| a randomized, double-blind, placebo-controlled pilot study to assess the ability of rifaximin to prevent recurrent diarrhoea in patients with clostridium difficile infection. | uncontrolled case series have demonstrated decreased clostridium difficile infection (cdi) recurrence in patients given rifaximin after standard antibiotic therapy. however, clinical trials assessing whether rifaximin decreases recurrent diarrhoea in patients with cdi have not been performed. the purpose of this study was to assess rates of recurrent diarrhoea in patients with cdi given rifaximin versus placebo immediately after standard therapy. | 2011 | 21948965 |
| divergent rifamycin susceptibilities of clostridium difficile strains in canada and italy and predictive accuracy of rifampin etest for rifamycin resistance. | we tested the activities of rifampin (rif) and rifaximin (rfx) against 180 clostridium difficile clinical isolates selected from canadian and italian culture collections. mics were determined by clsi agar dilution for both drugs and by etest for rif. sixteen of 85 italian isolates (18.8%) showed high-level resistance to both rifamycins (mics, >16 μg/ml), compared to 2 of 95 (2.1%) canadian isolates. two new rpob mutations were identified in rifamycin-resistant isolates. rif susceptibility by ete ... | 2011 | 21998414 |
| epidemiology and clinical characteristics of clostridium difficile infection in a korean tertiary hospital. | in order to investigate the incidence, clinical and microbiologic characteristics of clostridium difficile infection (cdi) in korea, a prospective observational study was performed. from september 2008 through january 2010, all patients whose stool was tested for toxin assay a&b and/or c. difficile culture were studied for clinical characteristics. toxin types of the isolates from stool were tested. the mean incidence of cdi per 100,000 patient-days was 71.6 by month (range, 52.5-114.0), and the ... | 2011 | 22022175 |
| risk factors associated with complications and mortality in patients with clostridium difficile infection. | clostridium difficile infection (cdi) has increased in frequency and severity over the past decade. an understanding of the modifiable risk factors for disease severity has considerable clinical applicability. | 2011 | 21976459 |
| [treatment of recurrent clostridium difficile diarrhoea using sequential therapy with vancomycin followed by rifaximin.] | | 2011 | 22105006 |
| surface layers of clostridium difficile endospores. | clostridium difficile is an important human pathogen and one where the primary cause of disease is due to the transmission of spores. we have investigated the proteins found in the outer coat layers of c. difficile spores of pathogenic strain 630 (cd630). five coat proteins, cota, cotb, cotcb, cotd, and cote, were shown to be expressed on the outer coat layers of the spore. we demonstrate that purified spores carry catalase, peroxiredoxin, and chitinase activity and that this activity correlates ... | 2011 | 21949071 |
| antimicrobial use and risk for recurrent clostridium difficile infection. | although antimicrobial use during and immediately after clostridium difficile infection (cdi) is discouraged, the frequency and consequences of such use are poorly defined. we sought to determine the frequency of non-cdi antimicrobial therapy during and after treatment for cdi, and the association of such therapy with recurrent disease. | 2011 | 21944159 |
| host s-nitrosylation inhibits clostridial small molecule-activated glucosylating toxins. | the global prevalence of severe clostridium difficile infection highlights the profound clinical significance of clostridial glucosylating toxins. virulence is dependent on the autoactivation of a toxin cysteine protease, which is promoted by the allosteric cofactor inositol hexakisphosphate (insp(6)). host mechanisms that protect against such exotoxins are poorly understood. it is increasingly appreciated that the pleiotropic functions attributed to nitric oxide (no), including host immunity, a ... | 2011 | 21857653 |
| csi: a severity index for clostridium difficile infection at the time of admission. | clostridium difficile is a common cause of nosocomial diarrhoea in the usa. to develop a score model that would help to identify severe versus mild or moderate c. difficile infection (cdi) upon admission we performed a retrospective cohort study. between january 2004 and december 2007, 255 patients met inclusion criteria for this study. severe cdi was defined as cases that required colectomy, intensive care unit management, ended in death, or hospitalisation of >10 days. data recorded included p ... | 2011 | 21849220 |
| antibiotic prophylaxis after uncomplicated ureteroscopic stone treatment: is there a difference? | abstract purpose: we evaluated the risk of development of a symptomatic urinary tract infection (uti) based on the antibiotic prophylaxis given to a patient during and after uncomplicated ureteroscopy (urs) for urolithiasis. patients and methods: we retrospectively reviewed the charts of patients who underwent urs, laser lithotripsy, and stent placement for the management of stones from 2004/2005 (group 1) and 2009/2010 (group 2). we excluded all patients with preoperative positive cultures, ... | 2011 | 22003847 |
| the role of toxin a and toxin b in the virulence of clostridium difficile. | during the past decade, there has been a striking increase in clostridium difficile nosocomial infections worldwide predominantly due to the emergence of epidemic or hypervirulent isolates, leading to an increased research focus on this bacterium. particular interest has surrounded the two large clostridial toxins encoded by most virulent isolates, known as toxin a and toxin b. toxin a was thought to be the major virulence factor for many years; however, it is becoming increasingly evident that ... | 2011 | 22154163 |
| clostridium perfringens type c and clostridium difficile co-infection in foals. | clostridium perfringens type c is one of the most important agents of enteric disease in newborn foals. clostridium difficile is now recognized as an important cause of enterocolitis in horses of all ages. while infections by c. perfringens type c or c. difficile are frequently seen, we are not aware of any report describing combined infection by these two microorganisms in foals. we present here five cases of foal enterocolitis associated with c. difficile and c. perfringens type c infection. f ... | 2011 | 22177970 |
| an enhanced dna fingerprinting service to investigate potential clostridium difficile infection case clusters sharing the same pcr ribotype. | of 53 potential clostridium difficile infection (cdi) case clusters/outbreaks, affecting 2 to 41 patients in 27 institutions, 19% comprised unrelated isolates and 34% had highly related and distinct isolates as shown by multilocus variable-number tandem-repeat analysis, despite sharing a common ribotype. these findings emphasize the value of enhanced fingerprinting to confirm or refute suspected cdi case clusters. | 2011 | 21956986 |
| clostridium difficile associated diarrhea: new rules for an old game. | c. difficile associated diarrhea (cdad) is now considered to be one of the commonest causes of nosocomial diarrhea. cdad, once considered to be a "nuisance" disease, has lately become a "killer" disease with appearance of a hypervirulent strain, toxinotype iii. although the incidence and severity of cdad have increased in the western world especially in health care settings; it still is under-recognized in india and asia. any episode of diarrhea with fever and leucocytosis in a patient on some a ... | 2011 | 21922851 |
| systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent clostridium difficile infection. | clostridium difficile infection (cdi) is a gastrointestinal disease believed to be causally related to perturbations to the intestinal microbiota. when standard treatment has failed, intestinal microbiota transplantation (imt) is an alternative therapy for patients with cdi. imt involves infusing intestinal microorganisms (in a suspension of healthy donor stool) into the intestine of a sick patient to restore the microbiota. however, protocols and reported efficacy for imt vary. we conducted a s ... | 2011 | 22002980 |
| clostridium difficile infection in hiv-seropositive individuals and transplant recipients. | immunocompromise is a commonly cited risk factor for clostridium difficile infection (cdi). we reviewed the experimental and epidemiological literature on cdi in three immunocompromised groups, hiv-seropositive individuals, haematopoietic stem cell or bone marrow transplant recipients and solid organ transplant recipients. all three groups have varying degrees of impairment of humoral immunity, a major factor influencing the outcome of cdi. soluble hiv proteins such as nef and immunosuppressive ... | 2011 | 22178989 |
| comparative effectiveness of clostridium difficile treatments: a systematic review. | background: clostridium difficile infection is increasing in incidence and severity. the optimal treatment is unknown. purpose: to determine whether, among adults with c. difficile infection, treatment with certain antibiotics compared with others results in differences in initial cure, recurrence, and harms. data sources: medline, amed, clinicaltrials.gov, and cochrane databases (search dates: inception through august 2011, limited to english-language reports); bibliography review. study se ... | 2011 | 22184691 |
| cefoperazone-treated mice as an experimental platform to assess differential virulence of clostridium difficile strains. | the toxin-producing bacterium c. difficile is the leading cause of antibiotic-associated colitis, with an estimated 500,000 cases c. difficile infection (cdi) each year in the u.s with a cost approaching 3 billion dollars. despite the significance of cdi, the pathogenesis of this infection is still being defined. the recent development of tractable murine models of cdi will help define the determinants of c. difficile pathogenesis in vivo. to determine if cefoperazone-treated mice could be utili ... | 2011 | 22198617 |
| diverting loop ileostomy and colonic lavage: an alternative to total abdominal colectomy for the treatment of severe, complicated clostridium difficile associated disease. | to determine whether a minimally invasive, colon-preserving approach could serve as an alternative to total colectomy in the treatment of severe, complicated clostridium difficile-associated disease (cdad). | 2011 | 21865943 |
| retargeting clostridium difficile toxin b to neuronal cells as a potential vehicle for cytosolic delivery of therapeutic biomolecules to treat botulism. | botulinum neurotoxins (bonts) deliver a protease to neurons which can cause a flaccid paralysis called botulism. development of botulism antidotes will require neuronal delivery of agents that inhibit or destroy the bont protease. here, we investigated the potential of engineering clostridium difficile toxin b (tcdb) as a neuronal delivery vehicle by testing two recombinant tcdb chimeras. for agt-tcdb chimera, an alkyltransferase (agt) was appended to the n-terminal glucosyltransferase (gt) of t ... | 2012 | 21941543 |
| economic impact of clostridium difficile infection in a multihospital cohort of academic health centers. | to assess the economic impact of clostridium difficile infection (cdi) in a large multihospital cohort. | 2011 | 21923438 |
| Relapse versus reinfection: surveillance of Clostridium difficile infection. | Molecular typing was used to examine surveillance definitions for recurrent Clostridium difficile-associated diarrhea. Among 102 patients, 85 had a second episode within 8 weeks, 88% of which were relapses. Of 49 second episodes occurring after > 8 weeks, 65% were relapses. Categorization of a recurrent episode occurring after >8 weeks as a new infection may misrepresent the majority of episodes for surveillance. | 2011 | 21976462 |
| Association Between Proton Pump Inhibitor Therapy and Clostridium difficile Infection in a Meta-Analysis. | BACKGROUND & AIMS: In the past decade, there has been a growing epidemic of Clostridium difficile infection (CDI). During this time, use of proton pump inhibitors (PPIs) has increased exponentially. We evaluated the association between PPI therapy and the risk of CDI by performing a meta-analysis. METHODS: We searched MEDLINE and 4 other databases for subject headings and text words related to CDI and PPI in articles published from 1990 to 2010. All observational studies that investigated the ri ... | 2011 | 22019794 |
| Spironolactone and colitis: Increased mortality in rodents and in humans. | BACKGROUND: Crohn's disease causes intestinal inflammation leading to intestinal fibrosis. Spironolactone is an antifibrotic medication commonly used in heart failure to reduce mortality. We examined whether spironolactone is antifibrotic in the context of intestinal inflammation. METHODS: In vitro, spironolactone repressed fibrogenesis in transforming growth factor beta (TGF-ß)-stimulated human colonic myofibroblasts. However, spironolactone therapy significantly increased mortality in two rode ... | 2011 | 22081497 |
| need for clinicopathologic correlation of clostridium difficile colitis in view of molecular diagnosis. | | 2012 | 22187416 |
| inappropriate prescribing of proton pump inhibitors in hospitalized patients. | background: proton pump inhibitors have numerous important side effects, yet they are prescribed for outpatients who do not have recognized indications. less is known with respect to prescribing for inpatients. objective: to determine the rate of inappropriate prescribing of protein pump inhibitors and to assess reasons why they are prescribed. design and participants: the study was a retrospective review of administrative data for adult hospital patients discharged from the medicine service of ... | 2011 | 22190465 |
| Clostridium difficile prevalence rates in a large healthcare system stratified according to patient population, age, gender, and specimen consistency. | We evaluated Clostridium difficile prevalence rates in 2,807 clinically indicated stool specimens stratified by inpatient (IP), nursing home patient (NH), outpatient (OP), age, gender, and specimen consistency using bacterial culture, toxin detection, and polymerase chain reaction (PCR) ribotyping. Rates were determined based on the detection of toxigenic C. difficile isolates. We identified significant differences in the rates between patient populations and with age. Specimens from NH had a hi ... | 2011 | 22167256 |
| Rifaximin Is Effective for the Treatment of Clostridium difficile-Associated Diarrhea: Results of an Open-Label Pilot Study. | Objectives. This open-label trial assessed the efficacy and safety of rifaximin as first-line therapy in hospitalized patients with Clostridium difficile-associated diarrhea (CDAD). Methods. We enrolled thirteen patients who had a confirmed diagnosis of CDAD characterized by =3 unformed stools/day and positive C. difficile toxin assay. Those patients received rifaximin 400?mg three times daily for 10 days. Resolution of symptoms, repeat assay 10 days after treatment, and followup for recurrence ... | 2011 | 22114587 |
| A two-stage algorithm for Clostridium difficile including PCR: can we replace the toxin EIA? | A two step, three-test algorithm for Clostridium difficile infection (CDI) was reviewed. Stool samples were tested by enzyme immunoassays for C. difficile common antigen glutamate dehydrogenase (G) and toxin A/B (T). Samples with discordant results were tested by polymerase chain reaction detecting the toxin B gene (P). The algorithm quickly identified patients with detectable toxin A/B, whereas a large group of patients excreting toxigenic C. difficile but with toxin A/B production below detect ... | 2012 | 22104474 |
| Pathology Consultation on Detection of Clostridium difficile. | Laboratory methods for detecting Clostridium difficile have undergone considerable evolution since the organism's etiologic association with antibiotic-associated diarrhea and colitis was established. Clearly, familiarity with the advantages and shortcomings of the various assays is essential for the laboratory director when choosing among these tests. For the consulting pathologist, furthermore, an understanding of the laboratory's role in securing a diagnosis of C difficile infection (CDI) is ... | 2012 | 22180472 |
| Suspected transmission of norovirus in eight long-term care facilities attributed to staff working at multiple institutions. | SUMMARYThis study reports on gastroenteritis outbreaks suspected of being norovirus infections in eight long-term care facilities. A descriptive epidemiological investigation was used to depict sources of infections and control measures. Outbreaks affected 299 (31%) of 954 residents and 95 (11%) of 843 staff. Attack rates were higher in residents (range 17-55%) than staff (range 3-35%). Person-to-person spread was suspected. The case-hospitalization rate was 2·5%, and no death occurred. Eight st ... | 2011 | 22152686 |
| Clinical approach to severe Clostridium difficile infection: update for the hospital practitioner. | The rising incidence of Clostridium difficile (C. difficile) infection or CDI is now a problem of pandemic proportions. The NAP1 hypervirulent strain of C. difficile is responsible for a majority of recent epidemics and the widespread use of fluoroquinolone antibiotics may have facilitated the selective proliferation of this strain. The NAP1 strain also is more likely to cause severe and fulminant colitis characterized by marked leukocytosis, renal failure, hemodynamic instability, and toxic meg ... | 2011 | 22075280 |
| Toxic megacolon due to fulminant Clostridium Difficile colitis. | | 2011 | 21861326 |
| Clostridium difficile Toxins and Severe C. difficile Infection. | | 2011 | 22147800 |
| [Effects of clostridium difficile toxin a on proliferation of K562 cells]. | This study was aimed to investigate the effect of clostridium difficile toxin A (Tcd A) on proliferation of K562 cells and its mechanism. The proliferative activity of K562 cells exposed to Tcd A was tested by MTT assay; cell cycle distribution and mitochondrial membrane potential were analyzed by flow cytometry; the protein expression of cytochrome C and DNA fragmentation were observed by immunohistochemistry staining and agarose gel electrophoresis respectively. The results indicated that Tcd ... | 2011 | 21867609 |
| fidaxomicin: a novel macrocyclic antibiotic approved for treatment of clostridium difficile infection. | fidaxomicin, a nonabsorbed macrocyclic compound, is the first antimicrobial agent approved by the fda for the treatment of clostridium difficile infection (cdi) in adults over the last 25 years. it is bactericidal, and its mechanism of action relates to inhibition of a rna polymerase at a site distinct from where rifamycins interact. fidaxomicin, 200 milligrams by mouth twice daily, is not inferior to vancomycin, 125 milligrams by mouth 4 times daily, for treatment of cdi as determined by clinic ... | 2011 | 22156854 |
| Clostridium difficile infection ward rounds. | | 2012 | 22099499 |
| loop-mediated isothermal amplification compared to real-time pcr and enzyme immunoassay for toxigenic c. difficile detection. | clostridium difficile (cd) infection is the primary cause of healthcare-associated diarrhea. while most laboratories have been using rapid antigen tests for detecting cd toxins, these have poor sensitivity; newer molecular methods offer rapid results with high test sensitivity and specificity. this study was designed to compare the performance of two molecular assays (meridian illumigene, bd geneohm) with two antigen assays (wampole quik check complete, techlab tox a/b ii) to detect toxigenic cd ... | 2011 | 22189114 |
| Profound Alterations of Intestinal Microbiota following a Single Dose of Clindamycin Results in Sustained Susceptibility to Clostridium difficile-Induced Colitis. | Antibiotic-induced changes in the intestinal microbiota predispose mammalian hosts to infection with antibiotic-resistant pathogens. Clostridium difficile is a Gram-positive intestinal pathogen that causes colitis and diarrhea in patients following antibiotic treatment. Clindamycin predisposes patients to C. difficile colitis. Here, we have used Roche-454 16S rRNA gene pyrosequencing to longitudinally characterize the intestinal microbiota of mice following clindamycin treatment in the presence ... | 2012 | 22006564 |
| High prevalence of toxinogenic Clostridium difficile in Nigerian adult HIV patients. | Clostridium difficile is the most commonly identified bacterial cause of nosocomial and HIV-related diarrhea. In many developing countries, antibiotic access is unregulated. Nigeria has the third highest HIV burden worldwide. Due to perceptions of low prevalence and resource incapacity, patients with diarrhea are not tested for toxinogenic C. difficile infection (CDI). In this pilot study which included 97 HIV-positive patients at two hospitals in Nigeria, the estimated prevalence of CDI was 43% ... | 2011 | 21855100 |
| Molecular detection of toxigenic cdifficile: toxin A or B gene? | | 2011 | 21882760 |
| Clostridium difficile Mixed Infection and Reinfection. | Isolates from consecutive Clostridium difficile infection (CDI) fecal samples underwent multilocus sequence typing. Potential reinfections with different genotypes were identified in 88/560 (16%) sample pairs taken 1 to 1,414 days (median, 24; interquartile range [IQR], 1 to 52 days) apart; odds of reinfection increased by 58% for every doubling of time between samples. Of 109 sample pairs taken on the same day, 3 (3%) had different genotypes. Considering samples 0 to 7 days apart as the same CD ... | 2012 | 22075589 |
| clostridium difficile in poultry and poultry meat. | the incidence and severity of disease associated with toxigenic clostridium difficile have increased in hospitals in north america from the emergence of newer, more virulent strains. toxigenic c. difficile has been isolated from food animals and retail meat with potential implications of transfer to human beings. the objective of the present study was to determine the prevalence of toxigenic c. difficile in chickens and retail poultry meat in texas. seven c. difficile isolates were detected in f ... | 2011 | 21877928 |
| Type-specific risk factors and outcome in an outbreak with 2 different Clostridium difficile types simultaneously in 1 hospital. | Clostridium difficile infection (CDI) due to polymerase chain reaction (PCR) ribotype 027 (type 027) has been described worldwide. In some countries, an increase was reported of toxin A-negative PCR ribotype 017 (type 017). We encountered an outbreak due to these 2 types occurring simultaneously in a 980-bed teaching hospital in the Netherlands. | 2011 | 21914851 |
| host and pathogen factors for clostridium difficile infection and colonization. | clostridium difficile infection is the leading cause of health care-associated diarrhea, and the bacterium can also be carried asymptomatically. the objective of this study was to identify host and bacterial factors associated with health care-associated acquisition of c. difficile infection and colonization. | 2011 | 22047560 |
| Fecal Transplantation, Through Colonoscopy, Is Effective Therapy for Recurrent Clostridium difficile Infection. | BACKGROUND & AIMS: Treatment of recurrent Clostridium difficile infection (CDI) with antibiotics leads to recurrences in up to 50% of patients. We investigated the efficacy of fecal transplantation in treatment of recurrent CDI. METHODS: We reviewed records from 70 patients with recurrent CDI who had undergone fecal transplantation. Fecal transplantation was performed at colonoscopy by infusing fresh donor feces into cecum. Before transplantation, the patients had whole-bowel lavage with polyeth ... | 2011 | 22155369 |
| recognition of greater diversity of bacillus species and related bacteria in human faeces. | in a study looking at culturable aerobic actinobacteria associated with the human gastrointestinal tract, the vast majority of isolates obtained from dried human faeces belonged to the genus bacillus and related bacteria. a total of 124 isolates were recovered from the faeces of 10 healthy adult donors. 16s rrna gene sequence analyses showed the majority belonged to the families bacillaceae (n=81) and paenibacillaceae (n=3), with bacillus species isolated from all donors. isolates tentatively id ... | 2011 | 22041546 |
| Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. | BACKGROUND: Clostridium difficile infections (CDIs) are common in developed countries and affect >250?000 hospitalized patients annually in the USA. The most important risk factor for the disease is antibiotic therapy. METHODS: To determine the period at risk for CDI after cessation of antibiotics, we performed a multicentre case-control study in the Netherlands between March 2006 and May 2009. Three hundred and thirty-seven hospitalized patients with diarrhoea and a positive toxin test were com ... | 2011 | 22146873 |
| [Towards a better awareness of Clostridium difficile-associated infection]. | | 2011 | 21940015 |
| Genetic markers for Clostridium difficile lineages linked to hypervirulence. | Rapid identification of hypervirulent Clostridium difficile strains is essential for preventing their spread. Recent completion of several full-length C. difficile genomes provided an excellent opportunity to identify potentially unique genes that characterize hypervirulent strains. Based on sequence comparisons between C. difficile strains we describe two gene insertions into the genome of hypervirulent PCR ribotypes 078 and 027. Analysis of these regions, of 1.7 and 4.2 kb, respectively, revea ... | 2011 | 21873406 |
| [Clostridium difficile-Associated Infections in a Septic Ward of a Level 1 Trauma Centre: An Analysis of 159 Patients.] | BACKGROUND: Clostridium difficile-associated infections are severe nosocomial infections. In recent studies, dramatic increases of CD-associated infections for the U.?S.?A. and Germany have been described, which leads to additional risk for patients and higher costs. Despite several studies, there is no study available which analyses the incidence of CD-associated infections on a septic ward at a level 1 trauma centre. Therefore, this study was performed to analyse the incidence and risk factors ... | 2011 | 22065373 |
| development and evaluation of an ovine antibody-based platform for treatment of clostridium difficile infection. | treatment of clostridium difficile is a major problem as a hospital-associated infection which can cause severe, recurrent diarrhea. the currently available antibiotics are not effective in all cases and alternative treatments are required. in the present study, an ovine antibody-based platform for passive immunotherapy of c. difficile infection is described. antibodies with high toxin-neutralizing titers were generated against c. difficile toxins a and b and were shown to neutralize three seque ... | 2011 | 22144483 |
| protection from c. difficile toxin b-catalysed rac/cdc42 glucosylation by tauroursodeoxycholic acid-induced rac/cdc42 phosphorylation. | abstract toxin a (tcda) and toxin b (tcdb) are the major virulence factors of clostridium difficile-associated diarrhea (cdad). tcda and tcdb mono-glucoslyate small gtpases of the rho family, thereby causing actin re-organisation in colonocytes, resulting in the loss of colonic barrier function. the hydrophilic bile acid tauroursodeoxycholic acid (tudca) is an approved drug for the treatment of cholestasis and biliary cirrhosis. in this study, tudcainduced activation of akt 1 is presented to i ... | 2011 | 22059737 |
| decreasing the prevalence of clostridium difficile in a long-term care facility. | | 2011 | 22080670 |
| fewer recurrent infections of c. difficile seen with fidaxomicin. this new class of antibiotic--the macrocycles--has a greater sustained response against re-infection than vancomycin. | | 2011 | 21848202 |
| Molecular epidemiology of Clostridium difficile strains in children compared with that of strains circulating in adults with Clostridium difficile-associated infection. | Molecular analysis of Clostridium difficile (28 isolates) from children (n = 128) in Oxfordshire, United Kingdom, identified eight toxigenic genotypes. Six of these were isolated from 27% of concurrent adult C. difficile-associated infections studied (n = 83). No children carried hypervirulent PCR ribotype 027. Children could participate in the transmission of some adult disease-causing genotypes. | 2011 | 21940476 |
| in vitro activity of cb-183,315, vancomycin and metronidazole against 556 strains of clostridium difficile, 445 other intestinal anaerobes and 56 enterobacteriaceae species. | mics for cb-183,315, a novel lipopeptide antibiotic, vancomycin and metronidazole were determined for intestinal anaerobes and enterobacteriaceae. the mic(90) for gram-negative anaerobes was >8192, 8192 and 4 μg/ml for cb-183,315, vancomycin and metronidazole, respectively. against enterobacteriaceae, mic(90)s were >8192 μg/ml, 1024 μg/ml and1024 μg/ml, respectively. cb-183,315 mic(90) for c. difficile was 0.5 μg/ml. its lack of activity against normal fecal organisms makes it a promising new ag ... | 2011 | 22183166 |
| clostridium difficile and routine cleaning - alternative options to the use of stronger chlorine-releasing disinfectants. | | 2011 | 22197673 |
| the effect of hospital-acquired infection with clostridium difficile on length of stay in hospital. | the effect of hospital-acquired infection with clostridium difficile on length of stay in hospital is not yet fully understood. we determined the independent impact of hospital-acquired infection with c. difficile on length of stay in hospital. | 2011 | 22143235 |
| systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. | background: the use of proton pump inhibitors (ppis) is increasing worldwide. suppression of gastric acid alters the susceptibility to enteric bacterial pathogens. aim this systematic review was undertaken to examine the relationship between ppi use and susceptibility to enteric infections by a specific pathogen based on published literature and to discuss the potential mechanisms of ppi enhanced pathogenesis of enteric infections. methods pubmed, ovid medline databases were searched. search t ... | 2011 | 21999643 |
| a point prevalence survey of health care-associated infections in canadian pediatric inpatients. | background: health care-associated infections (hais) cause considerable morbidity and mortality to hospitalized patients. the objective of this point prevalence study was to assess the burden of hais in the canadian pediatric population, updating results reported from a similar study conducted in 2002. methods: a point prevalence survey of pediatric inpatients was conducted in february 2009 in 30 pediatric or combined adult/pediatric hospitals. data pertaining to one 24-hour period were collecte ... | 2011 | 22078941 |
| genetic organisation, mobility and predicted functions of genes on integrated, mobile genetic elements in sequenced strains of clostridium difficile. | clostridium difficile is the leading cause of hospital-associated diarrhoea in the us and europe. recently the incidence of c. difficile-associated disease has risen dramatically and concomitantly with the emergence of 'hypervirulent' strains associated with more severe disease and increased mortality. c. difficile contains numerous mobile genetic elements, resulting in the potential for a highly plastic genome. in the first sequenced strain, 630, there is one proven conjugative transposon (ctn) ... | 2011 | 21876735 |
| probiotics in clostridium difficile infection. | clostridium difficile infection (cdi) is one of the most prevalent nosocomial infections. a dramatic increase in the incidence and severity of cdi has been noted in the past decade. current recommendations suggest metronidazole as first-line therapy in mild to moderately severe cdi and oral vancomycin in individuals with severe cdi, or when metronidazole fails or is contradicted. alterations of the colonic microbiota, usually caused by antimicrobial therapy, seem to play a critical role in cdi p ... | 2011 | 21992956 |
| Impact of clostridial glucosylating toxins on the proteome of colonic cells determined by isotope-coded protein labeling and LC-MALDI. | ABSTRACT: | 2011 | 21849038 |
| approach to the patient with infectious colitis. | to provide current recommendations for evaluation and treatment of patients with infectious colitis. infectious colitis is diagnosed in someone with diarrhea and one or more of the following: fever and/or dysentery, stools containing inflammatory markers such as leukocytes, lactoferrin, or calprotectin, or positive stool culture for an invasive or inflammatory bacterial enteropathogen including shigella, salmonella, campylobacter, shiga toxin-producing escherichia coli (stec) or clostridium diff ... | 2012 | 22080825 |
| Reducing the risk of severe complications among patients with Clostridium difficile infection. | The incidence and severity of Clostridium difficile infections are increasing, and there is a need to optimize the prevention of complicated disease. | 2011 | 21876858 |
| Clostridium difficile hospitalizations in Louisiana: a 10 year review. | Clostridium difficile (CD) is a common cause of diarrhea in hospitalized patients and can cause more serious intestinal conditions such as pseudomembranous colitis, toxic megacolon, perforations of the colon, sepsis, and even death. Clostridium difficile associated disease (CDAD) is mainly a health care associated illness. Known risk factors for CDAD are antibiotics, gastrointestinal surgery/manipulation, long length of stay in health care settings, serious underlying illness, a compromised immu ... | 2011 | 21954651 |
| [Clostridium difficile infection in child with no previous risk]. | | 2011 | 21982551 |
| macrocyclic antibiotics: a novel class of drug for the treatment of clostridium difficile infection. | | 2012 | 22142153 |
| Prevalence of Clostridium difficile Toxin Genes in the Feces of Veal Calves and Incidence of Ground Veal Contamination. | Abstract A study was conducted in two parts to determine the prevalence of toxigenic Clostridium difficile in veal calves and retail meat. The first part of the study focused on the veal production continuum (farm to abattoir). Fifty calves from 4 veal herds (n=200) were followed for 18-22 weeks from the time of arrival on the veal farm to the time of slaughter. Fecal samples were collected from calves every 4-6 weeks. Half of the calves included in the study (n=100) were followed to the abatt ... | 2011 | 21988399 |
| multiresistant escherichia coli in aged care: the gathering storm. | | 2011 | 22060066 |
| Enteropathogenic bacteria in dogs and cats: diagnosis, epidemiology, treatment, and control. | This report offers a consensus opinion on the diagnosis, epidemiology, treatment, and control of the primary enteropathogenic bacteria in dogs and cats, with an emphasis on Clostridium difficile, Clostridium perfringens, Campylobacter spp., Salmonella spp., and Escherichia coli associated with granulomatous colitis in Boxers. Veterinarians are challenged when attempting to diagnose animals with suspected bacterial-associated diarrhea because well-scrutinized practice guidelines that provide obje ... | 2011 | 22092607 |
| Recurrent refractory Clostridium difficile colitis treated successfully with rifaximin and tigecycline: A case report and review of the literature. | Abstract Clostridium difficile colitis infection is on the rise and is considerably increasing the duration of hospital stay, as well as healthcare costs. The management of C. difficile colitis has become more challenging with the increasing failure of therapeutic response to metronidazole and oral vancomycin. Tigecycline is a new glycylcycline that has shown in vitro activity against C. difficile. We report herein a case of C. difficile colitis that failed to improve on a combination of metro ... | 2011 | 22077098 |
| detection of toxigenic clostridium difficile in pediatric stool samples: an evaluation of quik check complete antigen assay, bd geneohm cdiff pcr, and progastro cd pcr assays. | the performance of c. diff quik chek complete (qcc), bd geneohm cdiff pcr (bd), and progastro cd pcr (pg) assays was evaluated in detecting clostridium difficile infection (cdi) in children using 200 frozen stool specimens. the results of the tests were compared to the toxigenic culture (tc) as 'gold standard.' the sensitivity, specificity, positive predictive value, and negative predictive value were as follows. qcc antigen (gdh + toxin-a/b) = 70.8%, 97.4%, 89.5%, and 91.4%; bd pcr = 89.6%, 96. ... | 2011 | 21899975 |
| incidence of clostridium difficile infections in patients receiving antimicrobial and acid-suppression therapy. | to determine the incidence of clostridium difficile infection (cdi) at one community hospital by identifying patients with stool samples positive for c. difficile toxin a or b, and to compare the incidence with a 2008 national estimate; and to determine which patient characteristics and concomitant antimicrobial and acid-suppression drugs are risk factors for the development of cdi. | 2011 | 21923450 |
| Antimicrobial prescribing practices in response to different Clostridium difficile diagnostic methodologies. | We evaluated treatment decisions and antimicrobial use related to 2 testing algorithms for Clostridium difficile infection (CDI). Our findings suggest that a 2-step testing algorithm using rapid polymerase chain reaction confirmatory testing leads to decreased unnecessary anti-CDI antimicrobial use. In addition, a significant proportion of patients with confirmed CDI were not treated according to recommended guidelines. | 2011 | 22011545 |
| tackling c difficile with environmental cleaning. | chlorine-based cleaning products are often used in acute settings for high-level disinfection of the environment to help control c difficile. however, these products must be used at high concentrations, making them irritant, toxic and corrosive. this means they are inappropriate for the near-patient environment, and can lead to user resistance and non-compliance. more recently, products using peracetic acid and hydrogen peroxide have become available, which are highly effective even under condit ... | 2011 | 21998939 |
| role of rho gtpases in human trophoblast migration induced by igfbp1. | insulin like growth factor binding protein-1 (igfbp1), the main secretory product of the decidualized endometrium of a pregnant woman has previously been shown to interact with the alpha5beta1 integrin of evt cell surface to stimulate its migration in an igf-independent manner. this migration stimulation has also been shown to require activation of extracellular signal regulated kinases 1 and 2 (mapk3/1) and focal adhesion kinase (fak, official symbol ptk). the present study examined the roles o ... | 2011 | 21940708 |
| assessment of severity of clostridium difficile infection. | | 2011 | 21876855 |
| aerial dissemination of clostridium difficile on a pig farm and its environment. | clostridium difficile is increasingly recognized as an important enteropathogen in both humans and animals. the finding of c. difficile in air samples in hospitals suggests a role for aerial dissemination in the transmission of human c. difficile infection. the present study was designed to investigate the occurrence of airborne c. difficile in, and nearby a pig farm with a high prevalence of c. difficile. airborne colony counts in the farrowing pens peaked on the moments shortly after or during ... | 2011 | 22014605 |
| predictors of fatal outcome after colectomy for fulminant clostridium difficile colitis: a 10-year experience. dr.markelov@gmail.com. | surgical treatment of fulminant clostridium difficile colitis has high mortality rates. identification of a set of preoperative characteristics that could predict outcome after surgery is necessary to optimize clinical management and guide surgical timing. data were retrospectively collected on patients operated on for c. difficile colitis between 2000 and 2010 at our institution. statistical analysis was performed to identify predictors of mortality. we reviewed the records of 13 inpatients di ... | 2011 | 21944509 |
| clostridium difficile carriage in elderly subjects and associated changes in the intestinal microbiota. | clostridium difficile is an important nosocomial pathogen associated particularly with diarrhoeal disease in elderly individuals in hospitals and long-term care facilities. we examined the carriage rate of clostridium difficile by culture as a function of faecal microbiota composition in elderly subjects recruited from the community, outpatient and short term respite and long term hospital stay. the carriage rate ranged from 1.6% (n=123) for subjects in the community, 9.5% (n=43) in outpatient s ... | 2011 | 22162545 |
| Malignant neuroleptic syndrome and Clostridium difficile: Causal association or mere coincidence? | | 2011 | 22154227 |
| Risk Factors and Outcomes Associated With Severe Clostridium difficile Infection in Children. | BACKGROUND:: The incidence and severity of Clostridium difficile infection (CDI) is increasing among adults; however, little is known about the epidemiology of CDI among children. METHODS:: We conducted a nested case-control study to identify the risk factors for and a prospective cohort study to determine the outcomes associated with severe CDI at 2 children's hospitals. Severe CDI was defined as CDI and at least 1 complication or =2 laboratory or clinical indicators consistent with severe dise ... | 2011 | 22031485 |
| Liver Graft Failure and Hyperbilirubinemia in Liver Transplantation Recipients After Clostridium difficile Infection. | Liver transplant recipients are at high risk for Clostridium difficile infection. We have recently encountered multiple cases of CDI in our liver transplant recipients and for some of them it led to severe hyperbilirubinemia, liver failure, and even death. Our goals are to report our experience and analyze the factors that contributed to unfavorable outcomes. | 2011 | 22172853 |
| sporulation studies in clostridium difficile. | clostridium difficile is a leading cause of healthcare-associated diarrhoea. in recent years, certain c. difficile types have become highly represented among clinical isolates and are associated with outbreaks of increased disease severity, higher relapse rates and an expanded repertoire of antibiotic resistance. endospores, produced during sporulation, play a pivotal role in infection and disease transmission and it has been suggested in the literature that these so-called 'hypervirulent' c. di ... | 2011 | 21864584 |
| prevalence, enumeration, and antimicrobial agent resistance of clostridium difficile in cattle at harvest in the united states. | to assess the potential for food contamination with clostridium difficile from food animals, we conducted a cross-sectional fecal prevalence study in 944 randomly selected cattle harvested at seven commercial meat processing plants, representing four distant regions (median distance of 1,500 km) of the united states. in all, 944 animals were sampled in the summer of 2008. c. difficile was isolated from 1.8% (17 of 944) of cattle, with median fecal shedding concentration of 2.2 log cfu/g (range ... | 2011 | 22004807 |
| Evaluation of doripenem utilization and susceptibilities at a large urban hospital. | Background Bacterial resistance presents a constant challenge in the treatment of hospitalized patients, particularly with Gram-negative infections. Carbapenems have an important role in the treatment of resistant nosocomial organisms. Doripenem, a recently approved carbapenem, has shown efficacy in clinical trials, but there is little published data on utilization in a general patient population. Objective The clinical utilization of doripenem in a general adult inpatient population was evaluat ... | 2011 | 21984226 |
| extended multilocus variable-number tandem-repeat analysis of clostridium difficile correlates exactly with ribotyping and enables identification of hospital transmission. | pcr ribotyping is currently used in many countries for epidemiological investigation to track transmission and to identify emerging variants of clostridium difficile. although pcr ribotyping differentiates over 300 types, it is not always sufficiently discriminatory for epidemiological investigations particularly for common ribotypes, e.g., ribotypes 027, 106, and 017. multilocus variable-number tandem-repeat analysis (mlva) is a highly discriminatory molecular subtyping method that has been app ... | 2011 | 21849691 |
| Nosocomial and non-nosocomial Clostridium difficile infections in hospitalised patients in Belgium: compulsory surveillance data from 2008 to 2010. | Surveillance of Clostridium difficile infection (CDI) is compulsory in Belgian hospitals. Our objectives were to compare incidence and case characteristics of nosocomial infections (Nc-CDI) with onset of diarrhoea more than two days after hospital admission, with non-nosocomial cases (Nnc-CDI). The database included inpatients from 2008 to 2010. Of 8,351 cases reported by 150 hospitals, 3,102 (37%) were classified as Nnc-CDI and 5,249 (63%) as Nc-CDI. In 2010, the mean incidence per 1,000 admiss ... | 2011 | 22085603 |
| Spread and persistence of Clostridium difficile spores during and after cleaning with sporicidal disinfectants. | | 2011 | 22172407 |
| The vermiform appendix and recurrent Clostridium difficile infection: a curious connection. | | 2011 | 21893132 |
| Gastrointestinal infection as a trigger for inflammatory bowel disease. | There is accumulating evidence on the importance of microbes in the development and maintenance of both the intestinal and immune systems. This review focuses on the current findings on the role of gastrointestinal pathogens in the cause of chronic inflammatory bowel disease. | 2012 | 22080823 |
| increasing hospital costs for clostridium difficile colitis: type of hospital matters. | to assess differences in hospital costs for inpatients with clostridium difficile (cd) colitis based on hospital size, rural or urban hospital setting, and hospital designation as a teaching institution. | 2011 | 22000185 |
| Engineered single-domain antibodies with high protease resistance and thermal stability. | The extreme pH and protease-rich environment of the upper gastrointestinal tract is a major obstacle facing orally-administered protein therapeutics, including antibodies. Through protein engineering, several Clostridium difficile toxin A-specific heavy chain antibody variable domains (V(H)Hs) were expressed with an additional disulfide bond by introducing Ala/Gly54Cys and Ile78Cys mutations. Mutant antibodies were compared to their wild-type counterparts with respect to expression yield, non-ag ... | 2011 | 22140551 |
| Frequent Hospital Readmissions for Clostridium difficile Infection and the Impact on Estimates of Hospital-Associated C. difficile Burden. | Objective. Clostridium difficile infection (CDI) is associated with hospitalization and may cause readmission following admission for any reason. We aimed to measure the incidence of readmissions due to CDI. Design. Retrospective cohort study. Patients. Adult inpatients in Orange County, California, who presented with new-onset CDI within 12 weeks of discharge. Methods. We assessed mandatory 2000-2007 hospital discharge data for trends in hospital-associated CDI (HA-CDI) incidence, with and w ... | 2012 | 22173518 |
| fidaxomicin: in clostridium difficile infection. | fidaxomicin is a first-in-class macrocyclic antibacterial that primarily demonstrates activity against species of clostridia, predominantly clostridium difficile, while having limited or no activity against normal faecal microflora. fidaxomicin is minimally absorbed following oral administration and is excreted almost solely in the faeces. fidaxomicin displayed a high level of antibacterial activity against c. difficile in vitro, with a minimum inhibitory concentration required to inhibit 90% of ... | 2011 | 22141387 |
| Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection. | Background. Diagnosis and management of Clostridium difficile infection (CDI) rely upon clinical assessments and diagnostic studies. Among diagnostic tests, lower gastrointestinal (GI) endoscopy in the setting of CDI remains controversial. Objective. To describe the role of lower endoscopy in CDI management. Methods. Retrospective study of lower endoscopies in CDI at four metropolitan hospitals, July 2005 through December 2007. Results. Of 1760 CDI inpatients, 45 lower endoscopies were performed ... | 2011 | 22028704 |
| Clostridium difficile infection: an update on epidemiology, risk factors, and therapeutic options. | The incidence and severity of Clostridium difficile infection (CDI) around the world has increased over the past 20 years due to the emergence of hypervirulent strains, increased use and misuse of antibiotics, and the increase of susceptible at-risk populations. Treatments currently available for CDI are inadequate to impede the increasing spread and virulence of the infection, avoid recurrence in chronic patients or prevent infection in at-risk populations. | 2012 | 22134217 |
| Bedpan washer disinfectors: an in-use evaluation of cleaning and disinfection. | As part of a comprehensive approach to decreasing Clostridium difficile in our health authority, an evaluation of the in-use performance of 2 brands of bedpan decontaminators (BPDs) in 2 acute care facilities was performed. | 2011 | 21864763 |