| clostridium difficile toxin biology. | clostridium difficile is the cause of antibiotics-associated diarrhea and pseudomembranous colitis. the pathogen produces three protein toxins: c. difficile toxins a (tcda) and b (tcdb), and c. difficile transferase toxin (cdt). the single-chain toxins tcda and tcdb are the main virulence factors. they bind to cell membrane receptors and are internalized. the nterminal glucosyltransferase and autoprotease domains of the toxins translocate from low-ph endosomes into the cytosol. after activation ... | 2017 | 28657883 |
| the remedy within: will the microbiome fulfill its therapeutic promise? | the last decade of research has witnessed a tremendous upsurge in our understanding of the intestinal microbiome and its role in a large range of human diseases, which has incited hopes for a rapid clinical utilization of the new insights for the development of microbiome-based therapies. nonetheless, only a single microbiome-targeted therapy has so far found its way into clinical routine: fecal microbiota transplantation for patients suffering from recurrent clostridium difficile infections. he ... | 2017 | 28656322 |
| clostridium difficile infection and the role of adaptive immunity in the microbiome. | | 2017 | 28656028 |
| clinical and molecular characteristics of community-acquired clostridium difficile infections in comparison with those of hospital-acquired c. difficile. | community-acquired clostridium difficile infection (ca-cdi) is a growing concern. ca-cdi differs from hospital-acquired c. difficile infection (ha-cdi) in its epidemiology, risk factors, severity, and outcomes. in this study, we investigated c. difficile infections in a tertiary care hospital in seoul, korea, and compared the ca-cdi and ha-cdi cases diagnosed in the same period. total 593 cases were confirmed as cdi in 2014, of which ca-cdi accounted for 68 (11.5%) of the total cdi cases. compar ... | 2017 | 28655581 |
| tobacco use as a screener for clostridium difficile infection outcomes. | we conducted a retrospective cohort study to evaluate the utility of self-reported tobacco use for developing a clinical prediction rule for poor outcomes of clostridium difficile infection. we found that patients with any history of smoking were significantly less likely than never smokers to be cured of their infection within two weeks. disease recurrence, readmission within thirty days, death before treatment completion, and the severity of clostridium difficile infection were not associated ... | 2017 | 28655511 |
| a nutrient-regulated cyclic diguanylate phosphodiesterase controls clostridium difficile biofilm and toxin production during stationary phase. | the signaling molecule cyclic diguanylate (c-di-gmp) mediates physiological adaptation to extracellular stimuli in a wide range of bacteria. the complex metabolic pathways governing c-di-gmp synthesis and degradation are highly regulated, but the specific cues that impact c-di-gmp signaling are largely unknown. in the intestinal pathogen clostridium difficile, c-di-gmp inhibits flagellar motility and toxin production and promotes pilus-dependent biofilm formation, but no specific biological func ... | 2017 | 28652311 |
| probiotic containing lactobacillus casei, lactobacillus bulgaricus, and streptococcus thermophiles (actimel) for the prevention of clostridium difficile associated diarrhoea in the elderly with proximal femur fractures. | the incidence of clostridium difficile associated diarrhoea (cdad) is greater in elderly patients. probiotics may have a beneficial effect in the prevention of cdad. however, their effect in elderly orthopaedic patients has not been previously reported. between april 2013 and april 2014, 105 patients admitted with femoral neck fractures, and who required 3days of antibiotics for infection of any cause, were prescribed the probiotic actimel until 3days after the last antibiotic dose. the incidenc ... | 2017 | 28652125 |
| clostridium difficile-associated colitis post-transplant is not associated with elevation of tacrolimus concentrations. | diarrhea is a common condition after solid organ transplant (sot); clostridium difficile-associated colitis (cdac) is one of the most common infections after sot. we documented previously that some types of enteritis are associated with an elevation of tacrolimus (tac) trough concentrations by interfering with the drug's complex metabolism. | 2017 | 28650734 |
| identification of donor microbe species that colonize and persist long term in the recipient after fecal transplant for recurrent clostridium difficile. | fecal microbiota transplantation has been shown to be an effective treatment for patients with recurrent c. difficile colitis. although fecal microbiota transplantation helps to re-establish a normal gut function in patients, the extent of the repopulation of the recipient microbial community varies. to further understand this variation, it is important to determine the fate of donor microbes in the patients following fecal microbiota transplantation. we have developed a new method that utilizes ... | 2017 | 28649413 |
| use of antibiotics and the prevalence of antibiotic-associated diarrhoea in patients with spinal cord injuries: an international, multi-centre study. | little is known about the use of antibiotics and the extent of antibiotic-associated diarrhoea (aad) in patients with spinal cord injuries (scis). | 2017 | 28647425 |
| fecal microbiota transplantation for recurrent clostridium difficile infection in children. | fecal microbiota transplantation (fmt) is a relatively simple, promising treatment for recurrent clostridium difficile infection. while there are a wide variety of approaches including mode of delivery, the results are nonetheless encouraging, even amongst younger children. experience with fmt in the pediatric population is increasing, showing similar success compared to adults. this article will provide an overview of c. difficile infection along with review of the rationale, methods and compli ... | 2017 | 28646951 |
| impact of end stage kidney disease on costs and outcomes of clostridium difficile infection. | to assess the impact of end stage kidney disease (eskd) on the outcomes of clostridium difficile infection (cdi), including complications of infection, length of hospital stay, overall mortality, and healthcare burden. | 2017 | 28645569 |
| impact of the nap-1 strain on disease severity, mortality, and recurrence of healthcare-associated clostridium difficile infection. | studies are conflicting regarding the association of the north american pulsed-field gel electrophoresis type 1 (nap1) strain in clostridium difficile infection (cdi) and outcomes. we evaluated the association of nap1 with healthcare-associated cdi disease severity, mortality, and recurrence at our academic medical center. | 2017 | 28645479 |
| poorer outcomes among cancer patients diagnosed with clostridium difficile infections in united states community hospitals. | cancer predisposes patients to clostridium difficile infection (cdi) due to health care exposures and medications that disrupt the gut microbiota or reduce immune response. despite this association, the national rate of cdi among cancer patients is unknown. furthermore, it is unclear how cdi affects clinical outcomes in cancer. the objective of this study was to describe cdi incidence and health outcomes nationally among cancer patients in the united states (u.s.). | 2017 | 28645266 |
| predictors of mortality in cirrhosis inpatients with clostridium difficile infection. | clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis. | 2017 | 28644310 |
| the effects of fasting and massive diarrhea on absorption of enteral vancomycin in critically ill patients: a retrospective observational study. | although vancomycin (vcm) is not absorbed from healthy intestinal mucosa, elevations in the serum vcm concentrations have been reported in some cases. the aims of this study are to evaluate the necessity of therapeutic drug monitoring (tdm) during enteral vcm administration in critically ill patients. | 2017 | 28642864 |
| the role of tigecycline in the management of clostridium difficile infection: a retrospective cohort study. | we aimed to compare the outcomes of patients with c.difficile infection (cdi) treated either with tigecycline associated with vancomycin, or with vancomycin alone. | 2017 | 28642147 |
| increasing rates of clostridium difficile infection in mexican hospitals. | the epidemiology of clostridium difficile infection (cdi) has changed in the last two decades. there is a lack of information regarding incidence and severity of cdi, especially in the developing world. | 2017 | 28641091 |
| using probiotics in clinical practice: where are we now? a review of existing meta-analyses. | the scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. this study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiologic and pathological conditions, such as metabolic disease, antibiotic-associated and clostridium difficile-associated diarrhea, ibs, constipation, ibd, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associ ... | 2017 | 28640662 |
| the effect of hospital biocide sodium dichloroisocyanurate on the viability and properties of clostridium difficile spores. | clostridium difficile is the primary cause of healthcare-associated diarrhoea globally and produces spores which are resistant to commonly used biocides and are able persist on contaminated surfaces for months. this study examined the effect of sublethal concentrations of the biocide sodium dichloroisocyanurate (nadcc) on the viability of spores produced by 21 clinical isolates of c. difficile representing a range of pcr ribotypes. spores exposed to 500 ppm nadcc for 10 min exhibited between a 4 ... | 2017 | 28639362 |
| economic barriers in the treatment of clostridium difficile infection with oral vancomycin. | vancomycin is an increasingly important option for the treatment of clostridium difficile infection, but economic barriers to its use remain significant in the outpatient setting. generic vancomycin capsules are still inexplicably expensive and not universally covered by insurers. this report highlights the potential adverse consequences of cost-related nonadherence to vancomycin therapy and the challenges that clinicians face when prescribing oral vancomycin. | 2017 | 28638841 |
| risk factors that predict recurrent clostridium difficile infections in surgical patients. | clostridium difficile (c. difficile) infection (cdi) is a serious problem mostly studied during patients' index infections. the aim of this study is to define the incidence of primary and recurrent postoperative (postop) cdi in a single institution's entire surgical population and to identify risk factors that influence disease recurrence. using electronic medical records from 2002 to 2012, charts were reviewed from all patients with laboratory-proven (enzyme-linked immunosorbent assay or polyme ... | 2017 | 28637570 |
| ibd: a growing and vulnerable cohort of hospitalized patients with clostridium difficile infection. | the most recent nationwide data show a rising incidence of clostridium difficile infection in hospitalized patients with ulcerative colitis (uc). we describe recent national trends with regard to incidence, mortality, and the rate of total colectomy. the nationwide inpatient sample database identified patients admitted to hospitals in the united states with diagnoses of c. difficile and inflammatory bowel disease (ibd) during the study years 2007 to 2013. we analyzed incidence of c. difficile, m ... | 2017 | 28637562 |
| bezlotoxumab: anti-toxin b monoclonal antibody to prevent recurrence of clostridium difficile infection. | clostridium difficile infection (cdi) is the most common nosocomial infection in the u.s. 25% of cdi patients go on to develop recurrent cdi (rcdi) following current standard of care (soc) therapy, leading to morbidity, mortality and economic loss. the first passive immunotherapy drug targeting c.difficile toxin b (bezlotoxumab) has been approved recently by the fda and ema for prevention of rcdi. areas covered: a body of key studies was selected and reviewed by the authors. the unmet needs in c ... | 2017 | 28636484 |
| covalent attachment and pro-pro endopeptidase (ppep-1)-mediated release of clostridium difficile cell surface proteins involved in adhesion. | in the past decade, clostridium difficile has emerged as an important gut pathogen. this anaerobic, gram-positive bacterium is the main cause of infectious nosocomial diarrhea. whereas much is known about the mechanism through which the c. difficile toxins cause diarrhea, relatively little is known about the dynamics of adhesion and motility, which is mediated by cell surface proteins. this review will discuss the recent advances in our understanding of the sortase-mediated covalent attachment o ... | 2017 | 28636257 |
| impact of recurrent clostridium difficile infection: hospitalization and patient quality of life. | data quantifying outcomes of recurrent clostridium difficile infection (rcdi) are lacking. we sought to determine the uk hospital resource use and health-related quality of life (hrqol) associated with rcdi hospitalizations. | 2017 | 28633368 |
| prevalence of clostridium difficile infection among the patients attending a tertiary care teaching hospital. | clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. it is associated with considerable morbidity and mortality due to widespread use of antibiotics. | 2017 | 28631639 |
| effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and clostridium difficile infection: a systematic review and meta-analysis. | antibiotic stewardship programmes have been shown to reduce antibiotic use and hospital costs. we aimed to evaluate evidence of the effect of antibiotic stewardship on the incidence of infections and colonisation with antibiotic-resistant bacteria. | 2017 | 28629876 |
| probabilistic invasion underlies natural gut microbiome stability. | species compositions of gut microbiomes impact host health [1-3], but the processes determining these compositions are largely unknown. an unexplained observation is that gut species composition varies widely between individuals but is largely stable over time within individuals [4, 5]. stochastic factors during establishment may drive these alternative stable states (colonized versus non-colonized) [6, 7], which can influence susceptibility to pathogens, such as clostridium difficile. here we s ... | 2017 | 28625783 |
| [fulminant clostridium difficile colitis: new challenges in critical care medicine]. | fulminant clostridium difficile colitis (fcdc) means severe clostridium difficile colitis (cdc), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. now clostridium difficile (cd) becomes one of the most important medical institutions related infectious pathogens. in particular, the recently discovered mutant ... | 2017 | 28625250 |
| treatment of asymptomatic uti in older delirious medical in-patients: a prospective cohort study. | despite clinical practice guidelines, asymptomatic bacteriuria (asb) in older people is frequently treated. a common reason for treating asb is a change in mental status. | 2017 | 28624753 |
| bovine antibodies targeting primary and recurrent clostridium difficile disease are a potent antibiotic alternative. | the increased incidence of antibiotic resistant 'superbugs' has amplified the use of broad spectrum antibiotics worldwide. an unintended consequence of antimicrobial treatment is disruption of the gastrointestinal microbiota, resulting in susceptibility to opportunistic pathogens, such as clostridium difficile. paradoxically, treatment of c. difficile infections (cdi) also involves antibiotic use, leaving patients susceptible to re-infection. this serious health threat has led to an urgent call ... | 2017 | 28623367 |
| impact of a collaborative strategy to reduce the inappropriate use of acid suppressive therapy in non-intensive care unit patients. | stress ulcer prophylaxis (sup) is inappropriately prescribed in more than 30% of non-intensive care unit (icu) patients, leading to unnecessary adverse events as well as increases in economic burden. | 2017 | 28622739 |
| antibiotic prophylaxis for surgical site infections as a risk factor for infection with clostridium difficile. | we aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior to surgery and infection with clostridium difficile. | 2017 | 28622340 |
| antibiotic-associated haemorrhagic colitis: not always clostridium difficile. | antibiotic-associated colitis is a gastrointestinal complication of antibiotic use commonly seen in hospitalised patients, with clostridium difficile (c. difficile) colitis being the most common type. we present a case of haemorrhagic colitis secondary to klebsiella oxytoca following self-initiated amoxicillin-clavulanic acid use. an 85-year-old woman presented to the emergency department with abdominal pain and mucobloody diarrhoea. history was notable for an ongoing 5-day course of amoxicillin ... | 2017 | 28619975 |
| high metabolic versatility of different toxigenic and non-toxigenic clostridioides difficile isolates. | clostridioides difficile (formerly clostridium difficile) is a major nosocomial pathogen with an increasing number of community-acquired infections causing symptoms from mild diarrhea to life-threatening colitis. the pathogenicity of c. difficile is considered to be mainly associated with the production of genome-encoded toxins a and b. in addition, some strains also encode and express the binary toxin cdt. however; a large number of non-toxigenic c. difficile strains have been isolated from the ... | 2017 | 28619474 |
| microbiota therapy for clostridium difficile and antibiotic resistant enteric infections. | bacterial pathogens are increasingly antibiotic resistant, and development of clinically effective antibiotics is lagging. curing infections increasingly requires antimicrobials that are broader spectrum, more toxic, and more expensive, and mortality attributable to antibiotic-resistant pathogens is rising. the commensal microbiota, comprising microbes that colonize the mammalian gastrointestinal tract, can provide high levels of resistance to infection, and the contributions of specific bacteri ... | 2017 | 28617651 |
| clostridium difficile pcr cycle threshold predicts free toxin. | there is no stand-alone clostridium difficile diagnostic that can sensitively and rapidly detect fecal free toxins. we investigated the performance of the c. difficile pcr cycle threshold (ct ) for predicting free toxin status. consecutive stool samples (n = 312) positive for toxigenic c. difficile by the genexpert c. difficile/epi tcdb pcr assay were tested with the rapid membrane c. diff quik chek complete immunoassay (rmeia). rmeia toxin-negative samples were tested with the cell cytotoxicity ... | 2017 | 28615471 |
| antibiotics vs. appendectomy for acute uncomplicated appendicitis in adults: review of the evidence and future directions. | acute appendicitis is the most common abdominal surgical emergency in the united states, with a lifetime risk of 7%-8%. the treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. we determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. | 2017 | 28614043 |
| glucosyltransferase-dependent and -independent effects of tcdb on the proteome of hep-2 cells. | toxin b (tcdb) of the nosocomial pathogen c. difficile has been reported to exhibit a glucosyltransferase-dependent and -independent effect on treated hep-2 cells at toxin concentration above 0.3 nm. in order to investigate and further characterize both effects epithelial cells were treated with wild type tcdb and glucosyltransferase-deficient tcdbnxn and their proteomes were analyzed by lc-ms. triplex silac labeling was used for quantification. identification of 5212 and quantification of 4712 ... | 2017 | 28612519 |
| automatic environmental disinfection with hydrogen peroxide and silver ions versus manual environmental disinfection with sodium hypochlorite: a multicentre randomized before-and-after trial. | new technologies for automated disinfection have been developed, including the use of hydrogen peroxide atomized by specific equipment, with associated silver compounds. | 2017 | 28610932 |
| fecal microbiota transplantation in metabolic syndrome: history, present and future. | the history of fecal microbiota transplantation (fmt) dates back even to ancient china. recently, scientific studies have been looking into fmt as a promising treatment of various diseases, while in the process teaching us about the interaction between the human host and its resident microbial communities. current research focuses mainly on clostridium difficile infections, however interest is rising in other areas such as inflammatory bowel disease (ibd) and the metabolic syndrome. with regard ... | 2017 | 28609252 |
| intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease. | inflammatory bowel disease (ibd) is a complex set of diseases that lead to chronic inflammation in the gastrointestinal tract. although the etiology of ibd is not fully understood, it is well-known that the intestinal microbiota is associated with the development and maintenance of ibd. manipulation of the gut microbiota, therefore, may represent a target for ibd therapy. fecal microbiota transplantation (fmt), where fecal microbiota from a healthy donor is transplanted into a patient's gi tract ... | 2017 | 28609251 |
| stress ulcer prophylaxis in the intensive care unit trial: detailed statistical analysis plan. | in this statistical analysis plan, we aim to provide details of the pre-defined statistical analyses of the stress ulcer prophylaxis in the intensive care unit (sup-icu) trial. the aim of the sup-icu trial is to assess benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in adult patients in the intensive care unit (icu). | 2017 | 28608496 |
| risk factors for clostridium difficile infections - an overview of the evidence base and challenges in data synthesis. | recognition of a broad spectrum of disease and development of clostridium difficile infection (cdi) and recurrent cdi (rcdi) in populations previously considered to be at low risk has renewed attention on differences in the risk profile of patients. in the absence of primary prevention for cdi and limited treatment options, it is important to achieve a deep understanding of the multiple factors that influence the risk of developing cdi and rcdi. | 2017 | 28607673 |
| clostridium difficile flagella induce a pro-inflammatory response in intestinal epithelium of mice in cooperation with toxins. | clostridium difficile is the most important enteropathogen involved in gut nosocomial post-antibiotic infections. the emergence of hypervirulent strains has contributed to increased mortality and morbidity of cdi. the c. difficile toxins contribute directly to cdi-associated lesions of the gut, but other bacterial factors are needed for the bacteria to adhere and colonize the intestinal epithelium. the c. difficile flagella, which confer motility and chemotaxis for successful intestinal coloniza ... | 2017 | 28607468 |
| erratum to: surface layer proteins from virulent clostridium difficile ribotypes exhibit signatures of positive selection with consequences for innate immune response. | | 2017 | 28606132 |
| association of adverse events with antibiotic use in hospitalized patients. | estimates of the incidence of overall antibiotic-associated adverse drug events (ades) in hospitalized patients are generally unavailable. | 2017 | 28604925 |
| prevalence and molecular epidemiology of clostridium difficile infection in indonesia. | clostridium difficile has not been studied in detail in asia, particularly southeast asia. we thus performed a prevalence study across four hospitals in central java province, indonesia. stool samples were collected from patients with diarrhoea and tested by enzyme immunoassay for glutamate dehydrogenase (gdh) and toxin a/b (c diff quik chek complete, techlab). specimens were cultured and molecular typing was performed. in total, 340 samples were tested, of which 70 (20.6%) were gdh positive, wi ... | 2017 | 28603640 |
| antimicrobial susceptibility of clostridium difficile isolated in thailand. | exposure to antimicrobials is the major risk factor associated with clostridium difficile infection (cdi). paradoxically, treatment of cdi with antimicrobials remains the preferred option. to date, only three studies have investigated the antimicrobial susceptibility of c. difficile from thailand, two of which were published in the 1990s. this study aimed to investigate the contemporary antibiotic susceptibility of c. difficile isolated from patients in thailand. | 2017 | 28603609 |
| is frozen fecal microbiota transplantation as effective as fresh fecal microbiota transplantation in patients with recurrent or refractory clostridium difficile infection: a meta-analysis? | fecal microbiota transplantation (fmt) is a remarkably efficacious therapy for recurrent or refractory clostridium difficile infection (cdi), but not standardized. this work is to determine whether frozen fmt is as effective as fresh fmt. meta-analysis showed that frozen fmt was as effective as fresh fmt, both pooled first effective rate (65.0% (95% ci 57.0-73.0%) vs. 65.0% (95% ci 57.0-73.0%), p=0.962) and pooled second effective rate (95.0% (95% ci 91.0-99.0%) vs. 95.0% (95% ci 92.0-99.0%), p= ... | 2017 | 28602517 |
| impact of an electronic sepsis initiative on antibiotic use and health care facility-onset clostridium difficile infection rates. | although integrated, electronic sepsis screening and treatment protocols are thought to improve patient outcomes, less is known about their unintended consequences. we aimed to determine if the introduction of a sepsis initiative coincided with increases in broad-spectrum antibiotic use and health care facility-onset (hcfo) clostridium difficile infection (cdi) rates. | 2017 | 28602274 |
| prevalence of clostridium difficile infection in acute care hospitals, long-term care facilities, and outpatient clinics: is clostridium difficile infection underdiagnosed in long-term care facility patients? | clostridium difficile infection is a common cause of diarrhea in long-term care facility (ltcf) patients. the high prevalence of c difficile infection in ltcfs noted in our study calls for a critical need to educate ltcf staff to send diarrheal stool for c difficile testing to identify more cases and prevent transmission. | 2017 | 28602273 |
| detection of dna amplicons of polymerase chain reaction using litmus test. | we report on a new colorimetric dna detection method that takes advantage of the power of polymerase chain reaction (pcr) and the simplicity of the classic litmus test. the strategy makes use of a modified set of primers for pcr to facilitate ensuing manipulations of resultant dna amplicons: their tagging with urease and immobilization onto magnetic beads. the amplicon/urease-laden beads are then used to hydrolyze urea, resulting in the increase of ph that can be conveniently reported by a ph-se ... | 2017 | 28596600 |
| dipping into the clostridium difficile pool: are alcohol-based dispensers fomites for c difficile? | the purpose of this study was to evaluate alcohol-based dispensers as potential fomites for clostridium difficile. a convenience sample of 120 alcohol-based dispensers was evaluated for the presence of c difficile either by culture or polymerase chain reaction for c difficile toxin. the results demonstrated that c difficile was not cultured, and c difficile toxin was not detected using polymerase chain reaction; however, gram-positive rods, clostridium perfringens, pantoea agglomerans, coagulase ... | 2017 | 28596022 |
| the dangers of extreme body mass index values in patients with clostridium difficile. | to examine the association between body mass index (bmi) and in-hospital mortality in patients presenting with clostridium difficile infections in emergency department visits (ed) in the usa. infected patients with extreme bmis may have an elevated mortality risk, but prior studies examining this question have been too small to reach definitive conclusions. | 2017 | 28593617 |
| clostridium difficile colonization and/or infection during infancy and the risk of childhood allergic diseases. | the gut microbiota can influence several diseases through immune modulation; however, the exact role of microbes such as clostridium difficileand the relationship between microbiota colonization and allergic diseases are not well known. this study aimed to determine the relationship between c. difficilecolonization and/or infection (cdci) during infancy and allergic diseases during early childhood. | 2017 | 28592977 |
| cytokines are markers of the clostridium difficile-induced inflammatory response and predict disease severity. | the host immune response affects pathogen virulence in clostridium difficile infection (cdi). thus, cytokine responses to cdi likely are associated with disease initiation and progression. understanding the molecular drivers of inflammation and biochemical markers of disease severity is important for developing novel therapies and predicting disease prognosis. in this study, we investigated cytokine production in patients with cdi and evaluated the potential of cytokines to serve as biomarkers f ... | 2017 | 28592627 |
| distinguishing clostridium difficile recurrence from reinfection: independent validation of current recommendations. | objective distinguishing recurrent clostridium difficile infection (cdi), defined as cdi caused by the same genotype, from reinfection with a different genotype, has important implications for surveillance and clinical trials investigating treatment effectiveness. we validated the proposed 8-week period for distinguishing "same genotype cdi" from "different genotype cdi," and we aimed to identify clinical variables with distinctiveness to propose an improved definition. methods from january 2004 ... | 2017 | 28592348 |
| external validation of three prediction tools for patients at risk of a complicated course of clostridium difficile infection: disappointing in an outbreak setting. | objective estimating the risk of a complicated course of clostridium difficile infection (cdi) might help doctors guide treatment. we aimed to validate 3 published prediction models: hensgens (2014), na (2015), and welfare (2011). methods the validation cohort comprised 148 patients diagnosed with cdi between may 2013 and march 2014. during this period, 70 endemic cases of cdi occurred as well as 78 cases of cdi related to an outbreak of c. difficile ribotype 027. model calibration and discrimin ... | 2017 | 28592343 |
| [a prospective control study of saccharomyces boulardii in prevention of antibiotic-associated diarrhea in the older inpatients]. | objective: to study the value of saccharomyces boulardii for the prevention of antibiotic-associated diarrhea in older inpatients. methods: a total of 163 older patients who were treated with wide-spectrum antibiotics at least three days during january 2014 to december 2015 were randomly divided into control and study group. in study group, 81 patients were administrated with oral saccharomyces boulardii 500 mg twice a day for 21 days. the control group was of no intervention. morbidity rate of ... | 2017 | 28592037 |
| vancomycin taper and pulsed regimen with careful follow up for patients with recurrent clostridium difficile infection. | we retrospectively studied vancomycin taper and pulse treatment on 100 consecutive, evaluable patients with recurrent c. difficile infection. following taper to once-daily vancomycin dosing, 22 of 36 patients (61%) who received every-other-day (qod) and 50 of 64 (81%) who received qod followed by every-third-day dosing were cured (p = 0.03). | 2017 | 28591789 |
| repeat rifaximin for irritable bowel syndrome: no clinically significant changes in stool microbial antibiotic sensitivity. | rifaximin has demonstrated efficacy and safety for diarrhea-predominant irritable bowel syndrome (ibs-d). | 2017 | 28589238 |
| [individualized treatment strategies for clostridium difficile infections]. | upon hospitalization, up to 15.5% of patients are already colonized with a toxigenic clostridium difficile strain (tcd). the rate of asymptomatic colonization is 0-3% in healthy adults and up to 20-40% in hospitalized patients. the incidence and mortality of c. difficile infection (cdi) has significantly increased during recent years. mortality lies between 3 and 14%. cdi is generally caused by intestinal dysbiosis, which can be triggered by various factors, including antibiotics or immune suppr ... | 2017 | 28589214 |
| effectiveness of various cleaning and disinfectant products on clostridium difficile spores of pcr ribotypes 010, 014 and 027. | in healthcare facilities, clostridium difficile infections spread by transmission of bacterial spores. appropriate sporicidal disinfectants are needed to prevent development of clusters and outbreaks. in this study different cleaning/disinfecting wipes and sprays were tested for their efficacy against spores of distinctive c. difficile pcr ribotypes. | 2017 | 28588767 |
| different resistance mechanisms for cadazolid and linezolid in clostridium difficile found by whole-genome sequencing analysis. | cadazolid (cdz) is a new antibiotic currently in clinical development for the treatment of clostridium difficile infections. cdz interferes with the bacterial protein synthesis machinery. the aim of the present study was to identify resistance mechanisms for cdz and compare the results to those obtained for linezolid (lzd) in c. difficile by whole-genome sequencing (wgs) of strains generated by in vitro passages and to those obtained for lzd-resistant clinical isolates. clones of c. difficile 63 ... | 2017 | 28584149 |
| targeted metabolomics analysis identifies intestinal microbiota-derived urinary biomarkers of colonization resistance in antibiotic-treated mice. | antibiotics excreted into the intestinal tract may disrupt the microbiota that provide colonization resistance against enteric pathogens and alter normal metabolic functions of the microbiota. many of the bacterial metabolites produced in the intestinal tract are absorbed systemically and excreted in urine. here, we used a mouse model to test the hypothesis that alterations in levels of targeted bacterial metabolites in urine specimens could provide useful biomarkers indicating disrupted or inta ... | 2017 | 28584146 |
| safety, tolerability, systemic exposure, and metabolism of crs3123, a methionyl-trna synthetase inhibitor developed for treatment of clostridium difficile, in a phase 1 study. | clostridium difficile causes antibiotic-associated diarrhea and is a major public health concern. current therapies disrupt the protective intestinal flora, do not reliably prevent recurrent infections, and will be decreasingly effective should less susceptible strains emerge. crs3123 is an oral agent that inhibits bacterial methionyl-trna synthetase and has potent activity against c. difficile and aerobic gram-positive bacteria but little activity against gram-negative bacteria, including anaer ... | 2017 | 28584140 |
| the 5d framework: a clinical primer for fecal microbiota transplantation to treat clostridium difficile infection. | | 2017 | 28583769 |
| the recognition and characterisation of finnish clostridium difficile isolates resembling pcr-ribotype 027. | to characterise and compare twenty-eight finnish clostridiumdifficile rt027-like isolates, selected based on the presence of 18 bp deletion in the tcdc gene and toxin gene profile (a, b, binary), with eleven rt027 isolates from different finnish geographical areas and time periods. | 2017 | 28583353 |
| crystal structure of the multiple antibiotic resistance regulator marr from clostridium difficile. | regulators of multiple antibiotic resistance (marrs) are key players against toxins in prokaryotes. marr homologues have been identified in many bacterial and archaeal species which pose daunting antibiotic resistance issues that threaten public health. the continuous prevalence of clostridium difficile infection (cdi) throughout the world is associated with the abuse of antibiotics, and antibiotic treatments of cdi have limited effect. in the genome of c. difficile strain 630, the marr gene (id ... | 2017 | 28580925 |
| exploiting a host-commensal interaction to promote intestinal barrier function and enteric pathogen tolerance. | commensal intestinal bacteria can prevent pathogenic infection; however, limited knowledge of the mechanisms by which individual bacterial species contribute to pathogen resistance has restricted their potential for therapeutic application. here, we examined how colonization of mice with a human commensal enterococcus faecium protects against enteric infections. we show that e. faecium improves host intestinal epithelial defense programs to limit salmonella enterica serotype typhimurium pathogen ... | 2016 | 28580440 |
| identifying environmental reservoirs of clostridium difficile with a scent detection dog: preliminary evaluation. | prompted by an article describing a dog trained to detect clostridium difficile in patients, our institution evaluated a dog's ability to detect c. difficile scent from equipment and surfaces to assist in strategic deployment of adjunctive cleaning measures. | 2017 | 28579472 |
| compliance with clostridium difficile treatment guidelines: effect on patient outcomes. | guidelines for the severity classification and treatment of clostridium difficile infection (cdi) were published by infectious diseases society of america (idsa)/society for healthcare epidemiology of america (shea) in 2010; however, compliance and efficacy of these guidelines has not been widely investigated. this present study assessed compliance with guidelines and its effect on cdi patient outcomes as compared with before these recommendations. a retrospective study included all adult inpati ... | 2017 | 28578710 |
| extraintestinal clostridium difficile infection due to a ribotype different from that isolated from the feces of the patient: a case report. | extraintestinal infections due to clostridium difficile are uncommon. when such infections occur, extraintestinal c. difficile isolates are usually identical to fecal isolates. we present a rare case of a large postoperative abscess caused by c. difficile infection, in which different c. difficile strains were isolated from the abscess and from feces of the patient. an 82-year-old woman with cutaneous polyarteritis nodosa developed pain, skin ulcers, and extensive necrosis of the right leg. abov ... | 2017 | 28578133 |
| assessing the effect of patient screening and isolation on curtailing clostridium difficile infection in hospital settings. | patient screening at the time of hospital admission is not recommended as a routine practice, but may be an important strategy for containment of clostridium difficile infection (cdi) in hospital settings. we sought to investigate the effect of patient screening in the presence of asymptomatic carriers and in the context of imperfect patient isolation. | 2017 | 28577357 |
| adherence to clinical practice guidelines for the management of clostridium difficile infection in japan: a multicenter retrospective study. | this study was conducted to investigate the adherence to clinical practice guidelines (cpgs) for clostridium difficile infection (cdi). a retrospective multicenter observational study was conducted via chart review at four teaching hospitals in japan from april 2012 through september 2013. cdi was diagnosed based on positive identification of cd toxin by enzyme immunoassay testing. cdi patients were divided into non-severe and severe groups according to the severity criteria of four published gu ... | 2017 | 28577158 |
| safety and efficacy of antibacterial prophylaxis after craniotomy: a decision model analysis. | antibiotic prophylaxis has revolutionized the safety of neurosurgical procedures in the last century. today, the clinician's drug of choice before surgery often is based on the antibiotic's resistance profile and drug-induced complications. | 2017 | 28576711 |
| safety and pharmacokinetic study of fidaxomicin in children with clostridium difficile-associated diarrhea: a phase 2a multicenter clinical trial. | fidaxomicin is an approved therapy for clostridium difficile-associated diarrhea (cdad) in adults. the safety of fidaxomicin in children has not been reported. | 2017 | 28575523 |
| comparison of control of clostridium difficile infection in six english hospitals using whole-genome sequencing. | variation in clostridium difficile infection (cdi) rates between healthcare institutions suggests overall incidence could be reduced if the lowest rates could be achieved more widely. | 2017 | 28575285 |
| vancomycin taper and risk of failure of fecal microbiota transplant in patients with recurrent clostridium difficile infection. | we retrospectively analyzed a cohort of 109 subjects treated for rcdi with fmt at tertiary referral center between 2011 and 2014 to determine risk factors for fmt failure.. in a multivariate analysis, failure to use an oral vancomycin taper preceding fmt was associated with a significant risk of fmt failure (odds ratio [95% ci], 0.15 [0.007-0.40]). | 2017 | 28575220 |
| epidemiology, risk factors, and outcomes of infections in patients undergoing liver transplantation for hilar cholangiocarcinoma. | the epidemiology of infection after liver transplantation for hilar cholangiocarcinoma has not been systematically investigated. in this study of 124 patients, 255 infections occurred in 105 patients during the median follow-up of 4.2 years. the median time to first infection was 15.1 weeks (iqr 1.6-62.6). the most common sites were the abdomen, bloodstream, and musculoskeletal system. risk factors for any post-transplant infection were pre-transplant vre colonization (hazard ratio [hr] 1.9, p=. ... | 2017 | 28573685 |
| emergence of clostridium difficile tcdc variant 078 in marseille, france. | the purpose of this investigation was to evaluate the epidemiology of hypervirulent clostridium difficile ribotypes from january 2013 to february 2017 in the marseille area of southern france. by using the xpert clostridium difficile epi polymerase chain reaction (pcr) assay and sequencing the tcdc gene, we characterised c. difficile isolates from symptomatic patients diagnosed with c. difficile infection (cdi) in marseille university hospitals. we first tested retrospectively 278 c. difficile s ... | 2017 | 28573471 |
| functional amplification and preservation of human gut microbiota. | background: the availability of fresh stool samples is a prerequisite in most gut microbiota functional studies. objective: strategies for amplification and long-term gut microbiota preservation from fecal samples would favor sample sharing, help comparisons and reproducibility over time and between laboratories, and improve the safety and ethical issues surrounding fecal microbiota transplantations. design: taking advantage of in vitro gut-simulating systems, we amplified the microbial repertoi ... | 2017 | 28572754 |
| editorial: making fecal microbiota transplantation easier to swallow: freeze-dried preparation for recurrent clostridium difficile infections. | fecal microbiota transplant (fmt) has emerged as an effective and increasingly popular therapy for recurrent clostridium difficile infections in patients that have failed standard antimicrobial treatment. patient access to fmt is hampered by the logistics of manufacturing, storing, and delivering the inocula. an observational study describes the development and clinical efficacy of freeze-dried fmt capsules for oral administration. while awaiting the emergence of defined bacterial therapeutics f ... | 2017 | 28572645 |
| a protocol to characterize the morphological changes of clostridium difficile in response to antibiotic treatment. | assessment of antibiotic action with new drug development directed towards anaerobic bacteria is difficult and technically demanding. to gain insight into possible moa, morphologic changes associated with antibiotic exposure can be visualized using scanning electron microscopy (sem). integrating sem imaging with traditional kill curves may improve our insight into drug action and advance the drug development process. to test this premise, kill curves and sem studies were conducted using drugs wi ... | 2017 | 28570548 |
| how chinese clinicians face ethical and social challenges in fecal microbiota transplantation: a questionnaire study. | fecal microbiota transplantation (fmt) is reportedly the most effective therapy for relapsing clostridium difficile infection (cdi) and a potential therapeutic option for many diseases. it also poses important ethical concerns. this study is an attempt to assess clinicians' perception and attitudes towards ethical and social challenges raised by fecal microbiota transplantation. | 2017 | 28569156 |
| a retrospective study of patient factors that indicate provider nonadherence to an institutional clostridium difficile treatment guideline. | clostridium difficile infection (cdi) is treated most often with metronidazole or vancomycin. both have been effective in treatment of mild to moderate infection. in more severe cases, vancomycin may be more effective. | 2017 | 28569127 |
| therapy of the postinfectious irritable bowel syndrome: an update. | after acute infectious gastroenteritis, up to thirty percent of patients present prolonged gastrointestinal symptoms and a part of those affected patients can have the diagnostic criteria for postinfectious irritable bowel syndrome. treatment is symptom directed rather than curative and includes agents prescribed for the treatment of irritable bowel syndrome in general. prophylaxis or early treatment of acute bacterial diarrhea may reduce the risk of postinfectious irritable bowel syndrome devel ... | 2017 | 28559695 |
| incidence and risk factors for community and hospital acquisition of clostridium difficile infection in the tel aviv sourasky medical center. | objectives to estimate the incidence and identified risk factors for community-acquired (ca) and hospital-acquired (ha) clostridium difficile infection (cdi) methods we conducted 2 parallel case-control studies at tel aviv sourasky medical center from january 1, 2011, to december 31, 2014. we identified persons with cdi, determined whether infection was community or hospital acquired, and calculated incidence rates from 2007 to 2014. we collected demographic, clinical, and epidemiological inform ... | 2017 | 28558856 |
| effects of a new hospital-wide surgical consultation protocol in patients with clostridium difficile colitis. | fulminant clostridium difficile colitis (fcdc) occurs in 2%-8% of patients with cdc and carries a high death rate. prompt operation may reduce death. our aim was to determine whether a standardized hospital-wide protocol for surgical referral in cdc would result in earlier surgical consultation, earlier identification of patients who could benefit from surgical therapy, and reduced deaths from fcdc. | 2017 | 28557651 |
| clostridium difficile infections in finland, 2008-2015: trends, diagnostics and ribotypes. | we evaluated clostridium difficile (cd) diagnostics in finnish clinical microbiology laboratories during 2006-2011, with an update in 2015, in relation to cd surveillance data of the national infectious disease register (nidr) and ribotyping data from the national reference laboratory during the years 2008-2015. in 2011, diagnostic activity varied regionally more than three-fold and the positivity rate ranged between 7 and 21%. nucleic acid amplification testing (naat) was implemented in the reg ... | 2017 | 28555402 |
| trends in the use of laboratory tests for the diagnosis of clostridium difficile infection and association with incidence rates in quebec, canada, 2010-2014. | several clostridium difficile infection (cdi) surveillance programs do not specify laboratory strategies to use. we investigated the evolution in testing strategies used across quebec, canada, and its association with incidence rates. | 2017 | 28549882 |
| investigation of community carriage rates of clostridium difficile and hungatella hathewayi in healthy volunteers from four regions of england. | faecal samples from 1365 healthy asymptomatic volunteers from four regions in england were screened for the presence of clostridium difficile between december 2013 and july 2014. the carriage rate of c. difficile in healthy patients was 0.5%, which is lower than reported previously. this study demonstrates that the true community reservoir of c. difficile in the healthy uk population is very low and is, therefore, unlikely to be a reservoir for infections diagnosed in the hospital setting. | 2017 | 28549779 |
| synthesis of defined and functionalized glycans of lipoteichoic acid: a cell surface polysaccharide from clostridium difficile. | two structurally defined, functionalized glycans of lipoteichoic acid (lta, also known as ps-iii) from c. difficile, which have one or two repeating units of lta linked to the core trisaccharide, were efficiently synthesized via a convergent [2 + 3] or [2 + 2 + 3] strategy. the α-linkage of both n-acetylglucosamine residues in the repeating unit were constructed with glycosyl imidates of azidosugars as donors, while the phosphodiester bridges between the oligosaccharides were fashioned using h-p ... | 2017 | 28548838 |
| evidence-based approach to clostridium difficile infection. | | 2017 | 28546796 |
| fecal microbiota transplantation: from clostridium difficile to inflammatory bowel disease. | fecal microbiota transplantation (fmt) has evolved from a case report in the medical literature to the basis of major innovations in the treatment of clostridium difficile infection (cdi) and, potentially, inflammatory bowel disease (ibd). in the clinical setting, fmt was noted to significantly lower the risk of recurrent cdi, likely by increasing microbial diversity and altering the metabolic environment in the intestinal tract of recipients. in parallel, advances in the ability to quantify and ... | 2017 | 28546791 |
| clostridium difficile toxins a and b: receptors, pores, and translocation into cells. | the most potent toxins secreted by pathogenic bacteria contain enzymatic moieties that must reach the cytosol of target cells to exert their full toxicity. toxins such as anthrax, diphtheria, and botulinum toxin all use three well-defined functional domains to intoxicate cells: a receptor-binding moiety that triggers endocytosis into acidified vesicles by binding to a specific host-cell receptor, a translocation domain that forms pores across the endosomal membrane in response to acidic ph, and ... | 2017 | 28545305 |
| a multicenter, retrospective, case-cohort study of the epidemiology and risk factors for clostridium difficile infection among cord blood transplant recipients. | clostridium difficile infection (cdi) is the leading cause of health-care associated infectious diarrhea. the aim of this study was to evaluate the epidemiology and risk factors for cdi in the 100 days following umbilical cord blood transplantation (ucbt) at three boston hospitals. | 2017 | 28544102 |
| clostridium difficile infection in solid organ transplant recipients. | clostridium difficile infection (cdi) is a major healthcare-associated infection that causes significant morbidity and an economic impact in the united states. in this review, we provide an overview of clostridium difficile infection in solid organ transplant recipients with an emphasis on recent literature. | 2017 | 28542111 |