| heterogeneity of clostridium difficile isolates from infants. | in order to improve our understanding of the role of clostridium difficile in infants we characterised the strains isolated from this population. the production of toxin a and toxin b was studied. the toxin a, playing a major role in the disease, was searched for in faecal samples. the serogroup of the isolates was determined because some serogroups have been shown to be more pathogenic than others. over a 9-month period, 102 faecal samples from 102 hospitalised infants (0-12 months) were analys ... | 1993 | 8482281 |
| be alert to an avoidable problem. management and prevention of antibiotic-acquired diarrhoea. | antibiotic-associated diarrhoea is an unpleasant and distressing problem for patients and health professionals alike. although this condition can be treated with drugs, patient relapses are common. implementation of rigorous infection control policies are therefore required. | 1993 | 8483957 |
| detection of clostridium difficile enterotoxin gene in clinical specimens by the polymerase chain reaction. | a rapid assay was developed for detection of the clostridium difficile enterotoxin gene in stool specimens by means of the polymerase chain reaction (pcr). the pcr primers amplified a 63-bp repetitive sequence of the enterotoxin gene, thereby generating a distinctive ladder pattern of dna bands following electrophoresis. crude dna extracts from stools containing c. difficile produced one (63-bp) or more bands of the characteristic ladder. of 172 stool specimens from 58 patients, 37 gave positive ... | 1993 | 8487296 |
| the use of a commercially available enzyme immunoassay for the detection of clostridium difficile toxin a. | a commercially available enzyme immunoassay (eia) for the detection of clostridium difficile toxin a (premier toxin a eia, meridian diagnostics, cincinnati, ohio) was compared with tissue culture cytotoxicity assay, enterotoxigenic culture, and latex agglutination test for the laboratory diagnosis of c difficile-associated disease. when evaluated for detection of c difficile-associated disease using clinical specimens, eia was the most sensitive (83.1%) and tissue culture cytotoxicity assay was ... | 1993 | 8489340 |
| three-year prevalence of enteropathogenic bacteria in an urban patient population in germany. | the prevalence of enteropathogenic bacteria over a three-year period was 3.1% in an urban population in germany. nontyphoidal salmonella spp. (1.8% prevalence) represented 59.3% of all positive isolates, followed by campylobacter spp., which constituted 22.1% of such isolates. clostridium difficile toxin was detected in 5.6% of samples submitted specifically for detection of cytotoxigenic c. difficile. the seasonal distribution showed an increase of salmonella, shigella and aeromonas/plesiomonas ... | 1993 | 8491518 |
| medical technologists using molecular epidemiology as part of the infection control team. | two medical technologists were appointed as permanent members of a new epidemiology section in the diagnostic microbiology laboratory of a large veterans administration medical center in the fall of 1989. these positions accounted for 9% of the total microbiology staff and were created on a temporary basis 2 years earlier from a need to have dedicated technical expertise for use in the culture, isolation, and typing of nosocomial organisms. the technologists have evaluated outbreaks due to clost ... | 1993 | 8495585 |
| fecal leukocytes in stool specimens submitted for clostridium difficile toxin assay. | to determine their diagnostic utility, fecal leukocytes were sought by methylene blue stain in 502 consecutive stool specimens submitted for clostridium difficile toxin assay. in addition, the stability of fecal leukocytes was assessed by daily examination of 23 stool specimens stored at 4 degrees c and room temperature. the sensitivity, specificity, and positive and negative predictive values of fecal leukocytes in predicting c. difficile toxin assay results were 28%, 92%, 27%, and 93%, respect ... | 1993 | 8495586 |
| [clostridium difficile enteritis complicated by symphysitis. good effect of fecal streptococci]. | | 1993 | 8502035 |
| clostridium difficile infection is a treatable cause of diarrhea in patients with advanced human immunodeficiency virus infection: a study of seven consecutive patients admitted from 1986 to 1992 to a university teaching hospital. | of 427 human immunodeficiency virus-seropositive patients admitted to the robert wood johnson university hospital from january 1986 through august 1992, seven had clostridium difficile enteric infection documented by the presence of cytotoxin b in the stool, without other enteric infection. all seven patients had aids, and all had recently received antibiotics. these patients had a severe clinical presentation of c. difficile infection. all patients had profound watery diarrhea, with a mean of 2 ... | 1993 | 8503386 |
| clostridium difficile diarrhea in patients with aids versus non-aids controls. methods of treatment and clinical response to treatment. | we reviewed the hospital charts of 17 patients with aids and clostridium difficile diarrhea to determine antibiotic use before c. difficile infection, methods of treatment for c. difficile diarrhea, and response of diarrhea to treatment. left shift and total white blood cell count before and after treatment for c. difficile were also determined. non-hiv-infected patients with c. difficile diarrhea served as controls. in the patients with aids, resolution of diarrhea was noted in 15 (88%) patient ... | 1993 | 8505488 |
| serogroup f strains of clostridium difficile produce toxin b but not toxin a. | most toxigenic strains of clostridium difficile produce two toxins: an enterotoxin (toxin a) and a cytotoxin (toxin b). only one strain (strain 8864) has been reported to produce toxin b but no toxin a. serogroup f strains (44) of c. difficile, often isolated from asymptomatic infants, have been examined for toxin production. these strains, which were from distinct geographical and clinical sources, did not produce any detectable toxin a in vitro when examined in three distinct immunoassays. nev ... | 1993 | 8510136 |
| prevalence and toxigenicity of clostridium difficile isolates in fecal microflora of preterm infants in the intensive care nursery. | fecal isolates of clostridium difficile and its toxin b were followed prospectively in 50 preterm intensive care nursery (icn) patients. the first stool specimen was obtained after 1 week of enteral feeding, at 15 +/- 1 days of life, and 2 more specimens were collected at 2-week intervals, 24 +/- 1 and 32 +/- 2 days of life. the stools were cultured for c. difficile, and tested for c. difficile toxin b. in the first specimen 15% of stools grew c. difficile. in the second specimen c. difficile is ... | 1993 | 8513027 |
| [toxic megacolon in pseudomembranous colitis. complicated course of antibiotic-induced clostridium difficile colitis]. | we report on a patient with antibiotic-induced pseudomembranous colitis aggravated by toxic megacolon. colonoscopy not only rapidly permits the diagnosis to be established, but the relief of pressure achieved simultaneously also has a therapeutic effect. if treatment comprising parenteral fluid and electrolyte replacement in combination with oral vancomycin fails to effect an improvement, surgery becomes necessary. current recommendations for treatment are discussed on the basis of a review of t ... | 1993 | 8514224 |
| [nosocomial infections caused by anaerobes]. | | 1995 | 8519821 |
| have enteric infections a role in 5-fluorouracil-associated diarrhea? | in 16 advanced colorectal cancer patients with 5-fluorouracil-associated diarrhea, we evaluated the role of bacterial pathogens in the development of this adverse effect. neither clostridium difficile nor other pathogens were cultured from fecal specimens. these data seem to suggest that it is unlikely that intestinal infections have a role in the pathogenesis of 5fu-associated diarrhea. | 1995 | 8520881 |
| [diagnostic and therapeutic strategy in severe acute colitis in adults]. | | 1995 | 8522096 |
| diagnostic value of clostridium difficile cytotoxin assay. | | 1995 | 8522782 |
| clostridium difficile--associated diarrhoeal diseases: an overview. | | 1995 | 8522806 |
| [diarrhea associated with clostridium difficile and salmonella enteritidis in a patient with hiv infection]. | | 1995 | 8523960 |
| shigellosis in children from north india: a clinicopathological study. | stool samples of 1488 children suffering from acute diarrhoea were studied for bacterial culture and sensitivity. shigella culture was positive in 143 (10 per cent) children and 53 hospitalized children could be studied in detail. thirty-six (68 per cent) children were under 2 years of age and peak prevalence was observed in summer months. fever and diarrhoea were universal features; 96 per cent had blood and mucus in the stools, but 32 per cent started with watery diarrhoea lasting 1-3 days fol ... | 1995 | 8531265 |
| wound botulism--california, 1995. from the center for disease control and prevention. | | 1996 | 8531319 |
| three cases of hemorrhagic colitis in west virginia due to escherichia coli o157:h7. | escherichia coli o157:h7 is an emerging cause of food-borne illness. this bacterial pathogen, most commonly transmitted by undercooked ground beef, causes hemorrhagic colitis. it has been associated with the hemolytic uremic syndrome and death, mostly in children and the elderly. this article describes three patients treated for sporadic cases of escherichia coli o157:h7-associated hemorrhagic colitis at charleston area medical center over a three-week period. | 1995 | 8533400 |
| characterisation of an enterotoxin-negative, cytotoxin-positive strain of clostridium sordellii. | in ileal loop assay, elisa and anion-exchange column chromatography, clostridium sordellii strain 6018 was shown to produce a cytotoxin, but no detectable enterotoxin. dna sequence and polymerase chain reaction analyses indicated that the lack of enterotoxin activity is not due to a lack of gene transcription, but to lack of a major portion of the enterotoxin gene. this is the first characterisation of such a strain. | 1996 | 8544213 |
| [a rare cause of severe diarrhea in children: pseudomembranous colitis]. | pseudomembranous colitis is a rare and serious complication of treatment by antibiotics. the case of a patient with a protracted pseudomembranous colitis followed by two relapses is reported. | 1995 | 8547977 |
| antibiotic-induced colitis. | most cases of antibiotic-associated diarrhea can be classified into two categories: cases in which clostridium difficile is implicated and cases in which no putative agent or recognized pathophysiological mechanism is recognized. c difficile colonization produces a spectrum of conditions, ranging from asymptomatic carriage to fatal pseudomembranous colitis: it is implicated in virtually all cases of pseudomembranous colitis and up to 25% of cases of antibiotic-associated diarrhea without colitis ... | 1995 | 8548209 |
| synthesis of bluetongue virus chimeric vp3 molecules and their interactions with vp7 protein to assemble into virus core-like particles. | bluetongue virus (btv) core-like particles (clps) are formed in the cytoplasm of insect cells when only two major proteins (vp3 and vp7) of the btv core are expressed by baculovirus vectors (t. j. french and p. roy, 1990, j. virol. 64, 1530-1536). we have recently reported that five small internal deletion mutants of vp3 form clps when provided with unmodified vp7 protein (d1-5; s. tanaka and p. roy, 1994, j. virol. 68, 2795-2802). to investigate whether foreign sequences can be inserted into vp ... | 1995 | 8553561 |
| the lack of value of repeated clostridium difficile cytotoxicity assays. | to determine the value of repeated clostridium difficile cytotoxicity assays (ca). | 1996 | 8554444 |
| a predictive model to identify clostridium difficile toxin in hospitalized patients with diarrhea. | although clostridium difficile is a common pathogen in hospitalized patients with diarrhea, no study has attempted to develop a predictive model to estimate the likelihood of c. difficile positivity. | 1996 | 8561149 |
| antibiotic-associated pseudomembranous enteritis due to clostridium difficile. | | 1995 | 8562771 |
| rapid polymerase chain reaction method for specific detection of toxigenic clostridium difficile. | a rapid polymerase chain reaction (pcr) method for detection of toxigenic clostridium difficile directly from fecal samples by amplification of toxin a gene fragments was investigated. the technique was applied to monitor the spread of the microorganism in a long-term care ward with a relatively high incidence of overt episodes of diarrhea. the pcr approach has several advantages over traditional methods, rapidly allowing the specific detection of toxigenic clostridium difficile strains from sto ... | 1995 | 8565994 |
| [severe forms of pseudomembranous colitis caused by clostridium difficile]. | clostridium difficile causes a broad spectrum of enteric diseases in humans, ranging from mild antibiotic-associated diarrhoea to more severe pseudomembranous colitis. the authors report four cases of life-threatening pseudomembranous colitis with haemodynamic changes. infection due to clostridium difficile should be kept in mind whenever a patient undergoing antibiotic therapy develops a symptomatology of an acute abdomen. | 1995 | 8572394 |
| pseudomonas aeruginosa as a cause of infectious diarrhea successfully treated with oral ciprofloxacin. | to describe an immunocompromised patient (without aids) with nosocomial infectious diarrhea caused by pseudomonas aeruginosa. oral ciprofloxacin therapy proved to be effective. | 1995 | 8573957 |
| inhibition of receptor signaling to phospholipase d by clostridium difficile toxin b. role of rho proteins. | rho proteins have been reported to activate phospholipase d (pld) in in vitro preparations. to examine the role of rho proteins in receptor signaling to pld, we studied the effect of clostridium difficile toxin b, which glucosylates rho proteins, on the regulation of pld activity in human embryonic kidney (hek) cells stably expressing the m3 muscarinic acetylcholine receptor (machr). toxin b treatment of hek cells potently and efficiently blocked machr-stimulated pld. in contrast, basal and phor ... | 1996 | 8576201 |
| the interplay between enteric pathogens and gastrointestinal mucins. | | 1995 | 8576804 |
| pseudomembranous colitis: ct findings in children. | a spectrum of nodular haustral thickening and an accordion pattern have been reported as specific features of pseudomembranous colitis (pmc) in adults. a retrospective review of nine patients with pmc was performed to assess whether this spectrum of ct findings also occurred in children. in four girls and five boys, ct scans were performed within 3 days of a positive stool toxin assay for clostridium difficile. documented ct abnormalities included nodular haustral thickening, the accordion patte ... | 1995 | 8577512 |
| clinical and molecular epidemiology of sporadic and clustered cases of nosocomial clostridium difficile diarrhea. | a prospective clinical and molecular epidemiologic study was conducted to define the frequency of nosocomial clostridium difficile patient-to-patient transmission in an urban tertiary referral hospital. patients and | 1996 | 8579084 |
| epidemiology of infectious and iatrogenic nosocomial diarrhea in a cohort of general medicine patients. | nosocomial diarrhea is a common problem in hospitals, but the epidemiology, causes, and consequences of infectious and iatrogenic nosocomial diarrhea are rarely documented in follow-up or surveillance studies of nosocomial infections. the objective of this study was to describe the epidemiology of nosocomial diarrhea in a cohort study of hospitalized patients. | 1995 | 8585641 |
| comparison of arbitrarily primed pcr with restriction endonuclease and immunoblot analyses for typing clostridium difficile isolates. | arbitrarily primed pcr (ap-pcr) was used to genotype 26 clinical isolates of clostridium difficile previously analyzed by immunoblotting (ib) and 20 isolates typed by restriction endonuclease analysis (rea) with hindiii. two levels of differentiation were achieved with the ap-pcr approach by use of two different arbitrary primers. with the 19-mer arbitrary primer t-7 (first level of differentiation), a good correlation was found between ib and ap-pcr typing. twenty isolates grouped into six ib t ... | 1995 | 8586695 |
| clostridium difficile-associated diarrhoea and length of hospital stay. | | 1995 | 8586796 |
| diarrhoea caused by clostridium difficile: response time for treatment with metronidazole and vancomycin. | one hundred patients, known to have been excreting clostridium difficile cytotoxin in faeces, were reviewed retrospectively to determine the response time for treatment with oral metronidazole and vancomycin, and the effect of the additional administration of anti-motility agents. records were available for 78 patients of whom 58 had received treatment with either metronidazole or vancomycin. response and relapse rates were similar for the two treatment regimens. however, the mean duration of sy ... | 1995 | 8591942 |
| biotherapeutic agents. a neglected modality for the treatment and prevention of selected intestinal and vaginal infections. | to evaluate the potential of biotherapeutic agents (microorganisms with therapeutic properties) for the prevention and/or treatment of selected intestinal and vaginal infections. | 1996 | 8596226 |
| a new form of particulate single and multiple immunogen delivery system based on recombinant bluetongue virus-derived tubules. | the development of particular vector systems for the presentation of immunogenic epitopes provides a powerful approach for the delivery of antigens. these include the core-like particles formed by recombinant bluetongue virus (btv) capsid proteins vp3 and vp7 synthesized in insect cells by recombinant baculoviruses. previously we have reported localization of an antigenic site on the surface of tubular structures formed by the nonstructural protein ns1 of btv, and their potential use for epitope ... | 1996 | 8599217 |
| enteric precautions for clostridium difficile. | | 1996 | 8600710 |
| risk of diarrhoea due to clostridium difficile during cefotaxime treatment. cefotaxime compares favourably with other third generation cephalosporins. | | 1996 | 8605486 |
| risk of diarrhoea due to clostridium difficile during cefotaxime treatment. mortality due to c difficile colitis in elderly people has been underestimated. | | 1996 | 8605487 |
| increased substance p receptor expression by blood vessels and lymphoid aggregates in clostridium difficile-induced pseudomembranous colitis. | pseudomembranous colitis is most often caused by toxins secreted by clostridium difficile following bowel flora overgrowth after antibiotic use. the secretory and inflammatory effects observed in c. difficile toxin a-induced enterocolitis in the rat ileum are inhibited by cp-96,345, a substance p (sp) receptor antagonist. to determine if sp plays a role in the pathogenesis of human pseudomembranous colitis, sp receptor distribution was examined in a toxin a-positive specimen of bowel. quantitati ... | 1996 | 8617145 |
| betalactam therapy and intestinal flora. | betalactams, mainly when orally administered, may lead to intestinal flora modifications related to their spectrum of activity, rate of absorption and degradation. therefore it is important to investigate the possible influence of recently developed oral cephem derivatives on normal human microflora. we have investigated the impact on normal human intestinal flora in a 10-day course with cefetamet-pivoxil (cet, 500 mg bid) in comparison to cefixime (cfx, 400 mg qd) or cefuroxime axetil (ca, 250 ... | 1995 | 8618110 |
| case records of the massachusetts general hospital. weekly clinicopathological exercises. case 17-1996. a 48-year-old man with the acquired immunodeficiency syndrome, abdominal pain, and bloody diarrhea. | | 1996 | 8618586 |
| antibiotics a21459 a and b, new inhibitors of bacterial protein synthesis. ii. structure elucidation. | the structures of the antibiotics, active against a few gram-negative bacteria and clostridium difficile, were determined on the basis of physicochemical analyses on the intact molecules and on the acid hydrolysate of a21459 a. fab-ms and 1h and 13c nmr investigations identified the amino acid units and determined their sequence. antibiotics a21459 a and b are homodetic cyclic peptides constituted by eight amino acid units. they are glycine, methoxytryptophan, tryptophan, cysteine, alanine, sarc ... | 1996 | 8621355 |
| inactivation of ras by clostridium sordellii lethal toxin-catalyzed glucosylation. | the lethal toxin (lt) from clostridium sordellii belongs to the family of large clostridial cytotoxins causing morphological alterations in cultured cell lines accompanied by destruction of the actin cytoskeleton. c. sordellii lt exhibits 90% homology to clostridium difficile toxin b, which has been recently identified as a monoglucosyltransferase (just, i., selzer, j., wilm, m., von eichel-streiber, c., mann, m., and aktories, k. (1995) nature 375, 500-503). we report here that lt too is a gluc ... | 1996 | 8626575 |
| inhibition of fc epsilon-ri-mediated activation of rat basophilic leukemia cells by clostridium difficile toxin b (monoglucosyltransferase) | treatment of rat basophilic leukemia (rbl) 2h3-hm1 cells with clostridium difficile toxin b (2 ng/ml), which reportedly depolymerizes the actin cytoskeleton, blocked [3h]serotonin release induced by 2,4-dinitrophenyl-bovine serum albumin, carbachol, mastoparan, and reduced ionophore a23187-stimulated degranulation by about 55-60%. in lysates of rbl cells, toxin b 14c-glucosylated two major and one minor protein. by using two-dimensional gel electrophoresis and immunoblotting, rhoa and cdc42 were ... | 1996 | 8631752 |
| prognostic criteria in clostridium difficile colitis. | to determine the prognostic factors in clostridium difficile (cd) colitis. | 1996 | 8633491 |
| udp-glucose deficiency in a mutant cell line protects against glucosyltransferase toxins from clostridium difficile and clostridium sordellii. | we have previously isolated a fibroblast mutant cell with high resistance to the two rho-modifying glucosyltransferase toxins a and b of clostridium difficile. we demonstrate here a low level of udp-glucose in the mutant, which explains its toxin resistance since: (i) to obtain a detectable toxin b-mediated rho modification in lysates of mutant cells, addition of udp-glucose was required, and it promoted the rho modification dose-dependently; (ii) high pressure liquid chromatography analysis of ... | 1996 | 8636120 |
| small-bowel bacterial overgrowth in children with chronic diarrhea, abdominal pain, or both. | to evaluate the frequency of small-bowel bacterial overgrowth (sbbo) as a cause of chronic digestive symptoms in a large cohort of children, using the glucose breath hydrogen test (bht). | 1996 | 8636812 |
| antigenicity of amino-acid sequences from clostridium difficile toxin b. | clostridium difficile toxins a and b cause antibiotic-associated colitis. whereas antigenic determinants specifying neutralisation of toxin a have been partially elucidated, those of toxin b remain unknown. to define antigenic determinants of toxin b, synthetic peptides were prepared for five linear sequences selected by computer analysis for putative t and b epitopes. peptides spanning the carboxy terminal region (aa 2155-2283) were also selected because this region contains repetitive units th ... | 1996 | 8636964 |
| herpes simplex virus (hsv) colitis in a bone marrow transplant recipient. | herpes simplex virus (hsv) infections are common in bone marrow transplantation patients. unusual sites may be involved, however colonic disease with hsv is rare. we report a successfully treated case of colitis due to hsv, cytomegalovirus, clostridium difficile and graft-versus-host disease in an allogeneic marrow recipient. | 1996 | 8640181 |
| clostridium difficile colitis associated with cisplatin-based chemotherapy in ovarian cancer patients. | the purpose of this study was to examine the incidence and cause of clostridium difficile colitis occurring after cisplatin-based combination chemotherapy in ovarian cancer patients. thirty-three patients with primary ovarian malignancy were treated with cisplatin-based combination chemotherapy ranging from 1 to 12 (mean 4.6) cycles. all patients who developed diarrhea after undergoing the cancer chemotherapy were examined to determine whether or not they were complicated by c difficile colitis. ... | 1996 | 8641617 |
| enhancement of clostridium difficile toxin production in biotin-limited conditions. | the effect of biotin on toxin production by clostridium difficile was examined in a defined medium. when toxin production by strain kz 1647, which was isolated from a healthy adult, was examined in relation to its biotin requirement, it was found that with decreasing concentrations of biotin, bacterial growth was decreased, but production of both toxins a and b were remarkably increased, particularly with 0.05 nm biotin. the time course of production of both toxins in biotin-limited conditions w ... | 1996 | 8642571 |
| cell surface properties of clostridium difficile: haemagglutination, relative hydrophobicity and charge. | five well characterised strains of clostridium difficile of differing virulence and two escherichia coli strains, a verotoxigenic o157:h7 isolate and a urinary isolate, were examined for cell surface hydrophobicity and charge, and haemagglutinating ability. phase partition in hexadecane or octan-1-ol was similar for c. difficile and e. coli, as was retention by hydrophobic interaction chromatography (hic), indicating moderate hydrophobicity. the salt agglutination test showed e. coli to be hydro ... | 1996 | 8642572 |
| diagnosis of clostridium difficile--associated disease: patient selection and test perfection. | | 1996 | 8644758 |
| clinical prediction rules to optimize cytotoxin testing for clostridium difficile in hospitalized patients with diarrhea. | although routine testing of hospitalized patients with diarrhea for clostridium difficile cytotoxin has been advocated as a high-yield procedure, the rationale for this practice has been questioned. to target a low-yield subgroup for whom routine testing could be deferred, we derived a clinical decision rule for predicting results of the c difficile cytotoxin assay in hospitalized adults with diarrhea. | 1996 | 8644759 |
| surgery for pancreatic tumors during pregnancy: a case report and review of the literature. | seven cases of surgery of pancreatic tumors during pregnancy have been reported in the literature. six of the cases resulted in live term births. the patient discussed herein, a 37-year-old para 2-0-0-2 white female, had surgery for the removal of a pancreatic mass at 20 2/7 weeks' gestation. no intraoperative complications occurred, and both mother and fetus appeared to have done well. the postoperative course was complicated by pseudomembranous enterocolitis caused by c. difficile, which was t ... | 1996 | 8645381 |
| clostridium difficile colitis in the critically ill. | morbidity and treatment of clostridium difficile colitis (cdc) continue to be controversial. some claim minimum morbidity, which may be a function of differences in patient population and/or bacterial virulence. | 1996 | 8646945 |
| [antibiotic-associated diarrhea in light of personal observations]. | examination was performed in a group of 539 adult patients with diarrhea admitted to the department of infectious diseases in gdańsk from 1991 to 1994. the group of 17 patients with antibiotic-associated colitis (aac) was analysed. the antibiotics responsible for aac were lincosamides, cephalosporins and penicillins. aac was diagnosed by anamnesis, medical examination and detection of toxin a clostridium difficile in stool samples. the contrast enema, colonoscopy and histopathological examinatio ... | 1995 | 8650032 |
| the clinical spectrum of clostridium difficile colitis in immunocompromised patients. | clostridium difficile colitis is a nosocomial infection that continues to cause significant hospital morbidity despite adequate treatment. this morbidity may be especially costly in the immunocompromised patient who now makes up a greater percentage of hospitalized patients. the purpose of this study was to evaluate if patients in immunocompromised states are at risk for relapse of clostridium difficile colitis, and to determine the efficacy of metronidazole in these patients. a retrospective ch ... | 1996 | 8651560 |
| granulocyte-macrophage colony-stimulating factor therapy in patients with chemotherapy-induced aplasia and clostridium difficile enterocolitis. | | 1995 | 8652281 |
| use of pulsed-field gel electrophoresis for investigation of an outbreak of clostridium difficile infection among geriatric patients. | a six-month outbreak of clostridium difficile infection among elderly residents of a middle-term-care facility was investigated. pulsed-field gel electrophoresis was used to genotype 22 outbreak strains and 30 epidemiologically unrelated strains. a prospective case-control study was conducted to identify risk factors for epidemic clostridium difficile-associated diarrhea. all epidemiologically unrelated clostridium difficile strains of the same serogroup could be differentiated by their dna patt ... | 1995 | 8654450 |
| nosocomial empyema caused by clostridium difficile. | pleural infection with clostridium difficile is extremely rare. a case of nosocomial empyema following chest drain insertion in a 46 year old man is described. the potential of c difficile to cause extra-intestinal infections should be recognised and its isolation from other sites should not be ignored. | 1996 | 8655688 |
| response of recurrent medulloblastoma to low-dose oral etoposide. | the outcome for patients with recurrent medulloblastoma has historically been poor, with most patients dying of disseminated disease. here, we report on seven patients with recurrent medulloblastoma, most heavily pretreated with a variety of chemotherapeutic agents, including parenteral etoposide (vp-16), who showed responses to the administration of repeated courses of low-dose oral vp-16. | 1996 | 8656261 |
| [side effects and consequences of frequently used antibiotics in clinical practice]. | oral antimicrobial substances belonging to the beta-lactams, quinolones, macrolides, tetracyclines and the trimethoprim-sulfamethoxazole combination are among the most prescribed classes of drugs in private practice. knowledge of the potential side effects considered in the light of various patient-associated factors such as genetic makeup, renal and liver function, underlying diseases, drug allergies and coadministered drugs, is important in order to minimize the risk of adverse reactions. this ... | 1996 | 8658092 |
| community-acquired toxigenic clostridium difficile diarrhoea in the normoxaemic elderly who have received no antimicrobials: soft evidence for ischaemic colitis? | we report three examples of community-acquired toxigenic clostridium difficile diarrhoea in elderly patients who had neither received antimicrobial therapy nor been institutionalised. these cases stimulated interest in the non-antimicrobial changes which might predispose the host to c. difficile-related disease and raised the spectre of bowel ischaemia as a possible aetiological factor. | 1996 | 8658116 |
| [the value of rectosigmoidoscopy and the bacteriologic culture of colon biopsies in the etiologic diagnosis of acute diarrhea of adults. a prospective study of 65 patients]. | the goal of this study was to evaluate the contribution of sigmoidoscopy with bioptic microbiology to the etiologic diagnosis of acute diarrhea in adults. patients and methods. sixty-five patients with acute diarrhea were included prospectively from february 1993 to november 1994. ages ranged from 17 to 83 years. in each patient, two stool samples were cultured and three examined for parasites. clostridium difficile toxin was looked for in the 18 patients who had taken antimicrobials before onse ... | 1996 | 8669803 |
| effect of clostridium difficile toxin a on human intestinal epithelial cells: induction of interleukin 8 production and apoptosis after cell detachment. | clostridium difficile is the aetiological agent of pseudomembranous colitis, and animal studies suggest the essential role of secreted toxin a in inducing disease. this study examined the biological responses to toxin a by human intestinal epithelial cells. confluent monolayers of caco2, ht29, and t84 cells and primary epithelial cells in organ cultures of human colonic biopsy specimens and after detachment with edta were studied. interleukin 8 was assayed using enzyme linked immunosorbent assay ... | 1996 | 8675084 |
| albendazole-induced pseudomembranous colitis. | we report a patient with aids and intestinal microsporidiosis. while undergoing treatment with albendazole, he developed worsening diarrhea with abdominal pain and fever. the diagnosis of pseudomembranous colitis was made by flexible sigmoidoscopy and a positive stool specimen for clostridium difficile toxin. the patient's symptoms resolved with oral vancomycin and his stool c. difficile toxin became negative. albendazole is an antibiotic that is chemically related to metronidazole. although a f ... | 1996 | 8678015 |
| prevalence and pathogenicity of clostridium difficile in hospitalized patients. a french multicenter study. | although clostridium difficile is the main agent responsible for nosocomial diarrhea in adults, its prevalence in stool cultures sent to hospital microbiology laboratories is not clearly established. | 1996 | 8678714 |
| in vitro activity of mdl 62,879 against gram-positive bacteria and bacteroides species. | the new thiazolyl peptide antibiotic mdl 62,879 (ge2270 a) showed excellent in vitro activity in testing against staphylococci and streptococci, with mic90s ranging from 0.23 to 0.9 mg/l. it was very active against clostridium difficile and propionibacterium acnes (mic90 0.06 mg/l in each case) and had variable activity against bacteroides spp. mdl 62,879 had exceptionally good activity against enterococcus faecalis, including against a collection of high-level aminoglycoside-resistant isolates ... | 1995 | 8681991 |
| usefulness of culture in the diagnosis of clostridium difficile infection. | | 1995 | 8681993 |
| acute flexor tenosynovitis in association with clostridium difficile infection: a case report. | | 1996 | 8683072 |
| the distribution of clostridium difficile in the environment of south wales. | a large study of the distribution of clostridium difficile in the environment of the cardiff area of south wales was performed with a methodology designed to maximise recovery. a total of 2580 samples was taken, with 184 (7.1%) yielding isolates. the highest yield for c. difficile was obtained from river waters, with 14 (87.5%) of 16 samples from four rivers positive, and from sea water samples with 7 (44%) of 15 positive from six beaches on the bristol channel. in addition, 7 (46.7%) of 15 samp ... | 1996 | 8683549 |
| [a case of slowly resolving enteritis caused by clostridium difficile]. | clostridium difficile is considered as the most important cause of severe antibiotic-associated diarrhea and pseudomembranous colitis. we describe the case of an one year old boy presenting c. difficile chronic diarrhea without previous antibiotic treatments. | 1995 | 8685005 |
| [epidemiology of clostridium difficile nosocomial infections]. | clostridium difficile accounts for 15-25% of cases of antibiotic-associated diarrhea (aad) and for virtually all cases of antibiotic-associated pseudo-membranous colitis (pmc). this anaerobic bacterium is also carried in the gastro-intestinal tract of less than 3% of the normal adult population and can be isolated from the feces of 50-70% asymptomatic neonates. since recent years, c. difficile has been identified as the leading cause of nosocomial diarrhea in adults. pathogenesis relies on a dis ... | 1996 | 8685186 |
| nitric oxide inhibits rat intestinal secretion by clostridium difficile toxin a but not vibrio cholerae enterotoxin. | intestinal inflammation is associated with increased synthesis of nitric oxide, whereas inhibition of no synthase (nos) reduces experimental chronic intestinal inflammation. the aim of this study was to test the effects of no blockers and donors on acute intestinal inflammation induced by clostridium difficile toxin a in rat ileum. | 1996 | 8690206 |
| a receptor decoy inhibits the enterotoxic effects of clostridium difficile toxin a in rat ileum. | clostridium difficile toxin a causes secretion and intestinal inflammation in rodents by binding to a specific trisaccharide gal alpha 1-3gal beta 1-4 glcnac on enterocyte receptors. the purpose of this study was to explore the ability of synsorb 90 (synsorb biotech inc., calgary, alberta, canada), and inert support carrying this trisaccharide, to bind toxin a in vitro and to inhibit its enterotoxic effects in vivo. | 1996 | 8690209 |
| diagnostic value of clostridium difficile cytotoxin assay. | | 1996 | 8690887 |
| rabbit sucrase-isomaltase contains a functional intestinal receptor for clostridium difficile toxin a. | the intestinal effects of clostridium difficile toxin a are inidated by toxin binding to luminal enterocyte receptors. we reported previously that the rabbit ileal brush border (bb) receptor is a glycoprotein with an alpha-d-galactose containing trisaccharide in the toxin-binding domain (1991. j. clin. invest. 88:119-125). in this study we characterized the rabbit ileal bb receptor for this toxin. purified toxin receptor peptides of 19 and 24 amino acids showed 100% homology with rabbit sucrase- ... | 1996 | 8698855 |
| effect of clostridium difficile toxin b on ige receptor-mediated signal transduction in rat basophilic leukemia cells: inhibition of phospholipase d activation. | antigen (ag)-stimulated phospholipase d (pld) activation and secretion were almost abolished by pretreatment of rat basophilic leukemia (rbl)-2h3 cells for 4 h with 5 ng/ml clostridium difficile toxin b which is known to inhibit rho family proteins (rho, cdc42, rac). the concentration-dependent inhibition of pld activation was well correlated with the level of glucosylation of rho family proteins. in streptolysin o-permeabilized rbl cells, toxin b suppressed [3h] phosphatidylbutanol (pbut) forma ... | 1996 | 8702431 |
| [epidemiologic study of infectious diarrhea in infants]. | the authors considered the epidemiological and microbiological aspects of the infectious diarrhea caused by bacteria, protozoan and viruses observed at the infantile hospital, alessandria, and at the malpighi diagnostic center, chivasso, turin, over a period of 14 months. furthermore, a greater interest has been given to the role of clostridium difficile diarrhea, since hospitalized patients are often predisposed to the development of this disease due to the antimicrobial prophylaxis or therapy. | 1994 | 8706978 |
| clostridium difficile contamination of blood pressure cuffs: a call for a closer look at gloving practices in the era of universal precautions. | we report an outbreak of clostridium difficile-associated diarrhea at our medical center following adoption of universal precautions. environmental cultures revealed unexpected contamination of blood pressure cuffs at a rate similar to that for bedside commodes (10% and 11.5%, respectively). an observational survey revealed that healthcare workers in the patient care areas not infrequently failed to remove their potentially stool-contaminated gloves prior to touching clean surfaces, which might ... | 1996 | 8708361 |
| the use and abuse of routine stool microbiology: a college of american pathologists q-probes study of 601 institutions. | to examine the efficiency with which physicians use routine stool microbiology tests. | 1996 | 8712901 |
| [clostridium difficile: an increasing nosocomial pathogen]. | | 1996 | 8714151 |
| [clostridium difficile and diarrhea associated with the use of antibiotics in the origin of nosocomial and community-acquired diarrhea]. | clostridium difficile is currently recognized as an important nosocomial enteric pathogen. the significance as etiologic agent of community and nosocomial diarrhea is not well known in spain. | 1996 | 8714156 |
| comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of clostridium difficile-associated diarrhea. | we conducted a prospective, randomized study to compare the efficacy of oral fusidic acid, oral metronidazole, oral vancomycin, and oral teicoplanin for the treatment of clostridium difficile-associated diarrhea. treatment resulted in clinical cure for 94% of the patients who were treated with vancomycin, 96% of those treated with teicoplanin, 93% of those treated with fusidic acid, and 94% of those treated with metronidazole. clinical symptoms recurred in 16% of patients treated with vancomycin ... | 1996 | 8722937 |
| whole-bowel irrigation as an adjunct to the treatment of chronic, relapsing clostridium difficile colitis. | we report the successful treatment of two patients with chronic, intractable clostridium difficile infection using whole-bowel irrigation with a polyethylene glycol solution (golytely) as adjunctive therapy. before this treatment, both patients had recurrent symptoms of diarrhea, weight loss, abdominal pain, and documented c. difficile toxin-positive stools despite multiple pharmacologic treatments. each child was prescribed myriad drug therapies, including vancomycin, metronidazole, bacitracin, ... | 1996 | 8724255 |
| comparison of pcr-based approaches to molecular epidemiologic analysis of clostridium difficile. | representative isolates of the 10 serogroups of clostridium difficile and 39 clinical isolates (30 toxigenic and 9 nontoxigenic), including 5 isolates from a confirmed nosocomial outbreak, were analyzed by using two previously described arbitrary-primer pcr (ap-pcr) molecular typing methodologies (ap-pg05 and ap-arb11) and pcr ribotyping. the two ap-pcr methods investigated gave comparable results; ap-pg05 and ap-arb11 identified 8 and 7 groups among the serogroup isolates and classified the cli ... | 1996 | 8727893 |
| role of stool screening tests in diagnosis of inflammatory bacterial enteritis and in selection of specimens likely to yield invasive enteric pathogens. | the leuko-test yielded a negative predictive value of 98.4% when it was used to screen 325 patients for inflammatory bacterial enteritis and a negative predictive value of 99.4% when it was used to screen 416 stool specimens for those from which enteric pathogens would likely be recovered when cultured. neither microscopy for fecal leukocytes nor an assay for fecal occult blood, alone or in combination, allowed for the reliable detection of invasive bacterial enteritis or the reliable selection ... | 1996 | 8727895 |
| extraintestinal clostridium difficile infections. | | 1996 | 8729213 |
| sulphasalazine treatment and the colorectal mucosa-associated flora in ulcerative colitis. | to study the influence of sulphasalazine treatment on the mucosa-associated bacterial flora of rectal biopsy tissue specimens in patients with ulcerative colitis. | 1996 | 8730244 |
| [what should be done for diarrhea during antibiotic therapy?]. | | 1996 | 8737495 |
| incidence of diarrhea and clostridium difficile toxin in stools from hospitalized patients receiving clindamycin, beta-lactams, or nonantibiotic medications. | | 1996 | 8742665 |
| comparison of two commercial enzyme immunoassays with cytotoxicity assay and culture for the diagnosis of clostridium difficile related diarrhea. | 184 stool samples were analysed for the presence of clostridium difficile and toxins using the meridian premier toxin a and techlab tox-a eia kits, selective culture and cytotoxin assay. of the 184 samples 36 stools tested positive for cytotoxin. in comparison the sensitivity and specificity of the eias and culture were as follows: meridian, 72 and 87, techlab, 64 and 95, and selective culture, 83 and 96%, respectively. the positive predictive values and negative predictive values for the variou ... | 1996 | 8743827 |