| efficient sporulation in clostridium difficile requires disruption of the sigmak gene. | a 14.6 kb prophage-like insertion, termed skincd, was found to interrupt the sigk gene, which encodes an rna polymerase sigma factor essential for sporulation, in six strains of clostridium difficile. until now, bacillus subtilis was the only spore-former shown to carry such an insertion, and the presence of the insertion is not required for efficient sporulation in this organism. the b. subtilis and c. difficile skin elements proved to be divergent in sequence, inserted at different sites withi ... | 2003 | 12694623 |
| coordinate regulation of salmonella enterica serovar typhimurium invasion of epithelial cells by the arp2/3 complex and rho gtpases. | salmonella enterica serovar typhimurium can infect epithelial cells via the basolateral surface after breaching the intestinal epithelium, yet little is known about this process. here, we show that actin polymerization driven by the arp2/3 complex is critical to both basolateral and apical bacterial invasion of polarized mdck cells. while there is also a dependence upon toxin b-sensitive rho gtpases, none of the four gtpases known to be activated by s. enterica serovar typhimurium sope are indiv ... | 2003 | 12704163 |
| igg antibodies against microorganisms and atopic disease in danish adults: the copenhagen allergy study. | seropositivity to food-borne and orofecal microorganisms (hepatitis a virus, helicobacter pylori, and toxoplasma gondii ), which are considered to be markers of poor hygiene, has been reported to be associated with a lower prevalence of atopy. in contrast, colonization of the gut with clostridium difficile, a potential intestinal bacterial pathogen, in early childhood may be associated with a higher prevalence of atopy. | 2003 | 12704368 |
| a 5-year study of the bacterial pathogens associated with acute diarrhoea on the island of crete, greece, and their resistance to antibiotics. | during a 5-year period (1995-1999) a total of 7090 stool samples obtained from patients with acute diarrhoea, mostly community-acquired, were examined for bacterial pathogens, in the greek island of crete. one or more enteric pathogens were isolated from 987 patients (14%). salmonella enterica were the most commonly isolated bacteria (6%), followed by campylobacter spp. (4.2%), and enteropathogenic escherichia coli (epec) (1.8%). yersinia enterocolitica (0.6%), shigella spp. (0.3%), and aeromona ... | 2003 | 12705628 |
| acute gastroenteritis in children : what role for antibacterials? | the aim of this article is to define the currently accepted role of antibacterials in the treatment of acute gastroenteritis in children. most cases of acute gastroenteritis in children are viral, self-limited, and need only supportive treatment. appropriate fluid and electrolyte therapy, with close attention to nutrition, remain central to therapy.antibacterial therapy serves as an adjunct, to shorten the clinical course, eradicate causative organisms, reduce transmission, and prevent invasive ... | 2003 | 12716215 |
| [pseudo-membranous colitis]. | | 2003 | 12722265 |
| colonization and infection with multiple nosocomial pathogens among patients colonized with vancomycin-resistant enterococcus. | to test the hypothesis that patients colonized with vancomycin-resistant enterococcus (vre) have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with vre. | 2003 | 12725351 |
| safety and tolerability of linezolid. | clinical trials have shown that linezolid (600 mg twice daily in adults) is safe and generally well tolerated for up to 28 days. drug-related adverse events, which are typically mild to moderate in intensity and of limited duration, include diarrhoea, nausea and headache in adults, and diarrhoea, loose stools and vomiting in children. clostridium difficile-related complications with linezolid are uncommon. linezolid is a weak, reversible monoamine oxidase inhibitor: foods containing high concent ... | 2003 | 12730142 |
| enteric flora and lymphocyte-derived cytokines determine expression of heat shock proteins in mouse colonic epithelial cells. | inducible heat shock proteins (hsps), particularly hsp25 and hsp72, are expressed by surface colonocytes and may have a role in protecting intestinal epithelial cells against injury. this study is aimed at determining if enteric bacteria and/or immune signals regulate their physiologic expression. | 2003 | 12730879 |
| [nosocomial diarrhea outbreak due to clostridium difficile in a vascular surgery department]. | clostridium difficile is considered the most common cause of nosocomial-acquired diarrhea. in spain this condition is rarely reported. | 2003 | 12732113 |
| surveillance of nosocomial infections in adult recipients of allogeneic and autologous bone marrow and peripheral blood stem-cell transplantation. | to identify overall and site-specific rates of nosocomial infections (nis) during the neutropenic, as compared to the non-neutropenic stage of treatment in adult recipients of allogeneic and autologous bone marrow transplantation (bmt) and peripheral blood stem-cell transplantation (pbsct), a prospective, 54-month study was started at the haematological stem cell transplantation unit of the university hospital of freiburg, germany. ni types were identified using modified cdc definitions. a total ... | 2003 | 12732887 |
| occupational exposure to cephalosporins leading to clostridium difficile infection. | | 2003 | 12733860 |
| clostridium difficile colitis causing toxic megacolon, severe sepsis and multiple organ dysfunction syndrome. | | 2003 | 12734650 |
| antimicrobial susceptibilities of canine clostridium difficile and clostridium perfringens isolates to commonly utilized antimicrobial drugs. | clostridium difficile and clostridium perfringens are anaerobic, gram-positive bacilli that are common causes of enteritis and enterotoxemias in both domestic animals and humans. both organisms have been associated with acute and chronic large and small bowel diarrhea, and acute hemorrhagic diarrheal syndrome in the dog. the objective of this study was to determine the in vitro antimicrobial susceptibilities of canine c. difficile and c. perfringens isolates in an effort to optimize antimicrobia ... | 2003 | 12742714 |
| hepatitis associated with clostridium difficile in an ostrich chick. | a live 19-day-old male ostrich chick was euthanized and necropsied. it was one of 12 chicks in a group in which 8 had died with history of anorexia, diarrhoea and weight loss. the birds had been treated with amikacin, piperacillin and enrofloxacin. necropsy of the ostrich revealed dehydration, mild ascites and serous atrophy of fat around the heart. the liver had numerous yellow tan foci on the capsular surface as well as on the cut surface. caecal contents were watery. microscopic examination o ... | 2003 | 12745381 |
| human intestinal epithelial and smooth muscle cells are potent producers of il-6. | interleukin-6 (il-6), a pluripotent cytokine, has traditionally been considered the product of proinflammatory cells. however, many other cell types have been shown to produce il-6. since intestinal inflammation is commonly associated with a vigorous systemic inflammatory response, we hypothesized that intestinal epithelial and smooth muscle cells might contribute to that response by producing il-6. we therefore studied the capacity of differentiated human intestinal epithelial and smooth muscle ... | 2003 | 12745542 |
| antibiotics and hospital-acquired clostridium difficile-associated diarrhoea: a systematic review. | a systematic review of studies that investigated the association of antibiotics with hospital-acquired clostridium difficile-associated diarrhoea (cdad) was undertaken to summarize the strength of the evidence for this relationship. the results from the studies identified were considered after critically reviewing the design and conduct of each study. although the majority of studies found an association with various antibiotics, antibiotic classes or components of antibiotic administration, mos ... | 2003 | 12746372 |
| recurrent colitis with different causes. | | 2003 | 12752856 |
| mutational analysis of the enzymatic domain of clostridium difficile toxin b reveals novel inhibitors of the wild-type toxin. | toxin b (tcdb), a major clostridium difficile virulence factor, glucosylates and inactivates the small gtp-binding proteins rho, rac, and cdc42. in the present study we provide evidence that enzymatically inactive fragments of the tcdb enzymatic domain are effective intracellular inhibitors of native tcdb. site-directed and deletion mutants of the tcdb enzymatic region (residues 1 to 556), lacking receptor binding and cell entry domains, were analyzed for attenuation of glucosyltransferase and g ... | 2003 | 12761111 |
| gastrointestinal disorders and the critically ill. clostridium difficile infection and pseudomembranous colitis. | clostridium difficile causes a spectrum of diseases ranging from diarrhoea to pseudomembranous colitis, primarily in the hospitalized elderly, although community-acquired infection is probably under-documented. host factors are increasingly recognized as critical determinants of disease expression. exposure to antibiotics, particularly those adversely affecting anaerobic gut flora, appears to create a niche which is exploited by c. difficile. several retrospective and intervention studies have i ... | 2003 | 12763508 |
| cdc42 and rhoa are differentially regulated during arachidonate-mediated hela cell adhesion. | cell adhesion to extracellular matrix requires stimulation of an eicosanoid signaling pathway through the metabolism of arachidonate by 5-lipoxygenase to leukotrienes and cyclooxygenase-1/2 to prostaglandins, as well as activation of the small gtpase signaling pathway involving cdc42 and rho. these signaling pathways direct remodeling of the actin cytoskeleton during the adhesion process, specifically the polymerization of actin during cell spreading and the bundling of actin filaments when cell ... | 2003 | 12767056 |
| evidence to support the existence of subgroups within the uk epidemic clostridium difficile strain (pcr ribotype 1). | we used three different dna fingerprinting techniques and clindamycin susceptibility testing to confirm that clostridium difficile pcr ribotype i isolates can be divided into two subclones. this observation may permit a better understanding of the epidemiology and pathogenicity of c. difficile infection. | 2003 | 12767851 |
| pseudomembranous and neutropenic enterocolitis in pediatric oncology patients. | neutropenic enterocolitis in oncological patients represents a wide spectrum of clinicopathological pictures each with its own entity. early diagnosis of enterocolitis can lead to improved supportive care and therefore better outcome. we present two cases--patient a, a child with pseudomembranous colitis caused by clostridium difficile, and patient b, a child with neutropenic enterocolitis, where no organism was found. by allowing an insight into the pathology, immunology and culture results, we ... | 2003 | 12768402 |
| current indications for blow-hole colostomy:ileostomy procedure. a single center experience. | because of improved medical care and surgical techniques blow-hole colostomy with loop ileostomy is now rarely performed to reduce operative risks in patients with toxic megacolon related to inflammatory bowel disease (ibd). we reviewed patient charts to identify continuing indications for this procedure. | 2003 | 12774252 |
| effects of cefotaxime and desacetylcefotaxime upon clostridium difficile proliferation and toxin production in a triple-stage chemostat model of the human gut. | clostridium difficile is recognized as an important nosocomial pathogen. c. difficile infection (cdi) is thought to arise as a result of depletion of the normal gut flora by antimicrobial agents. cefotaxime (ctx) is well-known for its propensity to cause cdi, but the reasons behind its particular predisposition to the disease remain unclear. previous investigations have so far relied upon the hamster model of cdi or human volunteers. we have used a triple-stage chemostat model of the human gut t ... | 2003 | 12775682 |
| clostridium difficile colitis following an open fracture: complications occur, even with straightforward trauma and straightforward decisions. | | 2003 | 12776090 |
| clostridium difficile colitis associated with hemolytic-uremic syndrome. | the authors report the case of a 46-year-old woman who presented with vomiting and profuse bloody diarrhea. laboratory studies were significant for a hematocrit of 27% and lactate dehydrogenase of 5,394 u/l (5,394 u/l). her renal function deteriorated rapidly with a peak creatinine of 12.4 mg/dl (1,096.4 micromol/l), and platelet count dropped simultaneously to a nadir of 123,000/microl (123 x 10(9)/l]. schistocytes were observed in peripheral blood smear. stool was positive for clostridium diff ... | 2003 | 12778432 |
| fluoroquinolone use and clostridium difficile-associated diarrhea. | we performed a case-control study to evaluate the association between antibiotic use and clostridium difficile-associated diarrhea (cdad), matching for admission unit and time at risk for cdad. a multivariable regression model showed that treatment with fluoroquinolones (odds ratio 12.7; 95% confidence interval 2.6 to 61.6) was the strongest risk factor for cdad. | 2003 | 12781017 |
| [antibiotic-associated diarrhea and pseudomembranous colitis. treatment and prevention of recurrence]. | | 2003 | 12784510 |
| arthritis associated with enteric infection. | reactive arthritis is classically seen following infection with enteric pathogens such as yersinia, salmonella, campylobacter and shigella. inflammatory arthritis has also been described following other enteric infection with organisms such as clostridium difficile, brucella and giardia. furthermore, arthritis is seen in whipple's disease, caused by the actinomycete tropheryma whippelii. this chapter reviews the current understanding of these conditions (with the exception of brucella, which is ... | 2003 | 12787523 |
| neonatal piglet losses associated with escherichia coli and clostridium difficile infection in a slovakian outdoor production unit. | | 2003 | 12788023 |
| hypotonicity induces membrane protrusions and actin remodeling via activation of small gtpases rac and cdc42 in rat-1 fibroblasts. | an important consequence of cell swelling is the reorganization of the f-actin cytoskeleton in different cell types. we demonstrate in this study by means of rhodamine-phalloidin labeling and fluorescence microscopy that a drastic reorganization of f-actin occurs in swollen rat-1 fibroblasts: stress fibers disappear and f-actin patches are formed in peripheral extensions at the cell border. moreover, we demonstrate that activation of both rac and cdc42, members of the family of small rho gtpases ... | 2003 | 12788692 |
| evaluation of repetitive element sequence-based pcr as a molecular typing method for clostridium difficile. | repetitive element sequence-based pcr (rep-pcr) is a typing method that enables the generation of dna fingerprinting that discriminates bacterial strains. in this study, we evaluated the applicability of rep-pcr in typing clostridium difficile clinical isolates. the results obtained by rep-pcr were compared with those obtained by pulsed-field gel electrophoresis (pfge) and pcr ribotyping. a high correspondence between pattern differentiations produced by rep-pcr and pfge was observed, whereas pc ... | 2003 | 12791864 |
| comparative in vitro activity of ph-027 versus linezolid and other anti-anaerobic antimicrobials against clinical isolates of clostridium difficile and other anaerobic bacteria. | ph-027 is a new 5-triazole oxazolidinone synthesized in our laboratories, which shows strong activity against gram-positive aerobic bacteria including clinical isolates. the objective of this study was to investigate the in vitro activity of this compound in comparison with linezolid and other antibiotics against gram-positive and gram-negative anaerobes. the in vitro activity of ph-027 in comparison with those of linezolid and other antimicrobial agents was evaluated against 201 clinical isolat ... | 2003 | 12797385 |
| rho protein inhibition blocks cyclooxygenase-2 expression by proinflammatory mediators in endothelial cells. | rho proteins participate in the regulation of inflammatory gene expression in endothelial cells. we made use of clostridium difficile toxin b-10643 (tcdb-10463) which inhibites rhoa/rac1/cdc42 to analyze their role in expression and regulation of cyclooxygenase-2 (cox-2) in endothelial cells (ec). pretreatment of ec with tcdb-10643 prevented lipopolysaccharide (lps)-or tumor necrosis factor-alpha (tnfalpha)-related cox-2 expression but had no effect on cox-1 protein levels. tcdb-10463 preincubat ... | 2003 | 12797548 |
| rho protein-mediated changes in the structure of the actin cytoskeleton regulate human inducible no synthase gene expression. | rho proteins (rho, rac, cdc 42) are known to control the organization of the actin cytoskeleton as well as gene expression. inhibition of rho proteins by clostridium difficile toxin b disrupted the f-actin cytoskeleton and enhanced cytokine-induced inducible nitric oxide synthase (inos) expression in human epithelial cells. also specific inhibition by y-27632 of p160rock, which mediates rho effects on actin fibers, caused a disruption of the actin cytoskeleton and a superinduction of cytokine-in ... | 2003 | 12799187 |
| clostridium difficile-associated diarrhea in a pediatric hospital. | this retrospective cohort analysis examined the risk factors, symptoms, and severity of disease associated with c. difficile in pediatric inpatients. risk factors for a c. difficile-positive test were an oncologic diagnosis, diarrhea of more than 2 days' duration, and gastrointestinal symptoms, especially abdominal pain. over a 3.5-year period, there was a total of 22 c. difficile-positive patients, and most had mild, self-limiting diarrheal illness. no cases of c. difficile diarrhea were identi ... | 2003 | 12800729 |
| [gene-engineering approach for the production of a and b toxin fragments for diagnostic and immunotherapeutic use in clostridium difficile infection]. | clostridium difficle is a causative agent of severe and difficult-to-diagnose human infections. toxins a and b, which modify the ras-like proteins of eukaryotic cells, are the major factor in the pathogenicity of the discussed causative agent. these very toxins are considered as the key components of the developed diagnostic and therapeutic-and-preventive preparations. the c-terminal fragments of toxins a and b as well as hybrid products, consisting of fragments of both toxins, were cloned, with ... | 2003 | 12800770 |
| toxin b of clostridium difficile activates human vip submucosal neurons, in part via an il-1beta-dependent pathway. | this study investigated whether toxin b of clostridium difficile can activate human submucosal neurons and the involved pathways. isolated segments of human colon were placed in organ culture for 3 h in the presence of toxin b or il-1beta. whole mounts of internal submucosal plexus were stained with antibodies against c-fos, neuron-specific enolase (nse), vasoactive intestinal polypeptide (vip), and substance p (sp). the membrane potential (vm) response of submucosal neurons to local application ... | 2003 | 12801886 |
| infectious complications in patients receiving mobilization chemotherapy for autologous peripheral blood stem cell collection. | the purpose of this retrospective study was to evaluate infectious complications in patients receiving mobilization chemotherapy for stem cell collection prior to autologous peripheral blood stem cell transplantation. an additional goal was to evaluate risk factors associated with the development of infectious complications. at the medical college of georgia bmt center, 54 patients were administered mobilization chemotherapy for the purpose of collecting stem cells between june, 1997, and may, 2 ... | 2003 | 12804174 |
| the host cell chaperone hsp90 is essential for translocation of the binary clostridium botulinum c2 toxin into the cytosol. | clostridium botulinum c2 toxin is the prototype of the binary actin-adp-ribosylating toxins and consists of the binding component c2ii and the enzyme component c2i. the activated binding component c2iia forms heptamers, which bind to carbohydrates on the cell surface and interact with the enzyme component c2i. this toxin complex is taken up by receptor-mediated endocytosis. in acidic endosomes, heptameric c2iia forms pores and mediates the translocation of c2i into the cytosol. we report that th ... | 2003 | 12805360 |
| restriction of third generation cephalosporin use reduces the incidence of clostridium difficile-associated diarrhoea in hospitalised patients. | third generation cephalosporin antibiotics (3gc) have become the antibiotics of choice in many hospitals in recent years for the treatment of infections such as community-acquired pneumonia. however, increased use of 3gcs has also been associated with a rise in the occurrence of antibiotic-associated diarrhoea due to clostridium difficile, as well as an increase in the prevalence of antibiotic resistant organisms such as methicillin resistant staphylococcus aureus, vancomycin resistant entrococc ... | 2003 | 12807270 |
| non-antibiotic therapies for infectious diseases. | the emergence of multiple antibiotic resistant organisms in the general community is a potentially serious threat to public health. the emergence of antibiotic resistance has not yet prompted a radical revision of antibiotic utilisation. instead it has prompted the development of additional antibiotics. unfortunately, this does not relieve the underlying selection pressure that drives the development of resistance. a paradigm shift in the treatment of infectious disease is necessary to prevent a ... | 2003 | 12807291 |
| clostridium difficile in a geriatric unit: a prospective epidemiological study employing a novel s-layer typing method. | clostridium difficile is the major identifiable cause of antibiotic-associated diarrhoea in the uk. the aim of this study was to employ traditional culture, toxin detection and a novel typing method to determine the level of c. difficile colonization and disease in a population of elderly patients and to investigate the association between strains in the patients and their environment. three hundred and ninety patients between 62 and 101 years of age admitted to a geriatric unit in the royal vic ... | 2003 | 12808079 |
| treatment of ulcerative colitis using fecal bacteriotherapy. | although the etiology of idiopathic ulcerative colitis (uc) remains poorly understood, the intestinal flora is suspected to play an important role. specific, consistent abnormalities in flora composition peculiar to uc have not yet been described, however clostridium difficile colitis has been cured by the infusion of human fecal flora into the colon. this approach may also be applicable to the treatment of uc on the basis of restoration of flora imbalances. | 2003 | 12811208 |
| clostridium difficile-associated diarrhea: predictors of severity in patients presenting to the emergency department. | experiences with clostridium difficile-associated diarrhea (cdad) were reviewed to determine predictors of severity in patients presenting from the community. | 2003 | 12813602 |
| prevalence of asymptomatic clostridium difficile colonization in a nursing home population: a cross-sectional study. | we conducted a cross-sectional study to determine the prevalence of asymptomatic clostridium difficile in a nursing home population. | 2003 | 12813999 |
| clostridium difficile colitis in older adults in long-term facilities and the community: do their outcomes differ? | to determine if older adults from long-term care facilities (ltcf) have a greater risk of death than older people in the community after the development of clostridium difficile (cd) colitis during hospitalization. | 2000 | 12818032 |
| impact of changes in antibiotic policy on clostridium difficile-associated diarrhoea (cdad) over a five-year period in a district general hospital. | the impact of changes in antibiotic policy on clostridium difficile-associated diarrhoea (cdad), over a five-year period between 1995 and 2000, were studied in the preston acute hospitals trust. in 1996 the policy was changed in the preston acute hospitals trust from cefotaxime to ceftriaxone for initial treatment of severe sepsis or pneumonia in medical patients. over the next nine months the average number of patients with c. difficile toxin-positive stools per quarter increased from 16 to 39. ... | 2003 | 12818582 |
| comparison of the effect of detergent versus hypochlorite cleaning on environmental contamination and incidence of clostridium difficile infection. | to determine how best to decontaminate the hospital environment of clostridium difficile, we carried out a cross-over study on two elderly medicine wards to determine whether cleaning with a hypochlorite disinfectant was better than using neutral detergent in reducing the incidence of c. difficile infection (cdi). we examined 1128 environmental samples in two years, 35% of which grew c. difficile. there was a significant decrease of cdi incidence on ward x, from 8.9 to 5.3 cases per 100 admissio ... | 2003 | 12818583 |
| in vitro activities of ramoplanin, teicoplanin, vancomycin, linezolid, bacitracin, and four other antimicrobials against intestinal anaerobic bacteria. | by using an agar dilution method, the in vitro activities of ramoplanin, teicoplanin, vancomycin, linezolid, and five other agents were determined against 300 gram-positive and 54 gram-negative strains of intestinal anaerobes. ramoplanin was active at <or=2 microg/ml against 287 of 300 (95.7%) gram-positive organisms, including 18 strains of clostridium difficile for which mics of ramoplanin were 0.25 to 0.5 microg/ml; for 3 of these, linezolid mics were 8 to 16 micro g/ml. nineteen clostridium ... | 2003 | 12821492 |
| involvement of enteric nerves in permeability changes due to deoxycholic acid in rat jejunum in vivo. | stress and clostridium difficile toxin a increase epithelial permeability in the small intestine via vagus and visceral afferents, in turn activating mucosal mast cells. bile acids also increase epithelial permeability but it is not known if nerves or mast cells are involved in this effect in the small intestine. | 2003 | 12823182 |
| gastroenteritis and antibiotic-associated diarrhea. | acute gastroenteritis is a common cause of emergency and office visits. this article reviews causes, pathogenesis, diagnosis, prevention, and treatment. the incidence of antibiotic-associated colitis is increasing worldwide as a consequence of widespread use of broad-spectrum antibiotics for various illnesses. the pathogenic organism, clostridium difficile, produces two enterotoxins, toxin a and toxin b, that cause colonic mucosal inflammation. c. difficile infection presents with a wide range o ... | 2003 | 12825250 |
| recurrent extraintestinal clostridium difficile infection. | | 2003 | 12829209 |
| clinical role of beta-lactam/beta-lactamase inhibitor combinations. | the use of beta-lactamase inhibitors in combination with beta-lactam antibiotics is currently the most successful strategy to combat a specific resistance mechanism. their broad spectrum of activity originates from the ability of respective inhibitors to inactivate a wide range of beta-lactamases produced by gram-positive, gram-negative, anaerobic and even acid-fast pathogens. clinical experience confirms their effectiveness in the empirical treatment of respiratory, intra-abdominal, and skin an ... | 2003 | 12834367 |
| molecular analysis of clostridium difficile strains isolated from 18 cases of recurrent clostridium difficile-associated diarrhea. | recurrence of clostridium difficile-associated diarrhea (cdad) occurs in 15 to 20% of patients after discontinuation of treatment. arbitrarily primed pcr was used to investigate the epidemiology of recurrent cdad in 18 patients. reinfection with a new strain occurred in 6 of 18 patients (33.3%), while 12 patients relapsed with the original strain shortly after discontinuation of treatment. these data suggest that reinfection with exogenous c. difficile is a common problem and that not all recurr ... | 2003 | 12843107 |
| mechanism of quinolone resistance in anaerobic bacteria. | several recently developed quinolones have excellent activity against a broad range of aerobic and anaerobic bacteria and are thus potential drugs for the treatment of serious anaerobic and mixed infections. resistance to quinolones is increasing worldwide, but is still relatively infrequent among anaerobes. two main mechanisms, alteration of target enzymes (gyrase and topoisomerase iv) caused by chromosomal mutations in encoding genes, or reduced intracellular accumulation due to increased effl ... | 2003 | 12848726 |
| antecedent use of fluoroquinolones is associated with resistance to moxifloxacin in clostridium difficile. | moxifloxacin is characterized by high activity against gram-positive cocci and some gram-positive and -negative anaerobes, including clostridium difficile. this study investigates the role of prior quinolone use in relation to patterns of susceptibility of c. difficile to moxifloxacin. | 2003 | 12848728 |
| a parent as a vector of salmonella brandenburg nosocomial infection in a neonatal intensive care unit. | a newborn baby was admitted to the neonatal intensive care unit (nicu) of st germain en laye hospital (france) because of premature birth. on day 12, he contracted gastroenteritis due to salmonella brandenbourg. the salmonellosis led to a septic shock syndrome with a brief cardiopulmonary arrest. he was treated with intravenous ceftriaxone and gentamicin, and the evolution was favorable. microbiological investigations revealed that the mother was the vector for this nosocomial infection. s. bran ... | 2003 | 12848735 |
| a comparison of two feeding methods in the alleviation of diarrhoea in older tube-fed patients: a randomised controlled trial. | to compare the effect of two feeding methods on older tube-fed patients suffering from diarrhoea. | 2003 | 12851181 |
| recombinant single-chain variable fragment antibodies directed against clostridium difficile toxin b produced by use of an optimized phage display system. | recombinant antibody cloning and phage display technologies were used to produce single-chain antibodies (scfv) against clostridium difficile toxin b. the starting material was the mouse b cell hybridoma line 5a8, which generates a monoclonal antibody against the toxin. the integrated cloning, screening, and phage display system of krebber et al. (j. immunol. methods 201:35-55, 1997) allowed us to rapidly obtain toxin b-binding scfv sequences derived from the hybridoma cell line. the best candid ... | 2003 | 12853390 |
| clostridium difficile infections related to antibiotic use and infection control facilities in two university hospitals. | we investigated whether a reduction in antibiotic use at the aker university hospital (aker) led to a reduction in clostridium difficile-associated diarrhoea (cdad). we compared the incidence of cdad in aker and tromsoe university hospitals (tromsoe) and related it to antibiotic use and facilities for infection control between 1993-2001. for this purpose we also performed point prevalence studies. total antibiotic use was the same in the two hospitals. in spite of a reduction in the use of broad ... | 2003 | 12855235 |
| proton pump inhibitors as a risk factor for clostridium difficile diarrhoea. | clostridium difficile is the main infectious cause of colitis in hospital inpatients. the incidence is increasing, and it is associated with significant mortality, morbidity, and increased length of stay. the main risk factor is use of broad-spectrum antibiotics, and antibiotic restriction is the most effective control measure. we carried out a retrospective case-control study to investigate whether use of proton pump inhibitors (ppi) was an additional risk factor. ppi use within the preceding e ... | 2003 | 12855243 |
| chronic lymphocytic leukemia and its treament has depressed immunocompetence. | | 2003 | 12866612 |
| comparative study on apoptosis induction of smmc7721 and vero cells by clostridium difficile toxin a. | clostridium difficile is recognized as a frequent cause of antibiotic-induced diarrhea. this study was designed to investigate whether clostridium difficile toxin a might induce apoptosis on human hepatoma cell line smmc7721 and african green monkey kidney vero cells. | 2003 | 12866963 |
| transcription and analysis of polymorphism in a cluster of genes encoding surface-associated proteins of clostridium difficile. | recent investigations of the clostridium difficile genome have revealed the presence of a cluster of 17 genes, 11 of which encode proteins with similar two-domain structures, likely to be surface-anchored proteins. two of these genes have been proven to encode proteins involved in cell adherence: slpa encodes the precursor of the two proteins of the s-layer, p36 and p47, whereas cwp66 encodes the cwp66 adhesin. to gain further insight into the function of this cluster, we further focused on slpa ... | 2003 | 12867455 |
| prevalent pcr ribotypes of clinical and environmental strains of clostridium difficile isolated from intensive-therapy unit patients in kuwait. | ninety-five isolates of clostridium difficile from symptomatic and asymptomatic patients and 18 from their environment in the intensive-therapy units (itus) of four teaching hospitals in kuwait were typed by pcr amplification of rrna intergenic spacer regions (pcr ribotyping). a total of 32 different ribotypes was detected among the clinical isolates. the predominant ribotypes from the clinical isolates were types 097 and 078, which accounted for approximately 40 % of all isolates in the itus in ... | 2003 | 12867566 |
| failure of intravenous linezolid to treat clostridium difficile associated diarrhea. | | 2003 | 12868561 |
| [high incidence and complications of clostridium difficile diarrhea among patients with renal diseases]. | clostridium difficile is the main agent causing antimicrobial associated nosocomial diarrhea. chronic renal failure is a risk factor for this type of diarrhea. | 2003 | 12870234 |
| collagenous colitis associated with clostridium difficile: a cause effect? | | 2003 | 12870798 |
| clinical correlation of toxin and common antigen enzyme immunoassay testing in patients with clostridium difficile disease. | the aim of the present study was to assess the correlation of triage micro clostridium difficile panel and toxin b cytotoxicity assay with the clinical diagnosis of c. difficile diarrhea. | 2003 | 12873579 |
| clostridium difficile: prevalence in horses and environment, and antimicrobial susceptibility. | clostridium difficile has been associated with acute colitis in mature horses. | 2003 | 12875324 |
| [diarrhea during enteral feeding]. | prevalence: diarrhea occurs in 2 to 70% of tube-fed patients, depending on their disease (with an increased risk in critically ill patients) and on the definition of diarrhea used. consequences: diarrhea increases morbidity, particularly since the nutritional goals are harder to reach. causes: relevant causes today are related to the nutrition (irregular and too high output, jejunal site, low sodium and fiber contents), to the patient (malnutrition, stress, underlying diseases), and predominantl ... | 2003 | 12876540 |
| clostridium difficile, vancomycin, and enterococcus. | | 1995 | 12879532 |
| clostridium difficile toxin b is an inflammatory enterotoxin in human intestine. | clostridium difficile causes antibiotic-associated diarrhea and pseudomembranous colitis, diseases afflicting millions of people each year. although c. difficile releases 2 structurally similar exotoxins, toxin a and toxin b, animal experiments suggest that only toxin a mediates diarrhea and enterocolitis. however, toxin a-negative/toxin b-positive strains of c. difficile recently were isolated from patients with antibiotic-associated diarrhea and colitis, indicating that toxin b also may be pat ... | 2003 | 12891543 |
| expression of recombinant clostridium difficile toxin a using the bacillus megaterium system. | pathogenic clostridium difficile produces two major protein toxins, toxin a and toxin b. we used the bacillus megaterium expression system for expression of recombinant toxin a. the construct for the toxin a gene was obtained by the following cloning strategy: the gene for toxin a was generated in three parts, each of them ligated into a cloning vector. the three parts were sequentially fused to the complete gene. the holotoxin gene was ligated into the expression vector pwh1520. this vector was ... | 2003 | 12893263 |
| reducing delays in the diagnosis and treatment of clostridium difficile diarrhoea. | the diagnosis of clostridium difficile diarrhoea is often delayed. | 2003 | 12897343 |
| gastrointestinal side effects of drugs. | drugs can have adverse effects on any part of the gastrointestinal (gi) tract from mouth to colon. it is essential that a detailed and accurate drug history is taken in patients presenting with gi complaints. many drug-induced effects will regress or heal on cessation of treatment. nsaids are usually associated with gastric and duodenal ulcers but are also recognised to cause lichen planus in the mouth, oesophageal inflammation and strictures, and small bowel and colonic ulcers and strictures. a ... | 2003 | 12904098 |
| [comparison of ap-pcr methods, ribotyping (pcr-ribotyping) and pulsed-field electrophoresis (pfge) for strains of clostridium difficile producing toxin b and not producing toxin a]. | in this study were used ap-pcr, pcr-ribotyping and pulsed-field elecrophoresis (pfge) for comparative study of toxin a-negative/toxin b-posi-tive clostridium difficile strains with deletion in toxin a gen. we investigated nine unrelated clinical strains, isolated from different units and different time from patients suffering to antibiotic associated diarrhea (aad). we found that toxin a-negative/toxin b-positive c. difficile strains isolated in poland belonging to a single genotype a, are being ... | 2003 | 12908415 |
| [detection of ermb gene responsible for high level resistance to clindamycin (mls type resistance) among clostridium difficile strains isolated from antibiotic associated diarrhea (aad)]. | in 68 c. difficile strains isolated from feacal samples of patients with antibiotic associated diarrhoea (aad) investigated presence of ermb gene transferable of high level resistance to clindamycin. the primers set 2980/2981 used for identification of ermb gene amplified a 688 bp segment. we used the etest to assess all strains for susceptibility to clindamycin. this study demonstrates that 57% of strains isolated from faecal samples of patients with aad were highly resistant to clindamycin (mi ... | 2003 | 12908416 |
| detection of clostridium difficile cytotoxin and clostridium perfringens enterotoxin in cases of diarrhoea in the community. | faecal specimens from 843 cases of diarrhoea in the community were tested for the presence of clostridium difficile cytotoxin and clostridium perfringens enterotoxin. c. difficile cytotoxin was detected in faecal specimens from 0.6 % of cases aged at least 2 years by using a vero cell assay. factors associated with detection of c. difficile cytotoxin were antibiotic therapy, age over 60 years and living in a home with other elderly people. three methods were used for the detection of c. perfring ... | 2003 | 12909650 |
| antimicrobial activity of smap-29 against the bacteroides fragilis group and clostridia. | the cathelicidin-derived peptide smap-29 exerts rapid and broad-spectrum antimicrobial activity against aerobic bacteria and fungi. in this study, the effects of the peptide against the bacteroides fragilis group, including antibiotic-resistant isolates, clostridium perfringens and clostridium difficile reference and clinical isolates, were investigated. | 2003 | 12917245 |
| involvement of rho family g protein in the cell signaling for sperm incorporation during fertilization of mouse eggs: inhibition by clostridium difficile toxin b. | sperm-egg interaction was investigated in mouse eggs freed from the zona pellucida and injected with clostridium difficile toxin b, the inhibitor of rho family small g proteins. toxin b reduced in a dose-dependent manner the percentage of eggs associated with sperm fusion on the surface or sperm nucleus decondensation in the ooplasm, examined by injection of a dna-staining dye into the egg and transfer of the dye to the fused sperm head after recording intracellular ca(2+) responses for 100 min ... | 2003 | 12921750 |
| association of common variable immunodeficiency with atypical collagenous colitis. | collagenous colitis is a condition characterized by chronic, watery diarrhoea, which is diagnosed histologically as most cases reveal a normal colonoscopic appearance. the aetiology is poorly understood, but nonsteroidal anti-inflammatory drugs or infections may act as triggers for an immune-mediated process. in this report, an unusual case of collagenous colitis associated with pseudomembrane formation is described. stool assay was negative for clostridium difficile cytotoxin b. there are only ... | 2003 | 12923382 |
| inhibition of rho family gtpases results in increased tnf-alpha production after lipopolysaccharide exposure. | these studies demonstrate that treatment of macrophages with lovastatin, a cholesterol-lowering drug that blocks farnesylation and geranylgeranylation of target proteins, increases lps-induced tnf-alpha production. this is reversed by the addition of mevalonate, which bypasses the lovastatin block. examination of membrane localization of rhoa, cdc42, rac1, and ras demonstrated decreased membrane localization of the geranylgeranylated rho family members (rhoa, cdc42, and rac1) with no change in t ... | 2003 | 12928415 |
| regulation of parathyroid hormone-stimulated phospholipase d in umr-106 cells by calcium, map kinase, and small g proteins. | signaling intermediates for pth and phorbol activation of pld in umr-106 cells were determined. calcium was required, and the effects of pth, phorbol, and calcium were dependent on p42/44 map kinase and small g proteins, specifically rhoa, acting through rho kinase. | 2003 | 12929934 |
| pseudomembranous colitis with fatal outcome in a 43-year-old man. | pseudomembranous colitis is a life-threatening complication of broad spectrum antibiotic therapy caused by clostridium difficile. untreated, the disease can lead to severe and in many cases fatal complications such as peritonitis due to colonic wall perforation, shock as a consequence of volume depletion, toxic megacolon and massive lower gastrointestinal haemorrhage. fatal complications mostly occur in elderly people with a high degree of comorbidity. we report the case of a 43-year-old patient ... | 2002 | 12935660 |
| prevalence of clostridium spp. and clostridium difficile in children with acute diarrhea in são paulo city, brazil. | species of clostridium are widely distributed in the environment, inhabiting both human and animal gastrointestinal tracts. clostridium difficile is an important pathogen associated with outbreaks of pseudomembranous colitis and other intestinal disorders, such as diarrhea. in this study, the prevalence of clostridium spp. and c. difficile, from hospitalized children with acute diarrhea, was examined. these children were admitted to 3 different hospitals for over 12 months. eighteen (20%) and 19 ... | 2003 | 12937752 |
| high frequency of antibiotic-associated diarrhea due to toxin a-negative, toxin b-positive clostridium difficile in a hospital in japan and risk factors for infection. | patients hospitalized in a hospital with a high incidence of antibiotic-associated diarrhea due to toxin a-negative, toxin b-positive (a-/b+) clostridium difficile were retrospectively investigated to determine the clinical manifestations and risk factors for infection. of 77 clostridium difficile isolates obtained from 77 patients during the 1-year investigation period, 30 were a-/b+ and 47 were toxin a-positive, toxin b-positive (a+/b+). by pulsed-field gel electrophoresis analysis, 23 of the ... | 2003 | 12938013 |
| cellular uptake of clostridium difficile toxin b. translocation of the n-terminal catalytic domain into the cytosol of eukaryotic cells. | clostridium difficile toxin b (269 kda) is one of the causative agents of antibiotic-associated diarrhea and pseudomembranous colitis. toxin b acts in the cytosol of eukaryotic target cells where it inactivates rho gtpases by monoglucosylation. the catalytic domain of toxin b is located at the n terminus (amino acid residues 1-546). the c-terminal and the middle region of the toxin seem to be involved in receptor binding and translocation. here we studied whether the full-length toxin or only a ... | 2003 | 12941936 |
| construction of a fusion protein carrying antigenic determinants of enteric clostridial toxins. | clostridium difficile and clostridium perfringens type a are infectious agents of enteric diseases. the main virulence factors of these microorganisms include toxins a and b of c. difficile (toxa and toxb) and enterotoxin of c. perfringens (cpe). in this study genetic constructions have been created for the expression of toxa, toxb and cpe fragments either as individual components or as a hybrid multidomain (toxa-toxb-cpe) protein. rabbit monospecific sera raised against individual peptides reac ... | 2003 | 12951260 |
| modulation of the expression of connective tissue growth factor by alterations of the cytoskeleton. | modulation of the cytoskeletal architecture was shown to regulate the expression of ctgf (connective tissue growth factor, ccn2). the microtubule disrupting agents nocodazole and colchicine strongly up-regulated ctgf expression, which was prevented upon stabilization of the microtubules by paclitaxel. as a consequence of microtubule disruption, rhoa was activated and the actin stress fibers were stabilized. both effects were related to ctgf induction. overexpression of constitutively active rhoa ... | 2003 | 12951326 |
| lactobacillus plantarum 299v for the treatment of recurrent clostridium difficile-associated diarrhoea: a double-blind, placebo-controlled trial. | a double-blind, placebo-controlled trial was performed to analyse the ability of lactobacillus plantarum 299v to prevent further recurrent episodes of clostridium difficile-associated diarrhoea (rcdad). recurrence of clinical symptoms (main outcome) was seen in 4 of 11 patients who received metronidazole in combination with l. plantarum 299v and in 6 of 9 treated with metronidazole in combination with placebo. the lactobacilli treatment had no side-effects. although the small sample size does no ... | 2003 | 12953945 |
| epidemiology and molecular characterization of clostridium difficile strains from patients with diarrhea: low disease incidence and evidence of limited cross-infection in a swedish teaching hospital. | we prospectively studied the epidemiology of clostridium difficile-associated diarrhea (cdad) in a 900-bed hospital over the course of 12 months by pcr-ribotyping of c. difficile isolates. a total of 304 cases were diagnosed, corresponding to an overall incidence of 7/1,000 admissions, with higher rates in nephrology, hematology, and organ transplantation wards (37, 30, and 21/1,000), and 72% were classified as hospital associated (onset in hospital or onset at home but after a hospital stay wit ... | 2003 | 12958221 |
| recent emergence of an epidemic clindamycin-resistant clone of clostridium difficile among polish patients with c. difficile-associated diarrhea. | analysis of both the antibiotic resistance and the virulence characteristics of anaerobic human microbial pathogens is important in order to improve our understanding of a number of clinically significant infectious diseases, including clostridium difficile-associated diarrhea (cdad). we determined the presence of the clindamycin resistance-associated gene ermb and the ribotype of 33 c. difficile strains isolated from polish patients suffering from cdad. while all strains produced cytotoxin b (t ... | 2003 | 12958245 |
| mastoparan-induced insulin secretion from insulin-secreting betatc3 and ins-1 cells: evidence for its regulation by rho subfamily of g proteins. | mastoparan, a tetradecapeptide from wasp venom, stimulates insulin secretion from the islet beta-cells, presumably via activation of trimeric g proteins. herein, we used clostridial toxins, which selectively modify and inactivate the rho subfamily of g proteins, to examine whether mastoparan-induced insulin secretion also involves activation of these signaling proteins. mastoparan, but not mastoparan 17 (an inactive analog of mastoparan), significantly stimulated insulin secretion from betatc3 a ... | 2003 | 12960065 |
| [effect of a polyoxydonium immunoregulator on the biological properties of microorganisms]. | the effect of the synthetic immunomodulator polyoxydonium (po) on some biological properties of pathogenic bacteria (shigella flexneri, salmonella enteritidis), opportunistic bacteria (klebsiella pneumoniae, escherichia coli, pseudomonas aeruginosa, staphylococcus aureus, bacteroides fragilis, peptostreptococcus anaerobius, prevotella melaninogenica, propionibacterium propionicum, clostridium difficile) and fungi (candida albicans), isolated during enteric infections, enteric dysbiosis, pyoinfla ... | 2003 | 12966885 |
| [evaluation of the effect of medicines on biological properties of clostridium difficile]. | the presence of the persistence factors (anti-lysozyme and anti-complement activity) in the vegetative forms of c. difficile was experimentally proved. the effect of different medicines (vitamins b1, b6 and c, prebiotic inulin, probiotics bifidumbacterin and enterol) on the persistence factors of c. difficile and microbial resistance to vancomycin, thienam, lincomycin, clindamycin was evaluated. the anti-lysozyme and anti-complement activity of c. difficile was found to decrease under the influe ... | 2003 | 12966888 |
| [production of recombinant fragments of the clostridium tetani neurotoxin for the development of new immune-prophylaxis preparations against tetanus]. | tetanus belongs to dangerous infection diseases, whose effective prevention can be ensured by vaccines. the acting substance of tetanus vaccines, presently in use, is a partially purified and deprived-of-lethal-action clostridium tetani neurotoxin. the construction of a subunit preparation on the basis of toxin fragments obtained through gene engineering could be a method aimed at promoting the quality of the used tetanus vaccines. with this goal in mind, we built, within the present case study, ... | 2003 | 12966924 |
| simultaneous assays for clostridium difficile and faecal lactoferrin in ulcerative colitis. | infectious agents may be one of the important factors in initiating or perpetuating ulcerative colitis. increasing evidence has accumulated regarding the role of clostridium difficile (c. difficile) infection in the exacerbation of ulcerative colitis. the present work was undertaken to study the implications of c. difficile toxin (cdt) and faecal lactoferrin (fl) positivity in patients with idiopathic ulcerative colitis (iuc) in a north indian hospital. ninety-four faecal samples from patients o ... | 2003 | 12974208 |