| preventing clostridium difficile infection in the intensive care unit. | clostridium difficile is a formidable problem in the twenty-first century. because of injudicious use of antibiotics, the emergence of the hypervirulent epidemic strain of this organism has been difficult to contain. the nap1/bi/027 strain causes more-severe disease than other widely prevalent strains and affects patients who were not traditionally thought to be at risk for clostridium difficile infection. critically ill patients remain at high risk for this pathogen, and preventive measures, su ... | 2013 | 23182524 |
| real-time polymerase chain reaction method for detection of toxigenic clostridium difficile from stools and presumptive identification of nap1 clone. | this study describes the development of a cost-effective, multiplex real-time polymerase chain reaction (rtpcr) method for detection of toxigenic clostridium difficile from stools and presumptive identification of the nap-1 strain. the diagnostic value of the new method is for the detection of toxigenic c. difficile which has the following performance characteristics: 99.8% specificity, 95.1% sensitivity, 97.5% positive predictive value, and 99.5% negative predictive value. examination of 24 spe ... | 2013 | 23182075 |
| lymphopenia as a novel marker of clostridium difficile infection recurrence. | treatment of clostridium difficile infection (cdi) is often limited by recurrence in 25% of cases. the objective of this study was to determine risk factors of cdi recurrence during a provincial endemic. | 2013 | 23178420 |
| clinical audit: recent practice in caring for patients with acute severe colitis compared with published guidelines--is there a problem? | acute severe colitis (asc) is a serious condition with possible outcomes of emergency colectomy and mortality. validated guidelines exist to help avoid these. | 2013 | 23176535 |
| multiple factors modulate biofilm formation by the anaerobic pathogen clostridium difficile. | bacteria within biofilms are protected from multiple stresses, including immune responses and antimicrobial agents. the biofilm-forming ability of bacterial pathogens has been associated with increased antibiotic resistance and chronic recurrent infections. although biofilms have been well studied for several gut pathogens, little is known about biofilm formation by anaerobic gut species. the obligate anaerobe clostridium difficile causes c. difficile infection (cdi), a major health care-associa ... | 2013 | 23175653 |
| development and evaluation of a novel, semiautomated clostridium difficile typing platform. | we describe a novel, semiautomated clostridium difficile typing platform that is based on pcr-ribotyping in conjunction with a semiautomated molecular typing system. the platform is reproducible with minimal intra- or interassay variability. this method exhibited a discriminatory index of 0.954 and is therefore comparable to more arduous typing systems, such as pulsed-field gel electrophoresis. | 2013 | 23175261 |
| epidemiology, risk factors, and outcomes of clostridium difficile infection in kidney transplant recipients. | we sought to describe the epidemiology and risk factors for clostridium difficile infection (cdi) among kidney transplant recipients (ktr) between 1 january 2008 and 31 december 2010. | 2013 | 23173772 |
| clostridium difficile isolated from the fecal contents of swine in japan. | a total of 250 fecal content samples were collected from 25 farrow-to-finish pig farms and examined for the prevalence of clostridium difficile by using ethanol treatment followed by plating onto selective media--cycloserine-cefoxitin-mannitol agar--for the isolation of clostridium difficile. two specimens (0.8%, 95% confidential interval: 0-2.9%) were positive for c. difficile. one isolate was only positive for toxin b, and the other isolate was negative for both toxins a and b. thus, prevalenc ... | 2013 | 23171688 |
| probiotics prevent clostridium difficile in people taking antibiotics. | | 2012 | 23169808 |
| an unusual method of diagnosing a common disease. | a 34-year-old woman presented with non-bloody diarrhoea of 14 days duration and vomiting. physical examination was unremarkable. she had hypokalaemia and metabolic acidosis. stool studies were negative for clostridium difficile toxin, faecal leucocytes and parasites. colon appeared normal on colonoscopy. pronounced scalloping of ileal folds was noted on ileoscopy. ileal biopsies revealed villous blunting, crypt hyperplasia, marked intraepithelial lymphocytosis and lymphocytic infiltration of the ... | 2012 | 23166167 |
| significance of proton pump inhibitor types for clostridium difficile infection. | | 2013 | 23164689 |
| relationship of symptom duration and fecal bacteriotherapy in clostridium difficile infection-pooled data analysis and a systematic review. | clostridium difficle-associated infection (cdi) is usually treated with antibiotics; nevertheless, the infection has a high relapse rate. case series and case reports using fecal microbiota transplant (fmt) for cdi show promising results. however, there are no large studies to provide evidence for the efficacy of this therapy. the aim of this pooled patient data meta-analysis was to determine the efficacy of fmt in cdi. | 2013 | 23163886 |
| isolation of clostridium difficile from peritoneal fluid. | | 2012 | 23163311 |
| current and emerging management options for clostridium difficile infection: what is the role of fidaxomicin? | until recently, treatment of clostridium difficile infection (cdi) was mainly limited to oral metronidazole and vancomycin, neither of which is optimal. up to 25% of patients with cdi experience recurrence of infection within 30 days following treatment with these agents, while c. 45-65% of these patients experience further (and sometimes multiple) recurrences. recurrent cdi represents a major treatment challenge for which new therapeutic options are sorely needed. fidaxomicin is a first-in-clas ... | 2012 | 23121552 |
| can we identify patients at high risk of recurrent clostridium difficile infection? | although most patients with clostridium difficile infection (cdi) can be managed effectively with discontinuation of prescribed antibiotics and additional treatment with oral metronidazole or vancomycin, up to 25% experience disease recurrence, usually within 30 days of treatment. failure to mount a systemic anti-toxin antibody response differentiates patients with cdi and recurrent cdi from symptomless carriers of toxinogenic c. difficile. the immunological senescence that accompanies ageing ma ... | 2012 | 23121551 |
| overcoming barriers to effective recognition and diagnosis of clostridium difficile infection. | with the frequency of cases of clostridium difficile infection (cdi) increasing in many developed countries, accurate and reliable laboratory diagnosis of cdi is more important than ever. however, the diagnosis of cdi has been handicapped by the existence of two reference standards, one of which detects c. difficile toxin (cytotoxin assay) and the other only toxigenic strains (cytotoxigenic culture). being relatively slow and laborious to perform, these reference methods were largely abandoned a ... | 2012 | 23121550 |
| consequences of clostridium difficile infection: understanding the healthcare burden. | clostridium difficile is the leading cause of infectious nosocomial diarrhoea in developed countries, with a measured incidence of approximately five episodes per 10,000 days of hospital stay in europe. accurate diagnosis of c. difficile infection (cdi) is a prerequisite for obtaining reliable epidemiological data, but in many european countries diagnosis is probably suboptimal. a significant percentage of cdi cases are missed because clinicians often fail to request tests for c. difficile toxin ... | 2012 | 23121549 |
| breaking the cycle of recurrent clostridium difficile infections. | | 2012 | 23121548 |
| time to act against clostridium difficile infection. | | 2012 | 23121547 |
| [infection frequency in patients with chronic idiopathic ulcerative colitis]. | ulcerative colitis (uc) is a chronic inflammatory bowel disease characterized by diffuse inflammation of the mucosa of the colon. up to now, diverse observational studies have implicated a wide variety of pathogenic microorganisms as causal and exacerbating factors in uc. clostridium difficile (c. difficile) infection has been associated with recurrence and treatment failure and its incidence in patients with uc has been on the rise in the last few years. | 2012 | 23159238 |
| ribotyping in the detection of clostridium difficile outbreaks in a single university hospital. | clostridium difficile infection (cdi) is the most important bacterial cause of hospital-acquired diarrhoea. although reports of deaths associated with cdi have been decreasing since a peak in 2007 in england and northern ireland, it remains a major cause of morbidity and mortality. the health protection agency's clostridium difficile ribotyping network (cdrn) aims to provide information to help optimize the management of cases of cdi. this study assesses the value of ribotyping to detect outbrea ... | 2013 | 23158685 |
| fidaxomicin for the treatment of clostridium difficile infections. | clostridium difficile infection (cdi), also known as c. difficile-associated disease or diarrhoea (cdad), is an important cause of hospital-acquired diarrhoea with disease severity ranging from mild diarrhoea to fulminant colitis. in addition, over 40% of new cases of cdi occur outside hospital. ▾ fidaxomicin (dificlir - astellas), the first antibiotic in a new class called macrocyclics, has recently been licensed for the treatment of c. difficile infection in adults. here we provide a brief ove ... | 2012 | 23154594 |
| [clostridium difficile: is it time to start worrying?]. | | 2012 | 23153414 |
| safety and efficacy of fidaxomicin in the treatment of clostridium difficile-associated diarrhea. | clostridium difficile-associated diarrhea (cdad) is the most common cause of healthcare-associated diarrhea. the current recommended treatment regimens of metronidazole and vancomycin have not changed in nearly 25 years. fidaxomicin, an exceedingly narrow spectrum macrolide antibiotic, was recently approved for the treatment of cdad. in phase iii clinical trials, fidaxomicin was noninferior to vancomycin in achieving clinical cure of cdad. furthermore, fidaxomicin was associated with fewer recur ... | 2012 | 23152733 |
| antimicrobial susceptibility and resistance mechanisms of clinical clostridium difficile from a chinese tertiary hospital. | clostridium difficile is a predominant cause of antibiotic-associated diarrhoea. it is increasingly difficult to treat c. difficile infection efficiently owing to its multidrug resistance. in the present study, 60 clinical c. difficile isolates were collected and analysed for their genotype, antimicrobial susceptibility and resistance mechanisms. tandem repeat sequence typing (trst) generated 21 types, including the epidemic clone tr017. antimicrobial susceptibility testing of eight antibiotics ... | 2013 | 23148985 |
| vancomycin treatment's association with delayed intestinal tissue injury, clostridial overgrowth, and recurrence of clostridium difficile infection in mice. | antibiotic treatment, including vancomycin, for clostridium difficile infection (cdi) has been associated with recurrence of disease in up to 25% of infected persons. this study investigated the effects of vancomycin on the clinical outcomes, intestinal histopathology, and anaerobic community during and after treatment in a murine model of cdi. c57bl/6 mice were challenged with c. difficile strain vpi 10463 after pretreatment with an antibiotic cocktail. twenty-four hours after infection, mice w ... | 2013 | 23147742 |
| both fidaxomicin and vancomycin inhibit outgrowth of clostridium difficile spores. | fidaxomicin (fdx) is approved to treat clostridium difficile-associated diarrhea and is superior to vancomycin in providing a sustained clinical response (cure without recurrence in the subsequent 25 days). the mechanism(s) behind the low recurrence rate of fdx-treated patients could be multifactorial. here, we tested effects of fdx, its metabolite op-1118, and vancomycin on spore germination and determined that none affected the initiation of spore germination but all inhibited outgrowth of veg ... | 2013 | 23147724 |
| protective antibody responses against clostridium difficile elicited by a dna vaccine expressing the enzymatic domain of toxin b. | a dna vaccination approach was used in the current study to screen for the immunogenicity of different fragments of toxin a and toxin b from clostridium difficile. with this approach, protein antigens do not need to be produced in vitro and the immunogenicity of candidate c. difficile antigens can be identified directly in animals. codon optimized toxin gene fragments were individually cloned into the dna vaccine vector and tested in mice and rabbits for their ability to elicit c. difficile toxi ... | 2013 | 23143772 |
| efficacy of different cleaning and disinfection methods against clostridium difficile spores: importance of physical removal versus sporicidal inactivation. | we tested the effectiveness of disinfectants and wipe methods against clostridium difficile spores. wiping with nonsporicidal agents (physical removal) was effective in removing more than 2.9 log(10) c. difficile spores. wiping with sporicidal agents eliminated more than 3.90 log(10) c. difficile spores (physical removal and/or inactivation). spraying with a sporicide eliminated more than 3.44 log(10) c. difficile spores but would not remove debris. | 2012 | 23143366 |
| effective antimicrobial stewardship in a long-term care facility through an infectious disease consultation service: keeping a lid on antibiotic use. | we introduced a long-term care facility (ltcf) infectious disease (id) consultation service (lid service) that provides on-site consultations to residents of a veterans affairs (va) ltcf. we determined the impact of the lid service on antimicrobial use and clostridium difficile infections at the ltcf. | 2012 | 23143354 |
| colectomy in intensive care patients: operative findings and outcomes. | with a critical illness, intestinal complications are associated with high morbidity and mortality. | 2013 | 23142989 |
| a prospective study to examine the epidemiology of methicillin-resistant staphylococcus aureus and clostridium difficile contamination in the general environment of three community hospitals in southern ontario, canada. | the hospital environment has been suggested as playing an important role in the transmission of hospital-associated (ha) pathogens. however, studies investigating the contamination of the hospital environment with methicillin-resistant staphylococcus aureus (mrsa) or clostridium difficile have generally focused on point prevalence studies of only a single pathogen. research evaluating the roles of these two pathogens, concurrently, in the general hospital environment has not been conducted. the ... | 2012 | 23136936 |
| quantitative fecal lactoferrin in toxin-positive and toxin-negative clostridium difficile specimens. | quantitative fecal lactoferrin was measured in 112 patients tested for toxigenic clostridium difficile using glutamate dehydrogenase (gdh) and toxin immunoassays combined with tcdb pcr. lactoferrin levels were higher in the gdh-positive/toxin-positive group (79 μg/ml) than in the gdh-positive/toxin-negative/pcr-positive (21 μg/ml) and the gdh-negative groups (13 μg/ml). differences in fecal lactoferrin levels suggest variable presence or severity of c. difficile infection among toxin-positive an ... | 2013 | 23135940 |
| the surgical management of active ulcerative colitis complicated by clostridium difficile infection. | clostridium difficile stool toxin is detected in 5-20 % of patients with acute exacerbations of ulcerative colitis (uc). there is little data regarding the safety of surgery for uc with concurrent c. difficile. | 2013 | 23135837 |
| targeted restoration of the intestinal microbiota with a simple, defined bacteriotherapy resolves relapsing clostridium difficile disease in mice. | relapsing c. difficile disease in humans is linked to a pathological imbalance within the intestinal microbiota, termed dysbiosis, which remains poorly understood. we show that mice infected with epidemic c. difficile (genotype 027/bi) develop highly contagious, chronic intestinal disease and persistent dysbiosis characterized by a distinct, simplified microbiota containing opportunistic pathogens and altered metabolite production. chronic c. difficile 027/bi infection was refractory to vancomyc ... | 2012 | 23133377 |
| evaluation of commercial kits for extraction of dna and rna from clostridium difficile. | commercial nucleic acid extraction kits are a cost effective, efficient and convenient way to isolate dna and rna from bacteria. despite the increasing importance of the gastrointestinal pathogen, clostridium difficile, and the increased use of nucleic acids in its identification, characterization, and investigation of virulence factors, no standardized or recommended methods for nucleic acid isolation exist. here, we sought to evaluate 4 commercial dna extraction kits and 3 commercial rna extra ... | 2012 | 23128271 |
| clostridium difficile infection: new insights into management. | clostridium difficile was first described as a cause of diarrhea in 1978 and is now among the leading 3 hospital-acquired infections in the united states, along with methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococci. in the past 2 decades, there has been an increase in the incidence, severity, and recurrence rates of c difficile infection, all of which are associated with poor outcomes. in addition, several novel risk factors and newer treatment methods are emergin ... | 2012 | 23127735 |
| clostridium difficile infection in patients with chronic kidney disease. | to examine the rate of clostridium difficile infection (cdi) and hospital-associated outcomes in a national cohort of hospitalized patients with chronic kidney disease (ckd) and assess the impact of long-term dialysis on outcome in these patients. | 2012 | 23127731 |
| clostridium difficile: the emerging epidemic. | | 2012 | 23127729 |
| outcome of icu patients with clostridium difficile infection. | as data from clostridium difficile infection (cdi) in intensive care unit (icu) are still scarce, our objectives were to assess the morbidity and mortality of icu-acquired cdi. | 2012 | 23127327 |
| antibody against tcdb, but not tcda, prevents development of gastrointestinal and systemic clostridium difficile disease. | a dramatic increase in morbidity and mortality from clostridium difficile infection (cdi) due to the recent emergence of virulent, antibiotic-resistant strains has led to a search for alternatives to antibiotics, including vaccines and immune-based therapy that target the 2 key toxins-tcda and tcdb. | 2013 | 23125448 |
| fecal microbiota transplantation for fulminant clostridium difficile infection in an allogeneic stem cell transplant patient. | we present a case of severe clostridium difficile infection (cdi) in a non-neutropenic allogeneic hematopoietic stem cell transplant recipient who was treated successfully with fecal microbiota therapy after standard pharmacologic therapy had failed. following naso-jejunal instillation of donor stool, the patient's symptoms resolved within 48 h. bowel resection was averted. this is the first case in the literature, to our knowledge, to describe fecal microbiota therapy in a profoundly immunocomp ... | 2012 | 23121625 |
| faecal microbiota transplantation for severe clostridium difficile infection in the intensive care unit. | we describe a case of faecal microbiota transplantation (fmt) used for severe binary toxin-positive clostridium difficile infection in an intensive care setting. the patient was admitted to the icu of a tertiary hospital and failed traditional maximal pharmacological management. adjunctive therapy with fmt given through gastroscopy resulted in resolution of the c. difficile-related symptoms. although there is a growing experience with fmt for recurrent c. difficile infection, published evidence ... | 2013 | 23117471 |
| community-acquired clostridium difficile nap1/027-associated diarrhea in an eighteen month old child. | clostridium difficile infection (cdi), characterized by symptoms varying from diarrhea to life-threatening colitis, is a major complication of antibiotic therapy. studies suggested that cdi is emerging as an important cause of childhood diarrhea in community and hospital settings. this work is the first report of a documented case of community-acquired cdi by a nap1 hypervirulent strain in an eighteen month old child from latin america. | 2012 | 23116882 |
| increased susceptibility of melanin-concentrating hormone-deficient mice to infection with salmonella enterica serovar typhimurium. | melanin-concentrating hormone (mch) was initially identified in mammals as a hypothalamic neuropeptide regulating appetite and energy balance. however, the wide distribution of mch receptors in peripheral tissues suggests additional functions for mch which remain largely unknown. we have previously reported that mice lacking mch develop attenuated intestinal inflammation when exposed to clostridium difficile toxin a. to further characterize the role of mch in host defense mechanisms against inte ... | 2013 | 23115043 |
| [current data and trends on the development of antibiotic resistance of clostridium difficile]. | clostridium difficile is the most common pathogen causing antibiotic-associated diarrhea. antibiotic therapy also favors the development and the epidemic spreading of multiresistant strains. in this present retrospective study clinical isolates from the university of saarland medical center and of other german isolate referring hospitals were characterized by genotyping and antibiotic resistance testing. the most prevalent strains were ribotypes 001 (18%), 014 (16%) and 027 (15%). sensitivity to ... | 2012 | 23114440 |
| clostridium difficile 027-associated pseudomembranous colitis after short-term treatment with cefuroxime and cephalexin in an elderly orthopedic patient: a case report. | clostridium difficile ribotype 027 has become increasingly prevalent in european countries. the clinical picture varies from self-limiting diarrhea to pseudomembranous colitis with toxic megacolon and ultimately death. use of antibiotics is the principal risk factor; others include comorbidity, advanced age and hospitalization. however even with extensive knowledge of risk factors, it remains difficult to define "minimum risk," as illustrated by the following case. | 2012 | 23113897 |
| pneumatosis intestinalis in a patient with recurrent clostridium difficile infection. | a 65-year-old man with long-standing diarrhoea, recurrent clostridium difficile infection (cdi) in the previous 5 months presented to the gastroenterology clinic with recurrent diarrhoea and abdominal cramping. physical examination was negative for signs of acute abdomen. stool c difficile pcr was positive. abdominal imaging demonstrated an extensive pneumatosis intestinalis involving the small bowel and a dilated small bowel loop. he was treated conservatively with oral vancomycin for recurrent ... | 2012 | 23112256 |
| from natural product to marketed drug: the tiacumicin odyssey. | the first members of the tiacumicin family of antibiotics, encompassing more than 40 compounds, were isolated in 1975. structurally, the core aglycon is an 18-membered macrolactone having two conjugated diene units, one isolated double bond, 5 stereogenic centers and most often, at least one glycosidic linkage. tiacumicin b, a rna synthesis inhibitor, is a narrow-spectrum antibiotic against clostridia. for the treatment of clostridium difficile infection (cdi), it has the same cure rate as vanco ... | 2013 | 23111588 |
| new molecular methods for the diagnosis of clostridium difficile infections. | clostridium difficile is recognized as the major agent responsible for nosocomial diarrhea in hospitalized patients. accurate diagnosis of c. difficile infection (cdi) is essential for optimal treatment and prevention but continues to be challenging. there are currently two reference assays for the diagnosis of cdi with different targets: the cytotoxicity assay that detects free toxins and the toxigenic culture which detects the organism with the potential to produce toxin. in 2009, nucleic acid ... | 2012 | 23110263 |
| response failure to the treatment of clostridium difficile infection and its impact on 30-day mortality. | few data are available on response failure and hospital mortality. this study aimed to evaluate the association between response failure to the treatment of cdi and 30-day mortality. | 2013 | 23108084 |
| comparison of a frozen human foreskin fibroblast cell assay to an enzyme immunoassay and toxigenic culture for the detection of toxigenic clostridium difficile. | this study set out to validate the hs27 readycell assay (rccna) as an alternative ccna method compared against a commonly used commercial enzyme immunoassay (eia) method and toxigenic culture (tc) reference standard. a total of 860 samples were identified from those submitted to the health protection agency microbiology laboratories over a 30-week period. rccna performed much better than eia when using tc as a gold standard, with sensitivities of 90.8% versus 78.6% and positive predictive value ... | 2013 | 23107315 |
| analysis of metronidazole susceptibility in different clostridium difficile pcr ribotypes. | susceptibility to metronidazole was investigated in 81 clostridium difficile strains, belonging to nine different pcr ribotypes, by three different laboratory methods. | 2013 | 23104495 |
| diagnosis of clostridium difficile infection using real-time pcr. | clostridium difficile is known to cause antibiotic-associated diarrhea and pseudomembranous colitis. toxinogenic strains of the bacterium produce toxins a (tcda) and b (tcdb), which are associated with the pathogenicity. the standard methods for diagnosis of c. difficile infection include the cell cytotoxicity assay and the culture of a toxinogenic strain. due to the long turnaround time of these methods, more rapid methods are preferred. enzyme immunoassays are fast, but lack sensitivity. there ... | 2013 | 23104294 |
| clostridium difficile: a european perspective. | clostridium difficile infection is the leading cause of diarrhoea in the industrialised world. first identified in 1935, our knowledge about the clonal population structure, toxins and pcr ribotypes is still increasing. new pcr ribotypes and sequence types are frequently added. in the last decade hypervirulent strains have emerged and been associated with increased severity of disease, high recurrence and significant mortality. although previously a primarily hospital- or health-care acquired in ... | 2013 | 23103666 |
| electronic ward round: finding time for the inpatient with clostridium difficile infection. | | 2013 | 23103665 |
| fecal microbiota transplantation: techniques, applications, and issues. | fecal microbiota transplantation (fmt) has gained widespread recognition in light of the recent clostridium difficile infection (cdi) epidemic, responsible for almost 110,000 deaths per year. the procedure's success rate has caused experts to reflect on what other conditions may benefit. this article provides an overview of (1) description and history of fmt, (2) fmt publications in cdi, (3) the concept of the gut microbiota as a virtual organ, (4) rationale for fmt use, (5) fmt use in inflammat ... | 2012 | 23101687 |
| the role of probiotics in the prevention and treatment of antibiotic-associated diarrhea and clostridium difficile colitis. | clostridium difficile colitis is the most common gastrointestinal infection, exceeding all other gastrointestinal infections combined. there has been a dramatic increase in clostridium difficile infection (cdi) worldwide during the past decade. antibiotic therapy is a trigger precipitating antibiotic-associated diarrhea (aad), which may lead to cdi. the antibiotic alters the protective, diverse bacteria allowing pathogenic bacteria to cause disease. probiotics have been effective in reducing aad ... | 2012 | 23101686 |
| clostridium difficile infection and partial membrane cofactor protein (cd46) deficiency. | | 2012 | 23101426 |
| clostridium difficile testing: have we got it right? | | 2013 | 23100357 |
| [clostridium difficile--unfairly set in the corner?]. | | 2012 | 23097893 |
| vitamin d deficiency: a potential risk factor for clostridium difficile infection. | | 2012 | 23097616 |
| [clostridium difficile epidemic, chile 2012: report of the chilean society for infectious diseases. a scientific historical analysis]. | a summary report from the chilean society for infectious diseases regarding the presence of a clostridium difficile epidemic with several fatalities in chile's premier emergency public hospital in santiago is used to make a scientific historical analysis of the situation. this summary report identifies several hygienic and sanitary shortcomings that may have played a role in triggering this major epidemic. these include deficiencies in hand washing policies, overcrowding of beds in wards, relaxa ... | 2012 | 23096554 |
| [clostridium difficile associated infections: an updated view]. | clostridium difficile is an emerging anaerobic, spore forming pathogen, recognized as the etiological agent of ~ 30% of antibiotic associated diarrheas. clinical symptoms can fluctuate from mild to moderate diarrhea, pseudomembranous colitis and toxic megacolon. the incidence of c. difficile associated infections (cdai) is ~ 1% of total hospitalized patients. cdai has a mortality rate of ~1 to 5%, and a relapse rate of ~ 20%. the appearance of severe outbreaks of cdai could be attributed to chan ... | 2012 | 23096544 |
| rifaximin in the treatment of recurrent clostridium difficile infection. | clostridium difficile can cause severe antibiotic-associated colitis. conventional treatments with metronidazole and vancomycin improve symptoms, but after discontinuation of treatment, c. difficile infection (cdi) recurs in a number of patients. rifaximin is a rifamycin-based non-systemic antibiotic that has effect against c. difficile. | 2013 | 23095030 |
| toward an understanding of changes in diversity associated with fecal microbiome transplantation based on 16s rrna gene deep sequencing. | fecal microbiome transplantation by low-volume enema is an effective, safe, and inexpensive alternative to antibiotic therapy for patients with chronic relapsing clostridium difficile infection (cdi). we explored the microbial diversity of pre- and posttransplant stool specimens from cdi patients (n = 6) using deep sequencing of the 16s rrna gene. while interindividual variability in microbiota change occurs with fecal transplantation and vancomycin exposure, in this pilot study we note that cli ... | 2012 | 23093385 |
| comparison of genexpert pcr to bd geneohm for detecting c. difficile toxin gene in gdh positive toxin negative samples. | the need for rapid diagnosis of clostridium difficile (c. difficile) associated infection in a clinical microbiology laboratory has provided the stimulus for new diagnostic tests and testing protocols. a two-test algorithm has been proposed using assays such as quik chek complete, which detects both c. difficile glutamate dehydrogenase (gdh) and c. difficile toxins a and b, followed by reflex testing of samples having inconclusive results (gdh positive and toxin negative) with pcr for identifica ... | 2012 | 23090736 |
| current and future challenges in the development of antimicrobial agents. | micro-organisms exist to survive. even in the absence of antimicrobial agents, many have determinants of resistance that may be expressed phenotypically, should the need arise. with the advent of the antibiotic age, as more and more drugs were developed to treat serious infections, micro-organisms (particularly bacteria) rapidly developed resistance determinants to prevent their own demise.the most important determinants of resistance have been in the gram-positive and gram-negative bacteria. am ... | 2012 | 23090595 |
| [clostridium-difficile-colitis: more frequent and more severe]. | | 2012 | 23088039 |
| predicting recurrence of c. difficile colitis using bacterial virulence factors: binary toxin is the key. | recurrent clostridium difficile colitis is common, yet the ability to predict recurrence is poorly developed. | 2013 | 23086451 |
| immune responses to clostridium difficile infection. | clostridium difficile is the causal agent of antibiotic-associated diarrhea and is a leading cause of hospital-acquired infections in the us. c. difficile has been known to cause severe diarrhea and colitis for more than 30 years, but the emergence of a newer, hypervirulent strain of c. difficile (bi/nap1) has further compounded the problem, and recently both the number of cases and mortality associated with c. difficile-associated diarrhea have been increasing. one of the major drivers of disea ... | 2012 | 23084763 |
| impact of infectious complications after elective surgery on hospital readmission and late deaths in the u.s. medicare population. | whereas the negative impact of infectious complications (ic) during the index hospitalization after elective surgery is well established, the long-term ramifications of hospital-acquired post-operative infections are not well studied. this analysis evaluated the impact of a hospital-acquired ic after open abdominal vascular surgery on the readmission rate and the mortality rates 30 and 90 days after initial discharge. | 2012 | 23082877 |
| prevalence of clostridium difficile toxin in diarhoeal stool samples of patients from a tertiary hospital in north eastern penisular malaysia. | this study describes the prevalence of clostridium difficile toxin (cdt) in loose stool samples from inpatients aged more than two years of a tertiary hospital. a total of 175 samples that had been examined were from stool samples that were sent to the medical microbiology & parasitology laboratory for various clinical indications. the toxin was detected by a commercial immunochromatograhic test, and the patients' demography, clinical features, treatment and outcomes were analyzed from their med ... | 2012 | 23082450 |
| ageing and gut microbes: perspectives for health maintenance and longevity. | the ageing process affects the human gut microbiota phylogenetic composition and its interaction with the immune system. age-related gut microbiota modifications are associated with immunosenescence and inflamm-ageing in a sort of self-sustaining loop, which allows the placement of gut microbiota unbalances among both the causes and the effects of the inflamm-ageing process. even if, up to now, the link between gut microbiota and the ageing process is only partially understood, the gut ecosystem ... | 2013 | 23079287 |
| association of decreased serum protein fractions with clostridium difficile infection in the acute care setting: a case-control study. | this study examines the association of decreased levels of serum proteins with the occurrence of clostridium difficile-associated diarrhea (cdad) in hospitalized patients. | 2012 | 23075246 |
| retraction notice to "apoptosis of ct26 colorectal cancer cells induced by clostridium difficile toxin a stimulates potent anti-tumor immunity" [biochem. biophys. res. commun. 422 (2012) 15-21]. | | 2012 | 23071973 |
| modeling the role of peroxisome proliferator-activated receptor γ and microrna-146 in mucosal immune responses to clostridium difficile. | clostridium difficile is an anaerobic bacterium that has re-emerged as a facultative pathogen and can cause nosocomial diarrhea, colitis or even death. peroxisome proliferator-activated receptor (ppar) γ has been implicated in the prevention of inflammation in autoimmune and infectious diseases; however, its role in the immunoregulatory mechanisms modulating host responses to c. difficile and its toxins remains largely unknown. to characterize the role of pparγ in c. difficile-associated disease ... | 2012 | 23071818 |
| succession in the gut microbiome following antibiotic and antibody therapies for clostridium difficile. | antibiotic disruption of the intestinal microbiota may cause susceptibility to pathogens that is resolved by progressive bacterial outgrowth and colonization. succession is central to ecological theory but not widely documented in studies of the vertebrate microbiome. here, we study succession in the hamster gut after treatment with antibiotics and exposure to clostridium difficile. c. difficile infection is typically lethal in hamsters, but protection can be conferred with neutralizing antibodi ... | 2012 | 23071679 |
| aminoacyl-trna synthetase inhibitors as antimicrobial agents: a patent review from 2006 till present. | aminoacyl-trna synthetases (aarss) are one of the leading targets for development of antimicrobial agents. although these enzymes are well conserved among prokaryotes, significant divergence has occurred between prokaryotic and eukaryotic aarss, which can be exploited in the discovery of broad-spectrum antibacterial agents. although several aars inhibitors have been reported before, they failed as a result of poor selectivity and limited cell penetration. | 2012 | 23062029 |
| impact of clostridium difficile colitis on 5-year health outcomes in patients with ulcerative colitis. | clostridium difficile colitis (cdc) is associated with an increased short-term mortality risk in hospitalised ulcerative colitis (uc) patients. we sought to determine whether cdc also impacts long-term risks of adverse health events in this population. | 2012 | 23061526 |
| acute kidney injury is an independent marker of severity in clostridium difficile infection: a nationwide survey. | to examine clinical outcomes in hospitalized clostridium difficile infection (cdi) patients with acute kidney injury (aki) using the national hospital discharge survey for 2005 to 2009. | 2013 | 23059411 |
| clostridium difficile postantibiotic diarrhoea diagnosis. | to study the frequency of clostridium difficile in postantibiotic diarrhoea in patients admitted to the medical ward of a secondary care hospital. | 2012 | 23058147 |
| diagnosis of clostridium difficile-associated disease: examination of multiple algorithms using toxin eia, glutamate dehydrogenase eia and loop-mediated isothermal amplification. | the laboratory diagnosis of clostridium difficile infection (cdi) needs to be accurate and timely to ensure optimal patient management, infection control and reliable surveillance. three methods are evaluated using 810 consecutive stool samples against toxigenic culture: cdt tox a/b premier enzyme immunoassay (eia) kit (meridian bioscience, europe), premier eia for c. difficile glutamate dehydrogenase (gdh) (meridian bioscience, europe) and the illumigene kit (meridian bioscience, europe), both ... | 2012 | 23057158 |
| clostridium difficile: changing epidemiology, treatment and infection prevention measures. | clostridium difficile was first reported as a cause of antibiotic-associated colitis in 1978. in more recent years we have witnessed disturbing trends associated with c. difficile infection (cdi). cdi has become more common, affecting populations previously considered at low risk, more severe with an associated increase in mortality, and more difficult to treat with some patients experiencing multiple relapses and a reduced responsiveness to previously effective antibiotics. these trends have be ... | 2012 | 23054932 |
| evaluation of clostridium difficile fecal load and limit of detection during a prospective comparison of two molecular tests, the illumigene c. difficile and xpert c. difficile/epi tests. | in a large prospective comparison, the illumigene test detected clostridium difficile in 98% of toxin-positive and 58% of toxin-negative samples confirmed positive by other methods. the xpert was uniformly sensitive. most samples with discrepant results had c. difficile concentrations below the illumigene limit of detection. the significance of low-level c. difficile detection needs investigation. | 2013 | 23052320 |
| association of relapse of clostridium difficile disease with bi/nap1/027. | recurrent clostridium difficile infection (cdi) occurs in up to 35% of patients. recurrences can be due to either relapse with the same strain or reinfection with another strain. in this study, multilocus variable-number tandem-repeat analysis (mlva) was performed on c. difficile isolates from patients with recurrent cdi to distinguish relapse from reinfection. in addition, univariate and multivariate analyses were performed to identify risk factors associated with relapse. among patients with a ... | 2012 | 23052318 |
| stability of vancomycin in syrspend sf. | vancomycin is administered orally for the treatment of pseudomembranous colitis induced by clostridium difficile. vancomycin is marketed for this purpose by viropharma as vancocin in 125-mg and 250-mg capsules. the need for other dose form options for those patients who cannot take capsules has led compounding pharmacies to seek other alternatives, namely oral solutions and suspensions. additionally, some patients are unable to use suspending agents containing alcohol or sorbitol. the objective ... | 2013 | 23050329 |
| [clostridium difficile associated diarrhea: reliable therapy with vancomycin capsules]. | | 2012 | 23045940 |
| recent changes in clostridium difficile infection. | clostridium difficile is the main cause of nosocomial diarrhea. diarrhea associated with c. difficile has increased incidence, morbidity, and mortality in the last few years. the major related risk factors include use of antibiotics, elderly patients and prolonged hospital stay. many patients receive combinations of antibiotics or multiple antibiotics, which represents the main risk to develop diarrhea associated to c. difficile or its recurrence. therefore, interventions to improve antibiotic p ... | 2012 | 23045838 |
| intrarectal instillation of clostridium difficile toxin a triggers colonic inflammation and tissue damage: development of a novel and efficient mouse model of clostridium difficile toxin exposure. | clostridium difficile, a major cause of hospital-acquired diarrhea, triggers disease through the release of two toxins, toxin a (tcda) and toxin b (tcdb). these toxins disrupt the cytoskeleton of the intestinal epithelial cell, increasing intestinal permeability and triggering the release of inflammatory mediators resulting in intestinal injury and inflammation. the most prevalent animal model to study tcda/tcdb-induced intestinal injury involves injecting toxin into the lumen of a surgically ge ... | 2012 | 23045481 |
| contribution of adenosine a(2b) receptors in clostridium difficile intoxication and infection. | clostridium difficile toxins a (tcda) and b (tcdb) induce a pronounced systemic and intestinal inflammatory response. a(2b) adenosine receptors (a(2b)ars) are the predominant adenosine receptors in the intestinal epithelium. we investigated whether a(2b)ars are upregulated in human intestinal cells by tcda or tcdb and whether blockade of a(2b)ars can ameliorate c. difficile tcda-induced enteritis and alter the outcome of c. difficile infection (cdi). adenosine receptor subtype (a(1), a(2a), a(2b ... | 2012 | 23045479 |
| an evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms. | admission to a room previously occupied by a patient with certain multidrug-resistant organisms (mdros) increases the risk of acquisition. traditional cleaning strategies do not remove all environmental mdros. we evaluated the environmental and clinical impact of hydrogen peroxide vapor (hpv) room disinfection. | 2013 | 23042972 |
| does candida species overgrowth protect against clostridium difficile infection? | | 2013 | 23042967 |
| hospital-onset clostridium difficile infection rates in persons with cancer or hematopoietic stem cell transplant: a c3ic network report. | a multicenter survey of 11 cancer centers was performed to determine the rate of hospital-onset clostridium difficile infection (ho-cdi) and surveillance practices. pooled rates of ho-cdi in patients with cancer were twice the rates reported for all us patients (15.8 vs 7.4 per 10,000 patient-days). rates were elevated regardless of diagnostic test used. | 2012 | 23041818 |
| burden of clostridium difficile infection in long-term care facilities in monroe county, new york. | long-term care facility (ltcf) residents are at increased risk of clostridium difficile infection (cdi). however, little is known about the incidence, recurrence, and severity of cdi in ltcfs or the extent to which acute care exposure contributes to cdi in ltcfs. we describe the epidemiology of cdi in a cohort of ltcf residents in monroe county, new york, where recent estimates suggest a cdi incidence in hospitals of 9.2 cases per 10,000 patient-days. | 2012 | 23041808 |
| empirical antimicrobial prescriptions in patients with clostridium difficile infection at hospital admission and impact on clinical outcome. | to determine, among patients with clostridium difficile infection (cdi) at hospital admission, the impact of concurrent use of systemic, non-cdi-related antimicrobials on clinical outcomes and the risk factors associated with unnecessary antimicrobial prescribing. | 2012 | 23041807 |
| effect of hospital-wide chlorhexidine patient bathing on healthcare-associated infections. | chlorhexidine gluconate (chg) bathing has been used primarily in critical care to prevent central line-associated bloodstream infections and infections due to multidrug-resistant organisms. the objective was to determine the effect of hospital-wide chg patient bathing on healthcare-associated infections (hais). | 2012 | 23041806 |
| equal efficacy of glucoprotamin and an aldehyde product for environmental disinfection in a hematologic transplant unit: a prospective crossover trial. | the inanimate hospital environment has emerged as an important reservoir of nosocomial pathogens. in particular, multidrug-resistant pathogens, such as methicillin-resistant staphylococcus aureus, acinetobacter species, and clostridium difficile, play a major role in the transmission of hospital-acquired infections. in europe, aldehydes, chlorine, and quaternary ammonium compounds have been commonly used for environmental disinfection. glucoprotamin, a newer active compound for disinfectants, ha ... | 2012 | 23041803 |
| fecal microbiota transplantation: past, present and future. | fecal microbiota transplantation (fmt) re-establishes a balanced intestinal flora with resultant cure of recurrent clostridium difficile infection (rcdi). fmt has also been used to treat other gastrointestinal (gi) diseases including inflammatory bowel disease (ibd), irritable bowel syndrome (ibs), and chronic constipation and a variety of non-gi disorders. the purpose of this review is to discuss the intestinal microbiota and fmt treatment of gi and non-gi diseases. | 2013 | 23041678 |
| clostridium difficile in young farm animals and slaughter animals in belgium. | faecal carriage of clostridium difficile in healthy animals has been reported recently, especially in piglets and calves. however there is limited data about carriage in animals just prior to slaughter in europe. the main objective of this study was to determine the presence of c. difficile in pigs and cattle at the slaughterhouse. c. difficile was isolated in 6.9% of the cattle at the slaughterhouse. none of the pig slaughter samples were positive for c. difficile after an enrichment time of 72 ... | 2012 | 23041559 |