| biomedical applications of nisin. | nisin is a bacteriocin produced by a group of gram-positive bacteria that belongs to lactococcus and streptococcus species. nisin is classified as a type a (i) lantibiotic that is synthesized from mrna and the translated peptide contains several unusual amino acids due to post-translational modifications. over the past few decades, nisin has been used widely as a food biopreservative. since then, many natural and genetically modified variants of nisin have been identified and studied for their u ... | 2016 | 26678028 |
| impact of variations in test method parameters on in vitro activity of surotomycin against clostridium difficile and surotomycin quality control limits for broth microdilution and agar dilution susceptibility testing. | test parameter variations were evaluated for their effects on surotomycin mics. calcium concentration was the only variable that influenced mics; therefore, 50 μg/ml (standard for lipopeptide testing) is recommended. quality control ranges for clostridium difficile (0.12 to 1 μg/ml) and eggerthella lenta (broth, 1 to 4 μg/ml; agar, 1 to 8 μg/ml) were approved by the clinical and laboratory standards institute based on these data. | 2016 | 26677246 |
| clostridium difficile ribotypes in humans and animals in brazil. | clostridium difficile is an emerging enteropathogen responsible for pseudomembranous colitis in humans and diarrhoea in several domestic and wild animal species. despite its known importance, there are few studies about c. difficile polymerase chain reaction (pcr) ribotypes in brazil and the actual knowledge is restricted to studies on human isolates. the aim of the study was therefore to compare c. difficile ribotypes isolated from humans and animals in brazil. seventy-six c. difficile strains ... | 2015 | 26676318 |
| optimal screening and donor management in a public stool bank. | fecal microbiota transplantation is an effective treatment for recurrent clostridium difficile infection and is being investigated as a treatment for other microbiota-associated diseases. to facilitate these activities, an international public stool bank has been created, which screens donors and processes stools in a standardized manner. the goal of this research is to use mathematical modeling and analysis to optimize screening and donor management at the stool bank. | 2015 | 26675010 |
| the susceptibility of celiac disease intestinal microbiota to clostridium difficile infection. | | 2015 | 26673511 |
| discovery and development of surotomycin for the treatment of clostridium difficile. | the primary challenge for treating clostridium difficile infections (cdi) is maintenance of clinical response after the end of treatment (sustained clinical response). disease recurrence following a positive clinical response occurs in approximately 6-25 % of patients after the first episode and in up to 65 % for subsequent recurrences. surotomycin, a novel cyclic lipopeptide antibiotic with a core derived by streptomyces roseosporus fermentation, disrupts c. difficile cellular membrane activity ... | 2016 | 26670919 |
| clostridium difficile infection in chilean patients submitted to hematopoietic stem cell transplantation. | patients submitted to hematopoietic stem cell transplantation have an increased risk of clostridium difficile infection and multiple risk factors have been identified. published reports have indicated an incidence from 9% to 30% of transplant patients however to date there is no information about infection in these patients in chile. | 2017 | 26670401 |
| clostridium difficile infection is a frequent but well-controlled event after hematopoietic cell transplantation. | | 2017 | 26670398 |
| reexamining the germination phenotypes of several clostridium difficile strains suggests another role for the cspc germinant receptor. | clostridium difficile spore germination is essential for colonization and disease. the signals that initiate c. difficile spore germination are a combination of taurocholic acid (a bile acid) and glycine. interestingly, the chenodeoxycholic acid class (cdca) bile acids competitively inhibit taurocholic acid-mediated germination, suggesting that compounds that inhibit spore germination could be developed into drugs that prophylactically prevent c. difficile infection or reduce recurring disease. ... | 2015 | 26668265 |
| diagnostic yield of routine enteropathogenic stool tests in pediatric ulcerative colitis. | it can be important to exclude infectious etiologies prior to adjusting immunosuppressive therapy in patients with ulcerative colitis (uc) exacerbation. we sought to determine the diagnostic yield of routine infectious stool studies in pediatric uc patients. | 2015 | 26663793 |
| systematic review with meta-analysis: long-term outcomes of faecal microbiota transplantation for clostridium difficile infection. | clostridium difficile infection is a major cause of nosocomial diarrhoea. | 2016 | 26662643 |
| peri-transplant clostridium difficile infections in patients undergoing allogeneic hematopoietic progenitor cell transplant. | clostridium difficile infections (cdi) remain the leading cause of infectious diarrhea among hospitalized patients in this country. patients with hematologic malignancies, especially those who undergo hematopoietic progenitor cell transplants are particularly at risk for developing cdi. one hundred and forty seven consecutive allogeneic hematopoietic progenitor cell transplants were analyzed for peri-transplant clostridium difficile infections (pt-cdi). sixteen patients (11%) developed pt-cdi (m ... | 2016 | 26661725 |
| persistence of clostridium difficile in wastewater treatment-derived biosolids during land application or windrow composting. | to determine the persistence of clostridium difficile spores in biosolids during composting or when amended into soil and held under natural environmental climatic conditions. | 2016 | 26661445 |
| the impact of the introduction of fidaxomicin on the management of clostridium difficile infection in seven nhs secondary care hospitals in england: a series of local service evaluations. | clostridium difficile infection (cdi) is associated with high mortality. reducing incidence is a priority for patients, clinicians, the national health service (nhs) and public health england alike. in june 2012, fidaxomicin (fdx) was launched for the treatment of adults with cdi. the objective of this evaluation was to collect robust real-world data to understand the effectiveness of fdx in routine practice. in seven hospitals introducing fdx between july 2012 and july 2013, data were collected ... | 2016 | 26661400 |
| effect of an antimicrobial stewardship bundle for patients with clostridium difficile infection. | the study objective was to determine whether there was an improvement in compliance with recommended clostridium difficile infection (cdi) treatment after introduction of an institutional cdi bundle with daily antimicrobial stewardship assessment. | 2016 | 26661392 |
| ultrasensitive detection and quantification of toxins for optimized diagnosis of clostridium difficile infection. | recently developed ultrasensitive and quantitative methods for detection of clostridium difficile toxins provide new tools for diagnosis and, potentially, for management of c. difficile infection (cdi). compared to methods that detect toxigenic organism, ultrasensitive toxin detection may allow diagnosis of cdi with increased clinical specificity, without sacrificing clinical sensitivity; measurement of toxin levels may also provide information relevant to disease prognosis. this minireview prov ... | 2016 | 26659205 |
| the role of glutamate dehydrogenase (gdh) testing assay in the diagnosis of clostridium difficile infections: a high sensitive screening test and an essential step in the proposed laboratory diagnosis workflow for developing countries like china. | the incidence and severity of clostridium difficile infection (cdi) in north america and europe has increased significantly since the 2000s. however, cdi is not widely recognized in china and other developing countries due to limited laboratory diagnostic capacity and low awareness. most published studies on laboratory workflows for cdi diagnosis are from developed countries, and thus may not be suitable for most developing countries. therefore, an alternative strategy for developing countries i ... | 2015 | 26659011 |
| probiotics in digestive diseases: focus on lactobacillus gg. | probiotics are becoming increasingly important in basic and clinical research, but they are also a subject of considerable economic interest due to their expanding popularity. they are live micro-organisms which, when administered in adequate amounts, confer a health benefit to the host. from this very well-known definition, it is clear that, unlike drugs, probiotics might be useful in healthy subjects to reduce the risk of developing certain diseases or to optimise some physiological functions. ... | 2015 | 26657927 |
| proton pump inhibitors affect the gut microbiome. | proton pump inhibitors (ppis) are among the top 10 most widely used drugs in the world. ppi use has been associated with an increased risk of enteric infections, most notably clostridium difficile. the gut microbiome plays an important role in enteric infections, by resisting or promoting colonisation by pathogens. in this study, we investigated the influence of ppi use on the gut microbiome. | 2016 | 26657899 |
| subinhibitory concentrations of metronidazole increase biofilm formation in clostridium difficile strains. | resistance mechanism to metronidazole is still poorly understood, even if the number of reports on clostridium difficile strains with reduced susceptibility to this antibiotic is increasing. in this study, we investigated the ability of the c. difficile strains 7032994, 7032985 and 7032989, showing different susceptibility profiles to metronidazole but all belonging to the pcr ribotype 010, to form biofilm in vitro in presence and absence of subinhibitory concentrations of metronidazole. the qua ... | 2016 | 26656887 |
| clostridium difficile-diagnostic and clinical challenges. | | 2016 | 26656133 |
| the insect peptide copa3 increases colonic epithelial cell proliferation and mucosal barrier function to prevent inflammatory responses in the gut. | the epithelial cells of the gut form a physical barrier against the luminal contents. the collapse of this barrier causes inflammation, and its therapeutic restoration can protect the gut against inflammation. egf enhances mucosal barrier function and increases colonocyte proliferation, thereby ameliorating inflammatory responses in the gut. based on our previous finding that the insect peptide copa3 promotes neuronal growth, we herein tested whether copa3 could increase the cell proliferation o ... | 2016 | 26655716 |
| prevention of infections in nursing homes: antibiotic prophylaxis versus infection control and antimicrobial stewardship measures. | because of the lack of structural and human resources for implementing more effective and safe preventive procedures, antimicrobial prophylaxis is often used to prevent infections in nursing homes. however, if data on the efficacy of antibiotic prophylaxis in nursing homes are null, there is a plenty of evidence that the inappropriate use of antimicrobials in this setting is associated with a high rate of colonization and infection with multi-drug-resistant organisms (mdros), and of clostridium ... | 2016 | 26655286 |
| an intervention to reduce health care personnel hand contamination during care of patients with clostridium difficile infection. | in a quasi-experimental study, an educational intervention to improve the technique for personal protective equipment (ppe) removal in conjunction with disinfection of gloves before removal of ppe reduced acquisition of clostridium difficile spores on the hands of health care personnel caring for patients with c difficile infection. | 2015 | 26654239 |
| hydrogen peroxide vapor room disinfection and hand hygiene improvements reduce clostridium difficile infection, methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococci, and extended-spectrum β-lactamase. | we report a statistically significant reduction in clostridium difficile infection (from 1.38 to 0.90 cases per 1,000 patient days), vancomycin-resistant enterococci (from 0.21 to 0.01 cases per 1,000 patient days), and extended-spectrum β-lactamase-producing gram-negative bacteria (from 0.16 to 0.01 cases per 1,000 patient days) associated with the introduction of hydrogen peroxide vapor for terminal decontamination of patient rooms and improvements in hand hygiene compliance. | 2015 | 26654237 |
| association of clostridium difficile infection in hospital mortality: a systematic review and meta-analysis. | the purpose of this study was to evaluate whether clostridium difficile infection (cdi) contributed to hospital mortality and whether the correlation between intensive care units (icus) and surgical wards in hospital cdi risk still remain controversial. | 2015 | 26654234 |
| colectomy in pediatric ulcerative colitis: a single center experience of indications, outcomes, and complications. | there is a paucity of data on outcomes and complications of colectomy for pediatric ulcerative colitis (uc). this study reports the experience of a regional center for 18years. | 2016 | 26653944 |
| clostridium difficile infection in texas hospitals, 2007-2011. | | 2016 | 26651237 |
| clostridium difficile infection: a rarity in patients receiving chronic antibiotic treatment for crohn's disease. | prolonged antibiotic use is limited by several adverse effects, one of which is clostridium difficile infection (cdi). the aim of this study was to determine the incidence of cdi in patients receiving chronic antibiotic treatment for crohn's disease (cd). | 2016 | 26650148 |
| clinical significance of clostridium difficile in children less than 2 years old: a case-control study. | the significance of clostridium difficile (cd) in the stools of children 2 years old or younger remains unclear. the aim of this study was to investigate risk factors and clinical evolution of diarrheic children ≤2 years old with or without cd in their stools. | 2016 | 26650114 |
| clostridium difficile infections among adults and children in mwanza/tanzania: is it an underappreciated pathogen among immunocompromised patients in sub-saharan africa? | little is known regarding the epidemiology clostridium difficile in developing countries. fresh stool samples from patients with diarrhoea were cultured anaerobically. c. difficile was detected in nine (6.4%) of 141 (95% confidence interval 4.2-13.1), of which seven (77.8%) were from children. hiv infection, prolonged hospitalization and antibiotic use were independent factors associated with the occurrence of c. difficile in the gastrointestinal tract. two of the toxigenic isolates were typed a ... | 2015 | 26649183 |
| novel approaches to treating clostridium difficile-associated colitis. | clostridium difficile is being recognized as a growing threat to many health-care systems. epidemiology data shows that infection rates are soaring and the disease burden is increasing. despite the efficacy of standard treatments, it is becoming evident that novel therapeutics will be required to tackle this disease. these new treatments aim to enhance the intestinal microbial barrier, activate the immune system and neutralize the toxins that mediate this disease. many of these therapies are sti ... | 2016 | 26643655 |
| bacteriophage combinations significantly reduce clostridium difficile growth in vitro and proliferation in vivo. | the microbiome dysbiosis caused by antibiotic treatment has been associated with both susceptibility to and relapse of clostridium difficile infection (cdi). bacteriophage (phage) therapy offers target specificity and dose amplification in situ, but few studies have focused on its use in cdi treatment. this mainly reflects the lack of strictly virulent phages that target this pathogen. while it is widely accepted that temperate phages are unsuitable for therapeutic purposes due to their transduc ... | 2016 | 26643348 |
| antimicrobial therapy of acute diarrhoea: a clinical review. | diarrhoea is one of the most commonly occurring diseases. this article presents a review of the current state of the treatment of acute infectious diarrhoea, as well as of the most important pathogens. the general principles of the therapy of diarrhoea are exemplified, followed by a description of the targeted antimicrobial therapy of the most important bacterial gastrointestinal infections, including salmonellosis, shigellosis and campylobacter infections, as well as infections with pathogenic ... | 2016 | 26641310 |
| [microbiological diagnosis of clostridium difficile infection]. | the clinical microbiology laboratory plays an essential role in the management of clostri- dium difficile infections, showing an increase in frequency and severity. many tests (culture, eia, pcr), detecting bacteria or their antigens, toxin genes or free toxins, allow the microbio- logist to provide the clinician and the infection control specialist with a reliable diagnosis as- sistance, which meet essential criteria for ra- pidity, sensitivity and specificity. this review presents the diagnost ... | 2015 | 26638514 |
| metagenomic approach for identification of the pathogens associated with diarrhea in stool specimens. | the potential to rapidly capture the entire microbial community structure and/or gene content makes metagenomic sequencing an attractive tool for pathogen identification and the detection of resistance/virulence genes in clinical settings. here, we assessed the consistency between pcr from a diagnostic laboratory, quantitative pcr (qpcr) from a research laboratory, 16s rrna gene sequencing, and metagenomic shotgun sequencing (mss) for clostridium difficile identification in diarrhea stool sample ... | 2016 | 26637379 |
| implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis. | asymptomatic bacteriuria in the elderly commonly results in antibiotic administration and, in turn, contributes to antimicrobial resistance, adverse drug events, and increased costs. this is a major problem in the long-term care facility (ltcf) setting, where residents frequently transition to and from the acute-care setting, often transporting drug-resistant organisms across the continuum of care. the goal of this study was to assess the feasibility and efficacy of antimicrobial stewardship pro ... | 2015 | 26634119 |
| clostridium difficile carriage in healthy pregnant women in china. | infection with clostridium difficile has been shown to have particularly poor outcomes for pregnant women, including an increased risk of death. the purpose of this study was to investigate the prevalence, genotypic distribution, and characterization of c. difficile strains isolated from pregnant women without diarrhea in china. as part of this study, 3.7% (37 out of 1009) of samples acquired from pregnant females tested positive for c. difficile. of these positive samples, 27.0% (10) were toxig ... | 2016 | 26633756 |
| the role of rho gtpases in toxicity of clostridium difficile toxins. | clostridium difficile (c. difficile) is the main cause of antibiotic-associated diarrhea prevailing in hospital settings. in the past decade, the morbidity and mortality of c. difficile infection (cdi) has increased significantly due to the emergence of hypervirulent strains. toxin a (tcda) and toxin b (tcdb), the two exotoxins of c. difficile, are the major virulence factors of cdi. the common mode of action of tcda and tcdb is elicited by specific glucosylation of rho-gtpase proteins in the ho ... | 2015 | 26633511 |
| [clostridium difficile associated diarrhea in children]. | clostridium difficile is the most commonly isolated organism in antimicrobial and health care-associated diarrhea and is growing in relevance in community-acquired infections. it is a gram-positive bacillus acquired via the fecal-oral route in the community and in hospital setting. | 2015 | 26633112 |
| [clinic and epidemiologic description of clostridium difficile infection in a pediatric population]. | clostridium difficile (cuj-associated disease (cdad) and the role of the hypervirulent strain nap1 have not been well characterized in pediatrics. | 2015 | 26633108 |
| good's syndrome patients hospitalized for infections: a single-center retrospective study. | good's syndrome (gs) is a rare combination of thymoma and hypogammaglobulinemia, resulting in immunodeficiency. patients with gs are highly susceptible to bacterial infection, particularly encapsulated bacterial infection in upper and lower respiratory tracts. good's syndrome patients with moderate-to- severe infection are often hospitalized. clinical features of gs patients remain to be characterized.patients with the discharge diagnosis of gs and simultaneous infection from peking union medica ... | 2015 | 26632723 |
| [clinical characteristics of metronidazole-induced encephalopathy: a report of two cases and a review of 32 japanese cases in the literature]. | metronidazole is an antibiotic classically used against most anaerobic bacteria and protozoa. because an intravenous form of metronidazole has recently entered the market, the use of this antibiotic is attracting renewed interest in many clinical settings in japan. however, neurotoxicity is a major adverse event: in the central nervous system metronidazole-induced encephalopathy is a rare but serious condition. we performed a literature review of 34 cases including 2 of our cases, 25 from domest ... | 2015 | 26630786 |
| establishing a fecal microbiota transplant service for the treatment of clostridium difficile infection. | recurrent or refractory clostridium difficile infection (cdi) has become an increasing problem in the past decade. fecal microbiota transplant (fmt) is a highly efficacious treatment for recurrent cdi; however, a number of technical, logistical, and regulatory issues have hampered the development of an fmt capability at many hospitals. the development of a frozen stool bank of screened donor stool is an important step in the standardization of the procedure. this gives clinicians rapid access to ... | 2016 | 26628567 |
| problems after restorative proctocolectomy: assessment and therapy. | restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice for patients with ulcerative colitis or familial adenomatous polyposis who require colectomy. although the surgical procedure significantly improves the patients' quality of life, complications are common. mechanical or structural complications related to surgical techniques as well as chronic pouchitis are common after the procedure. | 2016 | 26628102 |
| variation in risk of hospital-onset clostridium difficile infection across β-lactam antibiotics in children with new-onset acute lymphoblastic leukemia. | antibiotic exposure is common among children with leukemia. however, limited data exist regarding the risk of clostridium difficile infection (cdi) across anti-pseudomonal β-lactam antibiotics commonly used for fever and neutropenia. | 2014 | 26625453 |
| follow-up of pseudomembranous colitis in children using colonoscopy: a case report. | pseudomembranous colitis (pmc) occurs mainly in adults and is believed to be caused almost exclusively by toxins produced by clostridium difficile. colonoscopy found that pmc occurs mainly in the colon, sigmoid colon and rectum in up to 80% ~ 100% of cases. colonoscopy is simple and fast. it has the significance of making a definite diagnosis and can be used as the main examination method of diagnosis. reports of children suffering from pmc are rare. herein, we report a case of pmc in a child. t ... | 2015 | 26624602 |
| a review of clostridium difficile infection at the university hospital of the west indies, jamaica. | this study examined the frequency of clostridium difficile infection (cdi) among hospital admission and diarrhoeal stool samples over a six-year period. | 2015 | 26624597 |
| clostridium difficile outbreak caused by nap1/bi/027 strain and non-027 strains in a mexican hospital. | clostridium difficile infections caused by the nap1/b1/027 strain are more severe, difficult to treat, and frequently associated with relapses. | 2016 | 26620948 |
| [recurrent disease due to ribotype 027 clostridium difficile]. | | 2017 | 26620602 |
| mortality benefits of antibiotic computerised decision support system: modifying effects of age. | antibiotic computerised decision support systems (cdsss) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. we conducted a prospective cohort study in a 1500-bed tertiary-care hospital in singapore, to evaluate the effectiveness of the hospital's antibiotic cdss on patients' clinical outcomes, and the modification of these effects by patient factors. to account for clustering, we used multilevel logistic regression models. one-quarter of 1886 eli ... | 2015 | 26617195 |
| incidence of clostridium difficile infection in patients receiving high-risk antibiotics with or without a proton pump inhibitor. | considering the incidence and severity of clostridium difficile infection (cdi), risk reduction strategies are crucial. prior studies suggest that proton pump inhibitor (ppi) use can increase the risk of cdi over antibiotics alone; however, data and guidelines have been conflicting. | 2016 | 26616410 |
| the or environment--hand hygiene, cleaning, and clostridium difficile. | | 2015 | 26616318 |
| fecal transplantation successfully treats recurrent d-lactic acidosis in a child with short bowel syndrome. | d-lactic acidosis can occur in patients with short bowel syndrome (sbs) when excessive malabsorbed carbohydrate (cho) enters the colon and is metabolized by colonic bacteria to d-lactate. d-lactate can be absorbed systemically, and increased serum levels are associated with central nervous system toxicity manifested by confusion, ataxia, and slurred speech. current therapy, usually directed toward suppressing intestinal bacterial overgrowth and limiting ingested cho, is not always successful. fe ... | 2015 | 26616138 |
| toxicity assessment of clostridium difficile toxins in rodent models and protection of vaccination. | clostridium difficile is the leading cause of hospital-acquired diarrhea, also known as c. difficile associated diarrhea. the two major toxins, toxin a and toxin b are produced by most c. difficile bacteria, but some strains, such as bi/nap1/027 isolates, produce a third toxin called binary toxin. the precise biological role of binary toxin is not clear but it has been shown to be a cytotoxin for vero cells. we evaluated the toxicity of these toxins in mice and hamsters and found that binary tox ... | 2016 | 26614590 |
| the challenge of clostridium difficile infection: overview of clinical manifestations, diagnostic tools and therapeutic options. | the most important infectious cause of antibiotic-associated diarrhoea and colitis is clostridium difficile, which is a gram-positive, anaerobic, spore-forming, toxin-producing bacillus. in this overview we will discuss the diagnostic and therapeutic management of patients presenting with suspected or proven c. difficile infection (cdi). the clinical spectrum varies from asymptomatic c. difficile carriers to fulminant colitis with multi-organ failure. the onset of symptoms is usually within 2 we ... | 2015 | 26612229 |
| use of the cobas 4800 system for the rapid detection of toxigenic clostridium difficile and methicillin-resistant staphylococcus aureus. | the new cobas® cdiff and cobas® mrsa/sa tests were compared with conventional methods for the rapid detection of toxigenic clostridium difficile and methicillin-resistant staphylococcus aureus. the final concordance between cobas cdiff test and gdh/toxin gene screening was 97.62% and between cobas mrsa/sa test and chromogenic culture, 91.30%, respectively. | 2016 | 26611812 |
| the first report of a previously undescribed ebv-negative nk-cell lymphoma of the gi tract presenting as chronic diarrhoea with eosinophilia. | a 74-year-old man presented with a 2-month history of watery diarrhoea. his complete blood count showed lymphopaenia and marked eosinophilia. investigations for common infectious causes including clostridium difficile toxin, stool culture, ova and parasites were negative. endoscopy revealed extensive colitis and a ct of the abdomen identified numerous large abdominal lymph nodes suspicious for lymphoma. multiple tissue samples were obtained; colon, mesenteric lymph node and bone marrow biopsy, a ... | 2015 | 26611482 |
| epidemiology and factors associated with candidaemia following clostridium difficile infection in adults within metropolitan atlanta, 2009-2013. | we assessed prevalence of and risk factors for candidaemia following clostridium difficile infection (cdi) using longitudinal population-based surveillance. of 13 615 adults with cdi, 113 (0·8%) developed candidaemia in the 120 days following cdi. in a matched case-control analysis, severe cdi and cdi treatment with vancomycin + metronidazole were associated with development of candidaemia following cdi. | 2016 | 26608090 |
| in the endemic setting, clostridium difficile ribotype 027 is virulent but not hypervirulent - erratum. | | 2016 | 26607744 |
| amoebiasis masquerading as inflammatory bowel disease. | a 60-year-old japanese man presented with bloody diarrhoea. he stated that he had been diagnosed with ulcerative colitis (uc) 3 years prior, but discontinued follow-up care as treatment was ineffective. one year later, he came to our hospital with anorexia and weight loss. the abdomen was soft and flat without tenderness. laboratory tests were unremarkable; faecal culture and clostridium difficile toxin were negative. findings and biopsy from a subsequent colonoscopy reconfirmed his diagnosis of ... | 2015 | 26607188 |
| analysis of morbidity and mortality outcomes in postoperative clostridium difficile infection in the veterans health administration. | this study analyzes and reports clostridium difficile infection (cdi) rates, risk factors, and associations with postoperative outcomes in the veterans health administration (vha). | 2016 | 26606675 |
| the high stakes of postoperative clostridium difficile infection. | | 2016 | 26606279 |
| economic burden of clostridium difficile in five hospitals of the florence health care system in italy. | despite the awareness about the increasing rates of clostridium difficile infection (cdi) and the economic burden arising from its management (prolonged hospitalization, laboratory tests, visits, surgical treatment, environmental sanitation), few studies are available in italy on the economic costs directly attributable to the cdi. the florence health care system has designed a study with the aim of describing the costs attributable to the cdi and defines the incremental economic burden associat ... | 2015 | 26604846 |
| memory of germinant stimuli in bacterial spores. | bacterial spores, despite being metabolically dormant, possess the remarkable capacity to detect nutrients and other molecules in their environment through a biochemical sensory apparatus that can trigger spore germination, allowing the return to vegetative growth within minutes of exposure of germinants. we demonstrate here that bacterial spores of multiple species retain memory of transient exposures to germinant stimuli that can result in altered responses to subsequent exposure. the magnitud ... | 2015 | 26604257 |
| the aged gut in inflammatory bowel diseases. | senescence is accompanied by various anatomical and functional alterations starting from mastication and deglutition and consequent modifications of nutrition. in addition, the widespread use of proton pump inhibitors and non-steroidal anti-inflammatory drugs in aged subjects weakens the gastric barrier, thus contributing to easier entry of microbes into the gastrointestinal tract. the microbiota of the elderly is less stable than that of younger adults, therefore, gut dysbiosis is more frequent ... | 2015 | 26603728 |
| binding and entry of clostridium difficile toxin b is mediated by multiple domains. | clostridium difficile is responsible for a number of serious gastrointestinal diseases caused primarily by two exotoxins, tcda and tcdb. these toxins enter host cells by binding unique receptors, at least partially via their combined repetitive oligopeptides (crops) domains. our study investigated structural determinants necessary for binding and entry of tcdb. deletion analyses identified tcdb residues 1372-1493 as essential for cytotoxicity in three cell lines. consistent with this observation ... | 2015 | 26602083 |
| investigation of a cluster of clostridium difficile infections in a pediatric oncology setting. | we investigated an increase in clostridium difficile infection (cdi) among pediatric oncology patients. | 2016 | 26601705 |
| cost-effectiveness in clostridium difficile treatment decision-making. | to develop a framework for the clinical and health economic assessment for management of clostridium difficile infection (cdi). | 2015 | 26601096 |
| the effectiveness of lactobacillus beverages in controlling infections among the residents of an aged care facility: a randomized placebo-controlled double-blind trial. | to clarify the usefulness of lactobacillus casei strain shirota (lcs)-fermented milk in the normalization of bowel movements and improvement of infection control for the elderly residents and staff of facilities for the elderly. | 2016 | 26599038 |
| regulation of type iv pili contributes to surface behaviors of historical and epidemic strains of clostridium difficile. | the intestinal pathogen clostridium difficile is an urgent public health threat that causes antibiotic-associated diarrhea and is a leading cause of fatal nosocomial infections in the united states. c. difficile rates of recurrence and mortality have increased in recent years due to the emergence of so-called "hypervirulent" epidemic strains. a great deal of the basic biology of c. difficile has not been characterized. recent findings that flagellar motility, toxin synthesis, and type iv pilus ( ... | 2015 | 26598364 |
| making a case for pediatric antimicrobial stewardship programs. | although antimicrobials are commonly used in children, it is important to remember that they can have a profound impact on this unique patient population. inadvertent consequences of antiinfective use in children include antimicrobial resistance, infection caused by clostridium difficile, increased risk of obesity, and adverse drug events. in addition, compared with adults, children have different dosing requirements, antimicrobial formulation needs, pharmacokinetics, and antimicrobial susceptib ... | 2015 | 26598095 |
| probiotics and fecal microbiota transplant for primary and secondary prevention of clostridium difficile infection. | clostridium difficile infection (cdi) is the most common cause of nosocomial diarrhea and is associated with an increased risk of mortality. the use of probiotics and fecal microbiota transplantation (fmt) has been studied to reduce the incidence and severity of this infection, but variable efficacy and safety data have been reported. probiotics are hypothesized to be effective in the management of cdi through a number of mechanisms that include maintenance of normal gastrointestinal flora, anti ... | 2015 | 26598094 |
| virulence factors of clostridium difficile and their role during infection. | clostridium difficile is the prominent etiological agent of healthcare-associated diarrhea. the disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. the main risk factor for developing an infection after contamination by the resistant spores is the disruption of the gut microbiota, allowing the spores to germinate. the colonization of the gut is likely to be governed by the bacterial resistance to the host response and the bacterial adhesion to the mucosa. to d ... | 2016 | 26596863 |
| effectiveness of probiotic in preventing and treating antibiotic-associated diarrhoea and/or clostridium difficile-associated diarrhoea in patients with spinal cord injury: a protocol of systematic review of randomised controlled trials. | probiotics may prevent antibiotic-associated and clostridium difficile-associated diarrhoea (aad/cdad). many spinal cord injury centre (scic) practitioners consider probiotics generically and may not realise that efficacy can be strain-, dose- and disease-specific. in order to confirm these effects and fully evaluate the extent of probiotic effectiveness in these patients, a systematic review and meta-analysis is indicated. | 2015 | 26596269 |
| routine detection of clostridium difficile in western australia. | despite increasing infection rates, clostridium difficile is not currently routinely tested for in all diarrhoeal faecal specimens in australia. in july 2014, all diarrhoeal specimens submitted to a diagnostic laboratory in western australia were surveyed to determine the true prevalence of c. difficile. in total, 1010 diarrhoeal non-duplicate faecal specimens were received during the month. testing for c. difficile was requested, or the criteria for a c. difficile investigation were met, for 67 ... | 2016 | 26592987 |
| assessment of clostridium difficile burden in patients over time with first episode infection following fidaxomicin or vancomycin. | in patients with first episode clostridium difficile infection treated with vancomycin or fidaxomicin, more patients receiving fidaxomicin achieved at least 2 log10 colony-forming units/g reduction in spores at the follow-up visit (p=.02). similar to published literature, a higher proportion of patients receiving fidaxomicin demonstrated sustained clinical response. | 2016 | 26592763 |
| clarifying the management of clostridium difficile infection. | | 2015 | 26584845 |
| quantitative lipoproteomics in clostridium difficile reveals a role for lipoproteins in sporulation. | bacterial lipoproteins are surface exposed, anchored to the membrane by s-diacylglyceryl modification of the n-terminal cysteine thiol. they play important roles in many essential cellular processes and in bacterial pathogenesis. for example, clostridium difficile is a gram-positive anaerobe that causes severe gastrointestinal disease; however, its lipoproteome remains poorly characterized. here we describe the application of metabolic tagging with alkyne-tagged lipid analogs, in combination wit ... | 2015 | 26584780 |
| [recent antibiotic use in german acute care hospitals - from benchmarking to improved prescribing and quality care]. | in view of increasing rates of bacterial resistance and clostridium difficile infections efforts to enhance appropriate and intelligent antibiotic prescribing have become important. a prerequisite is the availability of reliable antibiotic use data. so far antibiotic consumption data in this country had only a very limited coverage of acute care hospitals. | 2015 | 26583825 |
| concomitant medical conditions and therapies preclude accurate classification of children with severe or severe complicated clostridium difficile infection. | severe and severe complicated clostridium difficile infections (scdi/sccdi) were retrospectively assessed in a pediatric cohort. underlying medical conditions and concomitant medical therapy preclude accurate classification of children with scdi/sccdi, using current cdi severity definitions. revised cdi definitions in children should focus on more objective, age-appropriate, and cdi-specific markers of severity. | 2015 | 26582882 |
| clinical and healthcare burden of multiple recurrences of clostridium difficile infection. | clostridium difficile infection (cdi) is associated with a high risk of recurrence (rcdi). few studies have focused on multiple recurrences. to evaluate the potential of novel treatments targeting recurrence, we assessed the burden and severity of rcdi. | 2016 | 26582748 |
| development and evaluation of double locus sequence typing for molecular epidemiological investigations of clostridium difficile. | despite the development of novel typing methods based on whole genome sequencing, most laboratories still rely on classical molecular methods for outbreak investigation or surveillance. reference methods for clostridium difficile include ribotyping and pulsed-field gel electrophoresis, which are band-comparing methods often difficult to establish and which require reference strain collections. here, we present the double locus sequence typing (dlst) scheme as a tool to analyse c. difficile isola ... | 2016 | 26581425 |
| application of density gradient for the isolation of the fecal microbial stool component and the potential use thereof. | the idea of considering the gut microbiota as a virtual human organ has led to the concept of fecal microbiota transplantation (fmt), which has recently been extremely successful in the treatment of cases of recurrent clostridium difficile infection. administration of safe, viable, and representative fecal microbiota is crucial for fmt. to our knowledge, suitable techniques and systematic conditions for separating the fecal microbiota from stool samples have not been thoroughly investigated. in ... | 2015 | 26581409 |
| clostridium difficile colonization in asymptomatic infants 1 to 12 months old, admitted to a community hospital. | | 2016 | 26581362 |
| asymptomatic clostridium difficile colonization: epidemiology and clinical implications. | the epidemiology of clostridium difficile infection (cdi) has changed over the past decades with the emergence of highly virulent strains. the role of asymptomatic c. difficile colonization as part of the clinical spectrum of cdi is complex because many risk factors are common to both disease and asymptomatic states. in this article, we review the role of asymptomatic c. difficile colonization in the progression to symptomatic cdi, describe the epidemiology of asymptomatic c. difficile colonizat ... | 2015 | 26573915 |
| neutralization of clostridium difficile toxin b mediated by engineered lactobacilli that produce single-domain antibodies. | clostridium difficile is the primary cause of nosocomial antibiotic-associated diarrhea in the western world. the major virulence factors of c. difficile are two exotoxins, toxin a (tcda) and toxin b (tcdb), which cause extensive colonic inflammation and epithelial damage manifested by episodes of diarrhea. in this study, we explored the basis for an oral antitoxin strategy based on engineered lactobacillus strains expressing tcdb-neutralizing antibody fragments in the gastrointestinal tract. va ... | 2015 | 26573738 |
| [diagnostic workup and therapy of infectious diarrhea. current standards]. | infectious diarrhea is very common; its severity ranges from uncomplicated, self-limiting courses to potentially life-threatening disease. a rapid diagnostic workup providing detailed information on the suspected pathogen should be performed only in patients at risk, analyzing one single stool sample for salmonella, shigella, campylobacter, and norovirus. in the presence of risk factors, such as a history of antibiotic exposure within the last 3 months, testing for clostridium difficile should b ... | 2015 | 26573083 |
| the effect of broader, directed antimicrobial prophylaxis including fungal coverage on perioperative infectious complications after radical cystectomy. | radical cystectomy (rc) with urinary diversion has a significant risk of infection. in an effort to decrease the rate of infectious complications, we instituted a broader, culture-based preoperative antimicrobial regimen, including fungal coverage, and studied its effect on infectious complications after rc. | 2016 | 26572724 |
| treatment of clostridium difficile infection in mice with vancomycin alone is as effective as treatment with vancomycin and metronidazole in combination. | clostridium difficile is a major cause of nosocomial infectious diarrhoea. treatment of c. difficile infection (cdi) depends on disease severity. a combination of vancomycin and metronidazole is often recommended in severe cases. the aim of this study was to examine, in a murine model of cdi, if mice treated with a combination of vancomycin and metronidazole had a better clinical outcome than mice treated with vancomycin or metronidazole alone. | 2015 | 26568840 |
| fecal microbiota transplantation: current clinical efficacy and future prospects. | fecal microbiota transplantation (fmt) has gained mainstream attention with its remarkable efficacy in treating recurrent clostridium difficile infection (rcdi) when there are no other effective therapies. methods of selecting donors and routes of administration vary among studies, but there are now randomized controlled trials showing efficacy of fmt in treating rcdi. ongoing trials of fmt for other disease such as inflammatory bowel disease are underway; this therapy should not be used for the ... | 2015 | 26566371 |
| a high rate of alternative diagnoses in patients referred for presumed clostridium difficile infection. | we evaluated a cohort of patients referred to our center for presumed recurrent clostridium difficile infection (cdi) to determine final diagnoses and outcomes. | 2016 | 26565971 |
| novel therapeutic strategies for clostridium difficile infections. | in recent years, clostridium difficile has become the primary cause of antibiotic-associated diarrhea and pseudomembranous colitis, resulting in long and complicated hospital stays that represent a serious burden for patients as well as health care systems. currently, conservative treatment of c. difficile infection (cdi) relies on the antibiotics vancomycin, metronidazole or fidaxomicin, or in case of multiple recurrences, fecal microbiota transplantation (fmt). | 2016 | 26565670 |
| safety and durability of rbx2660 (microbiota suspension) for recurrent clostridium difficile infection: results of the punch cd study. | managing recurrent clostridium difficile infection (cdi) presents a significant challenge for clinicians and patients. fecal microbiota transplantation (fmt) is a highly effective therapy for recurrent cdi, yet availability of a standardized, safe, and effective product has been lacking. our aim in this study was to assess the safety and effectiveness of rbx2660 (microbiota suspension), a commercially prepared fmt drug manufactured using standardized processes and available in a ready-to-use for ... | 2016 | 26565008 |
| inactivation of clostridium difficile in sewage sludge by anaerobic thermophilic digestion. | there has been an increase in community-associated clostridium difficile infections with biosolids derived from wastewater treatment being identified as one potential source. the current study evaluated the efficacy of thermophilic digestion in decreasing levels of c. difficile ribotype 078 associated with sewage sludge. five isolates of c. difficile 078 were introduced (final density of 5 log cfu/g) into digested sludge and subjected to anaerobic digestion at mesophilic (36 or 42 °c) or thermop ... | 2016 | 26564276 |
| correction for zhang et al., toxin-mediated paracellular transport of antitoxin antibodies facilitates protection against clostridium difficile infection. | | 2015 | 26556881 |
| inhibitory effect of epigallocatechin gallate on the virulence of clostridium difficile pcr ribotype 027. | clostridium difficile infection (cdi) is the most prevalent cause of health-care-associated infections. cdi-related health-care costs and deaths are both increasing annually on a global scale. c. difficile have been reported in food products in canada, europe, and the united states; however, the systematic transmission of c. difficile between humans and animals is yet to be understood. because of the limitations of current therapeutic options, there is a need for the development of new patient t ... | 2015 | 26556797 |
| diagnostic testing for clostridium difficile in italian microbiological laboratories. | a laboratory diagnosis survey of clostridium difficile infection (cdi) was performed in italy in 2012-2013. questionnaires from 278 healthcare settings from 15 regions of italy were collected and analysed. eighty seven percent of the laboratories declared to routinely perform cdi diagnosis, 99% of them only after the clinician's request. among the 216 laboratories providing information on the size of the hospitals in which they were located, 65 had more than 500 beds (large hospitals), while 151 ... | 2016 | 26555737 |
| nisin is an effective inhibitor of clostridium difficile vegetative cells and spore germination. | clostridium difficile is the most frequently identified enteric pathogen in patients with nosocomial antibiotic-associated diarrhoea and pseudomembranous colitis. several clinically isolated c. difficile strains are resistant to antibiotics other than metronidazole and vancomycin. recently, bacteriocins of lactic acid bacteria have been proposed as an alternative or complementary treatment. the aim of this study was to investigate the inhibitory effect of nisin, a bacteriocin produced by several ... | 2016 | 26555543 |
| defining appropriate use of proton-pump inhibitors among medical inpatients. | proton-pump inhibitors (ppis) are commonly used among medical inpatients, both for prophylaxis against upper gastrointestinal bleeding (ugib) and continuation of outpatient use. while ppis reduce the risk of ugib, they also appear to increase the risk of hospital-acquired pneumonia (hap) and clostridium difficile infection (cdi). depending upon the underlying risks of these conditions and the changes in those risks with ppis, use of proton-pump inhibitors may lead to a net benefit or net harm am ... | 2016 | 26553337 |