| successful treatment of severe clostridium difficile infection by administration of crushed fidaxomicin via a nasogastric tube in a critically ill patient. | to report the successful use of crushed fidaxomicin via a nasogastric tube for treatment of a severe clostridium difficile infection in a critically ill patient. | 2017 | 28027991 |
| the effects of the transforming care at the bedside program on perceived team effectiveness and patient outcomes. | the objective of the study was to document the impact of transforming care at the bedside (tcab) program on health care team's effectiveness, patient safety, and patient experience. a pretest and posttest (team effectiveness) and a time-series study design (patient experience and safety) were used. the intervention (the tcab program) was implemented in 8 units in a multihospital academic health science center in montreal, quebec, canada. the impact of tcab interventions was measured using the te ... | 2017 | 28027197 |
| role of p38alpha/beta map kinase in cell susceptibility to clostridium sordellii lethal toxin and clostridium difficile toxin b. | lethal toxin from clostridium sordellii (tcsl), which is casually involved in the toxic shock syndrome and in gas gangrene, enters its target cells by receptor-mediated endocytosis. inside the cell, tcsl mono-o-glucosylates and thereby inactivates rac/cdc42 and ras subtype gtpases, resulting in actin reorganization and an activation of p38 map kinase. while a role of p38 map kinase in tcsl-induced cell death is well established, data on a role of p38 map kinase in tcsl-induced actin reorganizati ... | 2016 | 28025502 |
| costs of clostridium difficile infection in pediatric operations: a propensity score-matching analysis. | the purpose of this analysis was to assess the burden of clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. | 2016 | 28024858 |
| lactobacillus probiotics in the prevention of diarrhea associated with clostridium difficile: a systematic review and bayesian hierarchical meta-analysis. | recent meta-analyses of the efficacy of probiotics for preventing diarrhea associated with clostridium difficile have concluded there is a large effect favouring probiotics. we reexamined this evidence, which contradicts the results of a more recent large randomized controlled trial that found no benefit of lactobacillus probiotics for preventing c. difficile-associated diarrhea. | 2017 | 28018885 |
| clostridium difficile infection: evolution, phylogeny and molecular epidemiology. | over the recent decades, clostridium difficile infection (cdi) has emerged as a global public health threat. despite growing attention, c. difficile remains a poorly understood pathogen, however, the exquisite sensitivity offered by next generation sequencing (ngs) technology has enabled analysis of the genome of c. difficile, giving us access to massive genomic data on factors such as virulence, evolution, and genetic relatedness within c. difficile groups. ngs has also demonstrated excellence ... | 2017 | 28012982 |
| oral vancomycin followed by fecal transplantation versus tapering oral vancomycin treatment for recurrent clostridium difficile infection: an open-label, randomized controlled trial. | fecal transplantation (ft) is a promising treatment for recurrent clostridium difficile infection (cdi), but its true effectiveness remains unknown. we compared 14 days of oral vancomycin followed by a single ft by enema with oral vancomycin taper (standard of care) in adult patients experiencing acute recurrence of cdi. | 2017 | 28011612 |
| fecal fixation: fecal microbiota transplantation for clostridium difficile infection. | | 2017 | 28011611 |
| outcomes with fidaxomicin therapy in clostridium difficile infection. | fidaxomicin is a new antibiotic used to treat clostridium difficile infection (cdi). given limited clinical experience with fidaxomicin, we assessed outcomes in a diverse cohort of patients with cdi treated with fidaxomicin. | 2016 | 28009682 |
| [fecal microbiota transplantation: indications and perspectives]. | fecal transplantation demonstrated in a randomized trial its superiority compared to antibiotics in recurrent clostridium difficile (cd) infections. used in first-line treatment, it has reduced the mortality of patients suffering of cd infections caused by ribotype 027 and made it possible to cure patients with severe manifestations of cd infections caused by other ribotypes. the use of frozen microbiota, now validated, facilitates fecal microbiota transplantation. in addition, the frozen microb ... | 2016 | 28008840 |
| a review of dose-responses of probiotics in human studies. | the probiotic definition requires the administration of an 'adequate amount' in order to obtain a health benefit. what that amount should be is not indicated. here, an overview is given of studies that investigated the dose-response relation of probiotics in human interventions. studies were divided in; meta-analyses, meta-analyses on specific probiotic strains, and studies testing two or more doses of a probiotic (combination) in the same study. meta-analyses on the effect of probiotics on anti ... | 2016 | 28008787 |
| therapeutic interventions for gut dysbiosis and related disorders in the elderly: antibiotics, probiotics or faecal microbiota transplantation? | ageing and physiological functions of the human body are inversely proportional to each other. the gut microbiota and host immune system co-evolve from infants to the elderly. ageing is accompanied by a decline in gut microbial diversity, immunity and metabolism, which increases susceptibility to infections. any compositional change in the gut is directly linked to gastrointestinal disorders, obesity and metabolic diseases. increase in opportunistic pathogen invasion in the gut like clostridium ... | 2016 | 28008784 |
| response to comment on "a small-molecule antivirulence agent for treating clostridium difficile infection". | ebselen's antivirulence activity in clostridium difficile infection is likely due to multiple modes of action, but the contribution of each to its efficacy remains unclear. | 2016 | 28003551 |
| comment on "a small-molecule antivirulence agent for treating clostridium difficile infection". | new insights into the mechanism of action of ebselen, a small-molecule antivirulence agent that reduces disease pathology in a mouse model of clostridium difficile infection, suggest a different molecular target may be responsible for its efficacy. | 2016 | 28003550 |
| clinical characteristics and treatment outcomes of clostridium difficile infections by pcr ribotype 017 and 018 strains. | the objective of this study was to identify the clinical characteristics of clostridium difficile infections (cdis) caused by toxin a-negative/toxin b-positive (a-b+) pcr ribotype 017 (r017) and a+b+ ribotype 018 (r018) strains, prevalent in asian countries. from february 2010 through january 2013, all cdi patients in our hospital were enrolled; their medical records were retrospectively reviewed, and the isolates were characterized by toxigenic culture and pcr ribotyping. based on the ribotypes ... | 2016 | 28002482 |
| risk factors for hospital-acquired clostridium difficile infection among pediatric patients with cancer. | hospital-acquired clostridium difficile infection (cdi) may cause life-threatening colitis for children with cancer, making identification of risk factors important. we described characteristics of pediatric cancer patients with primary and recurring cdi, and evaluated potential risk factors. among 189 cancer patients, 51 cases (27%) of cdi and 94 matched controls of cancer patients without cdi were analyzed. multivariable logistic regression was used to evaluate the association between cdi and ... | 2017 | 28002256 |
| fecal microbiota transplant in severe and severe-complicated clostridium difficile: a promising treatment approach. | severe and severe-complicated clostridium difficile infection (cdi) is associated with high morbidity and mortality. colectomy is standard of care; however, post-surgical mortality rates approach 50%. case reports suggest fecal microbiota transplant (fmt) is a promising treatment of severe and severe-complicated disease but there is a paucity of data. here, we present a single center experience with a novel sequential fmt protocol for patients refractory to maximal medical therapy. this approach ... | 2016 | 28001467 |
| traditional chinese medicine qpyf as preventive treatment for clostridium difficile associated diarrhea in a mouse model. | traditional chinese medicine qpyf has a good effect for treating antibiotic-associated diarrhea in clinical practice. the aim of this study is to test its efficacy to prevent clostridium difficile associated diarrhea (cdad) in a mouse model. c57bl/6 mice were infected with clostridium difficile vpi 10463 after exposure to antimicrobial mixture. qpyf was administered from 7 days prior to clostridium difficile infection to 20 days after infection, and its effect was compared with no treatment and ... | 2016 | 27999606 |
| detection, ribotyping and antimicrobial resistance properties of clostridium difficile strains isolated from the cases of diarrhea. | clostridium difficile is the most prevalent cause of antibiotic-associated infectious diarrhea al-around the world. prevalence of virulent and resistant strains of clostridium difficile is increasing now a day. the present investigation was carried out to study the prevalence, ribotyping and antibiotic resistance pattern of c. difficile isolated from diarrheic and non-diarrheic pediatrics. | 2016 | 27999477 |
| complete microbiota engraftment is not essential for recovery from recurrent clostridium difficile infection following fecal microbiota transplantation. | bacterial communities from subjects treated for recurrent clostridium difficile infection (rcdi) by fecal microbiota transplantation (fmt), using either heterologous donor stool samples or autologous stool samples, were characterized by illumina next-generation sequencing. as previously reported, the success of heterologous fmt (90%) was superior to that of autologous fmt (43%) (p = 0.019), and post-fmt intestinal bacterial communities differed significantly between treatment arms (p < 0.001). s ... | 2016 | 27999162 |
| electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 uk infection specialists. | the implementation of electronic prescribing and medication administration (epma) systems is a priority for hospitals and a potential component of antimicrobial stewardship (ams). | 2017 | 27999065 |
| cumulative and temporal associations between antimicrobial prescribing and community-associated clostridium difficile infection: population-based case-control study using administrative data. | community-associated clostridium difficile infection (ca-cdi; defined as cases without prior hospitalization in the previous 12 weeks who were either tested outside of hospital or tested within 2 days of admission to hospital) is a major public health problem. this study estimates the magnitude of the association between temporal and cumulative prescribing of antimicrobials in primary care and ca-cdi. | 2017 | 27999064 |
| gut-sparing treatment of urinary tract infection in patients at high risk of clostridium difficile infection. | recipients of faecal microbiota transplantation (fmt) in treatment of recurrent clostridium difficile infection (rcdi) remain at markedly increased risk of re-infection with c. difficile with new antibiotic provocations. urinary tract infections (utis) are common indications for antibiotics in these patients, often resulting in c. difficile re-infection. | 2017 | 27999027 |
| the microbiome: what will the future hold? | current research on the human microbiome has opened our eyes to the intimate relationship that we have with the bacteria that populate our gastrointestinal tract and its potential relationship to health and disease. to date, clinical research on the microbiome has identified intriguing associations between an altered microbiome and disease states, but proven therapeutic applications have been very limited. the ingestion of prebiotics, probiotics, and/or synbiotics is appealing to the general pub ... | 2016 | 27997976 |
| the emerging metabolic view of clostridium difficile pathogenesis. | it is widely accepted that clostridium difficile exploits dysbiosis and leverages inflammation to thrive in the gut environment, where it can asymptomatically colonize humans or cause a toxin-mediated disease ranging in severity from frequent watery diarrhea to pseudomembranous colitis or toxic megacolon. here, we synthesize recent findings from the gut microbiota and enteric pathogenesis fields to inform the next steps toward a better understanding of c. difficile infection (cdi). in this revie ... | 2016 | 27997854 |
| role of interferon-γ and inflammatory monocytes in driving colonic inflammation during acute clostridium difficile infection in mice. | the inflammatory response to the colonic pathogen clostridium difficile is characterized by the induction of inflammatory cytokines including interleukin-23 (il-23) and interferon-γ (ifn-γ) and the recruitment of myeloid cells including ly6c(h)(igh) monocytes. il-23 knockout mice showed reduced expression of the monocyte chemokines ccl4 and ccl7, but not ccl2, as well as reduced ly6c(h)(igh) ly6g(m)(id) monocyte recruitment to the colon in response to c. difficile colitis. clostridium difficile- ... | 2017 | 27995603 |
| clostridium difficile infection: updates in management. | clostridium difficile was first identified in 1978 as a diarrhea-causing bacterium in humans. in the last three decades, c. difficile infection (cdi) has reached an epidemic state, both in health care and community settings worldwide. there has been substantial progress in the field of cdi, including identification of novel risk factors, presence of cdi in individuals not considered at risk previously, and treatment options including new drugs, monoclonal antibodies, and fecal microbiota transpl ... | 2017 | 27995486 |
| in vitro activities of mcb3681 and eight comparators against clostridium difficile isolates with known ribotypes and diverse geographical spread. | treatments for clostridium difficile infection remain limited, despite the introduction of fidaxomicin, and development of new agents is necessary. we determined the in vitro susceptibilities of 199 prevalent or emerging clostridium difficile pcr ribotypes to mcb3681, a novel investigational quinolonyl-oxazolidinone, and 8 comparators (metronidazole, vancomycin, fidaxomicin, moxifloxacin, ciprofloxacin, clindamycin, tigecycline, and linezolid). mcb3681 showed good activity against c. difficile w ... | 2017 | 27993853 |
| presence of clostridium difficile in pig faecal samples and wild animal species associated with pig farms. | to determine the presence of clostridium difficile on fattening pig farms in north-eastern spain. | 2017 | 27990723 |
| homogeneous and digital proximity ligation assays for the detection of clostridium difficile toxins a and b. | the proximity ligation assay (pla) detects proteins via their interaction with pairs of proximity probes, which are antibodies coupled to noncomplementary dna oligonucleotides. the binding of both proximity probes to their epitopes on the target protein brings the oligonucleotides together, allowing them to be bridged by a third oligonucleotide with complementarity to the other two. this enables their ligation and the detection of the resulting amplicon by real-time quantitative pcr (qpcr), whic ... | 2016 | 27990343 |
| novel portable platform for molecular detection of toxigenic clostridium difficile in faeces: a diagnostic accuracy study. | a novel portable platform for nucleic acid amplification enables rapid detection of diarrhoea causing toxigenic clostridium difficile directly from faeces, even in resource-limited settings. we evaluated the accuracy and precision of the new commercial molecular test system. | 2016 | 27988815 |
| probiotics and prevention of clostridium difficile infection. | the role of probiotics as adjunctive measures in the prevention of clostridium difficile infection (cdi) has been controversial. however, a growing body of evidence has suggested that they have a role in primary prevention of cdi. elements of this controversy are reviewed and the proposed mechanisms of action, the value and cost effectiveness of probiotics are addressed with a focus on three agents, saccharomyces boulardii, lactobacillus rhamnosus gg and the combination of lactobacillus acidophi ... | 2016 | 27988389 |
| predictors of severe outcomes in patients with clostridium difficile infection from a hispanic population. | factors associated with complicated clostridium difficile infection (cdi) may vary among populations, and predictors of severe outcomes in cdi have not been studied in hispanic patients. the aim of this study was to identify factors associated with a higher risk of colectomy, all-cause mortality, and cdi-associated mortality in a hispanic population. | 2017 | 27987135 |
| evaluation of the novel artus c. difficile qs-rgq, vanr qs-rgq and mrsa/sa qs-rgq assays for the laboratory diagnosis of clostridium difficile infection (cdi), and for vancomycin-resistant enterococci (vre) and methicillin-resistant staphylococcus aureus (mrsa) screening. | clostridium difficile, methicillin-resistant staphylococcus aureus (mrsa) and vancomycin-resistant enterococci (vre) are worldwide prevalent healthcare-associated pathogens. we have evaluated three qiagen artus qs-rgq assays for the detection of these pathogens. we examined 200 stool samples previously tested for c. difficile infection (cdi), 94 rectal swabs previously screened for vre and 200 mrsa screening nasal swabs. with the routine diagnostic laboratory results being adopted as the gold st ... | 2016 | 27987047 |
| clinical and microbiological characteristics of clostridium difficile infection among hospitalized children in the netherlands. | little is known about pediatric clostridium difficile infection (cdi) epidemiology. we describe the clinical and microbiological characteristics of cdi among hospitalized children in the netherlands. | 2017 | 27986664 |
| donor screening experience for fecal microbiota transplantation in patients with recurrent c. difficile infection. | to evaluate our experience with stool donor recruitment, screening, retention, and donor perception for fecal microbiota transplantation (fmt). | 2016 | 27984397 |
| clostridium difficile colonization and antibiotics response in polyferms continuous model mimicking elderly intestinal fermentation. | clostridium difficile (cd), a spore-forming and toxin-producing bacterium, is the main cause for antibiotic-associated diarrhea in the elderly. here we investigated cd colonization in novel in vitro fermentation models inoculated with immobilized elderly fecal microbiota and the effects of antibiotic treatments. | 2016 | 27980686 |
| successful therapy of severe pseudomembranous clostridium difficile colitis using a combination of fecal microbiota therapy and fidaxomicin. | the aim of this work was to describe the use of a combination of fidaxomicin and fecal microbiota therapy (fmt) in clostridium difficile infection (cdi). | 2017 | 27978522 |
| recurrent clostridium difficile infection in children: patient risk factors and markers of intestinal inflammation. | the management of clostridium difficile infection (cdi) in children is complicated by recurrence rates of 20%-30%. the identification of risk factors associated with recurrent disease might allow early recognition of those children at highest risk. | 2017 | 27977555 |
| molecular epidemiology of clostridium difficile infection in hospitalized patients in eastern china. | few studies on risk factors for and transmission of clostridium difficile infection (cdi) in china have been reported. a cross-sectional study was conducted for 3 years in eastern china. consecutive stool specimens from hospitalized patients with diarrhea were cultured for c. difficile. c. difficile isolates from these patients then were analyzed for toxin genes, genotypes, and antimicrobial resistance. a severity score for the cdi in each patient was determined by a blinded review of the medica ... | 2017 | 27974547 |
| prospective randomized controlled study on the effects of saccharomyces boulardii cncm i-745 and amoxicillin-clavulanate or the combination on the gut microbiota of healthy volunteers. | probiotics are believed to be beneficial in maintaining a healthy gut microbiota whereas antibiotics are known to induce dysbiosis. this study aimed to examine the effects of the probiotic saccharomyces boulardii cncm i-745 (sb), the antibiotic amoxicillin-clavulanate (ac) and the combination on the microbiota and symptoms of healthy humans. healthy subjects were randomized to one of 4 study groups: sb for 14 days, ac for 7 days, sb plus ac, control (no treatment). participants gave stool sample ... | 2017 | 27973989 |
| antibiotic treatment of hospitalized patients with pneumonia complicated by clostridium difficile infection. | clostridium difficile infection (cdi) is one of the most common gastrointestinal complication after antimicrobial treatment. it is estimated that cdi after pneumonia treatment is connected with a higher mortality than other causes of hospitalization. the aim of the study was to assess the relationship between the kind of antibiotic used for pneumonia treatment and mortality from post-pneumonia cdi. we addressed the issue by examining retrospectively the records of 217 patients who met the diagno ... | 2016 | 27966110 |
| isolation of clostridium difficile from dogs with digestive disorders, including stable metronidazole-resistant strains. | the prevalence of clostridium difficile in 107 dogs with diverse digestive disorders attended in a spanish veterinary teaching hospital was assessed. the microorganism was isolated from 13 dogs (12.1%) of different disease groups. isolates belonged to pcr ribotypes 078, 106, 154 and 430 (all of them toxigenic) and 110 (non-toxigenic), and were resistant to several antimicrobial drugs. notably, seven isolates obtained from different dogs displayed stable resistance to metronidazole. the results o ... | 2017 | 27965048 |
| an institutional comparison of total abdominal colectomy and diverting loop ileostomy and colonic lavage in the treatment of severe, complicated clostridium difficile infections. | total abdominal colectomy (tac) is the standard surgical treatment of clostridium difficile infection (cdi). an alternative therapy, loop ileostomy and colonic lavage (il), was described in 2011, but the results have never been validated. | 2017 | 27964924 |
| repeat clostridium difficile testing. | | 2016 | 27959982 |
| clostridium difficile infection and fecal microbiota transplant. | clostridium difficile infection (cdi) is a major source of morbidity and mortality for hospitalized patients. although most patients have a clinical response to existing antimicrobial therapies, recurrent infection develops in up to 30% of patients. fecal microbiota transplant is a novel approach to this complex problem, with an efficacy rate of nearly 90% in the setting of multiple recurrent cdi. this review covers the current epidemiology of cdi (including toxigenic and nontoxigenic strains, r ... | 2016 | 27959316 |
| evaluation of the biofire filmarray® gastrointestinalpanel in a midwestern academic hospital. | the biofire filmarray® gastrointestinal panel (gip) was implemented to replace traditional stool culture and enzyme immunoassay (eia) testing for stool pathogens. the purpose of this study was to evaluate the detection rate, incidence of coinfection, and culture recovery rate of gastrointestinal (gi) pathogens detected by the gip over a 1-year period. a total of 2257 stools collected from january to december 2015 were tested using the gip. clostridium difficile colonization was also evaluated by ... | 2017 | 27957599 |
| risk factors and epidemiology of clostridium difficile infection in hematopoietic stem cell transplant recipients during the peritransplant period. | hematopoietic stem cell transplant (hsct) recipients represent a high-risk group for developing clostridium difficile (cd) infection (cdi). we aimed to identify specific risk factors for cdi in an hsct patient population during the peritransplant period. | 2017 | 27943501 |
| risk factors for the development of clostridium difficile infection in adult allogeneic hematopoietic stem cell transplant recipients: a single-center study in québec, canada. | clostridium difficile infection (cdi) is a significant complication of allogeneic hematopoietic stem cell transplantation (allo-hsct). our primary objective was to determine risk factors for the development of cdi during the first year following allo-hsct. | 2017 | 27943498 |
| efficacy of computed tomography for the prediction of colectomy and mortality in patients with clostridium difficile infection. | to develop a ct predictor scale for the need for colectomy and to evaluate predictors of all-cause mortality within 30 days after diagnosis ofc. difficile infection (cdi). | 2016 | 27942384 |
| clostridium difficile toxin a undergoes clathrin-independent, pacsin2-dependent endocytosis. | clostridium difficile infection affects a significant number of hospitalized patients in the united states. two homologous exotoxins, tcda and tcdb, are the major virulence factors in c. difficile pathogenesis. the toxins are glucosyltransferases that inactivate rho family-gtpases to disrupt host cellular function and cause fluid secretion, inflammation, and cell death. toxicity depends on receptor binding and subsequent endocytosis. tcdb has been shown to enter cells by clathrin-dependent endoc ... | 2016 | 27942025 |
| reduction in hospital-associated methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococcus with daily chlorhexidine gluconate bathing for medical inpatients. | daily bathing with chlorhexidine gluconate (chg) is increasingly used in intensive care units to prevent hospital-associated infections, but limited evidence exists for noncritical care settings. | 2017 | 27938986 |
| stable core virome despite variable microbiome after fecal transfer. | we recently described the 4.5-year time course of the enteric bacterial microbiota and virome of a patient cured from recurrent clostridium difficile infection (rcdi) by fecal microbiota transplantation (fmt). here, we extended the virome analyses and found the patient's phage population to exhibit highly donor-similar characteristics following fmt, which remained stable for the whole period tested (up to 7 months). moreover, the detected viral populations of donor and patient exhibited comparab ... | 2016 | 27935413 |
| development and validation of a liquid chromatography tandem mass spectrometry assay for the measurement of faecal metronidazole. | metronidazole is an oral antibiotic which is widely used in the treatment of patients with clostridium difficile associated disease. | 2016 | 27932283 |
| acute bronchitis. | cough is the most common illness-related reason for ambulatory care visits in the united states. acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. pertussis should be suspected in patients with cough persisting for more than two weeks that is a ... | 2016 | 27929206 |
| evaluation of correlation between pretest probability for clostridium difficile infection and clostridium difficile enzyme immunoassay results. | the objective of this study was to evaluate the clinical characteristics and outcomes of hospitalized patients tested for clostridium difficile and determine the correlation between pretest probability for c. difficile infection (cdi) and assay results. patients with testing ordered for c. difficile were enrolled and assigned a high, medium, or low pretest probability of cdi based on clinical evaluation, laboratory, and imaging results. stool was tested for c. difficile by toxin enzyme immunoass ... | 2017 | 27927930 |
| expert consensus on metrics to assess the impact of patient-level antimicrobial stewardship interventions in acute-care settings. | antimicrobial stewardship programs (asps) positively impact patient care, but metrics to assess asp impact are poorly defined. we used a modified delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. an expert panel rated 90 candidate metrics on a 9-point likert scale for association with 4 criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardshi ... | 2017 | 27927866 |
| fecal microbiota transplantation for recurrent clostridium difficile infection in patients with inflammatory bowel disease: a single-center experience. | | 2017 | 27923723 |
| in vitro inhibition of clostridium difficile by commercial probiotics: a microcalorimetric study. | the aim of the study was to investigate the influence of some commercial probiotics on the growth of clostridium difficile using isothermal microcalorimetry, a technique which can monitor the real time growth of bacteria. commercial probiotic strains and products, lactobacillus acidophilus la-5(®), bifidobacterium lactis bb-12(®), probio 7(®) and symprove™ were co-cultured with c. difficile in brain heart infusion (bhi) broth supplemented with 0.1% (w/v) l-cysteine hydrochloride and 0.1% (w/v) s ... | 2017 | 27923699 |
| clostridium difficile in an urban, university-affiliated long-term acute-care hospital. | objectives to describe the characteristics and impact of clostridium difficile infection (cdi) in a long-term acute-care hospital (ltach). design retrospective matched cohort study. setting a 38-bed, urban, university-affiliated ltach. methods the characteristics of ltach-onset cdi were assessed among patients hospitalized between july 2008 and october 2015. patients with cdi were matched to concurrently hospitalized patients without a diagnosis of cdi. severe cdi was defined as cdi with 2 or mo ... | 2017 | 27923419 |
| erratum: dietary zinc alters the microbiota and decreases resistance to clostridium difficile infection. | | 2016 | 27923021 |
| hiv-associated changes in the enteric microbial community: potential role in loss of homeostasis and development of systemic inflammation. | despite hiv therapy advances, average life expectancy in hiv-infected individuals on effective treatment is significantly decreased relative to uninfected persons, largely because of increased incidence of inflammation-related diseases, such as cardiovascular disease and renal dysfunction. the enteric microbial community could potentially cause this inflammation, as hiv-driven destruction of gastrointestinal cd4 t cells may disturb the microbiota-mucosal immune system balance, disrupting the sta ... | 2017 | 27922852 |
| genomic study of the type ivc secretion system in clostridium difficile: understanding c. difficile evolution via horizontal gene transfer. | clostridium difficile, the etiological agent of clostridium difficile infection (cdi), is a gram-positive, spore-forming bacillus that is responsible for ∼20% of antibiotic-related cases of diarrhea and nearly all cases of pseudomembranous colitis. previous data have shown that a substantial proportion (11%) of the c. difficile genome consists of mobile genetic elements, including seven conjugative transposons. however, the mechanism underlying the formation of a mosaic genome in c. difficile is ... | 2017 | 27922269 |
| structural insights into substrate recognition by clostridium difficile sortase. | sortases function as cysteine transpeptidases that catalyze the covalent attachment of virulence-associated surface proteins into the cell wall peptidoglycan in gram-positive bacteria. the substrate proteins targeted by sortase enzymes have a cell wall sorting signal (cwss) located at the c-terminus. up to date, it is still not well understood how sortases with structural resemblance among different classes and diverse species of bacteria achieve substrate specificity. in this study, we focus on ... | 2016 | 27921010 |
| re-evaluating the inhibition of stress erosions (revise): a protocol for pilot randomized controlled trial. | clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (icu), most commonly prescribing proton pump inhibitors (ppis). however, the incidence of gastrointestinal (gi) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. therefore, a large randomized clinical trial (rct) is needed to inform modern practice. the aim of this multicenter pilot trial is to determine the fe ... | 2017 | 27920416 |
| correction: chen, s., et al. identification of an essential region for translocation of clostridium difficile toxin b. toxins 2016, 8, 241. | n/a. | 2016 | 27918428 |
| management of clostridium difficile infection. | since the discovery of clostridium difficile infection (cdi) in the 1970s, there has been an increase in the incidence, severity, and recurrence rate of the disease. we reviewed the recent cdi literature in pubmed published before february 28, 2016 that focused on advances in therapy. despite a large number of studies describing methods for diagnosing the disease, there is currently no definitive test that identifies this infection with certainty, which complicates therapy. recommended therapy f ... | 2016 | 27917075 |
| familial mediterranean fever mutations lift the obligatory requirement for microtubules in pyrin inflammasome activation. | familial mediterranean fever (fmf) is the most common monogenic autoinflammatory disease worldwide. it is caused by mutations in the inflammasome adaptor pyrin, but how fmf mutations alter signaling in fmf patients is unknown. herein, we establish clostridium difficile and its enterotoxin a (tcda) as pyrin-activating agents and show that wild-type and fmf pyrin are differentially controlled by microtubules. diverse microtubule assembly inhibitors prevented pyrin-mediated caspase-1 activation and ... | 2016 | 27911804 |
| a review of experimental and off-label therapies for clostridium difficile infection. | in spite of increased awareness and the efforts taken to optimize clostridium difficile infection (cdi) management, with the limited number of currently available antibiotics for c. difficile the halt of this increasing epidemic remains out of reach. there are, however, close to 80 alternative treatment methods with controversial anti-clostridial efficacy or in experimental phase today. indeed, some of these therapies are expected to become acknowledged members of the recommended anti-cdi arsena ... | 2017 | 27910000 |
| clostridium difficile carriage in adult cystic fibrosis (cf); implications for patients with cf and the potential for transmission of nosocomial infection. | clostridium difficile is an anaerobic gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal-oral route. despite increasing carriage rates and the presence of c. difficile toxin in stool, patients with cf rarely appear to develop typical manifestations of c. difficile infection (cdi). in this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of c. difficile in a cohort of 60 adult patients with cf wh ... | 2017 | 27908697 |
| antimicrobial stewardship programs that target only high-cost, broad-spectrum antimicrobials miss opportunities to reduce clostridium difficile infections. | antimicrobial stewardship programs are promoted as a strategy to reduce clostridium difficile infections. we implemented an antimicrobial stewardship program comprised of formulary restriction plus prospective audit with feedback for high-cost and broad-spectrum antimicrobials. subsequently, we reviewed all heath care facility-onset, health care facility-associated c difficile infections. we found that most of these infections were associated with the antecedent receipt of nonaudited, and often ... | 2016 | 27908435 |
| duodenitis-proximal jejunitis in horses after experimental administration of clostridium difficile toxins. | duodenitis-proximal jejunitis (dpj) is an acute sporadic gastrointestinal disorder of horses of unknown cause. | 2017 | 27906466 |
| bezlotoxumab: first global approval. | bezlotoxumab (zinplava™) is a human monoclonal antibody against clostridium difficile toxin b developed by merck & co. in october 2016 it was approved in the usa for reducing the recurrence of c. difficile infection. this article summarizes the milestones in the development of bezlotoxumab leading to this first approval for use in patients receiving antibacterial drug treatment for c. difficile infection who are at high risk for recurrence of c. difficile infection. | 2016 | 27905086 |
| the incidence and drug resistance of clostridium difficile infection in mainland china: a systematic review and meta-analysis. | it has been widely reported that the incidence and severity of clostridium difficile infection (cdi) have increased dramatically in north america and europe. however, little is known about cdi in mainland china. in this study, we aimed to investigate the incidence of cdi and the main epidemic and drug-resistant strains of c. difficile in mainland china through meta-analysis of related studies published after the year 2010. a total of 51 eligible studies were included. the pooled incidence of tox ... | 2016 | 27897206 |
| dysbiosis of fecal microbiota and high frequency of citrobacter, klebsiella spp., and actinomycetes in patients with irritable bowel syndrome and gastroenteritis. | this study was aimed to characterize putative differences of fecal microbiota between irritable bowel syndrome (ibs) and gastroenteritis patients and healthy controls. | 2016 | 27895859 |
| clostridium difficile: a healthcare-associated infection of unknown significance in adults in sub-saharan africa. | clostridium difficile infection (cdi) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality, and financial implications. cdi is a healthcare-associated infection for which the primary risk factor is antibiotic usage, and it is the leading cause of bacterial diarrhoea in hiv-infected patients in the united states. little is known about the disease burden of cdi in sub-saharan africa, where hiv and healthcare-associated infections are more preva ... | 2016 | 27895832 |
| multicenter observational study of ceftaroline fosamil for methicillin-resistant staphylococcus aureus bloodstream infections. | novel therapies for methicillin-resistant staphylococcus aureus (mrsa) bloodstream infection (bsi) are needed in the setting of reduced antibiotic susceptibilities and therapeutic failure. ceftaroline is a cephalosporin antibiotic with mrsa activity. although not fda approved for mrsa bsi, ceftaroline has generated much interest as a potential treatment option. however, detailed descriptions of its use in this setting remain limited. to address this, we conducted a retrospective, multicenter, ob ... | 2017 | 27895012 |
| detection of a cfr(b) variant in german enterococcus faecium clinical isolates and the impact on linezolid resistance in enterococcus spp. | the national reference centre for staphylococci and enterococci in germany has received an increasing number of clinical linezolid-resistant e. faecium isolates in recent years. five isolates harbored a cfr(b) variant gene locus the product of which is capable of conferring linezolid resistance. the cfr(b)-like methyltransferase gene was also detected in clostridium difficile. antimicrobial susceptibility was determined for cfr(b)-positive and linezolid-resistant e. faecium isolates and two isog ... | 2016 | 27893790 |
| consensus report: faecal microbiota transfer - clinical applications and procedures. | faecal microbiota transplantation or transfer (fmt) aims at replacing or reinforcing the gut microbiota of a patient with the microbiota from a healthy donor. not many controlled or randomised studies have been published evaluating the use of fmt for other diseases than clostridium difficile infection, making it difficult for clinicians to decide on a suitable indication. | 2017 | 27891639 |
| enteric glial cells are susceptible to clostridium difficile toxin b. | clostridium difficile causes nosocomial/antibiotic-associated diarrhoea and pseudomembranous colitis. the major virulence factors are toxin a and toxin b (tcdb), which inactivate gtpases by monoglucosylation, leading to cytopathic (cytoskeleton alteration, cell rounding) and cytotoxic effects (cell-cycle arrest, apoptosis). c. difficile toxins breaching the intestinal epithelial barrier can act on underlying cells, enterocytes, colonocytes, and enteric neurons, as described in vitro and in vivo, ... | 2017 | 27891552 |
| interaction of gut microbiota with bile acid metabolism and its influence on disease states. | primary bile acids serve important roles in cholesterol metabolism, lipid digestion, host-microbe interactions, and regulatory pathways in the human host. while most bile acids are reabsorbed and recycled via enterohepatic cycling, ∼5% serve as substrates for bacterial biotransformation in the colon. enzymes involved in various transformations have been characterized from cultured gut bacteria and reveal taxa-specific distribution. more recently, bioinformatic approaches have revealed greater di ... | 2017 | 27888332 |
| asymptomatic colitis induced by low-dose methotrexate. | a woman aged 77 years with a history of rheumatoid arthritis (ra) presented with inflammatory colitis confined to her rectum, which was incidentally found by a screening colonoscopy. histopathological examination of colonic biopsies showed non-specific inflammatory infiltrates of lymphocytes, the cause of which was unknown. she had been diagnosed with ra 5 years before, and she was receiving methotrexate 6 mg weekly, to which tocilizumab had been added 4 years earlier, which achieved stable cont ... | 2016 | 27888222 |
| mortality, hospital costs, payments, and readmissions associated with clostridium difficile infection among medicare beneficiaries. | the management of clostridium difficile infection (cdi) among hospitalized patients is costly, and ongoing payment reform is compelling hospitals to reduce its burden. to assess the impact of cdi on mortality, hospital costs, healthcare use, and medicare payments for beneficiaries who were discharged with cdi listed as a secondary international classification of diseases, ninth revision, clinical modification claim diagnosis. | 2015 | 27885315 |
| burden of clostridium difficile-associated disease among patients residing in nursing homes: a population-based cohort study. | clostridium difficile (c. difficile) infection (cdi) is the leading cause of nosocomial diarrhea in the united states. this study aimed to examine the incidence of cdi and evaluate mortality and economic burden of cdi in an elderly population who reside in nursing homes (nhs). | 2016 | 27884118 |
| [adalimumab as induction therapy for crohn's disease - one center study]. | adalimumab is a subcutaneously administered recombinant fully human monoclonal antibody targeting tumor necrosis factor alpha. it has been approved for use in poland to treat patients with crohn's disease under the program of polish national health found since 2010. | 2016 | 27883347 |
| highly divergent clostridium difficile strains isolated from the environment. | clostridium difficile is one of the most important human and animal pathogens. however, the bacterium is ubiquitous and can be isolated from various sources. here we report the prevalence and characterization of c. difficile in less studied environmental samples, puddle water (n = 104) and soil (n = 79). c. difficile was detected in 14.4% of puddle water and in 36.7% of soil samples. environmental strains displayed antimicrobial resistance patterns comparable to already published data of human a ... | 2016 | 27880843 |
| patients' views on fecal microbiota transplantation: an acceptable therapeutic option in inflammatory bowel disease? | fecal microbiota transplantation (fmt) represents a new therapeutic option that has been studied in two randomized-controlled trials in ulcerative colitis patients. our study aimed to identify patients' views on the use of this novel therapeutic approach. | 2017 | 27879485 |
| the role of single-shot metronidazole in the prevention of clostridium difficile infection following ileostomy reversal surgery. | symptomatic infection with clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. in february 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, in a bid to reduce rates of clostridium difficile infection. | 2016 | 27878620 |
| national survey of practice of faecal microbiota transplantation for clostridium difficile infection in the uk. | | 2017 | 27876399 |
| diagnosis and treatment of clostridium difficile (c. diff) colitis: review of the literature and a perspective in gynecologic oncology. | clostridium difficile infection (cdi) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. although patients with a gynecologic malignancy may be at a higher risk of developing cdi due to an increased likelihood of having one or more risk factors, data do not consistently support the i ... | 2017 | 27876339 |
| chlorhexidine bathing and health care-associated infections among adult intensive care patients: a systematic review and meta-analysis. | health care-associated infections (hai) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (kaye and marchaim, j am geriatr soc 62(2):306-11, 2014; roberts and scott, med care 48(11):1026-35, 2010; warren and quadir, crit care med 34(8):2084-9, 2006; zimlichman and henderson, jama intern med 173(22):2039-46, 2013). importantly, infections acquired during a hospital stay have been shown to be preventable (loveday and wilson, j hosp infect 86:s1-70, 2014). i ... | 2016 | 27876075 |
| survival and prevalence of clostridium difficile in manure compost derived from pigs. | pigs, particularly piglets, have been identified as reservoir hosts of clostridium difficile. to examine the survival ability of this pathogen in pig feces-based manure compost, c. difficile spores, which were prepared to contain as few vegetative cells as possible, were artificially inoculated into pig feces and incubated at different temperatures. while c. difficile survived in the feces incubated at temperatures below 37 °c for over 30 days, cell numbers gradually decreased at thermophilic te ... | 2017 | 27871997 |
| prevalence and molecular characterization of clostridium difficile isolates from a pig slaughterhouse, pork, and humans in taiwan. | clostridium difficile causes antibiotic-associated diarrhea in both humans and animals. the ribotype 078, predominant in food animals, is associated with community-acquired c. difficile infection, and c. difficile is suggested to be a foodborne pathogen. recently, the c. difficile ribotype 078 lineage emerged in patients and pigs in taiwan. this study aimed to investigate the prevalence and molecular characterization of c. difficile isolated from a pig slaughterhouse, retail meat, ready-to-eat m ... | 2017 | 27870984 |
| efficacy of sterile fecal filtrate transfer for treating patients with clostridium difficile infection. | fecal microbiota transplantation (fmt) is a highly effective therapy for recurrent clostridium difficile infection (cdi). however, transferring undefined living bacteria entails uncontrollable risks for infectious and metabolic or malignant diseases, particularly in immunocompromised patients. we investigated whether sterile fecal filtrates (containing bacterial debris, proteins, antimicrobial compounds, metabolic products, and oligonucleotides/dna), rather than intact microorganisms, are effect ... | 2017 | 27866880 |
| evaluation of an automated room decontamination device using aerosolized peracetic acid. | because manual cleaning is often suboptimal, there is increasing interest in use of automated devices for room decontamination. we demonstrated that an ultrasonic room fogging system that generates submicron droplets of peracetic acid and hydrogen peroxide eliminated clostridium difficile spores and vegetative pathogens from exposed carriers in hospital rooms and adjacent bathrooms. | 2017 | 27866755 |
| an increase in healthcare-associated clostridium difficile infection associated with use of a defective peracetic acid-based surface disinfectant. | background we investigated an increase in the incidence of healthcare-associated clostridium difficile infection (cdi) that occurred following a change from a bleach disinfectant to a peracetic acid-based disinfectant. objective to evaluate the efficacy of the peracetic acid-based disinfectant. design laboratory-based product evaluation. methods the commercial peracetic acid-based product is activated on site by mixing a small volume of concentrated hydrogen peroxide and peracetic acid present i ... | 2017 | 27866475 |
| bezlotoxumab approved to prevent clostridium difficile recurrence. | | 2016 | 27864194 |
| liver abscess and bacteremia caused by lactobacillus: role of probiotics? case report and review of the literature. | lactobacilli are non-spore forming, lactic acid producing, gram-positive rods. they are a part of the normal gastrointestinal and genitourinary microbiota and have rarely been reported to be the cause of infections. lactobacilli species are considered non-pathogenic organisms and have been used as probiotics to prevent antibiotic associated diarrhea. there are sporadic reported cases of infections related to lactobacilli containing probiotics. | 2016 | 27863462 |
| rethinking strategies to select antibiotic therapy in clostridium difficile infection. | in recent years, clostridium difficile infection (cdi) has become a global public health threat associated with increased morbidity, mortality, and economic burden, all of which are exacerbated with disease recurrence. current guidelines informing treatment decisions are largely based on definitions of disease severity at diagnosis, with subjective components not well delineated across treatment algorithms and clinical trials. furthermore, there is little evidence linking severity at onset to ou ... | 2016 | 27862113 |
| evidence for dual receptor-binding sites in clostridium difficile toxin a. | tcda (308 kda) and tcdb (270 kda) disrupt the integrity of the intestinal epithelial barrier and provide an environment favorable for clostridium difficile colonization. recent evidence suggests that entry of tcda into cells is mediated by at least two domains. here, we report the characterization of a second receptor-binding domain (rbd2) for tcda. while both the isolated combined repetitive oligopeptides (crops) and rbd2 fragments are rapidly internalized into cells under physiologic condition ... | 2016 | 27861794 |