Publications

TitleAbstractYear
Filter
PMID
Filter
immunization of adult hamsters against clostridium difficile-associated ileocecitis and transfer of protection to infant hamsters.in this investigation, the role of antibodies against clostridium difficile toxins a and b in protecting hamsters against c. difficile-associated ileocecitis was examined. we also studied the transfer of protection against c. difficile-associated intestinal disease from immunized female hamsters to their infants. adult female hamsters immunized parenterally with toxoid a or a mixture containing both toxoids a and b were protected against clindamycin-induced c. difficile-associated fatal ileoceci ...19873679541
plasmid profiles of clostridium difficile isolates from patients with antibiotic-associated colitis in two community hospitals. 19873680990
[mucosal blood flow as a cause of pseudomembranous colitis]. 19873682263
acute diarrhoea in adults: a prospective study.a prospective study of 74 adults with acute diarrhoea was carried out in sydney in 1984-1985 to determine the infective agents that were involved and their relationship to clinical, epidemiological and laboratory features. thirty-four potential pathogens were identified in 32 (43.2%) patients. these included, in order of frequency: campylobacter spp., rotavirus, clostridium difficile, salmonella enteritidis, aeromonas hydrophila, vibrio parahaemolyticus, adenovirus, a small round virus and giard ...19873683260
[effect of clostridium difficile toxin on human large intestine motility. in vitro studies]. 19873683327
rectal swab cultures for clostridium difficile surveillance studies.we compared the recovery of clostridium difficile from hospitalized patients by two collection methods: rectal swabs and stool cultures. rectal swab cultures were as sensitive as stool cultures and were more easily obtained. transport of swabs in an anaerobic vacutainer system resulted in longer survival times compared with transport in amies medium.19873693551
an evaluation of ampicillin pharmacokinetics and toxicity in guinea pigs.sodium ampicillin was administered subcutaneously to 350-550 g male dunkin hartley guinea pigs at doses of 6, 8 and 10 mg/kg tid for 5 days. over a period of 12 days, the lowest ampicillin dose appeared to be tolerated well. however, significant body weight reduction and mortality occurred with the two higher dosage regimens. cecal cultures of dead animals confirmed the presence of clostridium difficile, an organism associated with antibiotic-induced enterotoxemia. assay of serum collected from ...19873695404
clinical considerations in the diagnosis of antimicrobial agent-associated gastroenteritis.most gastrointestinal infections secondary to the use of antimicrobial agents that have been documented are related to overgrowth of clostridium difficile which produces a spectrum from severe pseudomembranous colitis to mild diarrhea or asymptomatic carriage. the most common inducers of pseudomembranous colitis or antimicrobial agent-associated diarrhea are ampicillin, clindamycin, and various cephalosporins, but almost all antimicrobials may cause this problem. symptoms vary from watery to blo ...19863698542
yersinia colitis masquerading as pseudomembranous colitis.we describe a 15-month-old male who presented with fever and diarrhea 24 hr after receiving antibiotics for otitis media. a flexible sigmoidoscopy was initially interpreted endoscopically as antibiotic-associated pseudomembranous colitis, and the patient was treated with vancomycin. the diagnosis of antibiotic-associated colitis was excluded in our patient by the negative stool examination for clostridium difficile toxin, the failure to obtain supportive features on rectal biopsy, and the failur ...19863698772
method for the typing of clostridium difficile based on polyacrylamide gel electrophoresis of [35s]methionine-labeled proteins.a typing method for clostridium difficile based on the incorporation of [35s]methionine into cellular proteins, their separation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and their visualization by autoradiography is described. on analysis of the radiolabeled-protein profiles, nine distinct groups were observed (a to e and w to z). the method, which is simple, reproducible, and readily expandable, has been applied in epidemiological studies to demonstrate cross-infection and ...19863700603
evaluation of a commercial kit for the routine detection of clostridium difficile cytotoxin by tissue culture.the toxi-titer microtiter plate system (bartels immunodiagnostic supplies, inc., bellevue, wash.) is a simplified procedure for detecting the cytotoxin produced by clostridium difficile in stool filtrates. in a parallel study of 74 stool specimens, results from the toxin-titer system compared favorably with those from the conventional system. our experience with the toxin-titer system in testing 540 stool specimens was, in general, satisfactory, although a few problems with toxin control did occ ...19863700631
clostridium difficile in diarrheal disease. 19863701124
variations in the anaerobic faecal flora of ten healthy human volunteers with special reference to the bacteroides fragilis-group and clostridium difficile.ninety nine stool specimens of ten healthy human volunteers were collected over a one year period, and processed anaerobically. the individual variations in intestinal colonization with bacteria of the bacteroides fragilis-group were detected, using the bacteroides bile esculin medium and an identification scheme for bile-resistant bacteroides species. clostridium difficile agar supplemented with cycloserine/cefoxtin was used to detect the incidence of c. difficile in this group. the species of ...19863705797
evaluation of a commercial cytotoxicity assay for detection of clostridium difficile toxin.a comparative study was performed to determine the accuracy of clostridium difficile toxin detection. a commercial cytotoxicity assay (bartels immunodiagnostic supply, bellevue, wash.) was compared with conventional microcytotoxicity assays, using vero and mrc-5 cells. the bartels system was found to be essentially equivalent to conventional cytotoxicity assays currently being performed for routine c. difficile toxin detection.19863711282
changing epidemiology, diagnosis, and treatment of clostridium difficile toxin-associated colitis.one hundred and ninety patients with clostridium difficile toxin-associated colitis (ctac) or pseudomembranous colitis (pmc) were identified, from microbiology records, disease index and proctoscopy service records, and studied retrospectively. ctac was associated with cephalosporin antibiotic administration in 70 per cent of the patients. ctac developed postoperatively in 108 patients after all types of surgery with no preponderance for abdominal surgery. identification of cytotoxin in stool sa ...19863719271
rapid identification of clostridium difficile by determination of leucine arylamidase activity. 19863720738
technique for measuring 50% end points in cytotoxicity assays for clostridium difficile toxins.serial dilutions of clostridium difficile culture filtrates were incubated overnight with hela cell monolayers. cells were fixed in formalin, stained with crystal violet, rinsed, and drained. cell rounding could be observed microscopically in the stained monolayers. absorbance of the retained dye on monolayers in the drained wells was measured at 595 nm-405 nm. end points could also be estimated visually. the dilution at which dye absorbance was reduced by 50% agreed with that determined by micr ...19863722420
an in-vitro model of colonisation resistance to clostridium difficile infection.to investigate the importance of the normal gut flora in preventing the establishment of clostridium difficile in vivo we have developed an in-vitro test system based on growth in faecal emulsions. growth of c. difficile and cytotoxin production are inhibited in faecal emulsions from healthy adults, but not in sterilised emulsions; the importance of viable bacteria in the inhibitory system is evident. generally, faecal emulsions derived from infants, children and geriatric patients were less inh ...19863723582
[clostridium difficile and its significance as an intestinal pathogenic bacterium]. 19863725396
effect of moxalactam on human fecal microflora.five healthy male adults received 2 g of moxalactam every 12 h for 7 days. the alterations of fecal microflora were investigated before, during, and after treatment with moxalactam. on day 7 of treatment, the number of total bacteria was decreased in all subjects. there was marked suppression of the obligate anaerobic bacteria and enterobacteria to undetectable levels, but the counts of streptococcus spp. and lactobacillus spp. increased. on day 7, two subjects had clostridium innocuum and clost ...19863729329
application of a technique for serogrouping clostridium difficile in an outbreak of antibiotic-associated diarrhoea.a severe outbreak of clostridium difficile antibiotic-associated diarrhoea (aad) in an orthopaedic surgical unit is reported. thirty-seven cases and eight relapses were observed. the 45 related strains together with another 13 strains of c. difficile isolated during the same period in other wards of the same hospital were typed by detection of cytotoxin production, determination of sorbitol fermentation and serogrouping by agglutination with six rabbit antisera defining the serogroups a, b, c, d ...19863734468
aetiology and epidemiology of acute gastro-enteritis in swedish children.in a prospective 1-year study, 144 children attending or admitted to hospital and 272 children outside hospital with acute gastro-enteritis and 200 controls were investigated by a broad panel of diagnostic methods for enteropathogenic agents in the faeces and for related antibody responses. enteropathogens were identified in 77% of the inpatients, 63% of the outpatients and 8% of the controls. rotavirus and yersinia enterocolitica were detected significantly more often among inpatients. altogeth ...19863734469
detection of clostridial toxins in stools from children with diarrhoea.a cell-culture assay was used to detect toxins directly in stools from sporadic cases of infantile diarrhoea. cytotoxins were revealed in 11 out of 58 samples from children with diarrhoea, nine of whom had no common enteric pathogens in their stools. a preliminary characterisation of the cytotoxins was obtained by neutralisation tests with clostridial antitoxins.19863735388
sporogenesis and toxin a production by clostridium difficile.the kinetics of spore production by clostridium difficile were not paralleled by release of c. difficile toxin a in vitro. toxin a was not found to be associated with either purified whole spores or spore coats. residual traces of toxin a detected in spore contents were almost certainly derived from contaminating vegetative cell debris. thus, toxin a is unlikely to be a spore constituent or associated with sporogenesis.19863735389
detection of clostridium difficile toxins a (enterotoxin) and b (cytotoxin) in clinical specimens. evaluation of a latex agglutination test.a new latex test, culturette brand rapid latex test for detection of clostridium difficile toxin a, was tested on 408 stool samples. in 247 frozen tissue culture supernate specimens previously obtained from patients with c. difficile-associated diarrhea (cad), the latex test (enterotoxin) was positive in 182 (74%) as compared with 194 (79%) for the repeat tissue culture (p greater than 0.1) cytotoxin (toxin b) test. testing of 161 fresh stool samples found the latex test superior to tissue cultu ...19863739972
[incidence and origin of clostridium difficile in neonatology].the epidemiology of clostridium difficile was studied prospectively in 101 newborn infants by screening of fecal samples collected in the first or second day of life and in the fourth or fifth one. a vaginal swab and a stool specimen were collected from mothers before delivery. environmental cultures were obtained from selected sites in the ward, while colonization of intestinal tract and contamination of the hands were evaluated in the personnel. c. difficile was isolated from the feces of 13 i ...19863741636
cell surface binding site for clostridium difficile enterotoxin: evidence for a glycoconjugate containing the sequence gal alpha 1-3gal beta 1-4glcnac.this study was undertaken to determine whether a binding site for clostridium difficile enterotoxin (toxin a) exists in the brush border membranes (bbms) of the hamster, an animal known to be extremely sensitive to the action of the toxin. toxin a was the only antigen adsorbed by the bbms from the culture filtrate of c. difficile. the finding that binding activity could not be destroyed by heat indicated that a carbohydrate moiety might be involved. we therefore examined erythrocytes from variou ...19863744552
the carrier state: clostridium difficile. 19863745032
predicting the susceptibility of anaerobes to cefoperazone, cefotaxime, and cefoxitin with the thioglycolate broth disk procedure.a variety of clinical anaerobic isolates were tested against cefoperazone (216 strains), cefoxitin (120 strains), and cefotaxime (120 strains) by the thioglycolate anaerobic broth disk method, and the results were compared with the national committee for clinical laboratory standards reference agar dilution method. the broth disk and reference breakpoint concentrations were as follows: cefoperazone, 60 and 64 or 30 and 32 micrograms/ml; cefotaxime, 30 and 32 micrograms/ml; cefoxitin, 18 and 16 m ...19863745418
isolation of clostridium difficile from human jejunum: identification of a reservoir for disease?the possibility that the small intestine may represent a reservoir for clostridium difficile was studied, using segments of human jejunum collected at necropsy. our results (three of 100 specimens positive for c difficile culture) support the hypothesis that c difficile can be found in human jejunum and that it adheres to the normal mucosa as a resident bacterium. these findings suggest that gastrointestinal disease caused by c difficile has an endogenous origin.19863745477
[undesirable colorectal effects of drugs].the most severe adverse reactions associated with medicinal treatment of the colon involve pseudomembranous colitis following antibiotic treatment, notably with clindamycin, lincomycin and betalactamine. the frequency of this adverse reaction is poorly defined: 1 per 100 to 1 per 5 000 treatments depending on the study. lesions are explained by the cytotoxic effect of clostridium difficile toxin. necrotizing anorectitis has been seen in cases of abuse of suppositories containing propoxyphene. th ...19863752909
[pseudomembranous rectocolitis].the following conclusions were drawn from a study of 15 cases of pseudo-membranous coloproctitis (pmcp): pmcp was seen in subjects of both sexes and all ages. the causative agent was found in all antibiotic classes. clinical signs comprised constant diarrhea, fever, abdominal pain, toxic shock and, more rarely, pseudo-occlusive, pseudo-perforative surgical evidence. diagnosis involved visualization of pseudo-membranes by endoscopy. lesions were most frequent in the left colon and increased in se ...19863752911
hydrophobic and adherence properties of clostridium difficile.nine strains of clostridium difficile isolated from symptomatic and asymptomatic patients and four other species of clostridia were tested for relative hydrophobicity by determining the degree of adherence to polystyrene. under three different conditions of growth all strains of clostridium difficile had high rates of adherence, whereas the other clostridial species showed no pronounced adherence. isolates of clostridium difficile were also tested for their ability to adhere to human embryonic i ...19863758054
clostridium difficile cytotoxin inhibits protein synthesis in fibroblasts and intestinal mucosa.the pathophysiology of clostridium difficile colitis is thought to be mediated by release of toxin a, an enterotoxin, and toxin b, a cytotoxin. we compared the differential effects of toxin b on protein synthesis in imr-90 fibroblasts and in hamster esophagus, stomach, gallbladder, small intestine, and cecum in organ culture. toxin b in low concentrations stimulated (p less than 0.001) incorporation of [3h]leucine into fibroblast proteins, whereas at higher dosages it inhibited incorporation (p ...19863758606
[role of clostridium difficile toxins in pseudomembranous colitis with special reference to experimental studies using germfree rats]. 19863761681
fecal bacterial microflora of newborn infants during intensive care management and treatment with five antibiotic regimens.aerobic and anaerobic fecal bacterial flora of normal newborn infants, of preterm newborn infants without other health problems and of five groups of newborn infants treated with combinations of benzylpenicillin, cloxacillin, flucloxacillin, ampicillin, cefuroxime, cefoxitin and gentamicin were compared. preterm birth alone was associated with growth of klebsiella which could be attributed to a higher rate of cesarean section in preterm than in term infants. all antibiotic regimens led to a pron ...19863763418
clostridium difficile antibiotic-associated colitis. 19863766494
clostridium difficile culture-positive toxin-negative diarrhea.antibiotic-associated colitis (aac) is confirmed by the isolation of clostridium difficile cytotoxin from stool in patients with diarrhea. culture of the organism has not been required to confirm the diagnosis. a review of cases of c. difficile culture-positive patients was performed in an attempt to clarify the significance of culture-positive toxin-negative (cptn) compared to culture-positive toxin-positive (cptp) disease. during an 11-month period, 45 patients were identified who had stool cu ...19863766495
gastrointestinal features of culture-positive yersinia enterocolitica infection.yersinia enterocolitica was cultured from feces of 122 symptomatic adults in a single facility using selective culture media; all isolates were confirmed in an independent reference laboratory. of 128 isolates, multiple serotypes were defined and all were biochemically typical for yersinia enterocolitica. other agents were seen in 20 patients; of these, seven were yersinia fredriksenii and six were clostridium difficile. diarrhea (80%) and abdominal pain (64%) were common, whereas other features ...19873781177
faecal metronidazole concentrations during oral and intravenous therapy for antibiotic associated colitis due to clostridium difficile.faecal metronidazole and hydroxymetronidazole concentrations measured by high pressure liquid chromatography are reported during 10 episodes of clostridium difficile colitis in nine patients. bactericidal faecal concentrations were present in all patients with acute disease receiving oral or intravenous metronidazole, and all responded to therapy. metronidazole and hydroxymetronidazole concentrations fell as the diarrhoea improved and neither substance was detectable in the faeces of five patien ...19863781329
comparison of serogrouping and polyacrylamide gel electrophoresis for typing clostridium difficile.a typing scheme for clostridium difficile based on slide agglutination with rabbit antisera was previously described. it allows the differentiation of 10 serogroups designated a, b, c, d, f, g, h, i, k, and x. we studied the correlation between serogrouping and polyacrylamide gel electrophoresis (page) of whole-cell proteins. a total of 202 isolates from different sources were analyzed by page after ultrasonic disintegration of cells from an 18-h liquid culture and treatment with sodium dodecyl ...19863782463
[clostridium difficile in the feces of children with and without diarrhea]. 19863790227
a role for colonic stasis in the pathogenesis of disease related to clostridium difficile.the records of 133 consecutive patients (65 men, 68 women; age range, 15 months to 88 years; median, 57 years) with either a positive clostridium difficile stool culture or toxin assay from 1982 to 1984 were reviewed in order to assess the pattern of this disease in a large hospital and to examine the type of patient at risk. all patients had diarrhea and/or bloody stools (121 and 36, respectively). less specific symptoms were common. most patients had been exposed to multiple antibiotics, but o ...19863792161
prairie dog model for antimicrobial agent-induced clostridium difficile diarrhea.we have noted that prairie dogs given cefoxitin develop diarrhea and lose weight yet survive for periods of up to 4 weeks. therefore, we tested the hypothesis that cefoxitin causes clostridium difficile cecitis in prairie dogs. six prairie dogs were given a single intramuscular dose of 100 mg of cefoxitin per kg of body weight, and six control animals received saline; both groups were sacrificed 1 week later. controls had no diarrhea and lost 2% of their body weight, whereas cefoxitin-treated an ...19873793229
purification and characterization of clostridium sordellii lethal toxin and cross-reactivity with clostridium difficile cytotoxin.lethal toxin (lt) was purified from clostridium sordellii ip82 by deae-trisacryl, ultrogel aca3-4 gel filtration, and hydroxyapatite column chromatography. the molecular weight of purified lt was estimated to be 240,000 to 250,000, and the pi was at ph 4.55. lt was lethal for mice by intraperitoneal injection (3.4 x 10(5) mouse lethal doses per mg of protein), cytotoxic for vero cells (6.1 x 10(4) cytotoxic units per mg of protein), erythematous and edematous by intradermal injection in guinea p ...19873793234
isolation of clostridium difficile from various colonies of laboratory mice.an attempt was made to isolate clostridium difficile from a total of 565 mice from nine different conventional mouse colonies and six different specified-pathogen-free mouse colonies. c. difficile was isolated from all the conventional colonies but from none of the specified-pathogen-free colonies. ampicillin injected intraperitoneally increased the isolation rate of c. difficile from mouse faeces to 63.6% compared with 19.4% from untreated mice.19863795866
in vitro activity of efrotomycin, ciprofloxacin, and six other antimicrobials against clostridium difficile.the susceptibility of 69 clinical isolates of clostridium difficile from the minneapolis veterans administration medical center and 29 c. difficile strains from other hospitals to efrotomycin, ciprofloxacin, and six other antimicrobials was tested in vitro by agar dilution. ciprofloxin (mic50 and mic90 = 8 mcg/ml) was only moderately active whereas efrotomycin (mic50 = 0.125, mic90 = 0.25 mcg/ml) was highly active against c. difficile.19873802745
nosocomial diarrhoeas in a surgical division hyperendemic for clostridium difficile: epidemiologic aspects emerging from an analysis of clinical records.having previously shown that clostridium difficile was responsible for an intense and protracted endemic of nosocomial diarrhoeas in the surgical division of a tuscan hospital, we started a retrospective analysis on all records from the affected division, to cover a period of 15 months. a statistical description is given of a large series of nosocomial diarrhoeas, as well as direct estimates of their incidence rates in selected high risk subgroups. the situation described is epidemiologically un ...19863803539
fever due to clostridium difficile during hemodialytic treatment.a ten-year-old on hemodialysis had a prolonged unexplained fever secondary to clostridium difficile antibiotic-associated colitis and posed a great diagnostic challenge.19863804581
a comparison of the clinico-pathological features with stool pathogens in patients hospitalised with the symptom of diarrhoea.the clinico-pathological features of 515 adult patients admitted to a major regional infectious diseases unit in united kingdom with the symptom complex of diarrhoea were compared to the pathogens detected in their stool specimens. routine clinical examination supported by basic pathological and laboratory investigations identified 138 (28%) in whom the cause of diarrhoea was extragastrointestinal or non-infectious gastrointestinal. of the 351 patients (72%) with infectious gastroenteritis 72 (2 ...19863810049
[clostridium difficile infections]. 19863810619
[clostridium difficile infections]. 19863810620
prevention of clostridium difficile induced mortality in gnotobiotic mice by saccharomyces boulardii.oral preventive treatment of gnotobiotic mice by saccharomyces boulardii significantly decreased mortality following clostridium difficile infection. a single s. boulardii ingestion protected 16% of mice, whereas 56% were protected when s. boulardii was given continuously in the drinking water. no direct antagonistic effect of the yeast on c. difficile numbers was detected, whereas a modulation of fecal cytotoxin production was demonstrated.19863815159
[the immunoenzyme system in research on e. coli enterotoxin lt and c. difficile toxins]. 19863826991
epidemiology of an outbreak of clostridium difficile-associated-diarrhoea. application of a typing system. 19863826999
faecal carriage of clostridium difficile in cystic fibrosis patients. 19863827000
[clostridium difficile colitis in patients with blood diseases]. 19863827004
[the isolation of clostridium difficile and the detection of its cytotoxin from the hamster colitis model]. 19853837547
the influence of single dose intravenous antibiotics on faecal flora and emergence of clostridium difficile.the influence of a single intravenous dose of antibiotic on faecal flora and the emergence of clostridium difficile was studied in volunteers. seventy-eight volunteers (13 groups of 6 receiving 5 penicillins and 8 cephalosporins) were given a single intravenous dose of antibiotic. results were compared with a control group of 6 volunteers who did not receive an antibiotic. changes in the faecal flora were monitored over two weeks. only cephalosporins were associated with emergence of cl. diffici ...19853846592
in vitro activity of cefbuperazone against anaerobic bacteria.the in vitro activity of cefbuperazone was compared with that of cefoxitin, moxalactam, and piperacillin against 305 strains of anaerobic bacteria. piperacillin was the most active overall, inhibiting 97% of all anaerobes tested at 128 micrograms/ml. cefbuperazone had poor activity against the bacteroides fragilis group and clostridium difficile (43 and 0% susceptible, respectively) but good activity (90.5%) against all other anaerobic bacterial species tested.19853847274
effect of aspoxicillin on anaerobic bacteria.aspoxicillin (aspc), a semisynthetic penicillin has a broad spectrum of antibacterial activities against gram-positive and gram-negative anaerobic bacteria. its in vitro antibacterial activity was less than those of cefoxitin against peptostreptococcus and veillonella, but was significantly high against bacteroides fragilis, one of the most clinically important anaerobe. the therapeutic and/or protective effect of aspc in experimental subcutaneous abscess or experimental intraabdominal mixed inf ...19853850132
clostridium difficile isolation in leukemic children on maintenance cancer chemotherapy. a preliminary study.between december 1982 and november 1983, stool specimens from 15 children with acute lymphoblastic leukemia, who were on maintenance cancer chemotherapy, were examined weekly for the presence of clostridium difficile and its toxin. four out of 15 patients were positive for c. difficile: three patients had stool specimens that did not contain toxin, but cultures yielded growth of toxigenic c. difficile on only one occasion. the fourth patient, who had a recent history of hospitalization, particul ...19853857141
clostridium difficile in haematological malignancy.twenty patients with haematological malignancies who developed clostridium difficile bowel infection or colonisation are described. all isolates of c difficile were toxigenic in vitro and faecal cytotoxin (toxin b) was detected in 20/26 episodes. ten of 20 episodes with detectable faecal cytotoxin were associated with typical antibiotic associated diarrhoea. in the other 10 episodes (nine patients), there was a severe unusual illness which was associated with detection of c difficile. the unusua ...19853857233
role for newer beta-lactam antibiotics in treatment of osteomyelitis.monotherapy of osteomyelitis with the newer broad-spectrum beta-lactam antibiotics has become attractive because of the efficacy, safety, and cost of these antibiotics when compared with conventional combination therapy. imipenem/cilastatin is a recent and promising addition to this antibiotic family. experience with imipenem/cilastatin and that reported for cefotaxime, ceftazidime, and ceftizoxime in the treatment of biopsy-proved osteomyelitis was compared, using data from published reports fr ...19853859212
safety and efficacy of high-dose treatment with imipenem-cilastatin in seriously ill patients.imipenem-cilastatin was given in doses of 1 g intravenously every 6 h to 31 patients. twenty-five patients, with 27 infections, were clinically evaluable and received 20 to 210 g of imipenem for a duration of 5 to 56 days (average 16.3 days). infections included seven cases of osteomyelitis, seven of bacteremia, five of cellulitis, two of pneumonia, three of pelvic cellulitis, two of intraabdominal abscess, and one each of empyema, mediastinitis, and endometritis. fifty-five percent of the infec ...19853860187
the comparative in-vitro activity of cefotetan against anaerobic bacteria.the in-vitro activity of cefotetan, a new cephamycin, was assessed against a total of 336 strains of anaerobic bacteria by means of an agar dilution procedure and compared with that of cefoxitin, mezlocillin, piperacillin, clindamycin and metronidazole. overall clindamycin and metronidazole were the most active of the test compounds. cefotetan showed good activity against anaerobic cocci and clostridia, except for clostridium difficile (mic90 = 16 mg/l), although it was comparatively less active ...19853861604
effect of imipenem/cilastatin on the colonic microflora.the effect of imipenem/cilastatin on the colonic microflora was investigated in 10 patients receiving the drug for six to 11 days. fecal specimens were cultured quantitatively for aerobic and anaerobic microorganisms before, during, and after therapy. imipenem/cilastatin treatment was associated with minor changes in the colonic flora. a small decrease in the numbers of enterobacteria, enterococci, anaerobic cocci, and organisms of the bacteroides fragilis group was observed. after treatment was ...19853863218
[a clinical study of antibiotic-associated acute hemorrhagic colitis, with special reference of clostridium difficile]. 19853872955
relationship between fecal alpha 1-antitrypsin and colonization with clostridium difficile in asymptomatic infants. 19853874946
studies with temocillin in a hamster model of antibiotic-associated colitis.hamsters given the new penicillin temocillin, either orally or by injection, did not develop antibiotic-associated colitis, whereas animals given the control antibiotics cefoxitin or clindamycin developed the disease, which is characterized by marked hemorrhagic cecitis and high cecal levels of clostridium difficile cytotoxin.19853875312
the pharmacokinetics and safety of ceftazidime in the neonate.the pharmacokinetics and safety of ceftazidime (25 mg/kg twice daily intravenously or intramuscularly) were determined in 41 young, premature neonates who were clinically infected and would otherwise have received gentamicin plus penicillin. ceftazidime was assayed in 46 series of blood samples by hplc. blood was collected before, during and after treatment for analysis of biochemical and haematological factors. faecal specimens were examined for the presence of clostridium difficile and its tox ...19853882658
stool desorbing activity: a possible cause of false-positive reactions in competitive enzyme immunoassays.we have developed a competitive enzyme immunoassay for the measurement of purified toxin a of clostridium difficile. however, when we applied this assay to the detection of c. difficile toxin in stool specimens, we noted a high rate of nonspecific activity in fecal specimens which did not contain toxin. we found that the low specificity (26%) of the assay was due to the presence in stool specimens of interfering factors which desorbed the antigen coated on the solid-phase surface. these factors ...19853882746
pathogenesis of pseudomembranous colitis.this work is concerned with new morphologic data pointing to an immune component in the pathogenesis of pseudomembranous colitis. the focal distribution of the pseudomembranes suggests selective damage induced by clostridium difficile toxins. the sites of attachment to the mucosa correspond anatomically to the intestinal structures specialized for immune information and response. furthermore, viable iga production supports the view that toxins are carried to lymphoid aggregates where plasma cell ...19853885623
studies of metabolites in diarrheal stool specimens containing shigella species by frequency-pulsed electron capture gas-liquid chromatography.eleven diarrheal stool specimens and 10 control stool specimens from cairo, egypt, were studied by frequency-pulsed electron capture gas-liquid chromatography (fpec-glc). four cases involving shigella sonnei, three cases involving shigella boydii, and four cases involving shigella flexneri were studied. the aqueous stools were centrifuged, extracted with organic solvents, and derivatized to form specific electron-capturing derivatives of carboxylic acids, alcohols, hydroxy acids, and amines. ana ...19853886695
increased risk of illness among nursery staff caring for neonates with necrotizing enterocolitis.in 1983 an outbreak of necrotizing enterocolitis (nec) and hemorrhagic gastroenteritis occurred in our newborn nurseries. eleven children were ill and three required bowel resections. during the outbreak many of the medical and nursing staff in the nurseries also were ill, prompting a microbiologic and epidemiologic investigation. bacterial and viral cultures, clostridium difficile toxin assays, enzyme-linked immunosorbent assays for viral antigens and immunoelectron microscopy of stools identif ...19853889874
short-chain fatty acids in intestinal content of germfree mice monocontaminated with escherichia coli or clostridium difficile.the short-chain fatty acids (scfas) have been analysed in coecal and small-intestinal content of conventional (conv) and germfree (gf) mice, in germfree mice monocontaminated with escherichia coli (mec) or clostridium difficile (mcd), and in germfree mice conventionalized by the visitor technique (exg). the total concentrations of scfas in coecal content, measured by gas chromatography, were (mean (sd), mmol/kg): conv, 125.2 (32.9); gf, 1.02 (0.39); mec, 6.88 (0.76); mcd, 4.50 (0.12); and exg, 1 ...19853890142
review of the in vitro spectrum of activity of imipenem.imipenem (n-formimidoyl thienamycin, mk0787), a new carbapenem was found to have the widest antimicrobial activity of currently available beta-lactam drugs. enterobacteriaceae had minimal inhibitory concentrations of imipenem of 8.0 micrograms/ml or less for 99.8 percent of clinical isolates. only rare strains of enterobacter species and proteus mirabilis have higher imipenem minimal inhibitory concentration results. hemophilus and neisseria species were inhibited, but minimal inhibitory concent ...19853890537
management of antibiotic-associated pseudomembranous colitis.the diagnosis, etiology, epidemiology, and drug therapy of antibiotic-associated pseudomembranous colitis (aapmc) are reviewed. aapmc is an uncommon but potentially serious adverse reaction to therapy with almost any oral or injectable antibiotic and certain antineoplastic agents that alter intestinal flora. proliferation of clostridium difficile and subsequent release of clostridial cytotoxins cause pseudomembranous lesions and symptoms such as watery diarrhea, cramping abdominal pain, and low- ...19853891202
treatment of clostridium difficile colitis. 19853899842
the significance of quantitative results of c. difficile cultures and toxin assays in patients with diarrhea.the clinical courses of 114 patients with positive clostridium difficile cultures or toxin assays performed between 1981 and 1984 were reviewed to determine the relationship between outcome of treatment and quantitative bacteriologic test results. c. difficile culture was positive in 60 of 91 patients while toxin assay was positive in 99 of 114. one third of the patients received supportive therapy only, and 30 percent of these failed to resolve their symptoms. ninety-one percent of the patients ...19853902411
an immunochemical method for fingerprinting clostridium difficile.the use of sodium dodecyl sulphate-polyacrylamide gel electrophoresis in association with electrophoretic transfer of proteins to nitrocellulose and subsequent probing with antisera appears useful as a method for fingerprinting clostridium difficile. thorough testing of the stability of the antigenic nature of isolates of the organism during subculture and antigen preparation has shown it to be remarkably stable both in vitro and in vivo. minor differences in the method of antigen extraction do ...19853902977
pathogenesis and diagnosis of clostridium difficile enterocolitis.antibiotic associated clostridium difficile enterocolitis is an infectious disease with symptoms ranging from self-limiting diarrhoea to severe colitis with bloody stools and formation of pseudomembranes. the carrier rate of c. difficile in a general swedish population was found to be low (2%; 11/594). in patients with acute diarrhoea unrelated to antibiotics the bacterium or its toxin was found in 3% (12/398). in patients with diarrhoea associated with antibiotics c. difficile or its toxin was ...19853906856
discovery and development of the monobactams.a novel procedure designed to detect naturally occurring beta-lactam-containing molecules led to isolation of the monobactams - structurally unique, bacterially produced, monocyclic beta-lactam antibiotics. although none of these monobactams exhibited impressive antimicrobial activity, side-chain variation - as with the penicillins and cephalosporins - resulted in potently active compounds. aztreonam was chosen from hundreds of compounds for extended laboratory studies. in addition to a unique c ...19853909315
clinical experience with aztreonam in the treatment of gram-negative bacteremia.aztreonam was used for the treatment of gram-negative bacteremia in 101 patients. in 34 instances a second antibiotic was prescribed for the treatment of suspected or documented gram-positive or anaerobic infection. the sources of bacteremia were the urinary tract (50 patients), an intraabdominal site (17), the respiratory tract (8), an intravascular site (9), and an unknown site (17). the clinical response rate was 92% (91 of 99 patients). the bacteriologic response rate was 97% (98 of 101 pati ...19853909338
cefuroxime versus ceftriaxone prophylaxis in cardiovascular surgery.in a randomized, prospective study a 2-day course of cefuroxime prophylaxis (zinacef, 1.5g every 12 h) was compared with 2-day ceftriaxone prophylaxis (rocephin, 2g i.v. plus 1g i.v. after 24 h). to date 512 patients undergoing cardiac (n = 418) and major vascular surgery (n = 94) entered the study: 258 in the cefuroxime and 254 in the ceftriaxone group. the one-month lethality rate was 1.0%. the total infection rate was 4.7% (12 patients in the cefuroxime and 12 in the cefuroxime group. septica ...19853915287
effects of clostridium difficile toxins given intragastrically to animals.we examined the activities of clostridium difficile toxin preparations given intragastrically to hamsters, mice, and rats. the culture filtrate from a highly toxigenic strain of c. difficile caused hemorrhage and accumulation of fluid in the small intestine and cecum, diarrhea, and death in hamsters and mice. in rats, the culture filtrate caused only a small amount of fluid accumulation and slight hemorrhage along the small intestine. when toxin a was removed from the culture filtrate, the filtr ...19853917975
[isolation of clostridium difficile from specimens other than stool]. 19853923135
[a case of clostridium difficile colitis induced by rifampicin]. 19853925038
in-vitro activity of sch 34343 against nosocomial pathogens: methicillin-resistant staphylococci, gentamicin-susceptible and -resistant streptococcus faecalis, clostridium difficile and bacteroides fragilis.the in-vitro activity of sch 34343, a new beta-lactam antimicrobial, was studied in vitro by quantitative broth dilution methods. it was found to have good antibacterial activity against four emerging problem pathogens: methicillin-resistant staphylococcus aureus, streptococcus faecalis isolates showing high level resistance to gentamicin (and other aminoglycosides), clostridium difficile (the cause of pseudomembranous colitis), and bacteroides fragilis. on the basis of these promising results, ...19853928577
clostridium difficile colitis mimicking acute peritonitis.five patients receiving penicillin v potassium or a cephalosporin antibiotic for 18 hours to 22 days developed fever, marked leukocytosis, and signs and symptoms that suggested right-lower-quadrant peritoneal irritation. all underwent emergency laparotomy, at which dilatation and inflammation of the ascending colon were found. only one of the patients had profuse diarrhea, and two patients had no diarrhea prior to laparotomy. postoperatively, clostridium difficile colitis was diagnosed by stool ...19853931611
[significance of ureaplasma urealyticum and clostridium difficile in nongonococcal urethritis]. 19853932554
[the effect of prostaglandins on cytotoxin and enterotoxin production of clostridium difficile]. 19853936886
antimicrobial activity of aridicins, novel glycopeptide antibiotics with high and prolonged levels in blood.three new glycopeptide antibiotics, aridicins a, b, and c, produced by kibdelosporangium aridum have a spectrum of antimicrobial activity in vitro which is similar to that of vancomycin. the antimicrobial activities of these glycopeptides against clinical bacterial isolates were compared with those of vancomycin and other related glycopeptide antibiotics in vitro by agar dilution and microtiter broth dilution tests and in vivo in mouse protection studies. in vitro they were somewhat less effecti ...19853937489
p-cresol formation by cell-free extracts of clostridium difficile.cell-free extracts of clostridium difficile were shown to form p-cresol by decarboxylation of p-hydroxyphenylacetic acid. this activity required both high and low molecular weight fractions. the active component of the low molecular weight fraction had properties of an amino acid and could be replaced by serine, threonine or the corresponding alpha keto acids. pyruvate was shown to function catalytically. since the high molecular weight fraction was o2-sensitive and since dithionite was as effec ...19853938267
[demonstration of clostridium difficile and toxin b in patients at a university clinic].107 stool specimens from not hospitalized individuals and 69 stool specimens from 61 hospitalized patients (internal medicine) were examined for c. difficile and toxin b. included were 42 specimens of 33 female patients of the department of maxillo-facial surgery, receiving prophylactic clindamycin and 7 samples from the ward staff. from the samples of the first group, c. difficile was isolated in one case (0.93%), whereas 8 out of 61 internal patients (13%) were positive for c. difficile by cul ...19853939049
[enterocolitis caused by clostridium difficile. analysis of 15 cases in adults].each of 48 patients with suspected clostridium difficile enterocolitis after treatment with antibiotics underwent a faecal test in which a clostridium difficile culture was set up and a cytotoxin test carried out. the detection of clostridium difficile was positive in 15 cases. diarrhoea with varying severity was present in all patients, most frequently after medication with the newer cephalosporins. nine patients also underwent rectoscopy: a typical pseudo-membranous colitis was seen only in 5 ...19863940837
the epidemiology of clostridium difficile with use of a typing scheme: nosocomial acquisition and cross-infection among immunocompromised patients. 19863941281
testing for clostridium difficile. 19863941630
clostridium difficile-associated diarrhea and colitis in adults. a prospective case-controlled epidemiologic study.in a one-year period, 149 adult cases of clostridium difficile-associated diarrhea and colitis were compared with 148 diarrhea-free controls. eighty-seven percent were nosocomial and 75% were on surgical services. endoscopy revealed pseudomembranes in 51% of the 109 cases in which stool cytotoxin was present, compared with 11% of the 40 cases that were culture-positive but cytotoxin-negative. cases diagnosed only by stool culture showed essentially no differences from controls, 21% of whom had a ...19863942469
clostridium difficile colitis/diarrhea. 19863942643
Displaying items 801 - 900 of 12134