| [clostridium difficile nosocomial diarrhoea--side-effect of antibiotic administration]. | c. difficile is recognised as the main cause for colitis in hospitalised patients which are treated with antibiotics, chemotherapics or other drugs that disturb intestinal microbiota. thus, a rapid and correct diagnostic of clostridium difficile infections is essential for preventing nosocomial infection spread. empiric therapy, regardless of the laboratory investigation results, is inadequate, especially in epidemic situations, as not all the cases of diarrhoea are due to c. difficile infection ... | 2010 | 21553478 |
| clostridium difficile diarrhea and fecal transplantation. | | 2011 | 21555950 |
| modified fecal transplantation. | | 2011 | 21555954 |
| epidemiological model for clostridium difficile transmission in healthcare settings. | objective. recent outbreaks of clostridium difficile infection (cdi) have been difficult to control, and data indicate that the importance of different sources of transmission may have changed. our objectives were to evaluate the contributions of asymptomatic and symptomatic c. difficile carriers to new colonizations and to determine the most important epidemiological factors influencing c. difficile transmission. design, setting, and patients. retrospective cohort study of all patients admitted ... | 2011 | 21558767 |
| an evaluation of the impact of a single-dose intravenous immunoglobulin regimen in the treatment of clostridium difficile infections. | | 2011 | 21558782 |
| [prevention of antibiotic-associated diarrhea in children]. | one of the most frequent complications of antibiotic therapy is a diarrheal syndrome, which may be related both to the direct toxic effects of antibiotics on the gastrointestinal tract, and the activation of conditionally pathogenic intestinal flora. particular attention gets to present the problem of c. difficile-infection, which may be the consequence of the development of pseudomembranous colitis in both children and adults. the article presents current data on the prevalence, etiology, patho ... | 2011 | 21560397 |
| fidaxomicin for clostridium difficile infection. | | 2011 | 21561360 |
| fidaxomicin for clostridium difficile infection. | | 2011 | 21561361 |
| clospore: a liquid medium for producing high titers of semi-purified spores of clostridium difficile. | clostridium difficile continues to cause infections in healthcare and other settings. its spores survive well indoors and require sporicidal chemicals for infection control. however, proper testing of disinfectants is impeded due to difficulties in obtaining viable spores of high enough quality and titers to meet current regulations for sporicidal claims. a new liquid medium (clospore) has been developed, based on a systematic review of the compositions of 20 other available media. c. difficile ... | 2011 | 21563698 |
| imipenem-induced clostridium difficile diarrhea in a patient with chronic renal failure. | an 80-year-old man was diagnosed to have pneumonia and advanced chronic kidney disease. he presented with anuria and hemodialysis, by temporary femoral catheter, was initiated. he was empirically treated with imipenem/cilastatin 500 mg/24 h after hemodialysis. after 10 days of antibiotic intake, he developed severe diarrhea. diagnosis of clostridium difficile (cd)-associated diarrhea was confirmed by detection of the toxins a and b in his stool. imipenem therapy was discontinued; vancomycin 500 ... | 2011 | 21566316 |
| recurrent clostridium difficile infection: what are the treatment options? | clostridium difficile infection (cdi) is an increasing problem in hospitalized patients. recurrences of disease, despite the recommended treatments with metronidazole or vancomycin, are frequently seen and pose major problems for the clinical management of patients with cdi. evidence for efficient clinical cure and low recurrence rates with primary use of alternative antibacterial treatment, such as fidaxomicin and rifaximin, is growing and these treatment strategies need further exploration. th ... | 2011 | 21568363 |
| prevalence of clostridium difficile in horses. | fecal samples were collected to establish the apparent prevalence of clostridium difficile shedding in standardbred and thoroughbred racehorses housed at 4 racetracks and 2 breeding facilities, and in horses admitted to a referral large animal clinic. forty-one (7.59%) of 540 racetrack horses, seven (5.83%) of 120 breeding farm horses, and four (4.88%) out of 82 horses admitted to the referral clinic were culture-positive for c. difficile. an overall fecal culture prevalence of 7.01% for c. diff ... | 2011 | 21570780 |
| [clostridium difficile enteritis.] | introduction: clostridium difficile infection of the small intestine is infrequent. method: we present the first case of c. difficile enteritis (cde) diagnosed in spain and provide a review of the literature. results: a 30-year-old man underwent surgery for recurrence of a retroperitoneal germ cell tumor. seven days later the patient developed vomiting, diarrhea and, finally, intestinal obstruction due to pseudomembranes caused by cde. only 57 cases of cde have been reported in the literature. t ... | 2011 | 21571399 |
| the key sigma factor of transition phase, sigh, controls sporulation, metabolism and virulence factor expression in clostridium difficile. | toxin synthesis in clostridium difficile increases as cells enter into stationary phase. we first compared the expression profiles of strain 630e during exponential growth and at the onset of stationary phase and showed that genes involved in sporulation, cellular division, motility as well as carbon and amino acid metabolisms were differentially expressed under these conditions. we inactivated the sigh gene encoding an alternative sigma factor involved in the transition to post-exponential phas ... | 2011 | 21572003 |
| feruloylated and nonferuloylated arabino-oligosaccharides from sugar beet pectin selectively stimulate the growth of bifidobacterium spp. in human fecal in vitro fermentations. | the side chains of the rhamnogalacturonan i fraction in sugar beet pectin are particularly rich in arabinan moieties, which may be substituted with feruloyl groups. in this work the arabinan-rich fraction resulting from sugar beet pulp based pectin production was separated by amberlite xad hydrophobic interaction and membrane separation into four fractions based on feruloyl substitution and arabino-oligosaccharide chain length: short-chain (dp 2-10) and long-chain (dp 7-14) feruloylated and nonf ... | 2011 | 21574556 |
| a mouse relapse model of clostridium difficile infection. | clostridium difficile is the causative agent of primary and recurrent antibiotic-associated diarrhea and colitis in hospitalized patients. the disease is mainly caused by two exotoxins tcda and tcdb produced by the bacteria. recurrent c. difficile infection (cdi) constitutes one of the most significant clinical issues of this disease, and occurs in more than 20% of patients after the first episode, and may be increasing in frequency. however, there is no well-established animal model of cdi rela ... | 2011 | 21576341 |
| infective complications after transrectal ultrasound-guided prostate biopsy following a new protocol for antibiotic prophylaxis aimed at reducing hospital-acquired infections. | study type - therapy (case series) level of evidence 4 what's known on the subject? and what does the study add? • clostridium difficile infections have been a serious problem throughout the nhs and have forced clinicians to change the types of antibiotics they routinely prescribe. • ciprofloxacin is a good choice of prophylactic agent for trusp bx • co-amoxiclav and gentamicin have never been studied in combinations as prophylaxis for trusp bx. • co-amoxiclav and gentamicin in combination a ... | 2011 | 21592292 |
| clostridium difficile transcriptome analysis using pig ligated loop model reveals modulation of pathways not modulated in vitro. | a pig ligated loop model was used to analyze the in vivo transcriptome response of clostridium difficile. bacterial rna from the loops was retrieved at different times and was used for microarray analysis. several virulence-associated genes and genes involved in sporulation cascade were differentially expressed (de). in concordance with observed upregulation of toxin genes in microarray, enzyme-linked immunosorbent assay estimation of total toxin showed high amounts of toxin in the loops. severa ... | 2011 | 21592991 |
| differential binding and internalisation of clostridium difficile toxin a by human peripheral blood monocytes, neutrophils and lymphocytes. | colitis due to c. difficile infection is mediated by secreted toxins a and b and is characterised by infiltration by cells from the systemic circulation. the aim of our study was to investigate interactions between fluorescently labelled toxin a and peripheral blood monocytes, neutrophils and lymphocytes. purified toxin a was labelled with alexa fluor(®) 488 (toxin a(488) ) and incubated with isolated human peripheral blood mononuclear cells (pbmncs) or washed whole blood cells for varying time ... | 2011 | 21595735 |
| evaluation of automated repetitive-sequence-based pcr (diversilab) compared to pcr ribotyping for rapid molecular typing of community- and nosocomial-acquired clostridium difficile. | automated repetitive pcr (rep-pcr; diversilab) was compared to pcr ribotyping of the 16s-23s rna intergenic spacer of clostridium difficile (cd) as the "gold standard" method for cd typing. pcr products were separated on diversilab labchips (biomérieux, st. laurent, quebec, canada) utilizing a 2100 bioanalyzer (agilent technologies, santa clara, ca) operating the diversilab v1.4 assay. bioanalyzer data were exported to a secure diversilab website and analyzed with diversilab v3.4 software. repli ... | 2011 | 21596222 |
| use of alternative or adjuvant pharmacologic treatment strategies in the prevention and treatment of clostridium difficile infection. | infection with clostridium difficile is currently the leading cause of infectious diarrhea in hospitalized patients, and recent surveillance data indicate that c. difficile has surpassed methicillin-resistant staphylococcus aureus as the number one cause of hospital-acquired infections in some areas of the usa. in addition, concern over c. difficile has increased over the past decade due to the appearance of new hypervirulent strains. metronidazole and vancomycin have remained the treatments of ... | 2011 | 21596604 |
| colonoscopic fecal bacteriotherapy in the treatment of recurrent clostridium difficile infection--results and follow-up. | | 2011 | 21608450 |
| clostridium difficile infection: a comprehensive review. | clostridium difficile is one of the most important causes of healthcare acquired diarrhea. the disease spectrum caused by c. difficile infection ranges from mild, self-limited, illness to a severe, life-threatening colitis. the incidence of c. difficile associated disease has risen dramatically over the last decade, leading to increased research interest aiming at the discovery of new virulence factors and the development of new treatment and prevention regimens. this review summarizes the patho ... | 2011 | 21609252 |
| a possible oligosaccharide-conjugate vaccine candidate for clostridium difficile is antigenic and immunogenic. | nosocomial infections with the gram-positive pathogen clostridium difficile pose a major risk for hospitalized patients and result in significant costs to health care systems. here, we present the chemical synthesis of a ps-ii hapten of a cell wall polysaccharide of hypervirulent ribotype 027 of c. difficile. mice were immunized with a conjugate consisting of the synthetic hexasaccharide and the diphtheria toxoid variant crm(197). the immunogenicity of the glycan repeating unit was demonstrated ... | 2011 | 21609839 |
| binding of clostridium difficile toxins to human milk oligosaccharides. | the binding of recombinant fragments of the c-terminal cell-binding domains of the two large exotoxins, toxin a (tcda) and toxin b (tcdb), expressed by clostridium difficile and a library consisting of the most abundant neutral and acidic human milk oligosaccharides (hmos) was examined quantitatively at 25 °c and ph 7 using the direct electrospray ionization mass spectrometry (es-ms) assay. the results of the es-ms measurements indicate that both toxins fragments investigated, tcdb-b1 and tcda-a ... | 2011 | 21610194 |
| [luminal gastroenterology and inflammation.] | luminal inflammation of the intestine is a trigger of numerous gastrointestinal and non-gastrointestinal diseases. several mechanisms have an impact on luminal inflammation, such as antibiotic or immunosuppressive therapies. in this paper recent data and new therapeutic approaches are reported concerning gastrointestinal and non-gastrointestinal diseases, for example eosinophilic esophagitis, irritable bowel syndrome, crohn's disease and hepatic encephalopathy. in addition, recommendations are p ... | 2011 | 21611929 |
| super toxins from a super bug: structure and function of clostridium difficile toxins. | clostridium difficile, a highly infectious bacterium, is the leading cause of antibiotic-associated pseudomembranous colitis. in 2009, the number of death certificates mentioning c. difficile infection in the u.k. was estimated at 3933 with 44% of certificates recording infection as the underlying cause of death. a number of virulence factors facilitate its pathogenicity, among which are two potent exotoxins; toxins a and b. both are large monoglucosyltransferases that catalyse the glucosylation ... | 2011 | 21615333 |
| targeting the tcda gene: is this appropriate for detection of a and/or b clostridium difficile toxin-producing strains? | | 2011 | 21617002 |
| drug-related admissions and hospital-acquired adverse drug events in germany: a longitudinal analysis from 2003 to 2007 of icd-10-coded routine data. | abstract: background: adverse reactions and medication errors are complications of drug use. spontaneous reporting systems and pharmacoepidemiological studies incompletely detect the occurrence of these events in daily hospital care. in this study, the frequency and type of drug-related admissions and hospital-acquired adverse drug events (ade) in germany were assessed using routinely collected hospital data. methods: the study was based on aggregated hospital routine data covering the period 20 ... | 2011 | 21619706 |
| a case of hypocalcemia-related epilepsia partialis continua. | epilepsia partialis continua (epc) is a syndrome clinically defined as continuous spontaneous jerking confined to one part of the body, sometimes aggravated by action or sensory stimuli, occurring over hours, days or even years. in adults the more frequent recognized cause of epc is an acute cerebrovascular disease. acute severe hypocalcemia is a highly epileptogenic ionic disturbance, abnormally increasing neuronal excitability. in this short communication we describe the first probable case of ... | 2011 | 21621427 |
| clinical clostridium difficile: clonality and pathogenicity locus diversity. | clostridium difficile infection (cdi) is an important cause of mortality and morbidity in healthcare settings. the major virulence determinants are large clostridial toxins, toxin a (tcda) and toxin b (tcdb), encoded within the pathogenicity locus (paloc). isolates vary in pathogenicity from hypervirulent pcr-ribotypes 027 and 078 with high mortality, to benign non-toxigenic strains carried asymptomatically. the relative pathogenicity of most toxigenic genotypes is still unclear, but may be infl ... | 2011 | 21625511 |
| effective utilization of evolving methods for the laboratory diagnosis of clostridium difficile infection. | physicians should understand the performance characteristics of evolving laboratory tests used to diagnose clostridium difficile infection if they are to correctly integrate test results with clinical information and formulate an appropriate therapeutic intervention for patients with antibiotic-associated diarrhea. | 2011 | 21628487 |
| prsw is required for colonization, resistance to antimicrobial peptides and expression of extra-cytoplasmic function {sigma} factors in clostridium difficile. | clostridium difficile is an anaerobic, gram-positive, spore-forming opportunistic pathogen which is the most common cause of hospital-acquired infectious diarrhea. in numerous pathogens, stress response mechanisms are required for survival within the host. extra-cytoplasmic function sigma (σ) factors (ecf σ factors) are a major family of signal transduction systems which sense and respond to extracellular stresses. we have identified three c. difficile ecf σ factors. these ecf σ factors csft, cs ... | 2011 | 21628514 |
| reutericyclin and related analogues kill stationary phase clostridium difficile at achievable colonic concentrations. | objectives the stationary phase of clostridium difficile, which is associated with the symptoms of the diarrhoeal disease, is refractory to antibiotic killing. the aim of this study was to explore whether probiotic-derived reutericyclin and related synthetic analogues could kill stationary phase c. difficile at concentrations achievable in the gastrointestinal tract. methods the bactericidal activities of reutericyclin and lead compound derivatives were examined against logarithmic and stationar ... | 2011 | 21632577 |
| use of modified pcr ribotyping for detection of clostridium difficile ribotypes directly in stool samples. | pcr ribotyping was modified to allow direct detection of clostridium difficile from stool samples. direct pcr ribotyping was possible in 86 out of 99 c. difficile positive stool samples and in 84 cases (84,8%) the ribotype determined directly from the stool sample was identical to the ribotype of the strain isolated from the same stool sample. | 2011 | 21632902 |
| prophylactic antibiotics for variceal hemorrhage: clostridium difficile infection still can be a risk. | bron et al presented a retrospective study regarding the prophylactic use of antibiotics for variceal hemorrhage. antibiotics appeared to improve the survival rate of patients without increasing clostridium difficile infection (cdi). we argue against the conclusion of the authors and consider that this result may be simply due to concurrent use of metronidazole, a therapeutic agent against cdi. | 2011 | 21633604 |
| isolation of the first three cases of clostridium difficile polymerase chain reaction ribotype 027 in singapore. | introduction: the incidence of clostridium (c.) difficile infection (cdi) was on the rise from 2001 to 2006 in singapore. recent unpublished data suggests that its incidence had remained stable or decreased in most local public hospitals between 2006 and 2010. it is, however, not known if the polymerase chain reaction (pcr) ribotype 027 strains have been circulating, although reports suggest that this strain is emerging in asia, with the first cases reported from japan in 2007, as well as in hon ... | 2011 | 21633771 |
| characterization of a sugar-o-methyltransferase tias5 affords new tiacumicin analogues with improved antibacterial properties and reveals substrate promiscuity. | the 18-membered macrocyclic glycoside tiacumicin b, an rna polymerase inhibitor, is of great therapeutic significance in treating clostridium difficile infections. the recent characterization of the tiacumicin b biosynthetic gene cluster from dactylosporangium aurantiacum subsp. hamdenensis nrrl 18085 revealed the functions of two glycosyltransferases, a c-methyltransferase, an acyltransferase, two cytochrome p450s, and a tailoring dihalogenase in tiacumicin biosynthesis. here we report the gene ... | 2011 | 21633995 |
| repeat stool testing to diagnose clostridium difficile infection using enzyme immunoassay does not increase diagnostic yield. | background & aims: clostridium difficile infection (cdi) is a hospital-acquired infection with increasing incidence and severity. the most frequently used test to diagnose cdi is an enzyme immunoassay (eia) for toxins a and b in stool samples. it is common to test 2 or more stool samples, based on the assumption that this detects cdi with greater sensitivity than analysis of 1 sample. we investigated whether repeat stool testing significantly improves the diagnostic yield for cdi. methods: we pe ... | 2011 | 21635969 |
| two-step algorithm for the detection of clostridium difficile from stool samples. | | 2011 | 21636166 |
| current level of consensus on probiotic science-report of an expert meeting- london, 23 november 2009. | the present paper summarizes the consensus views of a group of 9 european clinicians and scientists on the current state of scientific knowledge on probiotics, covering those areas where there is substantial evidence for beneficial effects and those where the evidence base is poor or inconsistent. there was general agreement that probiotic effects were species and often strain specific. the experts agreed that some probiotics were effective in reducing the incidence and duration of rotavirus ... | 2010 | 21637035 |
| reduction in the microbial load on high-touch surfaces in hospital rooms by treatment with a portable saturated steam vapor disinfection system. | background: recent scientific literature suggests that portable steam vapor systems are capable of rapid, chemical-free surface disinfection in controlled laboratory studies. this study evaluated the efficacy of a portable steam vapor system in a hospital setting. methods: the study was carried out in 8 occupied rooms of a long-term care wing of a hospital. six surfaces per room were swabbed before and after steam treatment and analyzed for heterotrophic plate count (hpc), total coliforms, methi ... | 2011 | 21641089 |
| epidemiology of clostridium difficile on a veal farm: prevalence, molecular characterization and tetracycline resistance. | concern has been raised about the potential for clostridium difficile to be a bovine and foodborne pathogen, yet limited study has been performed in cattle, and none in veal calves. this study evaluated the epidemiology and microbiology of c. difficile on one veal farm. rectal swabs were obtained from calves within 48h of arrival and at one, 17 and 21 weeks later. selective culture for c. difficile was performed. isolates were characterized by pcr ribotyping and pcr for tcda, tcdb and cdta. tetr ... | 2011 | 21641131 |
| decline in incidence of clostridium difficile infection after relocation to a new hospital building with single rooms. | | 2011 | 21641679 |
| low risk of clostridium difficile infections in hospitalized patients with inflammatory bowel disease in a german tertiary referral center. | introduction: many reports, mainly from the us and canada but also a recent report from a center in europe, have documented the increasing impact of clostridium difficile infections in patients with inflammatory bowel disease (ibd) during the last years. to determine the prevalence of c. difficile infections in hospitalized ibd patients in a tertiary referral center in germany, we conducted this retrospective analysis. methods: data of all ibd in-patients treated due to an acute flare of their i ... | 2011 | 21646782 |
| probiotics for prevention of antibiotic-associated diarrhea and clostridium difficile-associated disease in hospitalized adults-a meta-analysis. | purpose: a serious complication associated with the use of most antibiotics is antibiotic-associated diarrhea (aad). the purpose of this article is to report findings from a meta-analysis of available studies on adult hospitalized populations to evaluate efficacy of probiotics for prevention of aad and clostridium difficile-associated disease (cdad). data sources: a comprehensive, systematic search was conducted to identify all relevant studies on probiotic efficacy for prevention of aad and cda ... | 2011 | 21649768 |
| the impact of icd-9-cm code rank order on the estimated prevalence of clostridium difficile infections. | us estimates of the clostridium difficile infection (cdi) burden have utilized international classification of disease, ninth revision, clinical modification (icd-9-cm) diagnosis codes. whether icd-9-cm code rank order affects cdi prevalence estimates is important because the national hospital discharge survey (nhds) and the nationwide inpatient sample (nis) have varying limits on the number of icd-9-cm codes collected. | 2011 | 21653298 |
| cumulative antibiotic exposures over time and the risk of clostridium difficile infection. | clostridium difficile infection (cdi) is a major cause of hospital-acquired diarrhea and is most commonly associated with changes in normal intestinal flora caused by administration of antibiotics. few studies have examined the risk of cdi associated with total dose, duration, or number of antibiotics while taking into account the complex changes in exposures over time. | 2011 | 21653301 |
| country-to-country transfer of patients and the risk of multi-resistant bacterial infection. | management of patients with a history of healthcare contact in multiple countries is now a reality for many clinicians. leisure tourism, the burgeoning industry of medical tourism, military conflict, natural disasters, and changing patterns of human migration may all contribute to this emerging epidemiological trend. such individuals may be both vectors and victims of healthcare-associated infection with multiresistant bacteria. current literature describes intercountry transfer of multiresistan ... | 2011 | 21653302 |
| harnessing the glucosyltransferase activities of clostridium difficile for functional studies of toxins a and b. | the incidence of clostridium difficile infection (cdi) has been increasing within the last decade. pathogenic strains of c. difficile produce toxin a and/or toxin b, which are important virulence factors in the pathogenesis of this bacterium. current methods for diagnosing cdi are mostly qualitative tests that detect either the bacterium or the toxins. we have developed an assay (cdifftox activity assay) to detect c. difficile toxin a and b activities that is quantitative and cost-efficient and ... | 2011 | 21653766 |
| bowel preparation for colectomy and risk of clostridium difficile infection. | mechanical bowel preparation before colectomy is controversial for several reasons, including a theoretically increased risk of clostridium difficile infection. | 2011 | 21654247 |
| clostridium difficile--a moving target. | clostridium difficile has been recognized as a pathogen in humans for over 40 years, but in the past decade the incidence has increased and, more importantly, the clinical presentation and consequences have become more serious, with increased morbidity and mortality. the emergence of a new, more pathogenic strain, bi/nap1/027, has driven these shifts. treatment of this disease has been with two antibiotics, metronidazole and vancomycin, but increasing recurrence, not uncommon with c. difficile i ... | 2011 | 21654927 |
| advantages and challenges of increased antimicrobial copper use and copper mining. | copper is a highly utilized metal for electrical, automotive, household objects, and more recently as an effective antimicrobial surface. copper-containing solutions applied to fruits and vegetables can prevent bacterial and fungal infections. bacteria, such as salmonellae and cronobacter sakazakii, often found in food contamination, are rapidly killed on contact with copper alloys. the antimicrobial effectiveness of copper alloys in the healthcare environment against bacteria causing hospital-a ... | 2011 | 21656137 |
| tn916-like genetic elements: a diverse group of modular mobile elements conferring antibiotic resistance. | antibiotic-resistant gram-positive bacteria are responsible for morbidity and mortality in healthcare environments. enterococcus faecium, enterococcus faecalis, staphylococcus aureus and streptococcus pneumoniae can all exhibit clinically relevant multidrug resistance phenotypes due to acquired resistance genes on mobile genetic elements. it is possible that clinically relevant multidrug-resistant clostridium difficile strains will appear in the future, as the organism is adept at acquiring mobi ... | 2011 | 21658082 |
| zero prevalence of clostridium difficile in wild passerine birds in europe. | clostridium difficile is an important bacterial pathogen of humans and a variety of animal species, where it can cause significant medical problems. the major public health concern is the possibility of inapparent animal reservoirs of c. difficile and shedding of bacteria to noninfected individuals or populations, as well as being a source of food contamination. migrating birds can be a key epizootiological factor for transmission and distribution of pathogens over a wide geographic range. there ... | 2011 | 21658108 |
| clostridium difficile has two parallel and essential sec secretion systems. | protein translocation across the cytoplasmic membrane is an essential process in all bacteria. the sec system, comprising at its core an atpase, seca, and a membrane channel, secyeg, is responsible for the majority of this protein transport. recently, a second parallel sec system has been described in a number of gram-positive species. this accessory sec system is characterized by the presence of a second copy of the energizing atpase, seca2; where it has been studied, seca2 is responsible for t ... | 2011 | 21659510 |
| encapsulation of cwp84 into pectin beads for oral vaccination against clostridium difficile. | we have designed an oral vaccine against clostridium difficile infection. the virulent factor cwp84, that is a cystein protease highly immunogenic in patients with c. difficile-associated disease, was entrapped within pectin beads. beads encapsulating cwp84 were shown to be stable in the simulated intestinal medium and to release the cystein protease once in the simulated colonic medium. three groups of hamsters were immunized, the first receiving pectin beads encapsulating cwp84, the second unl ... | 2011 | 21664462 |
| in vivo lysogenization of a clostridium difficile bacteriophage ðñcd119. | clostridium difficile is a nosocomial pathogen identified as the cause of antibiotic-associated diarrhea and colitis. in this study, we have documented the lysogeny of a c.┬ádifficile bacteriophage in hamsters during c.┬ádifficile infection. the lysogens isolated from the hamsters were toxin typed and their phage integration site was confirmed by pcr. through toxin elisa it was found that the toxin production in the in┬ávivo isolated lysogens was affected due to ðñcd119 lysogenization as in the ... | 2011 | 21664468 |
| clostridium difficile in children: colonisation and disease. | clostridium difficile is the commonest cause of hospital acquired diarrhoea in adults and is associated with significant mortality and morbidity. the clinical significance of c. difficile in children, however, is less certain. in this article we discuss colonisation and infection and describe c. difficile in childhood in terms of risk factors, epidemiology and management. | 2011 | 21664931 |
| using electronic health information to risk-stratify rates of clostridium difficile infection in us hospitals. | expanding hospitalized patients' risk stratification for clostridium difficile infection (cdi) is important for improving patient safety. we applied definitions for hospital-onset (ho) and community-onset (co) cdi to electronic data from 85 hospitals between january 2007 and june 2008 to identify factors associated with higher ho cdi rates. | 2011 | 21666394 |
| clostridium difficile infection in a long-term care facility: hospital-associated illness compared with long-term care-associated illness. | controversy exists over whether clostridium difficile infection (cdi) commonly occurs in long-term care facility residents who have not been recently transferred from an acute care hospital. | 2011 | 21666395 |
| the role played by contaminated surfaces in the transmission of nosocomial pathogens. | studies in the 1970s and 1980s suggested that environmental surface contamination played a negligible role in the endemic transmission of healthcare-associated infections. however, recent studies have demonstrated that several major nosocomial pathogens are shed by patients and contaminate hospital surfaces at concentrations sufficient for transmission, survive for extended periods, persist despite attempts to disinfect or remove them, and can be transferred to the hands of healthcare workers. e ... | 2011 | 21666400 |
| using oral vancomycin prescriptions as a proxy measure for clostridium difficile infections: a spatial and time series analysis. | sales for a drug may be correlated with the prevalence of a condition treated by the drug. we found that state data revealed a strong spatial association and national data a strong temporal association between clostridium difficile and oral vancomycin prescription sales, suggesting a new "signal" for detecting disease activity. | 2011 | 21666407 |
| serum markers for severe clostridium difficile infection in immunosuppressed hospitalized patients. | clostridium difficile infection (cdi) has emerged as the leading cause of nosocomial diarrhea in the developed world. the prompt recognition of severe cdi is essential in providing early aggressive therapy. though previous studies have identified leukocytosis, azotemia, and hypoalbuminemia as markers to differentiate severe from non-severe cdi in the general patient population, there is little data in immunosuppressed patients. we conducted a retrospective chart review of immunosuppressed patien ... | 2011 | 21667802 |
| the economic burden of clostridium difficile. | clin microbiol infect abstract: although clostridium difficile (c. difficile) is the leading cause of infectious diarrhoea in hospitalized patients, the economic burden of this major nosocomial pathogen for hospitals, third-party payers and society remains unclear. we developed an economic computer simulation model to determine the costs attributable to healthcare-acquired c. difficile infection (cdi) from the hospital, third-party payer and societal perspectives. sensitivity analyses explored ... | 2011 | 21668576 |
| multi-locus variable number tandem repeat analysis for investigation of the genetic association of clostridium difficile isolates from food, food animals and humans. | clostridium difficile is the primary known cause of antibiotic-associated diarrhea. diarrheal disease in food animals due to c. difficile infection has been well documented. recently, reports of c. difficile infections in patients with no known risk factors for disease have raised concern of community acquisition through food animals and food. in this study, multi-locus variable number tandem repeat analysis (mlva) was performed on a collection of 97c. difficile isolates of human, animal and ... | 2011 | 21669297 |
| practice of gastroenterologists in treating flaring inflammatory bowel disease patients with clostridium difficile: antibiotics alone or combined antibiotics/immunomodulators? | the optimal management of clostridium difficile infection (cdi) in flaring inflammatory bowel disease (ibd) patients has not been defined. limited data suggest that coadministration of immunomodulators (im) with antibiotics (ab) results in a worse outcome. we investigated the prevalent practice among north american gastroenterologists in this scenario. | 2011 | 21674710 |
| clostron-mediated engineering of clostridium. | the genus clostridium is a diverse assemblage of gram positive, anaerobic, endospore-forming bacteria. whilst certain species have achieved notoriety as important animal and human pathogens (e.g. clostridium difficile, clostridium botulinum, clostridium tetani, and clostridium perfringens), the vast majority of the genus are entirely benign, and are able to undertake all manner of useful biotransformations. prominent amongst them are those species able to produce the biofuels, butanol and ethano ... | 2011 | 21815105 |
| the emergence of clostridium difficile infection among peripartum women: a case-control study of a c. difficile outbreak on an obstetrical service. | objective. an outbreak of 20 peripartum clostridium difficile infections (cdi) occurred on the obstetrical service at the university of washington medical center (uwmc) between april 2006 and june 2007. in this report, we characterize the clinical manifestations, describe interventions that appeared to reduce cdi, and determine potential risk factors for peripartum cdi. methods. an investigation was initiated after the first three peripartum cdi cases. based on the findings, enhanced infection c ... | 2011 | 21811379 |
| fidaxomicin: first-in-class macrocyclic antibiotic. | the incidence of clostridium difficile has doubled over the past 15 years, and rising mortality rates associated with this infection have followed in its wake. c. difficile infection (cdi) has supplanted methicillin-resistant staphylococcus aureus as the major cause of nosocomial infection. an insufficient response rate to currently available cdi therapies has prompted the search for new and alternative treatment modalities for this disease. the investigational pipeline includes evaluation of ne ... | 2011 | 21810048 |
| molecular epidemiology of clostridium difficile in a tertiary medical center in israel: emergence of the polymerase chain reaction ribotype 027. | the rate of infection with clostridium difficile colitis and its associated mortality have been increasing in the last decade. the molecular epidemiology of c. difficile in israel has not been studied. | 2011 | 21809729 |
| the management of clostridium difficile-associated diarrhoea in a community hospital. | to review the management of patients with clostridium difficile-associated diarrhoea (cdad). | 2011 | 21809713 |
| clostridium difficile infection causing multiple organ failure and small-bowel enteritis. | | 2011 | 21809490 |
| a call to arms: the imperative for antimicrobial stewardship. | antimicrobial resistance is a major public health crisis. the prevalence of drug-resistant organisms, such as the emerging nap1 strain of clostridium difficile, now highly resistant to fluoroquinolones, acinetobacter species, klebsiella pneumoniae carbapenemase-producing organisms, and methicillin-resistant staphylococcus aureus, is increasing nationwide. the sources of antimicrobial resistance are manifold, but there is a well-documented causal relationship between antimicrobial use and misuse ... | 2011 | 21795727 |
| the insect peptide, coprisin, prevents clostridium difficile-mediated acute inflammation and mucosal damage through selective antimicrobial activity. | clostridium difficile-associated diarrhea and pseudomembranous colitis are typically treated with vancomycin or metronidazole, but recent increases in relapse incidence and the appearance of drug-resistant strains of c. difficile indicate the need for new antibiotics. we previously isolated an antibacterial peptide from copris tripartitus, a korean dung beetle, and identified a nine-amino-acid peptide (coprisin: llcialrkk) that had antimicrobial activity. here, we examined whether coprisin treat ... | 2011 | 21807975 |
| clostridium difficile-associated diarrhea in radiooncology: an underestimated problem for the feasibility of the radiooncological treatment? | abstract: background and purpose: over the last years an increasing incidence of clostridium difficile-associated diarrhea (cdad) has been reported. especially haematology-oncology patients are at risk of developing cdad. the aim of this analysis is to determine the incidence of cdad in radiooncological patients and to find out what relevance cdad has for the feasibility of the radiooncological treatment, as well as to detect and describe risk factors. patients and methods: in a retrospective an ... | 2011 | 21806799 |
| the interplay between microbiome dynamics and pathogen dynamics in a murine model of clostridium difficile infection. | clostridium difficile infection (cdi) arises in the setting of antibiotic administration where disruption of the normal indigenous gut microbiota leads to susceptibility to c. difficile colonization and colitis. using a murine model of cdi, we demonstrate that changes in the community structure of the indigenous gut microbiota are associated with the loss of colonization resistance against c. difficile. several antibiotic regimens were tested in combination for the ability to overcome colonizati ... | 2011 | 21804357 |
| both, toxin a and toxin b, are important in clostridium difficile infection. | the bacterium clostridium difficile is the leading cause of healthcare associated diarrhoea in the developed world and thus presents a major financial burden. the main virulence factors of c. difficile are two large toxins, a and b. over the years there has been some debate over the respective roles and importance of these two toxins. to address this, we recently constructed stable toxin mutants of c. difficile and found that they were virulent if either toxin a or toxin b was functional. this u ... | 2011 | 21804353 |
| disinfection methods for spores of bacillus atrophaeus, b. anthracis, clostridium tetani, c. botulinum and c. difficile. | to evaluate disinfection methods for environments contaminated with bioterrorism-associated microorganism (bacillus anthracis), we performed the following experiments. first, the sporicidal effects of sodium hypochlorite on spores of five bacterial species were evaluated. bacillus atrophaeus was the most resistant to hypochlorite, followed in order by b. anthracis, clostridium botulinum and clostridium tetani, and clostridium difficile. subsequently, using b. atrophaeus spores that were the most ... | 2011 | 21804226 |
| structure-based modification of a clostridium difficile targeting endolysin affects activity and host range. | endolysin cd27l causes cell lysis of the pathogen c. difficile, a major cause of nosocomial infection. we report a structural and functional analysis of the catalytic activity of cd27l against c. difficile and other bacterial strains. we show that truncation of the endolysin to the n-terminal domain cd27l(1-179) gave an increased lytic activity against cells of c. difficile, while the c-terminal region cd27l(180-270) failed to produce lysis. cd27l(1-179) also has increased activity against other ... | 2011 | 21803993 |
| evaluation of the sporicidal activity of different chemical disinfectants used in hospitals against clostridium difficile. | decontamination of surfaces and medical equipment is integral to the control of clostridium difficile transmission, and many products claim to inactivate this bacterium effectively. thirty-two disinfectants were tested against spores of c. difficile in a suspension test based on european standard bs en 13704:2002, with contact times of 1 and 60min in simulations of clean (0.3% albumin) and dirty (3% albumin) conditions. the addition of a 1-min contact time was chosen as a more realistic simulati ... | 2011 | 21802172 |
| fidaxomicin-the next step? a new narrow-spectrum macrocyclic antibiotic for the management of clostridium difficile infection. | | 2011 | 21801724 |
| mortality and associated risk factors in consecutive patients admitted to a uk nhs trust with community acquired bacteraemia. | purpose within the uk, there is lack of contemporary data on clinical outcomes in patients admitted to hospital with severe community acquired infection. the purpose of this study was to determine outcomes and risk factors associated with mortality in consecutive patients admitted to a uk nhs trust with community acquired infections that cause bacteraemia. methods from september 2007 to august 2008, demographic, clinical and microbiological data were collected on patients with laboratory confirm ... | 2011 | 21798969 |
| high alpha-1 antitrypsin clearance predicts severity of gut graft-versus-host disease (gvhd) in children. | hagen lem, schechter t, luk y, brodovitch a, gassas a, doyle jj. high alpha-1 antitrypsin clearance predicts severity of gut graft-versus-host disease (gvhd) in children. pediatr transplantation 2011. © 2011 john wiley & sons a/s. abstract: the clinical evaluation and management of gut gvhd is a significant challenge in pediatric hsct. it is often difficult to obtain pathological evidence to confirm diagnosis and/or to determine response to treatment. the severity of the disease itself may not ... | 2011 | 21797957 |
| expression, purification, crystallization and preliminary crystallographic analysis of a putative clostridium difficile surface protein cwp19. | cwp19 is a putatively surface-located protein from clostridium difficile. a recombinant n-terminal protein (residues 27-401) lacking the signal peptide and the c-terminal cell-wall-binding repeats (pfam04122) was crystallized using the sitting-drop vapour-diffusion method and diffracted to 2 å resolution. the crystal appeared to belong to the primitive monoclinic space group p2(1), with unit-cell parameters a = 109.1, b = 61.2, c = 109.2 å, ß = 111.85°, and is estimated to contain two molecules ... | 2011 | 21795789 |
| a clostridium difficile infection "intervention": change in toxin assay results in fewer c difficile infection cases without changes in patient outcomes. | background: clostridium difficile infection (cdi) is most commonly diagnosed using toxin enzyme immunoassays (eias). a sudden decrease in cdi incidence was noted after a change in the eia used at barnes-jewish hospital in st louis. the objective of this study was to determine whether the decreased cdi incidence related to the change in eia resulted in adverse patient outcomes. methods: electronic hospital databases were used to collect data on demographics, outcomes, and treatment of inpatients ... | 2011 | 21794950 |
| [risk factors for clostridium difficile infections in hospitalized patients.] | background and objectives: to identify risk factors, and to estimate the crude effects attributable to hospital acquired clostridium difficile infection (cdi). patients and methods: case-control study matched by age, gender, and admission date. patient and healthcare risk factors were evaluated. hospital stays and mortality were compared. results: thirty-eight cases and 76 controls were included (mean age 73 years). cases presented worse charlson index (p .02), higher pre-infection stay (median ... | 2011 | 21794881 |
| impact of a multipronged education strategy on antibiotic prescribing in quebec, canada. | background. antibiotic overuse and resistance have become a major threat in the last 2 decades. many programs tried to optimize antibiotic consumption in the inpatient setting, but the outpatient environment that represents the bulk of antibiotic use has been challenging. following a significant rise of clostridium difficile infections, all the health care stakeholders in the province of quebec, canada initiated a global education program targeting physicians and pharmacists. methods. a bundle a ... | 2011 | 21791439 |
| clostridium difficile and methicillin-resistant staphylococcus aureus shedding by slaughter-age pigs. | abstract: background: clostridium difficile and methicillin-resistant staphylococcus aureus are critical human pathogens and of increasing concern in food animals. because of the apparent impact of age on prevalence of these organisms, studies of slaughter age pigs are important when considering the potential for contamination of food. this study evaluated c. difficile and mrsa shedding by slaughter age pigs from farms across canada. results: clostridium difficile was isolated from 30/436 (6.9%) ... | 2011 | 21791057 |
| update on the management of ulcerative colitis. | the treatment options for inflammatory bowel disease have expanded with the introduction of biological therapies. recently published controlled clinical trials were searched and those that impact the clinical management of ulcerative colitis (uc) are discussed in this review. in the management of mild to moderate uc, mesalamine still remains the first choice of drug. the newly developed once daily formulations have shown equal efficacy to divided doses and possibly portend better compliance owin ... | 2011 | 21789495 |
| mutagenic analysis of the clostridium difficile flagellar proteins, flic and flid, and their contribution to virulence in hamsters. | although toxins a and b are known to be important contributors to the acute phase of clostridium difficile infection (cdi), the role of colonization and adherence to host tissues in the overall pathogenesis of these organisms remains unclear. consequently, we used the recently introduced intron-based clostron gene interruption system to eliminate the expression of two reported c. difficile colonization factors, the major flagellar structural subunit (flic) and the flagellar cap protein (flid), t ... | 2011 | 21788384 |
| role of faecal gas analysis for the diagnosis of ibd. | the diagnosis of ibd (inflammatory bowel disease) is based on the clinical evaluation of symptoms and signs leading to a series of investigations. the investigations used are often unpleasant for patients; they are invasive, costly and potentially dangerous. patients often report that the odour of flatus, or the gas emitted from faeces, is abnormal during a flare of their ibd. our group has characterized the vocs (volatile organic compounds) in the headspace gas emitted from faecal samples from ... | 2011 | 21787351 |
| a quantitative proteomic analysis of the heat stress response in <i>clostridium difficile</i> strain 630. | <i>clostridium difficile</i> is a serious nosocomial pathogen whose prevalence worldwide is increasing. post genomic technologies can now be deployed in order to develop understanding of the evolution and diversity of this important human pathogen, yet little is known about the adaptive ability of <i>c. difficile</i>. we used itraq labelling and 2d-lc-ms/ms driven proteomics to investigate the response of <i>c. difficile</i> 630 to a mild, but clinically relevant heat stress. a statistically val ... | 2011 | 21786815 |
| localization of the clostridium difficile cysteine protease cwp84 and insights into its maturation process. | clostridium difficile is a nosocomial pathogen involved in antibiotic-associated diarrhea. c. difficile expresses a cysteine protease, cwp84, which has been shown to degrade some proteins of the extracellular matrix and play a role in the maturation of the precursor of the s-layer proteins. we sought to analyze the localization and the maturation process of this protease. two identifiable forms of the protease were found to be associated in the bacteria: a form of about 80 kda and a cleaved one ... | 2011 | 21784932 |
| the relation between farm specific factors and prevalence of clostridium difficile in slaughter pigs. | foodborne ingestion through pork products of clostridium difficile has been suggested a possible route of transmission of c difficile from pigs to humans. to determine whether c. difficile bacteria are present in the intestines of slaughter pigs, rectum contents of 677 slaughter pigs from 52 farms were collected at the slaughterhouse. data on farm specific factors were collected and the association of these factors with the presence of c. difficile in pig herds from 39 farms was assessed. the pr ... | 2011 | 21783332 |
| direct detection of clostridium difficile 027 in diarrhoeal stool samples. | | 2011 | 21783275 |
| emergence of clostridium difficile ribotype 027 in korea. | clostridium difficile infection (cdi) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in north america and europe since 2003. the aims of this study were to determine the prevalence of ribotype 027 among c. difficile isolates in korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of cdi in patients infected with these isolates. | 2011 | 21779194 |
| the impact of recombination on dn/ds within recently emerged bacterial clones. | the development of next-generation sequencing platforms is set to reveal an unprecedented level of detail on short-term molecular evolutionary processes in bacteria. here we re-analyse genome-wide single nucleotide polymorphism (snp) datasets for recently emerged clones of methicillin resistant staphylococcus aureus (mrsa) and clostridium difficile. we note a highly significant enrichment of synonymous snps in those genes which have been affected by recombination, i.e. those genes on mobile elem ... | 2011 | 21779170 |
| comparison of a commercially available rep-pcr system (diversilab(r)) with pcr-ribotyping for typing of clostridium difficile strains. | this study compared a rep-pcr method (diversilab® system) to pcr-ribotyping. the discriminatory power of rep-pcr was 0.997. among the pcr-ribotype 027, different rep-types could be distinguished. rep-pcr showed a higher discriminatory power than pcr-ribotyping. nevertheless, this method requires technical skill and visual interpretation of rep-pcr fingerprint patterns may be difficult. | 2011 | 21775548 |
| at least it won't hurt: the personal risks of antibiotic exposure. | this review presents recent evidence regarding the adverse effects of antibiotic therapy mediated by collateral damage to commensal flora. two major drivers have characterized recent research in this field: new perspectives into human microbiota afforded by next-generation dna sequencing techniques and ongoing attention to antimicrobial resistance. new molecular techniques have illustrated that antibiotic therapy can disturb human microbiota, and that these changes are associated with infection. ... | 2011 | 21775205 |