| immune thrombocytopenia caused by fecal microbial transplantation in a patient with severe recurrent clostridium difficile infection. | | 2015 | 26302500 |
| human microbiome: from the bathroom to the bedside. | the human gut contains trillions of bacteria, the major phylae of which include bacteroidetes, firmicutes, actinobacteria and proteobacteria. fecal microbial transplantation (fmt) has been known of for many years but only recently has been subjected to rigorous examination. we review the evidence regarding fmt for recurrent clostridium difficile infection which has resulted in it being an approved treatment. in addition there is some evidence for its use in both irritable bowel syndrome and infl ... | 2015 | 26301122 |
| wses guidelines for management of clostridium difficile infection in surgical patients. | in the last two decades there have been dramatic changes in the epidemiology of clostridium difficile infection (cdi), with increases in incidence and severity of disease in many countries worldwide. the incidence of cdi has also increased in surgical patients. optimization of management of c difficile, has therefore become increasingly urgent. an international multidisciplinary panel of experts prepared evidenced-based world society of emergency surgery (wses) guidelines for management of cdi i ... | 2015 | 26300956 |
| the impact of pcr on clostridium difficile detection and clinical outcomes. | pcr has increasingly replaced toxin a and b enzyme immunoassay (eia) for the testing of clostridium difficile infection (cdi). this study evaluated the clinical outcomes of cdi and disease epidemiology since the introduction of pcr. clinical data and outcomes for patients admitted to a tertiary care centre during 2003 to 2012 were extracted using electronic medical records. outcomes and incidence of disease were compared between types of cdi testing. in total, 15.6% of 108,092 patients admitted ... | 2015 | 26297376 |
| antibiotic-associated diarrhea and the older dental patient: how do dentists respond? | gastrointestinal complications from antibiotic use, including clostridium difficile infection (cdi), can have significant morbidity, especially among older patients. this descriptive study surveyed dentists to find out how they would respond to a patient with signs indicating potential cdi. | 2015 | 26297332 |
| comparison of two types of matrix-assisted laser desorption/ionization time-of-flight mass spectrometer for the identification and typing of clostridium difficile. | microflex lt (bruker daltonics) and vitek ms (biomérieux) are bacterial identification systems that are based on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (maldi-tof ms). for vitek ms, two identification softwares, vitek ms ivd (ivd) and saramis (saramis), are available. microflex lt is equipped with maldi biotyper rtc software (biotyper). although the identification accuracy of each instrument has been compared for various bacteria, no detailed examination has ... | 2015 | 26296999 |
| complete genome sequence of the novel temperate clostridium difficile phage phicdif1296t. | clostridium difficile contains many integrated and extrachromosomal genetic elements. in this study, we determined, annotated, and analyzed the complete genome of the c. difficile bacteriophage phicdif1296t using single-molecule real-time sequencing technology. to our knowledge, this represents the largest genome (131 kb) of a temperate c. difficile phage recognized so far. | 2015 | 26294621 |
| novel method of infection prophylaxis in heart transplantation by retrosternal gentamycin sponge application. | surgical wound infections are more frequent in patients undergoing heart transplantation than in other heart surgery patients. there is a wide spread of sternal wound infection incidence in transplant patients ranging from 4% to 40%. it is first study describing local gentamicin sponge application during heart transplantation procedure. | 2015 | 26293080 |
| accurate detection of binary toxin producer from clostridium difficile by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. | thirsty-six binary toxin producers were detected with 2 genotypes (cdta(+) and cdtb(+)) among 265 clostridium difficile isolates by multiplex pcr. the rate of accurate differentiation between these 2 genotypes was 100% by 6-peak cluster analysis of spectra generated by bruker biotyper matrix-assisted laser desorption ionization/time-of-flight mass spectrometry. | 2015 | 26293008 |
| evaluating epidemiology and improving surveillance of infections associated with health care, united states. | the healthcare-associated infections community interface (haic), launched in 2009, is the newest major activity of the emerging infections program. the haic activity addresses population- and laboratory-based surveillance for clostridium difficile infections, candidemia, and multidrug-resistant gram-negative bacilli. other activities include special projects: the multistate healthcare-associated infections and antimicrobial use prevalence survey and projects that evaluate new approaches for impr ... | 2015 | 26291035 |
| humanized microbiota mice as a model of recurrent clostridium difficile disease. | clostridium difficile disease is the leading antibiotic-associated cause of diarrhea and nosocomial acquired infection in the western world. the per annum burden in the usa alone amounts to 250,000 cases with 14,000 ascribed deaths and medical costs in excess of a billion dollars. novel models for the study of c. difficile infection are therefore pertinent. | 2015 | 26289776 |
| differentiating virulent 027 and non-027 clostridium difficile strains by molecular methods. | hypervirulent clostridium difficile clade has been shown to include several lineages of ribotype 027 and also other ribotypes. we present data on additional non-027 strains, identified as presumptive 027 by two commercial molecular c. difficile assays. | 2015 | 26289601 |
| in the endemic setting, clostridium difficile ribotype 027 is virulent but not hypervirulent. | conflicting reports have been published on the association between clostridium difficile ribotypes and severe disease outcomes in patients with c. difficile infection (cdi); several so-called hypervirulent ribotypes have been described. we performed a multicenter study to assess severe disease presentation and severe outcomes among cdi patients infected with different ribotypes. | 2015 | 26288985 |
| rational therapy of clostridium difficile infections. | clostridium difficile infections (cdi) are increasingly important in patients with antibiotic treatments, ranging from mild, self-limiting to severe, life-threatening disease. currently, diagnostic algorithms and treatment guidelines are being adapted to novel tests and therapeutic options for recurrent cdi. | 2014 | 26288096 |
| gastrointestinal localization of metronidazole by a lactobacilli-inspired tetramic acid motif improves treatment outcomes in the hamster model of clostridium difficile infection. | metronidazole, a mainstay treatment for clostridium difficile infection (cdi), is often ineffective for severe cdi. whilst this is thought to arise from suboptimal levels of metronidazole in the colon due to rapid absorption, empirical validation is lacking. in contrast, reutericyclin, an antibacterial tetramic acid from lactobacillus reuteri, concentrates in the gastrointestinal tract. in this study, we modified metronidazole with reutericyclin's tetramic acid motif to obtain non-absorbed compo ... | 2015 | 26286574 |
| ceftolozane-tazobactam activity against phylogenetically diverse clostridium difficile strains. | ceftolozane-tazobactam (c/t) is approved for the treatment of complicated intra-abdominal and urinary tract infections and has varied activity against anaerobic bacteria. here, we evaluate the activity of c/t against a phylogenetically diverse collection of clostridium difficile isolates and report uniformly high mics (≥256 μg/ml) to c/t. | 2015 | 26282409 |
| ertapenem prophylaxis associated with an increased risk of clostridium difficile infection among surgical patients. | a case-control study was conducted to determine risk factors for hospital-onset clostridium difficile infection among patients admitted to 2 surgical units. ertapenem prophylaxis was significantly associated with c. difficile infection risk (odds ratio, 3.13 [95% ci, 1.13-8.68], p=.028) and may offer an antimicrobial stewardship target among surgical patients. | 2015 | 26278576 |
| risk for clostridium difficile infection after radical cystectomy for bladder cancer: analysis of a contemporary series. | this study seeks to evaluate the incidence and associated risk factors of clostridium difficile infection (cdi) in patients undergoing radical cystectomy (rc) for bladder cancer. | 2015 | 26278363 |
| rapid detection of ermb gene in clostridium difficile by loop-mediated isothermal amplification. | macrolide-lincosamide-streptogramin b resistance in clostridium difficile is mostly due to the ermb resistance determinant. here, we describe a sensitive and rapid molecular method to detect ermb in c. difficile to contribute to the wider epidemiological study. five sets of loop-mediated isothermal amplification (lamp) primers were designed and optimized for rapid detection of ermb. the specificity and sensitivity of the primers for ermb were detected, and the ermb lamp assay was compared to con ... | 2015 | 26272634 |
| pathological and bacteriological characterization of neonatal porcine diarrhoea of uncertain aetiology. | neonatal porcine diarrhoea of uncertain aetiology has been reported from a number of countries. this study investigated 50 diarrhoeic and 19 healthy piglets from 10 affected swedish herds. the piglets were blood-sampled for analysis of serum γ-globulin and necropsied, and the intestines were sampled for histopathology and cultured for escherichia coli, clostridium perfringens and clostridium difficile. escherichia coli isolates (n = 276) were examined by pcr for virulence genes encoding lt, sta, ... | 2015 | 26272503 |
| biochemical and immunological characterization of truncated fragments of the receptor-binding domains of c. difficile toxin a. | clostridium difficile is an emerging pathogen responsible for opportunistic infections in hospitals worldwide and is the main cause of antibiotic-associated pseudo-membranous colitis and diarrhea in humans. clostridial toxins a and b (tcda and tcdb) specifically bind to unknown glycoprotein(s) on the surface of epithelial cells in the host intestine, disrupting the intestinal barrier and ultimately leading to acute inflammation and diarrhea. the c-terminal receptor-binding domain (rbd) of tcda, ... | 2015 | 26271033 |
| faecal microbiota transplant for recurrent clostridium difficile infection using long-term frozen stool is effective: clinical efficacy and bacterial viability data. | faecal microbial transplant (fmt) for recurrent clostridium difficile infection (rcdi) is greatly facilitated by frozen stool banks. however, the effect of frozen storage of stool for greater than 2 months on the viability of stool bacteria is unknown and the efficacy of fmt is not clear. | 2015 | 26264455 |
| variable alterations of the microbiota, without metabolic or immunological change, following faecal microbiota transplantation in patients with chronic pouchitis. | faecal microbiota transplantation (fmt) is effective in the treatment of clostridium difficile infection, where efficacy correlates with changes in microbiota diversity and composition. the effects of fmt on recipient microbiota in inflammatory bowel diseases (ibd) remain unclear. we assessed the effects of fmt on microbiota composition and function, mucosal immune response, and clinical outcome in patients with chronic pouchitis. eight patients with chronic pouchitis (current pdai ≥7) were trea ... | 2015 | 26264409 |
| [fecal microbiota transfer (fmt) in a patient with refractory irritable bowel syndrome]. | irritable bowel syndrome is a disorder of the gastrointestinal tract with unknown etiology. recent clinical data support a link between changes in fecal microbiota with decreased biodiversity and the development of irritable bowel syndrome. whether these changes of the microbiota are caused by the disease or whether they develop during the course of the disease remains unclear. several studies demonstrated that fecal microbiota transfer (fmt) successfully attenuates clostridium difficile infecti ... | 2015 | 26261935 |
| incidence and clinical outcomes of clostridium difficile infection after treatment with tuberculosis medication. | to determine the incidence and clinical characteristics of tuberculosis (tb) medication-associated clostridium difficile infection. | 2016 | 26260753 |
| [ventriculo-gallbladder shunt: an alternative for the treatment of hydrocephalus]. | in the management of hydrocephalus, the ventriculo-gallbladder shunt is justified in situations where the ventriculo-peritoneal shunt is not useful due to peritoneal involvement and/or when the ventriculo-auricular and ventriculo-pleural shunts are contraindicated. | 2016 | 26259740 |
| updates on clostridium difficile infection. | | 2015 | 26259303 |
| cleaning hospital room surfaces to prevent health care-associated infections: a technical brief. | the cleaning of hard surfaces in hospital rooms is critical for reducing health care-associated infections. this review describes the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. key informants were interviewed, and a systematic search for publications since 1990 was done with the use of several bibliographic and gray literature resources. studies examinin ... | 2015 | 26258903 |
| antibiotic profiling of clostridium difficile ribotype 176--a multidrug resistant relative to c. difficile ribotype 027. | antibiotic profiling of twenty czech clostridium difficile pcr-ribotype 176 isolates revealed a high level of resistance to erythromycin, ciprofloxacin and moxifloxacin (n = 20) and to rifampicin (n = 13). accumulation of resistance mechanisms to multiple antibiotics highlight that pcr-ribotype 176 belong to problematic epidemic strains. | 2015 | 26256807 |
| increased risk of functional gastrointestinal sequelae after clostridium difficile infection among active duty united states military personnel (1998-2010). | some acute enteric infections are associated with the development of functional gastrointestinal disorders, most commonly irritable bowel syndrome but also other functional and organic gastrointestinal sequelae. clostridium difficile infection has increased in incidence and severity, however, few studies have evaluated functional disorders after this infection. | 2015 | 26255560 |
| hospital cost of clostridium difficile infection including the contribution of recurrences in french acute-care hospitals. | the impact of clostridium difficile infection (cdi) on healthcare costs is significant due to the extra costs of associated inpatient care. however, the specific contribution of recurrences has rarely been studied. | 2015 | 26253518 |
| racial differences in clostridium difficile infection rates are attributable to disparities in health care access. | this study confirms previously reported racial differences in clostridium difficile infection (cdi) rates in the united states and explores the nature of those differences. we conducted a retrospective study using the 2010 nationwide inpatient sample, the largest all-payer database of hospital discharges in the united states. we identified hospital stays most likely to include antibiotic treatment for infections, based on hospital discharge diagnoses, and we examined how cdi rates varied, in an ... | 2015 | 26248363 |
| multicenter, double-blind, randomized, phase 2 study evaluating the novel antibiotic cadazolid in patients with clostridium difficile infection. | cadazolid, a novel fluoroquinolone-oxazolidinone antibiotic, exhibits potent in vitro activity against clostridium difficile, including the epidemic bi/nap1/027 strain. this multicenter, randomized, double-blind, active reference group, phase 2 study evaluated the efficacy and safety of oral cadazolid in treatment of adult patients with c. difficile infection (cdi). eligible patients with first occurrence/first recurrence of cdi were randomized 1:1:1:1 to 250, 500, or 1,000 mg cadazolid twice da ... | 2015 | 26248357 |
| vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - united states. | treatments for health care-associated infections (hais) caused by antibiotic-resistant bacteria and clostridium difficile are limited, and some patients have developed untreatable infections. evidence-supported interventions are available, but coordinated approaches to interrupt the spread of hais could have a greater impact on reversing the increasing incidence of these infections than independent facility-based program efforts. | 2015 | 26247436 |
| multifocal clinical performance improvement across 21 hospitals. | improving quality and safety across an entire healthcare system in multiple clinical areas within a short time frame is challenging. we describe our experience with improving inpatient quality and safety at kaiser permanente northern california. the foundations of performance improvement are a “four-wheel drive” approach and a comprehensive driver diagram linking improvement goals to focal areas. by the end of 2011, substantial improvements occurred in hospital-acquired infections (central-line– ... | 2017 | 26247072 |
| recombinant lipoprotein-based vaccine candidates against c. difficile infections. | opportunistically nosocomial infections in hospitalized patients are often related to clostridium difficile infections (cdi) due to disruption of the intestinal micro-flora by antibiotic therapies during hospitalization. clostridial exotoxins a and b (tcda and tcdb) specifically bind to unknown glycoprotein(s) in the host intestine, disrupt the intestinal barrier leading to acute inflammation and diarrhea. the c-terminal receptor binding domain of tcda (a-rrbd) has been shown to elicit antibody ... | 2015 | 26245825 |
| dna-microarray-based genotyping of clostridium difficile. | clostridium difficile can cause antibiotic-associated diarrhea and a possibility of outbreaks in hospital settings warrants molecular typing. a microarray was designed that included toxin genes (tcda/b, cdta/b), genes related to antimicrobial resistance, the slpa gene and additional variable genes. | 2015 | 26242247 |
| ulcerated tophaceous gout. | gout is an inflammatory arthritis characterised by hyperuricemia, which, if poorly controlled, can lead to the development of tophi. we report the case of a 60-year-old caucasian man with poorly controlled polyarticular tophaceous gout with multiple comorbidities (including renal failure) who presented with tophaceous ulcers of the upper extremity. these ulcers caused extreme pain, requiring chronic opiate medications, and were associated with decreased sensation and reduced ability to move the ... | 2015 | 26240104 |
| u.s.-based national sentinel surveillance study for the epidemiology of clostridium difficile-associated diarrheal isolates and their susceptibility to fidaxomicin. | in 2011 a surveillance study for the susceptibility to fidaxomicin and epidemiology of clostridium difficile isolates in the united states was undertaken in seven geographically dispersed medical centers. this report encompasses baseline surveillance in 2011 and 2012 on 925 isolates. a convenience sample of c. difficile isolates or toxin positive stools from patients were referred to a central laboratory. antimicrobial susceptibility was determined by agar dilution (clsi m11-a8). clinical and la ... | 2015 | 26239985 |
| the importance of colonization with clostridium difficile on infection and transmission. | clostridium difficile infections (cdi) are the most common cause of healthcare-associated infections (hai) in the usa, accounting for 12 % of all hais [1]. reasons for such an increase are unknown but may relate to antibiotic use and evolution of a new, pathogenic strain, nap1/bi/027. the centers for disease control and prevention (cdc) identifies c. difficile as one of only three organisms to be assigned a designation of an "urgent" threat level. asymptomatic colonization with c. difficile is m ... | 2015 | 26239132 |
| predominance of pcr-ribotypes, 018 (smz) and 369 (trf) of clostridium difficile in japan: a potential relationship with other global circulating strains? | global spread and evolutionary links of an epidemic clostridium difficile strain (pcr-ribotype 027) have been noted in recent decades. however, in japan, no outbreaks caused by type 027 have been reported to date. a total of 120 c. difficile isolates from patients at 15 hospitals during non-outbreak seasons between 2011 and 2013 as well as 18 and 21 isolates collected from two hospitals in 2010 and 2009, respectively, in outbreak periods in japan, were examined. among these 120 isolates, japan-r ... | 2015 | 26238868 |
| incorrect diagnosis of clostridium difficile infection in a university hospital in japan. | physicians often fail to suspect clostridium difficile infection (cdi) and many microbiology laboratories use suboptimal diagnostic techniques. to estimate the extent of and reasons for incorrect diagnosis of cdi in japan, we investigated toxigenic c. difficile isolated from all stool culture samples and clinical course. over a 12-month period in 2010, all stool culture samples (n = 975) submitted from inpatients in a university hospital in japan were cultured for c. difficile and routine microb ... | 2015 | 26238001 |
| clostridium difficile diarrhea in the elderly: current issues and management options. | clostridium difficile infection (cdi) is the most common cause of infectious diarrhea in healthcare settings. along with antimicrobial exposure, advanced age has been shown to be a significant risk factor for the development and recurrence of, and mortality from, cdi. the substantial burden of cdi in the elderly may be related to frequent healthcare exposure, the necessity for more medications, altered intestinal microbiota, and complicated comorbidities. a diagnosis of cdi is based on evidence ... | 2015 | 26233437 |
| recommendations for the management of symptomatic clostridium difficile infection (cdi). | | 2015 | 26233089 |
| low sensitivity of fecal toxin a/b enzyme immunoassay for diagnosis of clostridium difficile infection in immunocompromised patients. | the optimal approach in laboratory diagnosis of clostridium difficile infection (cdi) is still not well defined. toxigenic culture (tc) or alternatively fecal toxin assay by cell cytotoxicity neutralization assay are considered to be the reference standard, but these methods are time-consuming and labor intensive. in many medical centers, diagnosis of cdi is therefore still based on fecal toxin a/b enzyme immunoassay (eia) directly from stool alone, balancing cost and speed against limited diagn ... | 2015 | 26232535 |
| relationship between sharps disposal containers and clostridium difficile infections in acute care hospitals. | sharps disposal containers are ubiquitous in health care facilities; however, there is paucity of data on their potential role in pathogen transmission. this study assessed the relationship between use of single-use versus reusable sharps containers and rates of clostridium difficile infections in a national sample of hospitals. | 2015 | 26231552 |
| industrial food animal production and community health. | industrial food animal production (ifap) is a source of environmental microbial and chemical hazards. a growing body of literature suggests that populations living near these operations and manure-applied crop fields are at elevated risk for several health outcomes. we reviewed the literature published since 2000 and identified four health outcomes consistently and positively associated with living near ifap: respiratory outcomes, methicillin-resistant staphylococcus aureus (mrsa), q fever, and ... | 2015 | 26231503 |
| regulation of clostridium difficile spore germination by the cspa pseudoprotease domain. | clostridium difficile is a spore-forming obligate anaerobe that is a leading cause of healthcare-associated infections. c. difficile infections begin when its metabolically dormant spores germinate in the gut of susceptible individuals. binding of bile salt germinants to the csp family pseudoprotease cspc triggers a proteolytic signaling cascade consisting of the csp family protease cspb and the cortex hydrolase slec. conserved across many of the clostridia, csp proteases are subtilisin-like ser ... | 2016 | 26231446 |
| a hospital-level cost-effectiveness analysis model for toxigenic clostridium difficile detection algorithms. | despite thorough analyses of the analytical performance of clostridium difficile tests and test algorithms, the financial impact at hospital level has not been well described. such a model should take institution-specific variables into account, such as incidence, request behaviour and infection control policies. | 2015 | 26231269 |
| prevalence of clostridium difficile toxinotypes in infected patients at a tertiary care center in lebanon. | due to the increase in the incidence of clostridium difficile associated diseases at a tertiary care center in lebanon, this study was undertaken to determine the prevalent c. difficile toxinotypes. | 2015 | 26230123 |
| systems modeling of interactions between mucosal immunity and the gut microbiome during clostridium difficile infection. | clostridium difficile infections are associated with the use of broad-spectrum antibiotics and result in an exuberant inflammatory response, leading to nosocomial diarrhea, colitis and even death. to better understand the dynamics of mucosal immunity during c. difficile infection from initiation through expansion to resolution, we built a computational model of the mucosal immune response to the bacterium. the model was calibrated using data from a mouse model of c. difficile infection. the mode ... | 2015 | 26230099 |
| the impact of clostridum difficile on surgical rate among ulcerative colitis patients: a systemic review and meta-analysis. | there is growing recognition of the impact of clostridum difficile infection (cdi) on patients with inflammatory bowel disease. clostridium difficile infection causes greater morbidity and mortality. this study aimed to evaluate the impact of c. difficile on surgical risk among ulcerative colitis (uc) patients. we searched the following databases: medline, embase, the cochrane central register of controlled trials, acp journal club, dare, cmr, and hta. studies were included if fulfilled the foll ... | 2017 | 26228363 |
| impact of toxigenic clostridium difficile colonization on the risk of subsequent c. difficile infection in intensive care unit patients. | clostridium difficile infection (cdi) in hospitalized patients is generally attributed to the current stay, but recent studies reveal high c. difficile colonization rates on admission. | 2015 | 26223207 |
| a curiously rare case of septic shock from clostridium difficile colitis. | this case provides the first report of a young healthy child presenting in septic shock from clostridium difficile colitis. this child had no identifiable risk factors for c. difficile, raising the suspicion for a hypervirulent strain. once infection was recognized and treated appropriately, the child made a full recovery. this case presentation highlights the need to consider c. difficile colitis in the differential diagnosis of severely ill patients, even in the absence of traditional risk fac ... | 2015 | 26221790 |
| correction: molecular epidemiology of clostridium difficile infection in a large teaching hospital in thailand. | | 2015 | 26221729 |
| surveillance for antimicrobial resistance in australian isolates of clostridium difficile, 2013-14. | the objective of this study was to determine the activity of fidaxomicin and comparator antimicrobials against clostridium difficile isolated from patients with c. difficile infection (cdi) in australian hospitals and in the community. | 2015 | 26221017 |
| mechanisms of hypervirulent clostridium difficile ribotype 027 displacement of endemic strains: an epidemiological model. | following rapid, global clonal dominance of hypervirulent ribotypes, clostridium difficile now constitutes the primary infectious cause of nosocomial diarrhoea. evidence indicates at least three possible mechanisms of hypervirulence that facilitates the successful invasion of these atypical strains: 1) increased infectiousness relative to endemic strains; 2) increased symptomatic disease rate relative to endemic strains; and 3) an ability to outcompete endemic strains in the host's gut. stochast ... | 2015 | 26218654 |
| systematic review with meta-analysis: saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. | antibiotic-associated diarrhoea is a common complication of antibiotic use, but it can be prevented with administration of probiotics. | 2015 | 26216624 |
| clostridium difficile colonization in hematopoietic stem cell transplant recipients: a prospective study of the epidemiology and outcomes involving toxigenic and nontoxigenic strains. | clostridium difficile is a leading cause of infectious diarrhea in hematopoietic stem cell transplant (hsct) recipients. asymptomatic colonization of the gastrointestinal tract occurs before development of c. difficile infection (cdi). this prospective study examines the rates, risk factors, and outcomes of colonization with toxigenic and nontoxigenic strains of c. difficile in hsct patients. this 18-month study was conducted in the hsct unit at the karmanos cancer center and wayne state univers ... | 2016 | 26211988 |
| [research progress of fecal microbiota transplantation]. | intestinal microbial ecosystem is the most complex and the largest micro-ecosystem of the mammals. the use of antibiotics can lead to a lot of major changes of the flora, making the intestinal flora damaged and impacted, even developing clostridium difficile infection. fecal microbiota transplantation (fmt) as a special organ transplant therapy, which can rebuild the intestinal flora, has raised the clinical concerns. it has been used in the refractory clostridium difficile, inflammatory bowel d ... | 2015 | 26211780 |
| probiotics for clostridium difficile infection in adults (pico): study protocol for a double-blind, randomized controlled trial. | clostridium difficile is a pathogen of rapidly increasing public health importance. an estimated quarter of a million clostridium difficile infections (cdi) occur in the united states annually, at a resultant cost of 14,000 deaths and 1 billion dollars. clostridium difficile related deaths have risen 400% over the last decade, and current standard antibiotic treatments are only 75 to 85% successful. besides increasing the risk of antibiotic resistance and side effects, these treatments are very ... | 2015 | 26210512 |
| clostridium difficile infections after blunt trauma: a different patient population? | the epidemiology of clostridium difficile-associated infection (cdi) has changed, and it is evident that susceptibility is related not only to exposures and bacterial potency, but host factors as well. several small studies have suggested that cdi after trauma is associated with a different patient phenotype. the purpose of this study was to examine and describe the epidemiologic factors associated with c. difficile in blunt trauma patients without traumatic brain injury using the trauma-related ... | 2015 | 26207402 |
| [fecal microbiota transplantation in recurrent clostridium difficile infection. report of one case]. | fecal microbiota transplantation (fmt) has an incomparable efficacy to treat recurrent clostridium difficile infection, with near 90% of success. we report a 57 years old woman who developed an antibiotic associated diarrhea with a positive polymerase chain reaction test for clostridium difficile toxin. she was successfully treated with vancomycin trice but diarrhea recurred. therefore a fecal microbiota transplant was performed using solid stools from a relative, diluted in saline and instilled ... | 2015 | 26204547 |
| [treatment of a severe clostridium difficile infection with colonic lavages. report of one case]. | a loop ileostomy with intraoperative anterograde colonic lavage has been described as an alternative to colectomy in the management of cases of clostridium difficile infection refractory to medical treatment. we report a 69 years old diabetic women admitted with a septic shock. an abdominal cat scan showed a pan-colitis that seemed to be infectious. a polymerase chain reaction was positive for clostridium difficile. due to the failure to improve after full medical treatment, a derivative loop il ... | 2015 | 26203580 |
| risk factors for recurrent hospital-acquired clostridium difficile infection in a japanese university hospital. | clostridium difficile infection (cdi) is a highly prevalent hospital-associated infection. although most patients respond well to discontinuation of antibiotics, 20%-30% of patients relapse. to initiate early therapeutic measures, the risk factors for recurrent cdi must be identified, although very few japanese studies have used standard surveillance definitions to identify these risk factors. | 2015 | 26203270 |
| development and validation of digital enzyme-linked immunosorbent assays for ultrasensitive detection and quantification of clostridium difficile toxins in stool. | the currently available diagnostics for clostridium difficile infection (cdi) have major limitations. despite mounting evidence that toxin detection is paramount for diagnosis, conventional toxin immunoassays are insufficiently sensitive and cytotoxicity assays too complex; assays that detect toxigenic organisms (toxigenic culture [tc] and nucleic acid amplification testing [naat]) are confounded by asymptomatic colonization by toxigenic c. difficile. we developed ultrasensitive digital enzyme-l ... | 2015 | 26202120 |
| antimicrobial resistance: thinking outside the box. | the health care system is challenged by another serious issue: antimicrobial resistance. clostridium difficile is the most common infection in health care institutions and is becoming resistant to standard treatment. carbapenem-resistant enterobacteriaceae can be found in almost every state in the united states. confounding the antimicrobial resistance issue is the fact that few new antimicrobials are being developed by pharmaceutical companies. the situation is so critical that the white house ... | 2017 | 26200730 |
| pathogenesis of clostridium difficile infection and its potential role in inflammatory bowel disease. | colonization with toxigenic clostridium difficile may be associated with a wide spectrum of clinical presentation ranging from asymptomatic carriage to mild diarrhea to life-threatening colitis. over the last 15 years, there has been a marked increase in the incidence of c. difficile infection, which predominantly affects elderly patients on antibiotics. more recently, there has been significant interest in the association between inflammatory bowel disease (ibd) and c. difficile infection. this ... | 2015 | 26199993 |
| homozygosity for the e526v mutation in fibrinogen a alpha-chain amyloidosis: the first report. | systemic hereditary amyloidoses are autosomal dominant diseases associated with mutations in genes encoding ten different proteins. the clinical phenotype has implications on therapeutic approach, but it is commonly variable and largely dependent on the type of mutation. except for rare cases involving gelsolin or transthyretin, patients are heterozygous for the amyloidogenic variants. here we describe the first patient identified worldwide as homozygous for a nephropathic amyloidosis, involving ... | 2015 | 26199771 |
| isolation and quantitation of clostridium difficile in aqueous and fecal matter using two types of selective media. | we evaluated the isolation and quantitation of clostridium difficile from aqueous and fecal samples utilizing chromid cdif and cycloserine, cefoxitin, and fructose-containing agar with horse blood and taurocholate media. growth was similar between the two. chromid cdif provided enhanced isolation and required no ethanol pretreatment to inhibit normal flora. chromid cdif also improved turn-around time, requiring only 24 hours' incubation. | 2016 | 26198865 |
| a primer on on-demand polymerase chain reaction technology. | efforts to reduce health care-associated infections (hais) have grown in both scale and sophistication over the past few decades; however, the increasing threat of antimicrobial resistance and the impact of new legislation regarding hais on health care economics make the fight against them all the more urgent. on-demand polymerase chain reaction (pcr) technology has proven to be a highly effective weapon in this fight, offering the ability to accurately and efficiently identify disease-causing p ... | 2015 | 26198577 |
| microbiome changes associated with sustained eradication of clostridium difficile after single faecal microbiota transplantation in children with and without inflammatory bowel disease. | little data are available regarding the effectiveness and associated microbiome changes of faecal microbiota transplantation (fmt) for clostridium difficile infection (cdi) in children, especially in those with inflammatory bowel disease (ibd) with presumed underlying dysbiosis. | 2015 | 26198180 |
| fate of clostridium botulinum and incidence of pathogenic clostridia in biogas processes. | this study aimed to assess the sanitary situation in agricultural biogas plants (bp) regarding pathogenic clostridium spp. | 2015 | 26198084 |
| age-stratified treatment response rates in hospitalized patients with clostridium difficile infection treated with metronidazole. | consensus on the optimal treatment of clostridium difficile infection (cdi) is rapidly changing. treatment with metronidazole has been associated with increased clinical failure rates; however, the reasons for this are unclear. the purpose of this study was to assess age-related treatment response rates in hospitalized patients with cdi treated with metronidazole. this was a retrospective, multicenter cohort study of hospitalized patients with cdi. patients were assessed for refractory cdi, defi ... | 2015 | 26195522 |
| robot-assisted laparoscopic repair of vesicovaginal fistula: a single-center experience. | to describe our surgical technique and outcomes with robot-assisted laparoscopic repair of vesicovaginal fistula (vvf) in 10 patients. | 2015 | 26194296 |
| incidence and costs of clostridium difficile infections in canada. | background. limited data are available on direct medical costs and lost productivity due to clostridium difficile infection (cdi) in canada. methods. we developed an economic model to estimate the costs of managing hospitalized and community-dwelling patients with cdi in canada. the number of episodes was projected based on publicly available national rates of hospital-associated cdi and the estimate that 64% of all cdi is hospital-associated. clostridium difficile infection recurrences were c ... | 2015 | 26191534 |
| horizontal infection prevention measures and a risk-managed approach to vancomycin-resistant enterococci: an evaluation. | the use of infection control measures in the management of vancomycin-resistant enterococci (vre) is hotly debated. a risk-managed approach to vre control after the introduction of 2 horizontal infection prevention measures-an environmental cleaning (ec) and an antimicrobial stewardship (ams) program-was assessed. | 2015 | 26190379 |
| use of intravenous immunoglobulin in severe clostridium difficile-associated diarrhea. | clostridium difficile infection is an increasingly common cause of healthcare-acquired diarrhea. there remains substantial morbidity and mortality, even with current modalities of treatment. the aim of our study was to investigate the role of intravenous immunoglobulin (ivig) on mortality in patients with severe clostridium difficile-associated diarrhea (cdad). | 2015 | 26189489 |
| pitfalls in diagnosis of pediatric clostridium difficile infection. | the incidence of clostridium difficile infection (cdi) has risen among children and c difficile is increasingly recognized as an important cause of healthcare-associated diarrhea among pediatric patients. still, increased identification of cdi in healthy children in the community and increased testing among infants requires cautious interpretation, given the high prevalence of asymptomatic colonization in young infants and frequent detection of viruses and other co-pathogens in stool specimens i ... | 2015 | 26188603 |
| bacterial infections in hematopoietic stem cell transplant recipients. | bacterial infections are major complications after hematopoietic stem cell transplant (hsct). they consist mainly of bloodstream infections (bsi), followed by pneumonia and gastrointestinal infections, including typhlitis and clostridium difficile infection. microbiological data come mostly from bsi. coagulase negative staphylococci and enterobacteriaceae are the most frequent pathogens causing approximately 25% of bsi each, followed by enterococci, p. aeruginosa and viridans streptococci. bacte ... | 2015 | 26185610 |
| [cystic fibrosis: toward a genetic treatment; clostridium difficile versus clostridium difficile]. | | 2015 | 26182641 |
| defined nutrient diets alter susceptibility to clostridium difficile associated disease in a murine model. | clostridium difficile is a major identifiable and treatable cause of antibiotic-associated diarrhea. poor nutritional status contributes to mortality through weakened host defenses against various pathogens. the primary goal of this study was to assess the contribution of a reduced protein diet to the outcomes of c. difficile infection in a murine model. | 2015 | 26181795 |
| loss of vancomycin-resistant enterococcus fecal dominance in an organ transplant patient with clostridium difficile colitis after fecal microbiota transplant. | we report the use of fecal microbiota transplantation in a single heart-kidney transplant recipient with recurrent clostridium difficile, vancomycin-resistant enterococcus (vre) fecal dominance, and recurrent vre infections. fecal microbiota transplantation resulted in the reconstruction of a diverse microbiota with (1) reduced relative abundance of c difficile and vre and (2) positive clinical outcome. | 2015 | 26180828 |
| genomic epidemiology of a protracted hospital outbreak caused by a toxin a-negative clostridium difficile sublineage pcr ribotype 017 strain in london, england. | clostridium difficile remains the leading cause of nosocomial diarrhea worldwide, which is largely considered to be due to the production of two potent toxins: tcda and tcdb. however, pcr ribotype (rt) 017, one of five clonal lineages of human virulent c. difficile, lacks tcda expression but causes widespread disease. whole-genome sequencing was applied to 35 isolates from hospitalized patients with c. difficile infection (cdi) and two environmental ward isolates in london, england. the phylogen ... | 2015 | 26179308 |
| the clostridium difficile cell wall protein cwpv confers phase-variable phage resistance. | bacteriophages are present in virtually all ecosystems, and bacteria have developed multiple antiphage strategies to counter their attacks. clostridium difficile is an important pathogen causing severe intestinal infections in humans and animals. here we show that the conserved cell-surface protein cwpv provides antiphage protection in c. difficile. this protein, for which the expression is phase-variable, is classified into five types, each differing in their repeat-containing c-terminal domain ... | 2015 | 26179020 |
| clostridium difficile infection. | | 2015 | 26176399 |
| clostridium difficile infection. | | 2015 | 26176398 |
| clostridium difficile infection. | | 2015 | 26176397 |
| clostridium difficile infection. | | 2015 | 26176396 |
| antibiotic-induced alterations of the murine gut microbiota and subsequent effects on colonization resistance against clostridium difficile. | perturbations to the gut microbiota can result in a loss of colonization resistance against gastrointestinal pathogens such as clostridium difficile. although c. difficile infection is commonly associated with antibiotic use, the precise alterations to the microbiota associated with this loss in function are unknown. we used a variety of antibiotic perturbations to generate a diverse array of gut microbiota structures, which were then challenged with c. difficile spores. across these treatments ... | 2015 | 26173701 |
| ultrasound diagnosis of clostridium difficile-associated diarrhea. | clostridium difficile colitis is diagnosed using an immunoassay or polymerase chain reaction (pcr) assay for toxins a/b. since ultrasound is frequently used as a screening test for hospitalized patients suffering from different abdominal morbidities, we searched for sonographic indicators of c. difficile infection (cdi). in a prospective and blinded case-control study, abdominal ultrasound was performed on hospitalized patients for whom stool samples were sent for c. difficile toxin immunoassay. ... | 2015 | 26173691 |
| effects of fluoroquinolone restriction (from 2007 to 2012) on clostridium difficile infections: interrupted time-series analysis. | antimicrobial stewardship is a key component in the reduction of healthcare-associated infections, particularly clostridium difficile infection (cdi). we successfully restricted the use of cephalosporins and, subsequently, fluoroquinolones. from an endemically high level of >280 cases per year in 2007-08, the number of cdis reduced to 72 cases in 2011-12. | 2015 | 26169793 |
| novel riboswitch-binding flavin analog that protects mice against clostridium difficile infection without inhibiting cecal flora. | novel mechanisms of action and new chemical scaffolds are needed to rejuvenate antibacterial drug discovery, and riboswitch regulators of bacterial gene expression are a promising class of targets for the discovery of new leads. herein, we report the characterization of 5-(3-(4-fluorophenyl)butyl)-7,8-dimethylpyrido[3,4-b]quinoxaline-1,3(2h,5h)-dione (5fdqd)-an analog of riboflavin that was designed to bind riboswitches that naturally recognize the essential coenzyme flavin mononucleotide (fmn) ... | 2015 | 26169403 |
| fecal microbiota transplantation eliminates clostridium difficile in a murine model of relapsing disease. | recurrent clostridium difficile infection (cdi) is of particular concern among health care-associated infections. the role of the microbiota in disease recovery is apparent given the success of fecal microbiota transplantation (fmt) for recurrent cdi. here, we present a murine model of cdi relapse to further define the microbiota recovery following fmt. cefoperazone-treated mice were infected with c. difficile 630 spores and treated with vancomycin after development of clinical disease. vancomyc ... | 2015 | 26169276 |
| methods to prevent or treat refractory diseases by focusing on intestinal microbes using lps and macrophages. | intestinal microbes are known to influence host homeostasis by producing various substances. recently, the presence of a diverse range of intestinal microbiota has been shown to play a key role in the maintenance of health, along with influencing the host's innate immunity towards various diseases. for example, fecal microbiota transplantation (fmt) from healthy individuals was remarkably effective in cases of refractory clostridium difficile colitis. conversely, decreased number of intestinal m ... | 2015 | 26168477 |
| [analysis of clostridium difficile associated diarrhea in pediatric patients with antibiotic-associated diarrhea]. | to analyze the incidence and treatment of clostridium difficile infection (cdi) in pediatric patients with antibiotic-associated diarrhea (aad). | 2015 | 26165021 |
| risk factors for community-associated clostridium difficile-associated diarrhea in children. | clostridium difficile-associated diarrhea (cdad) is increasingly diagnosed in children in community settings. this study aims to assess recent antibiotic use and other risk factors in children with community-associated (ca-) cdad compared with children with other diarrheal illnesses in a tertiary care setting. | 2015 | 26164847 |
| proton pump inhibitors alter specific taxa in the human gastrointestinal microbiome: a crossover trial. | we conducted an open-label crossover trial to test whether proton pump inhibitors (ppis) affect the gastrointestinal microbiome to facilitate clostridium difficile infection (cdi). twelve healthy volunteers each donated 2 baseline fecal samples, 4 weeks apart (at weeks 0 and 4). they then took ppis for 4 weeks (40 mg omeprazole, twice daily) and fecal samples were collected at week 8. six individuals took the ppis for an additional 4 weeks (from week 8 to 12) and fecal samples were collected fro ... | 2015 | 26164495 |
| first implementation of frozen, capsulized faecal microbiota transplantation for recurrent clostridium difficile infection into clinical practice in europe. | | 2015 | 26163107 |
| innate immune defenses mediated by two ilc subsets are critical for protection against acute clostridium difficile infection. | infection with the opportunistic enteric pathogen clostridium difficile is an increasingly common clinical complication that follows antibiotic treatment-induced gut microbiota perturbation. innate lymphoid cells (ilcs) are early responders to enteric pathogens; however, their role during c. difficile infection is undefined. to identify immune pathways that mediate recovery from c. difficile infection, we challenged c57bl/6, rag1(-/-) (which lack t and b cells), and rag2(-/-)il2rg(-/-) (ragγc(-/ ... | 2015 | 26159718 |