| genome sequence and analysis of peptoclostridium difficile strain zjcdc-s82. | peptoclostridium difficile (clostridium difficile) is the major pathogen associated with infectious diarrhea in humans. concomitant with the increased incidence of c. difficile infection worldwide, there is an increasing concern regarding this infection type. this study reports a draft assembly and detailed sequence analysis of c. difficile strain zjcdc-s82. the de novo assembled genome was 4.19 mb in size, which includes 4,013 protein-coding genes, 41 rrna genes, and 84 trna genes. along with t ... | 2016 | 26823648 |
| prevalence of probiotic use among inpatients: a descriptive study of 145 u.s. hospitals. | to inform clinical guidance, public health efforts, and research directions, probiotic use in u.s. health care needs to be better understood. this work aimed to assess the prevalence of inpatient probiotic use in a sample of u.s. hospitals. | 2016 | 26822808 |
| fecal transplantation for clostridium difficile-"all stool may not be created equal". | clostridium difficile is a gram-positive bacterium that is recognized as a causative organism of pseudomembranous enterocolitis. this infection has become a major public health challenge and is a source of considerable morbidity and mortality in those infected. we present a 62-year-old african american female with a long history of hiv infection, who presented with abdominal pain and continuous diarrhea due to pseudomembranous colitis. after failing multiple episodes of conventional therapy, it ... | 2016 | 26821578 |
| infection prevention in transplantation. | the number of patients undergoing hematopoietic cell and solid organ transplantation are increasing every year, as are the number of centers both transplanting and caring for these patients. improvements in transplant procedures, immunosuppressive regimens, and prevention of transplant-associated complications have led to marked improvements in survival in both populations. infections remain one of the most important sources of excess morbidity and mortality in transplant, and therefore, infecti ... | 2016 | 26820654 |
| difficult case of cronkhite-canada syndrome with small intestinal bacterial overgrowth, clostridium difficile infection and polymyalgia rheumatica. | a 64-year-old woman presented with heavy diarrhoea, nausea and weight loss accompanied by alopecia and dystrophic fingernails and toenails. the preceding diagnosis of an inflammatory bowel disease, a common pitfall, was excluded by endoscopic work up. instead, cronkhite-canada syndrome (ccs), a rare polyposis condition, was identified as the reason for this almost pathognomonic combination of diagnostic findings including various polyps throughout the entire intestine and ectodermal abnormalitie ... | 2016 | 26818813 |
| inappropriate antibiotic use and gastric acid suppression preceding clostridium difficile infection. | | 2016 | 26818749 |
| decolonization in prevention of health care-associated infections. | colonization with health care-associated pathogens such as staphylococcus aureus, enterococci, gram-negative organisms, and clostridium difficile is associated with increased risk of infection. decolonization is an evidence-based intervention that can be used to prevent health care-associated infections (hais). this review evaluates agents used for nasal topical decolonization, topical (e.g., skin) decolonization, oral decolonization, and selective digestive or oropharyngeal decontamination. alt ... | 2016 | 26817630 |
| microbiome regulation of autoimmune, gut and liver associated diseases. | extensive analysis of the complexity and diversity of microbiota using metagenomics in the gut and other body sites has provided evidence that dysbiosis occurs in many disease states. with the application of next generation sequencing technology this research is starting to uncover the impact of microbiota on metabolic, physiological and immunological pathways and elucidate the cellular and molecular mechanisms involved. to highlight these advances we have focused on autoimmunity and gut and liv ... | 2015 | 26817477 |
| is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? a natural experiment with non-equivalent controls. | a wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. however, studies have been limited to the us with limited evidence from elsewhere. the aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. | 2016 | 26811373 |
| tigecycline as last resort in severe refractory clostridium difficile infection: a case report. | | 2016 | 26810610 |
| a detrimental role of immunosuppressive drug, dexamethasone, during clostridium difficile infection in association with a gastrointestinal microbial shift. | we investigated the increased risk of clostridium difficile infection (cdi) caused by the combined use of antibiotics and an immunosuppressive drug in a mouse model. our data showed that an approximate return to pretreatment conditions of gut microbiota occurred within days after cessation of the antibiotic treatment, whereas the recovery of gut microbiota was delayed with the combined treatment of antibiotics and dexamethasone, leading to an increased severity of cdi. an alteration of gut micro ... | 2016 | 26809802 |
| potassium acetate blocks clostridium difficile toxin a-induced microtubule disassembly by directly inhibiting histone deacetylase 6, thereby ameliorating inflammatory responses in the gut. | clostridium difficile toxin a is known to cause deacetylation of tubulin proteins, which blocks microtubule formation and triggers barrier dysfunction in the gut. based on our previous finding that the clostridium difficile toxin a-dependent activation of histone deacetylase 6 (hdac-6) is responsible for tubulin deacetylation and subsequent microtubule disassembly, we herein examined the possible effect of potassium acetate (pa; whose acetyl group prevents the binding of tubulin to hdac-6) as a ... | 2016 | 26809801 |
| effect of variation in test methods on performance of ultraviolet-c radiation room decontamination. | to determine the effect of variation in test methods on performance of an ultraviolet-c (uv-c) room decontamination device. | 2016 | 26809607 |
| older is not wiser, immunologically speaking: effect of aging on host response to clostridium difficile infections. | clostridium difficile infection (cdi) is the most common cause of antibiotic-associated diarrhea and a significant burden on the health care system. aging has been identified in the literature as a risk factor for cdi as well as adverse outcome from cdi. although this effect of advanced age on cdi could be partially explained by clinical factors associated with aging, biologic factors are important. innate immune system, responsible for immediate response to acute infections, plays a major role ... | 2016 | 26809495 |
| adverse events in faecal microbiota transplant: a review of the literature. | faecal microbiota transplant (fmt) is the infusion of donor faeces into the gut with the aim of improving microbial diversity. the procedure has gained significant interest recently in the treatment of recurrent clostridium difficile infection (cdi). the literature is currently dominated by small case series and isolated case reports. there is no standardization of methods and recording of outcomes. | 2016 | 26803556 |
| clostridium difficile recurrences in stockholm. | sixty-eight hospital-admitted patients with a first episode of clostridium difficile infection (cdi) were included and followed up during 1 year. faeces samples were collected at 1, 2, 6 and 12 months after inclusion and analyzed for the presence of c. difficile toxin b, genes for toxin a, toxin b, binary toxin and tcdc deletion by pcr. all strains were also pcr-ribotyped and the mics of the isolates were determined against eight antimicrobial agents. in 68 patients initially included, antibioti ... | 2016 | 26802875 |
| burden of nursing home-onset clostridium difficile infection in the united states: estimates of incidence and patient outcomes. | background. approximately 4 million americans receive nursing home (nh) care annually. nursing home residents commonly have risk factors for clostridium difficile infection (cdi), including advanced age and antibiotic exposures. we estimated national incidence of nh-onset (nho) cdi and patient outcomes. methods. we identified nho-cdi cases from population-based surveillance of 10 geographic areas in the united states. cases were defined by c difficile-positive stool collected in an nh (or from ... | 2016 | 26798767 |
| descriptive epidemiology of infectious gastrointestinal illnesses in sydney, australia, 2007-2010. | there is a lack of information about the prevalence of gastrointestinal illnesses in australia. current disease surveillance systems capture only a few pathogens. the aim of this study is to describe the epidemiology of infectious gastrointestinal illnesses in sydney, australia. | 2017 | 26798556 |
| reactive oxygen species as additional determinants for cytotoxicity of clostridium difficile toxins a and b. | clostridium difficile infections can induce mild to severe diarrhoea and the often associated characteristic pseudomembranous colitis. two protein toxins, the large glucosyltransferases tcda and tcdb, are the main pathogenicity factors that can induce all clinical symptoms in animal models. the classical molecular mode of action of these homologous toxins is the inhibition of rho gtpases by mono-glucosylation. rho-inhibition leads to breakdown of the actin cytoskeleton, induces stress-activated ... | 2016 | 26797634 |
| asymptomatic rectal colonization with carbapenem-resistant enterobacteriaceae and clostridium difficile among residents of a long-term care facility in new york city. | residents of long-term care facilities (ltcfs) are at increased risk for colonization and development of infections with multidrug-resistant organisms. this study was undertaken to determine prevalence of asymptomatic rectal colonization with clostridium difficile (and proportion of 027/nap1/bi ribotype) or carbapenem-resistant enterobacteriaceae (cre) in an ltcf population. | 2016 | 26796684 |
| development and validation of a clostridium difficile health-related quality-of-life questionnaire. | patients with clostridium difficile infection (cdi) can experience long-term symptoms and poor quality of life due to the disease. despite this, a health-related quality of life (hrqol) instrument specific for patients with cdi does not exist. the aim of this study was to develop and validate a disease-specific instrument to assess hrqol in patients with cdi. | 2016 | 26796081 |
| acquisition of clostridium difficile on hands of healthcare personnel caring for patients with resolved c. difficile infection. | in an observational study, we found that healthcare personnel frequently acquired clostridium difficile on their hands when caring for patients with recently resolved c. difficile infection (cdi) (<6 weeks after treatment) who were no longer under contact precautions. continuing contact precautions after diarrhea resolves may be useful to reduce transmission. | 2016 | 26795900 |
| [fecal bacteriotherapy for the treatment of recurrent clostridium difficile colitis used in the clinic of infectious diseases of the university hospital brno in 2010-2014 - a prospective study]. | the aim of the study is to assess the efficacy of fecal bacteriotherapy in the treatment of clostridium difficile colitis. | 2015 | 26795227 |
| in vivo synthesis of cyclic-di-gmp using a recombinant adenovirus preferentially improves adaptive immune responses against extracellular antigens. | there is a compelling need for more effective vaccine adjuvants to augment induction of ag-specific adaptive immune responses. recent reports suggested the bacterial second messenger bis-(3'-5')-cyclic-dimeric-guanosine monophosphate (c-di-gmp) acts as an innate immune system modulator. we recently incorporated a vibrio cholerae diguanylate cyclase into an adenovirus vaccine, fostering production of c-di-gmp as well as proinflammatory responses in mice. in this study, we recombined a more potent ... | 2016 | 26792800 |
| association of healthcare exposure with acquisition of different clostridium difficile strain types in patients with recurrent infection or colonization after clinical resolution of initial infection. | following the resolution of an episode of clostridium difficile infection (cdi), the factors associated with acquisition of different c. difficile strain types in patients with recurrent infection or persistent colonization have not been evaluated. | 2016 | 26792686 |
| faecal microbiota transplantation for recurrent clostridium difficile infection and beyond: risks and regulation. | | 2016 | 26792682 |
| clostridium difficile flagella predominantly activate tlr5-linked nf-κb pathway in epithelial cells. | clostridium difficile has become the most common enteropathogen responsible for intestinal nosocomial post-antibiotic infections. this has coincided with the appearance of serious cases related to the emergence of hypervirulent strains. the toxins are the main virulence factors and elicit an inflammatory response during c. difficile infection. however, other bacterial components appear to be involved in the inflammatory process. in some pathogens, flagella play a role in pathogenesis through abn ... | 2016 | 26790921 |
| changes in colonic bile acid composition following fecal microbiota transplantation are sufficient to control clostridium difficile germination and growth. | fecal microbiota transplantation (fmt) is a highly effective therapy for recurrent clostridium difficile infection (r-cdi), but its mechanisms remain poorly understood. emerging evidence suggests that gut bile acids have significant influence on the physiology of c. difficile, and therefore on patient susceptibility to recurrent infection. we analyzed spore germination of 10 clinical c. difficile isolates exposed to combinations of bile acids present in patient feces before and after fmt. bile a ... | 2016 | 26789728 |
| prevalence and clinical outcomes of clostridium difficile infection in the intensive care unit: a systematic review and meta-analysis. | background. intensive care unit (icu) patients are at higher risk for clostridium difficile infection (cdi). | 2016 | 26788544 |
| the stealthy superbug: the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of st228 methicillin-resistant staphylococcus aureus. | whole-genome sequencing (wgs) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant staphylococcus aureus (mrsa) sequence type 228 (st228) sccmec i that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of st228, rather than repeated introductions ... | 2016 | 26787833 |
| impact of surotomycin on the gut microbiota of healthy volunteers in a phase 1 clinical trial. | clostridium difficile-associated diarrhea has been associated with disruption of the normal intestinal microbiota, particularly thebacteroides fragilisgroup andprevotellaspecies. surotomycin is a bactericidal cyclic lipopeptide in development for treatment ofclostridium difficile-associated diarrhea that has selective and potent activity againstc. difficileand other gram-positive bacteria and a minimal impact on intestinal gram-negative organisms. the impacts of ascending doses of surotomycin on ... | 2016 | 26787687 |
| assessing the activity of microbicides against bacterial spores: knowledge and pitfalls. | bacterial endospores (spores) have a higher intrinsic resistance to microbicides as compared to other microbial forms, most likely due to their impermeable outer layers and low water content. though structural differences between the spores of various bacterial species may account for observed variations in their resistance to microbicides, flaws in methods for testing the sporicidal activity of microbicides often exaggerate the differences. this has major implications when considering the selec ... | 2016 | 26784857 |
| evaluation of a low-intensity ultraviolet-c radiation device for decontamination of computer keyboards. | computer keyboards are a potential source for dissemination of pathogenic microorganisms. we demonstrated that a low-intensity ultraviolet-c (uv-c) radiation device was effective in reducing methicillin-resistant staphylococcus aureus, carbapenem-resistant escherichia coli, and clostridium difficile spores on steel carriers and significantly reduced bacterial counts on in-use keyboards. | 2016 | 26781219 |
| a case of primary invasive aspergillus colitis masquerading as clostridium difficile infection. | | 2016 | 26780696 |
| organism burden, toxin concentration, and lactoferrin concentration do not distinguish between clinically significant and nonsignificant diarrhea in patients with clostridium difficile. | clostridium difficile infection is often overdiagnosed in patients with mild diarrhea. we evaluated 4 biomarkers as surrogates for clinically significant diarrhea (≥ 3 episodes in 24 hours) in 59 pcr-positive patients with and 59 pcr-positive patients without clinically significant diarrhea. organism burden (median tcdb cycle threshold value, 26.9 versus 27.1, p=0.25) and toxin a and b concentrations (toxin a, median, 0 versus 0 ng/ml, p=0.42; toxin b, median, 0 versus 0 ng/ml, p=0.25) were not ... | 2016 | 26778484 |
| effects of a predictive preventive model for prevention of clostridium difficile infection in patients in intensive care units. | health care-acquired clostridium difficile infection (hacdi) is associated with adverse outcomes at both the organization and patient level. factors that increase risk for development of hacdi have been identified. objectives of this study were to develop a predictive screening tool to identify patients at risk for hacdi and implement a bundle of mitigation interventions. | 2016 | 26775936 |
| bile acid modifications at the microbe-host interface: potential for nutraceutical and pharmaceutical interventions in host health. | bile acids have emerged as important signaling molecules in the host, as they interact either locally or systemically with specific cellular receptors, in particular the farnesoid x receptor (fxr) and tgr5. these signaling functions influence systemic lipid and cholesterol metabolism, energy metabolism, immune homeostasis, and intestinal electrolyte balance. through defined enzymatic activities, the gut microbiota can significantly modify the signaling properties of bile acids and therefore can ... | 2016 | 26772409 |
| novel therapies for severe clostridium difficile colitis. | clostridium difficile infection (cdi) is becoming a large healthcare burden with increasing incidence, high recurrence rates, and associated morbidity and mortality. disease severity varies from mild to severe and complicated presentations. current mainstays of therapy in severe cdi include: fluid resuscitation, support of organ dysfunction, discontinuation of inciting agents, and antibiotic treatment. | 2016 | 26771898 |
| prophylactic use of gentamicin/flucloxacillin versus cefuroxime in surgery: a meta analysis of clinical studies. | to conduct meta-analyses of all available studies comparing efficacies of prophylactic cefuroxime and prophylactic gentamicin/flucloxacillin (gen/flu) in preventing post-operative wound infections and their association with risks of clostridium difficile infections and post-operative renal impairment. | 2015 | 26770380 |
| advanced chronic kidney disease: a strong risk factor for clostridium difficile infection. | it has been suggested that chronic kidney disease (ckd) is a risk factor for clostridium difficile infection (cdi) and is associated with increased mortality among patients infected with c. difficile. however, recent studies of the clinical impact of ckd on cdi in asians are still insufficient. we sought to determine the relationship between ckd and cdi in a korean population. | 2016 | 26767866 |
| quality outcomes in the surgical intensive care unit after electronic health record implementation. | the electronic health record (ehr) is increasingly viewed as a means to provide more coordinated, patient-centered care. few studies consider the impact of ehrs on quality of care in the intensive care unit (icu) setting. | 2015 | 26767058 |
| shaping public health initiatives in kidney diseases: the peer kidney care initiative. | while broad-based societal efforts to improve public health have targeted disorders such as cardiovascular disease and cancer for several decades, efforts devoted to kidney disease have developed only more recently. the peer kidney care initiative, a novel effort designed to address knowledge gaps in the care of patients with kidney disease, examines key disease processes, the roles of geography and seasonality on outcomes, and longitudinal trends in outcomes over time. | 2016 | 26765683 |
| non-toxigenic clostridium difficile to prevent recurrent c. difficile infection. | | 2016 | 26763618 |
| clostridium perfringens type a netf and nete positive and clostridium difficile co-infection in two adult dogs. | the aim of this study was to report two cases of clostridium perfringens type a and clostridium difficile co-infection in adult dogs. both animals were positive for a/b toxin. toxigenic c. difficile and c. perfringens type a positive for nete and netf-encoding genes were isolated. this report reinforces the necessity of studying a possible synergism of c. difficile and c. perfringens in enteric disorders. | 2016 | 26762654 |
| potential of lactoferrin to prevent antibiotic-induced clostridium difficile infection. | clostridium difficile infection (cdi) is a global healthcare problem. recent evidence suggests that the availability of iron may be important for c. difficile growth. this study evaluated the comparative effects of iron-depleted (1% fe(3+) saturated) bovine apo-lactoferrin (apo-blf) and iron-saturated (85% fe(3+) saturated) bovine holo-lactoferrin (holo-blf) in a human in vitro gut model that simulates cdi. | 2016 | 26759363 |
| frozen vs fresh fecal microbiota transplantation and clinical resolution of diarrhea in patients with recurrent clostridium difficile infection: a randomized clinical trial. | clostridium difficile infection (cdi) is a major burden in health care and community settings. cdi recurrence is of particular concern because of limited treatment options and associated clinical and infection control issues. fecal microbiota transplantation (fmt) is a promising, but not readily available, intervention. | 2016 | 26757463 |
| expanded evidence for frozen fecal microbiota transplantation for clostridium difficile infection: a fresh take. | | 2016 | 26757461 |
| probiotics for the prevention of antibiotic-associated diarrhea in children. | this article provides recommendations, developed by the working group (wg) on probiotics of the european society for pediatric gastroenterology, hepatology, and nutrition, for the use of probiotics for the prevention of antibiotic-associated diarrhea (aad) in children based on a systematic review of previously completed systematic reviews and of randomized controlled trials published subsequently to these reviews. the use of probiotics for the treatment of aad is not covered. the recommendations ... | 2016 | 26756877 |
| oral and parenteral versus parenteral antibiotic prophylaxis in elective laparoscopic colorectal surgery (jmto prev 07-01): a phase 3, multicenter, open-label, randomized trial. | to confirm the efficacy of oral and parenteral antibiotic prophylaxis (abx) in the elective laparoscopic colorectal surgery. | 2016 | 26756752 |
| analysis of tcdb proteins within the hypervirulent clade 2 reveals an impact of rhoa glucosylation on clostridium difficile proinflammatory activities. | clostridium difficile strains within the hypervirulent clade 2 are responsible for nosocomial outbreaks worldwide. the increased pathogenic potential of these strains has been attributed to several factors but is still poorly understood. during a c. difficile outbreak, a strain from this clade was found to induce a variant cytopathic effect (cpe), different from the canonical arborizing cpe. this strain (nap1v) belongs to the nap1 genotype but to a ribotype different from the epidemic nap1/rt027 ... | 2016 | 26755157 |
| first recurrence of clostridium difficile infection: clinical relevance, risk factors, and prognosis. | therapy for recurrent clostridium difficile-associated diarrhea (cdad) is challenging. we evaluated the frequency, associated risk factors, and prognosis of first cdad recurrences. prospective cohort study of all consecutive cases of primary cdad diagnosed in a university hospital from january 2006 to june 2013. recurrent infection was defined as reappearance of symptoms within 8 weeks of the primary diagnosis, provided that cdad symptoms had previously resolved and a new toxin test was positive ... | 2016 | 26753991 |
| antimicrobial stewardship in a long-term acute care hospital using offsite electronic medical record audit. | objective to offer antimicrobial stewardship to a long-term acute care hospital using telemedicine. methods we conducted an uninterrupted time-series analysis to measure the impact of antimicrobial stewardship on hospital-acquired clostridium difficile infection (cdi) rates and antimicrobial use. simple linear regression was used to analyze changes in antimicrobial use; poisson regression was used to estimate the incidence rate ratio in cdi rates. the preimplementation period was april 1, 2010-m ... | 2016 | 26752662 |
| discontinuation of systematic surveillance and contact precautions for vancomycin-resistant enterococcus (vre) and its impact on the incidence of vre faecium bacteremia in patients with hematologic malignancies. | objective to study the effect of discontinuation of systematic surveillance for vancomycin-resistant enterococcus (vre) and contact isolation of colonized patients on the incidence of vre bacteremia setting a hematology-oncology unit with high prevalence of vre colonization characterized by predominantly sporadic molecular epidemiology participants inpatients with hematologic malignancies and recipients of hematopoietic stem cell transplantation methods the incidence of vre bacteremia was measur ... | 2016 | 26750087 |
| fidaxomicin: a novel agent for the treatment of clostridium difficile infection. | due to the limitations of existing treatment options for clostridium difficile infection (cdi), new therapies are needed. | 2017 | 26744587 |
| severe refractory clostridium difficile infection with good response to fecal microbiota transplantation: a case report. | a 49-year-old woman diagnosed with pseudomembranous enterocolitis was transferred to our hospital for medical treatment. she responded poorly to treatment with vancomycin hydrochloride and metronidazole, so she underwent fecal microbiota transplantation. treatment effects were observed the next day, and the diarrhea disappeared within 3 days. colonoscopy 4 days later revealed the resolution of pseudomembranes, and no recurrences were reported within the first year after discharge. | 2017 | 26743554 |
| clostridium difficile associated reactive arthritis: case report and literature review. | extra-gastro-intestinal tract manifestations associated with clostridium difficile infection (cdi), including reactive arthritis (rea), are uncommon. | 2016 | 26743187 |
| the first two clostridium difficile ribotype 027/st1 isolates identified in beijing, china-an emerging problem or a neglected threat? | clostridium difficile hyper-virulent ribotype 027 strain has become a significant concern globally, but has rarely been reported in asian countries including china. recently, a retrospective single-center study in beijing, china, detected two ribotype 027 c. difficile isolates from two patients coming for outpatient visits in 2012 and 2013. we performed a systematic investigation of the two isolates (and patients). both c. difficile isolates had the typical pcr ribotype 027 profile; were positiv ... | 2016 | 26740150 |
| the use of an iv to po clinical intervention form to improve antibiotic administration in a community based hospital. | antimicrobials are among the most commonly prescribed medications in acute care settings, with 50% of antimicrobial use deemed inappropriate. antimicrobial stewardship programs (asp) aim to optimize antibiotic use in order to improve patient clinical outcomes while minimizing unwanted effects of therapy including clostridium difficile infection (cdi) and the emergence of resistant organisms. antimicrobial stewardship involves a coordinated set of interventions that ensure patients who require an ... | 2015 | 26734367 |
| mutant generation by allelic exchange and genome resequencing of the biobutanol organism clostridium acetobutylicum atcc 824. | clostridium acetobutylicum represents a paradigm chassis for the industrial production of the biofuel biobutanol and a focus for metabolic engineering. we have previously developed procedures for the creation of in-frame, marker-less deletion mutants in the pathogen clostridium difficile based on the use of pyre and coda genes as counter selection markers. in the current study we sought to test their suitability for use in c. acetobutylicum. | 2016 | 26732067 |
| risk factors for recurrent clostridium difficile infection in allogeneic hematopoietic cell transplant recipients. | clostridium difficile infection (cdi) is one of the leading causes of hospital-acquired infections in recent times. hematopoietic stem cell transplantation (hsct) confers increased risk for cdi because of prolonged hospital stay, immunosuppression, the need to use broad-spectrum antibiotics and a complex interplay of preparative regimen and gvhd-induced gut mucosal damage. our study evaluated risk factors (rf) for recurrent cdi in hsct recipients given the ubiquity of traditional rf for cdi in t ... | 2016 | 26726944 |
| research in review: driving critical care practice change. | during the past year, studies were published that will lead to practice change, address challenges at the bedside, and introduce new care strategies. this article summarizes some of this important work and considers it in the context of previous research and practice. examples of research-based practice changes include the performance and assessment of septic shock resuscitation, and the integration of tourniquets and massive transfusions in civilian trauma. care challenges addressed include eth ... | 2016 | 26724298 |
| functional anatomy of the colonic bioreactor: impact of antibiotics and saccharomyces boulardii on bacterial composition in human fecal cylinders. | sections of fecal cylinders were analyzed using fluorescence in situ hybridization targeting 180 bacterial groups. samples were collected from three groups of women (n=20 each) treated for bacterial vaginosis with ciprofloxacin+metronidazole. group a only received the combined antibiotic regimen, whereas the a/sb group received concomitant saccharomyces boulardii cncm i-745 treatment, and the a_sb group received s. boulardii prophylaxis following the 14-day antibiotic course. the number of stool ... | 2016 | 26723852 |
| identification of oligosaccharides in human milk bound onto the toxin a carbohydrate binding site of clostridium difficile. | the oligosaccharides in human milk constitute a major innate immunological mechanism by which breastfed infants gain protection against infectious diarrhea. clostridium difficile is the most important cause of nosocomial diarrhea, and the c-terminus of toxin a with its carbohydrate binding site, tcda-f2, demonstrates specific abolishment of cytotoxicity and receptor binding activity upon diethylpyrocarbonate modification of the histidine residues in tcda. tcda-f2 was cloned and expressed in e. c ... | 2016 | 26718473 |
| evaluation of xpert c. difficile, bd max cdiff, imdx c. difficile for abbott m2000, and illumigene c. difficile assays for direct detection of toxigenic clostridium difficile in stool specimens. | we evaluated the performance of four commercial nucleic acid amplification tests (naats: xpert c. difficile, bd max cdiff, imdx c. difficile for abbott m2000, and illumigene c. difficile) for direct and rapid detection of clostridium difficile toxin genes. | 2016 | 26709260 |
| clostridium difficile-related hospitalizations in madrid (spain) between 2003 and 2014, a rising trend. | | 2016 | 26709248 |
| [identifying gaps between guidelines and clinical practice in clostridium difficile infection]. | the first aim was to determine whether patients are being treated in accordance with the society for healthcare epidemiology of america and the infectious diseases society of america (idsa/shea) clostridium difficile guidelines and whether adherence impacts patient outcomes. the second aim was to identify specific action items in the guidelines that are not being translated into clinical practice, for their subsequent implementation. | 2016 | 26708998 |
| clostridium difficile-mediated effects on human intestinal epithelia: modelling host-pathogen interactions in a vertical diffusion chamber. | clostridium difficile infection is one of the leading causes of healthcare associated diarrhoea in the developed world. although the contribution of c. difficile toxins to disease pathogenesis is now well understood, many facets of host-pathogen interactions between the human intestinal epithelia and the c. difficile bacterium that may contribute to asymptomatic carriage and/or clinical disease remain less clear. herein, we tested the hypothesis that c. difficile strains mediate intestinal epith ... | 2016 | 26708704 |
| synergistic efficacy of 405 nm light and chlorinated disinfectants for the enhanced decontamination of clostridium difficile spores. | the ability of clostridium difficile to form highly resilient spores which can survive in the environment for prolonged periods causes major contamination problems. antimicrobial 405 nm light is being developed for environmental decontamination within hospitals, however further information relating to its sporicidal efficacy is required. this study aims to establish the efficacy of 405 nm light for inactivation of c. difficile vegetative cells and spores, and to establish whether spore susceptib ... | 2016 | 26708703 |
| sentinel community clostridium difficile infection (cdi) surveillance in scotland, april 2013 to march 2014. | surveillance of clostridium difficile infection (cdi) in scotland does not currently distinguish between cdi cases from hospitals and the community. therefore, the incidence of cdi in the community is unknown, and the burden of disease and the relationship with the hospital/healthcare setting is not well understood. a one-year sentinel community surveillance programme was initiated in collaboration with five scottish health boards in 2013 (representing 36% of all cdi cases reported in scotland). ... | 2016 | 26708405 |
| comparison of a novel chemiluminescent based algorithm to three algorithmic approaches for the laboratory diagnosis of clostridium difficile infection. | rapid commercial assays, including nucleic acid amplification tests and immunoassays for clostridium. difficile toxins, have replaced the use of older assays. they are included in a two-step algorithm diagnosis, including first the detection of the glutamate dehydrogenase (gdh) as a screening method and second the detection of toxins as a confirmatory method. although assays that detect the presence of free toxins in feces are known to lack sensitivity, they are preferable to confirm infection. ... | 2015 | 26705425 |
| the uncertain benefits of combination therapy for clostridium difficile infection. | | 2016 | 26703863 |
| 25-hydroxyvitamin d concentrations and clostridium difficile infection: a meta-analysis. | well-known risk factors for clostridium difficile infection (cdi) are exposure to antibiotics and gastric acid suppressants. recent studies have provided some evidence of an association between hypovitaminosis d and the risk of cdi. therefore, this meta-analysis aimed to pool all the existing evidence to investigate the association between 25-hydroxyvitamin d (25[oh]d) and cdi. | 2015 | 26701764 |
| susceptibility of clostridium difficile to the food preservatives sodium nitrite, sodium nitrate and sodium metabisulphite. | clostridium difficile is an important enteric pathogen of humans and food animals. recently it has been isolated from retail foods with prevalences up to 42%, prompting concern that contaminated foods may be one of the reasons for increased community-acquired c. difficile infection (ca-cdi). a number of studies have examined the prevalence of c. difficile in raw meats and fresh vegetables; however, fewer studies have examined the prevalence of c. difficile in ready-to-eat meat. the aim of this s ... | 2016 | 26700884 |
| spectrum of clostridium difficile infections: particular clinical situations. | incidence, pathogenesis, diagnostic techniques and therapeutic management of cdi have prompted abundant and adequate recent literature. however, report on clinical manifestations of cdi is frequently biased by the type of patients selected, the retrospective nature of many papers, the epidemic or endemic characteristics of the population reported. this article seeks to review some less discussed clinical and epidemiological aspects of cdi trying to include the clinical manifestations of this dis ... | 2016 | 26700883 |
| nonclinical safety assessment of syn-004: an oral β-lactamase for the protection of the gut microbiome from disruption by biliary-excreted, intravenously administered antibiotics. | syn-004 is a first in class, recombinant β-lactamase that degrades β-lactam antibiotics and has been formulated to be administered orally to patients receiving intravenous β-lactam antibiotics including cephalosporins. syn-004 is intended to degrade unmetabolized antibiotics excreted into the intestines and thus has the potential to protect the gut microbiome from disruption by these antibiotics. protection of the gut microbiome is expected to protect against opportunistic enteric infections suc ... | 2016 | 26700136 |
| comparison of multilocus sequence typing and the xpert c. difficile/epi assay for identification of clostridium difficile 027/nap1/bi. | clostridium difficile 027/nap1/bi is the most common c. difficile strain in the united states. the xpert c. difficile/epi assay allows rapid, presumptive identification of c. difficile nap1. we compared xpert c. difficile/epi to multilocus sequence typing for identification of c. difficile nap1 and found "very good" agreement at 97.9% (κ = 0.86; 95% confidence interval, 0.80 to 0.91). | 2016 | 26699700 |
| clinical features and characteristics of clostridium difficile pcr-ribotype 176 infection: results from a 1-year university hospital internal ward study. | clostridium difficile infection (cdi) is a major cause of antibiotic-associated diarrhoea. given an increasing cdi incidence and global spread of epidemic ribotypes, a 1-year study was performed to analyse the molecular characteristics of c. difficile isolates and associated clinical outcomes from patients diagnosed with cdi in the internal medicine department at university hospital motol, prague from february 2013 to february 2014. | 2015 | 26698842 |
| molecular characteristics of clostridium difficile strains from patients with a first recurrence more than 8 weeks after the primary infection. | nearly all published studies of recurrent clostridium difficile infections (cdi) report recurrent cdi within 8 weeks after the primary infection. this study explored the molecular characteristics of c. difficile isolates from the first recurrent cdi more than 8 weeks after the primary infection. | 2015 | 26698688 |
| self-administered home series fecal "minitransplants" for recurrent clostridium difficile infection on a rectal remnant. | a fecal microbiota transplant has proved to be an extremely effective method for patients with recurrent infections with clostridium difficile. we present the case of a 65-year-old female patient with multiple clostridium difficile infection (cdi) relapses on the rectal remnant, post-colectomy for a cdi-related toxic megacolon. the patient also evidenced associated symptomatic clostridium difficile vaginal infection. she was successfully treated with serial fecal "minitransplants" (self-administ ... | 2015 | 26697583 |
| clostridium difficile infection in hospitalized cirrhotic patients with hepatic encephalopathy. | patients with liver cirrhosis are at-risk population for clostridium difficile infection (cdi). there is a paucity of data on the incidence of cdi in cirrhotics with hepatic encephalopathy (he). the aim of the study was to evaluate the incidence and risk factors for cdi in cirrhotics hospitalized with he. | 2015 | 26697567 |
| nutritional keys for intestinal barrier modulation. | the intestinal tract represents the largest interface between the external environment and the human body. nutrient uptake mostly happens in the intestinal tract, where the epithelial surface is constantly exposed to dietary antigens. since inflammatory response toward these antigens may be deleterious for the host, a plethora of protective mechanisms take place to avoid or attenuate local damage. for instance, the intestinal barrier is able to elicit a dynamic response that either promotes or i ... | 2015 | 26697008 |
| epidemiology, outcomes, and predictors of mortality in hospitalized adults with clostridium difficile infection. | studies have demonstrated an increasing clostridium difficile infection (cdi) incidence in hospitals and the community, with increasing morbidity and mortality. in this study, we analyzed data from the national hospital discharge survey (nhds) to evaluate cdi epidemiology, outcomes, and predictors of mortality in hospitalized adults. we identified cases of cdi (and associated comorbid conditions) from nhds data from 2005 through 2009 using icd-9 codes. weighted univariate and multivariate analys ... | 2016 | 26694494 |
| reducing overutilization of testing for clostridium difficile infection in a pediatric hospital system: a quality improvement initiative. | study objectives included addressing overuse of clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing. | 2016 | 26692547 |
| the effect of lactobacillus plantarum 299v on the incidence of clostridium difficile infection in high risk patients treated with antibiotics. | lactobacillus plantarum 299v (lp299v) has been used in order to reduce gastrointestinal symptoms during antibiotic exposure. however, it remains controversial whether or not probiotics are effective in the prevention of clostridium difficile infections (cdi) among patients receiving antibiotics. the aim of this study was to analyze the cdi among patients receiving antibiotics and hospitalized in the period before and after starting routine use of lp299v as a prevention of this infection. | 2015 | 26690209 |
| clostridium difficile infection in pediatric inflammatory bowel disease. | children with inflammatory bowel disease (ibd) are disproportionately susceptible to clostridium difficile infection (cdi) and the incidence is increasing. there has also been growing recognition of asymptomatic c. difficile colonization in pediatric ibd, which can sometimes be very difficult to distinguish from symptomatic c. difficile-associated disease in this population. in this study, we discuss the current knowledge of c. difficile infection in children with ibd, reviewing epidemiology, ri ... | 2016 | 26689599 |
| immunogenicity and protective efficacy of clostridium difficile spore proteins. | clostridium difficile is a spore-forming, anaerobic, gram-positive organism that is the leading cause of antibiotic-associated infectious diarrhea, commonly known as c. difficile infection (cdi). c. difficile spores play an important role in the pathogenesis of cdi. spore proteins, especially those that are surface-bound may play an essential role in the germination, colonization and persistence of c. difficile in the human gut. in our current study, we report the identification of two surface-b ... | 2016 | 26688279 |
| clostridium difficile: the more we learn, the less we know. | | 2016 | 26687712 |
| contamination of australian newborn calf carcasses at slaughter with clostridium difficile. | in north america and europe, reports of a genetic overlap between toxigenic strains of clostridium difficile isolated from humans, livestock and retail meat suggest that food-borne transmission may be occurring. we investigated the prevalence, concentration and genetic diversity of c. difficile on the carcasses (n = 300) and in the faeces (n = 30) of neonatal veal calves at three abattoirs in australia in 2013. selective culture (both direct and enrichment) was performed, and all isolates were c ... | 2016 | 26686811 |
| clostridium difficile infections in veterans health administration long-term care facilities. | a nationwide initiative was implemented in february 2014 to decrease clostridium difficile infections (cdi) in veterans affairs (va) long-term care facilities. we report a baseline of national cdi data collected during the 2 years before the initiative. | 2016 | 26686361 |
| impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital. | the role of contaminated environments in the spread of hospital-associated infections has been well documented. this study reports the impact of a pulsed xenon ultraviolet no-touch disinfection system on infection rates in a community care facility. | 2016 | 26684369 |
| postdischarge decontamination of mrsa, vre, and clostridium difficile isolation rooms using 2 commercially available automated ultraviolet-c-emitting devices. | two ultraviolet-c (uvc)-emitting devices were evaluated for effectiveness in reducing methicillin-resistant staphylococcus aureus (mrsa), vancomycin-resistant enterococci (vre), and clostridium difficile (cd). | 2016 | 26684367 |
| crystal structure of the ctp1l endolysin reveals how its activity is regulated by a secondary translation product. | bacteriophages produce endolysins, which lyse the bacterial host cell to release newly produced virions. the timing of lysis is regulated and is thought to involve the activation of a molecular switch. we present a crystal structure of the activated endolysin ctp1l that targets clostridium tyrobutyricum, consisting of a complex between the full-length protein and an n-terminally truncated c-terminal cell wall binding domain (cbd). the truncated cbd is produced through an internal translation sta ... | 2016 | 26683375 |
| genome-based infection tracking reveals dynamics of clostridium difficile transmission and disease recurrence. | accurate tracking of clostridium difficile transmission within healthcare settings is key to its containment but is hindered by the lack of discriminatory power of standard genotyping methods. we describe a whole-genome phylogenetic-based method to track the transmission of individual clones in infected hospital patients from the epidemic c. difficile 027/st1 lineage, and to distinguish between the 2 causes of recurrent disease, relapse (same strain), or reinfection (different strain). | 2016 | 26683317 |
| editorial commentary: whole-genome sequencing of clostridium difficile: exquisitely sensitive but not yet optimally applied. | | 2016 | 26683316 |
| the sos response master regulator lexa is associated with sporulation, motility and biofilm formation in clostridium difficile. | the lexa regulated sos network is a bacterial response to dna damage of metabolic or environmental origin. in clostridium difficile, a nosocomial pathogen causing a range of intestinal diseases, the in-silico deduced lexa network included the core sos genes involved in the dna repair and genes involved in various other biological functions that vary among different ribotypes. here we describe the construction and characterization of a lexa clostron mutant in c. difficile r20291 strain. the mutat ... | 2015 | 26682547 |
| two patients with fulminant clostridium difficile enteritis who had not undergone total colectomy: a case series and review of the literature. | introduction. clostridium difficile is the most common cause of healthcare associated infectious diarrhea, and its most common clinical manifestation is pseudomembranous colitis. small bowel enteritis is reported infrequently in the literature and typically occurs only in patients who have undergone ileal pouch anastomosis due to inflammatory bowel disease or total abdominal colectomy for other reasons. presentation of cases. we report here two cases in which patients developed small bowel c. di ... | 2015 | 26682082 |
| time-resolved amino acid uptake of clostridium difficile 630δerm and concomitant fermentation product and toxin formation. | clostridium difficile is one of the major nosocomial threats causing severe gastrointestinal infections. compared to the well documented clinical symptoms, little is known about the processes in the bacterial cell like the regulation and activity of metabolic pathways. in this study, we present time-resolved and global data of extracellular substrates and products. in a second part, we focus on the correlation of fermentation products and substrate uptake with toxin production. | 2015 | 26680234 |
| a novel, sporicidal formulation of ethanol for glove decontamination to prevent clostridium difficile hand contamination during glove removal. | decontamination of gloves before removal could reduce the risk for contamination of hands of personnel caring for patients with clostridium difficile infection. we demonstrated that a novel sporicidal formulation of ethanol rapidly reduced c. difficile spores on gloved hands without adverse odor, respiratory irritation, or staining of clothing. | 2016 | 26679745 |
| clostridium difficile infection incidence: impact of audit and feedback programme to improve room cleaning. | audit and feedback programmes (afps) using fluorescent marking lead to improvements in room cleaning but have not been linked to reduced clostridium difficile infection (cdi) incidence. | 2016 | 26679727 |
| persistence of clostridium difficile rt 237 infection in a western australian piggery. | clostridium difficile is commonly associated with healthcare-related infections in humans, and is an emerging pathogen in food animal species. there is potential for transmission of c. difficile from animals or animal products to humans. this study aimed to determine if c. difficile rt 237 had persisted in a western australian piggery or if there had been a temporal change in c. difficile diversity. c. difficile carriage in litters with and without diarrhea was investigated, as was the acquisiti ... | 2016 | 26679487 |