| [a novel approach to genotyping of hospital isolates of clostridium difficile]. | development of a novel approach in genotyping of clostridium difficile and its testing on the example of 140 hospital isolates. | 2016 | 27228665 |
| clostridium difficile infection. | | 2016 | 27227752 |
| [fecal microbiota transplantation in relapsing clostridium difficile colitis]. | since the turn of the millennium there has been an alarming increase in the incidence and severity of clostridium difficile infections. stopping medication with the triggering antibiotic and switching to a recommended antibiotic leads to healing up in 80%. however, patients who relapse have a 40% risk of an additional relapse and those with 2 or more episodes face a 60% risk. fecal microbiota transplantation (fmt) is a new therapeutic option. up to now there only exist two randomized studies (un ... | 2016 | 27221557 |
| chinese physicians' perceptions of fecal microbiota transplantation. | to explore chinese physicians' perceptions towards fecal microbiota transplantation (fmt) and to provide information and an assessment of fmt development in china. | 2016 | 27217707 |
| clostridium difficile infection following systemic antibiotic administration in randomised controlled trials: a systematic review and meta-analysis. | antibiotics have been the most important risk factor for clostridium difficile infection (cdi). however, only data from non-randomised studies have been reviewed. we sought to evaluate the risk for development of cdi associated with the major antibiotic classes by analysing data from randomised controlled trials (rcts). the pubmed, cochrane and scopus databases were searched and the references of selected rcts were also hand-searched. eligible studies should have compared only one antibiotic ver ... | 2016 | 27216385 |
| recurrence of clostridium difficile infection in patients with inflammatory bowel disease: the recidivism study. | recurrent clostridium difficile infection (rcdi) contributes to a significant burden of disease in patients with inflammatory bowel disease (ibd). in this study, we seek to identify risk factors for rcdi in a population of ibd patients at the mount sinai hospital ibd centre. | 2016 | 27215924 |
| fecal microbiota transplantation for recurrent clostridium difficile infection in hematopoietic stem cell transplant recipients. | recurrent clostridium difficile infection (cdi) is a consequence of intestinal dysbiosis and is particularly common following hematopoietic stem cell transplantation (hsct). fecal microbiota transplantation (fmt) is an effective method of treating cdi by correcting intestinal dysbiosis by passive transfer of healthy donor microflora. fmt has not been widely used in immunocompromised patients, including hsct recipients, owing to concern for donor-derived infection. here, we describe initial resul ... | 2016 | 27214585 |
| assessing the magnitude and trends in hospital acquired infections in canadian hospitals through sequential point prevalence surveys. | healthcare acquired infections (hai) are an important public health problem in developed countries, but comprehensive data on trends over time are lacking. prevalence surveys have been used as a surrogate for incidence studies and can be readily repeated. | 2016 | 27213039 |
| the microbiota and immune response during clostridium difficile infection. | clostridium difficile is a gram-positive, spore forming anaerobe that infects the gut when the normal microbiota has been disrupted. c. difficile infection (cdi) is the most common cause of hospital acquired infection in the united states, and the leading cause of death due to gastroenteritis. patients suffering from cdi have varying symptoms which range from mild diarrhea to pseudomembranous colitis and death. the involvement of the immune response to influence disease severity is just beginnin ... | 2016 | 27212111 |
| [role of care surgery in the treatment of pseudomembranous colitis]. | pseudomembranous colitis, caused by clostridium difficile, has an increased incidence in recent years, driven mainly by the indiscriminate use of antibiotics. although initial treatment is medical, the role of emergency surgery has gained ground due to high mortality and the emergence of increasingly virulent strains. in our country the prevalence is still low so sometimes our experience in handling is limited. | 2016 | 27209466 |
| economic burden of primary compared with recurrent clostridium difficile infection in hospitalized patients: a prospective cohort study. | few studies have investigated the additional healthcare costs of recurrent c. difficile infection (cdi). | 2016 | 27209056 |
| risk factors associated with interfacility transfers among patients with clostridium difficile infection. | preventing the transmission of clostridium difficile infection (cdi) over the continuum of care presents an important challenge for infection control. | 2016 | 27207161 |
| elevated fecal calprotectin associates with adverse outcomes from clostridium difficile infection in older adults. | clostridium difficile infection (cdi) causes a mild to moderate colitis in most patients, but some, especially older adults, develop severe, adverse outcomes. biomarkers predicting outcomes are needed to optimize treatments. this study tested whether fecal calprotectin associated with a composite primary outcome of complicated cdi (intensive care unit admission, colectomy, or death due to cdi within 30 days of diagnosis) and/or 8-week recurrence. | 2016 | 27206404 |
| the surgical management of complicated clostridium difficile infection: alternatives to colectomy. | clostridium difficile is the most common nosocomial infection in the united states. there is a subset of patients for whom medical therapy fails or who progress rapidly to the development of complicated disease, often marked by critical systemic illness. patients with complicated clostridium difficile infection (cdi) who progress or fail to improve benefit from surgery. | 2016 | 27206241 |
| antibiotic stewardship programs in u.s. acute care hospitals: findings from the 2014 national healthcare safety network annual hospital survey. | the national action plan to combat antibiotic resistant bacteria calls for all us hospitals to improve antibiotic prescribing as a key prevention strategy for resistance and clostridium difficile antibiotic stewardship programs (asps) will be important in this effort but implementation is not well understood. | 2016 | 27199462 |
| fecal microbiota transplantation for the intestinal decolonization of extensively antimicrobial-resistant opportunistic pathogens: a review. | treatment options for multidrug-resistant (mdr) bacterial infections are limited and often less effective. non-pharmacologic approaches to preventing or treating mdr infections are currently restricted to improved antimicrobial stewardship and infection control practices. fecal microbiota transplantation (fmt), a highly effective treatment for recurrent clostridium difficile infection, has emerged as a promising therapy for intestinal mdr bacterial decolonization. a total of eight case reports h ... | 2016 | 27194400 |
| new approaches to infection prevention and control: implementing a risk-based model regionally. | infectious disease outbreaks result in substantial inconvenience to patients and disruption of clinical activity. | 2016 | 27194074 |
| increasing incidence of clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the italian region with the oldest population. | limited information is available on the incidence of clostridium difficile infections (cdis) in italian hospitals. in this study, we assessed the changes in the incidence of cdi over a 5-year period in a teaching hospital in liguria, the italian region with the oldest population. secondary endpoints were the development of severe cdi and 30-day mortality. the annual incidence of cdi/10000 patient-days significantly increased from 0·54 in 2010 to 3·04 in 2014 (χ 2 for trend, p < 0·001). the media ... | 2016 | 27193828 |
| the burden of clostridium difficile after cervical spine surgery. | study design retrospective database analysis. objective the purpose of this study is to investigate incidence, comorbidities, and impact on health care resources of clostridium difficile infection after cervical spine surgery. methods a total of 1,602,130 cervical spine surgeries from the nationwide inpatient sample database from 2002 to 2011 were included. patients were included for study based on international classification of diseases ninth revision, clinical modification procedural codes fo ... | 2016 | 27190732 |
| atypical presentation of c. difficile infection: report of a case with literature review. | clostridium difficile (c. difficile) is a gram-positive, obligate, anaerobic spore-forming bacillus first reported by hall and o'toole in 1935. it occurs mostly after antibiotic use and invariably presents with watery diarrhea. we describe an atypical presentation of c. difficile in a 64-year-old caucasian female who presented to the our emergency department with abdominal pain, nausea, and vomiting for one day. a complete blood count revealed leukocytosis 30 x 10(9)/l and a subsequent computed ... | 2016 | 27190728 |
| impact of a healthcare provider educational intervention on frequency of clostridium difficile polymerase chain reaction testing in children: a segmented regression analysis. | although clostridium difficile infections (cdis) are increasingly diagnosed in children, many children diagnosed with cdi lack classic risk factors. frequent use of highly sensitive tcdb polymerase chain reaction (pcr) testing in low-risk patients leads to cdi misdiagnosis and unnecessary cdi antibiotic use in children with c difficile carriage. | 2016 | 27190172 |
| hiv infection results in metabolic alterations in the gut microbiota different from those induced by other diseases. | imbalances in gut bacteria have been associated with multiple diseases. however, whether there are disease-specific changes in gut microbial metabolism remains unknown. here, we demonstrate that human immunodeficiency virus (hiv) infection (n = 33) changes, at quantifiable levels, the metabolism of gut bacteria. these changes are different than those observed in patients with the auto-immune disease systemic lupus erythaematosus (n = 18), and clostridium difficile-associated diarrhoea (n = 6). u ... | 2016 | 27189771 |
| preclinical development of ramizol, an antibiotic belonging to a new class, for the treatment of clostridium difficile colitis. | antibiotic-resistant bacteria is a major threat to human health and is predicted to become the leading cause of death from disease by 2050. despite the recent resurgence of research and development in the area, few antibiotics have reached the market, with most of the recently approved antibiotics corresponding to new uses for old antibiotics, or structurally similar derivatives thereof. we have recently reported an in silico approach that led to the design of an entirely new class of antibiotic ... | 2016 | 27189122 |
| adverse event reporting for proton pump inhibitor therapy: an overview of systematic reviews. | to assist clinicians in counseling patients regarding the risk of adverse events from proton pump inhibitors (ppis), by synthesizing evidence from published systematic reviews of antireflux therapy. | 2016 | 27188706 |
| predictors of early failure after fecal microbiota transplantation for the therapy of clostridium difficile infection: a multicenter study. | fecal microbiota transplant (fmt) is a highly efficacious treatment for recurrent or refractory clostridium difficile infection (cdi); however, 10-20% of patients fail to achieve cure after a single fmt. the aim of this study was to identify risk factors associated with fmt failure and to develop and validate a prediction model for fmt failure. | 2016 | 27185076 |
| impact of sink location on hand hygiene compliance after care of patients with clostridium difficile infection: a cross-sectional study. | the impact of sink location on hand washing compliance after contact with patients with clostridium difficile infection (cdi) is poorly understood. the aim of this study is to determine the location of hand wash sinks available to healthcare workers (hcws) after caring for patients with cdi and to assess the impact on hand washing compliance. | 2016 | 27184488 |
| epidemiology of clostridium difficile infection-associated reactive arthritis in children: an underdiagnosed, potentially morbid condition. | the incidence of clostridium difficile infection has increased among children. the epidemiology of pediatric c difficile infection-associated reactive arthritis is poorly understood. | 2016 | 27182697 |
| clostridium difficile infection in children: a review. | clostridium difficile is a sporogenic, anaerobic, gram-positive, emerging enteric pathogen. it represents the most common cause of health care-associated diarrhoea in the united states, with significantly associated morbidity, mortality, and health care costs. historically regarded as a little more than an innocent coloniser bystander of the gastrointestinal tract of children, c difficile has increasingly demonstrated its behaviour as a true pathogen in the paediatric age groups. this organism m ... | 2016 | 27182626 |
| analysis of clostridium difficile infections in patients hospitalized at the nephrological ward in poland. | few studies have evaluated the incidence and risk factors of clostridium difficile infection (cdi) in the adult polish population, in particular in solid organ recipients hospitalized at the nephrological ward. | 2016 | 27180967 |
| probiotics as adjunctive therapy for preventing clostridium difficile infection - what are we waiting for? | with the end of the golden era of antibiotic discovery, the emergence of a new post-antibiotic age threatens to thrust global health and modern medicine back to the pre-antibiotic era. antibiotic overuse has resulted in the natural evolution and selection of multi-drug resistant bacteria. one major public health threat, clostridium difficile, is now the single leading cause of hospital-acquired bacterial infections and is by far the most deadly enteric pathogen for the u.s. | 2016 | 27180657 |
| administration of probiotic kefir to mice with clostridium difficile infection exacerbates disease. | lifeway(®) kefir, a fermented milk product containing 12 probiotic organisms, is reported to show promise as an alternative to fecal microbiota transplantation for recurrent clostridium difficile infection (cdi). we employed a murine cdi model to study the probiotic protective mechanisms and unexpectedly determined that kefir drastically increased disease severity. our results emphasize the need for further independent clinical testing of kefir as alternative therapy in recurrent cdi. | 2016 | 27180007 |
| structural and functional changes within the gut microbiota and susceptibility to clostridium difficile infection. | alteration of the gut microbial community structure and function through antibiotic use increases susceptibility to colonization by clostridium difficile and other enteric pathogens. however, the mechanisms that mediate colonization resistance remain elusive. as the leading definable cause of infectious diarrhea, toxigenic c. difficile represents a burden for patients and health care systems, underscoring the need for better diagnostics and treatment strategies. next-generation sequence data has ... | 2016 | 27180006 |
| n-3 and n-6 fatty acid changes in the erythrocyte membranes of patients with 658240251 clostridium difficile infection. | the implications of circulating essential fatty acids (fa) on the inflammatory risk profile and clinical outcome are still unclear. in order to gain a deeper understanding of the role of polyunsaturated fatty acids (pufa) in the pathogenesis of acute infection, we analyzed the fa content in red blood cell (rbc) membranes of patients with clostridium difficile infection (cdi) and controls. we prospectively studied 60 patients including 30 patients with cdi and 30 controls to assess lipid concentr ... | 2016 | 27172707 |
| [fecal microbiota transplantation]. | fecal microbiota transplantation (fmt) is a therapeutic method, in which the fecal microflora from healthy donors is transmitted to the patient to restore the healthy microbial composition of the gut. in the recent years, there is a growing interest in the therapeutic potential of fmt in various diseases. the standard fmt protocols do not exist. procedures of fmt vary in several aspects such as donor selection, preparation of fecal material, preparation of the recipient and administration way. f ... | 2016 | 27172442 |
| pseudomembranous colitis: not always clostridium difficile. | although clostridium difficile infection is the cause of most cases of pseudomembranous colitis, clinicians should consider less common causes, especially if pseudomembranes are seen on endoscopy but testing remains negative for c difficile or if presumed c difficile infection does not respond to treatment. histologic review of colonic mucosal biopsy specimens can provide clues to the underlying cause. | 2016 | 27168512 |
| endogenous il-17 as a factor determining the severity of clostridium difficile infection in mice. | clostridium difficile infection (cdi) is a toxin-mediated intestinal disease. toxin a, toxin b and binary toxin are believed to be responsible for the pathogenesis of cdi, which is characterized by massive infiltration of neutrophils at the infected intestinal mucosa. il-17 is one of the cytokines that play critical roles in several inflammatory and immunological diseases through various actions, including promoting neutrophil recruitment. the aim of this study was to examine the role of this cy ... | 2016 | 27166143 |
| gut microbiota composition and clostridium difficile infection in hospitalized elderly individuals: a metagenomic study. | the gut microbiota composition of elderly hospitalized patients with clostridium difficile infection (cdi) exposed to previous antibiotic treatment is still poorly investigated. the aim of this study was to compare the microbiota composition by means of 16s rrna microbial profiling among three groups of hospitalized elderly patients (age ≥ 65) under standard diet including 25 cdi-positive (cdi group), 29 cdi-negative exposed to antibiotic treatment (ab+ group) and 30 cdi-negative subjects not on ... | 2016 | 27166072 |
| pseudomembranous colitis secondary to methicillin-resistant staphylococcus aureus (mrsa). | a 37-year-old woman with a history of type ii diabetes and crohn's disease, status postcholecystectomy, presented with a >2-week history of cramping abdominal pain, nausea, non-bloody/non-bilious emesis and, later, diarrhoea. a flexible sigmoidoscopy was performed, revealing that 'a segmental pseudomembrane was found from rectum to sigmoid colon'. clostridium difficile pcr on the stool was repeated twice and resulted negative both times. a food history prior to onset of symptoms was consistent w ... | 2016 | 27165998 |
| predominance and high antibiotic resistance of the emerging clostridium difficile genotypes napcr1 and nap9 in a costa rican hospital over a 2-year period without outbreaks. | clostridium difficile is the major causative agent of nosocomial antibiotic-associated diarrhea. in a 2009 outbreak of c. difficile-associated diarrhea that was recorded in a major costa rican hospital, the hypervirulent nap1 strain (45%) predominated together with a local genotype variant (napcr1, 31%). both strains were fluoroquinolone-resistant and the napcr1 genotype, in addition, was resistant to clindamycin and rifampicin. we now report on the genotypes and antibiotic susceptibilities of 6 ... | 2016 | 27165560 |
| infection: targeting asymptomatic carriers of clostridium difficile infection. | | 2016 | 27165512 |
| impact of microbial derived secondary bile acids on colonization resistance against clostridium difficile in the gastrointestinal tract. | clostridium difficile is an anaerobic, gram positive, spore-forming bacillus that is the leading cause of nosocomial gastroenteritis. clostridium difficile infection (cdi) is associated with increasing morbidity and mortality, consequently posing an urgent threat to public health. recurrence of cdi after successful treatment with antibiotics is high, thus necessitating discovery of novel therapeutics against this pathogen. susceptibility to cdi is associated with alterations in the gut microbiot ... | 2016 | 27163871 |
| how to manipulate the microbiota: fecal microbiota transplantation. | fecal microbiota transplantation (fmt) is a rather straightforward therapy that manipulates the human gastrointestinal (gi) microbiota, by which a healthy donor microbiota is transferred into an existing but disturbed microbial ecosystem. this is a natural process that occurs already at birth; infants are rapidly colonized by a specific microbial community, the composition of which strongly depends on the mode of delivery and which therefore most likely originates from the mother (palmer et al. ... | 2016 | 27161356 |
| clostridium difficile infection. | infection of the colon with the gram-positive bacterium clostridium difficile is potentially life threatening, especially in elderly people and in patients who have dysbiosis of the gut microbiota following antimicrobial drug exposure. c. difficile is the leading cause of health-care-associated infective diarrhoea. the life cycle of c. difficile is influenced by antimicrobial agents, the host immune system, and the host microbiota and its associated metabolites. the primary mediators of inflamma ... | 2016 | 27158839 |
| clostridium difficile associated diarrhea. | clostridium difficile associated diarrhea (cdad) is increasingly important in primary care, and associated with high cost, significant morbidity and mortality. as the preferred treatment for different groups of patients varies considerably, it is important to stratify cdad patients into mild versus severe and uncomplicated versus complicated. while treatment with either metronidazole or oral vancomycin cures a majority of patients, and despite improvement in early diagnosis and therapy, recurren ... | 2016 | 27156262 |
| clostridium difficile ribotype 176 - a predictor for high mortality and risk of nosocomial spread? | the objective of this survey was to determine the incidence of clostridium difficile infections (cdi) at the department of infectious diseases, bulovka hospital, and to evaluate clinical and epidemiological data on cdi patients together with a detailed molecular characterisation of c. difficile isolates. the patient outcomes were correlated to causative c. difficile pcr-ribotype. | 2016 | 27155489 |
| the challenge of clostridium difficile infection. | clostridium difficile infection is a major problem in the united states, resulting in significant morbidity, mortality, and financial costs to the health care system. this commentary provides an update regarding the epidemiology, diagnosis, current recommended management, and challenges surrounding c. difficile infection. | 2016 | 27154892 |
| clostridium difficile toxins a and b: insights into pathogenic properties and extraintestinal effects. | clostridium difficile infection (cdi) has significant clinical impact especially on the elderly and/or immunocompromised patients. the pathogenicity of clostridium difficile is mainly mediated by two exotoxins: toxin a (tcda) and toxin b (tcdb). these toxins primarily disrupt the cytoskeletal structure and the tight junctions of target cells causing cell rounding and ultimately cell death. detectable c. difficile toxemia is strongly associated with fulminant disease. however, besides the well-kn ... | 2016 | 27153087 |
| fecal transplantation: any real hope for inflammatory bowel disease? | fecal microbiota transplant (fmt) has emerged as an important treatment for antibiotic resistant or recurrent clostridium difficile infection. there has been a great deal of media coverage of the efficacy of fmt, and patients with inflammatory bowel disease (ibd) understandably wonder if this approach would also work for them. there are also instructions on 'do it yourself' fmt therapy on the web. it is important to understand whether there is evidence that this approach is effective in ibd so t ... | 2016 | 27152872 |
| high mobility group box1 protein is involved in acute inflammation induced by clostridium difficile toxin a. | high mobility group box1 (hmgb1), as a damage-associated inflammatory factor, contributes to the pathogenesis of numerous chronic inflammatory and autoimmune diseases. in this study, we explored the role of hmgb1 in cdi (clostridium difficile infection) by in vivo and in vitro experiments. our results showed that hmgb1 might play an important role in the acute inflammatory responses to c. difficile toxin a (tcda), affect early inflammatory factors, and induce inflammation via the hmgb1-tlr4 path ... | 2016 | 27151296 |
| production of the ramoplanin activity analogue by double gene inactivation. | glycopeptides such as vancomycin and telavancin are essential for treating infections caused by gram-positive bacteria. but the dwindling availability of new antibiotics and the emergence of resistant bacteria are making effective antibiotic treatment increasingly difficult. ramoplanin, an inhibitor of bacterial cell wall biosynthesis, is a highly effective antibiotic against a wide range of gram-positive bacteria, including methicillin-resistant staphylococcus aureus, vancomycin-intermediate re ... | 2016 | 27149627 |
| rifaximin for the treatment of irritable bowel syndrome - a drug safety evaluation. | irritable bowel syndrome is a functional gastrointestinal disorder with a multifactorial etiology. alterations of intestinal motility and immunity, gut-brain interactions, as well as gut microbiota dysbiosis contribute to the development of irritable bowel syndrome. therefore, gut microbiota modulation by non-absorbable antibiotics is a therapeutic option in patients with ibs. | 2016 | 27149541 |
| extended perioperative antibiotic coverage in conjunction with intraoperative bile cultures decreases infectious complications after pancreaticoduodenectomy. | background. bile contamination from the digestive tract is a well-known risk factor for postoperative complications. despite the literature concerning prevalence of bacterobilia and fungobilia in patients with biliary pathologies, there are no specific recommendations for perioperative antimicrobial coverage for biliary/pancreatic procedures. we evaluated the effect of at least 72 hours of perioperative broad spectrum antibiotic coverage on outcomes of pancreaticoduodenectomy (pd). materials and ... | 2016 | 27147813 |
| detection of 23 gastrointestinal pathogens among children who present with diarrhea. | in the era of widespread rotavirus vaccine use, toxigenic clostridium difficile, diarrheagenic escherichia coli, and viruses (particularly norovirus) are commonly detected among children with infectious gastroenteritis in the united states by using a multipathogen molecular panel. | 2016 | 27147712 |
| risk factors for recurrent clostridium difficile infection in pediatric inpatients. | the purpose of this study was to identify the risk factors during the incident clostridium difficile infection (cdi) episode, associated with developing recurrent cdi within 60 days, among hospitalized children that may be amenable to intervention. | 2016 | 27146969 |
| transplanting a microbial organ: the good, the bad, and the unknown. | fecal microbiota transplantation (fmt) has received increased attention as a therapy for correcting intestinal dysbiosis and restoring a state of health in patients suffering from either recalcitrant infection by clostridium difficile or more complex disease states, such as inflammatory bowel disease (ibd). the "gut microbial organ" from the donor that is used in these transplants may serve to transfer genetic material between donor and recipient via virus-like particles, specifically bacterioph ... | 2016 | 27143392 |
| efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials. | the relative efficacy and safety of proton pump inhibitors (ppis) compared to histamine-2-receptor antagonists (h2ras) should guide their use in reducing bleeding risk in the critically ill. | 2016 | 27142116 |
| effect of passive immunotherapy against clostridium difficile infection: a systematic review and meta-analysis. | this systematic review aimed to determine the effect of antibody therapy against clostridium difficile infection (cdi) using meta-analysis. in total, 28 studies (animals - 12; human - 17) were identified from the database on the basis of inclusion criteria; then selected studies were systematically reviewed and statistically analyzed. in animal experiments, the pooled relative risk of eight potential studies suggested that the antibody treatment could reduce the risk of cdi. however, the methodo ... | 2016 | 27140414 |
| clostridium difficile infection in patients with inflammatory bowel disease. | clostridium difficile infection (cdi) is now the leading cause of nosocomial infection. there has been an upsurge of cdi in patients with inflammatory bowel disease (ibd). ibd patients with cdi have increased morbidity and mortality. the establishment, proliferation, and recurrence of cdi in ibd patients form a complex interplay of microbial, environmental, and host-susceptibility factors. different risk factors have been found predisposing ibd patients to cdi. vancomycin performs better than me ... | 2016 | 27137789 |
| fecal microbiota transplant for clostridium difficile infection in older adults. | the objective of this study was to describe the safety of fecal microbiota transplant (fmt) for clostridium difficile infection (cdi) among older adults. | 2016 | 27134658 |
| occupational health risks associated with the use of germicides in health care. | environmental surfaces have been clearly linked to transmission of key pathogens in health care facilities, including methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococcus, clostridium difficile, norovirus, and multidrug-resistant gram-negative bacilli. for this reason, routine disinfection of environmental surfaces in patient rooms is recommended. in addition, decontamination of shared medical devices between use by different patients is also recommended. environmental ... | 2016 | 27131141 |
| effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: focus on clinical trials. | over the last decade, substantial scientific evidence has accumulated that indicates contamination of environmental surfaces in hospital rooms plays an important role in the transmission of key health care-associated pathogens (eg, methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococci, clostridium difficile, acinetobacter spp). for example, a patient admitted to a room previously occupied by a patient colonized or infected with one of these pathogens has a higher risk for ... | 2016 | 27131140 |
| reducing health care-associated infections by implementing a novel all hands on deck approach for hand hygiene compliance. | hand hygiene is a key intervention for preventing health care-associated infections; however, maintaining high compliance is a challenge, and accurate measurement of compliance can be difficult. a novel program that engaged all health care personnel to measure compliance and provide real-time interventions overcame many barriers for compliance measurement and proved effective for sustaining high compliance and reducing health care-associated infections. | 2016 | 27131129 |
| clostridium difficile clade 5 in australia: antimicrobial susceptibility profiling of pcr ribotypes of human and animal origin. | increasing reports of genetic overlap between animal and human sources of clostridium difficile necessitate an understanding of antimicrobial susceptibility and resistance in these populations. in this study, we sought to investigate the in vitro activities of 13 antimicrobials against a unique collection of clade 5 c. difficile isolates of australian animal and human origin. | 2016 | 27130808 |
| impact of microbiology cascade reporting on antibiotic de-escalation in cefazolin-susceptible gram-negative bacteremia. | cascade reporting (cr) involves reporting the susceptibilities of broad-spectrum agents only when the organism is resistant to more narrow-spectrum agents. the purpose of this study is to evaluate the impact of cr on antibiotic de-escalation practices and to characterize the impact of cr on clinical outcomes. cr rules were implemented in the microbiology laboratory at atlantic health system (ahs) in june 2013. a retrospective chart review was conducted at two community teaching hospitals in adul ... | 2016 | 27130036 |
| fecal microbiota transplantation using upper gastrointestinal tract for the treatment of refractory or severe complicated clostridium difficile infection in elderly patients in poor medical condition: the first study in an asian country. | background and aims. fecal microbiota transplantation (fmt) is a highly effective treatment option for refractory clostridium difficile infection (cdi). fmt may be challenging in patients with a low performance status, because of their poor medical condition. the aims of this study were to describe our experience treating patients in poor medical condition with refractory or severe complicated cdi using fmt via the upper gi tract route. methods. this study was a retrospective review of seven eld ... | 2016 | 27127501 |
| getting to a man's heart through his colon. | a 69-year-old man presented with a progressively enlarging pulsatile mass in the left side of his chest. because of a history of an ischemic cardiomyopathy, he had been randomized in 2003 to undergo coronary artery bypass grafting with a dor procedure, as part of the surgical treatment for ischemic heart failure (stich) trial. our patient's imaging studies, including a thoracic computed tomogram and transthoracic echocardiogram, were now of concern for left ventricular pseudoaneurysm. he was tak ... | 2016 | 27127437 |
| durable coexistence of donor and recipient strains after fecal microbiota transplantation. | fecal microbiota transplantation (fmt) has shown efficacy in treating recurrent clostridium difficile infection and is increasingly being applied to other gastrointestinal disorders, yet the fate of native and introduced microbial strains remains largely unknown. to quantify the extent of donor microbiota colonization, we monitored strain populations in fecal samples from a recent fmt study on metabolic syndrome patients using single-nucleotide variants in metagenomes. we found extensive coexist ... | 2016 | 27126044 |
| [chronic salmonella typhimurium diarrhea in an immunocompetent patient]. | chronic diarrhea caused by infection in immunocompetent patients is an infrequent condition in developed countries, although certain pathogens,generally parasites (giardia lamblia, isospora belli,cryptosporidium, cyclospora, strongyloides, ameba,trichuris and schistosoma) and some bacteria (aeromonas,plesiomonas, campylobacter, clostridium difficile, salmonella or mycobacterium tuberculosis)can cause persistent diarrhea.we present the case of a patient who showed salmonella typhimurium in his st ... | 2016 | 27125610 |
| repeat clostridium difficile pcr testing after a negative result. | | 2016 | 27124907 |
| developing a clinical prediction rule for first hospital-onset clostridium difficile infections: a retrospective observational study. | background the healthcare burden of hospital-acquired clostridium difficile infection (cdi) demands attention and calls for a solution. identifying patients' risk of developing a primary nosocomial cdi is a critical first step in reducing the development of new cases of cdi. objective to derive a clinical prediction rule that can predict a patient's risk of acquiring a primary cdi. design retrospective cohort study. setting large tertiary healthcare center. patients total of 61,482 subjects aged ... | 2016 | 27123975 |
| dynamics of the fecal microbiome in patients with recurrent and nonrecurrent clostridium difficile infection. | recurrent clostridium difficile infection (cdi) remains problematic, with up to 30 % of individuals diagnosed with primary cdi experiencing at least one episode of recurrence. the success of microbial-based therapeutics, such as fecal microbiota transplantation, for the treatment of recurrent cdi underscores the importance of restoring the microbiota. however, few studies have looked at the microbial factors that contribute to the development of recurrent disease. here we compare microbial chang ... | 2016 | 27121861 |
| epidemiology, diagnosis, and management of clostridium difficile infection in patients with inflammatory bowel disease. | clostridium difficile infection (cdi) is a major source of morbidity and mortality for the u.s. health care system and frequently complicates the course of inflammatory bowel disease (ibd). patients with ibd are more likely to be colonized with c. difficile and develop active infection than the general population. they are also more likely to have severe cdi and develop subsequent complications such as ibd flare, colectomy, or death. even after successful initial treatment and recovery, recurren ... | 2016 | 27120571 |
| nqo1-knockout mice are highly sensitive to clostridium difficile toxin a-induced enteritis. | clostridium difficile toxin a causes acute gut inflammation in animals and humans. it is known to downregulate the tight junctions between colonic epithelial cells, allowing luminal contents to access body tissues and trigger acute immune responses. however, it is not yet known whether this loss of the barrier function is a critical factor in the progression of toxin a-induced pseudomembranous colitis. we previously showed that nadh:quinone oxidoreductase 1 (nqo1) ko (knockout) mice spontaneousl ... | 2016 | 27116994 |
| uk renal registry 18th annual report: chapter 12 epidemiology of reported infections amongst patients receiving dialysis for established renal failure in england 2013 to 2014: a joint report from public health england and the uk renal registry. | from 1st may 2013 to 30th april 2014 there were 35 episodes of methicillin resistant staphylococcus aureus (mrsa) bacteraemia in established renal failure patients on dialysis. this is now fairly stable year-on-year equating to a rate of 0.15 episodes per 100 dialysis patient years, following an initial decline in rates from 4.0 episodes per 100 dialysis patient years in 2005 when reporting began. methicillin sensitive staphylococcus aureus (mssa) bacteraemia rates were slightly higher this year ... | 2016 | 27116291 |
| effect of detecting and isolating clostridium difficile carriers at hospital admission on the incidence of c difficile infections: a quasi-experimental controlled study. | clostridium difficile infection (cdi) is a major cause of health care-associated infection worldwide, and new preventive strategies are urgently needed. current control measures do not target asymptomatic carriers, despite evidence that they can contaminate the hospital environment and health care workers' hands and potentially transmit c difficile to other patients. | 2016 | 27111806 |
| active surveillance and isolation of asymptomatic carriers of clostridium difficile at hospital admission: containing what lies under the waterline. | | 2016 | 27111468 |
| efficacy and mechanisms of action of fecal microbiota transplantation in ulcerative colitis: pitfalls and promises from a first meta-analysis. | inflammatory bowel disease (ibd) is the results of a chronic inflammatory process deriving from disequilibrium between self-microbiota composition and immune response. | 2016 | 27109966 |
| determination of the extent of clostridium difficile colonisation and toxin accumulation in sows and neonatal piglets. | clostridium difficile is an important spore-forming, opportunistic pathogen in animal husbandry and health care. in pig farming, only neonatal piglets are affected, and diarrhoea and necrotising lesions are common symptoms leading to dehydration and in some cases death. this study aimed at the assessment of the quantitative development of c. difficile colonisation in neonatal piglets by determining the shedding of spores and c. difficile toxins a (tcda) and b (tcdb) concentrations in sow (n = 5- ... | 2016 | 27108595 |
| a novel method for imaging the pharmacological effects of antibiotic treatment on clostridium difficile. | clostridium difficile is a significant cause of nosocomial-acquired infection that results in severe diarrhea and can lead to mortality. treatment options for c. difficile infection (cdi) are limited, however, new antibiotics are being developed. current methods for determining efficacy of experimental antibiotics on c. difficile involve antibiotic killing rates and do not give insight into the drug's pharmacologic effects. considering this, we hypothesized that by using scanning electron micros ... | 2016 | 27108094 |
| immune responses induced by clostridium difficile. | the spectrum of clostridium difficile infections is highly variable, ranging from asymptomatic carriage to fatal colitis depending on the strain virulence and on the host, its gut microbiota and its immune response. after disruption of the gut microbiota, c. difficile pathogenesis can be divided into three steps: 1) contamination by spores and their germination; 2) multiplication of vegetative cells and intestinal colonization using colonization factors; 3) production of the toxins tcda and tcdb ... | 2016 | 27108093 |
| the role of clostridium difficile in the paediatric and neonatal gut - a narrative review. | clostridium difficile is an important nosocomial pathogen in adults. its significance in children is less well defined, but cases of c. difficile infection (cdi) appear to be increasingly prevalent in paediatric patients. this review aims to summarize reported clostridium difficile carriage rates across children of different age groups, appraise the relationship between cdi and factors such as method of delivery, type of infant feed, antibiotic use, and co-morbidities, and review factors affecti ... | 2016 | 27107991 |
| epidemiology of clostridium difficile infections in australia: enhanced surveillance to evaluate time trends and severity of illness in victoria, 2010-2014. | with epidemic strains of clostridium difficile posing a substantial healthcare burden internationally, there is a need for longitudinal evaluation of clostridium difficile infection (cdi) events in australia. | 2016 | 27107622 |
| corrigendum to "length of stay and mortality due to clostridium difficile infection acquired in the intensive care unit" journal of critical care (2013) 28, 335-340. | | 2016 | 27107495 |
| risk factors for clostridium difficile infection in hospitalized patients with community-acquired pneumonia. | clostridium difficile infection (cdi) is strongly associated with anti-biotic treatment, and community-acquired pneumonia (cap) is the leading indication for anti-biotic prescription in hospitals. this study assessed the incidence of and risk factors for cdi in a cohort of patients hospitalized with cap. | 2016 | 27105657 |
| bacterial intestinal superinfections in inflammatory bowel diseases beyond clostridum difficile. | besides genetics and environmental factors, intestinal microbiota seem to play a major role in the pathogenesis of inflammatory bowel diseases. for many decades, it has been said that some enteropathogens may even trigger both inflammatory bowel disease development and disease flares. for this reason, stool testing had been performed in inflammatory bowel disease flares but current guidelines only recommend to rule out clostridium difficile infection and there is no clear advice for other entero ... | 2016 | 27104824 |
| recurrence and death after clostridium difficile infection: gender-dependant influence of proton pump inhibitor therapy. | to determine whether patients with a pre-existing ppi treatment had a higher risk of poor evolution (recurrence or death) when diagnosed with a toxicogenic clostridium difficile digestive infection. | 2016 | 27104118 |
| fecal transplantation using a nasoenteric tube during an initial episode of severe clostridium difficile infection. | the incidence of clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise. metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains. furthermore, antibiotic therapy results in recurrence rates of at least 20%. fecal transplantation may be a feasible treatment option for recurrent c. difficile infection; moreover, it may be an early treatme ... | 2016 | 27104013 |
| the burden of clostridium difficile infection: estimates of the incidence of cdi from u.s. administrative databases. | many administrative data sources are available to study the epidemiology of infectious diseases, including clostridium difficile infection (cdi), but few publications have compared cdi event rates across databases using similar methodology. we used comparable methods with multiple administrative databases to compare the incidence of cdi in older and younger persons in the united states. | 2016 | 27102582 |
| sporulation properties and antimicrobial susceptibility in endemic and rare clostridium difficile pcr ribotypes. | increased sporulation and antibiotic resistance have been proposed to be associated with certain clostridium difficile epidemic strains such as pcr ribotype 027. in this study we examined these properties in another widespread pcr ribotype, 014/020, in comparison to prevalent pcr ribotype 002 and a group of rarely represented pcr ribotypes. highest sporulation was observed in 014/020 strains at 24 h, while after 72 h pcr ribotype 002 and rare pcr ribotypes formed higher total number of spores. p ... | 2016 | 27095618 |
| diarrhoea in the critically ill is common, associated with poor outcome, and rarely due to clostridium difficile. | diarrhoea is common in intensive care unit (icu) patients, with a reported prevalence of 15-38%. many factors may cause diarrhoea, including clostridium difficile, drugs (e.g. laxatives, antibiotics) and enteral feeds. diarrhoea impacts on patient dignity, increases nursing workload and healthcare costs, and exacerbates morbidity through dermal injury, impaired enteral uptake and subsequent fluid imbalance. we analysed a cohort of 9331 consecutive patients admitted to a mixed general intensive c ... | 2016 | 27094447 |
| stress ulcer prophylaxis with a proton pump inhibitor versus placebo in critically ill patients (sup-icu trial): study protocol for a randomised controlled trial. | critically ill patients in the intensive care unit (icu) are at risk of clinically important gastrointestinal bleeding, and acid suppressants are frequently used prophylactically. however, stress ulcer prophylaxis may increase the risk of serious adverse events and, additionally, the quantity and quality of evidence supporting the use of stress ulcer prophylaxis is low. the aim of the sup-icu trial is to assess the benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in ad ... | 2016 | 27093939 |
| clinical outcomes of acid suppressive therapy use in hematology/oncology patients at an academic medical center. | acid suppressive therapy (ast)-namely, proton pump inhibitors (ppis) and histamine-2 receptor antagonists (h2ras)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (sup). | 2016 | 27091869 |
| ulcerative colitis patients with clostridium difficile are at increased risk of death, colectomy, and postoperative complications: a population-based inception cohort study. | clostridium difficile (c. difficile) may worsen the prognosis of ulcerative colitis (uc). the objectives of this study were to: (i) validate the international classification of diseases-10 (icd-10) code for c. difficile; (ii) determine the risk of c. difficile infection after diagnosis of uc; (iii) evaluate the effect of c. difficile infection on the risk of colectomy; and (iv) assess the association between c. difficile and postoperative complications. | 2016 | 27091322 |
| do piperacillin/tazobactam and other antibiotics with inhibitory activity against clostridium difficile reduce the risk for acquisition of c. difficile colonization? | systemic antibiotics vary widely in in vitro activity against clostridium difficile. some agents with activity against c. difficile (e.g., piperacillin/tazobactam) inhibit establishment of colonization in mice. we tested the hypothesis that piperacillin/tazobactam and other agents with activity against c. difficile achieve sufficient concentrations in the intestinal tract to inhibit colonization in patients. | 2016 | 27091232 |
| postoperative antimicrobials after lung transplantation and the development of multidrug-resistant bacterial and clostridium difficile infections: an analysis of 500 non-cystic fibrosis lung transplant patients. | broad-spectrum antimicrobials are given prophylactically post-transplant, although these agents are a risk factor for multidrug-resistant (mdr) infections and clostridium difficile infection (cdi). this study aimed to determine whether an association exists between the duration of antimicrobials given early post-transplant and the development of mdr infections or cdi. | 2016 | 27091109 |
| molecular and epidemiologic study of clostridium difficile reveals unusual heterogeneity in clinical strains circulating in different regions in portugal. | clostridium difficile infection (cdi) represents a great healthcare burden in developed countries. the emergence of the epidemic pcr ribotype (rt) 027 and its acquired fluoroquinolones resistance have accentuated the need for an active surveillance of cdi. here we report the first countrywide study of cdi in portugal with the characterization of 498 c. difficile clinical isolates from 20 hospitals in four regions in portugal regarding rt, virulence factors and antimicrobial susceptibility. we id ... | 2016 | 27091093 |
| microbiome mediation of infections in the cancer setting. | infections encountered in the cancer setting may arise from intensive cancer treatments or may result from the cancer itself, leading to risk of infections through immune compromise, disruption of anatomic barriers, and exposure to nosocomial (hospital-acquired) pathogens. consequently, cancer-related infections are unique and epidemiologically distinct from those in other patient populations and may be particularly challenging for clinicians to treat. there is increasing evidence that the micro ... | 2016 | 27090860 |
| effect of fidaxomicin versus vancomycin on susceptibility to intestinal colonization with vancomycin-resistant enterococci and klebsiella pneumoniae in mice. | the use of oral vancomycin or metronidazole for treatment of clostridium difficile infection (cdi) may promote colonization by health care-associated pathogens due to disruption of the intestinal microbiota. because the macrocyclic antibiotic fidaxomicin causes less alteration of the intestinal microbiota than vancomycin, we hypothesized that it would not lead to a loss of colonization resistance to vancomycin-resistant enterococci (vre) and extended-spectrum-β-lactamase-producing klebsiella pne ... | 2016 | 27090175 |
| metal ion activation of clostridium sordellii lethal toxin and clostridium difficile toxin b. | lethal toxin from clostridium sordellii (tcsl) and toxin b from clostridium difficile (tcdb) belong to the family of the "large clostridial glycosylating toxins." these toxins mono-o-glucosylate low molecular weight gtpases of the rho and ras families by exploiting udp-glucose as a hexose donor. tcsl is casually involved in the toxic shock syndrome and the gas gangrene. tcdb-together with toxin a (tcda)-is causative for the pseudomembranous colitis (pmc). here, we present evidence for the in vit ... | 2016 | 27089365 |
| national variability and appropriateness of surgical antibiotic prophylaxis in us children's hospitals. | appropriate use of surgical antibiotic prophylaxis (ap) reduces surgical site infection rates, but prior data suggest variability in use patterns. | 2016 | 27088649 |