| clostridium difficile carbohydrates: glucan in spores, psii common antigen in cells, immunogenicity of psii in swine and synthesis of a dual c. difficile-etec conjugate vaccine. | clostridium difficile is responsible for severe diarrhea in humans that may cause death. spores are the infectious form of c. difficile, which germinate into toxin-producing vegetative cells in response to bile acids. recently, we discovered that c. difficile cells possess three complex polysaccharides (pss), named psi, psii, and psiii, in which psi was only associated with a hypervirulent ribotype 027 strain, psii was hypothesized to be a common antigen, and psiii was a water-insoluble polymer. ... | 2012 | 22533919 |
| clostridium difficile on the transplantation radar. | | 2012 | 22531493 |
| an evaluation of the vidas cdab assay for the detection of clostridium difficile infection in a clinical laboratory. | | 2012 | 22531349 |
| improved recovery of clostridium difficile spores with the incorporation of synthetic taurocholate in cycloserine-cefoxitin-fructose agar (ccfa). | culture remains important for the detection and typing of clostridium difficile. culture of c. difficile spores can be enhanced on media supplemented with a germinant. despite this, unsupplemented media continues to be used in some laboratories. the aim of this study was to quantify the effect of the known germinant sodium taurocholate on recovery of c. difficile spores and to determine if the supplement impacts on the recovery of vegetative c. difficile. | 2012 | 22531346 |
| meta-analysis: probiotics in antibiotic-associated diarrhoea. | diarrhoea is a common occurrence in association with antibiotic administration. earlier studies and meta-analyses have suggested that probiotic administration reduces the incidence of antibiotic-associated diarrhoea (aad). | 2012 | 22531096 |
| patient and environmental service employee satisfaction of using germicidal bleach wipes for patient room cleaning. | more healthcare institutions are using bleach products which are sporicidal to reduce clostridium difficile infection (cdi). there may be patient and employee concerns about the appearance of bleach residue left on surfaces, odors, and respiratory tract irritation. the intervention used bleach wipes for daily and terminal patient room cleaning to reduce transmission of cdi and was implemented on patient care units with a relatively high incidence of cdi. both patients and environmental services ... | 2015 | 22530592 |
| a meta-analysis of probiotic efficacy for gastrointestinal diseases. | meta-analyses on the effects of probiotics on specific gastrointestinal diseases have generally shown positive effects on disease prevention and treatment; however, the relative efficacy of probiotic use for treatment and prevention across different gastrointestinal diseases, with differing etiology and mechanisms of action, has not been addressed. | 2012 | 22529959 |
| a prospective cohort study on hospital mortality due to clostridium difficile infection. | although an increase in burden of disease has frequently been reported for clostridium difficile infection (cdi), specific data on the effect of cdi on a patient's risk of death or overall hospital mortality are scarce. therefore, we performed a prospective cohort study to analyse the effect of cdi on the risk of pre-discharge all-cause death in all inpatients with cdi compared to all inpatients without cdi during 2009 in a single hospital. | 2012 | 22527876 |
| generation of an actagardine a variant library through saturation mutagenesis. | the lantibiotic actagardine a is nineteen amino acids in length and comprises three intertwined c-terminal methyllanthionine-bridged rings and an n-terminal lanthionine-bridged ring. produced by the actinomycete actinoplanes garbadinensis atcc 31049, actagardine a demonstrates antibacterial activity against important gram-positive pathogens. this activity combined with its ribosomal synthesis makes it an attractive target for the generation of lantibiotic variants with improved biological activi ... | 2012 | 22526797 |
| risk of clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. | several studies have raised concern regarding the possible association between proton-pump inhibitors (ppis) and clostridium difficile infection (cdi). we aimed to perform a systematic review of incident and recurrent cdi in ppi users, and to evaluate the relative impact of concurrent antibiotic use, or switching acid suppression to histamine-2-receptor antagonists (h2ras). | 2012 | 22525304 |
| decreased cure and increased recurrence rates for clostridium difficile infection caused by the epidemic c. difficile bi strain. | an epidemic strain of clostridium difficile designated by restriction endonuclease analysis (rea) as group bi has caused multiple outbreaks of severe c. difficile infection (cdi). the treatment response of patients infected with this strain is uncertain. | 2012 | 22523271 |
| cyclic diguanylate inversely regulates motility and aggregation in clostridium difficile. | clostridium difficile-associated disease is increasing in incidence and is costly to treat. our understanding of how this organism senses its entry into the host and adapts for growth in the large bowel is limited. the small-molecule second messenger cyclic diguanylate (c-di-gmp) has been extensively studied in gram-negative bacteria and has been shown to modulate motility, biofilm formation, and other processes in response to environmental signals, yet little is known about the functions of thi ... | 2012 | 22522894 |
| precise manipulation of the clostridium difficile chromosome reveals a lack of association between the tcdc genotype and toxin production. | clostridium difficile causes a potentially fatal diarrheal disease through the production of its principal virulence factors, toxin a and toxin b. the tcdc gene is thought to encode a negative regulator of toxin production. therefore, increased toxin production, and hence increased virulence, is often inferred in strains with an aberrant tcdc genotype. this report describes the first allele exchange system for precise genetic manipulation of c. difficile, using the coda gene of escherichia coli ... | 2012 | 22522680 |
| antimicrobial resistance, toxinotype, and genotypic profiling of clostridium difficile isolates of swine origin. | the occurrence of clostridium difficile infections in patients that do not fulfill the classical risk factors prompted us to investigate new risk factors of disease. the goal of this study was to characterize strains and associated antimicrobial resistance determinants of c. difficile isolated from swine raised in ohio and north carolina. genotypic approaches used include pcr detection, toxinotyping, dna sequencing, and pulsed-field gel electrophoresis (pfge) dna fingerprinting. thirty-one perce ... | 2012 | 22518873 |
| acp journal club. review: fidaxomicin is better than vancomycin for clostridium difficile recurrence. | | 2012 | 22508749 |
| clostridium difficile infection in the inflammatory bowel disease patient. | clostridium difficile infection (cdi) has been increasing in frequency and severity in patients with inflammatory bowel disease (ibd). population based and single center studies have shown worse clinical outcomes in concomitant cdi and ibd, with several reporting longer length of hospital stay, higher colectomy rates and increased mortality. clinically, cdi may be difficult to distinguish from an ibd flare and may range from an asymptomatic carrier state to severe life threatening colitis. the t ... | 2013 | 22508484 |
| characterizations of clinical isolates of clostridium difficile by toxin genotypes and by susceptibility to 12 antimicrobial agents, including fidaxomicin (opt-80) and rifaximin: a multicenter study in taiwan. | a total of 403 nonduplicate isolates of clostridium difficile were collected at three major teaching hospitals representing northern, central, and southern taiwan from january 2005 to december 2010. of these 403 isolates, 170 (42.2%) were presumed to be nontoxigenic due to the absence of genes for toxins a or b or binary toxin. the remaining 233 (57.8%) isolates carried toxin a and b genes, and 39 (16.7%) of these also had binary toxin genes. the mic(90) of all isolates for fidaxomicin and rifax ... | 2012 | 22508299 |
| acute and chronic pouchitis--pathogenesis, diagnosis and treatment. | restorative proctocolectomy with ileal pouch-anal anastomosis has become the procedure of choice for the majority of patients with ulcerative colitis who require surgical treatment. pouchitis, the most common long-term complication of the procedure, involves a spectrum of disease processes with heterogeneous risk factors, clinical features, disease courses and prognoses. in addition, clinical symptoms of pouchitis are not specific and often overlap with those of other inflammatory and functional ... | 2012 | 22508158 |
| clostridium difficile infection in hospitalized liver transplant patients: a nationwide analysis. | the incidence of clostridium difficile infection (cdi) is increasing among hospitalized patients. liver transplantation (lt) patients are at higher risk for acquiring cdi. small, single-center studies (but no nationwide analyses) have assessed this association. we used the nationwide inpatient sample of the healthcare cost and utilization project (2004-2008) for this retrospective, cross-sectional study. patients with any discharge diagnosis of lt composed the study population, and they were ide ... | 2012 | 22505356 |
| prevalence of clostridium difficile in uncooked ground meat products from pittsburgh, pennsylvania. | the prevalence of clostridium difficile in retail meat samples has varied widely. the food supply may be a source for c. difficile infections. a total of 102 ground meat and sausage samples from 3 grocers in pittsburgh, pa, were cultured for c. difficile. brand a pork sausages were resampled between may 2011 and january 2012. two out of 102 (2.0%) meat products initially sampled were positive for c. difficile; both were pork sausage from brand a from the same processing facility (facility a). on ... | 2012 | 22504814 |
| lactobacillus equigenerosi strain le1 invades equine epithelial cells. | lactobacillus equigenerosi strain le1, a natural inhabitant of the equine gastrointestinal tract, survived ph 3.0 and incubation in the presence of 1.5% (wt/vol) bile salts for at least 2 h. strain le1 showed 8% cell surface hydrophobicity, 60% auto-aggregation, and 47% coaggregation with clostridium difficile c6. only 1% of the cells adhered to viable buccal epithelial cells and invaded the cells within 20 min after contact. preincubation of strain le1 in a buffer containing pronase prevented a ... | 2012 | 22504808 |
| a gastroenterologist's guide to probiotics. | the enteric microbiota contribute to gastrointestinal health, and their disruption has been associated with many disease states. some patients consume probiotic products in attempts to manipulate the intestinal microbiota for health benefit. it is important for gastroenterologists to improve their understanding of the mechanisms of probiotics and the evidence that support their use in practice. clinical trials have assessed the therapeutic effects of probiotic agents for several disorders, inclu ... | 2012 | 22504002 |
| diagnosis of clostridium difficile infection. | | 2012 | 22503848 |
| detecting and treating clostridium difficile infections in patients with inflammatory bowel disease. | the prevalence of cdi in patients with ibd has increased over the last decade. the excess morbidity and mortality associated with cdi appears to be greater in patients with ibd than in those without preexisting bowel disease. the risk factors for cdi in ibd and non-ibd populations appear similar; unique ibd-related risk factors are use of maintenance immunosuppression and extent and severity of prior colitis. nevertheless, a significant proportion of cdi-ibd patients may have the disease without ... | 2012 | 22500522 |
| probiotics in the gastrointestinal diseases of the elderly. | changes of the gut microflora in elderly appear to involve a reduction in numbers of healthy bacteria (lactobacilli and bifidobacteria) and an increase in numbers of potentially pathogenic species. these changes are generally described as gastrointestinal disorders and infections. this review analyses benefits of probiotics in old people, with particular interesting for the latest researches relevant to elderly people, e.g. trials examining enteric infections, antibiotic-associated diarrhea and ... | 2012 | 22499466 |
| clinical and economic burden of clostridium difficile infection in europe: a systematic review of healthcare-facility-acquired infection. | pubmed, embase and conference abstracts were reviewed systematically to determine the clinical and economic burden associated with clostridium difficile infection (cdi) acquired and treated in european healthcare facilities. inclusion criteria were: published in the english language between 2000 and 2010, and study population of at least 20 patients with documented cdi acquired/treated in european healthcare facilities. data collection was completed by three unblinded reviewers using the cochran ... | 2012 | 22498638 |
| the implications of hospital acquired adverse events on mortality, length of stay and costs for patients undergoing radical cystectomy for bladder cancer. | the incidence of hospital acquired adverse events in radical cystectomy and their implications for hospital outcomes and costs remain poorly described. we describe the incidence of hospital acquired adverse events in radical cystectomy, and characterize its relationship with in-hospital mortality, length of stay and hospitalization costs. | 2012 | 22498229 |
| proton pump inhibitor use and clostridium difficile colitis: cause or coincidence? | | 2012 | 22495812 |
| evaluating contemporary antibiotics as a risk factor for clostridium difficile infection in surgical trauma patients. | with most clostridium difficile infections (cdi) occurring after exposure to antimicrobial treatment, specific antibiotics and duration of exposure were evaluated independently for increased risk of cdi in surgical patients. | 2012 | 22491554 |
| the roles of clostridium difficile and norovirus among gastroenteritis-associated deaths in the united states, 1999-2007. | globally, gastroenteritis is recognized as an important contributor to mortality among children, but population-based data on gastroenteritis deaths among adults and the contributions of specific pathogens are limited. we aimed to describe trends in gastroenteritis deaths across all ages in the united states and specifically estimate the contributions of clostridium difficile and norovirus. | 2012 | 22491338 |
| [animal sources of clostridium difficile]. | the bacterium clostridium difficile is pathogenic for both humans and animals. this feared nosocomial infectious agent is increasingly more important in the community as well. like in humans, the gastrointestinal tract is infected in animals. the bacterium may be transmitted from animals to humans via the food chain (e.g. pork meat) or by direct contact. identical human and animal isolates of c. difficile have been reported in several studies. the article presents results from a small local stud ... | 2012 | 22484972 |
| interval appendectomy after perforated appendicitis: what are the operative risks and luminal patency rates? | the need for interval appendectomy after nonoperative management of a perforated appendicitis is being questioned owing to recent studies that estimated recurrence rates as low as 5% because of obliteration of the appendiceal lumen. we review our experience with interval appendectomy in this subset of patients to determine the postoperative outcomes and luminal patency rates. | 2012 | 22482752 |
| growing a "positive culture" of antimicrobial stewardship in a community hospital. | promoting the appropriate use of antimicrobials is a core value of antimicrobial stewardship. prospective audit and feedback constitute an effective strategy for reducing the cost and use of antimicrobials, as well as their adverse effects, such as infection with clostridium difficile. | 2011 | 22479082 |
| environmental decontamination with ultraviolet radiation to prevent recurrent clostridium difficile infection in 2 roommates in a long-term care facility. | | 2012 | 22476286 |
| comparison of the microbiological efficacy of hydrogen peroxide vapor and ultraviolet light processes for room decontamination. | to compare the microbiological efficacy of hydrogen peroxide vapor (hpv) and ultraviolet radiation (uvc) for room decontamination. | 2012 | 22476278 |
| use of a structured panel process to define quality metrics for antimicrobial stewardship programs. | antimicrobial stewardship programs are being implemented in health care to reduce inappropriate antimicrobial use, adverse events, clostridium difficile infection, and antimicrobial resistance. there is no standardized approach to evaluate the impact of these programs. | 2012 | 22476277 |
| a multicenter study of clostridium difficile infection-related colectomy, 2000-2006. | to assess clostridium difficile infection (cdi)-related colectomy rates by cdi surveillance definitions and over time at multiple healthcare facilities. | 2012 | 22476273 |
| polymerase chain reaction testing for clostridium difficile. | | 2012 | 22475569 |
| multilocus sequence typing (mlst) analysis of 104 clostridium difficile strains isolated from china. | the phylogenetic and epidemic relationships of 104 clinical isolates of clostridium difficile from three hospitals of different geographical and population sources in china were investigated by multilocus sequence typing. twenty-two sequence types (sts) were identified, four of which, st117, st118, st119 and st129, were novel. no geographically specific and host population-specific phylogenetic lineages were found and there was no correlation between geographical origin or host population and st ... | 2013 | 22475233 |
| probiotics in the intensive care unit. | probiotics are living microorganisms that, when ingested in adequate amounts, provide benefits to the host. the benefits include either a shortened duration of infections or decreased susceptibility to pathogens. proposed mechanisms of beneficial effects include improving gastrointestinal barrier function, modification of the gut flora by inducing host cell antimicrobial peptides and/or local release of probiotic antimicrobial factors, competition for epithelial adherence, and immunomodulation. ... | 2012 | 22473797 |
| saccharomyces boulardii for the prevention of antibiotic-associated diarrhea in adult hospitalized patients: a single-center, randomized, double-blind, placebo-controlled trial. | antibiotic-associated diarrhea (aad) and clostridium difficile-associated diarrhea (cdad) are common complications of antibiotic use. probiotics were effective in preventing aad and cdad in several randomized controlled trials. this study was aimed at testing the effect of saccharomyces boulardii on the occurrence of aad and cdad in hospitalized patients. | 2012 | 22472744 |
| prevalence of clostridium difficile in excluded colons. | clostridium difficile infection is associated with substantial morbidity and mortality, increased duration of hospitalization, and a marked economic impact. several case reports and case series have described c. difficile infection in excluded bowels or immediately after reversal of defunctioning ileostomy. the aim of this prospective study is to detect whether the excluded colon is associated with a higher rate of c. difficile colonization than the normal population, which may increase the risk ... | 2012 | 22472396 |
| the long-term clinical course of pouchitis after total proctocolectomy and ipaa for ulcerative colitis. | pouchitis is the most common long-term complication after restorative total proctocolectomy and ipaa for ulcerative colitis. | 2012 | 22469801 |
| fecal transplant against relapsing clostridium difficile-associated diarrhea in 32 patients. | clostridium difficile-associated disease (cdad) with frequent watery stools, sometimes with painful bowel movements, fever and sickness, is probably the major known cause of antibiotic-associated diarrhea and colitis, most probably depending on a disruption of the normal intestinal balance in the microbiome. in this study, we have inoculated a mixture of fecal microbes--as an enema--originating from a healthy scandinavian middle-aged donor, regularly re-cultivated under strict anaerobic conditio ... | 2012 | 22468996 |
| discrepancies in testing recommendations for clostridium difficile infection: updated review favors amplification test systems. | | 2012 | 22468811 |
| polymerase chain reaction testing for clostridium difficile. | | 2012 | 22463792 |
| draft genome sequence of the nontoxigenic clostridium difficile strain cd37. | here we report the draft genome sequence of clostridium difficile strain cd37, the first nontoxigenic strain sequenced. every sequenced strain of clostridium difficile has been shown to contain multiple different mobile genetic elements. the draft genome sequence of strain cd37 reveals the presence of two putative conjugative transposons. | 2012 | 22461557 |
| clostridium difficile infection in gastroenterology settings: more frequent or better diagnosed? | | 2012 | 22457871 |
| prevalence and molecular characterization of clostridium difficile isolated from feedlot beef cattle upon arrival and mid-feeding period. | the presence of indistinguishable strains of clostridium difficile in humans, food animals and food, as well as the apparent emergence of the food-animal-associated ribotype 078/toxinotype v as a cause of community-associated c. difficile infection have created concerns about the potential for foodborne infection. while studies have reported c. difficile in calves, studies of cattle closer to the age of harvest are required. four commercial feedlots in alberta (canada) were enrolled for this stu ... | 2012 | 22455611 |
| clostridium difficile genotypes other than ribotype 078 that are prevalent among human, animal and environmental isolates. | characterising the overlap of c. difficile genotypes in different reservoirs can improve our understanding of possible transmission routes of this pathogen. most of the studies have focused on a comparison of the pcr ribotype 078 isolated from humans and animals. here we describe for the first time a comparison of c. difficile genotypes isolated during longer time intervals from different sources including humans, animals and the non-hospital environment. | 2012 | 22452857 |
| underestimation of clostridium difficile infection among clinicians: an international survey. | the objective of this investigation was to document clinicians' awareness regarding the incidence and severity of clostridium difficile-associated diarrhea (cdad). an international electronic survey was conducted among corresponding authors of articles indexed by pubmed and published during the last 10 years in 'core clinical journals'. a total of 1,163 clinicians answered (response rate 59%); most of the responses were submitted from north america (54.6%), europe (32.2%), and asia/pacific (11.6 ... | 2012 | 22450740 |
| long-term follow-up of colonoscopic fecal microbiota transplant for recurrent clostridium difficile infection. | clostridium difficile infection (cdi) has increased to epidemic proportions over the past 15 years, and recurrence rates of 30-65% with failure to respond to multiple courses of antimicrobials are common. the aim of this study was to report the efficacy of fecal microbiota transplantation (fmt) in patients with recurrent cdi in five geographically disparate medical centers across the united states. | 2012 | 22450732 |
| successful colonoscopic fecal transplant for severe acute clostridium difficile pseudomembranous colitis. | clostridium difficile-associated diarrhea has become one of the most common healthcare-associated infections, with significant morbidity and mortality, especially among the elderly in the inpatient setting. the standard approach with metronidazole and vancomycin is not very effective in treating patients with severe colitis and hence other alternatives have been explored. we herein describe the first successful experience of colonoscopic fecal transplant in a case of severe refractory c. diffici ... | 2012 | 22450020 |
| potential protective role of linezolid against clostridium difficile infection. | clostridium difficile infection (cdi) is one of the main causes of diarrhoea associated with antimicrobial therapy. antibiotics with good 'in vitro' activity against c. difficile could protect patients from developing cdi. in this study, the potential of linezolid to protect patients with ventilator-associated pneumonia (vap) from developing cdi was assessed. over a 4-year period, a cohort of patients who developed vap following major heart surgery (mhs) in gregorio marañón general hospital (mad ... | 2012 | 22445203 |
| biofilm-growing intestinal anaerobic bacteria. | sessile growth of anaerobic bacteria from the human intestinal tract has been poorly investigated, so far. we recently reported data on the close association existing between biliary stent clogging and polymicrobial biofilm development in its lumen. by exploiting the explanted stents as a rich source of anaerobic bacterial strains belonging to the genera bacteroides, clostridium, fusobacterium, finegoldia, prevotella, and veillonella, the present study focused on their ability to adhere, to grow ... | 2012 | 22444687 |
| statin use and the risk of clostridium difficile in academic medical centres. | to estimate the possible relationship between statin use and the risk of healthcare facility onset clostridium difficile. | 2012 | 22442166 |
| risk factors for clostridium difficile toxin-positive diarrhea: a population-based prospective case-control study. | increased incidence and severity of clostridium difficile infections (cdis) is of major concern. however, by minimizing known risk factors, the incidence can be decreased. the aim of this investigation was to calculate the incidence and assess risk factors for cdi in our population. a 1-year prospective population-based nationwide study in iceland of cdis was carried out. for risk factor evaluation, each case was matched with two age- and sex-matched controls that tested negative for c. difficil ... | 2012 | 22441775 |
| clostridium difficile colitis: increasing incidence, risk factors, and outcomes in solid organ transplant recipients. | clostridium difficile-associated diarrhea (cdad) is an increasingly important diagnosis in solid organ transplant recipients, with rising incidence and mortality. we describe the incidence, risk factors, and outcomes of colectomy for cdad after solid organ transplantation. | 2012 | 22441318 |
| clostridium difficile infection in an iranian hospital. | clostridium difficile infection (cdi) is an important cause of morbidity and mortality internationally, yet there are important regional differences in the epidemiology and microbiology of disease. most reports have come from north america and europe, with limited information from other regions, including the middle east. given the changes in the epidemiology of cdi in developed countries, particularly associated with the dissemination of hypervirulent epidemic clones, an understanding of the ep ... | 2012 | 22436392 |
| detection, treatment, and prevention of clostridium difficile infection. | clostridium difficile is a gram-positive anaerobic bacillus responsible for approximately 1 of 5 cases of antibiotic-associated diarrhea. c difficile infection (cdi) is defined by at least 3 unformed stools in a 24-hour period and stool, endoscopic, or histopathologic test results that indicate the presence of this bacteria. the history of cdi research can be divided into early (before 2000) and modern eras (after 2000). c difficile was first described in 1935, and the characteristics and causes ... | 2012 | 22433924 |
| prospective observational study on antibiotic-associated bloody diarrhea: report of 21 cases with a long-term follow-up from turkey. | antibiotic-associated hemorrhagic colitis is a distinct form of antibiotic-associated bloody diarrhea (aabd) in which clostridium difficile is absent. although the cause is not exactly known, reports have suggested the role of klebsiella oxytoca and/or c. difficile. | 2012 | 22433794 |
| current strategies for management of initial clostridium difficile infection. | in the past decade, an epidemic strain of clostridium difficile has led to increased incidence and severity of nosocomial c. difficile infections (cdi). responsiveness to standard antimicrobial care for this strain is declining, and the morbidity and mortality of cdi and recurrent cdi are rising. effective management requires a coordinated effort among all members of the healthcare team to facilitate early identification of patients at risk for cdi, early recognition of disease onset and confirm ... | 2012 | 22407996 |
| strategies for prevention of clostridium difficile infection. | infection control is the most essential component of an effective overall management strategy for prevention of nosocomial clostridium difficile infection (cdi). the cornerstones of cdi prevention are appropriate contact precautions and strict hand hygiene. other important tactics are effective environmental cleaning, identification and removal of environmental sources of c. difficile, and antibiotic stewardship. hospitalists, as coordinators of care for each patient and advocates for quality ca ... | 2012 | 22407995 |
| meeting the challenge of recurrent clostridium difficile infection. | recurrent clostridium difficile infection (cdi) is a growing problem that poses significant management challenges. there is no strong evidence to support a particular treatment strategy for recurrent cdi, especially those with multiple recurrences. however, a key strategy for reducing recurrent cdi is prompt diagnosis and treatment, facilitated by early recognition of patients at risk for recurrence. | 2012 | 22407994 |
| clostridium difficile infection: the scope of the problem. | clostridium difficile infection (cdi) is increasingly common, and it is associated with significant morbidity, mortality, and cost burden for patients and the healthcare system. the severity and rates of recurrent cdi and associated mortality are also increasing. this article is an overview of the changes in cdi epidemiology that have occurred since the turn of the century and the current scope of the problem. the 3 articles that follow in this supplement address the diagnosis and treatment of i ... | 2012 | 22407993 |
| genomic sequence of bacteriophage atcc 8074-b1 and activity of its endolysin and engineered variants against clostridium sporogenes. | lytic bacteriophage atcc 8074-b1 produces large plaques on its host clostridium sporogenes. sequencing of the 47,595-bp genome allowed the identification of 82 putative open reading frames, including those encoding proteins for head and tail morphogenesis and lysis. however, sequences commonly associated with lysogeny were absent. orf 22 encodes an endolysin, cs74l, that shows homology to n-acetylmuramoyl-l-alanine amidases, and when expressed in escherichia coli, the protein causes effective ly ... | 2012 | 22427494 |
| clostridium difficile of the ileum following total abdominal colectomy, with or without proctectomy: who is at risk? | clostridium difficile enteritis is considered a rare entity, although recent data suggest a significant increase in prevalence and incidence. there is paucity of data evaluating risk factors of c difficile enteritis following total colectomy. | 2012 | 22426266 |
| comparison of eight commercial enzyme immunoassays for the detection of clostridium difficile from stool samples and effect of strain type. | we compared the performance of 8 clostridium difficile enzyme immunoassays to cell cytotoxicity neutralization assay and toxigenic culture. the effect of strain type on assay performance was also examined. there were a total of 71 (14.4%) samples in which c. difficile was recovered; 58 (81.7%) of 71 were toxigenic. compared to a composite reference standard of either c. difficile cytotoxin assay positive or toxigenic c. difficile culture positive, the sensitivities of these assays varied from 31 ... | 2012 | 22424900 |
| clinical predictors of fulminant colitis in patients with clostridium difficile infection. | clostridium difficile infection (cdi) can affect up to 8% of hospitalized patients. twenty-five percent cdi patients may develop c. difficile associated diarrhea (cdad) and 1-3% may progress to fulminant c. difficile colitis (fcdc). once developed, fcdc has higher rates of complications and mortality. | 2015 | 22421720 |
| fk506-binding protein 51 interacts with clostridium botulinum c2 toxin and fk506 inhibits membrane translocation of the toxin in mammalian cells. | the binary clostridium botulinum c2 toxin consists of the binding/translocation component c2iia and the separate enzyme component c2i. c2iia delivers c2i into the cytosol of eukaryotic target cells where c2i adp-ribosylates actin. after receptor-mediated endocytosis of the c2iia/c2i complex, c2iia forms pores in membranes of acidified early endosomes and unfolded c2i translocates through the pores into the cytosol. membrane translocation of c2i is facilitated by the activities of host cell chape ... | 2012 | 22420783 |
| audit and feedback to reduce broad-spectrum antibiotic use among intensive care unit patients: a controlled interrupted time series analysis. | we aimed to rigorously evaluate the impact of prospective audit and feedback on broad-spectrum antimicrobial use among critical care patients. | 2012 | 22418630 |
| epidemiology and outcomes of clostridium difficile infections in hematopoietic stem cell transplant recipients. | background. clostridium difficile is the leading cause of infectious diarrhea among hospitalized patients and is a major concern for patients undergoing hematopoietic stem cell transplantation (hsct). risk factors and the natural history of c. difficile infection (cdi) are poorly understood in this population. methods. we performed a retrospective nested case-control study to describe the epidemiology, timing, and risk factors for cdi among adult patients who received hscts at our center from ja ... | 2012 | 22412059 |
| antimicrobial-resistant strains of clostridium difficile from north america. | a total of 316 toxigenic clostridium difficile clinical isolates of known pcr ribotypes from patients in north america were screened for resistance to clindamycin, metronidazole, moxifloxacin, and rifampin. clindamycin resistance was observed among 16 different ribotypes, with ribotypes 017, 053, and 078 showing the highest proportions of resistance. all isolates were susceptible to metronidazole. moxifloxacin resistance was present in >90% of pcr-ribotype 027 and 053 isolates but was less commo ... | 2012 | 22411613 |
| induction of cytokines in a macrophage cell line by proteins of clostridium difficile. | clostridium difficile is a major cause of nosocomial diarrhoea. the toxins produced by c. difficile are responsible for the characteristic pathology observed in c. difficile disease, but several surface-associated proteins of c. difficile are also recognized by the immune system and could modulate the immune response in infection. the aim of this study was to assess the induction of cytokines in a macrophage cell line in response to different antigens prepared from five c. difficile strains: the ... | 2012 | 22409477 |
| distribution of the vang-like gene cluster in clostridium difficile clinical isolates. | treatment of clostridium difficile infections generally requires cessation of their causative antibiotic and subsequent administration of metronidazole or vancomycin. intriguingly, the genome of c. difficile 630 contains a cryptic gene cluster homologous to the vang-type operon of enterococcus faecalis bm4518. we detected this cluster by pcr in 35 out of 41 clinical isolates, confirming its large prevalence in this species. the cluster was found to be located in a unique locus. comparison of thi ... | 2012 | 22409319 |
| identification and characterization of a bacterial hydrosulphide ion channel. | the hydrosulphide ion (hs(-)) and its undissociated form, hydrogen sulphide (h(2)s), which are believed to have been critical to the origin of life on earth, remain important in physiology and cellular signalling. as a major metabolite in anaerobic bacterial growth, hydrogen sulphide is a product of both assimilatory and dissimilatory sulphate reduction. these pathways can reduce various oxidized sulphur compounds including sulphate, sulphite and thiosulphate. the dissimilatory sulphate reductio ... | 2012 | 22407320 |
| clostridium difficile colitis: a review. | clostridium difficile has become an increasingly important nosocomial pathogen and is one of the most common causes of hospital-acquired diarrhea. the incidence of c difficile infection (cdi) is increasing worldwide. overuse of antibiotics is felt to be a major contributing factor leading to the increased incidence of cdi. the clinical manifestations of cdi vary from a mild form of the disease to fulminant diarrhea, leading to significant patient morbidity and mortality. the increasing incidence ... | 2012 | 22406889 |
| nosocomial diarrhea: a review of pathophysiology, etiology, and treatment strategies. | diarrhea is a frequent complication among hospitalized patients. nosocomial diarrhea is generally diagnosed as increased frequency and decreased consistency of stools developing after 72 hours of hospitalization. the causes of nosocomial diarrhea may be infectious or noninfectious. noninfectious etiologies occur most commonly, and are often adverse effects of medications or enteral nutrition therapies. infectious etiologies are most concerning and include clostridium difficile and norovirus. pat ... | 2012 | 22406888 |
| an overview of the diagnosis and management of clostridium difficile infection. | the diagnosis and treatment of clostridium difficile infection are becoming increasingly complex with the introduction of novel diagnostic techniques and new pharmacologic and nonpharmacologic treatments. the integration of these new approaches with older, established methods is a challenge to individual clinicians and hospital systems. this article provides an overview of the current methods for the diagnosis and treatment of c difficile infection. | 2012 | 22406887 |
| antimicrobial prophylaxis in noncardiac prosthetic device recipients. | secondary antimicrobial prophylaxis involves the use of ≥ 1 antimicrobial agent just prior to the time when a diagnostic/therapeutic procedure, which may induce infection, is to be performed. in the context of this article, antimicrobial agent(s) are administered to patients with ≥ 1 implanted prosthetic device in order to prevent metastatic seeding of the device(s) during bacteremia induced by a diagnostic/therapeutic procedure. antimicrobial agents used in this context are only administered pe ... | 2012 | 22406882 |
| high resolution melt analysis to track infections due to ribotype 027 clostridium difficile. | the increased prevalence of hypervirulent ribotype 027 clostridium difficile requires rapid identification of isolates in order to implement timely infection control strategies. high resolution melt (hrm) analysis of pcr products can identify strain variation amongst genera of bacteria. the intergenic (16s-23s rdna) spacer region contains sequence regions conserved within genera and other sequence region variables between species within genera. we wished to investigate whether hrm analysis of pc ... | 2012 | 22406296 |
| clostridium difficile infection is associated with worse long term outcome in patients with ulcerative colitis. | clostridium difficile infection (cdi) is becoming prevalent in general population as well as in patients with inflammatory bowel disease (ibd). | 2012 | 22405170 |
| diagnosing toxigenic clostridium difficile: new confidence bounds show culturing increases sensitivity of the toxin a/b enzyme immunoassay and refute gold standards. | to scrutinize published sensitivity estimates obtained using questionable gold standards by comparing sensitivities of culturing clostridium difficile in commercially available media followed by enzyme immunoassay (eia) toxin a or b detection (culture test) with applying the eia to stool samples alone (direct test). | 2012 | 22404319 |
| a new rapid method for clostridium difficile dna extraction and detection in stool: toward point-of-care diagnostic testing. | we describe a new method for the rapid diagnosis of clostridium difficile infection, with stool sample preparation and dna extraction by heat and physical disruption in a single-use lysis microreactor (lmr), followed by a rapid pcr amplification step. all steps can be accomplished in <20 minutes overall. gel electrophoresis is currently used to detect the amplification product, pending real-time availability with an ultra-rapid thermocycler. compared with the dual enzyme immunoassay (eia) screen ... | 2012 | 22402170 |
| secretome analysis of clostridium difficile strains. | clostridium difficile causes infections ranging from mild c. difficile-associated diarrhea to severe pseudomembranous colitis. since 2003 new hypervirulent c. difficile strains (pcr ribotype 027) emerged characterized by a dramatically increased mortality. the secretomes of the three c. difficile strains cdr20291, cd196, and cd630 were analyzed and compared. proteins were separated and analyzed by means of sds--page and lc-ms. ms data were analyzed using mascot and proteins were checked for expo ... | 2012 | 22398929 |
| vital signs: preventing clostridium difficile infections. | clostridium difficile infection (cdi) is a common and sometimes fatal health-care-associated infection; the incidence, deaths, and excess health-care costs resulting from cdis in hospitalized patients are all at historic highs. meanwhile, the contribution of nonhospital health-care exposures to the overall burden of cdi, and the ability of programs to prevent cdis by implementing cdc recommendations across a range of hospitals, have not been demonstrated previously. | 2012 | 22398844 |
| double trouble: how big a problem is redundant anaerobic antibiotic coverage in veterans affairs medical centres? | to assess the prevalence of, and the variation in, avoidable use of metronidazole in the veterans affairs (va) healthcare system | 2012 | 22398652 |
| treatment failure and recurrence of clostridium difficile infection following treatment with vancomycin or metronidazole: a systematic review of the evidence. | the objective of this review was to evaluate the frequency of treatment failure and recurrence of clostridium difficile infection (cdi) following treatment with vancomycin or metronidazole in recently performed studies (last 10 years). searches in pubmed and scopus were performed by two reviewers independently. data regarding treatment failure and recurrence following metronidazole and vancomycin treatment were extracted and analysed. in total, 39 articles (7005 patients) were selected for inclu ... | 2012 | 22398198 |
| macro and micro diversity of clostridium difficile isolates from diverse sources and geographical locations. | clostridium difficile has emerged rapidly as the leading cause of antibiotic-associated diarrheal disease, with the temporal and geographical appearance of dominant pcr ribotypes such as 017, 027 and 078. despite this continued threat, we have a poor understanding of how or why particular variants emerge and the sources of strains that dominate different human populations. we have undertaken a breadth genotyping study using multilocus sequence typing (mlst) analysis of 385 c. difficile strains f ... | 2012 | 22396735 |
| quantitative analysis of intestinal bacterial populations from term infants fed formula supplemented with fructo-oligosaccharides. | previous studies of infant formulas supplemented with oligosaccharides reported mixed results regarding the impact on intestinal microbial populations. the objective of this study was to examine the effect of supplementation of an infant formula with fructo-oligosaccharides (fos) on select groups of intestinal bacteria in term infants. | 2012 | 22395187 |
| a real-world evaluation of oral vancomycin for severe clostridium difficile infection: implications for antibiotic stewardship programs. | to assess antibiotic treatment patterns and clinical outcomes of patients with clostridium difficile infection (cdi) based on underlying severity of cdi disease. | 2012 | 22392421 |
| activity of a novel cyclic lipopeptide, cb-183,315, against resistant clostridium difficile and other gram-positive aerobic and anaerobic intestinal pathogens. | we evaluated the activity of cb-183,315 against clostridium difficile, including strains that are resistant to fluoroquinolones and metronidazole and with elevated mics to vancomycin as well as other gram-positive intestinal pathogens. the mics of cb-183,315 against all c. difficile isolates were ≤ 1 μg/ml. cb-183,315 had greater activity than vancomycin and metronidazole against c. difficile isolates and was more active than the comparators against vancomycin-resistant enterococcus (vre). cb-18 ... | 2012 | 22391542 |
| clostridium difficile infection after allogeneic hematopoietic stem cell transplantation: incidence, risk factors, and outcome. | clostridium difficile (c. difficile) infection was observed in 13% of recipients after hematopoietic stem cell transplantation (hsct), mainly in the first month posttransplantation. risk factors were cord blood as the source of stem cells, acute graft-versus-host disease (gvhd), and total body irradiation (tbi). no association was found with an increased risk of mortality. the purpose of this study was to evaluate the incidence, risk factors, and outcome of c. difficile infection (cdi) after hsc ... | 2012 | 22387347 |
| clostridium difficile: a new look at an old but increasingly deadly infection. | | 2012 | 22384754 |
| fidaxomicin, a new treatment for clostridium difficile infections. | clostridium difficile is currently the most important cause of infectious diarrhea in the united states. fidaxomicin, a macrolide antibiotic, was recently approved for treatment of c. difficile infections (cdis). in vitro studies demonstrate that fidaxomicin has a narrow spectrum of activity against c. difficile with minimal effect on the gut flora. clinical trials indicate that fidaxomicin is as effective as vancomycin for treatment of cdi with fewer recurrences. additionally, fidaxomicin has m ... | 2012 | 22384450 |
| spores of clostridium difficile clinical isolates display a diverse germination response to bile salts. | clostridium difficile spores play a pivotal role in the transmission of infectious diarrhoea, but in order to cause disease spores must complete germination and return to vegetative cell growth. while the mechanisms of spore germination are well understood in bacillus, knowledge of c. difficile germination remains limited. previous studies have shown that bile salts and amino acids play an important role in regulating the germination response of c. difficile spores. taurocholate, in combination ... | 2012 | 22384234 |
| association between appendectomy and clostridium difficile infection. | recent theory proposes that the appendix functions as a reservoir for commensal bacteria, and serves to re-inoculate the colon with normal flora in the event of pathogen exposure or purging of intestinal flora. if true, we reasoned that flora from a normal appendix could provide protection against clostridium difficile. we conducted this investigation to examine the protective effect of an intact appendix and test the hypothesis that prior appendectomy will be more common among patients with a p ... | 2012 | 22383922 |
| diarrhoeagenic escherichia coli as a predominant cause of paediatric nosocomial diarrhoea in india. | intestinal nosocomial infections remain a major concern in paediatric wards leading to increased morbidity and mortality. this study determined the aetiological and epidemiological profile of nosocomial diarrhoea (nd) among children admitted to a hospital in india. during the period of january 2008 to june 2009, we consecutively enrolled 100 children between the age of 2 months and 14 years who developed nd as defined by the centers for disease control and prevention. a control group of patients ... | 2012 | 22383443 |
| [current management of toxic megacolon]. | toxic megacolon is a rare and life-threatening complication of severe colitis, defined as a dilatation of the colon > 6 cm in the absence of distal obstruction in combination with signs of systemic toxicity (major criteria: fever, tachycardia, leukocytosis, anaemia). various triggers are known and the most common causes are underlying ulcerative colitis and clostridium difficile. diagnosis can easily be made by clinical examination, routine laboratory parameters and a plain x-ray of the abdomen. ... | 2012 | 22383287 |
| certification in infection control matters: impact of infection control department characteristics and policies on rates of multidrug-resistant infections. | the study objective is to describe infection control policies aimed at multidrug-resistant organisms (mdro) in california hospitals and assess the relationship among these policies, structural characteristics, and rates of methicillin-resistant staphylococcus aureus (mrsa) or vancomycin-resistant enterococcus (vre) bloodstream infections and clostridium difficile infections. | 2012 | 22381222 |