spread and persistence of clostridium difficile spores during and after cleaning with sporicidal disinfectants. | | 2011 | 21775017 |
laboratory diagnosis of clostridium difficile infection: in a state of transition or confusion or both? | | 2011 | 21775016 |
multidrug resistance in european clostridium difficile clinical isolates. | objectives multidrug resistance and antibiotic resistance mechanisms were investigated in 316 clostridium difficile clinical isolates collected during the first european surveillance on c. difficile in 2005. methods mics of eight different antibiotics were determined using etest. reserpine- and carbonyl cyanide m-chlorophenylhydrazone-sensitive efflux was tested using the agar dilution method. molecular analysis of the resistance mechanisms was performed using pcr assays, pcr mapping and sequenc ... | 2011 | 21771851 |
awareness about clostridium difficile infection among internal medicine residents in the united states. | clostridium difficile infection (cdi) is the leading infective cause of antibiotic associated diarrhea. the principal objective of this study was to assess the knowledge and awareness of internal medicine (im) residents regarding the epidemiology, clinical recognition, diagnosis and management of cdi. | 2011 | 21769073 |
terminal decontamination of patient rooms using an automated mobile uv light unit. | objective. to determine the ability of a mobile uv light unit to reduce bacterial contamination of environmental surfaces in patient rooms. methods. an automated mobile uv light unit that emits uv-c light was placed in 25 patient rooms after patient discharge and operated using a 1- or 2-stage procedure. aerobic colony counts were calculated for each of 5 standardized high-touch surfaces in the rooms before and after uv light decontamination (uvld). clostridium difficile spore log reductions ac ... | 2011 | 21768755 |
membrane translocation of binary actin-adp-ribosylating toxins from clostridium difficile and clostridium perfringens is facilitated by cyclophilin a and hsp90. | some hypervirulent strains of clostridium difficile produce the binary actin-adp-ribosylating toxin cdt in addition to the rho-glucosylating toxins a and b. it has been suggested that the presence of cdt increases the severity of the c. difficile-associated diseases including pseudomembranous colitis. cdt contains a binding and translocation component cdtb, which mediates the transport of the separate enzyme component cdta into the cytosol of target cells, where cdta modifies actin. here, we hav ... | 2011 | 21768281 |
pneumocystis carinii interactions with lung epithelial cells and matrix proteins induce expression and activity of the pcste20 kinase with subsequent phosphorylation of the downstream cell wall biosynthesis kinase pccbk1. | eukaryotic cell proliferation and phenotype are highly regulated by contact dependent mechanisms. we have previously shown that the binding and interaction of the opportunistic fungal pathogen pneumocystis carinii (pc) to lung epithelial cells and extracellular matrix proteins induces mrna expression of both the map kinase pcste20 and the cell wall remodeling enzyme pccbk1 (16). herein, we report that in addition to up-regulation of pcste20 mrna expression, pneumocystis pcste20 kinase activity i ... | 2011 | 21768277 |
clostridium difficile infection after malaria chemoprophylaxis with doxycycline: is there an association? | malaria chemoprophylaxis with doxycycline is commonly used in the united kingdom and in many other countries. it is considered to be associated with an increased risk of clostridium difficile associated diarrhea (cdad). we describe a case of diarrhea and a positive stool assay for c. difficile in a returning traveler, and review available literature. the commonly held concept of an association between doxycycline chemoprophylaxis and cdad is not supported by available data. | 2011 | 21767993 |
reproducibility of broth microdilution and comparison to agar dilution for testing cb-183,315 against clinical isolates of clostridium difficile. | this study evaluated the reproducibility and agreement of broth microdilution to agar dilution (ad) for testing cb-183,315, a novel lipopeptide antibiotic for clostridium difficile. reproducibility was 100% within ± one 2-fold dilution for 10 strains tested; agreement was 90-95% within one 2-fold dilution with ad for 103 clinical isolates. | 2011 | 21767714 |
best strategies in recurrent or persistent clostridium difficile infection. | abstract background: clostridium difficile infection (cdi) is the primary cause of antibiotic-associated colitis and 15-25% of nosocomial antibiotic-associated diarrhea. its clinical manifestations can range from mild diarrhea to toxic megacolon, bowel perforation, septic shock, and death. over the past decade, more virulent strains have become increasingly common causes, and the incidence of cdi has risen, especially in elderly patients. these developments have led to an increase in recurrent c ... | 2011 | 21767157 |
clostridium difficile: trouble for adults and children. | | 2011 | 21765334 |
clinical and infection control implications of clostridium difficile infection with negative enzyme immunoassay for toxin. | in a prospective study of 132 patients with a diagnosis of clostridium difficile infection (cdi) by polymerase chain reaction, 43 (32%) had enzyme immunoassay (eia) results negative for toxin. eia-negative patients with cdi did not differ in clinical presentation from eia-positive patients and presented a similar risk for transmission of spores. | 2011 | 21765078 |
impact of changes in clostridium difficile diagnostic testing on detection of c. difficile infection and all england mandatory surveillance data. | following the report of the centre for evidence-based purchasing, which suggested poor performance of clostridium difficile testing kits, revised guidance was issued by the department of health (england) recommending a two-test algorithm. the aim of this study was to survey english national health service (nhs) diagnostic microbiology laboratories using an electronic questionnaire to investigate changes in laboratory procedures in response to the guidance and model the impact these changes had o ... | 2011 | 21764171 |
incidence of and risk factors for community-associated clostridium difficile infection: a nested case-control study. | abstract: background: clostridium difficile is the most common cause of nosocomial infectious diarrhea in the united states. however, recent reports have documented that c. difficile infections (cdis) are occurring among patients without traditional risk factors. the purpose of this study was to examine the epidemiology of ca-cdi, by estimating the incidence of ca-cdi and ha-cdi, identifying patient-related risk factors for ca-cdi, and describing adverse health outcomes of ca-cdi. methods: we co ... | 2011 | 21762504 |
genome mining for radical sam protein determinants reveals multiple sactibiotic-like gene clusters. | thuricin cd is a two-component bacteriocin produced by bacillus thuringiensis that kills a wide range of clinically significant clostridium difficile. this bacteriocin has recently been characterized and consists of two distinct peptides, trnβ and trnα, which both possess 3 intrapeptide sulphur to α-carbon bridges and act synergistically. indeed, thuricin cd and subtilosin a are the only antimicrobials known to possess these unusual structures and are known as the sactibiotics (sulplur to alpha ... | 2011 | 21760885 |
novel inhibitors of surface layer processing in clostridium difficile. | clostridium difficile, a leading cause of hospital-acquired bacterial infection, is coated in a dense surface layer (s-layer) that is thought to provide both physicochemical protection and a scaffold for host-pathogen interactions. the key structural components of the s-layer are two proteins derived from a polypeptide precursor, slpa, via proteolytic cleavage by the protease cwp84. here, we report the design, synthesis and in vivo characterization of a panel of protease inhibitors and activity- ... | 2011 | 21752656 |
[the use of immunoglobulins in the treatment of infectious diseases]. | the use of immunoglobulins in the treatment of infectious diseases has a long tradition. initially immunoglobulins from hyperimmunised animals were used for their antitoxic and antimicrobial activity. the development of preparations of human intravenous immunoglobulin (ivig) and the observations of their long-term use enabled to assess their usefulness in the treatment of the diseases of proven or probable infectious etiology. in the treatment of infectious diseases ivig are currently used as im ... | 2011 | 21751556 |
[the disease caused by clostridium difficile in geriatric patients]. | the disease caused by the bacterium clostridium difficile/clostridium difficile associated disease/diarrhoea (cdad) is becoming a serious problem especially in geriatric patients, who are now relatively often treated by broad-spectrum antibiotics. the goal of our study was to evaluate the occurrence of the risk factors and to evaluate the complex of relations and coherence which lead to the cdad disease in a selected group of seniors treated at our institution. | 2011 | 21751507 |
binary toxin and death after clostridium difficile infection. | we compared 30-day case-fatality rates for patients infected with clostridium difficile possessing genes for toxins a and b without binary toxin (n = 212) with rates for patients infected with c. difficile possessing genes for a, b, and binary toxin. the latter group comprised patients infected with strains of pcr ribotype 027 (cd027, n = 193) or non-027 (cd non-027, n = 72). patients with binary toxin had higher case-fatality rates than patients without binary toxin, in univariate analysis (rel ... | 2011 | 21749757 |
epidemic strains of clostridium difficile are present in auckland, new zealand. | | 2011 | 21747433 |
molecular epidemiology and susceptibility profiles of clostridium difficile in new zealand, 2009. | the aim of this study was to provide baseline information on the molecular epidemiology and the antimicrobial susceptibility of clostridium difficile (c. difficile) clinical isolates from patients throughout new zealand. | 2011 | 21747423 |
identification of a novel virulence factor in clostridium difficile modulating toxin sensitivity of cultured epithelial cells. | two glucosylating toxins named toxins a and b play a role in pathogenesis of clostridium difficile infection. the interaction of the toxins with host cell factors proceeds to downstream stages of cytotoxic effects in cells, in which involvement of other c. difficile factors remains unknown. we utilized culture filtrate of c. difficile with a low dilution to characterize the influence of putative minor proteins on the organization of the actin cytoskeleton in cultured epithelial cells and found a ... | 2011 | 21746858 |
clinical features of clostridium difficile infection and molecular characterization of the isolated strains in a cohort of danish hospitalized patients. | the purpose of this study was to compare clinical features of clostridium difficile infection (cdi) to toxin gene profiles of the strains isolated from danish hospitalized patients. c. difficile isolates were characterized by pcr based molecular typing methods including toxin gene profiling and analysis of deletions and truncating mutations in the toxin regulating gene tcdc. clinical features were obtained by questionnaire. thirty percent of the cdi cases were classified as community-acquired. i ... | 2011 | 21744281 |
marginal costs of hospital-acquired conditions: information for priority-setting for patient safety programmes and research. | to estimate the relative inpatient costs of hospital-acquired conditions. | 2011 | 21719478 |
use of antimicrobials for eus-guided fna of pancreatic cysts: a retrospective, comparative analysis. | pancreatic cystic lesions present a challenge for patients and physicians alike. morphology alone is inaccurate in discriminating lesion pathology, and use of eus-guided fna (eus-fna) improves accuracy. current american society for gastrointestinal endoscopy guidelines recommend prophylactic antibiotics during fna of cystic lesions to minimize infection risk. however, evidence pertaining to infection risk has been conflicting. the use of prophylactic antibiotics might not be free of other advers ... | 2011 | 21704808 |
pcr ribotype prevalence and molecular basis of macrolide-lincosamide-streptogramin b (mlsb) and fluoroquinolone resistance in irish clinical clostridium difficile isolates. | background antimicrobial use is recognized as a risk factor for clostridium difficile infection (cdi) and outbreaks. we studied the relationship between pcr ribotype, antimicrobial susceptibility and the genetic basis of resistance in response to exposure to antimicrobial agents. methods c. difficile isolates were cultured from 133 cdi patients for whom recent antimicrobial drug exposure had been recorded. isolates were ribotyped by pcr and assessed for their susceptibility to the macrolide-linc ... | 2011 | 21712239 |
current use for old antibacterial agents: polymyxins, rifamycins, and aminoglycosides. | this article reviews three classes of antibacterial agents that are uncommonly used in bacterial infections and therefore can be thought of as special-use agents. the polymyxins are reserved for gram-negative bacilli that are resistant to virtually all other classes of drugs. rifampin is used therapeutically, occasionally as a companion drug in treatment of refractory gram-positive coccal infections, especially those involving foreign bodies. rifaximin is a new rifamycin that is a strict enteric ... | 2011 | 21679793 |
evaluation of a simultaneous detection kit for the glutamate dehydrogenase antigen and toxin a/b in feces for diagnosis of clostridium difficile infection. | rapid detection kits for toxin a/b in feces are widely used as a diagnostic tool for clostridium difficile infection (cdi). their low sensitivity, however, has been considered a problem. in this study, we evaluated a new rapid diagnostic kit for simultaneous detection of the glutamate dehydrogenase (gdh) antigen and toxin a/b, c. diff quik chek complete. a total of 60 stool specimens from 60 patients with antibiotic-associated diarrhea were examined. using c. difficile culture as the reference m ... | 2011 | 21725661 |
vancomycin "telephone". | | 2011 | 21690636 |
risk factors for recurrence of clostridium difficile infection: effect of vancomycin-resistant enterococci colonization. | recurrent clostridium difficile infection (cdi) is one of the most difficult problems in healthcare infection control. we evaluated the risk factors associated with recurrence in patients with cdi. a retrospective cohort study of 84 patients with cdi from december 2008 through october 2010 was performed at pusan national university yangsan hospital. recurrence occurred in 13.1% (11/84) of the cases and in-hospital mortality rate was 7.1% (6/84). stool colonization with vancomycin-resistant enter ... | 2011 | 21738336 |
bacteria as trigger for chronic gastrointestinal disorders. | apart from acute infections, microorganisms may also induce or perpetuate chronic inflammatory diseases and reversible or irreversible proliferation of various cells in the gastrointestinal tract (the extreme being adenocarcinoma and lymphoma). helicobacter pylori is not only involved in the pathogenesis of lymphoma and gastric adenocarcinoma. the steps and mechanisms of the carcinogenic process involve host predisposition, environmental factors, and strain virulence. the steps of lymphoma genes ... | 2011 | 21734380 |
increased health burden associated with clostridium difficile diarrhoea in inflammatory bowel disease. | | 2011 | 21726248 |
proton pump inhibitor-associated pneumonia: not a breath of fresh air after all? | over the past two decades, proton pump inhibitors (ppis) have emerged as highly effective and relatively safe agents for the treatment of a variety of gastrointestinal disorders. unfortunately, this desirable pharmacological profile has also contributed to superfluous and widespread use in both the inpatient and outpatient settings. while generally well-tolerated, research published over the last decade has associated these agents with increased risks of clostridium difficile disease, fractures ... | 2011 | 21731913 |
neuroleptic malignant syndrome with metoclopramide overdose coexisting with clostridium difficile diarrhea. | | 2011 | 21688103 |
inhibition of the cytotoxic effect of clostridium difficile in vitro by clostridium butyricum miyairi 588 strain. | in contrast to most modern pharmaceuticals, probiotics are used in many parts of the world with little or no research data on the complex system of interactions that each strain may elicit in the human body. research on probiotics has recently become more essential as probiotics have begun to be prescribed by clinicians as an alternative for some gut infections, especially when antibiotics are contraindicated. in this study, we attempt to elucidate the inhibitory interaction between the japanese ... | 2011 | 21700738 |
high horn's index score predicts poor outcomes in patients with clostridium difficile infection. | several variables have been proposed to predict the prognosis of patients with clostridium difficile infection (cdi), but a clinically useful tool to stratify resource utilization has not been determined. horn's index, a severity score based on underlying clinical illness, reliably predicts patients at high risk of cdi. the purpose of this study was to assess the use of horn's index to stratify patients with cdi at high risk of poor clinical and economic outcomes. hospitalized patients diagnosed ... | 2011 | 21700363 |
procalcitonin-guided antibiotic therapy for chronic obstructive pulmonary disease exacerbations. | the aim of this article is to review the current literature examining the use of procalcitonin-guided antibiotic therapy for management of chronic obstructive pulmonary disease (copd) exacerbations. procalcitonin is a serum marker that rises in response to bacterial infections, but remains low in nonbacterial infections and other proinflammatory conditions. to date, there are four randomized clinical trials which compare procalcitonin-guided antibiotic therapy to standard therapy in patients wit ... | 2011 | 21692680 |
diagnostic testing for clostridium difficile: a comprehensive survey of laboratories in england. | recent studies have shown poor performance of commonly used toxin enzyme immunoassays (eias) for laboratory testing for clostridium difficile infection (cdi). in 2009-2010, the uk health protection agency and the european society of clinical microbiology and infectious diseases stated that toxin eia testing alone is suboptimal, and recommended a two-step testing protocol (i.e. screening with one method and confirming the results with another method). all acute english national health service tru ... | 2011 | 21724296 |
clostridium difficile outbreak strain bi is highly endemic in chicago area hospitals. | objective.ôçâdescribe the clinical and molecular epidemiology of incident clostridium difficile infection (cdi) cases in chicago area acute healthcare facilities (hcfs). design and setting.ôçâlaboratory, clinical, and epidemiologic information was collected for patients with incident cdi who were admitted to acute hcfs in february 2009. stool cultures and restriction endonuclease analysis typing of the recovered c. difficile isolates was performed. patients.ôçâtwo hundred sixty-three patients fr ... | 2011 | 21828970 |
[apoptosis-inducing effect of clostridium difficile toxin a on k562 cells and its mechanism]. | this study was purposed to investigate the growth inhibition and apoptosis-inducing effect of clostridium difficile toxin a (tcda) on the leukemia cell line k562. the proliferative activity of k562 cells exposed to tcd a was tested by mtt assay, cell apoptosis was detected by flow cytometry; immunocytochemistry and colorimetric assay were employed to detect the protein expressions of bcl-2/bax and the activity of caspase-3, respectively. the results indicated that the proliferation of k562 cells ... | 2011 | 21729540 |
clostridium difficile colitis: factors associated with outcome and assessment of mortality at a national level. | previous descriptions of clostridium difficile colitis (cdc) epidemics may overestimate cost and mortality of cdc. | 2011 | 21720924 |
clostridium difficile laboratory testing in australia and new zealand: national survey results and australasian society for infectious diseases recommendations for best practice. | in order to improve the future reliability of surveillance for clostridium difficile infection (cdi), an australia/new zealand-wide survey was conducted to examine methods of laboratory diagnosis in use, identify deficiencies in practice and burden of cdi. | 2011 | 21716158 |
detection of clostridium difficile and salmonella in feral swine population in north carolina. | we sampled 161 feral pigs in eastern north carolina, usa, to determine the prevalence and antimicrobial resistance profile of clostridium difficile and salmonella. seven (4.4%) and eight (5.0%) pigs tested positive for c. difficile and salmonella, respectively, highlighting the importance of determining the epidemiology of these pathogens in feral pigs. | 2011 | 21719851 |
what would we do without metronidazole? | metronidazole is a treatment of choice for several types of infections, but coexisting conditions or concomitant medications may preclude its use. although tinidazole, a newer nitroimidazole, may be an option in cases where drug interactions make the use of metronidazole inadvisable, similar absolute contraindications exist. in situations where nitroimidazole use is contraindicated or inadvisable, clinicians may have difficulty deciding on efficacious treatment options. for the treatment of tric ... | 2011 | 21817887 |
pyrosequencing-based molecular monitoring of the intestinal bacterial colonization in preterm infants. | objectives:: to investigate the previously unexplored diversity of neonatal intestinal microbiota and monitor early intestinal colonization patterns in korean preterm infants using high-throughput pyrosequencing technology combined with 16s rdna- based molecular methods methods:: a total of 46,369 partial 16s rdna sequences obtained from 30 fecal samples serially taken from 10 very low birth weight preterm infants were analyzed. results:: a significant proportion of the molecular species (21.9%) ... | 2011 | 21734604 |
biology of clostridium difficile: implications for epidemiology and diagnosis. | clostridium difficile is an anaerobic, spore-forming, gram-positive rod that causes a spectrum of antibiotic-associated colitis through the elaboration of two large clostridial toxins and other virulence factors. since its discovery in 1978 as the agent responsible for pseudomembranous colitis, the organism has continued to evolve into an adaptable, aggressive, hypervirulent strain. advances in molecular methods and improved animal models have facilitated an understanding of how this organism su ... | 2011 | 21682645 |
right lower quadrant abdominal pain in an immunocompromised patient: importance for an urgent diagnosis and treatment. | this is a case of a 34 years old male hispanic patient with history of aids who presented to the er with severe right lower quadrant abdominal pain of three days of evolution, associated with fever, chills, nausea, vomiting, watery diarrhea, weakness and general malaise. acute appendicitis, clostridium difficile colitis and ischemic colitis were the most important clinical conditions to consider in the differential diagnosis. abdominal ct with iv contrast demonstrated thickening of the ascending ... | 2011 | 21696104 |
efficacy of fidaxomicin versus vancomycin as therapy for clostridium difficile infection in individuals taking concomitant antibiotics for other concurrent infections. | background.ôçâtreatment guidelines recommend stopping all implicated antibiotics at the onset of clostridium difficile infection (cdi), but many individuals have persistent or new infections necessitating the use of concomitant antibiotics (cas). we used data from 2 phase 3 trials to study effects of cas on response to fidaxomicin or vancomycin. methods.ôçâsubjects with cdi were treated for 10 days with fidaxomicin 200 mg every 12 hours or vancomycin 125 mg every 6 hours, assessed for resolution ... | 2011 | 21844027 |
endoscopic fecal microbiota transplantation: "first-line" treatment for severe clostridium difficile infection? | | 2011 | 21716124 |
tigecycline for the treatment of severe clostridium difficile infection. | to evaluate the evidence for the use of tigecycline in the treatment of clostridium difficile infection (cdi). | 2011 | 21730279 |
the impact of practice environment on laparoscopic colectomy utilization following colorectal residency: a survey of the ascrs young surgeons. | aim:ôçé it is often thought that practice patterns are different in private (pp) versus university hospital (uh) settings. we aimed to describe the impact of practice environment on the type of laparoscopic colectomy procedures performed by graduating colorectal surgeons. method:ôçé a review was carried out of prospectively gathered self-reported questionnaire data. graduates of ascrs approved colorectal residencies from 2004-2008 underwent an on-line survey, developed by the ascrs young surgeon ... | 2011 | 21689306 |
busulfan and metronidazole: an often forgotten but significant drug interaction. | to report the case of a clinically significant drug interaction between intravenous busulfan and oral metronidazole observed through busulfan therapeutic drug monitoring (tdm). | 2011 | 21730282 |
lack of effect of strain type on detection of toxigenic clostridium difficile by glutamate dehydrogenase and polymerase chain reaction. | glutamate dehydrogenase (gdh) is popular as a preliminary test for the detection of clostridium difficile. recent work has suggested that gdh sensitivity may vary according to ribotype and may be lower for ribotypes 002, 027, and 106 compared with polymerase chain reaction (pcr). we investigated this effect using a dilution series of 64 isolates tested by gdh and cepheid genexpert pcr. pcr was significantly more sensitive than gdh overall; however, there was no difference in detection according ... | 2011 | 21683272 |
unnecessary use of fluoroquinolone antibiotics in hospitalized patients. | abstract: | 2011 | 21729289 |
clostridium difficile enteritis in a patient after total proctocolectomy. | clostridium difficile infection is associated with antibiotic therapy and usually limited to the colonic mucosa. however, it is also a rare cause of enteritis, with only a few cases reported in the literature. in the present report, the case of a 30-year-old woman with clostridium difficile enteritis who previously had a panproctocolectomy with end ileostomy for severe ulcerative colitis is described. previously reported cases of clostridium difficile enteritis are also reviewed. previous antibi ... | 2009 | 21686438 |
evaluation of hospitalization for infections that are present on admission. | hospitals have experienced increasing requirements for public reporting of various infection rates using clinical and administrative data. until recently, such reports have not included analysis of "present on admission" (poa), an indicator designed to assess whether such infections are hospital acquired. the authors evaluated the frequency of the poa coding designation for 167 university healthsystem consortium hospitals for sepsis/septicemia (s-s), methicillin-resistant staphylococcus aureus ( ... | 2011 | 21724961 |
differential risk of clostridium difficile infection with proton pump inhibitor use by level of antibiotic exposure. | purpose: clostridium difficile infection (cdi) is a major cause of hospital-acquired diarrhea worldwide. we examined the risk of cdi associated with the use of acid-suppressive agents (proton pump inhibitors [ppi] and histamine-2 receptor blockers) and determined whether this risk varied by number or type of antibiotic (high or low cdi risk) received during hospitalization. methods: we conducted a retrospective cohort study of hospitalizations among adult patients at an academic teaching hospita ... | 2011 | 21833992 |
a role for tlr4 in clostridium difficile infection and the recognition of surface layer proteins. | clostridium difficile is the etiological agent of antibiotic-associated diarrhoea (aad) and pseudomembranous colitis in humans. the role of the surface layer proteins (slps) in this disease has not yet been fully explored. the aim of this study was to investigate a role for slps in the recognition of c. difficile and the subsequent activation of the immune system. bone marrow derived dendritic cells (dcs) exposed to slps were assessed for production of inflammatory cytokines, expression of cell ... | 2011 | 21738466 |
laboratory diagnosis of clostridium difficile infection in spain: a population-based survey. | a survey of laboratory diagnosis of clostridium difficile infection (cdi) was conducted in 103 spanish hospitals. a mean of 23.2 stool specimens/1000 admissions were processed to detect cdi. overall, 35.9% of the laboratories specifically selected stool specimens for diagnostic c.-ádifficile toxin testing. the most commonly used criteria were loose or watery stools, previous antibiotic therapy and nosocomial diarrhoea. most laboratories (95.1%) processed the stool specimens in house, mainly five ... | 2011 | 21741114 |
cholesterol- and sphingolipid-rich microdomains are essential for microtubule-based membrane protrusions induced by clostridium difficile transferase (cdt). | clostridium difficile toxin (cdt) is a binary actin-adp-ribosylating toxin that causes depolymerization of the actin cytoskeleton and formation of microtubule-based membrane protrusions, which are suggested to be involved in enhanced bacterial adhesion and colonization of hypervirulent c. difficile strains. here, we studied the involvement of membrane lipid components of human colon adenocarcinoma (caco-2) cells in formation of membrane protrusions. depletion of cholesterol by methyl-+¦-cyclodex ... | 2011 | 21705797 |
epidemiology of suspected clostridium difficile-associated hospital-acquired diarrhea in hospitalized patients at siriraj hospital. | clostridium difficile-associated disease (cdad) is an important cause of hospital-acquired diarrhea. | 2011 | 21721449 |
structural basis for a kolbe-type decarboxylation catalyzed by a glycyl radical enzyme. | 4-hydroxyphenylacetate decarboxylase is a [4fe-4s] cluster containing glycyl radical enzyme proposed to use a glycyl/thiyl radical dyad to catalyze the last step of tyrosine fermentation in clostridia. the decarboxylation product p-cresol (4-methylphenol) is a virulence factor of the human pathogen clostridium difficile . here we describe the crystal structures at 1.75 and 1.81 +à resolution of substrate-free and substrate-bound 4-hydroxyphenylacetate decarboxylase from the related clostridium s ... | 2011 | 21823587 |
pseudomembranous colitis in four patients with cystic fibrosis following lung transplantation. | in the present study, 4 patients with cystic fibrosis undergoing lung transplantation (from a total of 137) who developed fulminant pseudomembranous colitis are described. initial presentation was variable and the mortality rate was 50% despite urgent colectomy. in one case the presenting abdominal distension was thought to be due to meconium ileus equivalent. it is concluded that clostridium difficile colitis may be a difficult diagnosis in patients with cystic fibrosis and follows a fulminant ... | 2009 | 21686410 |
recurrence of clostridium difficile infection after total colectomy in an allogeneic stem cell transplant patient. | | 2011 | 21691259 |
chapter 2-12-7. anaerobic infections (individual fields): antibiotic-associated diarrhea and enterocolitis. | | 2011 | 21728113 |
comparative effects of the immediate and the extended release formulations of ciprofloxacin on normal human intestinal microflora. | ciprofloxacin is a well-known fluoroquinolone, active in vitro against most gram-negative and gram-positive bacteria. the purpose of the present study was to evaluate the ecological effects of an orally administered extended-release formulation of ciprofloxacin in comparison with an immediate-release formulation of ciprofloxacin on the normal human intestinal microflora. thirty-six healthy female subjects were included in the study. the extended-release formulation of ciprofloxacin was given as ... | 2011 | 21742583 |
impact of guidelines and enhanced antibiotic stewardship on reducing broad-spectrum antibiotic usage and its effect on incidence of clostridium difficile infection. | objectives to evaluate the impact of an 'intervention' consisting of revised antibiotic guidelines for empirical treatment of common infections and enhanced stewardship on reducing broad-spectrum antibiotic usage and its effect on incidence of clostridium difficile infection (cdi). methods this was a retrospective, quasi-experimental study using interrupted time series (its) over 12 months before and after the intervention. the setting was adult medical and surgical wards in university hospital ... | 2011 | 21676904 |
the intestinal microbiota and chronic disorders of the gut. | mucosal surfaces of the gut are colonized by large numbers of heterogeneous bacteria that contribute to intestinal health and disease. in genetically susceptible individuals, a 'pathogenic community' may arise, whereby abnormal gut flora contributes to alterations in the mucosa and local immune system leading to gastrointestinal disease. these diseases include enteric infections, such as clostridium difficile infection, small intestinal bacterial overgrowth, functional gastrointestinal disorders ... | 2011 | 21844910 |
review article: faecal transplantation therapy for gastrointestinal disease. | evidence is emerging regarding the relationship between a dysbiosis of the human gut microbiota and a number of gastrointestinal diseases as well as diseases beyond the gut. probiotics have been investigated in many gastrointestinal disease states, with variable and often modest outcomes. faecal transplantation is an alternative approach to manipulate the gut microbiota. | 2011 | 21682755 |
activities of a clostridium difficile infection reduction team. | | 2011 | 21719589 |
[left-sided ulcerative colitis reactivated and aggravated during clostridium difficile infection]. | clostridium difficile (c. difficile) infection appears to be closely related to reactivation, diagnostic delay, and disease progression in patients with inflammatory bowel disease. however, whether c. difficile infection triggers the reactivation of inflammatory bowel disease or vice versa is not certain. we report a case of reactivated and progressed left ulcerative colitis following c. difficile infection in a 56-year-old woman. a series of endoscopic findings in this case report strongly supp ... | 2011 | 21694491 |
healthcare cost and utilization project (hcup) statistical briefs | this statistical brief presents data from the healthcare cost and utilization project (hcup) on the trend in cdad from 1993 to 2005 and provides details on cdad hospitalizations for 2005. a recent evaluation of surveillance for cdad in hospitals found high sensitivity (78%) and specificity (99.7%) when using international classification of diseases, 9th revision (icd-9) codes. although it is not possible to determine whether these infections originated in a healthcare setting or were community a ... | 2006 | 21735570 |
postantibiotic effect of fidaxomicin and its major metabolite, op-1118, against clostridium difficile. | fidaxomicin (fdx), a narrow-spectrum antibiotic recently shown to be superior to vancomycin in providing sustained clinical response to clostridium difficile infection, was investigated along with its major metabolite, op-1118, with regard to their postantibiotic effects (pae). fdx was found to have a prolonged pae (10 h versus atcc strains and 5.5 h versus a clinical isolate), and op-1118's pae was longer than that of the standard comparator, vancomycin (3 versus 0 to 1.5 h, respectively). | 2011 | 21709084 |
clostridium difficile infection: monoclonal or polyclonal genesis? | clostridium difficile is considered to be a leading cause of hospital-acquired diarrhea. c. difficile (cdi) infection shows a high rate of recurrence. there would have to be a predominantly monoclonal mechanism of cdi within individual patients in order for molecular epidemiologic tools such as polymerase chain reaction (pcr) ribotyping to be useful in outbreak investigation or differentiation between infection relapse versus re-infection. it was the aim of our study to determine whether cdi is ... | 2011 | 21826436 |
clostridium difficile-associated colitis following the use of chinese medicine. | chinese medicine is becoming widely used in the uk to treat many medical conditions, including acne. we report a case in which chinese medicine, lian qiao bai du wan, was used to treat acne in a teenage boy. the patient then suffered severe diarrhoea with blood and mucus per rectum. examination of the stool revealed clostridium difficile infection. treatment with oral metronidazole improved his symptoms. | 2009 | 21686665 |
prevalence and genotypic characteristics of clostridium difficile in a closed and integrated human and swine population. | recently, an apparent rise in the number of cases attributed to community-acquired clostridium difficile infection has led researchers to explore additional sources of infection. the finding of c. difficile in food animals and retail meat has raised concern about potential food-borne and occupational exposures. the objective of this study was to compare c. difficile isolated from a closed population of healthy individuals consisting of both humans and swine in order to investigate possible food ... | 2011 | 21724899 |
probiotics in the prevention of antibiotic-associated diarrhoea and clostridium difficile infection. | diarrhoea, as a common side effect of antibiotics, increases treatment costs and length of stay in acute healthcare facilities. one potential strategy to prevent this side effect is the concurrent use of probiotic bacteria or yeast. this review discusses the evidence for the efficacy of probiotics in the prevention of antibiotic-associated diarrhoea and clostridium difficile infection; the potential mechanisms by which probiotics may work; their safety; what future research is required; and reco ... | 2011 | 21694803 |
immunization of hamsters against clostridium difficile infection using the cwp84 protease as an antigen. | clostridium difficile is a pathogen responsible for diarrhoea and colitis, particularly after antibiotic treatment. we evaluated the c. difficile protease cwp84, found to be associated with the s-layer proteins, as a vaccine antigen to limit the c. difficile intestinal colonization and therefore the development of the infection in a clindamycin-treated hamster model. first, we evaluated the immune response and the animal protection against death induced by several immunization routes: rectal, in ... | 2011 | 21707776 |
comparative susceptibilities of fidaxomicin (opt-80) of isolates collected at baseline, recurrence, and failure from patients in two fidaxomicin phase iii trials of clostridium difficile infection. | background: a 10-day course of oral fidaxomicin (200 mg bid), a potent new macrocyclic drug, was compared to vancomycin (125 mg qid) in 1,164 adults (1,105 modified intention to treat (mitt) population ) with cdi in two phase 3 randomized, double-blind trials at sites in north america and 7 european countries. results: of 1,105 mitt patients: 792 (71.7%) including 719/999 (72.0%) of the per-protocol population (pp) provided a c. difficile strain at baseline of which 356 received fidaxomicin with ... | 2011 | 21844318 |
impact of pcr testing for clostridium difficile on incident rates and potential on public reporting: is the playing field level? | | 2011 | 21828981 |
comparison of five assays for detection of clostridium difficile toxin. | performance characteristics of five assays for detection of clostridium difficile toxin were compared using fresh stool samples from patients with c. difficile infection (cdi). assays were performed simultaneously and according to the manufacturers' instructions. patients were included in the study if they exhibited clinical symptoms consistent with cdi. nonmolecular assays included glutamate dehydrogenase antigen tests, with positive findings followed by the premier toxin a and b enzyme immunoa ... | 2011 | 21704273 |
emergency colectomy for fulminant clostridium difficile colitis: striking the right balance. | abstract the number of reported cases of clostridium difficile (cd) infections has increased markedly worldwide. cd causes a spectrum of clinical syndromes, ranging from mild diarrhea to a very severe illness in the form of pseudomembranous colitis (pmc), toxic megacolon, leading to colonic perforation, peritonitis, and even death. in today's practice, toxic megacolon is more often caused by pseudomembranous colitis than ulcerative colitis. there is urgent need to establish clear guidelines abou ... | 2011 | 21843039 |
Over-diagnosis of Clostridium difficile. | | 2011 | 21831939 |
clostridium difficile disease and vancomycin--questionable clinical superiority. | | 2011 | 21690637 |
management of gram-positive bacterial infections in patients with cancer. | abstract bacterial infections, particularly those due to gram-positive bacteria, continue to predominate in patients with cancer. coagulase-negative and coagulase-positive staphylococci and enterococci remain as common pathogenic microorganisms. clostridium difficile has emerged as a significant pathogen. major clinical syndromes include vascular catheter-related infection, febrile neutropenia, diarrhea and colitis. rising antimicrobial resistance among gram-positive bacteria is of serious con ... | 2011 | 21740298 |
Clostridium difficile Has an Original Peptidoglycan Structure with a High Level of N-Acetylglucosamine Deacetylation and Mainly 3-3 Cross-links. | The structure of the vegetative cell wall peptidoglycan of Clostridium difficile was determined by analysis of its constituent muropeptides with a combination of reverse-phase high pressure liquid chromatography separation of muropeptides, amino acid analysis, mass spectrometry and tandem mass spectrometry. The structures assigned to 36 muropeptides evidenced several original features in C. difficile vegetative cell peptidoglycan. First, it is characterized by a strikingly high level of N-acetyl ... | 2011 | 21685382 |
Rifaximin: new therapeutic indication and future directions. | Rifaximin is a nonabsorbable oral antibiotic that acts locally in the gastrointestinal tract with minimal systemic adverse effects. Rifaximin received new labeling for reduction in the risk of the recurrence of overt hepatic encephalopathy (HE) in patients with advanced liver disease in March of 2010. | 2011 | 21741091 |
real numbers tell real stories in health services management. | in the words of one hospital manager, "hospital data is currently indigestible and alien to the average user." drawing upon the experience of an academic hospital that, contrary to established practice, published real numbers alongside rates and ratios during a clostridium difficile outbreak, the authors examined the pitfalls of publishing only abstract performance measures and the advantages of releasing real numbers to the public. this article identifies lessons for hospital board governance, ... | 2010 | 21739823 |
the appendix may protect against clostridium difficile recurrence. | several risk factors have been identified for the development of recurrent clostridium difficile infection (cdi) that alter host immunity and disrupt colonic flora. although the function of the appendix has been debated, its active, gut-associated lymphoid tissue and biofilm production indicate potential roles in recovery from initial cdi and protection against recurrent cdi. we investigated whether the presence or absence of an appendix is associated with cdi recurrence. | 2011 | 21699818 |
predictors of severity in ischaemic colitis. | purpose: ischaemic colitis (ic) is an inadequate perfusion leading to potentially life-threatening colonic inflammation. the aim was to identify patient characteristics that predict severity in biopsy-confirmed ic. methods: a retrospective study of consecutive patients admitted with a robust diagnosis of ic over a 5-year period was performed. as ic is often misdiagnosed, strict inclusion criteria including supporting histopathology, exclusion of inflammatory bowel disease, absence of recent anti ... | 2011 | 21842142 |
diarrhoea after broad spectrum antimicrobials. | | 2011 | 21708921 |
impact of clinical symptoms on interpretation of diagnostic assays for clostridium difficile infections. | asymptomatic clostridium difficile colonization is common in hospitalized patients. existing c. difficile assay comparisons lack data on severity of diarrhea or patient outcomes, limiting the ability to interpret their results in regard to the diagnosis of c. difficile infection (cdi). the objective of this study was to measure how including patient presentation with the c. difficile assay result impacted assay performance to diagnose cdi. stool specimens from 150 patients that met inclusion and ... | 2011 | 21697328 |
clostridium difficile infection and inflammatory bowel disease: a review. | the incidence of clostridium difficile infection (cdi) has significantly increased in the last decade in the united states adding to the health care burden of the country. patients with inflammatory bowel disease (ibd) have a higher prevalence of cdi and worse outcomes. in the past, the traditional risk factors for cdi were exposure to antibiotics and hospitalizations in elderly people. today, it is not uncommon to diagnose cdi in a pregnant women or young adult who has no risk factors. c. diffi ... | 2011 | 21915178 |
systemic dissemination of clostridium difficile toxins a and b is associated with severe, fatal disease in animal models. | (see the editorial commentary by johnson, on pages 353-4.) background. clostridium difficile infection (cdi) can cause a wide range of disease, from mild diarrhea to fulminant systemic disease. the incidence of systemic cdi with fatal consequence has increased rapidly in recent years. methods. using an ultrasensitive cytotoxicity assay, we measured c. difficile toxin a (tcda) and c. difficile toxin b (tcdb) in sera and body fluids of piglets and mice exposed to c. difficile to investigate the re ... | 2011 | 22147798 |
prospective evaluation of the meridian illumigene™ loop-mediated amplification assay and the gen probe progastro™ cd polymerase chain reaction assay for the direct detection of toxigenic clostridium difficile from fecal samples. | clostridium difficile is the most common and important cause of toxigenic colitis in the health care setting. laboratory diagnostics have included bacterial culture with further identification of toxigenic stains, or more commonly, direct detection of preformed toxin in stool samples using biological or immunochemistry assays. recently, molecular amplification assays for the direct detection of toxin-encoding genes have become available commercially. we prospectively evaluated 2 fda-cleared mole ... | 2012 | 22015321 |
activity in vitro of hydrogen peroxide vapour against clostridium difficile spores. | clostridium difficile spores are shed in high numbers by infected patients and are resistant to desiccation and some disinfectants. we explored the in vitro activity of hydrogen peroxide vapour (hpv) against several strains of c. difficile spores using a spore-carrier test. spores were dried on polyvinyl chloride or laminate carriers at mean concentrations of 4.7-6.9 log(10) spores/carrier, which were then decontaminated using hpv. c. difficile was completely eradicated from the exposed carriers ... | 2012 | 22099497 |
[clostridium difficile-induced necrotizing enteritis]. | clostridium difficile infection usually manifests as pseudomembranous colitis. infection of the small intestine is rare. c. difficile enteritis has a high mortality rate due to secondary enteric necrosis and perforation. | 2011 | 22166175 |
Hypervirulent Clostridium difficile PCR-ribotypes exhibit resistance to widely used disinfectants. | The increased prevalence of Clostridium difficile infection (CDI) has coincided with enhanced transmissibility and severity of disease, which is often linked to two distinct clonal lineages designated PCR-ribotype 027 and 017 responsible for CDI outbreaks in the USA, Europe and Asia. We assessed sporulation and susceptibility of three PCR-ribotypes; 012, 017 and 027 to four classes of disinfectants; chlorine releasing agents (CRAs), peroxygens, quaternary ammonium compounds (QAC) and biguanides. ... | 2011 | 22039420 |
Clostridium difficile infection in outpatients, Maryland and Connecticut, USA, 2002-2007. | Clostridium difficile, the most commonly recognized diarrheagenic pathogen among hospitalized persons, can cause outpatient diarrhea. Of 1,091 outpatients with diarrhea, we found 43 (3.9%) who were positive for C. difficile toxin. Only 7 had no recognized risk factors, and 3 had neither risk factors nor co-infection with another enteric pathogen. | 2011 | 22000379 |
Comparison between the two-step and the three-step algorithms for the detection of toxigenic Clostridium difficile. | To evaluate usefulness of applying either the two-step algorithm (Ag-EIAs and CCNA) or the three-step algorithm (all three assays) for better confirmation of toxigenic Clostridium difficile. The antigen enzyme immunoassays (Ag-EIAs) can accurately identify the glutamate dehydrogenase antigen of toxigenic and nontoxigenic Clostridium difficile. Therefore, it is used in combination with a toxin-detecting assay [cell line culture neutralization assay (CCNA), or the enzyme immunoassays for toxins A ... | 2011 | 21860113 |