| predominance of clostridium difficile ribotypes 017 and 078 among toxigenic clinical isolates in southern taiwan. | ribotypes and toxin genotypes of clinical c. difficile isolates in taiwan are rarely reported. a prospective surveillance study from january 2011 to january 2013 was conducted at the medical wards of a district hospital in southern taiwan. of the first toxigenic isolates from 120 patients, 68 (56.7%) of 120 isolates possessed both tcda and tcdb. of 52 (43.3%) with tcdb and truncated tcda (tcda-/tcdb+), all were ribotype 017 and none had binary toxin or tcdc deletion. eighteen (15%) toxigenic iso ... | 2016 | 27861606 |
| two clusters of fluoroquinolone and clindamycin-resistant clostridium difficile pcr ribotype 001 strain recognized by capillary electrophoresis ribotyping and multilocus variable tandem repeat analysis. | to perform a retrospective analysis of the high occurrence of clostridium difficile infection in the surgical department of a czech tertiary care hospital and to identify weaknesses in c. difficile infection (cdi) prevention and control policies. | 2016 | 27860531 |
| toxin a of the nosocomial pathogen clostridium difficile induces primary effects in the proteome of hep-2 cells. | this study was carried out to investigate the impact of high concentrations of clostridium difficile toxin a (tcda) on the proteome of human cells. it should also be examined whether a catalytically deficient mutant (tcdanxn ) has an effect on target cells. | 2017 | 27860399 |
| variability in antibiotic use across ontario acute care hospitals. | antibiotic stewardship is a required organizational practice for canadian acute care hospitals, yet data are scarce regarding the quantity and composition of antibiotic use across facilities. we sought to examine the variability, and risk-adjusted variability, in antibiotic use across acute care hospitals in ontario, canada's most populous province. | 2017 | 27856724 |
| draft genome sequence of robinsoniella peoriensis 6600698, a confounder of clostridium difficile diagnosis. | robinsoniella peoriensis is a gram-positive, strictly anaerobic, spore-forming, rod-shaped organism. here, we report the draft genome of r. peoriensis 6600698, initially classified as clostridium difficile due to growth on selective agar, a fecal gdh pcr-positive result, and clinical symptoms. r. peoriensis is a potential confounder of c. difficile diagnosis. | 2016 | 27856584 |
| gleaning insights from fecal microbiota transplantation and probiotic studies for the rational design of combination microbial therapies. | beneficial microorganisms hold promise for the treatment of numerous gastrointestinal diseases. the transfer of whole microbiota via fecal transplantation has already been shown to ameliorate the severity of diseases such as clostridium difficile infection, inflammatory bowel disease, and others. however, the exact mechanisms of fecal microbiota transplant efficacy and the particular strains conferring this benefit are still unclear. rationally designed combinations of microbial preparations may ... | 2017 | 27856521 |
| national age group trends in clostridium difficile infection incidence and health outcomes in united states community hospitals. | prior studies have demonstrated an increase in clostridium difficile infection (cdi) incidence in the united states (u.s.) in recent years, but trends among different age groups have not been evaluated. this study describes national cdi incidence by age group over a 10-year period and mortality and hospital length of stay (los) among patients with cdi. | 2016 | 27855653 |
| characterization of the clostridium difficile volatile metabolome using comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry. | clostridium difficile is a bacterial pathogen capable of causing life-threatening infections of the gastrointestinal tract characterized by severe diarrhea. exposure to certain classes of antibiotics, advanced age, and prolonged hospitalizations are known risk factors for infection by this organism. anecdotally, healthcare providers have reported that they can smell c. difficile infections in their patients, and several studies have suggested that there may indeed be an olfactory signal associat ... | 2016 | 27855313 |
| two novel myoviruses from the north of iraq reveal insights into clostridium difficile phage diversity and biology. | bacteriophages (phages) are increasingly being explored as therapeutic agents to combat bacterial diseases, including clostridium difficile infections. therapeutic phages need to be able to efficiently target and kill a wide range of clinically relevant strains. while many phage groups have yet to be investigated in detail, those with new and useful properties can potentially be identified when phages from newly studied geographies are characterised. here, we report the isolation of c. difficile ... | 2016 | 27854339 |
| detection of clostridium difficile in feces of asymptomatic patients admitted to the hospital. | recent evidence shows that patients asymptomatically colonized with clostridium difficile may contribute to the transmission of c. difficile in health care facilities. additionally, these patients may have a higher risk of developing c. difficile infection. the aim of this study was to compare a commercially available pcr directed to both toxin a and b (artus c. difficile qs-rgq kit ce; qiagen), an enzyme-linked fluorescent assay to glutamate dehydrogenase (gdh elfa) (vidas, biomérieux), and an ... | 2017 | 27852676 |
| rates of microbiologically diagnosed infection and pathogen detection in hematopoietic stem cell transplant patients. | infections remain a significant cause of mortality in hematopoietic stem cell transplant patients. evaluations of causes of infection are often unrevealing, and at some sites, increasing rates of antimicrobial resistance have been noticed. we performed a retrospective analysis of infection rates and microbiologic testing yield, or percent of tests ordered to diagnose an infection, in the first 100 days of 30 allogeneic and 56 autologous stem cell transplants performed at san antonio military med ... | 2016 | 27849508 |
| are proton pump inhibitors associated with an increased risk of clostridium difficile infection after considering confounding variables? | | 2017 | 27847127 |
| asymptomatic and yet c. difficile-toxin positive? prevalence and risk factors of carriers of toxigenic clostridium difficile among geriatric in-patients. | clostridium difficile infections (cdi) are the most frequent cause of diarrhoea in hospitals. geriatric patients are more often affected by the condition, by a relapse and complications. therefore, a crucial question is how often colonization with toxigenic clostridium difficile strains occurs in elderly patients without diarrhoea and whether there is a "risk pattern" of colonized patients that can be defined by geriatric assessment. furthermore, the probability for those asymptomatic carriers t ... | 2016 | 27846818 |
| identification of a novel mutation at the primary dimer interface of gyra conferring fluoroquinolone resistance in clostridium difficile. | the aim of this study was to determine whether alternative resistance mechanisms, other than mutation in the quinolone resistance-determining region (qrdr) of dna gyrase, could confer fluoroquinolone resistance in clostridium difficile. an in vitro-generated c. difficile mutant exhibiting increased fluoroquinolone resistance was isolated through antibiotic selection on ciprofloxacin. the qrdr of this mutant was investigated by chain-termination sequencing and was found to be devoid of mutation. ... | 2015 | 27842877 |
| vesicoileal fistula and clostridium difficile colitis in a child with acute lymphoblastic leukemia. | | 2016 | 27842209 |
| pharmacologic stress gastropathy prophylaxis may not be necessary in at-risk surgical trauma icu patients tolerating enteral nutrition. | stress gastropathy is a rare complication of the intensive care unit stay with high morbidity and mortality. there are data that support the concept that patients tolerating enteral nutrition have sufficient gut blood flow to obviate the need for prophylaxis; however, no robust studies exist. this study assesses the incidence of clinically significant gastrointestinal bleeding in surgical trauma intensive care unit (sticu) patients at risk of stress gastropathy secondary to mechanical ventilatio ... | 2016 | 27837045 |
| fecal calprotectin level reflects the severity of clostridium difficile infection. | clostridium difficile is a significant nosocomial and community-acquired pathogen, and is the leading cause of antibiotic-induced diarrhea associated with high morbidity and mortality. given that the treatment outcome depends on the severity of c. difficile infection (cdi), we aimed to establish an efficient method of assessing severity, and focused on the stool biomarker fecal calprotectin (fc). fc directly reflects the intestinal inflammation status of a patient, and can aid in interpreting th ... | 2017 | 27834066 |
| chemical and stress resistances of clostridium difficile spores and vegetative cells. | clostridium difficile is a gram-positive, sporogenic and anaerobic bacterium that causes a potentially fatal colitis. c. difficile enters the body as dormant spores that germinate in the colon to form vegetative cells that secrete toxins and cause the symptoms of infection. during transit through the intestine, some vegetative cells transform into spores, which are more resistant to killing by environmental insults than the vegetative cells. understanding the inherent resistance properties of th ... | 2016 | 27833595 |
| antimicrobial stewardship and environmental decontamination for the control of clostridium difficile transmission in healthcare settings. | we implement an agent-based model for clostridium difficile transmission in hospitals that accounts for several processes and individual factors including environmental and antibiotic heterogeneity in order to evaluate the efficacy of various control measures aimed at reducing environmental contamination and mitigating the effects of antibiotic use on transmission. in particular, we account for local contamination levels that contribute to the probability of colonization and we account for both ... | 2017 | 27826877 |
| colon-targeted delivery of igy against clostridium difficile toxin a and b by encapsulation in chitosan-ca pectinate microbeads. | this study investigated the use of a newly developed chitosan-ca pectinate microbead formulation for the colon-targeted delivery of anti-a/b toxin immunoglobulin of egg yolk (igy) to inhibit toxin binding to colon mucosa cells. the effect of the three components (pectinate, calcium chloride, and chitosan) used for the microbead production was examined with the aim of identifying the optimal levels to improve drug encapsulation efficiency, swelling ratio, and cumulative igy release rate. the opti ... | 2016 | 27826799 |
| infection: modulation of clostridium difficile infection by dietary zinc. | | 2016 | 27826138 |
| influence of antibiotics and case exposure on hospital-acquired clostridium difficile infection independent of illness severity. | previous studies of the association between antibiotic exposure and risk of hospital-acquired clostridium difficile-associated infection (cdi) have not fully accounted for patient severity of illness, and competing risks. | 2017 | 27825674 |
| clostridium difficile infection: stewardship's lowest hanging fruit? | | 2017 | 27825596 |
| effect of a national 4c antibiotic stewardship intervention on the clinical and molecular epidemiology of clostridium difficile infections in a region of scotland: a non-linear time-series analysis. | whereas many antibiotics increase risk of clostridium difficile infection through dysbiosis, epidemic c difficile ribotypes characterised by multidrug resistance might depend on antibiotic selection pressures arising from population use of specific drugs. we examined the effect of a national antibiotic stewardship intervention limiting the use of 4c antibiotics (fluoroquinolones, clindamycin, co-amoxiclav, and cephalosporins) and other infection prevention and control strategies on the clinical ... | 2017 | 27825595 |
| epidemiology and outcome of clostridium difficile infections in patients hospitalized in internal medicine: findings from the nationwide fadoi-practice study. | clostridium difficile (cd) is a leading cause of diarrhoea among hospitalized patients. the objective of this study was to evaluate the rate, the optimal diagnostic work-up, and outcome of cd infections (cdi) in internal medicine (im) wards in italy. | 2016 | 27825317 |
| clostridium difficile associated diarrhoea: an increased problem. | clostridium difficile associated diarrhoea is a major health problem that seems to be on the increase. in our study, we analyse the changes in the incidence of this infection over the last 11 years. | 2016 | 27823794 |
| electronic clostridium difficile infection bundle reduces time to initiation of contact precautions. | the impact of computerized order-entry bundles on timing of contact precaution initiation for c. difficile infection (cdi) remains largely unexplored. implementation of an electronic cdi prevention and management bundle that included an automatic isolation component significantly reduced time to initiation of contact precautions from 33.7 to 22.4 hours. infect control hosp epidemiol 2016;242-244. | 2017 | 27821198 |
| clostridium difficile infection in cancer patients. | | 2017 | 27817939 |
| a comprehensive study of costs associated with recurrent clostridium difficile infection. | background clostridium difficile infection (cdi) is the most common healthcare-associated infection and is associated with considerable morbidity. recurrent cdi is a key contributing factor to this morbidity. despite an estimated 83,000 recurrences annually in the united states, there are few accurate estimates of costs associated with recurrent cdi. objective we performed this study (1) to identify the health consequences of recurrent cdi including need for repeat hospitalization, intensive car ... | 2017 | 27817758 |
| drug utilization review of cephalosporins in a secondary care hospital in united arab emirates. | background cephalosporins are one of the most commonly used antibiotics in united arab emirates (uae). few studies have been carried out to evaluate the antibiotic utilization pattern in uae in spite of the obvious increase in cephalosporins resistance during the past decade. objective to assess the prescriptions pattern of cephalosporins among physicians at a secondary care hospital in ras al khaimah, uae. method this observational prospective study was carried out during october 2013 to april ... | 2016 | 27817172 |
| clostridium difficile infection due to pneumonia treatment: mortality risk models. | one of the most common gastrointestinal infection after the antibiotic treatment of community or nosocomial pneumonia is caused by the anaerobic spore clostridium difficile (c. difficile). the aim of this study was to retrospectively assess mortality due to c. difficile infection (cdi) in patients treated for pneumonia. we identified 94 cases of post-pneumonia cdi out of the 217 patients with cdi. the mortality issue was addressed by creating a mortality risk models using logistic regression and ... | 2017 | 27815923 |
| dissemination of clostridium difficile in food and the environment: significant sources of c. difficile community-acquired infection? | clostridium difficile is a significant pathogen with over 300 000 cases reported in north america annually. previously, it was thought that c. difficile was primarily a clinically associated infection. however, through the use of whole genome sequencing it has been revealed that the majority of cases are community acquired. the source of community-acquired c. difficile infections (cdi) is open to debate with foodborne being one route considered. clostridium difficile fits the criteria of a foodb ... | 2017 | 27813268 |
| genome sequence of clostridium paraputrificum 373-a1 isolated in chile from a patient infected with clostridium difficile. | clostridium paraputrificum is a gut microbiota member reported in several cases of bacteremia and coinfections. so far, only one genome sequence of a c. paraputrificum (agr2156) isolate is available. here, we present the draft genome of c. paraputrificum strain 373-a1, isolated from stools from a patient with c. difficile infection. | 2016 | 27811092 |
| distribution of clostridium difficile pcr ribotypes and high proportion of 027 and 176 in some hospitals in four south eastern european countries. | while clostridium difficile epidemiology is well documented in many european countries, data are largely missing for south eastern european region. here we report the pcr ribotype distribution of 249 c. difficile isolates received for typing from six hospital settings from croatia, bosnia and herzegovina, republic of macedonia and serbia in time period from 2008 to 2015. twenty-four pcr ribotypes were detected. the majority of strains from bosnia and herzegovina and serbia belonged to pcr riboty ... | 2016 | 27751937 |
| characterization of clostridium difficile pcr-ribotype 018: a problematic emerging type. | recent surveys indicate that the majority of toxigenic clostridium difficile strains isolated in european hospitals belonged to pcr-ribotypes (rts) different from rt 027 or rt 078. among these types, rt 018 has been reported in italy and, more recently, in korea and japan. in italy, strains rt 018 have become predominant in the early 2000s, whereas the majority of strains isolated before were rt 126, a type belonging to the same lineage as the rt 078. in this study, we have found that italian st ... | 2016 | 27725230 |
| gut eradication of vim-1 producing st9 klebsiella oxytoca after fecal microbiota transplantation for diarrhea caused by a clostridium difficile hypervirulent r027 strain. | we report the fecal carriage eradication of a vim-1-producing st9 klebsiella oxytoca strain in a pluripathological 84-year-old woman after fecal microbiota transplantation to control relapsing r027 hypervirulent clostridium difficile infections. the donor was her son, in which the absence of fecal carbapenemase-producing bacteria was corroborated. | 2016 | 27712927 |
| clostridium difficile: a rare cause of pyogenic liver abscess. | extra-intestinal infections due to clostridium difficile have been reported rarely. herein we report a case of pyogenic liver abscess from toxigenic c. difficile in an 80-year-old non-hospitalized woman with diabetes mellitus, cerebrovascular and cardiovascular diseases. the patient was admitted to the emergency department with fever and abdominal pain. there was no history of diarrhea or use of antibiotics. laboratory parameters revealed signs of inflammation and elevated ast and alt levels. ab ... | 2016 | 27693543 |
| molecular types and antimicrobial susceptibility patterns of clostridium difficile isolates in different epidemiological settings in a tertiary care center in israel. | the aims of this prospective study were to examine the correlation between the molecular types and the antimicrobial susceptibility patterns of clostridium difficile isolates with the source of acquisition and the occurrence of c. difficile infections (cdi) in a tertiary center in israel. all available isolates from community-acquired (ca) cdi episodes (n=43) and matching numbers of isolates from community-onset, hospital acquired (co-ha, n=67) and ha-cdi (n=56) and 32 cases of recurrent cdi wer ... | 2016 | 27638350 |
| a genetic assay for gene essentiality in clostridium. | essential genes of pathogens are potential therapeutic targets, but are difficult to verify. here, gene essentiality was determined by targeted knockout following engineered gene duplication. null mutants of candidate essential genes of clostridium difficile were viable only in the presence of a stable second copy of the gene. | 2016 | 27487328 |
| predictors of clostridium difficile infection-related mortality among older adults. | over 90% of annual deaths caused by clostridium difficile infection (cdi) occur in persons aged ≥65 years. however, no large-scale studies have been conducted to investigate predictors of cdi-related mortality among older adults. | 2016 | 27424303 |
| teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections. | | 2016 | 27424302 |
| a case of multiple recurrence of clostridium difficile infection with severe hematochezia in an immunocompromised host. | clostridium difficile infection (cdi) is increasing in incidence and severity. clinically, diarrhea frequently occurs, but severe hematochezia is rarely seen with cdi. we describe here a hematopoietic stem cell transplantation (hsct) recipient who experienced life-threatening gastrointestinal bleeding due to severe cdi. subsequent stool surveillance and molecular typing observed the patient who had two episodes of recurrence with a new strain of c. difficile distinct from the initial infection. ... | 2016 | 27377777 |
| clostridium difficile infection epidemiology and management: comparison of results of a prospective study with a retrospective one in a reference teaching and research hospital in northern italy. | clostridium difficile-associated disease (cdad) is the most common infectious antibiotic-associated diarrhea and is a growing health care problem. prevention of clostridium difficile infection focuses on clinical and epidemiologic infection control measures. | 2016 | 27372227 |
| hospitalized patients with heart failure and common bacterial infections: a nationwide analysis of concomitant clostridium difficile infection rates and in-hospital mortality. | patients with heart failure (hf) are frequently hospitalized with common bacterial infections. it is unknown whether they experience concomitant clostridium difficile infection (cdi) more frequently than patients without hf, and whether cdi affects their mortality. | 2016 | 27317844 |
| health care worker hand contamination at critical moments in outpatient care settings. | the delivery of health care in outpatient settings has steadily increased over the past 40 years. the risk of infection in these settings is considered to be low. however, the increasing severity of illness and complexity of care in outpatient settings creates a need to reexamine the transmission of pathogens in this setting. | 2016 | 27287735 |
| epidemiology of clostridium difficile infection in hospitalized oncology patients. | the epidemiology of clostridium difficile infection (cdi) among oncology inpatients is poorly understood. in multivariate analysis we identified age, history of cdi, and prior receipt of cephalosporins, β-lactam/β-lactamase inhibitors, metronidazole, and blood transfusion as risk factors associated with cdi. reducing broad-spectrum antibiotic use, particularly among older patients and those with a cdi history and recent blood transfusions, may decrease cdi risk in this population. | 2016 | 27287733 |
| a pilot study to assess the effectiveness and cost of routine universal use of peracetic acid sporicidal wipes in a real clinical environment. | peracetic acid sporicidal wipes have been shown to be an effective disinfectant, but in controlled test environments. their high cost may restrict use. | 2016 | 27238941 |
| cost-effectiveness of histamine2 receptor antagonists versus proton pump inhibitors for stress ulcer prophylaxis in critically ill patients. | to determine the cost-effectiveness of stress ulcer prophylaxis with histamine2 receptor antagonists (h2ras) versus proton pump inhibitors (ppis) in critically ill and mechanically ventilated adults. | 2017 | 27809338 |
| nutrition and the gut microbiome in the elderly. | the gut microbiota is the assembly of microorganisms living in our intestine and their genomes are known as the microbiome. the correct composition and functionality of this microbiome is essential for maintaining a "healthy status." aging is related to changes in the gut microbiota which are frequently associated with physiological modifications of the gastrointestinal tract, as well as, to changes in dietary patterns, together with a concomitant decline in cognitive and immune function, all to ... | 2017 | 27808595 |
| comparison of clostridium difficile ribotypes circulating in australian hospitals and communities. | clostridium difficile infection (cdi) is becoming less exclusively a health care-associated cdi (ha-cdi). the incidence of community-associated cdi (ca-cdi) has increased over the past few decades. it has been postulated that asymptomatic toxigenic c. difficile (tcd)-colonized patients may play a role in the transfer of c. difficile between the hospital setting and the community. thus, to investigate the relatedness of c. difficile across the hospital and community settings, we compared the char ... | 2017 | 27807147 |
| proton pump inhibitors do not increase risk for clostridium difficile infection in the intensive care unit. | patients in the intensive care unit (icu) frequently receive proton pump inhibitors (ppis) and have high rates of clostridium difficile infection (cdi). ppis have been associated with cdi in hospitalized patients, but icu patients differ fundamentally from non-icu patients and few studies have focused on ppi use exclusively in the critical care setting. we performed a retrospective cohort study to determine the associations between ppis and health-care facility-onset cdi in the icu. | 2016 | 27575714 |
| identification of factors impacting recurrent clostridium difficile infection and development of a risk evaluation tool. | recurrent clostridium difficile infection (rcdi) is a growing concern, yet limited data exists to clarify which patients are at highest risk. identification of these patients may better inform decisions of those who may benefit from prophylactic intervention. the purpose of this study was to determine which factors are associated with the recurrence of clostridium difficile infection (cdi) and to develop a risk stratification tool. methods. patients readmitted within 10 weeks of positive c. di ... | 2016 | 27806252 |
| costs and consequences associated with misdiagnosed lower extremity cellulitis. | inflammatory dermatoses of the lower extremity are often misdiagnosed as cellulitis (aka "pseudocellulitis") and treated with antibiotics and/or hospitalization. there is limited data on the cost and complications from misdiagnosed cellulitis. | 2016 | 27806170 |
| clostridium difficile infection: associations with chemotherapy, radiation therapy, and targeting therapy treatments. | although mucositis, diarrhea, and constipation as well as immunosuppression are well recognized side-effects of cancer treatment, the underlying mechanisms including changes in the composition of gut microbiota and clostridium difficile infection have not yet been thoroughly reviewed. | 2016 | 27804875 |
| hydralazine-induced anca vasculitis in the setting of acute clostridium difficile infection. | we report a rare case of hydralazine-induced anca associated glomerulonephritis with alveolar hemorrhage in the setting of acute clostridium difficile infection. a 71-year-old caucasian woman with hypertension, who was being treated with hydralazine 25 mg twice a day for six years, presented to the hospital with diarrhea, nausea, vomiting and anemia. she had acute kidney injury and urinalysis showed proteinuria, dysmorphic rbcs, and rare rbc cast. she was found to have clostridium difficile coli ... | 2016 | 27801920 |
| molecular epidemiology and antimicrobial susceptibility of clostridium difficile isolates from a university teaching hospital in china. | while the developed world has seen a significant increase in the number of scientific articles on clostridium difficile infection (cdi), the developing world still lags behind on this subject due to limited laboratory capacity, low awareness, and limited surveillance of this problem. as such, cdi is considered a neglected but potentially huge problem in developing countries. the major aim of this study was to systemically evaluate the utility of several molecular typing tools for cdi, including ... | 2016 | 27799923 |
| eosinophils, probiotics, and the microbiome. | there is currently substantial interest in the therapeutic properties of probiotic microorganisms as recent research suggests that oral administration of specific bacterial strains may reduce inflammation and alter the nature of endogenous microflora in the gastrointestinal tract. eosinophils are multifunctional tissue leukocytes, prominent among the resident cells of the gastrointestinal mucosa that promote local immunity. recent studies with genetically altered mice indicate that eosinophils n ... | 2016 | 27549754 |
| rasch analysis of the antimicrobial self-assessment toolkit for national health service (nhs) trusts (asat v17). | the antimicrobial self-assessment toolkit for national health service (nhs) trusts (asat) was developed to evaluate hospital-based antimicrobial stewardship programmes. iterative validity investigations of the asat were used to produce a 91-item asat v17 utilizing qualitative methodology. rasch analysis was used to generate question (item) behaviour estimates and to investigate the validity of asat v17. | 2017 | 27798214 |
| [clostridium difficile infection : what is currently available for treatment?] | clostridium difficile (c. difficile) is an anaerobic, gram-positive, spore-forming, toxin-secreting bacillus. it is transmitted via a fecal-oral route and can be found in 1-3 % of the healthy population. symptoms caused by c. difficile range from uncomplicated diarrhea to a toxic megacolon. the incidence, frequency of recurrence, and mortality rate of c. difficile infections (cdis) have increased significantly over the past few decades. the most important risk factor is antibiotic treatment in e ... | 2016 | 27796474 |
| dietary zinc alters the microbiota and decreases resistance to clostridium difficile infection. | clostridium difficile is the most commonly reported nosocomial pathogen in the united states and is an urgent public health concern worldwide. over the past decade, incidence, severity and costs associated with c. difficile infection (cdi) have increased dramatically. cdi is most commonly initiated by antibiotic-mediated disruption of the gut microbiota; however, non-antibiotic-associated cdi cases are well documented and on the rise. this suggests that unexplored environmental, nutrient and hos ... | 2016 | 27668938 |
| effect of fecal microbiota transplantation on recurrence in multiply recurrent clostridium difficile infection: a randomized trial. | to date, evidence for the efficacy of fecal microbiota transplantation (fmt) in recurrent clostridium difficile infection (cdi) has been limited to case series and open-label clinical trials. | 2016 | 27547925 |
| toxin profiles, pcr ribotypes and resistance patterns of clostridium difficile: a multicentre study in china, 2012-2013. | a total of 178 clinical isolates of clostridium difficile were collected from five major teaching hospitals representing northern, eastern and southern china from august 2012 to july 2013. among the 178 isolates, 162 (91.0%) were toxigenic, including 66 (40.7%) toxin a-negative, toxin b-positive, 95 (58.6%) toxin a-positive, toxin b-positive and only 1 (0.6%) toxin a-, toxin b- and binary toxin-positive. twenty-nine different pcr ribotypes were identified, of which 017 (21.0%), 012 (17.3%) and n ... | 2016 | 27793509 |
| snp-ing out the differences: investigating differences between clostridium difficile lab strains. | | 2016 | 27791481 |
| body mass index greater than 35 is associated with severe clostridium difficile infection. | obesity has been implicated in the acquisition of clostridium difficile infections (cdi), however, no study has investigated whether there is a correlation between body mass index (bmi) and cdi severity. | 2017 | 27790736 |
| understanding risk perceptions and responses of the public and health care professionals toward clostridium difficile: a qualitative interpretive description study. | the occurrence of clostridium difficile infection is a major health-related risk. how the public and health care professionals perceive and respond to a health-related risk is shaped by socially and contextually structured evaluations and interpretations. risk perceptions and responses are context dependent and therefore need to be understood within the context in which they are perceived and experienced. | 2017 | 27789069 |
| identification of risk factors associated with clostridium difficile infection in liver transplantation recipients: a single-center analysis. | clostridium difficile remains the leading cause of health care-associated infectious diarrhea, and its incidence and severity are increasing in liver transplant recipients. several known risk factors for c difficile infection (cdi) are inherently associated with liver transplantation, such as severe underlying illness, immunosuppression, abdominal surgery, and broad-spectrum antibiotic use. we conducted a single-center retrospective case control study to characterize risk factors for cdi among p ... | 2016 | 27788814 |
| a descriptive case study of the changing nature of nurses' work: the impact of managing infectious diseases requiring isolation. | methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococci, and clostridium difficile have increased in health care facilities worldwide. the complexity of caring for patients with infectious comorbidities has impacted nurses' daily work. a mixed-methods study at 1 community hospital in ontario, canada, demonstrated the cumulative effect of additional time spent on infection prevention and control measures resulted in trade-offs, cutting corners, and raised concerns about the ... | 2017 | 27776824 |
| assessing methanobrevibacter smithii and clostridium difficile as not conventional faecal indicators in effluents of a wastewater treatment plant integrated with sludge anaerobic digestion. | wastewater treatment plants (wwtp) are an important source of surface water contamination by enteric pathogens, affecting the role of environmental water as a microbial reservoir. we describe the release to the environment of certain anaerobes of human and environmental concern. the work was focused on emerging microbial targets. they are tracing, by rt-qpcr, on wwtp effluents, both liquid and solid, when an anaerobic digestion step is included. the focus is placed on clostridium spp. with the s ... | 2016 | 27697372 |
| asymptomatic clostridium difficile colonization in two australian tertiary hospitals, 2012-2014: prospective, repeated cross-sectional study. | to investigate the prevalence and risk factors for asymptomatic toxigenic (tcd) and nontoxigenic clostridium difficile (ntcd) colonization in a broad cross section of the general hospital population over a 3-year period. | 2017 | 27615716 |
| molecular characteristics of clostridium difficile isolates from human and animals in the north eastern region of india. | a total of 1034 samples were collected from different sources and c. difficile was isolated from 18 (9.04%) of 199 human, 9 (4.89%) of 184 cattle, 29 (12.44%) of 233 pig, and from 23 (13.94%) of 165 poultry samples. variations were observed on the rate of isolation according to age and clinical conditions (diarrhoea). none of the samples from cow, sheep, goat, local chicken, and wild animals yielded any c. difficile. out of those isolates, 8, 2, 19 and 6 isolates from human, cattle, pig and poul ... | 2016 | 27569848 |
| efficacy of oral vancomycin in preventing recurrent clostridium difficile infection in patients treated with systemic antimicrobial agents. | | 2016 | 27567123 |
| molecular characterisation of czech clostridium difficile isolates collected in 2013-2015. | clostridium difficile is a leading nosocomial pathogen and molecular typing is a crucial part of monitoring its occurrence and spread. over a three-year period (2013-2015), clinical c. difficile isolates from 32 czech hospitals were collected for molecular characterisation. of 2201 c. difficile isolates, 177 (8%) were non-toxigenic, 2024 (92%) were toxigenic (tcda and tcdb) and of these, 677 (33.5%) carried genes for binary toxin production (cdta, cdtb). capillary-electrophoresis (ce) ribotyping ... | 2016 | 27519407 |
| [clostridium difficile infections in geriatric patients]. | clostridium difficile is the main cause of nosocomial antibiotic-associated diarrhea in adults in europe and north america. infections with c. difficile typically occur in elderly patients with comorbidities and prior antibiotic therapy. other risk factors are proton pump inhibitors, which are taken by many elderly patients. the main virulence factors are toxins a and b. the clinical spectrum ranges from asymptomatic colonization to severe disease with abdominal complications and sepsis. the cur ... | 2016 | 27785569 |
| 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 | 27620311 |
| clostridium difficile presence in spanish and belgian hospitals. | clostridium difficile is recognised worldwide as the main cause of infectious bacterial antibiotic-associated diarrhoea in hospitals and other healthcare settings. the aim of this study was to first survey c. difficile prevalence during the summer of 2014 at the central university hospital of asturias (spain). by typing the isolates obtained, it was then possible to compare the ribotype distribution at the spanish hospital with results from the st luc university hospital in belgium over the same ... | 2016 | 27616443 |
| newly identified bacteriolytic enzymes that target a wide range of clinical isolates of clostridium difficile. | clostridium difficile has emerged as a major cause of infectious diarrhea in hospitalized patients, with increasing mortality rate and annual healthcare costs exceeding $3 billion. since c. difficile infections are associated with the use of antibiotics, there is an urgent need to develop treatments that can inactivate the bacterium selectively without affecting commensal microflora. lytic enzymes from bacteria and bacteriophages show promise as highly selective and effective antimicrobial agent ... | 2016 | 27260850 |
| insight into the 3d structure and substrate specificity of previously uncharacterized gnat superfamily acetyltransferases from pathogenic bacteria. | members of the gcn5-related n-acetyltransferase (gnat) superfamily catalyze the acetylation of a wide range of small molecule and protein substrates. due to their abundance in all kingdoms of life and diversity of their functions, they are implicated in many aspects of eukaryotic and prokaryotic physiology. although numerous gnats have been identified thus far, many remain structurally and functionally uncharacterized. the elucidation of their structures and functions is critical for broadening ... | 2017 | 27783928 |
| mechanisms for floor surfaces or environmental ground contamination to cause human infection: a systematic review. | shoe soles have been shown to transfer infectious microorganisms to floor and ground surfaces. however, the possible modes of transmission of infectious agents from floors or ground surfaces to human contact for infection have not been systematically reviewed. a systematic review was performed on articles indexed in medical databases (medline, embase, pubmed) using a pre-defined search strategy and mesh terms (date of last search: 15 march 2016). only primary research studies in english that inv ... | 2017 | 27780492 |
| a population-based longitudinal study of clostridium difficile infection-related hospitalization in mid-age and older australians. | clostridium difficile is the principal cause of infectious diarrhoea in hospitalized patients. we investigated the incidence and risk factors for hospitalization due to c. difficile infection (cdi) in older australians. we linked data from a population-based prospective cohort study (the 45 and up study) of 266 922 adults aged ⩾45 years recruited in new south wales, australia to hospitalization and death records for 2006-2012. we estimated the incidence of cdi hospitalization and calculated days ... | 2017 | 27780483 |
| new and emerging therapies for clostridium difficile infection. | clostridium difficile infection has attained high prominence given its prevalence and impacts on patients and healthcare institutions. multiple new approaches to the prevention and treatment of c. difficile infection (cdi) are undergoing clinical trials. | 2016 | 27753689 |
| crystal structures of two nitroreductases from hypervirulent clostridium difficile and functionally related interactions with the antibiotic metronidazole. | nitroreductases (nrs) are flavin mononucleotide (fmn)-dependent enzymes that catalyze the biotransformation of organic nitro compounds (rno2; r = alkyl, aryl) to the nitroso rn=o, hydroxylamino rnhoh, or amine rnh2 derivatives. metronidazole (mtz) is a nitro-containing antibiotic that is commonly prescribed for lower-gut infections caused by the anaerobic bacterium clostridium difficile. c. difficile infections rank number one among hospital acquired infections, and can result in diarrhea, sever ... | 2016 | 27623089 |
| determining the cause of recurrent clostridium difficile infection using whole genome sequencing. | understanding the contribution of relapse and reinfection to recurrent clostridium difficile infection (cdi) has implications for therapy and infection prevention, respectively. we used whole genome sequencing to determine the relation of c. difficile strains isolated from patients with recurrent cdi at an academic medical center in the united states. thirty-five toxigenic c. difficile isolates from 16 patients with 19 recurrent cdi episodes with median time of 53.5days (range, 13-362) between e ... | 2017 | 27771207 |
| a dna vaccine targeting tcda and tcdb induces protective immunity against clostridium difficile. | clostridium difficile-associated disease (cdad) constitutes a great majority of hospital diarrhea cases in industrialized countries and is induced by two types of large toxin molecules: toxin a (tcda) and toxin b (tcdb). development of immunotherapeutic approaches, either active or passive, has seen a resurgence in recent years. studies have described vaccine plasmids that express either tcda and/or tcdb receptor binding domain (rbd). however, the effectiveness of one vector encoding both toxin ... | 2016 | 27770789 |
| the projected effectiveness of clostridium difficile vaccination as part of an integrated infection control strategy. | early clinical trials of a clostridium difficile toxoid vaccine show efficacy in preventing c. difficile infection (cdi). the optimal patient group to target for vaccination programmes remains unexplored. this study performed a model-based evaluation of the effectiveness of different cdi vaccination strategies, within the context of existing infection prevention and control strategies such as antimicrobial stewardship. | 2016 | 27727031 |
| endoscopic peroral jejunal fecal microbiota transplantation. | fecal microbiota transplantation (fmt) is a valuable treatment modality for recurrent clostridium difficile (c. difficile) colitis. multiple questions including the best delivery route and volume remain unanswered. here, we report a case series of high-volume fmt using endoscopic jejunal application route. | 2016 | 27575658 |
| positive predictive value of the immunoassay for clostridium difficile toxin a and b detection at a private hospital. | clostridium difficile (c. difficile) is a gram-positive bacillus that is a common cause of diarrhea in the hospital environment, with a documented incidence of up to 10%. there are different methods to detect it, but a widely used test in our environment is the immunoassay for toxins a and b. | 2016 | 27316592 |
| [laboratory diagnosis of clostridium difficile infection]. | clostridium difficile is the leading cause of nosocomial diarrhoea in developed countries, and is one of the main aetiologic agents of community diarrhea. the eruption of the hypervirulent strain bi/nap1/027 has given rise to an increase in the morbidity and mortality of c.difficile infection (cdi). this document aims to review the main clinical pictures of cdi and the laboratory diagnosis, including sampling, transport and storage of specimens, specimen processing, diagnostic procedures, antimi ... | 2016 | 26493356 |
| rapid identification of the etiological factors causing diarrheal diseases. | the main objective of this investigation was to develop and pilot a real-time polymerase chain reaction (rt-pcr) diagnostic system for rapid and simultaneous identification of pathogens with a particular emphasis on diarrheal disease diagnostics. the diarrheal diseases were selected as a target for the pilot because they constitute a primary public health priority in georgia and worldwide. the product developed by our research team "neo_pcr_diagnostics" represents an original system for the iden ... | 2016 | 27770538 |
| epidemiology and recurrence rates of clostridium difficile infections in germany: a secondary data analysis. | clostridium difficile infection (cdi) is the most common cause of health-care-associated infectious diarrhea. recurrence rates are as high as 20-30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. according to the literature, the risk of cdi recurrence increases after the second relapse to 30-65%. accurate data for germany are not yet available. | 2016 | 27770261 |
| therapeutic manipulation of the microbiota: past, present, and considerations for the future. | the growing appreciation of the potential role of indigenous microbiota in disease has resulted in a concomitant interest in manipulating the microbiome for therapeutic effect. the most successful example of microbiota manipulation for treatment of a disease is in recurrent infection with the bacterial pathogen clostridium difficile. | 2016 | 27619640 |
| correction: importance of glutamate dehydrogenase (gdh) in clostridium difficile colonization in vivo. | [this corrects the article doi: 10.1371/journal.pone.0160107.]. | 2016 | 27768767 |
| household transmission of clostridium difficile to family members and domestic pets. | objective to determine the risk of clostridium difficile transmission from index cases with c. difficile infection (cdi) to their household contacts and domestic pets. design a prospective study from april 2011 to june 2013. setting patients with cdi from canadian tertiary care centers. participants patients with cdi, their household human contacts, and pets. methods epidemiologic information and stool or rectal swabs were collected from participants at enrollment and monthly for up to 4 months. ... | 2016 | 27767004 |
| fear of failure: engaging patients in antimicrobial stewardship after fecal transplantation for recurrent clostridium difficile infection. | | 2017 | 27766987 |
| laboratory experience with the liaison analyzer in the diagnosis of clostridium difficile-associated diarrhea. | chemiluminescent or enzyme-linked fluorescent immunoassays are commonly used to diagnose clostridium difficile-associated diarrhea. | 2016 | 27766170 |
| healthcare personnel attire and devices as fomites: a systematic review. | background transmission of pathogens within the hospital environment remains a hazard for hospitalized patients. healthcare personnel clothing and devices carried by them may harbor pathogens and contribute to the risk of pathogen transmission. objective to examine bacterial contamination of healthcare personnel attire and commonly used devices. methods systematic review. results of 1,175 studies screened, 72 individual studies assessed contamination of a variety of items, including white coats, ... | 2016 | 27609491 |
| mortality and costs in clostridium difficile infection among the elderly in the united states. | objective to examine attributable mortality and costs of clostridium difficile infection (cdi) in the medicare population. design a population-based cohort study among us adults aged at least 65 years in the 2008-2010 medicare 5% sample, with follow-up of 12 months. patients incident cdi episode was defined by the international classification of diseases, ninth revision, clinical modification code of 008.45 and no other occurrences within the preceding 12 months. to quantify the adjusted mortali ... | 2016 | 27572289 |
| a regional outbreak of clostridium difficile pcr-ribotype 027 infections in southeastern france from a single long-term care facility. | objective to describe and analyze a large outbreak of clostridium difficile 027 (cd-027) infections. methods confirmed cd-027 cases were defined as cd infection plus real-time polymerase chain reaction assay (pcr) positive for cd-027. clinical and microbiological data on patients with cd-027 infection were collected from january 2013 to december 2015 in the provence-alpes-côte-d'azur region (southeastern france). results in total, 19 healthcare facilities reported 144 cd-027 infections (112 conf ... | 2016 | 27484769 |
| gut microbiota differences in children from distinct socioeconomic levels living in the same urban area in brazil. | to compare gut microbiota in impoverished children versus children of high socioeconomic status living in the same urban area in brazil. | 2016 | 26982745 |
| utilization of health services among adults with recurrent clostridium difficile infection: a 12-year population-based study. | background considerable efforts have been dedicated to developing strategies to prevent and treat recurrent clostridium difficile infection (rcdi); however, evidence of the impact of rcdi on patient healthcare utilization and outcomes is limited. objective to compare healthcare utilization and 1-year mortality among adults who had rcdi, nonrecurrent cdi, or no cdi. methods we performed a nested case-control study among adult kaiser foundation health plan members from september 1, 2001, through d ... | 2017 | 27760583 |
| wall teichoic acids are involved in the medium-induced loss of function of the autolysin cd11 against clostridium difficile. | bacterial lysins are potent antibacterial enzymes with potential applications in the treatment of bacterial infections. some lysins lose activity in the growth media of target bacteria, and the underlying mechanism remains unclear. here we use cd11, an autolysin of clostridium difficile, as a model lysin to demonstrate that the inability of this enzyme to kill c. difficile in growth medium is not associated with inhibition of the enzyme activity by medium, or the modification of the cell wall pe ... | 2016 | 27759081 |