| [effect of meropenem on fecal flora in children]. | meropenem (mepm, sm-7338), a novel parenteral carbapenem antibiotic, was examined for its effect on intestinal flora in children. seven children with infectious diseases (3 male and 4 female children of age's ranging from 4 months to 8 years and 9 months weighing from 7.3 to 23.0 kg) were treated with mepm at doses ranging 10.3 to 40.5 mg/kg 3 or 4 times a day for 6 to 12 days. before, during and after the treatment, identities and numbers of various bacteria contained in 1 g of feces were deter ... | 1992 | 1479688 |
| influence of ceftriaxone on emergence of clostridium difficile. | the influence of long-term ceftriaxone administration on the emergence of clostridium difficile was studied with 80 patients receiving ceftriaxone for 14 days. in five patients (6.3%) c. difficile was cultured. the appearance of gastrointestinal disturbances during treatment with ceftriaxone was common, but the rate of emergence of c. difficile in immunocompetent patients was not high. | 1992 | 1482159 |
| impaired detection of faecal verocytotoxin in the presence of clostridium difficile cytotoxin in patients with haemolytic uraemic syndrome. | three cases of haemolytic uraemic syndrome associated with infection with verocytotoxin producing escherichia coli are described. the concomitant presence of clostridium difficile cytotoxin in the patients' stool impaired the detection of free faecal verocytotoxin. stool specimens containing clostridium difficile cytotoxin should thus be considered negative for verocytotoxin only after neutralisation of the clostridium difficile cytotoxin with antitoxin. | 1992 | 1486891 |
| effect of oral saccharomyces boulardii treatment on the activity of clostridium difficile toxins in mouse digestive tract. | human antibiotic-associated diarrhoea and pseudomembranous colitis are partly due to toxin production by clostridium difficile. it is now well documented that saccharomyces boulardii protects against c. difficile induced diseases. in an attempt to understand better the mechanism of this protective effect, the action of s. boulardii on a crude toxin preparation was studied in vitro and in vivo. the results showed that the yeast had no effect on the toxins in vitro but was able to protect mice ino ... | 1992 | 1488767 |
| [the influence of cefdinir on the intestinal bacterial flora]. | the influence of cefdinir (cfdn), a new oral cephalosporin, on the intestinal bacterial flora was studied in tetra-contaminated mice and in pediatric patients. cfdn in fine granules was administered at a dose of 10 mg/kg once a day for 5 consecutive days to mice contaminated with 4 different species of organism: escherichia coli, enterococcus faecalis, bacteroides fragilis and bifidobacterium breve. no remarkable changes were observed in the fecal viable cell counts except that decreases in e. c ... | 1992 | 1495195 |
| clostridium difficile diarrhea induced by cancer chemotherapy. | four patients had diarrhea due to clostridium difficile after receiving chemotherapy for cancer. none of the patients had received antibiotics for at least 4 weeks before the onset of diarrhea. at the time of admission of any of these four patients no outbreak of diarrhea was noted on the ward. each patient was admitted with the acute onset of diarrhea after receiving chemotherapy, at different times of the year. diarrhea was clinically important and was associated with dehydration, toxemia, and ... | 1992 | 1497405 |
| clostridium difficile infection--a poor prognostic sign in uremic patients? | uremia has been reported as a risk factor for the occurrence of infection with clostridium difficile. during the two-year period 1984-86, 110 episodes of clostridium difficile infection were encountered in 70 patients on a nephrology ward. sixty-two patients had chronic renal failure and eight had acute renal failure. sixty-seven of the patients were uremic and were treated with hemodialysis (n = 35), capd (n = 21), intermittent peritoneal dialysis (n = 6) or conservatively with a low protein di ... | 1992 | 1499170 |
| laboratory diagnosis of clostridium difficile-associated gastrointestinal disease: comparison of a monoclonal antibody enzyme immunoassay for toxins a and b with a monoclonal antibody enzyme immunoassay for toxin a only and two cytotoxicity assays. | a total of 320 stool specimens obtained from 262 patients suspected of having clostridium difficile-associated gastrointestinal disease were examined with two cytotoxicity assays (ctas) and two commercially available enzyme immunoassays (eias). the ctas were an in-house-developed procedure (university of massachusetts medical center [ummc], worcester, mass.) and a commercial test (bartels cta; baxter healthcare corp., west sacramento, calif.). one eia was a monoclonal antibody-based assay for c. ... | 1992 | 1500512 |
| colonisation with digoxin-reducing strains of eubacterium lentum and clostridium difficile infection in nursing home patients. | stool specimens obtained from 77 residents of a nursing home were analysed to determine the relationship between colonisation with digoxin-reducing strains of eubacterium lentum and infection with clostridium difficile. patients were categorised according to previous antibiotic treatment, prescription of enteral feedings, and pattern of bowel habits. colonisation with digoxin-reducing e. lentum was less common in subjects infected with c. difficile, in those treated with antibiotics previously, ... | 1992 | 1500644 |
| perforated pseudomembranous colitis in the breast-fed infant. | pseudomembranous colitis (pmc) is uncommon in the infant and complications requiring surgical intervention are rare. all prior cases have involved the direct administration of antibiotics to the child. a 2-month-old girl required bowel resection for perforation of a thickened and inflamed left colon. findings were consistent with pmc and the stool was clostridium difficile toxin positive. the patient was treated with vancomycin and did well. the patient's mother later admitted to self-administra ... | 1992 | 1501036 |
| antibiotic-associated colitis and cystic fibrosis. | the use of antibiotics in patients with cystic fibrosis is widespread, and fecal carriage of clostridium difficile occurs in up to 50% of these patients; however, antibiotic-associated colitis appears to be a rare occurrence. the reasons why this is so remain unknown. a case of antibiotic-associated colitis occurring in a patient with cystic fibrosis is described. possible mechanisms for the rarity of antibiotic-associated colitis are reviewed and implications for prompt diagnosis and therapy ar ... | 1992 | 1505297 |
| [clinical spectrum of antibiotic associated enterocolitis due to methicillin resistant staphylococcus aureus]. | historically, various types of antibiotic-associated diarrhea have been recognized. in the 1950-1960s, multi-resistant staphylococcus aureus was implicated to be major cause of antibiotic-associated diarrhea, especially pseudomembranous enterocolitis. in the late 1970s, a new type of antibiotic-associated diarrhea, which is characterized by pseudomembranous colitis and lack of fecal multi-resistant s. aureus, usually following lincosamide administration, was recognized. many studies have reveale ... | 1992 | 1507432 |
| how do you treat--and control--c. difficile infection? | | 1992 | 1510097 |
| automated lanes detection and comparison of bacterial electrophoretic protein fingerprints using fast fourier transformation. | a method of computer-automated analysis of bacterial fingerprints produced by electrophoresis of proteins in a one-dimensional slab gel system is described. proteins were visualized by silver staining. western blotting, or autoradiography. gels were recorded with a ccd camera, and after initial manual removal of the unwanted image margins, track margins were identified and extracted and a normalized trace was produced automatically using fourier routines to smooth plots required for this process ... | 1992 | 1511600 |
| clostridium difficile toxin a induces multinucleation in the human leukemic t cell line jurkat. | clostridium difficile toxin a is a cytotoxic enterotoxin known to be active on all mammalian cell lines tested up to now. it induces a disruption of the cytoskeleton, particularly the microfilament system, leading to inhibition of cell proliferation. here, we describe some effects of toxin a on the leukemic t cell line jurkat. cells exposed to the toxin did not divide, as cell numbers remained constant for 3 days in the presence of 0.5 to 1.0 micrograms/ml of the toxin. however, these cells were ... | 1992 | 1511704 |
| the effect of levofloxacin, an optically-active isomer of ofloxacin, on fecal microflora in human volunteers. | following oral administration of levofloxacin (lvfx, (s)-(-)-ofloxacin; formerly designated as dr-3355) at 200 mg per dose 3 times a day for 7 days to 6 healthy male volunteers, degrees of disturbance of the fecal microflora and fecal drug concentrations were examined. the total viable count remained unchanged during the study period due to the minimal change in the number of members of the family bacteroidaceae, the most predominant organisms. most of the aerobes including facultative anaerobes ... | 1992 | 1512920 |
| identification of toxigenic clostridium difficile strains using a toxin b gene-specific oligonucleotide probe. | we describe the use of a new specific synthetic oligonucleotide probe, deduced from the sequence of the gene for clostridium difficile toxin b, to identify toxigenic strains of c. difficile. this probe does not hybridize to the dna of non-toxigenic strains of c. difficile nor to dna isolated from different clostridium species, including c. sordellii. none of the enteric pathogenic bacteria tested were seen to hybridize with the probe. a preliminary study of direct probing of faecal specimens ind ... | 1992 | 1513339 |
| nosocomial diarrhoea due to a single strain of clostridium difficile: a prolonged outbreak in elderly patients. | an outbreak of diarrhoea occurred in an acute geriatric ward of a hospital (a). it affected six patients initially and was found to be due to a single strain of clostridium difficile. there was little evidence for asymptomatic carriage of this strain or others in the hospital patients. the following three months saw an increase in the number of symptomatic cases of c. difficile disease in two peripheral hospitals, b and c. patients had been moved from the outbreak ward to these hospitals. of 18 ... | 1992 | 1514452 |
| [eremomycin in the treatment of antibiotic-associated colitis in golden hamsters]. | the efficacy of eremomycin, a new glycopeptide antibiotic, was studied on a model of antibiotic-associated colitis in golden hamsters. the colitis was induced by intraperitoneal or intragastric administration of lincomycin. in a dose of 100 mg/kg administered orally once a day for 5 days eremomycin protected the animals from the lincomycin-induced colitis: some animals survived, the others died in later periods. when the animals were infected with a pathogenetic strain of clostridium difficile f ... | 1992 | 1514862 |
| cytotoxicity of clostridium difficile toxin a for human colonic and pancreatic carcinoma cell lines. | the use of bacterial exotoxins may constitute novel adjuncts to treatment of gastrointestinal tract malignancies. clostridium difficile toxin a was evaluated for its cytotoxic effect in vitro on 24 human cell lines and strains including carcinomas of the colon, pancreas, prostate, lung, breast, and lymphoid malignancies, as well as nonmalignant tissues. all nine colon and five pancreas cell lines were extraordinarily sensitive to the cytotoxic effect of clostridium difficile toxin a at very low ... | 1992 | 1516066 |
| influence of radiotherapy on intestinal microflora in cancer patients. | we investigated in 15 patients with carcinoma of the uterine cervix or endometrium, who were undergoing postoperative radiation therapy, the effects of different fractionated radiation exposures on counts of fecal bacteria, on the growth of clostridium difficile and clostridium perfringens enterotoxin production. we observed a generally significant decrease in intestinal microflora after the first radiation exposure, whereas at the end of radiotherapy all bacteria increased and reached basal val ... | 1992 | 1517812 |
| correlation between cytotoxin production and sporulation in clostridium difficile. | correlation between cytotoxin production and sporulation was demonstrated when a clostridium difficile culture was inoculated into fresh broth to give an initial count of less than 10 vegetative cells/ml with no spores. under these conditions, cytotoxin was produced and released during sporulation. addition of a sporulation inhibitor (acridine orange, 30 mg/l), resulted in a marked decrease in both sporulation and cytotoxin production, despite there being no change in the number of vegetative ce ... | 1992 | 1518037 |
| laparotomy for fulminant pseudomembranous colitis. | clostridium difficile-associated pseudomembranous colitis is an increasingly common nosocomial infection that usually responds to oral antibiotics. presentation as an acute abdomen occurred in 12 patients, leading to 14 laparotomies. a distinctive clinical picture was observed: advanced age, recent treatment with antibiotics, fever, abdominal pain, tenderness, marked leukocytosis, and ileus. only six of the 12 patients had diarrhea. five were immunosuppressed. abdominal computed tomographic scan ... | 1992 | 1524485 |
| evaluation of an enzyme immunoassay for detection of clostridium difficile toxin a. | | 1992 | 1526247 |
| [prevention of acute otitis media. amoxicillin versus glycoproteins from klebsiella pneumoniae. study in children under 5 years of age]. | several studies in the english language literature have shown that continuous antibiotic prophylaxis is more effective than a placebo in preventing recurrent otitis media. in this prospective, randomized trial the effectiveness of continuous amoxicillin therapy was compared with that of glycoproteins from klebsiella pneumoniae (gkp). the two treatments were administered during 3 months to children aged 1 to 5 years, who had at least 3 episodes of otitis media within the 3 months preceding their ... | 1992 | 1533455 |
| low levels of coagulation inhibitors in patients with clostridium difficile infection. | to investigate levels of coagulation inhibitors in sera from patients with clostridium difficile-associated diarrhoea and colitis, commercially available antigen assays were used for immunochemical determination of antithrombin iii, protein c and free protein s. sera from patients with clostridium difficile-associated diarrhoea and colitis showed significantly lowered levels of all measured inhibitors as compared to controls (student's t test). protein c (mean +/- sd): 0.70 +/- 0.30 vs. 1.28 +/- ... | 1992 | 1533851 |
| clinical illnesses associated with isolation of dysgonic fermenter 3 from stool samples. | the clinical significance of the fastidious organism df-3 isolated from stool cultures is unclear. we sought to improve our understanding of this organism and to further define its association with human disease. stool cultures for df-3 were obtained from three sources: an ongoing study of enteric pathogens in patients infected with the human immunodeficiency virus, a screening procedure in which all stool samples submitted for clostridium difficile toxin assay were cultured for df-3, and stool ... | 1992 | 1537908 |
| comparison of five cultural procedures for isolation of clostridium difficile from stools. | several procedures have been described for the culture of clostridium difficile from stool specimens. the goal of this study was to determine the effectiveness of five of these methods for the isolation of c. difficile from feces of patients suspected of having c. difficile-associated illness. a total of 564 stool specimens were cultured by using heat shock, ethanol treatment (et), and direct plating on carr-scarborough cycloserine-cefoxitin-fructose agar (ccfa) with horse blood (c/s medium), bb ... | 1992 | 1537928 |
| purification and characterization of the lethal toxin (alpha-toxin) of clostridium septicum. | clostridium septicum lethal (alpha-toxin) was purified and found to be a basic protein (pi 8.4) of approximately 48 kda that is both lethal and hemolytic. the alpha-toxin had a hemolytic activity of approximately 2 x 10(7) hemolytic units per mg and a 50% lethal dose of approximately 10 micrograms/kg of body weight for mice. the alpha-toxin formed concentration-dependent, sodium dodecyl sulfate-resistant aggregates of approximately 230 kda. mice immunized with alpha-toxin showed a significant in ... | 1992 | 1541552 |
| reduction in the incidence of clostridium difficile-associated diarrhea in an acute care hospital and a skilled nursing facility following replacement of electronic thermometers with single-use disposables. | to determine if the spread of clostridium difficile-associated diarrhea is related to the use of electronic thermometers in an acute hospital and a chronic healthcare facility. | 1992 | 1541811 |
| [colitis associated with antibiotics: diarrhea caused by clostridium difficile in a 10-year old child]. | | 1992 | 1543301 |
| specific binding of nucleotides and nad+ to clostridium difficile toxin a. | binding of nucleotides, a tetrapolyphosphate, and nad+ to purified toxin a of clostridium difficile was determined by monitoring changes in intrinsic fluorescence following excitation at 280 nm, and recording emissions at 340 nm. binding was specific for concentrations over the range 5 to 100 microm for atp, gtp, and their respective non-hydrolysable analogues amp-pnp and gpp(nh)p, tetrapolyphosphate and nad+. | 1992 | 1544441 |
| a non-haemagglutinating form of clostridium difficile toxin a. | analysis of crude culture filtrate of clostridium difficile by mono q-anion exchange fast protein liquid chromatography (fplc) demonstrated that toxin a had distinct peaks of activity for cytotoxicity and haemagglutination, as also did highly purified toxin a obtained by thyroglobulin affinity chromatography (tg) followed by two sequential anion-exchange chromatographic steps with q-sepharose ff and mono q. from tg unbound fractions a highly cytotoxic but weakly haemagglutinating variant (toxin ... | 1992 | 1548692 |
| an unusual case of myxedema megacolon with features of ischemic and pseudomembranous colitis. | myxedema megacolon is rare; usually, it manifests with abdominal distention, flatulence, and constipation. herein we describe a 72-year-old man who had intermittent diarrhea, bloating, and abdominal pain for more than a year. cultures of stool specimens for clostridium difficile enterotoxin were variably positive and negative. colonoscopic biopsy specimens were thought to be consistent with chronic ischemia. thyroid function tests showed severe hypothyroidism; the patient's symptoms resolved wit ... | 1992 | 1548953 |
| lack of care giver hand contamination with endemic bacterial pathogens in a nursing home. | prevalences of clostridium difficile and multiply resistant staphylococcus aureus (mrsa) were determined in nursing staff and residents of a 233-bed long-term care facility. twenty of 38 (52.6%) patients in the long-term care ward and three of 69 (4.3%) in the skilled-nursing ward were colonized with mrsa; 16 of 48 (33%) patients in the long-term care ward and seven of 52 (13%) in the nursing home ward were colonized with c. difficile. none of the 79 staff members whose hands were cultured had c ... | 1992 | 1554142 |
| comparative study of immunological properties and cytotoxic effects of clostridium difficile toxin b and clostridium sordellii toxin l. | we compared the immunological properties and cytotoxic effects of clostridium difficile toxin b and clostridium sordellii toxin l. these two cytotoxins are immunologically related in that the cytotoxic effect of either toxin can be neutralized by the polyclonal antiserum prepared against either cytotoxin. on the other hand, polyclonal antiserum prepared against clostridium difficile enterotoxin a did not cross-react with the cytotoxins b and l when tested by cytotoxic neutralization test nor by ... | 1992 | 1557784 |
| diarrhea in hospitalized patients. | clostridium difficle has been associated with diarrhea in hospitalized patients receiving antibiotic therapy and may be nosocomially acquired. rehabilitation hospital inpatients may require frequent antibiotic intervention and are thus at risk, although few reports of epidemics at such centers have been published. this study describes the impact of c. difficle-related disease among rehabilitation hospital inpatients. a retrospective review was conducted of all inpatients evaluated for diarrhea i ... | 1992 | 1558730 |
| clostridium difficile toxin-induced reactive arthritis in a patient with chronic reiter's syndrome. | the first case of clostridium difficile toxin-induced reactive arthritis in a patient with chronic reiter's syndrome is described and compared with previous cases of reactive arthritis associated with this organism. this case demonstrates how distinct clinical manifestations may develop at different times in reiter's syndrome, according to the infecting organism. diagnostic terminology is discussed in this context. clostridium difficile should now be considered a firmly established cause of reac ... | 1992 | 1563383 |
| evaluation of the latex agglutination test for detection of clostridium difficile. | we compared two clostridium difficile latex agglutination tests, meritec from meridian diagnostic (cincinnati, ohio) and cdt from becton-dickinson (cockeysville, md), on 289 specimens submitted for tissue culture cytotoxicity using mrc-5 cells. when compared with cdt, the meritec latex agglutination test had a sensitivity of 90% (26/29), a specificity of 97% (251/260), and a correlation of 96%. meritec was compared with tissue culture cytotoxicity on 357 specimens. meritec had a sensitivity of 7 ... | 1992 | 1580756 |
| simultaneous detection of toxin a and toxin b genetic determinants of clostridium difficile using the multiplex polymerase chain reaction. | a multiplex polymerase chain reaction was developed to simultaneously detect the presence of toxin a and toxin b genes of clostridium difficile. a 1050-bp fragment of the toxin b gene and a 1217-bp fragment of the toxin a gene were amplified from 42 toxic strains of c. difficile; however, from 10 nontoxic strains the toxin gene fragments were not amplified; these data demonstrate that this multiplex polymerase chain reaction procedure can be used to differentiate between toxic and nontoxic strai ... | 1992 | 1581867 |
| multicenter evaluation of a new enzyme immunoassay for detection of clostridium difficile enterotoxin a. | the premier clostridium difficile toxin a enzyme immunoassay (pta eia) (meridian diagnostics, inc., cincinnati, ohio) for rapid diagnosis of antibiotic-associated colitis (aac) was evaluated in a multicenter study. stool samples from 421 patients suspected of having aac were tested for toxin a by the pta eia and for toxin b by three tissue culture assays (tca) employing wi-38 cells (new england deaconess hospital) in conventional tubes or foreskin fibroblasts (children's hospital) or vero cells ... | 1992 | 1583104 |
| measurement of fecal lactoferrin as a marker of fecal leukocytes. | while diarrheal illnesses are extremely common in communities and hospitals throughout the world, an etiologic diagnosis may be expensive and cost-ineffective. although the presence of fecal leukocytes are helpful in the diagnosis and specific therapy of inflammatory diarrheas, this requires prompt microscopic examination of fecal specimens (preferably obtained in a cup rather than a swab or diaper) by a trained observer. we developed a simple, sensitive test for the detection of leukocytes in f ... | 1992 | 1583125 |
| confirmation that the latex-reactive protein of clostridium difficile is a glutamate dehydrogenase. | | 1992 | 1583152 |
| separate isolation of clostridium difficile spores and vegetative cells from the feces of newborn infants. | a modified taurocholate-cefoxitin-cycloserine-fructose agar medium, ph 5.5, on which vegetative cells alone could grow, was newly devised for separate isolation of clostridium difficile vegetative cells and spores from feces. the ratio of c. difficile-positive feces from healthy newborn infants younger than 10 days of the age was 30.8%, and 93.3% of feces from healthy infants older than 20 days were positive for c. difficile. c. difficile spores alone were detected in twenty-one samples (75%) of ... | 1992 | 1584078 |
| proteolytic activity of clostridium difficile. | ten isolates of clostridium difficile expressing different degrees of toxigenicity and virulence in an animal model were assayed for the production of proteolytic enzymes by various methods. all strains demonstrated some activity in one or more of the assay systems. there was no direct correlation between toxigenic status and enzyme production. however, those strains known to be highly virulent in a hamster model were the most proteolytic. the most commonly detected enzyme was cell associated, a ... | 1992 | 1588579 |
| massive haemorrhage due to rectosigmoid ulcers in a patient with extensive burns. | a 36-year-old white-skinned male was admitted with 45.5 per cent burns, mostly of full skin thickness. severe rectal bleeding from rectal ulcerations developed on postburn day 12. various conservative attempts at management failed, and after multiple transfusions, abdominoperineal resection was carried out with eventual complete recovery. complications during his acute phase included pseud. aeruginosa sepsis and clostridium difficile diarrhoea. extensive skin grafts were required. the cause of t ... | 1992 | 1590937 |
| evaluation of a new commercial clostridium difficile toxin a enzyme immunoassay using diarrhoeal stools. | a new, commercially available enzyme immunoassay for the detection of toxin a in stool specimens, the premier clostridium difficile toxin a test (meridian diagnostics), was evaluated using 228 diarrhoeal stool specimens. using a cytotoxin assay on hela cells as the reference method, this new test resulted in a sensitivity of 88% and a specificity of 95%. using the presence or absence of a toxigenic strain in the stools as the reference method, the sensitivity was similar to that of the cytotoxin ... | 1992 | 1597202 |
| susceptibility of anaerobic bacteria to tosufloxacin. | the in vitro activity of tosufloxacin against anaerobic cocci, propionibacterium acnes, clostridium perfringens, clostridium difficile, bacteroides fragilis, bacteroides spp. and fusobacteria was determined by the agar dilution method. this activity was compared with that of ciprofloxacin, piperacillin, cefoxitin, imipenem, clindamycin, metronidazole and chloramphenicol. tosufloxacin, imipenem, clindamycin, metronidazole and chloramphenicol were the most active agents tested. tosufloxacin has an ... | 1992 | 1597207 |
| influence of cefpirome on pharyngeal and faecal flora after single and multiple intravenous administrations of cefpirome to healthy volunteers. | the effect of single and multiple 2 g doses of i.v. cefpirome on pharyngeal and faecal flora was studied in ten male volunteers. there was no effect on pharyngeal flora. after a single dose, cefpirome had no effect on faecal flora but numbers of escherichia coli were reduced below the detection limit during multiple dose treatment. no strains of clostridium difficile were selected in this study and only a slight increase in the numbers of candida spp. were found. cefpirome, therefore, has little ... | 1992 | 1601763 |
| comparative sequence analysis of the clostridium difficile toxins a and b. | the six clones ptb112, ptb324, ptbs12, pcd122, pcd14 and pcd13 cover the tox locus of clostridium difficile vpi 10463. this region of 19 kb of chromosomal dna contains four open reading frames including the complete toxb and toxa genes. the two toxins show 63% amino acid (aa) homology, a relatedness that had been predicted by the cross-reactivity of some monoclonal antibodies (mab) but that is in contrast to the toxin specificity of polyclonal antisera. a special feature of toxa and toxb is thei ... | 1992 | 1603068 |
| microbic superinfection in relapse of inflammatory bowel disease. | to assess the association between symptomatic relapse of inflammatory bowel disease (ibd) and superinfection with enteropathogenic microorganisms, we determined prospectively the incidence of infections with enteropathogenic bacteria, protozoa, and helminths in patients with confirmed longstanding ibd. sixty-four patients with ibd (49 with crohn's disease [cd] and 15 with ulcerative colitis [uc]) were consecutively enrolled in the study when relapse occurred. multiple biopsies for histological a ... | 1992 | 1607606 |
| surgical abdomen due to clostridium difficile-induced colitis. | | 1992 | 1612351 |
| morphological changes of cultured endothelial cells after microinjection of toxins that act on the cytoskeleton. | clostridium novyi alpha-toxin and c. difficile toxins a and b (all 200 to 300 kda) and c. botulinum c2-i toxin (50 kda) caused a delayed and persistent retraction and rounding of microinjected cells. microinjected phalloidin acted fast and reversibly. unlike c2-i toxin, phalloidin passed through the intercellular junctions. specific antitoxin applied to the medium did not prevent the action of microinjected c. novyi or c. difficile toxin b. microinjected antitoxin protected against the toxins ap ... | 1992 | 1612768 |
| [bacterial gastrointestinal infections: acute gastroenteritis]. | the diagnosis of bacterial gastrointestinal infections is based on anamnesis, clinical signs and simple examinations of feces (fecal leucocytes, occult blood). thereby it can be decided, whether a microbial identification by culture or an antibiotic therapy is indicated. in case of noninvasive infections mediated by enterotoxins, an oral substitution of liquid will suffice. an antibiotic therapy is indicated in case of severe, febrile dysentery, shigellosis, cholera, typhoid fever as well as sev ... | 1992 | 1615459 |
| review of the in vitro antibacterial activity of cefprozil, a new oral cephalosporin. | cefprozil is a newer oral cephalosporin with a spectrum of activity against organisms that include gram-positive and gram-negative pathogens. a review of published data shows that cefprozil is active (susceptibility, less than or equal to 8 micrograms/ml; moderate susceptibility, 16 micrograms/ml; resistance, greater than or equal to 32 micrograms/ml) against gram-positive species such as streptococci, methicillin-susceptible staphylococci, and listeria monocytogenes; it may have marginal activi ... | 1992 | 1617037 |
| typing of toxic strains of clostridium difficile using dna fingerprints generated with arbitrary polymerase chain reaction primers. | clostridium difficile is the causative agent for pseudomembranous colitis in humans. toxic strains of c. difficile produce two toxins, toxin a and toxin b. a reliable and definitive method of typing the toxic strains of c. difficile is needed since nosocomial cross infection is a primary concern in hospitals and other health care facilities. a method for typing toxic strains of clostridium difficile using arbitrary polymerase chain reaction (pcr) primers is presented in this study. the c. diffic ... | 1992 | 1624110 |
| sensitivity in culture of epithelial cells from rhesus monkey kidney and human colon carcinoma to toxins a and b from clostridium difficile. | the effect of toxins a and b from clostridium difficile on human colon carcinoma cells (ht-29, epithelial), rhesus monkey kidney cells (ma-104, epithelial) and green monkey kidney cells (vero, fibroblast) was studied. both toxins caused rounding of ht-29 cells and rounding with projections remaining attached to the substrate in ma-104 and vero cells; however, the sensitivity to each toxin varies considerably. toxin a was detected in ng by vero, pg by ht-29 and fractions of pg by ma-104 cells; fo ... | 1992 | 1626323 |
| comparison of the vidas clostridium difficile toxin a immunoassay with c. difficile culture and cytotoxin and latex tests. | the vidas clostridium difficile toxin a immunoassay (cda) is a new, automated, enzyme-linked fluorescent-antibody assay for detection of c. difficile toxin a antigen in stool specimens. simultaneous, parallel testing was performed by using the vidas cda, the culturette brand cdt latex test for c. difficile antigens, and conventional laboratory cell culture tests for c. difficile, cytotoxicity and c. difficile culture. one hundred ninety-four consecutive fresh soft or liquid stool samples submitt ... | 1992 | 1629341 |
| [antibiotic-induced diarrhea and its prevention]. | | 1992 | 1631462 |
| transfer of tn916 and tn916 delta e into clostridium difficile: demonstration of a hot-spot for these elements in the c. difficile genome. | the conjugative transposon tn916 and a derivative tn916 delta e was transferred from bacillus subtilis into clostridium difficile cd37 by filter mating. all the c. difficile transconjugants appeared to contain one copy of the transposon integrated into the same position in the genome. transposition from the original site of integration was not observed. like tn916 the transferable tetracycline resistance determinant (tc-cd) of c. difficile has a preferred site of integration in c. difficile and ... | 1991 | 1647998 |
| tube feeding-related diarrhea in acutely ill patients. | acutely ill patients received tube feeding for an average of 15.8 days and, on average, 35% of those days were spent in the intensive care unit (icu). patients were prospectively assigned either a fiber-free formula (fff-osmolite hn, ross; n = 50) or a fiber-supplemented (soy polysaccharide 14.4 g/l) formula (fsf = jevity, ross; n = 50). diarrhea was defined as three or more loose or watery stools per day and occurred in 30% of all patients. diarrhea developed in 29 (41%) of the 71 patients who ... | 1991 | 1650854 |
| [isolation of enteropathogenic microorganism from patients with infection of the digestive tract during 1976 to 1988 in tenri hospital]. | enteropathogenic microorganisms isolated from feces of 9,393 patients with diarrhea or enteritis in our hospital between 1976 and 1988 were analyzed. as the result of the examination of 5,443 outpatients, 1,811 strains of pathogens were isolated from 1,686 cases (31.0%). several species including salmonella spp., escherichia coli serotype, vibrio parahaemolyticus, were isolated before 1978, and the incidence of pathogens was low (14.8%). for the 10-year period since 1979, the incidence markedly ... | 1991 | 1655921 |
| clostridium difficile infection in adult hamsters. | diarrhea was encountered in a group of adult female golden syrian hamsters (mesocricetus auratus) used for titrating the scrapie agent. ninety percent of the cases occurred in animals over 210 days old even though animals of all age groups lived in the colony concurrently. the cause of diarrhea was investigated in both uninoculated animals and those receiving greater than a limiting dilution of scrapie infectivity, i.e., animals that were not expected to contract the experimental scrapie disease ... | 1991 | 1667195 |
| clostridium difficile typhlitis associated with cecal mucosal hyperplasia in syrian hamsters. | a sudden increase in mortality occurred in a closed breeding colony of syrian hamsters (mesocricetus auratus). the colony consisted of approximately 40 hamsters, 8 of which were affected. four adult males died suddenly. one pregnant female and one weanling died after having been observed as depressed for 1 day and 2 weeks respectively. one weanling and one adult male were euthanized. all affected hamsters had signs of diarrhea. at necropsy, hemorrhagic fluid-filled ceca were noted in five of eig ... | 1991 | 1667196 |
| [the diagnosis and treatment of clostridium difficile enterocolitis]. | sixteen strains of clostridium difficile (c.d) were isolated from 29 patients with antibiotic-associated diarrhoea (aad). 9 of 14 c.d positive and 1 of 6 c.d negative fecal specimens were detected as cytotoxin positive. 10 aac patients received colonoscopy and 6 had congestion, edema and erosion of mucosa. three had yellow-white pseudomembrane on the surface of colon. in 17 clostridium difficile enterocolitis (cdec) was diagnosed by c.d isolation, cytotoxin detection and (or) colonoscopic findin ... | 1991 | 1667496 |
| toxin a of clostridium difficile binds to the human carbohydrate antigens i, x, and y. | clostridium difficile causes pseudomembranous colitis in humans. the enterotoxin (i.e., toxin a) from this organism is believed to be responsible for the initial intestinal pathology associated with this disease. previous work shows that this toxin binds to carbohydrates that contain gal alpha 1-3gal beta 1-4glcnac. however, this carbohydrate is not present on normal human cells. therefore, this study was undertaken to identify potential receptors for toxin a that do exist on human intestinal ep ... | 1991 | 1670930 |
| role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients. | the part that candida plays in antibiotic-associated diarrhoea was investigated in 24 elderly inpatients (mean age 74 years) who tested negative for clostridium difficile toxin and other intestinal pathogens. 7 had intestinal overgrowth of candida species (greater than or equal to 10(5) cfu/ml). none of the 24 matched, antibiotic-treated controls without diarrhoea had candida overgrowth. all 5 patients with diarrhoea and candida overgrowth treated with oral nystatin responded with resolution of ... | 1991 | 1671890 |
| an investigation into clostridium perfringens enterotoxin-associated diarrhoea. | an investigation was carried out to establish the incidence of diarrhoea associated with the presence of enterotoxigenic clostridium perfringens. the results indicate a high risk group, namely elderly hospitalized patients, who should be investigated for this organism in a similar way to clostridium difficile if symptoms occur. the significance of antibiotic association is suggested and cross-infection was shown to be a possibility. detection of the enterotoxin was accompanied in all cases by th ... | 1991 | 1680904 |
| candida spp. and clostridium difficile toxin-negative antibiotic-associated diarrhoea. | | 1991 | 1684608 |
| in-vitro activity of vancomycin, teicoplanin, daptomycin, ramoplanin, mdl 62873 and other agents against staphylococci, enterococci and clostridium difficile. | the minimum inhibitory concentrations (mics) of different antibiotics were determined by a broth microdilution method for staphylococci, enterococci and clostridium difficile. the antimicrobial agents tested were vancomycin, teicoplanin, daptomycin, ramoplanin, mdl 62873, rifampicin and piperacillin, the latter limited to enterococci. in terms of mic90s, daptomycin (0.89 mg/l). mdl 62873 (0.99 mg/l), and teicoplanin (1.50 mg/l) were found to be highly active against methicillin-resistant staphyl ... | 1990 | 1688341 |
| epidemiologic markers of clostridium difficile. | a wide range of epidemiologic markers have been identified for clostridium difficile. these markers are based on phenotypic characteristics of the organism, such as antibiotic resistance, bacteriocin or bacteriophage susceptibility, electrophoretic protein patterns, and immunologic markers. methods for determining genetic markers include plasmid and dna restriction endonuclease analysis and ribosomal rna restriction patterns. these methods have been applied to various degrees in epidemiologic st ... | 1990 | 1689505 |
| clostridium difficile invasion and toxin circulation in fatal pediatric pseudomembranous colitis. | the direct involvement of clostridium difficile in the lesional tissue of pseudomembranous colitis has not been demonstrated; the organism's effects have been assumed to be strictly toxin mediated. because c. difficile cytotoxin may be found incidentally in the intestinal lumina of asymptomatic infants, the role of the organism in a variety of pediatric intestinal diseases is uncertain. the authors studied seven cases of fatal pediatric pseudomembranous colitis in which the presence of c. diffic ... | 1990 | 1699407 |
| non-radioactive restriction fragment length polymorphism (rflp) typing of clostridium difficile. | a typing method for clostridium difficile based on restriction fragment length polymorphisms (rflp) is described. the technique utilizes commercially available escherichia coli ribosomal ribonucleic acid (rrna) as probe material. probe labelling, hybridization and detection was performed using the enhanced chemiluminescence (ecl) gene detection system. the probe labelling procedure was easy to perform, taking only 20 min. the complete typing method was comparatively simple, reproducible and read ... | 1991 | 1711990 |
| cytotoxic effects of children's faeces: relation to diarrhoea due to clostridium difficile and other enteric pathogens. | cytotoxicity of faecal extracts was demonstrated in 47 of 88 children (54%) referred for microbiological investigation of stools. cytotoxic clostridium difficile and vertotoxigenic escherichia coli (vtec) were the pathogens identified most commonly but cytotoxicity was also found in association with campylobacter jejuni, salmonella spp, shigella sonnei, giardia lamblia, rotavirus, adenovirus and poliovirus type 1 which had been acquired by oral immunization. in two patients, one of whom had cyst ... | 1991 | 1715139 |
| antigenic cross-reactivity and functional inhibition by antibodies to clostridium difficile toxin a, streptococcus mutans glucan-binding protein, and a synthetic peptide. | a 10-amino-acid repeating sequence of the hemagglutinating portion of clostridium difficile toxin a has been synthesized and used to produce antisera in rabbits. antipeptide antibody inhibited toxin a-mediated hemagglutination and neutralized cytotoxic activity. immunoblot analysis with the antipeptide antibody revealed cross-reactivity with native toxin, a recombinant protein containing the toxin a repeats, and a glucan-binding protein from streptococcus mutans whose primary structure has repea ... | 1991 | 1715320 |
| an extracellular material observed in clostridium difficile strains. | some extracellular material-- "capsule" has been observed among clostridium difficile strains. c. difficile strains (44 examined) contain different proportions of cells with "capsule" and without "capsules". toxigenic strains contained fewer capsulated cells than non-toxigenic strains. | 1990 | 1715642 |
| capsule-like structures in clostridium difficile strains. | fourteen strains of clostridium difficile, previously characterized by sds-page, were examined for the presence of surface structures. none of the strains were fimbriated but, when grown in the presence of glucose, all exhibited a thin ruthenium red-positive layer. two strains, belonging to different electrophoretic groups, were also observed after treatment with homologous and heterologous antisera. the strain belonging to the electrophoretic group 2, usually associated with the disease, showed ... | 1991 | 1723135 |
| phosphorylation of cellular proteins in response to treatment with clostridium difficile toxin b and clostridium sordellii toxin l. | toxin b from clostridium difficile induces typical morphological changes of cultured cells consisting of rounding up and arborization, which are associated with a dramatic disruption of microfilaments. in this study, we show that toxin l, a cytotoxin produced by bacterial strain clostridium sordellii, has similar effects on cultured cells including the redistribution of f-actin and of the adhesion plaque protein vinculin. it has been assumed that the mechanisms involved in cytopathic effects of ... | 1991 | 1724754 |
| comparative studies of serotype-specific clostridium difficile strains. | the following properties of serotype-specific clostridium difficile strains were studied: toxigenicity, encapsulation, susceptibility to certain antibiotics, biochemical properties, enzymatic activity. no correlation between toxin titer and frequency of capsule production as well as serogroup affiliation and sensitivity to antibiotics was observed. the strain representative of serogroup c attracts attention because of its distinct properties. | 1991 | 1725096 |
| preparation of antibacterial and antitoxic clostridium difficile sera. | preparation of clostridium difficile antibacterial and antitoxic sera is presented. fifty one strains (72%) were typeable within delmee scheme. twenty strains (28%) belonged to new polish serogroups designated 18, 27, 70, 71, 72, 88, 89 and nich. supernatants of all toxigenic clostridium difficile strains were neutralized by gamma-globulin fraction of goat clostridium difficile antitoxin in neutralization assay when it was performed on mccoy cell line. only 8 toxigenic strains (21%) were positiv ... | 1991 | 1726616 |
| effect of yogurt on clindamycin-induced clostridium difficile colitis in hamsters. | yogurt exhibits in vitro bactericidal activity against a variety of pathogenic microorganisms, including clostridium difficile. in the present studies, we tested whether yogurt ingestion could prevent or ameliorate antibiotic associated colitis in the clindamycin-treated hamster model. male golden syrian hamsters were given 5 mg/kg clindamycin subcutaneously 24 hr before and 6 hr following inoculation with 0.5 ml of less than 10, 10(3), 10(5), or 10(6) cfu/ml of c. difficile. hamsters in the con ... | 1992 | 1728517 |
| structural properties and evolutionary relationships of pspa, a surface protein of streptococcus pneumoniae, as revealed by sequence analysis. | analysis of the sequence for the gene encoding pspa (pneumococcal surface protein a) of streptococcus pneumoniae revealed the presence of four distinct domains in the mature protein. the structure of the n-terminal half of pspa was highly consistent with that of an alpha-helical coiled-coil protein. the alpha-helical domain was followed by a proline-rich domain (with two regions in which 18 of 43 and 5 of 11 of the residues are prolines) and a repeat domain consisting of 10 highly conserved 20-a ... | 1992 | 1729249 |
| [a lethal course in pseudomembranous enterocolitis during the parenteral administration of vancomycin and imipenem]. | a 48-year-old woman required mechanical ventilation after aortic valve replacement for decompensated aortic valve stenosis when bleeding complications developed and rethoracotomy had to be performed. acute renal failure necessitated haemodialysis. septic fever of unknown aetiology failed to respond to oxacillin, cefotaxim and tobramycin. the endotracheal cannula and central venous catheter were changed on the 24th postoperative day and the antibiotic treatment altered to 250 mg imipenem and 125 ... | 1992 | 1730214 |
| clostridium difficile toxin b disrupts the barrier function of t84 monolayers. | the contribution of toxin b to clostridium difficile-associated infection is undefined. toxin b induces dramatic phenotypic alterations (cytotoxic effects) in cultured mesenchymal and nonintestinal epithelial cells, yet its effects on intestinal epithelial cells are not clearly understood. the alterations induced by toxin b in nonintestinal cells appear to be secondary to toxin-induced redistribution of filamentous actin. it has not been determined whether toxin b exerts similar effects on cultu ... | 1992 | 1732112 |
| [cephalosporins--a common cause of nosocomial clostridium difficile diarrhea]. | | 1992 | 1734138 |
| [debatable questions on clostridium difficile diarrhea]. | | 1992 | 1734150 |
| clostridium difficile in children with malignant disease. | | 1991 | 1742187 |
| tetracyclines, chloramphenicol, erythromycin, clindamycin, and metronidazole. | the tetracyclines are effective in the treatment of chlamydia, mycoplasma pneumoniae, and rickettsial infections and also can be used for gonococcal infections in patients unable to tolerate penicillin. these drugs may cause gastrointestinal irritation, diarrhea, phototoxic dermatitis, and vestibular damage, and fatal reactions due to hepatotoxicity have occurred in pregnant women. chloramphenicol has a broad spectrum of bacteriostatic activity, but its association with suppression of the bone m ... | 1991 | 1749296 |
| relapse versus reinfection with clostridium difficile. | relapse of clostridium difficile-associated diarrhoea occurs in 15-20% of patients; however, whether relapse is due to an endogenous source of the organism or reinfection from the environment remains unclear. restriction enzyme analysis (rea) of chromosomal dna was used to type multiple isolates from ten patients who had experienced apparent relapses. more than half the relapses were due to infection with a new strain of c. difficile. the remaining patients were infected with the same strain, bu ... | 1991 | 1752311 |
| gastrointestinal carriage of clostridium difficile in cats and dogs attending veterinary clinics. | cats and dogs being treated at two veterinary clinics were investigated for gastrointestinal carriage of clostridium difficile using selective solid and enrichment media. thirty-two (39.5%) of 81 stool samples yielded c. difficile. there were significant differences in isolation rates between clinics, 61.0% of animals being positive at one clinic compared to 17.5% at the other (chi-square, p less than 0.005). of 29 animals receiving antibiotics, 15 (52.0%) harboured c. difficile while 11 (23.9%) ... | 1991 | 1752313 |
| [antibiotic-induced gastrointestinal side effects]. | | 1991 | 1752371 |
| clostridium difficile in faecal flora after perioperative prophylaxis with ampicillin or ceftriaxone. | | 1991 | 1753154 |
| development of a rapid enzyme immunoassay for clostridium difficile toxin a and its use in the diagnosis of c. difficile-associated disease. | a rapid (2.5 h) direct enzyme immunoassay (eia) for clostridium difficile toxin a was developed for clinical use. specimen centrifugation and filtration were not required. the eia detected toxin a levels in patient stool as low as 20 pg (2 ng/ml of stool). the test was 5,000 times more sensitive for toxin a than it was for toxin b and did not react with a panel of other bacterial species with the exception of one highly toxigenic strain of clostridium sordellii. the eia was compared with the cyt ... | 1991 | 1757540 |
| clinical and microbiological observations on cdc group df-3, a gram-negative coccobacillus. | sequential stool cultures submitted for routine culture were screened for the presence of cdc group df-3. of 690 specimens, 11 (1.6%) yielded moderate to heavy growth of df-3. information on the 11 patients from whom these specimens were obtained showed that 4 had a history of prolonged diarrheal disease that resolved after specific therapy to eradicate df-3, while for the other 7 patients no clear role could be established. microbiological characterization of the stool isolates and 10 cdc strai ... | 1991 | 1761678 |
| pneumatosis cystoides intestinalis in children beyond the first year of life: manifestations and management. | beyond infancy, pneumatosis cystoides intestinalis (pci) is rare. data concerning pathogenesis and treatment are limited. our experience with 12 children was examined to define predisposing factors, presentation, treatment, and outcome. nine children were immunosuppressed, thus identifying an important etiologic subgroup. presentation was variable but included abdominal pain, distention, diarrhea and hematochezia. clostridium difficile was found in 3 patients and cytomegalovirus in 1. radiograph ... | 1991 | 1765911 |
| evaluation of the proposed interaction of nucleic acid with clostridium difficile toxins a and b and the effects of nucleases on cytotoxicity. | both dna and rna were found to co-purify with clostridium difficile toxin b but not toxin a. dnaase treatment greatly reduced the cytotoxicity of toxin b but not of toxin a. rnaase had no effect on either toxin. the effects on toxin b were shown to be due to a contaminating protease and could be inhibited by the serine protease inhibitor phenylmethylsulphonyl fluoride. | 1991 | 1769556 |
| evaluation of cycloserine-cefoxitin-fructose agar and cycloserine-cefoxitin-fructose broth for recovery of clostridium difficile from environmental sites. | cycloserine-cefoxitin-fructose agar (ccfa) and cycloserine-cefoxitin-fructose broth (ccfb) containing either 500 or 250 micrograms of cycloserine per ml were compared for efficacy in the isolation of clostridium difficile from hospital ward environmental sites. a rodac imprint technique was used to inoculate prereduced ccfa. moistened swabs were used to inoculate prereduced ccfb from environmental sites immediately adjacent to the rodac sample sites. ccfa (6% positive) was significantly more sen ... | 1991 | 1774277 |
| identification of the latex test-reactive protein of clostridium difficile as glutamate dehydrogenase. | computer analysis showed that the gene encoding the latex test-reactive protein of clostridium difficile exhibited high levels of homology with glutamate dehydrogenases from various sources. further analysis demonstrated that the recombinant protein possessed glutamate dehydrogenase activity. our results show that the protein that reacts in commercial latex tests for c. difficile is a glutamate dehydrogenase. | 1991 | 1774279 |
| nontoxigenic strains of clostridium difficile lack the genes for both toxin a and toxin b. | a total of 39 toxigenic and 20 nontoxigenic strains of clostridium difficile were tested for the presence of either toxin a or toxin b by the polymerase chain reaction (pcr). all toxigenic strains produced cytotoxin as assayed by using highly sensitive fetal lung fibroblasts and were positive for toxin a as well as toxin b in the pcr assay. all nontoxigenic strains failed to produce toxin and were negative in the pcr assay. this study shows that nontoxigenic strains of clostridium difficile lack ... | 1991 | 1774285 |
| use of the polymerase chain reaction for the specific and direct detection of clostridium difficile in human feces. | the polymerase chain reaction was used for the detection of clostridium difficile, the etiologic agent of antibiotic-associated colitis. an upstream primer identical to a coding region (segment i) of the c. difficile 16s rrna gene and a downstream primer complementary to a highly conserved region of eubacterial 16s rrna served to amplify a targeted 270-base-pair fragment of genomic dna. this technique allowed the detection of as few as 10 c. difficile organisms among 10(6) escherichia coli bacte ... | 1991 | 1775837 |