| the monoclonal antitoxin antibodies (actoxumab-bezlotoxumab) treatment facilitates normalization of the gut microbiota of mice with clostridium difficile infection. | antibiotics have significant and long-lasting impacts on the intestinal microbiota and consequently reduce colonization resistance against clostridium difficile infection (cdi). standard therapy using antibiotics is associated with a high rate of disease recurrence, highlighting the need for novel treatment strategies that target toxins, the major virulence factors, rather than the organism itself. human monoclonal antibodies mk-3415a (actoxumab-bezlotoxumab) to c. difficile toxin a and toxin b, ... | 2016 | 27757389 |
| frizzled proteins are colonic epithelial receptors for c. difficile toxin b. | clostridium difficile toxin b (tcdb) is a critical virulence factor that causes diseases associated with c. difficile infection. here we carried out crispr-cas9-mediated genome-wide screens and identified the members of the wnt receptor frizzled family (fzds) as tcdb receptors. tcdb binds to the conserved wnt-binding site known as the cysteine-rich domain (crd), with the highest affinity towards fzd1, 2 and 7. tcdb competes with wnt for binding to fzds, and its binding blocks wnt signalling. fzd ... | 2016 | 27680706 |
| shoe soles as a potential vector for pathogen transmission: a systematic review. | shoe soles are possible vectors for infectious diseases. although studies have been performed to assess the prevalence of infectious pathogens on shoe soles and decontamination techniques, no systematic review has ever occurred. the aim of this study was to perform a systematic review of the literature to determine the prevalence of infectious agents on shoe bottoms and possible decontamination strategies. three electronic bibliographic databases were searched using a predefined search strategy ... | 2016 | 27495010 |
| nosocomial clostridium difficile-associated diarrhoea in assiut university children's hospital, egypt. | there are no large epidemiological studies of clostridium difficile-associated disease (cdad) in hospitalised children. | 2016 | 25496416 |
| burden of six healthcare-associated infections on european population health: estimating incidence-based disability-adjusted life years through a population prevalence-based modelling study. | estimating the burden of healthcare-associated infections (hais) compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. based on the methodology of the burden of communicable diseases in europe (bcode) project and 2011-2012 data from the european centre for disease prevention and control (ecdc) point prevalence survey (pps) of hais and antimicrobial use in european acute care hospit ... | 2016 | 27755545 |
| the use and efficacy of fecal microbiota transplantation for refractory clostridium difficile in patients with inflammatory bowel disease. | clostridium difficile (cd) is an anaerobic, spore-forming bacillus that is responsible for a spectrum of gastrointestinal illness ranging from asymptomatic carriage to toxic megacolon and death. the prevalence of cd infection is increasing in both hospitalized and community-based inflammatory bowel disease populations. standard antibiotic therapy fails to cure or prevent recurrence in more than 50% of patients, thus increasing the need for alternative therapies. recently, fecal microbiota transp ... | 2016 | 27755271 |
| increased rates of clostridium difficile infection and poor outcomes in patients with ibd with cytomegalovirus. | clostridium difficile infection (cdi) and cytomegalovirus (cmv) reactivation are associated with disease exacerbations and poor outcomes in inflammatory bowel disease (ibd). therefore, we assessed the association between these organisms in patients with ibd and the impact on colectomy. | 2016 | 27755270 |
| emergence and spread of moxifloxacin-resistant clostridium difficile ribotype 231 in sweden between 2006 and 2015. | an aggregation of moxifloxacin-resistant clostridium difficile ribotype 231 (rt231) isolates was first identified in the county of stockholm in 2008, and by the end of 2015 isolates of rt231 had spread to 13 of 21 swedish counties. we investigated the epidemiology of c. difficile rt231 in sweden between 2006 and 2015 using whole genome sequencing (wgs) and evaluated whether its emergence could be associated with extended moxifloxacin use. we performed wgs and phylogenetic analysis of 51 c. diffi ... | 2016 | 27752322 |
| thermal contrast amplification reader yielding 8-fold analytical improvement for disease detection with lateral flow assays. | there is an increasing need for highly sensitive and quantitative diagnostics at the point-of-care. the lateral flow immunoassay (lfa) is one of the most widely used point-of-care diagnostic tests; however, lfas generally suffer from low sensitivity and lack of quantification. to overcome these limitations, thermal contrast amplification (tca) is a new method that is based on the laser excitation of gold nanoparticles (gnps), the most commonly used visual signature, to evoke a thermal signature. ... | 2016 | 27750420 |
| successful colonoscopic fecal microbiota transplantation for active ulcerative colitis: first report from india. | forty-four-year-old male with ulcerative colitis (uc) for 11 years reported frequent relapse despite daily sulfasalazine 4 g, azathioprine 125 mg, and rectal 5-aminosalicylic acid. repeated use of corticosteroids led to cataract. at enrollment, he was passing eight stools a day with blood with a mayo score of 9 (3+1+3+2). stool was negative for ova/cysts/acid fast bacilli and clostridium difficile toxin assay. rectal biopsy showed cryptitis, crypt abscess, and crypt distortion with no inclusion ... | 2016 | 27718119 |
| [recurrences in clostridium difficile infections in cancer patients]. | | 2016 | 27293195 |
| the cost-efficiency and care effectiveness of probiotic administration with antibiotics to prevent hospital-acquired clostridium difficile infection. | health care facility-acquired clostridium difficile infections (hcfa-cdi) have increased over the last several decades despite facilities developing protocols for prescribing probiotics with antibiotics to prevent hcfa-cdi. the literature does not consistently support this. a retrospective medical record review evaluated the care effectiveness of this practice. care effectiveness was not found; patients receiving probiotics with antibiotics were twice as likely to develop hcfa-cdi (p = .004). ex ... | 2016 | 27749722 |
| an antimicrobial stewardship program based on systematic infectious disease consultation in a rehabilitation facility. | objective to assess the impact of an antimicrobial stewardship program (asp) on antibiotic consumption, clostridium difficile infections (cdi), and antimicrobial resistance patterns in a rehabilitation hospital. design quasi-experimental study of the periods before (from january 2011 to june 2012) and after (from july 2012 to december 2014) asp implementation. setting 150-bed rehabilitation hospital dedicated to patients with spinal-cord injuries. intervention beginning in july 2012, an asp was ... | 2017 | 27745559 |
| failure of risk-adjustment by test method for c. difficile laboratory-identified event reporting. | using an algorithm including both enzyme immunoassay (eia) and nucleic acid amplification (naat) for clostridium difficile infection (cdi) diagnosis, we found that the use of naat versus eia almost doubled our hospital-onset cdi laboratory-identified (labid) event standardized infection ratio (sir). we recommend that the current risk adjustment approach be modified. infect control hosp epidemiol 2016:1-3. | 2017 | 27745553 |
| clostridium difficile environmental contamination within a clinical laundry facility in the usa. | clostridium difficile is both a hospital and community acquired pathogen. the current study determined if c. difficile could be cultured from clinical laundry facility surfaces. a total of 240 surface samples were collected from dirty areas (n = 120), which handle soiled clinical linens, and from clean areas (n = 120), which process and fold the clean linens, within the university of washington consolidated laundry facility in 2015. sampling was done four times over the course of one year. the d ... | 2016 | 27744367 |
| the tipping point: patients predisposed to clostridium difficile infection and a hospital antimicrobial stewardship programme. | the incidence and severity of clostridium difficile infection (cdi) have increased in recent years. predictive models may help to identify at-risk patients before the onset of infection. early identification of high-risk patients could help antimicrobial stewardship (ams) programmes and other initiatives to better prevent c. difficile in these patients. | 2016 | 27742079 |
| a clostridium difficile cell wall glycopolymer locus influences bacterial shape, polysaccharide production and virulence. | clostridium difficile is a diarrheagenic pathogen associated with significant mortality and morbidity. while its glucosylating toxins are primary virulence determinants, there is increasing appreciation of important roles for non-toxin factors in c. difficile pathogenesis. cell wall glycopolymers (cwgs) influence the virulence of various pathogens. five c. difficile cwgs, including psii, have been structurally characterized, but their biosynthesis and significance in c. difficile infection is un ... | 2016 | 27741317 |
| probiotics and liver disease: where are we now and where are we going? | probiotics are live, nonpathogenic bacteria capable of colonizing the colonic mucosa. the most common probiotics include strains of lactobacillus or bifidobacteria, which are part of the normal gastrointestinal microbiota. initial studies of selected probiotic species have suggested potential efficacy in several gastrointestinal diseases including inflammatory bowel diseases (particularly pouchitis), antibiotic-related diarrhea, clostridium difficile toxin-induced colitis, infectious diarrhea, i ... | 2016 | 27741172 |
| probiotics history. | gut microbiota promotes healthy effects on the host and prevents diseases. probiotic (probios, for life) are defined as "live microorganisms which when administered in adequate amounts confer a health benefit on the host." at the beginning of 1900s louis pasteur identified the microorganisms responsible for the process of fermentation, whereas e. metchnikoff associated the enhanced longevity of bulgarian rural people to the regular consumption of fermented dairy products such as yogurt. he sugge ... | 2016 | 27741152 |
| clostridium difficile infection in dialysis patients. | clostridium difficile infection (cdi) is the most common cause of nosocomial diarrhea. patients with end-stage renal disease (esrd) may be at increased risk for cdi. patients with esrd with cdi have increased mortality, longer length of stay, and higher costs. the present studies extend these observations and address associated comorbidities, incidence of recurrence, and risk factors for mortality. we queried the united states renal data system (usrds) for patients with esrd diagnosed with cdi, ... | 2017 | 27737913 |
| quantitative structure activity relationship (qsar) studies on nitazoxanide-based analogues against clostridium difficile in vitro. | quantitative structure activity relationship (qsar) has been established between the various physiochemical parameters of a series of nitazoxanide-based analogues and its antibacterial activity against clostridium difficile. genetic function approximation (gfa) and comparative molecular field analysis (comfa) techniques were used to identify the descriptors that have influence on biological activity. the most influencing molecular descriptors identified in 2d-qsar include spatial, topological, a ... | 2016 | 27731829 |
| clinical use comparison of a semiautomated pcr with fluorescent ribotyping for typing of clostridium difficile. | molecular typing of clostridium difficile is performed to assess strain relatedness or place strains within an epidemiological context. different c. difficile ribotyping systems are available. however, a common strain library does not exist. we aimed to compare ribotyping results of 29 clinical c. difficile isolates by two methods: semiautomated pcr-ribotyping and fluorescent pcr-ribotyping. for certain ribotypes (n = 16/29; 55.2 %), the inter-laboratory reproducibility was consistent among mult ... | 2017 | 27730251 |
| selected topics in anaerobic bacteriology. | alteration in the host microbiome at skin and mucosal surfaces plays a role in the function of the immune system, and may predispose immunocompromised patients to infection. because obligate anaerobes are the predominant type of bacteria present in humans at skin and mucosal surfaces, immunocompromised patients are at increased risk for serious invasive infection due to anaerobes. laboratory approaches to the diagnosis of anaerobe infections that occur due to pyogenic, polymicrobial, or toxin-pr ... | 2016 | 27726792 |
| receipt of antibiotics in hospitalized patients and risk for clostridium difficile infection in subsequent patients who occupy the same bed. | to assess whether receipt of antibiotics by prior hospital bed occupants is associated with increased risk for cdi in subsequent patients who occupy the same bed. | 2016 | 27723860 |
| more than 50% of clostridium difficile isolates from pet dogs in flagstaff, usa, carry toxigenic genotypes. | nosocomial acquisition of clostridium difficile is well documented, yet recent studies have highlighted the importance of community acquired infections and identified community associated reservoirs for this pathogen. multiple studies have implicated companion pets and farm animals as possible sources of community acquired c. difficile infections in humans. to explore the potential role of pet dogs in human c. difficile infections we systematically collected canine fecal samples (n = 197) in fla ... | 2016 | 27723795 |
| fecal microbiota-based therapeutics for recurrent clostridium difficile infection, ulcerative colitis and obesity. | the human gut microbiome is a complex ecosystem of fundamental importance to human health. our increased understanding of gut microbial composition and functional interactions in health and disease states has spurred research efforts examining the gut microbiome as a valuable target for therapeutic intervention. this review provides updated insight into the state of the gut microbiome in recurrent clostridium difficile infection (cdi), ulcerative colitis (uc), and obesity while addressing the ra ... | 2016 | 27720396 |
| the efficacy of fidaxomicin in the treatment of clostridium difficile infection in a real-world clinical setting: a spanish multi-centre retrospective cohort. | the objective of this study was to evaluate the efficacy and safety of fidaxomicin in the real-life clinical setting. this was a retrospective cohort of patients with clostridium difficile infection (cdi) treated with fidaxomicin in 20 spanish hospitals between july 2013 and july 2014. clinical cure, 30-day recurrence, 30-day mortality, sustained cure, and factors associated with the failure to achieve sustained cure were analyzed. of the 72 patients in the cohort 41 (56.9 %) had a fatal underly ... | 2017 | 27718071 |
| rapid change of fecal microbiome and disappearance of clostridium difficile in a colonized infant after transition from breast milk to cow milk. | clostridium difficile is the most common known cause of antibiotic-associated diarrhea. upon the disturbance of gut microbiota by antibiotics, c. difficile establishes growth and releases toxins a and b, which cause tissue damage in the host. the symptoms of c. difficile infection disease range from mild diarrhea to pseudomembranous colitis and toxic megacolon. interestingly, 10-50 % of infants are asymptomatic carriers of c. difficile. this longitudinal study of the c. difficile colonization in ... | 2016 | 27717398 |
| longitudinal survey of clostridium difficile presence and gut microbiota composition in a belgian nursing home. | increasing age, several co-morbidities, environmental contamination, antibiotic exposure and other intestinal perturbations appear to be the greatest risk factors for c. difficile infection (cdi). therefore, elderly care home residents are considered particularly vulnerable to the infection. the main objective of this study was to evaluate and follow the prevalence of c. difficile in 23 elderly care home residents weekly during a 4-month period. a c. difficile microbiological detection scheme wa ... | 2016 | 27716140 |
| crystal structure and dna binding activity of a padr family transcription regulator from hypervirulent clostridium difficile r20291. | clostridium difficile is a spore-forming obligate anaerobe that can remain viable for extended periods, even in the presence of antibiotics, which contributes to the persistence of this bacterium as a human pathogen during host-to-host transmission and in hospital environments. we examined the structure and function of a gene product with the locus tag cdr20291_0991 (cdpadr1) as part of our broader goal aimed at elucidating transcription regulatory mechanisms involved in virulence and antibiotic ... | 2016 | 27716049 |
| characterization of the adherence of clostridium difficile spores: the integrity of the outermost layer affects adherence properties of spores of the epidemic strain r20291 to components of the intestinal mucosa. | clostridium difficile is the causative agent of the most frequently reported nosocomial diarrhea worldwide. the high incidence of recurrent infection is the main clinical challenge of c. difficile infections (cdi). formation of c. difficile spores of the epidemic strain r20291 has been shown to be essential for recurrent infection and transmission of the disease in a mouse model. however, the underlying mechanisms of how these spores persist in the colonic environment remains unclear. in this wo ... | 2016 | 27713865 |
| short- and long-term effects of oral vancomycin on the human intestinal microbiota. | oral vancomycin remains the mainstay of therapy for severe infections produced by clostridium difficile, the most prevalent cause of healthcare-associated infectious diarrhoea in developed countries. however, its short- and long-term effects on the human intestinal microbiota remain largely unknown. | 2017 | 27707993 |
| impact of ultraviolet germicidal irradiation for no-touch terminal room disinfection on clostridium difficile infection incidence among hematology-oncology patients. | objective to evaluate the impact of no-touch terminal room no-touch disinfection using ultraviolet wavelength c germicidal irradiation (uvgi) on c. difficile infection (cdi) rates on inpatient units with persistently high rates of cdi despite infection control measures. design interrupted time-series analysis with a comparison arm. setting 3 adult hematology-oncology units in a large, tertiary-care hospital. methods we conducted a 12-month prospective valuation of uvgi. rooms of patients with cd ... | 2017 | 27707423 |
| clearance of vancomycin-resistant enterococcus concomitant with administration of a microbiota-based drug targeted at recurrent clostridium difficile infection. | background. vancomycin-resistant enterococcus (vre) is a major healthcare-associated pathogen and a well known complication among transplant and immunocompromised patients. we report on stool vre clearance in a post hoc analysis of the phase 2 punch cd study assessing a microbiota-based drug for recurrent clostridium difficile infection (cdi). methods. a total of 34 patients enrolled in the punch cd study received 1 or 2 doses of rbx2660 (microbiota suspension). patients were requested to volu ... | 2016 | 27703995 |
| nodular colitis: endoscopic image an unusual finding. | an 82-year-old male with a history of high blood pressure, copd, chronic myeloid leukemia, and stage-4 chronic renal failure. admitted to hospital for lower-limb cellulitis and severe copd exacerbation, he received antibiotic therapy and bronchodilators. during his hospital stay he developed severe anemia and had an hematochezia event with no diarrhea. a complete colonoscopy found small (4-7 mm) nacreous elevated lesions, circumferential in shape, in the cecum and ascending colon with some bleed ... | 2016 | 27701886 |
| norovirus infection in solid organ transplant recipients: a single-center retrospective study. | norovirus (nov) is gaining recognition as an important cause of diarrhea among solid organ transplant (sot) recipients, but existing studies have been limited by a small sample size. | 2016 | 27699965 |
| toxin a-negative toxin b-positive ribotype 017 clostridium difficile is the dominant strain type in patients with diarrhoea attending tuberculosis hospitals in cape town, south africa. | the molecular epidemiology of c. difficile strains causing disease in south africa is currently unknown. previously, multidrug resistant ribotype (rt)017 strains were those most commonly isolated from patients with diarrhoea attending groote schuur hospital in cape town, south africa. this larger study aimed to investigate the molecular epidemiology and antibiotic susceptibility profiles of c. difficile strains in the greater cape town and regional areas. c. difficile strains were isolated from ... | 2017 | 27696234 |
| clostridium difficile infection in children: epidemiology and risk of recurrence in a low-prevalence country. | clostridium difficile infection (cdi) is increasingly found in children worldwide, but limited data are available from children living in southern europe. a 6-year retrospective study was performed to investigate the epidemiology, clinical features, treatment, and risk of recurrence in italy. data of children with community- and hospital-acquired cdi (ca-cdi and ha-cdi, respectively) seen at seven pediatric referral centers in italy were recorded retrospectively. annual infection rates/10,000 ho ... | 2017 | 27696233 |
| effect of detecting and isolating asymptomatic clostridium difficile carriers-reply. | | 2016 | 27695841 |
| effect of detecting and isolating asymptomatic clostridium difficile carriers. | | 2016 | 27695834 |
| influence of saccharomyces boulardii cncm i-745on the gut-associated immune system. | the probiotic saccharomyces boulardii cncm i-745 (also known as saccharomyces cerevisiae hansen cbs 5926; in the following s. boulardii) has proven its effectiveness in preventive and therapeutic treatment of many gastrointestinal diseases, especially diseases associated with acute diarrhea. in particular, antibiotic-associated diarrhea, clostridium difficile-associated diarrhea, traveller's diarrhea, as well as acute diarrhea due to common viral and bacterial infections in children and adults. | 2016 | 27695355 |
| host response to clostridium difficile infection: diagnostics and detection. | clostridium difficile infection (cdi) is a significant healthcare concern worldwide, and c. difficile is recognised as the most frequent aetiological agent of infectious healthcare-associated diarrhoea in hospitalised adult patients. the clinical manifestation of cdi varies from self-limited diarrhoea to life-threatening colitis. such a broad disease spectrum can be explained by the impact of host factors. currently, a complex cdi aetiology is widely accepted, acknowledging the interaction betwe ... | 2016 | 27693863 |
| high prevalence of nontoxigenic clostridium difficile isolated from hospitalized and non-hospitalized individuals in rural ghana. | since data about clostridium difficile infection in sub-saharan africa are scarce, we determined its epidemiology and risk factors in a cross-sectional study in eikwe, a rural community in ghana. we tested stool samples from 176 hospitalized patients with diarrhoea and from 131 asymptomatic non-hospitalized individuals for c. difficile and some other enteric pathogens. the overall prevalence rate of c. difficile was 4.9% with ribotype 084 being predominant. with 75% of the isolates, a high rate ... | 2016 | 27693000 |
| reduced health care-associated infections in an acute care community hospital using a combination of self-disinfecting copper-impregnated composite hard surfaces and linens. | the purpose of this study was to determine the effectiveness of copper-impregnated composite hard surfaces and linens in an acute care hospital to reduce health care-associated infections (hais). | 2016 | 27692785 |
| an evaluation of food as a potential source for clostridium difficile acquisition in hospitalized patients. | objective to determine whether clostridium difficile is present in the food of hospitalized patients and to estimate the risk of subsequent colonization associated with c. difficile in food. methods this was a prospective cohort study of inpatients at a university-affiliated tertiary care center, may 9, 2011-july 12, 2012. enrolled patients submitted a portion of food from each meal. patient stool specimens and/or rectal swabs were collected at enrollment, every 3 days thereafter, and at dischar ... | 2016 | 27691986 |
| mathematical modeling of the transmission dynamics of clostridium difficile infection and colonization in healthcare settings: a systematic review. | we conducted a systematic review of mathematical models of transmission dynamic of clostridium difficile infection (cdi) in healthcare settings, to provide an overview of existing models and their assessment of different cdi control strategies. | 2017 | 27690247 |
| henoch schonlein purpura and clostridium difficile infection: a hematologist's point of view. | | 2016 | 27689213 |
| serendipity in refractory celiac disease: full recovery of duodenal villi and clinical symptoms after fecal microbiota transfer. | treatment of refractory celiac disease type ii (rcd ii) and preventing the development of an enteropathy associated t-cell lymphoma in these patients is still difficult. in this case report, we describe a patient with rcd ii who received fecal microbiota transfer as treatment for a recurrent clostridium difficile infection, and remarkably showed a full recovery of duodenal villi and disappearance of celiac symptoms. this case suggests that altering the gut microbiota may hold promise in improvin ... | 2016 | 27689204 |
| chemokine cxcl13 expression was up-regulated in clostridium difficile infection. | clostridium difficile infection (cdi) is the leading cause of antibiotic- and healthcare-associated diarrhea. cxcl13 is a well-known cxc chemokine involved in inflammation, but its role in cdi remains unknown. in this study, serum and fecal samplings were collected from 51 cdi patients, 50 diarrhea patients without cdi and 50 healthy control subjects to determine the cxcl13 levels by enzyme-linked immunosorbent assay (elisa). besides, a mouse model of c. difficile infection was established, and ... | 2016 | 27685937 |
| measuring appropriate antimicrobial use: attempts at opening the black box. | indiscriminate antimicrobial use has plagued medicine since antibiotics were first introduced into clinical practice >70 years ago. infectious diseases physicians and public health officials have advocated for preservation of these life-saving drugs for many years. with rising burden of antimicrobial-resistant organisms and clostridium difficile infections, halting unnecessary antimicrobial use has become one of the largest public health concerns of our time. inappropriate antimicrobial use has ... | 2016 | 27682070 |
| eccmid 2016: addressing the burden of recurrent clostridium difficile infections. | 26th european congress of clinical microbiology and infectious diseases (eccmid), 9-12th april 2016, amsterdam, the netherlands the european congress of clinical microbiology and infectious diseases (eccmid) is the annual scientific meeting of the european society of clinical microbiology. eccmid 2016, held in amsterdam, the netherlands, was attended by over 11,600 clinical microbiologists and infectious disease physicians from more than 120 countries. the congress offered an essential opportuni ... | 2016 | 27679929 |
| assessing the risk of hospital-acquired clostridium difficile infection with proton pump inhibitor use: a meta-analysis. | background clostridium difficile is the principal infectious cause of antibiotic-associated diarrhea and accounts for 12% of hospital-acquired infections. recent literature has shown an increased risk of c. difficile infection (cdi) with proton pump inhibitor (ppi) use. objective to conduct a systematic assessment of the risk of hospital-acquired cdi following exposure to ppi. methods we searched multiple databases for studies examining the relationship between ppi and hospital-acquired cdi. poo ... | 2016 | 27677811 |
| the housefly musca domestica as a mechanical vector of clostridium difficile. | clostridium difficile is a bacterial healthcare-associated infection that may be transferred by houseflies (musca domestica) due to their close ecological association with humans and cosmopolitan nature. | 2016 | 27671221 |
| patients with risk factors for complications do not require longer antimicrobial therapy for complicated intra-abdominal infection. | a prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. we hypothesized that patients with specific risk factors for complications also had similar outcomes. short-course patients with obesity, diabetes, or acute physiology and chronic health evaluation ii ≥15 from the stop-it trial were compared with longer duration patients. outcomes ... | 2016 | 27670577 |
| inappropriate clostridium difficile testing and consequent overtreatment and inaccurate publicly reported metrics. | background the nationally reported metric for clostridium difficile infection (cdi) relies solely on laboratory testing, which can result in overreporting due to asymptomatic c. difficile colonization. objective to review the clinical scenarios of cases of healthcare facility-onset cdi (ho-cdi) and to determine the appropriateness of c. difficile testing on the basis of presence of symptomatic diarrhea in order to identify areas for improvement. design retrospective cohort study. setting northwe ... | 2016 | 27666285 |
| faecal microbiota transplantation for recurring clostridium difficile infection in a patient with crohn's disease and ileorectal anastomosis. | faecal microbiota transplantation (fmt) is increasingly being used to treat refractory and recurring clostridium difficile infection (cdi). although fmt appears to be safe and highly effective in patients with a preserved colon and immunocompetence, its use in patients with inflammatory bowel disease (ibd) who are on immunomodulating therapies is controversial. in particular, patients who have undergone colectomy may have different treatment responses to fmt. in this case report, we describe the ... | 2016 | 27664230 |
| vaccinology gets help from chemistry. | a recent report on the immunological activity of protein conjugates of synthetic lipoteicoic fragments from clostridium difficile underpins the use of these molecules for the development of a vaccine. in a recent issue of cell chemical biology, broecker et al. (2016) illustrate the utility of glycoarray-based selection of bacterial carbohydrates with the potential to become vaccine candidates. | 2016 | 27662251 |
| prevention of infection due to clostridium difficile. | clostridium difficile is one of the foremost nosocomial pathogens. preventing infection is particularly challenging. effective prevention efforts typically require a multifaceted bundled approach. a variety of infection control procedures may be advantageous, including strict hand decontamination with soap and water, contact precautions, and using chlorine-containing decontamination agents. additionally, risk factor reduction can help reduce the burden of disease. the risk factor modification is ... | 2016 | 27660089 |
| role of cephalosporins in the era of clostridium difficile infection. | the incidence of clostridium difficile infection (cdi) in europe has increased markedly since 2000. previous meta-analyses have suggested a strong association between cephalosporin use and cdi, and many national programmes on cdi control have focused on reducing cephalosporin usage. despite reductions in cephalosporin use, however, rates of cdi have continued to rise. this review examines the potential association of cdi with cephalosporins, and considers other factors that influence cdi risk. e ... | 2017 | 27659735 |
| fecal microbiota transplant in patients with recurrent clostridium difficile infection. | the clinical effectiveness of fecal microbiota transplant (fmt) for the treatment of recurrent clostridium difficile infections (rcdi) has been demonstrated in randomized controlled trials. to assess the current status of fmt in germany with respect to active centers, local standards, clinical effectiveness and safety, the microtrans registry (nct02681068) was established. | 2016 | 27658471 |
| overwhelming recurrent clostridium difficile infection after reversal of diverting loop ileostomy created for prior fulminant c. difficile colitis. | | 2016 | 27657564 |
| advances in the microbiome: applications to clostridium difficile infection. | clostridium difficile is a major cause of morbidity and mortality worldwide, causing over 400,000 infections and approximately 29,000 deaths in the united states alone each year. c. difficile is the most common cause of nosocomial diarrhoea in the developed world, and, in recent years, the emergence of hyper-virulent (mainly ribotypes 027 and 078, sometimes characterised by increased toxin production), epidemic strains and an increase in the number of community-acquired infections has caused fur ... | 2016 | 27657145 |
| 2016 update on medical overuse: a systematic review. | overuse of medical care is an increasingly recognized problem in clinical medicine. | 2016 | 27654002 |
| what's a snp between friends: the influence of single nucleotide polymorphisms on virulence and phenotypes of clostridium difficile strain 630 and derivatives. | clostridium difficile is a major cause of antibiotic induced diarrhea worldwide, responsible for significant annual mortalities and represents a considerable economic burden on healthcare systems. the two main c. difficile virulence factors are toxins a and b. isogenic toxin b mutants of 2 independently isolated erythromycin-sensitive derivatives (630e and 630δerm) of strain 630 were previously shown to exhibit substantively different phenotypes. compared to 630, strain 630e and its progeny grow ... | 2016 | 27652799 |
| tea and recurrent clostridium difficile infection. | background and aims. studies have shown effects of diet on gut microbiota. we aimed to identify foods associated with recurrent clostridium difficile infection (cdi). methods. in this cross-sectional survey, consecutive patients diagnosed with cdi were identified by electronic medical records. colitis symptoms and positive clostridium difficile assay were confirmed. health-care onset-health-care facility associated cdi was excluded. food surveys were mailed to 411 patients. survey responses serv ... | 2016 | 27651790 |
| clostridium difficile infection diagnostics - evaluation of the c. diff quik chek complete assay, a rapid enzyme immunoassay for detection of toxigenic c. difficile in clinical stool samples. | diagnostic testing for clostridium difficile infection (cdi) has, in recent years, seen the introduction of rapid dual-eia (enzyme immunoassay) tests combining species-specific glutamate dehydrogenase (gdh) with toxin a/b. in a prospective study, we compared the c. diff quik chek complete test to a combination of selective culture (sc) and loop-mediated isothermal amplification (lamp) of the toxin a gene. of 419 specimens, 68 were positive in sc including 62 positive in lamp (14.7%). the combine ... | 2016 | 27651167 |
| a comparison of histamine receptor antagonists versus proton pump inhibitor gastrointestinal ulcer prophylaxis in kidney transplant recipients. | there are several different agents that can be used for gastrointestinal (gi) ulcer prophylaxis in posttransplant recipients, such as histamine-2 receptor antagonists (h2ra) or proton pump inhibitors (ppis). | 2016 | 27650918 |
| community- and healthcare-associated clostridium difficile infections, finland, 2008-2013(1). | we evaluated incidence, case-fatality rate, and trends of community-associated (ca) and healthcare-associated (ha) clostridium difficile infections (cdis) in finland during 2008-2013. cdis were identified in the national infectious disease register, deaths in the national population information system, hospitalizations to classify infections as ca or ha in the national hospital discharge register, and genotypes in a reference laboratory. a total of 32,991 cdis were identified: 10,643 (32.3%) wer ... | 2016 | 27648884 |
| fecal microbiota transplant in patients with clostridium difficile infection: a systematic review. | fecal microbiota transplantation (fmt) restores a diverse bacterial profile to the gastrointestinal tract and may effectively treat patients with clostridium difficile infection (cdi). the objective of this systematic review was to evaluate the effectiveness of fmt in the treatment of cdi. | 2016 | 27648772 |
| the phosphotransfer protein cd1492 represses sporulation initiation in clostridium difficile. | the formation of spores is critical for the survival of clostridium difficile outside the host gastrointestinal tract. persistence of c. difficile spores greatly contributes to the spread of c. difficile infection (cdi), and the resistance of spores to antimicrobials facilitates the relapse of infection. despite the importance of sporulation to c. difficile pathogenesis, the molecular mechanisms controlling spore formation are not well understood. the initiation of sporulation is known to be reg ... | 2016 | 27647869 |
| risk factors for short- and long-term mortality in very old patients with clostridium difficile infection: a retrospective study. | most cases of clostridium difficile infections (cdi) occur in patients aged 65 years and older. older age is associated with increased mortality. risk factors for mortality in patients aged 80 years and older are not well recognized. | 2016 | 27647625 |
| taking advantage of public reporting: an infection composite score to assist evaluating hospital performance for infection prevention efforts. | the standardized infection ratio (sir) evaluates individual publicly reported health care-associated infections, but it may not assess overall performance. | 2016 | 27645403 |
| proton pump inhibitors and risk of clostridium difficile infection: a multi-country study using sequence symmetry analysis. | to determine the association between incident proton pump inhibitor (ppi) use and clostridium difficile infections across multiple countries method: national data covering the total population in australia and korea, the canadian population over 65 years and a 3 million person random sample data set from taiwan were assessed, as were data from a worker insurance population and a hospital inpatient/outpatient population in japan. sequence symmetry analysis was used to assess the association with ... | 2016 | 27645304 |
| non-invasive fecal microbiota transplantation for recurrent clostridium difficile infection in a patient presenting with hypertensive disorder post interventionem. | fecal microbiota transplantation has gathered much attention due to its high efficacy in resolving recurrent clostridium difficile infection. until today, it is recognized as a safe procedure without any severe side effects. patients with impaired conscious states suffering from recurrent episodes of aspiration are at increased risk by endoscopic interventions needed during standard approaches for fecal microbiota transplantation application.here, we illustrate the case of a tetraplegic patient ... | 2016 | 27644000 |
| [fecal microbiota transplantation, a novel therapy for recurrent clostridium difficile infection]. | clostridium difficile infection is caused by a disturbance of the gut microbiota, often resulting from the use of antibiotics. among a sub group of patients with this disorder, treatment with antibiotics is not effective. they develop a chronic, recurrent infection. such patients can be treated with a fecal microbiota transplantation (fmt), or fecal transplantation. the crucial steps for safe application of fecal transplantation are central donor selection and screening. to optimise safety and t ... | 2016 | 27643493 |
| pantoprazole or placebo for stress ulcer prophylaxis (pop-up): randomized double-blind exploratory study. | pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. however, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. our objective was to evaluate benefit or harm associated with pantoprazole administration. | 2016 | 27635481 |
| endoscopic delivery of fecal biotherapy in inflammatory bowel disease. | the intestinal microbiome plays an important role in the pathogenesis of inflammatory bowel disease (ibd). we are able to use the microbiome as a therapeutic target with use of fecal microbiota transplantation (fmt) for cure of recurrent clostridium difficile infection. given our ability to target the dysbiotic state with fmt, its use as therapy in ibd has tremendous potential. this overview discusses the practical considerations of fmt therapy with respect to our current understanding of safety ... | 2016 | 27633598 |
| reprofiled anthelmintics abate hypervirulent stationary-phase clostridium difficile. | prolonged use of broad-spectrum antibiotics disrupts the indigenous gut microbiota, which consequently enables toxigenic clostridium difficile species to proliferate and cause infection. the burden of c. difficile infections was exacerbated with the outbreak of hypervirulent strains that produce copious amounts of enterotoxins and spores. in recent past, membrane-active agents have generated a surge of interest due to their bactericidal property with a low propensity for resistance. in this stud ... | 2016 | 27633064 |
| hypersensitivity reaction following administration of low-dose oral vancomycin for the treatment of clostridium difficile in a patient with normal renal function. | systemic absorption of oral vancomycin for the treatment of clostridium difficile is thought to be trivial in patients without risk factors for increased systemic absorption and is often overlooked in clinical practice. a 51-year-old male elicits a suspected immunoglobulin e-mediated hypersensitivity following administration of low-dose oral vancomycin for the treatment of severe c difficile the patient had normal renal function and was administered low doses of the medication, however, had a me ... | 2016 | 27630210 |
| modulation of the surface-layer protein of clostridium difficile through cwp84 inhibition. | cysteine protease cwp84 is responsible for surface-layer processing in clostridium difficile and was also shown to cleave several human extracellular matrix components in vitro. to enable the facile identification and characterization of cwp84 inhibitors, we developed a fluorogenic 10-mer peptide based on the enzyme's natural substrate slpa that is amenable for use in fret-based high-throughput screening. the design of substrate-mimetic inhibitors led to epoxysuccinate 8c, which displayed an ina ... | 2016 | 27626098 |
| evaluation of the performance of c. diff quik chek complete and its usefulness in a hospital setting with a high prevalence of clostridium difficile infection. | rapid and accurate diagnosis of clostridium difficile infection (cdi) is crucial for patient care, infection control, and efficient surveillance. we evaluated c. diff quik chek complete (qcc; techlab), which detects glutamate dehydrogenase (gdh) antigen (qcc-ag) and toxin a/b (qcc-tox) simultaneously, and compared it to the laboratory diagnostics for cdi currently in use in a tertiary hospital setting with a high prevalence of cdi. qcc, ridascreen c. difficile toxin a/b assay (toxin eia; r-bioph ... | 2017 | 27625418 |
| disparate prevalence of toxigenic and nontoxigenic clostridium difficile among distinct adult patient populations in a single institution. | clostridium difficile (cd) disease remains a costly and important hospital-associated infection. although nontoxigenic cd is detected by some cd testing methods, can interfere with some detection algorithms and has been suggested as a treatment for cd disease, little is known about the relative occurrence of toxigenic and nontoxigenic cd in a single institution.we used both chromogenic and selective agar media to recover cd isolates and a molecular method to detect the toxin b gene from over 240 ... | 2016 | 27624898 |
| compared lethality rates of clostridium difficile infections at the local, regional and national levels in france. | | 2016 | 27621820 |
| modulation of microbiota as treatment for intestinal inflammatory disorders: an uptodate. | alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. there is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation (fmt). to summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, pubmed was searched using ter ... | 2016 | 27621567 |
| risk factors for recurrent clostridium difficile infections and strategies to decrease readmissions in a community hospital. | currently there are no universally accepted approaches for the prevention of recurrent clostridium difficile infections (cdi) following the initial infection. several studies have identified common risk factors for the emergence of recurrent cdi. identifying patients at high risk for recurrent cdi through the assessment of risk factors at initial diagnosis could enable health care providers to optimize available treatment options. a vancomycin hydrochloride-tapered regimen may be an effective tr ... | 2015 | 27621508 |
| efficacy of secondary prophylaxis with vancomycin for preventing recurrent clostridium difficile infections. | patients with clostridium difficile infection (cdi) who are re-exposed to antibiotics have a high likelihood of recurrence. we aimed to determine whether oral vancomycin as secondary prophylaxis reduces the risk of recurrence in patients recently diagnosed with cdi who undergo subsequent antibiotic exposure (cdi-ae). | 2016 | 27619835 |
| why rifampin (rifampicin) is a key component in the antibiotic treatment of hidradenitis suppurativa: a review of rifampin's effects on bacteria, bacterial biofilms, and the human immune system. | combinations of rifampin and clindamycin or rifampin, metronidazole, and moxifloxcin have been reported as effective treatments for hidradenitis suppurativa (hs) hurley stage 1 and hurley stage 2. clinical trials suggest that for stage 1 and mild stage 2 hs, clindamycin 300 mg twice daily and rifampin 300 mg twice daily for 10 weeks can substantially abate hs in ~80% of cases and remit hs in ~50% of cases. another study notes use of rifampin-moxifloxacin-metronidazole given for 6 weeks, dosed ... | 2016 | 27617596 |
| antibiotic resistance. | antimicrobial resistance in bacterial pathogens is a challenge that is associated with high morbidity and mortality. multidrug resistance patterns in gram-positive and -negative bacteria are difficult to treat and may even be untreatable with conventional antibiotics. there is currently a shortage of effective therapies, lack of successful prevention measures, and only a few new antibiotics, which require development of novel treatment options and alternative antimicrobial therapies. biofilms ar ... | 2016 | 27616769 |
| thrombocytopenia in hospitalized patients with severe clostridium difficile infection. | clostridium difficile infection (cdi) is a common cause of nosocomial diarrhea and colitis. the incidence and prognostic significance of thrombocytopenia as related to mode of acquisition (hospital vs. community), nap1/027 strain, and disease severity has not been examined. we performed a single-institution retrospective analysis of all adult inpatients from 2013 to 2014 diagnosed with cdi during their hospitalization to document the incidence/prevalence of thrombocytopenia and associated outcom ... | 2017 | 27614757 |
| oral, frozen fecal microbiota transplant (fmt) capsules for recurrent clostridium difficile infection. | fecal microbiota transplantation (fmt) has been shown to be safe and effective in treating refractory or relapsing c. difficile infection (cdi), but its use has been limited by practical barriers. we recently reported a small preliminary feasibility study using orally administered frozen fecal capsules. following these early results, we now report our clinical experience in a large cohort with structured follow-up. | 2016 | 27609178 |
| the epidemiology of clostridium difficile infection in patients with cancer. | clostridium difficile infection (cdi) is a significant cause of healthcare-associated diarrhoea, and the emergence of endemic strains resulting in poorer outcomes is recognised worldwide. patients with cancer are a specific high-risk group for development of infection. areas covered: in this review, modifiable and non-modifiable risk factors for cdi in adult patients with haematological malignancy or solid tumours are evaluated. in particular, the contribution of antimicrobial exposure, hospital ... | 2016 | 27606976 |
| clostridium difficile infection in production animals and avian species: a review. | clostridium difficile is the leading cause of antibiotic-associated diarrhea and colitis in hospitalized humans. recently, c. difficile infection (cdi) has been increasingly recognized as a cause of neonatal enteritis in food animals such as pigs, resulting in stunted growth, delays in weaning, and mortality, as well as colitis in large birds such as ostriches. c. difficile is a strictly anaerobic spore-forming bacterium, which produces two toxins a (tcda) and b (tcdb) as its main virulence fact ... | 2016 | 27602596 |
| bed utilisation and increased risk of clostridium difficile infections in acute hospitals in england in 2013/2014. | the study aimed to identify thresholds for hospital bed utilisation which are independently associated with significantly higher risks for clostridium difficile infections (cdi) in acute hospitals in england. | 2016 | 27601687 |
| [a scoring system for prescribing fidaxomicin in clostridium diffícile infection]. | recurrences of clostridium difficile infections lead to hospital readmissions and high costs, in addition to the suffering and frustration for the patients. fidaxomicin has recently been introduced as a new antibiotic that has been shown to significantly reduce the recurrence of this infection. despite this superiority, its high cost has led to very restrictive policies in its use, as such that many institutions only use it in patients with multiple recurrences. while waiting for new predictive ... | 2016 | 27601193 |
| rapid detection of clostridium difficile toxins and laboratory diagnosis of clostridium difficile infections. | clostridium difficile is an anaerobic, spore-forming and gram-positive bacillus. it is the major cause of antibiotic-associated diarrhea prevailing in hospital settings. the morbidity and mortality of c. difficile infection (cdi) has increased significantly due to the emergence of hypervirulent strains. because of the poor clinical different between cdi and other causes of hospital-acquired diarrhea, laboratory test for c. difficile is an important intervention for diagnosis of cdi. | 2016 | 27601055 |
| use of intravenous tigecycline in patients with severe clostridium difficile infection: a retrospective observational cohort study. | there are only a limited number of antimicrobials for treating severe clostridium difficile infection (scdi). tigecycline shows significant in vitro effect against c. difficile and is approved for management of complicated intra-abdominal infections. our aim was to analyse the efficacy of tigecycline compared with standard therapy (oral vancomycin plus intravenous metronidazole) in adults treated for scdi. a retrospective cohort study of such patients hospitalized at our department from january ... | 2016 | 27599690 |
| growth patterns of clostridium difficile - correlations with strains, binary toxin and disease severity: a prospective cohort study. | a broad spectrum of symptoms has been associated with c. difficile infection (cdi). several studies indicate that toxin-production correlates with growth rates of c. difficile. this study aimed to correlate growth rates of c. difficile with disease severity and strain characteristics. from 01/2003 to 10/2011, strains from a prospective cohort of all inpatients with cdi at the university hospital basel, switzerland were analyzed regarding binary toxin, presence of the tcdc deletion and ribotype. ... | 2016 | 27598309 |
| comparison of agar dilution and broth microdilution methods for clostridium difficile antimicrobial susceptibility testing. | in this study, the performance of the broth microdilution (bmd) method for testing the antimicrobial susceptibility of clostridium difficile in comparison with the agar dilution (ad) method used by the clinical and laboratory standards institute (clsi) was evaluated. in total, 70 non-duplicate c. difficile clinical isolates were used in this study. the minimum inhibitory concentrations (mics) of clindamycin, moxifloxacin, metronidazole and vancomycin were examined using ad and bmd. the results s ... | 2016 | 27598055 |
| effect of an antimicrobial stewardship intervention on outcomes for patients with clostridium difficile infection. | although antimicrobial stewardship programs (asps) are uniquely positioned to improve treatment of clostridium difficile infection (cdi) through targeted interventions, studies to date have not rigorously evaluated the influence of asp involvement on clinical outcomes attributed to cdi. | 2016 | 27592160 |
| epidemiology of multidrug resistant bacterial organisms and clostridium difficile in german hospitals in 2014: results from a nationwide one-day point prevalence of 329 german hospitals. | one important aspect in combatting resistance to antibiotics is to increase the awareness and knowledge by epidemiological studies. we therefore conducted a german-wide point-prevalence survey for multidrug resistant bacterial organisms (mdros) and clostridium difficile (cd) to assess the epidemiology and structure quality of infection control in german hospitals. | 2016 | 27590879 |