the patient was immediately started on intravenous ganciclovir. unfortunately, she ... | 2012 | 23234822 |
| fidaxomicin in the treatment of clostridium difficile-associated diarrhoea. | | 2013 | 23233241 |
| nosocomial infections in leukemic and solid-tumor cancer patients: distribution, outcome and microbial spectrum of anaerobes. | nosocomial infections cause significant morbidity and mortality in cancer patients. as a result of their debilitated immune system, cancer patients are likely candidates for colonization with anaerobes. we sought to compare the distribution of nosocomial infections in neutropenic and non-neutropenic cancer patients and to calculate the associated mortality rates. | 2012 | 23231490 |
| [why should antibiotic therapy be avoided in case of acute infectious diarrhea?]. | antibiotic prescription for acute diarrhea is not devoid of risks. there are individual risks for the patient, such as allergy, gastrointestinal side effects, clostridium difficile infection. there is also a risk of selection of antibiotic resistance in the digestive microbiota, leading to the emergence of multiresistant isolates such as extended-spectrum β-lactamase or carbapenemase producing enterobacteriaceae, which are able to disseminate worldwide. antibiotic prescriptions may thus be limit ... | 2013 | 23228474 |
| physician attitudes toward the use of fecal transplantation for recurrent clostridium difficile infection in a metropolitan area. | | 2013 | 23223589 |
| emergence and global spread of epidemic healthcare-associated clostridium difficile. | epidemic c. difficile (027/bi/nap1) has rapidly emerged in the past decade as the leading cause of antibiotic-associated diarrhea worldwide. however, the key events in evolutionary history leading to its emergence and the subsequent patterns of global spread remain unknown. here, we define the global population structure of c. difficile 027/bi/nap1 using whole-genome sequencing and phylogenetic analysis. we show that two distinct epidemic lineages, fqr1 and fqr2, not one as previously thought, e ... | 2013 | 23222960 |
| proline-dependent regulation of clostridium difficile stickland metabolism. | clostridium difficile, a proteolytic gram-positive anaerobe, has emerged as a significant nosocomial pathogen. stickland fermentation reactions are thought to be important for growth of c. difficile and appear to influence toxin production. in stickland reactions, pairs of amino acids donate and accept electrons, generating atp and reducing power in the process. reduction of the electron acceptors proline and glycine requires the d-proline reductase (pr) and the glycine reductase (gr) enzyme com ... | 2013 | 23222730 |
| clostridium difficile toxin a inhibits erythropoietin receptor-mediated colonocyte focal adhesion through inactivation of janus kinase-2. | previously, we demonstrated that the erythropoietin receptor (epor) is present on fibroblasts, where it regulates focal contact. here, we assessed whether this action of epor is involved in the reduced cell adhesion observed in colonocytes exposed to clostridium difficile toxin a. epor was present and functionally active in cells of the human colonic epithelial cell line ht29 and epithelial cells of human colon tissues. toxin a significantly decreased activating phosphorylations of epor and its ... | 2012 | 23221524 |
| proton pump inhibitor use may be associated with an increased risk of clostridium difficile infection. | | 2013 | 23220471 |
| [acute clostridium difficile gastroenteritis at the department of infectious diseases]. | clostridium difficile infection is known as the primary cause of nosocomial gastroenteritis, which accounts for approximately 20-25% of all diarrhea. infection can lead to a potentially fatal disease and the incidence of that is increasing worldwide. | 2012 | 23220365 |
| changing epidemiology of clostridium difficile-associated disease during stem cell transplantation. | the incidence and severity of clostridium difficile-associated disease (cdad) within the general population has risen dramatically over the past decade, yet little data are available from hematopoietic stem cell transplantation (hsct) centers. in the present study, we performed a chart review of 822 consecutive autologous and allogeneic hcst recipients treated at northwestern memorial hospital between 2004 and 2008 to determine the incidence of cdad at our institution. variables including age, s ... | 2013 | 23219779 |
| implementation of hospital-wide enhanced terminal cleaning of targeted patient rooms and its impact on endemic clostridium difficile infection rates. | implementation of a hospital-wide program of terminal cleaning of patient rooms revolving around hydrogen peroxide vapor (hpv) technology and evaluation of its impact on endemic nosocomial clostridium difficile-associated diarrhea (cdad) have not been previously reported. | 2013 | 23219675 |
| patient-days used for isolation in a community hospital. | isolation of patients with known or suspected infection strains the resources of hospitals, but little information exists on the actual utilization of isolation beds. | 2013 | 23219671 |
| characteristics of patients with clostridium difficile infection in taiwan. | the medical records of 84 patients with stool cultures positive for clostridium difficile during the period august 2007 to june 2009 were retrospectively reviewed. a case of confirmed (toxigenic)c. difficile infection (cdi) was defined by the presence of symptoms (fever, diarrhoea, abdominal discomfort or distension, ileus) and the presence of toxigenic c. difficile. patients with compatible clinical symptoms and stool cultures positive for non-toxigenic c. difficile isolates were defined as pro ... | 2013 | 23218131 |
| kefir-isolated lactococcus lactis subsp. lactis inhibits the cytotoxic effect of clostridium difficile in vitro. | kefir is a dairy product obtained by fermentation of milk with a complex microbial population and several health-promoting properties have been attributed to its consumption. in this work, we tested the ability of different kefir-isolated bacterial and yeast strains (lactobacillus kefir, lb. plantarum, lactococcus lactis subps. lactis, saccharomyces cerevisiae and kluyveromyces marxianus) or a mixture of them (mm) to antagonise the cytopathic effect of toxins from clostridium difficile (tcda and ... | 2013 | 23217732 |
| adenosine a2a receptor activation reduces recurrence and mortality from clostridium difficile infection in mice following vancomycin treatment. | activation of the a2a adenosine receptor (a2aar) decreases production of inflammatory cytokines, prevents c. difficile toxin a-induced enteritis and, in combination with antibiotics, increases survival from sepsis in mice. we investigated whether a2aar activation improves and a2aar deletion worsens outcomes in a murine model of c. difficile (strain vpi10463) infection (cdi). | 2012 | 23217055 |
| internal delorme's procedure for rectal outlet obstruction. | the outcome of the internal delorme's procedure (idp) for obstructed defaecation was assessed. | 2013 | 23216880 |
| development of clostridium difficile colitis in peritoneal dialysis patients treated for peritonitis. | | 2015 | 23212865 |
| urinary tract infection in male veterans: treatment patterns and outcomes. | lengthier antimicrobial therapy is associated with increased costs, antimicrobial resistance, and adverse drug events. therefore, establishing minimum effective antimicrobial treatment durations is an important public health goal. the optimal treatment duration and current treatment patterns for urinary tract infection (uti) in men are unknown. we used veterans affairs administrative data to study male uti treatment and outcomes. | 2013 | 23212273 |
| colonoscopic fecal microbiota transplant for recurrent clostridium difficile infection in a child. | | 2012 | 23211865 |
| simultaneous detection of viral and bacterial enteric pathogens using the seeplex® diarrhea ace detection system. | a panel of 223 faecal samples was analysed to determine the clinical utility of the seeplex® diarrhea ace detection multiplex pcr system (seeplex system; seegene, korea), a qualitative multiplexing pcr technology that enables simultaneous multi-pathogen detection of four viruses and/or ten bacteria associated with acute gastroenteritis. conventional diagnostic methods and a norovirus-specific multiplex real-time rt–pcr detected 98 pathogens in 96 samples. the seeplex system detected 81 pathogens ... | 2013 | 23211606 |
| [recommendations for diagnosis and therapy of colitis caused by clostridium difficile]. | clostridium difficile infection (cdi) is a disease of varying severity. its manifestations range from mild diarrhea to life-threatening paralytic ileus, painful distension of the large bowel and sepsis. another possible manifestation of the disease is recurrent colitis that can exhaust the patient. for establishing the diagnosis, the patient's stool should be examined with two or three different microbiological methods. immunochemical testing for the presence of clostridial toxins a and b shows ... | 2012 | 23208871 |
| fidaxomicin inhibits toxin production in clostridium difficile. | fidaxomicin, which was recently approved for the treatment of clostridium difficile-associated diarrhoea, demonstrates narrow-spectrum bactericidal activity via inhibition of rna polymerase. in this study we evaluated its inhibitory activity versus c. difficile toxin gene expression and toxin production by quantifying toxin mrna and protein. | 2013 | 23208832 |
| important clinical advances in the understanding of clostridium difficile infection. | clostridium difficile remains an important cause of infectious colitis, particularly in healthcare facilities. this review summarizes recent advances in the epidemiology, diagnosis, and treatment of this endemic pathogen. | 2013 | 23207596 |
| [preliminary investigation of intestinal microflora in patients with hepatic cirrhosis]. | to examine the differential levels of fecal bifidobacterium, bacteroides, eubacterium rectale-clostridium, escherichia coli, enterococcus, and clostridium difficile between patients with hepatic cirrhosis and healthy controls. fecal samples were collected from 29 patients with hepatic cirrhosis treated in the department of digestive diseases at zunyi hospital between march and december of 2010. | 2012 | 23206299 |
| immunisation of mares with binding domains of toxins a and b of clostridium difficile elicits serum and colostral antibodies that block toxin binding. | enterocolitis caused by clostridium difficile (c. difficile) is a serious, sometimes fatal, disease of neonatal foals and older horses. toxins a and b (tcda and b) produced by c. difficile are important virulence factors. immunisation of mares with receptor binding domains of toxins may prevent or reduce the severity of c. difficile colitis in foals. | 2013 | 23206274 |
| recombinational switching of the clostridium difficile s-layer and a novel glycosylation gene cluster revealed by large-scale whole-genome sequencing. | clostridium difficile is a major cause of nosocomial diarrhea, with 30-day mortality reaching 30%. the cell surface comprises a paracrystalline proteinaceous s-layer encoded by the slpa gene within the cell wall protein (cwp) gene cluster. our purpose was to understand the diversity and evolution of slpa and nearby genes also encoding immunodominant cell surface antigens. | 2013 | 23204167 |
| reduction in clostridium difficile infections in finland, 2008-2010. | in january 2008, laboratory-based surveillance of clostridium difficile was initiated as a part of the finnish national infectious disease register (nidr) and enhanced surveillance of hospitalized patients with c. difficile-associated infections (cdi) by the finnish hospital infection programme (siro). | 2013 | 23201398 |
| comparison of two selective media for the recovery of clostridium difficile from environmental surfaces. | two culture media were compared for their ability to isolate clostridium difficile from environmental sites within a uk hospital. the media were cefoxitin-cycloserine-egg yolk agar plus lysozyme (ccey/l) and chromid c. difficile. a wide range of environmental surfaces was sampled using sterile sponges (polywipes) and these were inoculated on to both media. c. difficile was recovered from 105 of 496 sites (21%) using a combination of both media. the sensitivity of chromid c. difficile was 87.6% c ... | 2013 | 23201396 |
| laboratory tests for diagnosis of clostridium difficile infection: past, present, and future. | | 2013 | 23200729 |
| understanding factors that impact on public and patient's risk perceptions and responses toward clostridium difficile and other health care-associated infections: a structured literature review. | clostridium difficile is the most common health care-associated infection and a major cause of death and increased morbidity. it is vital that patients and the public are provided with the right information and communication to assist them to understand their role in preventative measures. successful implementation of communication and management strategies hinges on individuals' risk perceptions. | 2013 | 23199700 |
| renal impairment after high-dose flucloxacillin and single-dose gentamicin prophylaxis in patients undergoing elective hip and knee replacement. | following advice from the scottish antimicrobial prescribing group, we switched our antibiotic prophylaxis for elective hip and knee replacement surgery from cefuroxime to flucloxacillin with single-dose gentamicin in order to reduce the incidence of clostridium difficile associated diarrhoea (cdad). a clinical impression that more patients subsequently developed acute kidney injury (aki) led us to examine this possibility in more detail. | 2013 | 23197677 |
| neutropenic enterocolitis, a growing concern in the era of widespread use of aggressive chemotherapy. | neutropenic enterocolitis (nec) is a life-threatening disease with substantial morbidity and mortality, seen primarily in patients with hematologic malignancies. the frequency of nec has increased with the widespread use of chemotherapeutic agents such as the taxanes, which cause severe gastrointestinal mucositis. neutropenic patients with fever and abdominal symptoms (cramping, pain, distention, diarrhea, gi bleeding), should undergo evaluation of the abdomen for bowel wall thickening of >4 mm, ... | 2013 | 23196957 |
| virulence and clinical outcomes in clostridium difficile infection: a complex business. | | 2013 | 23196956 |
| retrospective analysis of fluoroquinolone prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation. | patients undergoing allogeneic hematopoietic stem cell transplant are at a high risk for infection-related mortality in the immediate post-transplantation phase. prophylaxis with a fluoroquinolone is now recommended to reduce this risk with the stipulation that surveillance for increased fluoroquinolone resistance clostridium difficile associated diarrhea be conducted. | 2013 | 23184539 |
| effect of biotherapeutics on antitoxin igg in experimentally induced clostridium difficile infection. | recurrent diarrhoea after successful treatment of primary clostridium difficile associated disease (cdad) occurs due to bowel flora alterations and failure to mount an effective antibody response. apart from antibiotics, risk factors include immunosuppressive and acid-suppressive drug administration. biotherapeutics such as probiotic and epidermal growth factor (egf) may offer potential effective therapy for cdad. | 2012 | 23183468 |
| fecal microbiome transplantation for recurrent clostridium difficile infection: report on a case series. | clostridium difficile infection (cdi) continues to increase in incidence and severity, and was the most common nosocomial infection in the usa in 2010. most cases of cdi respond to a standard course of antibiotics, but recurrent c. difficile infection (rcdi) has become increasingly frequent, and alternative treatments are needed. we examined the efficacy of fecal microbiota transplantation (fmt) instilled into the upper gastrointestinal tract for rcdi. | 2013 | 23182843 |