| microfilament-disrupting clostridium difficile toxin b causes multinucleation of transformed cells but does not block capping of membrane ig. | the effects of clostridium difficile toxin b on some actin-dependent cellular functions were studied. a three-day incubation of intoxicated b-lymphocytes and transformed 3t3 fibroblasts resulted in dose-dependent multinucleation. using vimentin-negative daudi cells we showed that this effect of toxin b does not involve vimentin. as dna and protein syntheses are not impaired in the cells used, the results suggest that toxin b has an effect on the actin-containing contractile ring during mitosis, ... | 1990 | 2081549 |
| multicenter in vitro comparison of piperacillin and nine other antibacterials against 1,629 clinical isolates. | the antibacterial spectrum of activity of piperacillin was compared with that of other antibiotics against isolates of escherichia coli, enterobacter cloacae, haemophilus influenzae, klebsiella pneumoniae, pseudomonas aeruginosa, pseudomonas cepacia, pseudomonas maltophilia, serratia marcescens, enterococcus sp, bacteroides fragilis, bacteroides bivius, and clostridium difficile obtained from laboratories at hospitals in st. louis, in memphis, and in newark, new jersey. of the 1,629 isolates tes ... | 1990 | 2183941 |
| cloning of clostridium difficile toxin b gene and demonstration of high n-terminal homology between toxin a and b. | high titered clostridium sordellii lethal toxin antiserum, cross-reactive with c. difficile cytotoxin b (toxb), was used to isolate toxb fragments from a c. difficile expression library. recombinant clones containing toxb fragments of the 5' and 3' end were isolate. a 2.5-kb hincii fragment of chromosomal dna overlaps both groups of clones. a partial restriction map of the total toxb gene is presented. the gene is positioned upstream of utxa and toxa, toxb has a size of 6.9 kb, corresponding to ... | 1990 | 2082160 |
| [value of microbiologic studies for diagnosis of post-enteritis reactive arthritis]. | reactive arthritis may develop within a period of some days until upto 3 weeks after infections with yersinia enterocolitica, yersinia pseudotuberculosis, campylobacter jejuni/coli, shigella and salmonella. intestinal infections with klebsiella pneumoniae, clostridium perfringens, clostridium difficile, cryptosporidium, strongyloides stercoralis, taenia saginata and schistosoma mansoni are, in some cases, considered to be responsible for reactive arthritis. detection of pathogenic bacteria in fe ... | 1990 | 2085058 |
| [occurrence of clostridium difficile in feces of children with dysfunction of the digestive tract and other disorders]. | thousand and six hundred ninety two fecal samples from children of few weeks old up to over ten years were tested for the presence of clostridium difficile. most of them were treated with antibiotics and showed diarrhea symptoms. hundred and twenty three strains of c-difficile were submitted to serological typing and their sensitivity to 10 selected antibiotics and chemotherapeutic agents was determined. among 109 strains of c. difficile tested for enterotoxin production by latex test 82 strains ... | 1990 | 2087130 |
| open trial of cefepime (bmy 28142) for infections in hospitalized patients. | the safety and efficacy of cefepime, a new broad-spectrum, semisynthetic parenteral cephem antibiotic, were evaluated in an open trial at a single hospital. seventy patients were treated with cefepime: 44 had lower respiratory tract infections, 4 had urinary tract infections, and 22 had skin or soft tissue infections. of 65 clinically evaluable patients, 64 (98%) had satisfactory responses. no mortality or superinfections occurred. of 57 respiratory and urinary tract pathogens, 54 (95%) were era ... | 1990 | 2203309 |
| faecal excretion of ciprofloxacin after a single oral dose and its effect on faecal bacteria in healthy volunteers. | high concentrations of ciprofloxacin have been shown to persist in the faeces of volunteers for several days after a week of oral treatment with this drug, which was also found to have a prolonged effect on aerobic gram-negative intestinal bacteria. to determine whether a shorter course of ciprofloxacin would have the same prolonged effect, we treated ten healthy adult volunteers with a single oral dose of 750 mg ciprofloxacin and found that this was not followed by any significant changes in th ... | 1990 | 2211433 |
| the effect of cefuroxime axetil on the faecal flora of healthy volunteers. | the effect on the faecal flora of cefuroxime axetil, an oral ester of cefuroxime, was examined in ten healthy volunteers following a dose of 250 mg twice a day for 41/2 days. the mean blood concentration 2 h after the ninth dose was 3.6 mg/l and the urinary excretion was approximately 40% in 6 h and 50% in 24 h. two volunteers developed mild diarrhoea and one candida vaginitis. although there was variation between volunteers in the changes found in the faecal flora, the major effects were a redu ... | 1990 | 2211457 |
| clostridium difficile-associated disease in long-term care facilities. | | 1990 | 2212583 |
| loperamide related toxic megacolon in clostridium difficile colitis. | | 1990 | 2217023 |
| incidence of cytotoxin producing isolates of clostridium difficile in faeces of neonates and children in nigeria. | one hundred and fifty six (156) confirmed isolates of clostridium difficile from faeces of neonates and children in parts of anambra state, nigeria were screened and assayed for cytotoxin production by the tissue culture technique and the frequency of occurrence estimated. twenty three out of 156 isolates were found to be cytotoxin positive isolates representing a frequency of 14.8%. there was no difference between the frequency of occurrence of cytotoxin positive isolates in neonates and childr ... | 1990 | 2087200 |
| comparative in vitro activity of cefpirome and cefepime, two new cephalosporins. | in in vitro tests the broad-spectrum cephalosporins cefpirome and cefepime were highly active against enterobacteriaceae, although often less so against strains resistant to amoxicillin-clavulanate and ticarcillin-clavulanate, and against most strains of acinetobacter spp. and aeromonas hydrophila. they were also active against pseudomonas aeruginosa, although strains with non-plasmid mediated beta-lactam resistance were sometimes less sensitive. other pseudomonas spp. varied in their sensitivit ... | 1990 | 2226498 |
| molecular characterization of the clostridium difficile toxin a gene. | the gene encoding the toxin a protein of clostridium difficile (strain vpi 10463) was cloned and sequenced. the coding region of 8,133 base pairs had a mol% g + c of 26.9 and encodes 2,710 amino acids. the deduced polypeptide has a molecular mass of ca. 308 kilodaltons. nearly a third of the gene, at the 3' end, consists of 38 repeating sequences. the repeating units were grouped into two classes, i and ii, on the basis of length and the low levels of dna sequence similarities between them. ther ... | 1990 | 2105276 |
| diarrhea in tube-fed patients: feeding formula not necessarily the cause. | this study of diarrhea in tube-fed patients was undertaken to determine the proportion of cases in which feeding formula is not responsible for the diarrhea, the causes other than the feeding formula, and the diagnostic approach to diarrhea in tube-fed patients. | 1990 | 2105646 |
| comparison of a dot immunobinding assay, latex agglutination, and cytotoxin assay for laboratory diagnosis of clostridium difficile-associated diarrhea. | c. diff-cube, a dot immunobinding assay (dia) (difco laboratories, ann arbor, mich.) for detection of clostridium difficile toxin a in stool specimens, was compared with latex agglutination (la) (marion laboratories, kansas city, mo.) and cytotoxin assay (cta) for the laboratory diagnosis of c. difficile-associated diarrhea. a total of 200 stool specimens collected from 169 patients with suspected c. difficile diarrhea were tested. of the 198 specimens evaluated by all three methods, 36 (18%) fr ... | 1990 | 2112561 |
| toxin a of clostridium difficile is a potent cytotoxin. | clostridium difficile is the cause of antibiotic-associated colitis in humans. the organism produces toxin a, which is generally known as the enterotoxin, and toxin b, which is known as the cytotoxin. toxin a has been reported to have slight cytotoxic activity; in this study we show that cell lines (f9, otf9-63, and p19) which express a carbohydrate to which toxin a binds are more sensitive to the toxin. these cell lines can be used as research tools for determining concentrations of biologicall ... | 1990 | 2112562 |
| clostridium difficile toxin a carries a c-terminal repetitive structure homologous to the carbohydrate binding region of streptococcal glycosyltransferases. | a detailed analysis of the 8130-bp open reading frame (orf) of gene toxa and of an upstream orf designated utxa, indicates the presence of a transcription terminator stem-loop for toxa, promoter sequences, and shine-dalgarno boxes for toxa and utxa. no transcription terminator between toxa and utxa is suggested by the sequence. toxa contains two domains, one-third (c-terminal) with a repetitive structure and the residual two-thirds with no repetitions. the 2499-bp sequence encoding the repetitiv ... | 1990 | 2148295 |
| role of surgery in antibiotic-induced pseudomembranous enterocolitis. | with the increased use of prophylactic and broad-spectrum antibiotics, pseudomembranous colitis has emerged as a significant clinical problem. management with specific anti-clostridium difficile therapy (vancomycin or metronidazole) has reduced mortality to less than 2%. nevertheless, the disease may progress to a fulminant toxic colitis or colonic perforation. additionally, another subset of patients will present with a dramatic clinical picture, suggesting acute peritonitis, eventuating in unn ... | 1990 | 2240392 |
| hydrolytic enzyme production by clostridium difficile and its relationship to toxin production and virulence in the hamster model. | thirty isolates of clostridium difficile expressing different degrees of toxigenicity and virulence in an animal model were assayed for the production of chondroitin-4-sulphatase, hyaluronidase, heparinase, collagenase and protease. all strains demonstrated some hydrolytic enzyme activity. there was no direct correlation between toxigenic status, or virulence, and hydrolytic enzyme production. however, all five strains known to be highly virulent in the hamster model had hyaluronidase, chondroit ... | 1990 | 2156075 |
| enterotoxins from clostridium difficile; diarrhoeogenic potency and morphological effects in the rat intestine. | the action of toxins a, b, and c from clostridium difficile was studied in the small intestine and colon of rats. all three caused fluid accumulation in the small intestine, maximal secretion being induced by 1 micrograms of toxin a, 20 micrograms of b, and 15 micrograms of c. both toxins a and c caused shedding of epithelial cells from the villi without visible damage to crypt cells; toxin a caused further extensive necrosis and bleeding. toxin b caused secretion without visible damage to the e ... | 1990 | 2115017 |
| c. difficile toxin a increases intestinal permeability and induces cl- secretion. | mucosal sheets of guinea pig ileum mounted in ussing chambers were used to determine effects of highly purified clostridium difficile toxin a on intestinal structure and barrier function in the absence of recruited neutrophils and blood flow. with the use of standard electrophysiological and morphological techniques, our results indicate that 5 micrograms/ml mucosal toxin a induces substantial alteration in epithelial permeability and in structure of absorptive cells. transepithelial fluxes of m ... | 1990 | 2116728 |
| identification of toxigenic clostridium difficile strains by using a toxin a gene-specific probe. | a 4.5-kilobase psti fragment encoding part of the toxin a gene was isolated and used as a dna probe in colony hybridization studies with 58 toxigenic and 17 nontoxigenic clostridium difficile strains. all 58 toxigenic strains showed positive hybridization, in contrast to the 17 nontoxigenic strains. southern blot analysis with the toxin a gene probe showed hybridization to a single fragment of equal intensities for hindiii-digested genomic dnas isolated from c. difficile strains of wide-ranging ... | 1990 | 2118549 |
| nucleotide sequence of clostridium difficile toxin a gene fragment and detection of toxigenic strains by polymerase chain reaction. | a 1947 base pair (bp) fragment of the toxin a gene of clostridium difficile was sequenced. a continuous open reading frame was found, which contained 4 distinct groups of repeat nucleotide sequence with 88 to 100% identity within each group. the arrangement of the groups (a, 81 bp, b, c and d, 63 bp) was abcccdabcddabcccdabccdabcdabc. based on nucleotide sequence data from the c repeat group, a pair of oligonucleotide primers were synthesised and used in the polymerase chain reaction (pcr) to am ... | 1990 | 2118866 |
| studies of the subgingival microflora in patients with acquired immunodeficiency syndrome. | two unique forms of periodontal disease, hiv-gingivitis and hiv-periodontitis, have been described in patients with acquired immunodeficiency syndrome (aids). in order to determine the bacterial species associated with periodontitis in aids patients, the predominant cultivable microflora was examined in 21 subgingival plaque samples from 11 aids patients with periodontitis. the presence of putative periodontal pathogens including actinobacillus actinomycetemcomitans, bacteroides intermedius, por ... | 1990 | 2123926 |
| in vitro activity of teicoplanin, vancomycin, a16686, clindamycin, erythromycin and fusidic acid against anaerobic bacteria. | the in vitro activity of teicoplanin and a16686, two new glycopeptide antibiotics was determined against 196 isolates of anaerobic bacteria. the activity of teicoplanin and a16686, in comparison with that of vancomycin, clindamycin, erythromycin and fusidic acid was 2 to 16 times higher against the gram positive anaerobes, namely, propionibacterium acnes, clostridium perfringens, clostridium difficile, clostridium species, peptococcus species and peptostreptococcus species. however, bacteroides ... | 1990 | 2139737 |
| [effect of bmy-28100 on bacterial flora in adult human feces]. | we investigated effects of bmy-28100 on fecal bacteria. bmy-28100 was administered orally to 8 healthy male volunteers between 20 and 24 years of age weighing between 58.0 and 79.5 kg. all subjects were given one 250 mg capsule 3 times a day at 30 minutes after meal for 7 days. fecal bacterial counts were examined 5 days before the start of administration, the day of the start of administration, 3, 5 and 7 days after the start of administration, and 3, 5, 10, 20 and 30 days after the end of admi ... | 1990 | 2287057 |
| fructose 1-phosphate and the regulation of glucokinase activity in isolated hepatocytes. | fructose 1-phosphate kinase was partially purified from clostridium difficile and used to develop specific assays of fructose 1-phosphate and fructose. the concentration of fructose 1-phosphate was below the detection limit of the assay (25 pmol/mg protein) in hepatocytes incubated in the presence of glucose as sole carbohydrate. addition of fructose (0.05-1 mm) caused a concentration-dependent and transient increase in the fructose 1-phosphate content. glucagon (1 microm) and ethanol (10 mm) ca ... | 1990 | 2145154 |
| in vitro activity of ly 264826 compared with that of vancomycin against 100 clinical isolates each of methicillin-resistant staphylococcus aureus and clostridium difficile. | the in vitro activity of ly 264826, a new glycopeptide antibiotic, was compared with that of vancomycin against 100 strains each of methicillin-resistant staphylococcus aureus and clostridium difficile. ly 264826 was more active, by weight, than vancomycin against the isolates tested. the human serum protein binding of ly 264826 was 15.3% (range, 9.8 to 21.8%). | 1990 | 2291667 |
| inappropriate testing for diarrheal diseases in the hospital. | to assess the degree to which routine stool cultures, ova and parasite examinations, and clostridium difficile toxin assays may be inappropriately ordered on hospitalized patients, we conducted a retrospective study to determine the relative yield of these tests on specimens collected from outpatients and inpatients as a function of time after admission. during a 3-year period, only 1 of 191 positive stool cultures and none of the 90 ova and parasite examinations with positive results were from ... | 1990 | 2299766 |
| microbiological studies of the enterocolitis of hirschsprung's disease. | the results of a prospective study of 20 cases of newly diagnosed hirschsprung's disease (nine of whom developed enterocolitis) and 10 normal controls showed no variations in the bacterial flora (including clostridium difficile) in the stools of the groups studied. viral studies showed that rotavirus was present in the stools of seven of the nine cases of enterocolitis during the episode. we suggest that hirschsprung's enterocolitis may have a complex infective aetiology and that rotavirus plays ... | 1990 | 2176779 |
| clostridium difficile diarrhea and colonization after treatment with abdominal infection regimens containing clindamycin or metronidazole. | one hundred fifty-six patients with presumed or documented abdominal infections were treated with amikacin/metronidazole/placebo (group 1, 56 patients), amikacin/clindamycin/placebo (group 2, 57 patients), or amikacin/clindamycin/ampicillin (group 3, 43 patients) to determine both the therapeutic efficacy of the various regimens and the type of complications due to clostridium difficile. c. difficile diarrhea occurred in 15 of 156 patients (9.6%), and c. difficile colonization occurred in 14 of ... | 1990 | 2301715 |
| safety of parenteral third-generation cephalosporins. | knowledge of side effects associated with different cephalosporins may be of help to prescribers. there are several side effects that are common to all cephalosporins, but overall, cefotaxime and ceftizoxime cause the fewest adverse reactions. bleeding is probably the most common serious side effect of cephalosporins. moxalactam causes coagulopathy and bleeding more often than do other cephalosporins, probably because it is carboxylated and has a methylthiotetrazole side chain. cefoperazone also ... | 1990 | 2183609 |
| the influence of the normal flora on clostridium difficile colonisation of the gut. | the normal stable flora of the gut of man and other adult animal species provides an effective barrier to infection by clostridium difficile. attempts to understand this mechanism have involved continuous flow and batch culture systems and colonisation of antibiotic pre-treated or germ free animals with gut flora from the same or unrelated species. in general attempts to re-create the barrier effect with the whole caecal or faecal flora have been successful both in vitro and in vivo, whereas att ... | 1990 | 2184849 |
| in vitro antibacterial activity of bismuth subsalicylate. | this study was undertaken to determine the in vitro activity of bismuth subsalicylate (bss) and sodium salicylate (ss) against various groups of pathogenic bacteria. bss had the greatest activity against clostridium difficile, which had a minimal inhibitory concentration for 90% of the strains (mic90) of 128 micrograms/ml. the bacteroides fragilis group also had a relatively low mic90 of 512 micrograms/ml. bss had the least activity against pseudomonas (mic90, 6,144 micrograms/ml). ss was as act ... | 1990 | 2305178 |
| anaerobic bacteria and bacterial infections: perspectives on treatment and resistance in italy. | results of laboratory tests of 2,000 samples obtained from 1984 to 1987 from patients with suspected anaerobic infections and the clinical experience of these patients are reported. of these samples, 395 were positive for anaerobes; 36.5% of these 395 samples contained single organisms, and 63.5% contained a mixture of anaerobes and aerobes. abdominal infections were the infections most frequently caused by anaerobes. the bacteroides fragilis group and strains of peptostreptococcus were the micr ... | 1990 | 2305181 |
| escherichia coli o157:h7-associated colitis. a clinical and histological study of 11 cases. | hemorrhagic colitis is characterized by abdominal cramps, bloody diarrhea, and no or low-grade fever. most cases are caused by the shiga-like toxin-producing bacteria, escherichia coli o157:h7. nineteen colonic biopsy specimens and one resection specimen were reviewed from 11 patients with e. coli o157:h7-associated colitis to determine whether histologic features could be useful in diagnosis or in suggesting pathogenesis. all specimens showed hemorrhage and edema in the lamina propria. specimen ... | 1990 | 2188868 |
| prevention of clostridium difficile-induced experimental pseudomembranous colitis by saccharomyces boulardii: a scanning electron microscopic and microbiological study. | the ability of saccharomyces boulardii to protect mice against intestinal pathology caused by toxinogenic clostridium difficile was studied. different regions of the intestine of experimental mice were prepared for observation by scanning electron microscopy or homogenized for c. difficile enumeration and quantification of toxin a by enzyme immunoassay and toxin b by cytotoxicity. the test group was treated for 6 d with an s. boulardii suspension in drinking water and challenged with c. difficul ... | 1990 | 2200843 |
| cytotoxin-negative clostridium difficile. | | 1990 | 2322209 |
| [acute segmental hemorrhagic penicillin-associated colitis]. | four days after beginning a perioperative antibiotic prophylaxis with amoxicillin and clavulanic acid a 33-year-old patient developed an acute haemorrhagic diarrhoea with cramp-like lower abdominal pain. coloscopy revealed diffuse mucosal oedema with map-like ulcerations, increased susceptibility to trauma and submucous haemorrhages extending from the middle of the ascending to the middle of the descending colon. granulocytic inflammation with cryptal atrophy was seen histologically. stool cultu ... | 1990 | 2226187 |
| actin and lamin comprised filaments in the nuclei of chinese hamster ovary cells affected with clostridium difficile enterotoxin a. | the major change in the ultrastructure of chinese hamster ovary (cho) cells treated with clostridium difficile enterotoxin a was the formation of bundles of filaments in the nucleoplasm. the filaments appeared after 2.5 h and disappeared by the fourth hour of incubation with the toxin. to partially characterize these filaments, laser diffractometry and ultrastructural immunocytochemistry were employed. the bundles consist of coiled filaments of about 11 nm and 16 nm diameter and a main long axia ... | 1990 | 2090392 |
| detection of variant toxin a without hemagglutination activity of clostridium difficile and analysis of its biochemical and biological characteristics. | | 1990 | 2101141 |
| macrophage-dependent stimulation of t cell-depleted spleen cells by clostridium difficile toxin a and calcium ionophore. | clostridium difficile toxin a causes severe intestinal inflammation and fluid secretion in rabbit ileum and is chemotactic for neutrophils in vitro. the mechanism of intestinal injury produced by toxin a appears to involve direct epithelial cell damage as well as recruitment of an inflammatory cell response. the current study was undertaken to determine if toxin a can directly stimulate a proliferative response in lymphocytes. highly purified toxin a, in the presence of the calcium ionophore, io ... | 1990 | 2105851 |
| [low incidence of pseudomembranous colitis associated with antibiotics at a general hospital in lima]. | clostridium difficile is associated to episodes of diarrhea related to the use of antibiotics in general hospitals. the aim of this study has been to determine the incidence of this complication among the patients admitted in a 400 bed general hospital in lima, perú; we registered every day, in all the wards of the hospital, the presence of diarrhea in patients under antibiotic treatment. in every patient with diarrhea we investigated the presence of cytotoxin and cultivated for c. difficile in ... | 1990 | 2346679 |
| low-dose ciprofloxacin for selective decontamination of the digestive tract in human volunteers. | the effect on the faecal aerobic and anaerobic flora of ciprofloxacin given in low doses for selective decontamination of the digestive tract was investigated in ten human volunteers. the volunteers received 50, 100 and 200 mg of ciprofloxacin every 12 h for five days at intervals of three and five weeks respectively. no significant differences in the numbers of aerobes or anaerobes were seen after the 2 x 50 mg regime. the colony counts of most anaerobes and the total aerobe count were signific ... | 1990 | 2351146 |
| relapsing clostridium difficile colitis and reiter's syndrome. | we describe a patient with recurrent clostridium difficile-associated colitis who suffered severe arthritis and urethritis with each of three episodes of diarrhea. although immune complex formation was demonstrated in synovial fluid, neutralizing antibodies to c. difficile cytotoxin a and b were not found in either serum or synovial fluid. cholestyramine did not prevent a third episode of colitis which followed the use of amikacin. this patient was hla-b27 positive; she developed sacroiliitis, t ... | 1990 | 2353699 |
| [effect of rokitamycin on bacterial flora in human feces]. | rokitamycin, a newly developed macrolide antibiotic was orally administered to 7 healthy male volunteers (22-25 years) for 7 consecutive days to study changes in bacterial flora and concentrations of the drug in feces, and to observe adverse reactions and laboratory test parameters. a dose of 200 mg (2 tablets: 100 mg/tablet) was given 3 times daily before meals and the fecal studies were done on the 5 days before administration (adm.) [b.a.], at the time of administration (0), and the 3rd, 5th, ... | 1990 | 2362352 |
| inappropriate antibiotic use and the development of clostridium difficile colitis. | a three-year, retrospective, community-wide study reviewed all patients (n = 60) with positive clostridium difficile stool cytotoxin assays. the appropriateness of antibiotic administration in hospitalized patients (n = 48) who developed antibiotic-associated colitis (aac) was studied. only 25 per cent had antibiotics used appropriately with positive culture results and organisms susceptible to the antibiotic(s) given. another 25 per cent of cases had positive cultures, but the organisms were no ... | 1990 | 2363281 |
| nucleotide sequence of clostridium difficile toxin a. | | 1990 | 2109310 |
| lactic acid bacteria and human health. | although claims for health and nutritional benefits have been made for lactic acid bacteria in fermented dairy products for nearly a century, the nutritional and therapeutic value of these organisms is still controversial. this article will review the scientific basis of these claims. there are numerous studies showing fermentation of food with lactobacilli increase the quantity, availability, digestibility, and assimilability of nutrients. the basis for this conclusion comes from direct measure ... | 1990 | 2109988 |
| use of standardized screening procedures to identify adverse drug reactions. | the development of an adverse drug reaction (adr)-monitoring program using standardized screening procedures in a 650-bed hospital is described. a concurrent adr-reporting system that relied on health-care professionals to report observed adrs to the pharmacy had generated just two adr reports during the previous year. the pharmacy developed a program that used standardized procedures to screen for adrs. the technicon computer was programmed to screen the previous day's orders for antidotes or " ... | 1990 | 2368724 |
| virulence of ten serogroups of clostridium difficile in hamsters. | a slide agglutination technique identifying 10 serogroups of clostridium difficile (a,b,c,d,f,g,h,i,k and x) has been described previously. in this study, we have used the hamster to compare the ability of the 10 serogroup reference strains to colonise and produce disease. groups of four hamsters were each given a single intraperitoneal injection of either clindamycin or cefoxitin, and an oral challenge dose of c. difficile. the time taken to establish faecal colonisation and the length of survi ... | 1990 | 2231680 |
| [influence of cefodizime via intravenous bolus injection on human fecal flora]. | cefodizime (cdzm), a newly developed injectable cephem antibiotic, was given to 8 healthy male volunteers with ages 23-28 years (mean: 24 years) and body weights 54-73 kg (mean: 64 kg). 4 volunteers received 2 g b.i.d., intravenous infusion for 5 days, and 4 volunteers had 4 g b.i.d. for the same duration. we studied changes in bacterial flora and drug levels in feces, as well as changes in susceptibility of isolated microbes to cdzm, cefmetazole, cefotaxime (ctx) and cefoperazone. adverse drug ... | 1990 | 2232150 |
| risk factors for clostridium difficile toxin-associated diarrhea. | the hospital-wide attack rate for clostridium difficile-associated diarrhea at our tertiary-care university hospital was 0.02 per 100 patient discharges (0.02%) in 1982, but 0.41% and 1.47% in 1986 and 1987, respectively, with a peak incidence of 2.25% in the fourth quarter of 1987. hospital antibiotic usage patterns showed concurrent increased use of third-generation cephalosporins, and intravenous vancomycin and metronidazole. thirty-seven cases selected for study were older than 37 control pa ... | 1990 | 2373850 |
| control of clostridium difficile colitis outbreak by treating asymptomatic carriers with metronidazole. | | 1990 | 2252226 |
| nosocomial escherichia coli o157:h7 diarrhea. | | 1990 | 2252229 |
| 12th c. l. oakley lecture. pathogenesis of clostridium difficile infection of the gut. | on the basis of the above findings it is possible to propose a sequence of events following exposure to c. difficile. exposure of neonates to c. difficile leads to transient colonisation which is almost invariably asymptomatic; the reasons why colonisation is asymptomatic are not known. exposure of antibiotic-treated adults to c. difficile does not invariably lead to colonisation; however, in those instances where colonisation occurs, it may be transient and asymptomatic or transient and symptom ... | 1990 | 2258909 |
| prevalence of clostridium difficile on a mixed-function ward for the elderly. | we studied the prevalence of clostridium difficile over a period of 2 months on a mixed-function geriatric ward. seven (14%) of the 49 patients were long-stay but the remainder were in hospital for acute illness or required a short period of active rehabilitation. although 69% patients had recently received antibiotics, from only two (4%) was c. difficile isolated from their faeces. our results show that c. difficile is not endemic in patients on all geriatric wards as has been previously sugges ... | 1990 | 2273275 |
| incidence of clostridium difficile in infants in rural and urban areas of nigeria. | stool specimens collected from 320 infants under 5 years of age resident in both rural and urban centres of nsukka and enugu towns in anambra state, nigeria were examined for the presence of clostridium difficile and the frequency of occurrence determined. clostridium difficile was isolated from 156 out of 320 samples (48.8%). the frequency was higher in infants resident in rural areas (52.5-48.3%) than in their urban counterparts (47.8-42%). a high frequency rate (77%) was obtained in diarrheal ... | 1990 | 2273987 |
| detection of capsule in strains of clostridium difficile of varying virulence and toxigenicity. | nine toxigenic and six non-toxigenic strains of clostridium difficile, of varying virulence in the hamster model of antibiotic-associated colitis, were examined for the presence of a capsule. antibody stabilisation of the capsule with heterologous and/or homologous antiserum fixed in glutaraldehyde, or direct fixation in glutaraldehyde/diamine, were used with added ruthenium red to stain the capsular glycocalyx. all strains possessed a capsule which was either loose-knit or compact, sometimes wi ... | 1990 | 2277588 |
| [preventive effect of clostridium butyricum m588 against the proliferation of clostridium difficile during antimicrobial therapy]. | fecal flora of the patients without remarkable gastrointestinal diseases were studied. all patients were treated with antimicrobial drugs with or without miya-bm (the preparation of clostridium butyricum m588). the stools were examined before and after (during) antimicrobial treatment. fecal flora of 69 patients before medication was almost the same with that of healthy adults as has been reported by mitsuoka et al. after giving antimicrobials, most bacterial genus except enterococcus and yeasts ... | 1990 | 2286785 |
| rapid diagnosis of clostridium difficile-associated diarrhoea using a latex agglutination test. | a rapid latex agglutination test, culturette brand cdt from marion laboratories, was evaluated and compared to a tissue culture assay (tca) and isolation of clostridium difficile in 380 faecal specimens from 226 patients with clinically suspected clostridium difficile-associated diarrhoea. the sensitivity and specificity of the latex test compared with the tca were 83% and 80% respectively, and the positive and negative predictive values were 55% and 94% respectively. in patients with repeated s ... | 1990 | 2397115 |
| the colonic pathology of escherichia coli o157:h7 infection. | we report the colonic pathology of two surgical excisions and two autopsies from patients acutely infected by e. coli o157:h7. the right colon was most severely affected. extreme edema, fibrin deposition, and hemorrhage in the submucosa was the most distinctive finding. all cases showed patchy mucosal ulceration, mucosal hemorrhage, neutrophil infiltration, and microvascular thrombi. pseudomembranous lesions similar to those described in pseudomembranous colitis caused by clostridium difficile w ... | 1990 | 2403759 |
| diarrhea in developed and developing countries: magnitude, special settings, and etiologies. | diarrheal diseases are major causes of morbidity, with attack rates ranging from two to 12 or more illnesses per person per year in developed and developing countries. in addition, diarrheal illnesses account for an estimated 12,600 deaths each day in children in asia, africa, and latin america. the causes of diarrhea include a wide array of viruses, bacteria, and parasites, many of which have been recognized only in the last decade or two. while enterotoxigenic escherichia coli and rotaviruses ... | 1990 | 2406855 |
| pseudomembranous colitis: how useful is endoscopy? | clostridium difficile colitis may be diagnosed either by endoscopy or by laboratory tests. to determine the role of endoscopy, we reviewed 59 cases of confirmed c. difficile colitis. in all patients, the etiology was confirmed by stool tests. twenty-nine underwent lower gastrointestinal endoscopy. in 16 (55%) there was endoscopic confirmation of pseudomembranes while 4 (14%) had only nonspecific colitis. there was no apparent difference in the rate of detection of pseudomembranes between rigid s ... | 1990 | 2291163 |
| prospective, controlled study of vinyl glove use to interrupt clostridium difficile nosocomial transmission. | despite recognition that clostridium difficile diarrhea/colitis is a nosocomial infection, the manner in which this organism is transmitted is still not clear. hands of health care workers have been shown to be contaminated with c. difficile and suggested as a vehicle of transmission. therefore, we conducted a controlled trial of the use of disposable vinyl gloves by hospital personnel for all body substance contact (prior to the institution of universal body substance precautions) to study its ... | 1990 | 2301439 |
| effect of bismuth subsalicylate on fecal microflora. | several studies have documented the efficacy of bismuth subsalicylate (bss) for the prophylaxis and treatment of bacterial diarrhea. it is not known what effect, if any, bss has on the normal bowel flora. we quantitated the fecal flora in healthy volunteers before and after they took bss. in the first group, 8 ounces of bss was given on two successive days. in the second group, a standard oral intestinal lavage preparation (golytely) was used to clean the colon and then 8 ounces of bss was given ... | 1990 | 2305174 |
| effect of bismuth subsalicylate on clostridium difficile colitis in hamsters. | the therapeutic effect of bismuth subsalicylate (bss, pepto-bismol) in clostridium difficile colitis was studied in golden syrian hamsters. c. difficile was fed to the hamsters by orogastric intubation 2-3 days after their arrival. clindamycin (1.5 mg per animal) was given intraperitoneally 4 days later. twenty-four hours after challenge with clindamycin, animals were given bss at dosages of 5, 10, and 15 mg twice daily for 5 days by orogastric intubation. controls included untreated animals and ... | 1990 | 2305177 |
| cefamandole versus cefonicid prophylaxis in cardiovascular surgery: a prospective study. | we randomized 400 patients who were scheduled for an elective cardiovascular operation involving median sternotomy to receive cefamandole nafate or cefonicid in a prospective double-blind study. three hundred fifty-seven patients were evaluable for prophylactic efficacy. chest wound and donor site infections and early prosthetic valve endocarditis occurred more frequently with cefonicid (11 patients, 6.3%) than with cefamandole (4 patients, 2.2%) (p = 0.05). three patients, all in the cefonicid ... | 1990 | 2310250 |
| detection of specific antigens for ten serogroups of clostridium difficile. | we previously described a serogrouping technique for clostridium difficile based on slide agglutination with rabbit antisera raised against formol-treated cells. it allows the differentiation of ten serogroups, namely a, b, c, d, f, g, h, i, k and x. each serogroup displays a specific profile with several distinctive bands by polyacrylamide gel electrophoresis (page). in this study we investigated the common and specific antigenic determinants of the ten serogroups by immunoblotting. in a first ... | 1990 | 2314395 |
| clostridium difficile-associated diarrhea after norfloxacin. | although theoretically the spectrum of antimicrobial quinolone antibiotics are at low risk of producing clostridium difficile overgrowth and diarrhea, a patient developed this clinical problem while receiving norfloxacin. we review the antimicrobial activity of the quinolone antibiotics, with respect to their predisposition for producing c. difficile-induced diarrhea. | 1990 | 2324482 |
| enzyme immunoassay (elisa) for detection of clostridium difficile toxin b in specimens of faeces. | antisera against clostridium difficile toxin b were prepared in sheep and rabbit and were used in indirect and sandwich enzyme-linked immunosorbent assays (elisa) for the detection of toxin b. polyvinyl chloride and polystyrene microtitration plates were tested as solid phases for the assay. both assays had a lower limit of detection for toxin b of 1 ng/ml. they were used to detect the presence of toxin b in 210 human faecal specimens and also in the culture supernatant fluids of c. difficile st ... | 1990 | 2325114 |
| effect of ceftazidime and gentamicin on the oropharyngeal and faecal flora of patients with haematological malignancies. | thirty-four patients with haematological malignancies were studied to investigate the effect of empirical broad-spectrum antibiotic therapy (ceftazidime and gentamicin) on the gastro-intestinal flora. twenty-five patients with acute myeloid leukaemia or post-autologous bone-marrow transplantation were given framycetin, nystatin and colistin (fracon), and two patients with non-hodgkin's lymphoma were on co-trimoxazole, as long-term gut prophylaxis. semi-quantitative microbiology was carried out o ... | 1990 | 2228830 |
| postantibiotic colonization with clostridium difficile in nursing home patients. | clostridium difficile causes pseudomembranous colitis and is responsible for 20% to 25% of cases of postantibiotic diarrhea. in an earlier study, nursing-home patients with c. difficile infection were noted to have a high mortality rate. because most of these infected patients had been treated with antibiotics, it was not clear whether this high mortality rate was associated with c. difficile infection or simply with antibiotic treatment. a prospective study was carried out to determine the rate ... | 1990 | 2329250 |
| incidence of clostridium difficile in hospitalized children. a prospective study. | a total of 394 children, aged 0-14 years, referred to a paediatric department were investigated for the occurrence of clostridium difficile, its cytotoxin in faeces, and its clinical significance in a prospective study over one year. of the children in the investigation, 337 suffered from gastrointestinal diseases or had been treated with antibiotics prior to the investigation. twenty-four percent of these children had cl. difficile in one or more faecal samples and toxin was demonstrated in hal ... | 1990 | 2333742 |
| characterization of flagella of clostridium difficile and their role in serogrouping reactions. | slide agglutination with rabbit antisera allows the differentiation of 10 serogroups of clostridium difficile, namely, a, b, c, d, f, g, h, i, k, and x. each serogroup displays a specific protein profile in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, except for a, which displays 12 different protein profiles (a1 to a12). in the present work, electron microscopy revealed the presence of uniformly distributed flagella in the reference strains of serogroups g and k and in all strains ... | 1990 | 2229343 |
| ciprofloxacin as a cause of clostridium difficile-associated diarrhoea in an hiv antibody-positive patient. | ciprofloxacin is an uncommon cause of pseudomembranous colitis. a case is described in which diarrhoea was associated with the presence of clostridial toxin in an hiv-infected patient and the possible implications are discussed. | 1990 | 2230180 |
| clostridium difficile colitis in the hospital setting: a potentially explosive problem. | | 1990 | 2373849 |
| nucleotide sequence of clostridium difficile toxin b gene. | | 1990 | 2374729 |
| clostridium difficile infection in orthopaedic patients. | in a review of the results of toxin assays, twenty-five orthopaedic patients who had a clostridium difficile infection and associated diarrhea were identified. the infection was due to the use of antibiotics in all but one patient. seventeen patients had received the antibiotics prophylactically. the two most commonly implicated antibiotics were cefazolin and clindamycin, because those drugs had been commonly used for prophylaxis at the study institutions. however, other antibiotics were implica ... | 1990 | 2384505 |
| primary infection of ascitic fluid with clostridium difficile. | a case of a primary infection of ascitic fluid with a toxigenic strain of clostridium difficile is described. the strain belonged to the serogroup h which is often implicated in pseudomembranous colitis. nevertheless, our patient did not have any sign of colitis or diarrhoea before the ascitic infection. she was successfully treated by the intravenous administration of metronidazole but relapsed a few weeks later. a similar strain of serogroup h was again isolated. | 1990 | 2384684 |
| quantitative study of antibiotic-induced susceptibility to clostridium difficile enterocecitis in hamsters. | commonly used antibiotics were compared for their ability to induce clostridium difficile enterocecitis and death in hamsters. susceptibility to infection with c. difficile was measured by calculating 50% lethal doses (in cfu) for hamsters for various intervals after antibiotic treatment. infection occurred after very small doses of c. difficile were given to hamsters treated with clindamycin, ampicillin, flucloxacillin, and cefuroxime; there was little difference between the antibiotics in the ... | 1990 | 2386366 |
| risk factors for clostridium difficile carriage and c. difficile-associated diarrhea in a cohort of hospitalized patients. | a prospective cohort study of 399 consecutive patients in a single ward over an 11-month period was conducted to identify risk factors for nosocomial c. difficile colonization and diarrhea. the incidence of asymptomatic carriage was 13.0/100 patient admissions and the incidence of c. difficile-associated diarrhea was 7.8/100 patient admissions. increased age and more severe underlying illness were associated with increased risk of c. difficile carriage and diarrhea. multivariate models adjusting ... | 1990 | 2387993 |
| multiple relapses of clostridium difficile-associated diarrhea responding to an extended course of cholestyramine. | | 1989 | 2496393 |
| presumptive identification of clostridium difficile by detection of p-cresol in prepared peptone yeast glucose broth supplemented with p-hydroxyphenylacetic acid. | prereduced, anaerobically sterilized peptone yeast glucose broth was supplemented with p-hydroxyphenylacetic acid and used for the presumptive identification of clostridium difficile. two hundred eighty-two organisms were grown in this medium for 18 h and tested for p-cresol production by gas-liquid chromatography. all 49 stock and reference strains of c. difficile and 19 organisms confirmed as c. difficile produced p-cresol. p-cresol was not produced by 53 negative control or 161 test organisms ... | 1990 | 2394806 |
| short-chain fatty acid and organic acid concentrations in feces of healthy human volunteers and their correlations with anaerobe cultural counts during systemic ceftriaxone administration. | short-chain fatty acid (scfa) and organic acid concentrations and (an)aerobe cultural counts were determined simultaneously in fresh feces from 10 human volunteers before, during, and after 5 days of single-dose ceftriaxone administration. the changes and the correlation coefficients between these variables were tested to be significant (p less than 0.05). to investigate whether significant changes in the intestinal microflora could be predicted by significant changes in scfa/organic acid concen ... | 1990 | 2396083 |
| virulence factors of clostridium difficile. | in addition to the two major toxins of clostridium difficile--toxins a and b, which represent the major virulence factors--a number of other putative virulence factors have been described. these factors include fimbriae and the ability to associate with gut cells/mucus, the production of a capsule, the secretion of a range of hydrolytic enzymes, the production of other toxins (such as an actin-specific adp-ribosyltransferase by some strains), and the controversial possibility of the production o ... | 1990 | 2406871 |
| clostridium difficile: clinical considerations. | clostridium difficile was originally reported as an agent of enteric disease in 1977. subsequent work has shown this organism to be what many consider the most important bacterial pathogen of the gut in developed countries in terms of severity of disease and prevalence. a review of the literature indicates that almost all of the clinically relevant data for this organism were reported by 1981, including data on the spectrum of disease, clinical settings in which it is suspect, epidemiology, path ... | 1990 | 2406876 |
| prevention of further recurrences of clostridium difficile colitis with saccharomyces boulardii. | a patient with six documented episodes of recurrent clostridium difficile colitis over an eight-month period is described. relapses of colitis occurred despite treatment with vancomycin, metronidazole, bacitracin, and cholestyramine. each recurrence appeared to begin successively closer to the end of the previous course of treatment. four episodes were sufficiently severe to require hospitalization for rehydration. saccharomyces boulardii, a nonpathogenic yeast, was begun prior to discontinuing ... | 1990 | 2364845 |
| degradation of 2-phosphoglycerate by cytotoxin b of clostridium difficile. | cytotoxin b of c. difficile was highly purified by selective ammonium sulfate precipitation, biogel a5m chromatography, phenyl boronate hydrophobic interaction chromatography and ultracentrifugation. the final cytotoxic product had a specific activity of 7.8 x 10(8) units/mg protein and showed a single protein band with an estimated molecular weight of 163,000 when subjected to sds-page. immunoelectrophoresis of the final product showed a single precipitin arc. the addition of cytotoxin b to imi ... | 1990 | 2365093 |
| surface blebbing and cytoskeletal changes induced in vitro by toxin b from clostridium difficile: an immunochemical and ultrastructural study. | clostridium difficile toxin b is a powerful cytopathic agent without enterotoxic activity which is believed to be involved in the pathogenesis of pseudomembranous colitis. up until today, the mechanisms of toxin b cytotoxicity have not been elucidated. the results of in vitro studies performed on different cell lines by means of immunocytochemical and ultrastructural methods are reported here. low doses (0.15 ng/ml) of toxin b cause cell rounding and arborization. higher doses (up to 15 microgra ... | 1990 | 2369937 |
| characterization of toxins a and b of clostridium difficile with monoclonal antibodies. | two monoclonal antibodies (mabs) were used to learn more about the structures of clostridium difficile toxins a and b. one of the antibodies, the pcg-4 mab, reacted specifically with toxin a. this mab precipitated toxin a and neutralized the enterotoxic but not the cytotoxic activity of the toxin. the site to which the antibody bound was resistant to denaturation with sodium dodecyl sulfate; however, it was destroyed by n-bromosuccinimide. immunoblot analysis with the pcg-4 mab revealed the pres ... | 1986 | 2428753 |
| immunoblotting to demonstrate antigenic and immunogenic differences among nine standard strains of clostridium difficile. | the epidemiology of clostridium difficile-associated disease is being elucidated with the development of typing schemes for the organism. we recently described a new typing scheme based on the incorporation of [35s]methionine into bacterial proteins followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography. nine standard strains were identified. we report here some observations on the antigenic differences among these nine strains when studied by immunoblotting. t ... | 1986 | 2428826 |
| stimulation of enzyme secretion from isolated pancreatic acini by clostridium difficile toxin b. | exposure of isolated rat pancreatic acini to increasing concentrations (10 ng - 800 ng/ml) of toxin b from clostridium difficile produced a biphasic effect on the rate of secretion of amylase, trypsinogen, and chymotrypsinogen. whereas doses of toxin b from 10-30 ng/ml increased enzyme secretion by 15-20%, doses between 30 ng and 60 ng/ml showed a regression of this effect, whereafter the rate of secretion of amylase, trypsinogen, and chymotrypsinogen increased with increasing concentrations of ... | 1986 | 2432695 |
| immunochemical and structural similarities in toxin a and toxin b of clostridium difficile shown by binding to monoclonal antibodies. | clostridium difficile toxins a and b were shown to share immunochemical and structural features, including shared sequential epitopes. nineteen hybridomas generated after immunization of mice with a mixture of toxoids produced monoclonal antibodies, all igm(x), which bound to toxin a and toxin b in a solid-phase radioimmunoassay (ria). none of the antibodies neutralized the cytotoxicity of either toxin, alone or in pairs, nor did they neutralize mouse lethality. the antibodies did not inhibit he ... | 1988 | 2459808 |
| identification and characterization of clostridium difficile promoter element that is functional in escherichia coli. | the promoter element involved in the expression of a previously characterized cloned clostridial antigen was isolated and characterized. a restriction fragment containing the promoter element of the clostridium difficile insert was cloned using the promoter probe vector, pga46. subclones of the clostridial dna insert in pga46 were then analyzed by nucleotide sequencing and by s1 nuclease experiments. the clostridial promoter element exhibits a high degree of homology with typical escherichia col ... | 1988 | 2463955 |
| purification of two high molecular weight toxins of clostridium difficile which are antigenically related. | two cl. difficile toxins were isolated from cultures of cl. difficile strain vpi 10463. a purification procedure to prepare homogenous cl. difficile toxins is given. this procedure allows purification of high molecular weight toxins a and b without using immunaffinity chromatography. the main step of the purification is the separation of a partially purified toxin preparation over a fplc-mono q column by anion exchange chromatography. the experimental conditions for a rechromatography were deter ... | 1987 | 2467163 |
| [laboratory methods of diagnosing pseudomembranous colitis and diarrhea caused by clostridium difficile (review of the literature)]. | | 1989 | 2469839 |
| clostridium difficile toxin b: characterization and sequence of three peptides. | the cytotoxin, also named toxin b, was isolated from a toxigenic strain of clostridium difficile, purified to homogeneity and partially characterized. the purification procedure included ultrafiltration followed by anion-exchange chromatography. we noticed that a non-specific nucleic material eluted with the protein during the purification. the presence of these nucleic acids appeared to be important for the toxic activity of the protein. some characteristics of the cytotoxin were examined, espe ... | 1989 | 2474559 |
| diagnostic procedures for isolation and characterization of clostridium difficile associated with enterocolitis in foals. | | 1989 | 2488656 |
| [enumeration and identification of clostridium from stools treated with the thioglycollate-lysozyme method]. | we have used spore isolation by the sodium thioglycolate-lysozyme technique on collected stools. of the 51 stools studied, we found 41% of clostridium perfringens with an average ratio of 10(4) germs/gr. 15 strains were typical double hemolysis and trehalose positive-5 presented only one hemolysis and were trehalose negative. we only found a single strain of clostridium difficile with a rate of 10(4) germs/gr in the stools of a 10 months infant. | 1989 | 2489405 |