| clostridium difficile infection in low- and middle-human development index countries: a systematic review. | to describe the impact and epidemiology of clostridium difficile infection (cdi) in low- and middle-human development index (lmhdi) countries. | 2017 | 28796388 |
| data from a survey of clostridium perfringens and clostridium difficile shedding by dogs and cats in the madrid region (spain), including phenotypic and genetic characteristics of recovered isolates. | this article contains information related to a recent survey of the prevalence of fecal shedding of clostridium perfringens and c. difficile by dogs and cats attended in veterinary clinics located in the madrid region (spain). specifically, we provide detailed information about the clinics that participated in the survey, the demographic and clinic characteristics of recruited animals and the genetic and phenotypic characteristics (including antimicrobial susceptibility data), of recovered bacte ... | 2017 | 28795086 |
| saccharomyces cerevisiae var. boulardii fungemia following probiotic treatment. | probiotics are commonly prescribed as an adjuvant in the treatment of antibiotic-associated diarrhea caused by clostridium difficile. we report the case of an immunocompromised 73-year-old patient on chemotherapy who developed saccharomyces cerevisiae var. boulardii fungemia in a central venous catheter during treatment of antibiotic-associated pseudomembranous colitis with the probiotic saccharomyces cerevisiae var. boulardii. fungemia was resolved after interruption of probiotic administration ... | 2017 | 28794958 |
| genome characterization of a novel binary toxin-positive strain of clostridium difficile and comparison with the epidemic 027 and 078 strains. | clostridium difficile is an anaerobic gram-positive spore-forming gut pathogen that causes antibiotic-associated diarrhea worldwide. a small number of c. difficile strains express the binary toxin (cdt), which is generally found in c. difficile 027 (st1) and/or 078 (st11) in clinic. however, we isolated a binary toxin-positive non-027, non-078 c. difficile lc693 that is associated with severe diarrhea in china. the genotype of this strain was determined as st201. to understand the pathogenesis-b ... | 2017 | 28794800 |
| clostridium difficile infections in young infants: case presentations and literature review. | it has been assumed that symptomatic clostridium difficile infections do not occur in young infants, as this specific group would lack specific c. difficile toxin receptors. as a consequence, it is often current practice not to test for c. difficile in neonates and young infants up to 2 years of age presenting with (bloody) diarrhea. the evidence to support this is, however, weak and largely based on small, poorly designed animal studies. we present two young infants with recurrent bloody diarrh ... | 2017 | 28791215 |
| immunization with recombinant tcdb-encapsulated nanocomplex induces protection against clostridium difficile challenge in a mouse model. | clostridium difficile is considered to be one of the major cause of infectious diarrhea in healthcare systems worldwide. symptoms of c. difficile infection are caused largely by the production of two cytotoxins: toxin a (tcda) and toxin b (tcdb). vaccine development is considered desirable as it would decrease the mounting medical costs and mortality associated with c. difficile infections. biodegradable nanoparticles composed of poly-γ-glutamic acid (γ-pga) and chitosan have proven to be a safe ... | 2017 | 28790999 |
| pathogenicity locus, core genome, and accessory gene contributions to clostridium difficile virulence. | clostridium difficile is a spore-forming anaerobic bacterium that causes colitis in patients with disrupted colonic microbiota. while some individuals are asymptomatic c. difficile carriers, symptomatic disease ranges from mild diarrhea to potentially lethal toxic megacolon. the wide disease spectrum has been attributed to the infected host's age, underlying diseases, immune status, and microbiome composition. however, strain-specific differences in c. difficile virulence have also been implicat ... | 2017 | 28790208 |
| detection of acute gastroenteritis etiology in hospitalized young children: associated factors and outcomes. | the decision to test for the etiology of diarrhea is a challenging question for practicing pediatricians. | 2017 | 28790133 |
| carvacrol reduces clostridium difficile sporulation and spore outgrowth in vitro. | clostridium difficile is an anaerobic spore-forming pathogen that causes a serious toxin-mediated enteric disease in humans. therapeutic agents that are capable of reducing c. difficile spore production could significantly minimize the transmission and relapse of c. difficile infections. this study investigated the efficacy of a food-grade, plant-derived compound, carvacrol (cr), in reducing c. difficile spore production, germination and spore outgrowth. | 2017 | 28786786 |
| specificities of the intestinal microbiota in patients with inflammatory bowel disease and clostridium difficile infection. | clostridium difficile infection (cdi) is a common complication in inflammatory bowel disease (ibd) and has been associated with poor ibd outcome. intestinal microbiota composition in ibd patients with cdi has not been specifically evaluated to date. | 2017 | 28786749 |
| association between omeprazole use and clostridium difficile infection among hospitalized patients: a case-control study of the saudi population. | background: while few international studies have assessed the association between omeprazole use and the risk of clostridium difficile infection (cdi), research into this is lacking in saudi arabia and the middle east region. the aim of this study was to determine whether exposure to omeprazole is associated with the risk of clostridium difficile infection in a sample of hospitalized saudi patients. methodology: a retrospective matched case-control study was conducted at the king abdulaziz medic ... | 2017 | 28785535 |
| management of inflammatory bowel disease with clostridium difficile infection. | to address the management of clostridium difficile (c. difficile) infection (cdi) in the setting of suspected inflammatory bowel disease (ibd)-flare. | 2017 | 28785153 |
| tgf-β1/smads signaling pathway activation protects intestinal epithelium from clostridium difficile toxin a-induced damage. | clostridium difficile, the main cause of diarrhea in hospitalized patients, produces toxins a (tcda) and b (tcdb), which affect intestinal epithelial cell survival, proliferation, and migration, and induce an intense inflammatory response. tgf-β is a pleiotropic cytokine affecting enterocyte and immune/inflammatory responses. however, it has been shown that exposure of intestinal epithelium to a low concentration of tcda induces the release of tgf-β1, which has a protective effect on epithelial ... | 2017 | 28784928 |
| host factors are more important in predicting recurrent clostridium difficile infection than ribotype and use of antibiotics. | a frequent complication of clostridium difficile infection (cdi) is recurrent disease. the aim of this study was to determine whether early recurrence risk was higher after infection with ribotype 027 (outbreak strain) compared to infection with endemic strain types of c. difficile methods: consecutive patients diagnosed with cdi between may 2013 and march 2014 were included (outbreak strain, and non-outbreak strains). patients who developed recurrent cdi within 30 days after completion of cdi t ... | 2017 | 28782647 |
| the incidence and outcomes from clostridium difficile infection in hospitalized adults with inflammatory bowel disease. | clostridium difficile infection (cdi) may worsen outcomes in patients with inflammatory bowel disease (ibd), but large database-driven studies have conflicting results. the study objective is to analyze clinical features and outcomes in patients with cdi and ibd using the national hospital discharge survey (nhds) database from 2005 to 2009. | 2017 | 28782372 |
| is there a relationship between the presence of the binary toxin genes in clostridium difficile strains and the severity of c. difficile infection (cdi)? | some strains of clostridium difficile produce a binary toxin, in addition to the main c. difficile virulence factors (toxins a and b). there have been conflicting reports regarding the role of binary toxin and its relationship to the severity of c. difficile infection (cdi). samples, isolates and clinical data were collected as part of a prospective multicentre diagnostic study. clostridium difficile isolates (n = 1259) were tested by polymerase chain reaction (pcr) assay to detect binary toxin ... | 2017 | 28780742 |
| clostridium difficile infection. | clostridium difficile infection is a major health care challenge in terms of patient and economic consequences. for the patient, it is a morbid and sometimes a life-threatening iatrogenic complication of antibiotic treatment. in the united states, the provider's institution may face financial penalties, because the centers for disease control and prevention views this as an iatrogenic health care-associated complication that may not be reimbursable by the centers for medicare and medicaid servic ... | 2017 | 28779831 |
| healthcare-associated clostridium difficile infections are sustained by disease from the community. | clostridium difficile infections (cdis) are some of the most common hospital-associated infections worldwide. approximately 5% of the general population is colonised with the pathogen, but most are protected from disease by normal intestinal flora or immune responses to toxins. we developed a stochastic compartmental model of cdi in hospitals that captures the condition of the host's gut flora and the role of adaptive immune responses. a novel, derivative-based method for sensitivity analysis of ... | 2017 | 28776206 |
| amino acid differences in the 1753-to-1851 region of tcdb influence variations in tcdb1 and tcdb2 cell entry. | clostridium difficile tcdb2 enters cells with a higher efficiency than tcdb1 and exhibits an overall higher level of toxicity. however, the tcdb2-specific sequences that account for more efficient cell entry have not been reported. in this study, we examined the contribution of carboxy-terminal sequence differences to tcdb activity by comparing the binding, uptake, and endosomal localization of tcdb1 and tcdb2 or selected recombinant fragments of these proteins. our findings suggest that sequenc ... | 2017 | 28776043 |
| predictors of 30-day mortality in hospitalized patients with clostridium difficile infection. | clostridium difficile infection (cdi) is a significant cause of morbidity and mortality and is the most common nosocomial infection in the united states, with associated annual costs of approximately $3 billion. the epidemiology of cdi has changed with the identification of novel risk factors for incident and recurrent cdi. the aim of this study was to identify the predictors of 30-day mortality in hospitalized patients with cdi. | 2017 | 28771654 |
| fecal microbiota transplantation: beyond clostridium difficile. | fecal microbiota transplantation (fmt) has been established as standard of care in the treatment of antibiotic refractory clostridium difficile infection (rcdi). this review examines the current evidence that exists to support the use of fmt in the treatment of human disease beyond c. difficile infection. | 2017 | 28770495 |
| aetiology and clinical features of facial cellulitis: a prospective study. | in the early 20th century, the face was the predominant site of cellulitis. despite a relative decrease in the incidence of facial cellulitis, it is still common. there are few studies on this condition during the last decades. the aim of this study was to describe contemporary aetiological and clinical characteristics of patients admitted to hospital with non-suppurative facial cellulitis. | 2017 | 28768452 |
| therapy for clostridium difficile infection - any news beyond metronidazole and vancomycin? | infections with clostridium difficile (cdi) represent a major burden for the health care system. treatment is generally by antibiotic therapy with metronidazole and vancomycin, but efficacy remains suboptimal. areas covered: this review discusses established and emerging treatment options for cdi, and current therapeutic guidelines, taking into account disease severity and risk of relapse. expert commentary: new therapeutic approaches, including antibodies and new classes of antibiotics, and new ... | 2017 | 28766951 |
| high prevalence of subclass-specific binding and neutralizing antibodies against clostridium difficile toxins in adult cystic fibrosis sera: possible mode of immunoprotection against symptomatic c. difficile infection. | despite multiple risk factors and a high rate of colonization for clostridium difficile, the occurrence of c. difficile infection in patients with cystic fibrosis is rare. the aim of this study was to compare the prevalence of binding c. difficile toxin-specific immunoglobulin (ig)a, igg and anti-toxin neutralizing antibodies in the sera of adults with cystic fibrosis, symptomatic c. difficile infection (without cystic fibrosis) and healthy controls. | 2017 | 28765714 |
| severe infection in antineutrophil cytoplasmic antibody-associated vasculitis. | to compare the rate of severe infections after the onset of antineutrophil cytoplasmic antibody (anca)-associated vasculitis (aav) with the rate in the background population, and to identify predictors of severe infections among patients with aav. | 2017 | 28765251 |
| modeling new immunoregulatory therapeutics as antimicrobial alternatives for treating clostridium difficile infection. | the current treatment paradigm in clostridium difficile infection is the administration of antibiotics contributing to the high rates of recurrent infections. recent alternative strategies, such as fecal microbiome transplantation and anti-toxin antibodies, have shown similar efficacy in the treatment of c. difficile associated disease (cdad). however, barriers exist for either treatment or other novel treatments to displace antibiotics as the standard of care. to aid in the comparison of these ... | 2017 | 28764868 |
| vancomycin-resistant enterococci with vana gene in treated municipal wastewater and their association with human hospital strains. | vancomycin-resistant enterococci (vre) are pathogens of increasing medical importance. in brno, czech republic, we collected 37 samples from the effluent of a wastewater treatment plant (wwtp), 21 surface swabs from hospital settings, and 59 fecal samples from hospitalized patients and staff. moreover, we collected 284 gull cloacal swabs from the colony situated 35km downstream the wwtp. samples were cultured selectively. enterococci were identified using maldi-tof ms, phenotypically tested for ... | 2017 | 28763660 |
| probiotics for gastrointestinal conditions: a summary of the evidence. | probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. probiotics have been widely studied in a variety of gastrointestinal diseases. the most-studied species include lactobacillus, bifidobacterium, and saccharomyces. however, a lack of clear guidelines on when to use probiotics and the most effective probiotic for different gastrointestinal conditions may be confusing for family physicians and their patients. probi ... | 2017 | 28762696 |
| clostridium difficile colonizes alternative nutrient niches during infection across distinct murine gut microbiomes. | clostridium difficile is the largest single cause of hospital-acquired infection in the united states. a major risk factor for clostridium difficile infection (cdi) is prior exposure to antibiotics, as they disrupt the gut bacterial community which protects from c. difficile colonization. multiple antibiotic classes have been associated with cdi susceptibility, many leading to distinct community structures stemming from variation in bacterial targets of action. these community structures present ... | 2017 | 28761936 |
| next-generation probiotics targeting clostridium difficile through precursor-directed antimicrobial biosynthesis. | integration of antibiotic and probiotic therapy has the potential to lessen the public health burden to antimicrobial-associated diseases. clostridium difficile infection (cdi) represents an important example where rational design of next generation probiotics is being actively pursued to prevent disease recurrence. because intrinsic resistance to clinically relevant cdi antibiotics (vancomycin, metronidazole, and fidaxomicin) is a desired trait in such probiotic species, we screened several bac ... | 2017 | 28760934 |
| polyethylene glycol intestinal lavage in addition to usual antibiotic treatment for severe clostridium difficile colitis: a randomised controlled pilot study. | clostridium difficile infections (cdi) are common, costly and potentially life threatening. most cdi will respond to antibiotic therapy, but 3%-10% of all patients with cdi will progress to a severe, life-threatening course. complete removal of the large bowel is indicated for severe cdi. however, the 30-day mortality following surgical intervention for severe cdi ranges from 20% to 70%. a less invasive approach using surgical faecal diversion and direct colonic lavage with polyethylene glycol ( ... | 2017 | 28760801 |
| the potential of alcohol release doorplates to reduce surface contamination during hand contact. | optimal hand hygiene may be compromised by contact with contaminated environmental surfaces. | 2017 | 28760635 |
| the impact of a computerized clinical decision support tool on inappropriate clostridium difficile testing. | objective to evaluate the effectiveness of a computerized clinical decision support intervention aimed at reducing inappropriate clostridium difficile testing design retrospective cohort study setting university of pennsylvania health system, comprised of 3 large tertiary-care hospitals patients all adult patients admitted over a 2-year period intervention providers were required to use an order set integrated into a commercial electronic health record to order c. difficile toxin testing. the or ... | 2017 | 28760168 |
| nonantimicrobial drug targets for clostridium difficile infections. | clostridium difficile infection (cdi) is a major public health problem worldwide. treatment has become complicated due to the emergence of strains with increased toxigenicity and sporulation rate, together with rampant antibiotics use that disrupts colonization resistance of the colonic microbiota. as a result, there is a critical need for nonantibiotic treatments. therapies based on inhibiting the toxins, bacterial structures responsible for colonization, virulence and restoration of the gut mi ... | 2017 | 28759258 |
| acute appendicitis: an extracolonic manifestation of clostridium difficile colitis. | the current report is the case of a 30-year-old male patient who presented with symptomatology suggestive of appendicitis. however, careful history-taking and laboratory tests led to the diagnosis of clostridium difficile colitis, resulting in successful nonsurgical management of this patient. although both appendicitis and c. difficile colitis are common conditions, they are rarely diagnosed concurrently. this is reflected by paucity of literature describing this manifestation. given this curre ... | 2017 | 28757875 |
| associations between antimicrobial stewardship program elements and clostridium difficile infection performance. | hospitals are categorized as better, no different, or worse at a national level based on their clostridium difficile infection performance. institutional antimicrobial stewardship programs seek to decrease the occurrence of c difficile by implementing strategies to address antibiotic usage; however, optimal structure and strategies for accomplishing this remain largely unknown. we found that a higher proportion of hospitals with either a worse or no different rank used a postprescription audit a ... | 2017 | 28757087 |
| underutilization of norovirus testing in hematopoietic cell transplant recipients at a large cancer center. | the development of a new laboratory-developed norovirus assay provided an opportunity to assess testing patterns, incidence, and outcomes of norovirus among hematopoietic cell transplant (hct) recipients. clostridium difficile and norovirus tests from 1,393 hct recipients were compared in these analyses. in this population of high-risk patients, norovirus appeared to occur seasonally, but testing was infrequent despite a correlation with more severe disease when compared with patients with c dif ... | 2017 | 28757083 |
| burden of clostridium difficile infections in french hospitals in 2014 from the national health insurance perspective. | objective to describe the hospital stays of patients with clostridium difficile infection (cdi) and to measure the hospitalization costs of cdi (as primary and secondary diagnoses) from the french national health insurance perspective design burden of illness study setting all acute-care hospitals in france methods data were extracted from the french national hospitalization database (pmsi) for patients covered by the national health insurance scheme in 2014. hospitalizations were selected using ... | 2017 | 28756805 |
| antibiotic overuse is a major risk factor for clostridium difficile infection in surgical patients. | clostridium difficile infection (cdi) is associated with increased cost, morbidity, and mortality in postoperative patients. variable rates of postoperative cdi are reported among 4 surgical specialties during the 30-month study period. risk factors for cdi include antibiotic use, increased asa score, and increased admissions in the past year. | 2017 | 28756789 |
| organoid culture systems to study host-pathogen interactions. | recent advances in host-microbe interaction studies in organoid cultures have shown great promise and have laid the foundation for much more refined future studies using these systems. modeling of zika virus (zikv) infection in cerebral organoids have helped us understand its association with microcephaly. similarly, the pathogenesis of bacterial (helicobacter pylori, clostridium difficile) and viral (norovirus, rotaviruses) infections have been precisely dissected in organoid cultures. addition ... | 2017 | 28756233 |
| outcomes of clostridium difficile-infected patients managed in a common isolation unit compared with isolation in their bed of diagnosis. | cohorting clostridium difficile infection (cdi) patients is a strategy which has not been thoroughly evaluated. we compared clinical characteristics and outcomes of cdi patients treated in a common isolation unit (ciu) versus those treated in their bed of diagnosis. patients treated in the ciu showed lower mortality rates and antibiotic usage; however, a higher recurrence rate was reported. | 2017 | 28754222 |
| performance evaluation of the verigene(®)clostridium difficile nucleic acid test, an automated multiplex molecular testing system for detection of c. difficile toxin. | the verigene(®)clostridium difficile nucleic acid test (verigene(®) cdf test) is an automatic and rapid detection system for the genes encoding tcda, tcdb, binary toxin, and the single nucleotide deletion at base pair 117 in the tcdc based on microarray and pcr amplification. we compared the performance of the verigene(®) cdf test to that of two enzyme immunoassays, c. diff quik chek complete and x/pect toxin a/b, using 118 specimens. we found overall concordance rates of 81.4% and 78.8% between ... | 2017 | 28751156 |
| susceptibilities of clinical clostridium difficile isolates to antimicrobials: a systematic review and meta-analysis of studies since 1970. | although exposure to antibiotics can cause c. difficile infection, certain antibiotics are used to treat c. difficile. the measurements of antimicrobial clostridium difficile activity could help identifying antibiotic risk and emergent resistance. here, we describe publication patterns relating to c. difficile susceptibilities and estimate minimum inhibitory concentrations (mic) for antibiotic classes in the published literature between january, 1970 and june, 2014. | 2017 | 28750918 |
| the present status of fecal microbiota transplantation and its value in the elderly. | purpose of review: this article will review current literature describing fecal microbiota transplantation (fmt) in the treatment of various diseases, and its potential role in elderly patients (age ≥ 65 years). | 2017 | 28748314 |
| fecal transplantation as a treatment for clostridium difficile infection in patients with ulcerative colitis. | clostridium difficile (cd) infection is currently the most frequent etiology of nosocomial diarrhea. besides, its incidence is progressively increasing in ambulatory patients. inflammatory bowel disease (ibd) is a risk factor of cd infection itself, but also due to the regular immunosuppressive treatment used in these patients. at the present time, fecal transplantation (ft) is a safe and cost-effective alternative if the previous antibiotic treatments have failed. similar outcomes between patie ... | 2017 | 28747056 |
| magnitude and direction of the association between clostridium difficile infection and proton pump inhibitors in adults and pediatric patients: a systematic review and meta-analysis. | clostridium difficile infection (cdi) is a cause of increased morbidity and health care costs among hospitalized patients. proton pump inhibitors (ppis) are mainly used for the treatment of acid-related upper gastrointestinal diseases. the aim of the study was to assess the risks associated with initial and recurrent cdi in adult and pediatric patients treated with ppis. | 2017 | 28744822 |
| protection of hamsters from mortality by reducing fecal moxifloxacin concentration with dav131a in a model of moxifloxacin-induced clostridium difficile colitis. | lowering the gut exposure to antibiotics during treatments can prevent microbiota disruption. we evaluated the effect of an activated charcoal-based adsorbent, dav131a, on fecal free moxifloxacin concentration and mortality in a hamster model of moxifloxacin-induced c. difficile infection. | 2017 | 28739791 |
| molecular epidemiology and antimicrobial susceptibility of clostridium difficile isolated from the chinese people's liberation army general hospital in china. | clostridium difficile is a gram-positive, spore-forming obligate anaerobe responsible for antibiotic-associated diarrhoea. its virulence is associated with the production of endotoxins a and b and endospores, which can cause symptoms, such as diarrhoea, toxic megacolon, and pseudomembranous colitis. given the increasing elderly population and the well-recognized problem of over-prescribing of broad-spectrum antibiotics, it is critical to have an understanding of molecular epidemiology and antimi ... | 2017 | 28736259 |
| [recovery from episodes of clostridium difficile infection following the implementation of a consensus document]. | | 2017 | 28734905 |
| response to letter of k. singh, 'role of silver nitrate in the efficacy of hydrogen peroxide aerial decontamination systems' regarding s. ali et al. 'efficacy of two hydrogen peroxide vapour aerial decontamination systems for enhanced disinfection of meticillin-resistant staphylococcus aureus, klebsiella pneumoniae and clostridium difficile in single isolation rooms'. | | 2017 | 28734723 |
| what do visitors know and how do they feel about contact precautions? | patients with clostridium difficile infection (cdi) are placed in contact precautions. we surveyed 31 visitors of cdi patients to understand their compliance, knowledge, and perceptions of contact precautions. although most visitors knew where to find the required personal protective equipment, only 42% were fully compliant with gown and gloves. family members accounted for 90% of visitors, and roughly half of the reasons given for not gowning were related to a lack of perceived risk for family ... | 2017 | 28732742 |
| impact of simultaneous glutamate dehydrogenase (gdh) and toxin a/b rapid immunoassay on clostridium difficile diagnosis and treatment in hospitalized patients with antibiotic-associated diarrhea in a university hospital of brazil. | clostridium difficile is a major cause of health care-associated infection, but disagreement between diagnostic tests is an ongoing barrier to clinical decision making. conventional enzyme immunoassay (eia) for toxin detection is currently the most frequently used technique for cdi diagnosis, but its low sensitivity makes the development of an alternative strategy necessary for improving the diagnosis in developing countries. | 2017 | 28730697 |
| bezlotoxumab: a novel agent for the prevention of recurrent clostridium difficile infection. | over the last decade, the incidence and severity of clostridium difficile infection (cdi) have significantly increased, leading to a rise in cdi-associated hospitalizations, health care costs, and mortality. although treatment options exist for cdi, recurrence is frequent following treatment. furthermore, patients with at least one cdi recurrence are at an increased risk of developing additional recurrences. a novel approach to the prevention of recurrent cdi is the use of monoclonal antibodies ... | 2017 | 28730660 |
| clinical characteristics and ultrasonographic findings of acute bacterial enterocolitis in children. | this study clarified the bacterial pathogens currently causing acute infectious enterocolitis (aie) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. | 2017 | 28730135 |
| antimicrobial susceptibility of clostridium difficile isolates in israel. | an increase of clostridium difficile isolates with reduced susceptibility to various antimicrobial agents has been observed, including isolates that are non-susceptible to antibiotics that are routinely used for treatment of c. difficile, such as vancomycin and metronidazole. we determined the susceptibility rates of c. difficile isolates from hospitals in northern israel to various antibiotics including tigecycline, which was not previously reported from israel. | 2017 | 28729205 |
| perceptions of clostridium difficile infections among infection control professionals in taiwan. | high clostridium difficile colonization and infection rates among hospitalized patients had been noted in taiwan. nevertheless, the cognition about clinical diagnosis and management of cdi among infection control professionals in taiwan is not clear. | 2017 | 28728905 |
| detection of clostridium difficile antigen and toxin in stool specimens: comparison of the c. difficile quik chek complete enzyme immunoassay and genexpert c. difficile polymerase chain reaction assay. | accurate and rapid laboratory diagnosis of clostridium difficile infections (cdi) remains a significant challenge. a two-step algorithm for detection of toxigenic c. difficile in stool based on initial screening for glutamate dehydrogenase assay followed by confirmation by toxin a+b detection using an enzyme immunoassay (eia) or molecular assay has been proposed. we aimed to evaluate the c. difficile quik chek complete® (qcc-eia) versus the genexpert® c. difficile polymerase chain reaction (pcr) ... | 2017 | 28721981 |
| clinicians should assess the benefits and risks of using bezlotoxumab for reducing the risk of recurrent clostridium difficile infection. | | 2017 | 28716810 |
| gemcitabine associated pseudocellulitis: a missed diagnosis. | we report a case of a 51-year-old male with past medical history significant for cholangiocarcinoma presented with two weeks of worsening bilateral lower extremity swelling and erythema. patient has been on active chemotherapy for his cholangiocarcinoma with gemcitabine weekly infusions. physical exam was significant for bilaterally petechial rash coalescing into ecchymoses over the dorsum of the feet, sparing soles and toes, which dissipated into thinning petechiae more proximally. on labs he d ... | 2017 | 28714381 |
| excess mortality between 2007 and 2014 among patients with clostridium difficile infection: a french health insurance database analysis. | the impact of cdi (clostridium difficile infections) on mortality is controversial. | 2017 | 28712548 |
| vaccines in development for the primary prevention of clostridium difficile infection. | | 2017 | 28712463 |
| multicenter collaboration study on the β-lactam resistant enterobacteriaceae in japan - the 65th anniversary public interest purpose project of the japanese society of chemotherapy. | this study was conducted using the same method of the "1-day multicenter collaborative research for clostridium difficile infectious". this surveillance study was performed by 38 participating medical facilities across japan. of the 268 fecal specimens collected in this study, 5 (1.9%) carbapenem-resistant enterobacteriaceae (cre) were judged carbapenem resistant by the criteria of the infectious disease act, japan (2 mg/l or more and 64 mg/l or more mics for imipenem and cefmetazole, respective ... | 2017 | 28709901 |
| chemical genomics, structure elucidation, and in vivo studies of the marine-derived anticlostridial ecteinamycin. | a polyether antibiotic, ecteinamycin (1), was isolated from a marine actinomadura sp., cultivated from the ascidian ecteinascidia turbinata. (13)c enrichment, high resolution nmr spectroscopy, and molecular modeling enabled elucidation of the structure of 1, which was validated on the basis of comparisons with its recently reported crystal structure. importantly, ecteinamycin demonstrated potent activity against the toxigenic strain of clostridium difficile nap1/b1/027 (mic = 59 ng/μl), as well ... | 2017 | 28708379 |
| systematic review with meta-analysis: the efficacy of faecal microbiota transplantation for the treatment of recurrent and refractory clostridium difficile infection. | clostridium difficile infection (cdi) is the commonest nosocomial cause of diarrhoea. faecal microbiota transplantation (fmt) is an approved treatment for recurrent or refractory cdi but there is uncertainty about its use. | 2017 | 28707337 |
| clostridium difficile, colitis, and colonoscopy: pediatric perspective. | review tests available for detection of clostridium difficile (c. diff) induced disease, including when such tests should be done in children and how they should be interpreted. | 2017 | 28707191 |
| use of a neutralizing antibody helps identify structural features critical for binding of clostridium difficile toxin tcda to the host cell surface. | clostridium difficile is a clinically significant pathogen that causes mild-to-severe (and often recurrent) colon infections. disease symptoms stem from the activities of two large, multi-domain toxins known as tcda and tcdb. the toxins can bind, enter, and perturb host cell function through a multi-step mechanism of receptor binding, endocytosis, pore formation, autoproteolysis, and glucosyltransferase-mediated modification of host substrates. monoclonal antibodies that neutralize toxin activit ... | 2017 | 28705932 |
| prevalence and risk factors for colonization by clostridium difficile and extended-spectrum β-lactamase-producing enterobacteriaceae in rehabilitation clinics in germany. | rehabilitation clinics may vary widely in terms of type of care provided, duration of hospital stay, and case severity. few data are available on prevalence of clostridium difficile or extended-spectrum β-lactamase-producing enterobacteriaceae (esbl-e) colonization in rehabilitation clinics in germany. | 2017 | 28705583 |
| intestinal calcium and bile salts facilitate germination of clostridium difficile spores. | clostridium difficile (c. difficile) is an anaerobic gram-positive pathogen that is the leading cause of nosocomial bacterial infection globally. c. difficile infection (cdi) typically occurs after ingestion of infectious spores by a patient that has been treated with broad-spectrum antibiotics. while cdi is a toxin-mediated disease, transmission and pathogenesis are dependent on the ability to produce viable spores. these spores must become metabolically active (germinate) in order to cause dis ... | 2017 | 28704538 |
| treatment of decubitis ulcer stage iv in the patient with polytrauma and vertical share pelvic fracture, diagnosed entherocollitis and deep wound infection with clostridium difficile with combined negative pressure wound therapy (npwt) and faecal management system: case report. | the aim of this paper was to present a case with the successful treatment of decubitis ulcer stage iv in the patient with polytrauma and vertical share pelvic fracture and diagnosed entherocollitis combined with deep wound infection with clostridium difficile treated with combined negative pressure wound therapy (npwt) and faecal management system. | 2017 | 28698756 |
| high in vitro activity of fidaxomicin against clostridium difficile isolates from a university teaching hospital in china. | clostridium difficile infection (cdi) is a significant cause of morbidity and mortality in both the acute care setting and the wider healthcare system. the purpose of this study was to evaluate the in vitro activity of fidaxomicin against c.difficile isolates from a university teaching hospital in china. | 2017 | 28693926 |
| acquisition of clostridium difficile colonization and infection after transfer from a veterans affairs hospital to an affiliated long-term care facility. | background clostridium difficile infection (cdi) and asymptomatic carriage of toxigenic c. difficile are common in long-term care facilities (ltcfs). however, whether c. difficile is frequently acquired in the ltcf versus during acute-care admissions remains unknown. objective to test the hypothesis that ltcf residents often acquire c. difficile colonization and infection in the ltcf design this 5-month cohort study was conducted to determine the incidence of acquisition of c. difficile coloniza ... | 2017 | 28693636 |
| risk of surgical site infection, acute kidney injury, and clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: a national propensity-score-adjusted retrospective cohort study. | the optimal regimen for perioperative antimicrobial prophylaxis is controversial. use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (ssis). potential harms associated with combination regimens, including acute kidney inju ... | 2017 | 28692690 |
| detection of toxigenic clostridium difficile in paediatric patients. | our main objective was a revision of clinical, microbiological and epidemiological results of clostridium difficile-associated infection in paediatric patients (2010-2015). we compared the diagnoses performed by detection of toxins in feces and those performed by real-time pcr. | 2017 | 28689671 |
| room occupancy-associated transmission of mdro, clostridium difficile, or norovirus: results from a room surveillance project. | | 2017 | 28689514 |
| description and validation of a new automated surveillance system for clostridium difficile in denmark. | the surveillance of clostridium difficile (cd) in denmark consists of laboratory based data from departments of clinical microbiology (dcms) sent to the national registry of enteric pathogens (nrep). we validated a new surveillance system for cd based on the danish microbiology database (miba). miba automatically collects microbiological test results from all danish dcms. we built an algorithm to identify positive test results for cd recorded in miba. a cd case was defined as a person with a pos ... | 2017 | 28689506 |
| clostridium difficile infection in contemporary urologic practice. | clostridium difficile infection (cdi) is a high-impact hospital acquired condition and chief driver of excess morbidity, mortality, and treatment cost. diagnosis, treatment, and prevention of clostridium difficile infection is key component of any hospital based practice. urologists see a small percentage of all patients with cdi, however they traditionally utilize antibiotic agents that put patients at risk for cdi. urologic procedures making use of bowel have a significantly higher rate of cdi ... | 2017 | 28688849 |
| adrenal crisis in metastatic breast cancer. | a female patient with oestrogen receptor-positive and human epidermal growth factor receptor 2 (her2)-positive invasive lobular breast cancer presented with progressive disease on ct scan. some days after initiation of antineoplastic chemotherapy and anti-her2 targeted antibody therapy, the patient presented with profuse diarrhoea, neutropaenia, nausea and weakness. although clostridium difficile was rapidly tackled as a causative agent of gastrointestinal complaints, clinical situation did not ... | 2017 | 28687693 |
| prevalence and characteristics of clostridium perfringens and clostridium difficile in dogs and cats attended in diverse veterinary clinics from the madrid region. | despite extensive research on the epidemiology of pathogenic clostridia in dogs and cats, most published studies focus on a selected animal population and/or a single veterinary medical centre. we assessed the burden of clostridium perfringens and c. difficile shedding by small animals in 17 veterinary clinics located within the madrid region (spain) and differing in size, number and features of animals attended and other relevant characteristics. in addition, we studied the genetic diversity an ... | 2017 | 28687280 |
| antimicrobial stewardship approaches in the intensive care unit. | antimicrobial stewardship programs aim to monitor, improve, and measure responsible antibiotic use. the intensive care unit (icu), with its critically ill patients and prevalence of multiple drug-resistant pathogens, presents unique challenges. this article reviews approaches to stewardship with application to the icu, including the value of diagnostics, principles of empirical and definitive therapy, and measures of effectiveness. there is good evidence that antimicrobial stewardship results in ... | 2017 | 28687210 |
| recreational sandboxes for children and dogs can be a source of epidemic ribotypes of clostridium difficile. | different studies have suggested that the sand of public playgrounds could have a role in the transmission of infections, particularly in children. furthermore, free access of pets and other animals to the playgrounds might increase such a risk. we studied the presence of clostridium difficile in 20 pairs of sandboxes for children and dogs located in different playgrounds within the madrid region (spain). clostridium difficile isolation was performed by enrichment and selective culture procedure ... | 2017 | 28686001 |
| present and past perspectives on clostridium difficile infection. | clostridium difficile is a gram-positive bacillus that has become one of the main hospital-acquired human gastrointestinal infections in recent years. its incidence is on the rise, involving more virulent strains, affecting new and previously uncontemplated groups of patients, and producing changes in clinical presentation and treatment response that influence disease outcome. early diagnosis and disease stratification based on the severity of c.difficile infection are essential for therapeutic ... | 2017 | 28684034 |
| vancomycin vs metronidazole for clostridium difficile infection: focus on recurrence and mortality. | | 2017 | 28681270 |
| increasing incidence of clostridium difficile ribotype 001 associated with severe course of the infection and previous fluoroquinolone use in the czech republic, 2015. | the aim of the study was to provide an update on the epidemiology of c. difficile infection (cdi) in a representative number of hospitals within the czech republic in 2015. in 2015, twenty-eight czech hospitals were invited to participate in a cdi study. laboratories sent the first 20 consecutive c. difficile isolates for characterization by capillary-electrophoresis (ce) ribotyping and the presence of toxin genes and collected patient data on previous hospitalization, antibiotic treatment, the ... | 2017 | 28681203 |
| outcome after discontinuation of proton pump inhibitors at a residential care site: quality improvement project. | increased prescribing of proton pump inhibitors (ppis) in the past few decades can be attributed mainly to long-term use of this type of therapy. recent evidence indicates signals of harm associated with long-term use of ppis, such as increased risk of clostridium difficile infection, recurrence of c. difficile infection, and fracture. a few studies have assessed the effectiveness of step-down management of patients receiving long-term ppi therapy in ambulatory care settings. however, it is unkn ... | 2017 | 28680175 |
| cwp2 from clostridium difficile exhibits an extended three domain fold and cell adhesion in vitro. | colonization of the gut by clostridium difficile requires the adhesion of the bacterium to host cells. a range of cell surface located factors have been linked to adhesion including the s-layer protein lmw slp and the related protein cwp66. as well as these proteins, the s-layer of c. difficile may contain many others. one such protein is cwp2. here, we demonstrate the production of a c. difficile strain 630 cwp2 knockout mutant and assess the effect on the bacterium. the mutant results in incre ... | 2017 | 28677344 |
| update on intestinal microbiota in crohn's disease 2017: mechanisms, clinical application, adverse reactions and outlook. | the pathogenesis of cd is complex and it is thought to be associated with the environment, immune, hereditary, microbe and other factors. if the balance between the host and the intestinal microbes in cd patients was broken, immune-inflammatory response of susceptible individuals might be triggered. probiotics could improve the intestinal microbial flora balance and treat human effectively. there are several new mechanisms which might explain the role of probiotics. fecal microbiota transplantat ... | 2017 | 28677158 |
| [antimicrobials : some practical considerations]. | antibiotics are frequently prescribed in hospitalized and in outpatients. we review four important aspects for their daily prescription. in elderly patients, the prescription should take into account changes in the volume of distribution and the usual decline in renal function even in the absence of chronic kidney disease. particular antibiotics can trigger infection with clostridium difficile. we discuss actual and novel strategies for its prevention. renal toxicity of antibiotics includes acut ... | 2016 | 28675267 |
| fool me thrice: the evolving story of multiply recurrent clostridium difficile infection. | | 2017 | 28672286 |
| increasing incidence of multiply recurrent clostridium difficile infection in the united states: a cohort study. | clostridium difficile infection (cdi), the most common health care-associated infection, often recurs. fecal microbiota transplantation is increasingly used to treat multiply recurrent cdi (mrcdi). | 2017 | 28672282 |
| assessment of automating safety surveillance from electronic health records: analysis for the quality and safety review system. | in an effort to improve and standardize the collection of adverse event data, the agency for healthcare research and quality is developing and testing a patient safety surveillance system called the quality and safety review system (qsrs). its current abstraction from medical records is through manual human coders, taking an average of 75 minutes to complete the review and abstraction tasks for one patient record. with many healthcare systems across the country adopting electronic health record ... | 2017 | 28671914 |
| is clostridium difficile infection a risk factor for subsequent bloodstream infection? | clostridium difficile infection (cdi) is a common nosocomial diarrheal illness increasingly associated with mortality in united states. the underlying factors and mechanisms behind the recent increases in morbidity from cdi have not been fully elucidated. murine models suggest a mucosal barrier breakdown leads to bacterial translocation and subsequent bloodstream infection (bsi). this study tests the hypothesis that cdi is associated with subsequent bsi in humans. | 2017 | 28669864 |
| clostridium difficile chimeric toxin receptor binding domain vaccine induced protection against different strains in active and passive challenge models. | clostridium difficile is the number one cause of nosocomial antibiotic-associated diarrhea in developed countries. historically, pathogenesis was attributed two homologous glucosylating toxins, toxin-a (tcda) and toxin-b (tcdb). over the past decade, however, highly virulent epidemic strains of c. difficile (b1/nap1/027) have emerged and are linked to an increase in morbidity and mortality. increased virulence is attributed to multiple factors including: increased production of a- and b-toxins; ... | 2017 | 28669616 |
| the effect of ultraviolet light on clostridium difficile spore recovery versus bleach alone. | | 2017 | 28669367 |
| reducing fluoroquinolone use is a key step in controlling the burden of clostridium difficile infection. | | 2017 | 28668696 |
| anesthetic agents, neurodevelopmental risk and the connection to bacterial infections. | this short communication identifies a significant flaw in research investigating the neurodevelopmental consequences of general anesthesia exposure. we have identified that chronic environmental exposure to pervasive air pollutants that are also widely used as anesthetic agents, specifically nitrous oxide (n2o), may contribute to the rising prevalence of neurodevelopmental disorders. consistent with the emerging link between microbes and psychiatric illness risk, this epidemiological analysis ex ... | 2017 | 28666807 |
| impact of moving to a new hospital build, with a high proportion of single rooms, on healthcare-associated infections and outbreaks. | clostridium difficile infection, meticillin-sensitive staphylococcus aureus (mssa) and escherichia coli bacteraemia rates, and bed-days lost during norovirus outbreaks at north bristol nhs trust were analysed over a five-year period to determine whether moving to a new-build hospital with 75% single rooms reduced healthcare-associated infection rates. c. difficile, mssa bacteraemia and e. coli bacteraemia showed no change in the rate of decline after the move. bed-days lost due to norovirus were ... | 2017 | 28666780 |
| a cfr-like gene cfr(c) conferring linezolid resistance is common in clostridium difficile. | clostridium difficile t10 and clostridium bolteae 90b3 were co-resistant to phenicols, lincosamides, oxazolidinones, pleuromutilins and streptogramin a (phlopsa) and harbored an unreported cfr-like determinant that may alter the 23s rrna by m(8)a2503 methylation. the cfr-like cfr(c) gene was cloned in c. difficile 630δerm in which it conferred phlopsa resistance. in c. bolteae 90b3: (i) qrt-pcr analysis indicated that cfr(c) was similarly expressed in the absence or presence of either chloramphe ... | 2017 | 28663118 |
| fatal course of takotsubo cardiomyopathy in a female with recurrent clostridium difficile infection. | among diverse triggering factors of stress-induced takotsubo cardiomyopathy (tc), a viral or bacterial infection is rarely observed. sepsis is an exception, regardless of the etiologic pathogen, in which case an excess of catecholamines may result in acute left ventricular dysfunction. tc precipitated by clostridium difficile infection (cdi) has been reported only in two patients so far. | 2017 | 28662012 |
| the role of antimicrobial sutures in preventing surgical site infection. | introduction healthcare associated infections (hcais) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant staphylococcus aureus or emergent pathogens such as clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (ssi), either in the uk, the eu or the us. ssi is one of the hcais, which are all avoidable complications of a surgical ... | 2017 | 28660816 |
| moxifloxacin versus levofloxacin or ciprofloxacin prophylaxis in acute myeloid leukemia patients receiving chemotherapy. | patients receiving intensive chemotherapy regimens are at high risk for infectious complications due to prolonged neutropenia and hospital stay. fluoroquinolone antibiotics, mainly levofloxacin and ciprofloxacin, are the mainstay of prophylactic therapy for these patients. there is limited data regarding the utilization of other quinolone antibiotics including moxifloxacin in this setting. | 2017 | 28660351 |