| clostridium difficile infections in hiv-positive patients with diarrhoea. | patients with hiv/aids are at a high risk of being infected with toxin-producing strains of clostridium difficile (c. difficile) because of frequent hospitalization, exposure to antibiotics and antibiotic prophylaxis for opportunistic infections. there are little data from india on the prevalence of c. difficile infection in such patients. | 2015 | 25668083 |
| neuronal apoptosis induced by selective inhibition of rac gtpase versus global suppression of rho family gtpases is mediated by alterations in distinct mitogen-activated protein kinase signaling cascades. | rho family gtpases play integral roles in neuronal differentiation and survival. we have shown previously that clostridium difficile toxin b (toxb), an inhibitor of rhoa, rac1, and cdc42, induces apoptosis of cerebellar granule neurons (cgns). in this study, we compared the effects of toxb to a selective inhibitor of the rac-specific guanine nucleotide exchange factors tiam1 and trio (nsc23766). in a manner similar to toxb, selective inhibition of rac induces cgn apoptosis associated with enhanc ... | 2015 | 25666619 |
| the detection rate of enteric viruses and clostridium difficile in a waste water treatment plant effluent. | waste water treatment plant (wwtp) is considered as an important source of surface water contamination by enteric pathogens. in this study, we describe the occurrence of enteric viruses (group a rotaviruses, noroviruses, astroviruses, sapoviruses, hepatitis a virus, and hepatitis e virus) and clostridium difficile in the effluent of a wastewater treatment plant during a 1-year period. enteric viruses were simultaneously and efficiently concentrated in a single step using methacrylate monolithic ... | 2015 | 25663146 |
| is obesity a risk factor for clostridium difficile infection? | the epidemiology of clostridium difficile infection (cdi) has become an important area of investigation, especially in light of the global increase in both hospital-acquired (ha) and community-acquired (ca) cdi. recently, obesity was found to be associated with cdi and was suggested to represent an independent risk factor for it. | 2015 | 25660175 |
| the role of flagella in clostridium difficile pathogenicity. | clostridium difficile is widely publicised as a problem in the health-care system. disruption of the normal gut microbiota by antibiotic therapy allows c. difficile to colonise the colon. on colonisation, c. difficile produces two toxins that lead to disease, with symptoms ranging from mild-to-severe diarrhoea, to fulminant and often fatal pseudomembranous colitis (pmc). how c. difficile establishes initial colonisation of the host is an area of active investigation. recently there has been incr ... | 2015 | 25659185 |
| pulsed faecal microbiota transplantation for recalcitrant recurrent clostridium difficile infection. | | 2015 | 25658573 |
| recurrent clostridium difficile infection is associated with increased mortality. | clostridium difficile infections (cdi) are associated with decreased survival, and up to 30% of cdi patients may experience a recurrence. data on the impact of recurrent cdi on mortality are scarce. the purpose of this study was to determine whether recurrent cdi was independently associated with decreased 6-month survival compared with patients with cdi who did not develop a recurrence. we performed a retrospective cohort study at an academic, urban, tertiary care hospital. data were collected ... | 2015 | 25658560 |
| predicting the risk of clostridium difficile infection following an outpatient visit: development and external validation of a pragmatic, prognostic risk score. | increasing morbidity related to clostridium difficile infection (cdi) has heightened interest in the identification of patients who would most benefit from recognition of risk and intervention. we sought to develop and validate a prognostic risk score to predict cdi risk for individual patients following an outpatient healthcare visit. we assembled a cohort of kaiser permanente northwest (kpnw) patients with an index outpatient visit between 2005 and 2008, and identified cdi in the year followin ... | 2015 | 25658533 |
| burdening questions about clostridium difficile in pediatric inflammatory bowel diseases. | | 2015 | 25658059 |
| a prediction model for clostridium difficile recurrence. | clostridium difficile infection (cdi) is a growing problem in the community and hospital setting. its incidence has been on the rise over the past two decades, and it is quickly becoming a major concern for the health care system. high rate of recurrence is one of the major hurdles in the successful treatment of c. difficile infection. there have been few studies that have looked at patterns of recurrence. the studies currently available have shown a number of risk factors associated with c. dif ... | 2015 | 25656667 |
| manganese superoxide dismutase from human pathogen clostridium difficile. | clostridium difficile is a human pathogen that causes severe antibiotic-associated clostridium difficile infection (cdi). herein the mnsodcd from c. difficile was cloned, expressed in escherichia coli,and characterized by x-ray crystallography, uv/vis and epr spectroscopy, and activity assay, et al. the crystal structure of mnsodcd (2.32 å) reveals a manganese coordination geometry of distorted trigonal bipyramidal, with his111, his197 and asp193 providing the equatorial ligands and with his56 a ... | 2015 | 25655385 |
| emergence of an outbreak-associated clostridium difficile variant with increased virulence. | the prevalence of clostridium difficile infections has increased due to the emergence of epidemic variants from diverse genetic lineages. here we describe the emergence of a novel variant during an outbreak in a costa rican hospital that was associated with severe clinical presentations. this c. difficile variant elicited higher white blood cell counts and caused disease in younger patients than did other strains isolated during the outbreak. furthermore, it had a recurrence rate, a 30-day attri ... | 2015 | 25653402 |
| in vitro susceptibility of clostridium difficile to smt19969 and comparators, as well as the killing kinetics and post-antibiotic effects of smt19969 and comparators against c. difficile. | smt19969 is a novel antimicrobial under clinical development for the treatment of clostridium difficile infection (cdi). the objective was to determine the comparative susceptibility of 82 c. difficile clinical isolates (which included ribotype 027 isolates and isolates with reduced metronidazole susceptibility) to smt19969, fidaxomicin, vancomycin and metronidazole and to determine the killing kinetics and post-antibiotic effects of smt19969, fidaxomicin and vancomycin against c. difficile. | 2015 | 25652750 |
| smt19969 for clostridium difficile infection (cdi): in vivo efficacy compared with fidaxomicin and vancomycin in the hamster model of cdi. | smt19969 is a novel narrow-spectrum antimicrobial under development for the treatment of clostridium difficile infection (cdi). the objectives were to assess the relative efficacies of smt19969, vancomycin and fidaxomicin in the hamster model of cdi. | 2015 | 25652749 |
| environmental transmission of clostridium difficile: association between hospital room size and c. difficile infection. | to evaluate the association between hospital room square footage and acquisition of nosocomial clostridium difficile infection (cdi). | 2015 | 25652311 |
| manipulating the gut microbiota to maintain health and treat disease. | the intestinal microbiota composition varies between healthy and diseased individuals for numerous diseases. although any cause or effect relationship between the alterations in the gut microbiota and disease is not always clear, targeting the intestinal microbiota might offer new possibilities for prevention and/or treatment of disease. | 2015 | 25651995 |
| current status of the treatment of fulminant colitis. | fulminant colitis is not a well-defined entity, that constitutes a severe complication. it usually occurs in the course of úlcerative colitis and clostridium difficile colitis. a multidisciplinary management combining gastroenterologist and surgeons is crucial with intensive medical treatment and early surgery in non-responders. it is important to distinguish if we are facing a flare of ibd or, on the contrary, it is an infectious colitis, due to the fact that although general therapeutic measur ... | 2015 | 25649534 |
| clostridium difficile surface proteins are anchored to the cell wall using cwb2 motifs that recognise the anionic polymer psii. | gram-positive surface proteins can be covalently or non-covalently anchored to the cell wall and can impart important properties on the bacterium in respect of cell envelope organisation and interaction with the environment. we describe here a mechanism of protein anchoring involving tandem cwb2 motifs found in a large number of cell wall proteins in the firmicutes. in the clostridium difficile cell wall protein family, we show the three tandem repeats of the cwb2 motif are essential for correct ... | 2015 | 25649385 |
| high temporal resolution of glucosyltransferase dependent and independent effects of clostridium difficile toxins across multiple cell types. | clostridium difficile toxins a and b (tcda and tcdb), considered to be essential for c. difficile infection, affect the morphology of several cell types with different potencies and timing. however, morphological changes over various time scales are poorly characterized. the toxins' glucosyltransferase domains are critical to their deleterious effects, and cell responses to glucosyltransferase-independent activities are incompletely understood. by tracking morphological changes of multiple cell ... | 2015 | 25648517 |
| acid-suppressing agents and risk for clostridium difficile infection in pediatric patients. | acid-suppressing agents have been associated with increased clostridium difficile infection (cdi) in adults. the objective of this study was to evaluate the association of acid-suppressing therapy with the development of cdi in the pediatric population. | 2015 | 25644650 |
| diagnosis and management of clostridium difficile infection. | there have been dramatic changes in the epidemiology of clostridium difficile infection (cdi), with increases in incidence and severity of disease, attributed to the emergence of a fluoroquinolone-resistant "hypervirulent" strain, ribotype 027. c. difficile is now the most common pathogen causing hospital-acquired infection in u.s. hospitals, and community-acquired infections are increasing. the diagnosis of cdi is based on a combination of signs and symptoms, confirmed by laboratory tests. clin ... | 2015 | 25643269 |
| prevalence and risk factors associated with clostridium difficile shedding in veal calves in italy. | the aim of this study is to describe the prevalence and risk factors of clostridium difficile shedding in six farms belonging to two companies in northern italy. four hundred and twenty veal calves, randomly selected and individually identified, were sampled three times: at 0-16, 90-120, and 150 days after introduction. c. difficile was isolated at least once from 87 out of the 420 calves (20.7%). the prevalence of shedding was 20.24% at the first sampling and dropped to 0.72% at the second samp ... | 2015 | 25638401 |
| role of obesity and adipose tissue-derived cytokine leptin during clostridium difficile infection. | obesity is among the most pressing health concerns in the world since it is increasingly common even in the developing world, and is clearly associated with increased risk for chronic debilitating diseases and death. furthermore, obesity can influence the pathogenesis of infectious diseases by affecting the balance of pathogen clearance and pathological inflammation. the mechanisms that result in enhanced inflammation in obese individuals are poorly understood. clostridium difficile is a major c ... | 2015 | 25638400 |
| how to eradicate clostridium difficile from the environment. | during the last decade, clostridium difficile has emerged as a major cause of healthcare-associated diarrhoea and death. transmission of this spore-forming bacterium is thought to occur via the hands of healthcare providers or via the contaminated environment. therefore, enhanced environmental cleaning/disinfection of the rooms housing c. difficile-infected patients is warranted. guidelines from various scientific bodies have been published. they recommend performing environmental decontaminatio ... | 2015 | 25638358 |
| [acute diarrhea after kidney or kidney-pancreas transplantation]. | diarrhea is a frequent and potentially severe complication of kidney transplantation. we describe here, in a cross-sectional study, the epidemiological and microbiological characteristics of acute and persistent diarrhea in 52 inpatients with kidney and kidney-pancreas transplant in a hospital in buenos aires, 42 (80.8%) of whom had received a kidney and 10 (19.2%) a kidney-pancreas transplant. diarrhea was the reason of admission of 34 cases (65.4%). the etiology could be studied in 50 patients ... | 2015 | 25637897 |
| comparing the economic and health benefits of different approaches to diagnosing clostridium difficile infection. | accurate diagnosis of clostridium difficile infection (cdi) is essential to effectively managing patients and preventing transmission. despite the availability of several diagnostic tests, the optimal strategy is debatable and their economic values are unknown. we modified our previously existing c. difficile simulation model to determine the economic value of different cdi diagnostic approaches from the hospital perspective. we evaluated four diagnostic methods for a patient suspected of having ... | 2015 | 25636938 |
| rectal bacteriotherapy for recurrent clostridium difficile-associated diarrhoea: results from a case series of 55 patients in denmark 2000-2012. | clostridium difficile infection is one of the most common nosocomial infections. among other alternatives to standard treatment with vancomycin for recurrent infection are faecal microbiota transplantation and rectal bacteriotherapy with a fixed mixture of intestinal bacterial strains isolated from faeces of healthy persons to mimic a theoretical normal microflora. developed by dr. tvede and dr. rask-madsen, the latter method has been in use for selected patients during the last 25 years in denm ... | 2015 | 25636927 |
| complete genome sequence of the clostridium difficile laboratory strain 630δerm reveals differences from strain 630, including translocation of the mobile element ctn5. | clostridium difficile strain 630δerm is a spontaneous erythromycin sensitive derivative of the reference strain 630 obtained by serial passaging in antibiotic-free media. it is widely used as a defined and tractable c. difficile strain. though largely similar to the ancestral strain, it demonstrates phenotypic differences that might be the result of underlying genetic changes. here, we performed a de novo assembly based on single-molecule real-time sequencing and an analysis of major methylation ... | 2015 | 25636331 |
| gut check: clostridium difficile testing and treatment in the molecular testing era. | we evaluated the impact of nursing education and stewardship interventions on clostridium difficile testing and treatment appropriateness. diarrhea documentation increased for those with positive tests (45% to 70%); pretreatment laxative use decreased (50% to 19%). appropriate treatment increased for severe infection (57% to 93%), but all asymptomatically colonized patients were treated. | 2015 | 25633006 |
| evaluation of a pulsed xenon ultraviolet disinfection system for reduction of healthcare-associated pathogens in hospital rooms. | objective to determine the effectiveness of a pulsed xenon ultraviolet (px-uv) disinfection device for reduction in recovery of healthcare-associated pathogens. setting two acute-care hospitals. methods we examined the effectiveness of px-uv for killing of clostridium difficile spores, methicillin-resistant staphylococcus aureus (mrsa), and vancomycin-resistant enterococcus (vre) on glass carriers and evaluated the impact of pathogen concentration, distance from the device, organic load, and sha ... | 2015 | 25633002 |
| comorbidities, exposure to medications, and the risk of community-acquired clostridium difficile infection: a systematic review and meta-analysis. | clostridium difficile infection (cdi) has been extensively described in healthcare settings; however, risk factors associated with community-acquired (ca) cdi remain uncertain. this study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with ca-cdi. | 2015 | 25632995 |
| a comparison between national healthcare safety network laboratory-identified event reporting versus traditional surveillance for clostridium difficile infection. | objective hospitals in the national healthcare safety network began reporting laboratory-identified (labid) clostridium difficile infection (cdi) events in january 2013. our study quantified the differences between the labid and traditional surveillance methods. design cohort study. setting a cohort of 29 community hospitals in the southeastern united states. methods a period of 6 months (january 1, 2013, to june 30, 2013) of prospectively collected data using both labid and traditional surveill ... | 2015 | 25632994 |
| evaluation of portability and cost of a fluorescent pcr ribotyping protocol for clostridium difficile epidemiology. | clostridium difficile is the most commonly identified pathogen among health care-associated infections in the united states. there is a need for accurate and low-cost typing tools that produce comparable data across studies (i.e., portable data) to help characterize isolates during epidemiologic investigations of c. difficile outbreaks and sporadic cases of disease. the most popular c. difficile-typing technique is pcr ribotyping, and we previously developed methods using fluorescent pcr primers ... | 2015 | 25631804 |
| surveillance snapshot of clostridium difficile infection in hospitals across queensland detects binary toxin producing ribotype uk 244. | in north america and europe, the binary toxin positive clostridium difficile strains of the ribotypes 027 and 078 have been associated with death, toxic megacolon and other adverse outcomes. following an increase in c. difficile infections (cdis) in queensland, a prevalence study involving 175 hospitals was undertaken in early 2012, identifying 168 cases of cdi over a 2 month period. patient demographics and clinical characteristics were recorded, and c. difficile isolates were ribotyped and tes ... | 2014 | 25631588 |
| antibiotic therapy for acute uncomplicated pyelonephritis in women. take resistance into account. | acute uncomplicated pyelonephritis is a bacterial infection of the renal parenchyma, common in women. the bacterium responsible is usually escherichia coli. empirical antibiotic therapy should be initiated promptly to prevent serious complications. as of 2014, which empirical antibiotic regimen should be offered to non-pregnant adult women with acute uncomplicated pyelonephritis, while awaiting the results of antimicrobial susceptibility testing? we reviewed the available evidence using the stan ... | 2014 | 25629148 |
| low colonization rates of clostridium difficile among patients and healthcare workers at örebro university hospital in sweden. | the aim of this study was to investigate the rate of asymptomatic colonization rate of clostridium difficile among both healthcare workers (hcws) and patients in a hospital ward in sweden. in a prospective observational study, asymptomatic hcws (n = 22) (22/60; 37%) attending patients in an infectious disease ward in sweden participated and were screened once for c. difficile. at the same time, 58 consecutive patients (58/227; 26%) admitted to the same ward were screened for c. difficile, first ... | 2015 | 25627981 |
| low incidence of clostridium difficile infection (cdi) in patients treated with outpatient parenteral antimicrobial therapy (opat). | | 2015 | 25627769 |
| postoperative burden of hospital-acquired clostridium difficile infection. | objective clostridium difficile infection (cdi) is a common hospital-acquired infection. previous reports on the incidence, risk factors, and impact of cdi on resources in the surgical population are limited. in this context, we study cdi across diverse surgical settings. methods we prospectively identified patients with laboratory-confirmed postoperative cdi after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between july 2012 and september 2013 ... | 2015 | 25627760 |
| clostridium difficile the hospital plague. | clostridium difficile infection (cdi) has become one of the major public health threats in the last two decades. an increase has been observed not only in the rate of cdi, but also in its severity and mortality. symptoms caused by this pathogen are accompanied by intense local and systemic inflammation. we confirmed that raman microspectroscopy can help us in understanding cdi pathogenesis. a single erythrocyte of patients with cdi shows a difference, approximately 10 times, in the intensity of ... | 2015 | 25627751 |
| non-inferiority of pulsed xenon uv light versus bleach for reducing environmental clostridium difficile contamination on high-touch surfaces in clostridium difficile infection isolation rooms. | the standard for clostridium difficile surface decontamination is bleach solution at a concentration of 10 % of sodium hypochlorite. pulsed xenon uv light (px-uv) is a means of quickly producing germicidal uv that has been shown to be effective in reducing environmental contamination by c. difficile spores. the purpose of this study was to investigate whether px-uv was equivalent to bleach for decontamination of surfaces in c. difficile infection isolation rooms. high-touch surfaces in rooms pre ... | 2015 | 25627208 |
| acute gastroenteritis due to co-infection by salmonella and clostridium difficile. | | 2015 | 25626957 |
| inflammasome activation contributes to interleukin-23 production in response to clostridium difficile. | clostridium difficile is the most common hospital-acquired pathogen, causing antibiotic-associated diarrhea in over 250,000 patients annually in the united states. disease is primarily mediated by toxins a and b, which induce potent proinflammatory signaling in host cells and can activate an asc-containing inflammasome. recent findings suggest that the intensity of the host response to infection correlates with disease severity. our lab has identified the proinflammatory cytokine interleukin-23 ... | 2015 | 25626905 |
| risk factors for recurrent clostridium difficile infection: a systematic review and meta-analysis. | an estimated 20-30% of patients with primary clostridium difficile infection (cdi) develop recurrent cdi (rcdi) within 2 weeks of completion of therapy. while the actual mechanism of recurrence remains unknown, a variety of risk factors have been suggested and studied. the aim of this systematic review and meta-analysis was to evaluate current evidence on the risk factors for rcdi. | 2015 | 25626326 |
| diagnosis and treatment of clostridium difficile in adults: a systematic review. | since 2000, the incidence and severity of clostridium difficile infection (cdi) have increased. | 2015 | 25626036 |
| tigecycline exhibits inhibitory activity against clostridium difficile in the intestinal tract of hospitalised patients. | no new acquisition of clostridium difficile occurred among 12 hospitalised patients receiving tigecycline, and pre-existing colonisation was reduced to undetectable levels in 2 patients. moreover, 91% of stool suspensions obtained during tigecycline therapy exhibited inhibitory activity against c. difficile. these results suggest that tigecycline achieves sufficient concentrations to inhibit intestinal colonisation by c. difficile. | 2015 | 25623897 |
| meropenem versus piperacillin-tazobactam for definitive treatment of bloodstream infections due to ceftriaxone non-susceptible escherichia coli and klebsiella spp (the merino trial): study protocol for a randomised controlled trial. | gram-negative bacteria such as escherichia coli or klebsiella spp. frequently cause bloodstream infections. there has been a worldwide increase in resistance in these species to antibiotics such as third generation cephalosporins, largely driven by the acquisition of extended-spectrum beta-lactamase or plasmid-mediated ampc enzymes. carbapenems have been considered the most effective therapy for serious infections caused by such resistant bacteria; however, increased use creates selection pressu ... | 2015 | 25623485 |
| prolonged clostridium difficile infection may be associated with vitamin d deficiency. | clostridium difficile infection (cdi) is one of the leading causes of hospital-acquired infections, creating a financial burden for the u.s. healthcare system. reports suggest that vitamin d-deficient cdi patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. the objective here was to evaluate the relationship between vitamin d level and cdi recurrence. | 2016 | 25623479 |
| faecal microbiota transplantation in clostridium difficile infections. | | 2015 | 25623242 |
| risk of clostridium difficile infection in intensive care unit patients with sepsis exposed to metronidazole. | antimicrobial agents used to treat clostridium difficile infection (cdi), such as metronidazole and vancomycin, have been used during antibiotic treatment of other infections to try to prevent the development of cdi. we evaluated the hypothesis that intensive care unit (icu) patients who receive metronidazole as part of an antibiotic treatment regimen for sepsis have a lower risk of subsequently developing cdi. | 2015 | 25622943 |
| novel multiplex format of an extended multilocus variable-number-tandem-repeat analysis of clostridium difficile correlates with tandem repeat sequence typing. | subtyping of clostridium difficile is crucial for outbreak investigations. an extended multilocus variable-number tandem-repeat analysis (emlva) of 14 variable number tandem repeat (vntr) loci was validated in multiplex format compatible with a routine typing laboratory and showed excellent concordance with tandem repeat sequence typing (trst) and high discriminatory power. | 2015 | 25620018 |
| small molecule inhibitors of clostridium difficile toxin b-induced cellular damage. | clostridium difficile causes life-threatening diarrhea through the actions of its homologous toxins tcda and tcdb on human colonocytes. therapeutic agents that block toxin-induced damage are urgently needed to prevent the harmful consequences of toxin action that are not addressed with current antibiotic-based treatments. here, we developed an imaging-based phenotypic screen to identify small molecules that protected human cells from tcdb-induced cell rounding. a series of structurally diverse c ... | 2015 | 25619932 |
| in vivo bacterial imaging without engineering; a novel probe-based strategy facilitated by endogenous nitroreductase enzymes. | the feasibility of utilising bacteria as vectors for gene therapy is becoming increasingly recognised. this is primarily due to a number of intrinsic properties of bacteria such as their tumour targeting capabilities, their ability to carry large genetic or protein loads and the availability of well-established genetic engineering tools for a range of common lab strains. however, a number of issues relating to the use of bacteria as vectors for gene therapy need to be addressed in order for the ... | 2015 | 25619884 |
| adverse drug reactions in special populations - the elderly. | the international conference on harmonization considers older people a 'special population', as they differ from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics and greater vulnerability to adverse drug reactions (adrs). medical practice is often based on single disease guidelines derived from clinical trials that have not included frail older people or those with multiple morbidities. this presents a challenge caring for older people, as drug doses in trials may not be ac ... | 2015 | 25619317 |
| use of tigecycline in elderly patients for clostridium difficile infection. | | 2015 | 25619268 |
| comparison of antibiotic prophylaxis with cotrimoxazole/colistin (cot/col) versus ciprofloxacin (cip) in patients with acute myeloid leukemia. | recent meta-analyses showed that antibiotic prophylaxis in patients with neutropenia after chemotherapy reduced the incidence of fever and mortality rate. fluoroquinolones appear to be most effective and well tolerated. thus, in april 2008, we changed our antibiotic prophylaxis regimen from cotrimoxazole/colistin (cot/col) to the fluoroquinolone ciprofloxacin (cip) in patients with acute myeloid leukemia (aml). the aim of this retrospective study was to compare efficacy and development of bacter ... | 2015 | 25617073 |
| comparison of bd max cdiff and genomera c. difficile molecular assays for detection of toxigenic clostridium difficile from stools in conventional sample containers and in fecalswabs. | in this study, the usability and performance of genomera™ c. difficile and bd max™ cdiff nucleic acid amplification tests (naats) for the detection of toxigenic clostridium difficile were investigated in comparison with toxigenic culture and c. difficile toxin a- and toxin b-detecting immunochromatographic antigen (ia) test, the tox a/b quikchek®. in total, 302 faecal specimens were collected, 113 of which were in parallel to conventional sample containers and fecalswab liquid-based microbiology ... | 2015 | 25616552 |
| exposure of neutralizing epitopes in the carboxyl-terminal domain of tcdb is altered by a proximal hypervariable region. | the sequence, activity, and antigenicity of tcdb varies between different strains of clostridium difficile. as a result, ribotype-specific forms of tcdb exhibit different toxicities and are not strongly cross-neutralized. using a combination of biochemical and immunological approaches, we compared two important variants of tcdb (tcdb012 and tcdb027) to identify the mechanisms through which sequence differences alter epitopes and activity of the toxin. these analyses led to the discovery of a cri ... | 2015 | 25614625 |
| luminal toxin-binding agents for clostridium difficile infection. | to systematically search the literature for trials evaluating luminal toxin-binding agents (ltbas) for clostridium difficile infection (cdi). | 2016 | 25613056 |
| the preventive antibiotics in stroke study (pass): a pragmatic randomised open-label masked endpoint clinical trial. | in adults with acute stroke, infections occur commonly and are associated with an unfavourable functional outcome. in the preventive antibiotics in stroke study (pass) we aimed to establish whether or not preventive antimicrobial therapy with a third-generation cephalosporin, ceftriaxone, improves functional outcome in patients with acute stroke. | 2015 | 25612858 |
| clostridium difficile ileitis in pediatric inflammatory bowel disease: a case report and literature review. | | 2015 | 25611030 |
| supervised self-administration of outpatient parenteral antibiotic therapy: a report from a large tertiary hospital in australia. | outpatient parenteral antibiotic therapy (opat) has become established as a standard of care in most australian hospitals to treat a variety of infections. since 1998, the alternate site infusion service (asis) has provided an opat service to five hospitals in southern brisbane, queensland, using predominantly a patient or carer administration model (self-administered, s-opat). the aim of this study was to evaluate outcomes of our s-opat programme. | 2015 | 25603999 |
| risk factors for clostridium difficile diarrhea in patients with inflammatory bowel disease. | despite the growing incidence of clostridium difficile diarrhea (ccd) in patients with inflammatory bowel disease (ibd), little is known about the associated risk factors. | 2015 | 25603325 |
| clostridium difficile infection in inflammatory bowel disease. | | 2015 | 25603324 |
| chlorhexidine bathing and health care-associated infections: a randomized clinical trial. | daily bathing of critically ill patients with the broad-spectrum, topical antimicrobial agent chlorhexidine is widely performed and may reduce health care-associated infections. | 2015 | 25602496 |
| targeted localized use of therapeutic antibodies: a review of non-systemic, topical and oral applications. | therapeutic antibodies provide important tools in the "medicine chest" of today's clinician for the treatment of a range of disorders. typically monoclonal or polyclonal antibodies are administered in large doses, either directly or indirectly into the circulation, via a systemic route which is well suited for disseminated ailments. diseases confined within a specific localized tissue, however, may be treated more effectively and at reduced cost by a delivery system which targets directly the af ... | 2016 | 25600465 |
| the role of bifidobacterium lactis b94 plus inulin in the treatment of acute infectious diarrhea in children. | in contrast to many other studies of probiotic species, the number of publications evaluating bifidobacterium lactis and its combinations with prebiotics as treatments for acute infectious diarrhea is limited. we investigated the synbiotic effects of b. lactis b94 plus inulin on acute infectious diarrhea. | 2014 | 25599772 |
| clostridium difficile infection and inflammatory bowel disease. | over the past 15 years, clostridium difficile infection (cdi) in patients with inflammatory bowel disease (ibd) has increased both in incidence and severity. traditional risk factors for cdi are similar in ibd and non-ibd populations, but there is a significant proportion of ibd patients which have distinctive characteristics. patients with ulcerative colitis (uc) are more susceptible to cdi and have more severe outcomes than those with crohn's disease (cd). cdi may be difficult to distinguish f ... | 2014 | 25599768 |
| a possible route for foodborne transmission of clostridium difficile? | spores of toxigenic clostridium difficile and spores of food-poisoning strains of clostridium perfringens show a similar prevalence in meats. spores of both species are heat resistant and can survive cooking of foods. c. perfringens is a major cause of foodborne illness; studies are needed to determine whether c. difficile transmission by a similar route is a cause of infection. | 2015 | 25599421 |
| fecal microbiota transplantation for clostridium difficile infection: the ochsner experience. | clostridium difficile infection (cdi) accounts for 20%-30% of cases of antibiotic-associated diarrhea and is the most commonly recognized cause of infectious diarrhea in healthcare settings. the incidence of cdi is rising, while the effectiveness of antibiotics for treatment decreases with recurrent episodes. the use of fecal microbiota transplantation (fmt) for cure of cdi has been reported since 1958, and the worldwide cure rate is reported to be 93%. we report our experience with fmt for the ... | 2014 | 25598718 |
| emergence of toxin a-negative, toxin b-positive clostridium difficile strains: epidemiological and clinical considerations. | | 2015 | 25598331 |
| selection of nanobodies that block the enzymatic and cytotoxic activities of the binary clostridium difficile toxin cdt. | the spore-forming gut bacterium clostridium difficile is the leading cause of antibiotic-associated diarrhea in hospitalized patients. the major virulence factors are two large glucosylating cytotoxins. hypervirulent strains (e.g. ribotype 027) with higher morbidity and mortality additionally produce the binary cdt toxin (clostridium difficile transferase) that adp-ribosylates actin and induces microtubule-based cell protrusions. nanobodies are robust single domain antibodies derived from cameli ... | 2015 | 25597743 |
| metronidazole-induced encephalopathy after prolonged metronidazole course for treatment of c. difficile colitis. | a 65-year-old woman with a diagnosis of clostridium difficile colitis undergoing prolonged treatment with metronidazole was admitted to hospital for altered mentation, slurred speech and weakness. she was diagnosed with metronidazole-induced encephalopathy, confirmed with brain mri and improved when the offending agent was removed. this case report highlights encephalopathy as a complication of prolonged metronidazole treatment, which has become more common in clinical practice for the treatment ... | 2015 | 25596288 |
| risk factors, outcomes and epidemiology associated with clostridium difficile infection in patients with haematological malignancies in a tertiary care hospital in china. | the purpose of this study was to evaluate the risk factors, outcomes and epidemiology associated with clostridium difficile infection (cdi) in patients with haematological malignancies in a tertiary care hospital in china. c. difficile screening was performed on patients admitted for chemotherapy or haematopoietic stem cell transplantation between 2009 and 2013. c. difficile isolates were analysed by multilocus sequence typing, and a retrospective chart review was performed on all patients with ... | 2015 | 25596117 |
| management of severe ulcerative colitis. | acute severe steroid-refractory ulcerative colitis (asuc) provides challenges for physicians and surgeons who manage these patients. when a patient is diagnosed with asuc, they should be admitted for inpatient management including intravenous corticosteroids, venous thromboembolism prophylaxis, oral or enteral feeding if tolerated, and exclusion of infection including clostridium difficile. failure to improve by day 3 of corticosteroids requires escalation to medical rescue therapies such as inf ... | 2015 | 25595929 |
| colonization versus carriage of clostridium difficile. | asymptomatic carriage of toxigenic strains of clostridium difficile is common in health care facilities and the community. however, infection control efforts have traditionally focused almost entirely on symptomatic patients. there is now growing concern that asymptomatic carriers may be an underappreciated source of transmission. this article provides an overview of the pathogenesis and epidemiology of c difficile colonization, reviews the evidence that asymptomatic carriers shed spores and con ... | 2015 | 25595843 |
| diagnostic pitfalls in clostridium difficile infection. | accurate diagnosis of clostridium difficile infection (cdi) is important not only for patient care but also for epidemiology and disease research. as it is not possible clinically to reliably differentiate cdi from other causes of health care-associated diarrhea, the laboratory confirmation of cdi is essential. rapid commercial assays, including nucleic acid amplification tests and immunoassays for c difficile toxin and glutamate dehydrogenase, have largely superseded the use of older assays. al ... | 2015 | 25595842 |
| phosphatidylcholine and the intestinal mucus layer: in vitro efficacy against clostridium difficile-associated polymorphonuclear neutrophil activation. | phosphatidylcholine (pc), an important component of intestinal mucus, protects against clostridium difficile toxin-induced intestinal barrier injury in vitro. polymorphonuclear neutrophil (pmn) activation may contribute to intestinal injury and systemic toxicity in patients with c. difficile-associated disease. we therefore hypothesized that the intestinal barrier function against c. difficile toxin by exogenous pc would ameliorate pmn activation. | 2015 | 25595713 |
| media discourse on the social acceptability of fecal transplants. | advances in human microbiome research have generated considerable interest in elucidating the role of bacteria in health and the application of microbial ecosystem therapies and probiotics. fecal transplants involve the introduction of gut microbes from a healthy donor's stool to the patient and have been documented as effective for treating clostridium difficile infections (cdis) and some other gastrointestinal disorders. however, the treatment has encountered regulatory hurdles preventing wide ... | 2015 | 25595150 |
| trend, risk factors, and costs of clostridium difficile infections in vascular surgery. | starting in december 2013, the hospital inpatient quality reporting program included clostridium difficile infection (cdi) rates as a new publically reported quality measure. our goal was to review the trend, hospital variability in cdi rates, and associated risk factors and costs in vascular surgery. | 2015 | 25595110 |
| appendectomy: a risk factor for colectomy in patients with clostridium difficile. | the appendix, considered an intestinal microbiota reservoir, may be protective against the risk of fulminant clostridium difficile infection. | 2015 | 25588621 |
| treatment of recurrent and severe clostridium difficile infection. | clostridium difficile infection (cdi) is a serious complication of hospitalization and antibiotic use with a high mortality and very high costs. despite appropriate treatment, a subset of patients develop chronic recurrent cdi. some other patients develop severe and life-threatening colitis. the risk factors, pathogenesis, and treatment of recurrent cdi and severe cdi are discussed in this review. in particular, fecal microbiota transplantation (fmt) as a treatment strategy is outlined and a tre ... | 2015 | 25587656 |
| clinical characteristics of symptomatic clostridium difficile infection in children: conditions as infection risks and whether probiotics is effective. | this study investigated the clinical presentations of symptomatic clostridium difficile infection (cdi) in children. | 2014 | 25587523 |
| clostridium difficile infection, a descriptive analysis of solid organ transplant recipients at a single center. | clostridium difficile is a bacterial enteric pathogen, which causes clinical disease among solid organ transplant (sot) recipients. this large, single-center, retrospective study describes incidence, demographics, and impact of c. difficile infection (cdi) among adult sot recipients, cardiac (n=5), lung (n=14), liver (n=9), renal (n=26), and multiorgan (n=9) patients transplanted and diagnosed with cdi (geneb pcr) between 9/2009 and 12/2012. the overall incidence of cdi in our population during ... | 2015 | 25586932 |
| government introduces action plan to reduce deaths from sepsis. | tackling sepsis - the potentially fatal over-reaction of the immune system to infection - must be given the same priority as reducing clostridium difficile and mrsa infections, the government has said. | 2015 | 25585729 |
| the epidemiology of clostridium difficile infection inside and outside health care institutions. | this article describes the global changes in clostridium difficile epidemiology since the late twentieth century and into the twenty-first century when the new epidemic strain bi/nap1/027 emerged. the article provides an overview of how understanding of c difficile epidemiology has rapidly evolved since its initial association with colitis in 1974. it also discusses how c difficile has spread across the globe, the role of asymptomatic carriers in disease transmission, the increased recognition o ... | 2015 | 25582647 |
| potential sources of clostridium difficile in human infection. | the view of clostridium difficile infection as a hospital-acquired infection transmitted only by symptomatic patients is changing. although c difficile is present in food for human consumption, food-borne infection caused by c difficile has never been confirmed. more information on the infective dose and the level of contamination is needed to determine the risk for food-borne exposure to c difficile in humans. the emergence of c difficile polymerase chain reaction (pcr) ribotype 078 in humans i ... | 2015 | 25582646 |
| the contribution of strains and hosts to outcomes in clostridium difficile infection. | acquisition of clostridium difficile spores can be followed by a spectrum of clinical outcomes ranging from asymptomatic transit through the bowel to severe colitis and death. this clinical variability is a product of bacterial virulence and host susceptibility to the pathogen. it is important to identify patients at high risk of poor outcome so that increased monitoring and optimal treatment strategies can be instigated. this article discusses the evidence linking strain type to clinical outcom ... | 2015 | 25582645 |
| predictive values of models of clostridium difficile infection. | in vivo and in vitro models are widely used to simulate clostridium difficile infection (cdi). they have made considerable contributions in the study of c difficile pathogenesis, antibiotic predisposition to cdi, and population dynamics as well as the evaluation of new antimicrobial and immunologic therapeutics. although cdi models have greatly increased understanding of this complicated pathogen, all have limitations in reproducing human disease, notably their inability to generate a truly refl ... | 2015 | 25582644 |
| testing for clostridium difficile in patients newly diagnosed with inflammatory bowel disease in a community setting. | the incidence of clostridium difficile infection (cdi) in inflammatory bowel disease (ibd) is increasing, and cdi has a negative impact on ibd outcomes with both increased morbidity and mortality. data are lacking regarding the rate of appropriate testing for cdi at the time of diagnosis. | 2015 | 25581825 |
| does gastrointestinal dysmotility predispose to recurrent or severe forms of clostridium difficile infections? | clostridium difficile infection (cdi) is the most common cause of hospital-acquired diarrhea. a limited number of studies have looked at the risk factors for recurrent cdi. mitochondrial neurogastrointestinal encephalopathy (mngie) is a rare multisystemic disorder that causes gastrointestinal dysmotility. herein we present a patient with mngie who suffered recurrent and severe c. difficile infection despite appropriate treatment. we aim to bring the gastroenterologist's attention to gastrointest ... | 2014 | 25580313 |
| clostridium difficile with moxifloxacin/clindamycin resistance in vegetables in ohio, usa, and prevalence meta-analysis. | we (i) determined the prevalence of clostridium difficile and their antimicrobial resistance to six antimicrobial classes, in a variety of fresh vegetables sold in retail in ohio, usa, and (ii) conducted cumulative meta-analysis of reported prevalence in vegetables since the 1990s. six antimicrobial classes were tested for their relevance as risk factors for c. difficile infections (cdis) (clindamycin, moxifloxacin) or their clinical priority as exhaustive therapeutic options (metronidazole, van ... | 2014 | 25580297 |
| [fecal microbiota transplantation: review]. | fecal microbiota transplantation (fmt) has gained an increasing medical interest, since the recognition of the role of disturbed microbiota in the development of various diseases. to date, fmt is an established treatment modality for multiple recurrent clostridium difficile infection (rcdi), despite lack of standardization of the procedure. persisting normalization of the disturbed colonic microbiota associated with rcdi seems to be responsible for the therapeutic effect of fmt. for other diseas ... | 2015 | 25577013 |
| mobile genetic elements in clostridium difficile and their role in genome function. | approximately 11% the clostridium difficile genome is made up of mobile genetic elements which have a profound effect on the biology of the organism. this includes transfer of antibiotic resistance and other factors that allow the organism to survive challenging environments, modulation of toxin gene expression, transfer of the toxin genes themselves and the conversion of non-toxigenic strains to toxin producers. mobile genetic elements have also been adapted by investigators to probe the biolog ... | 2015 | 25576774 |
| an alkaline phosphatase reporter for use in clostridium difficile. | clostridium difficile is an anaerobic, gram-positive pathogen that causes severe gastrointestinal disease in humans and other mammals. c. difficile is notoriously difficult to work with and, until recently, few tools were available for genetic manipulation and molecular analyses. despite the recent advances in the field, there is no simple or cost-effective technique for measuring gene transcription in c. difficile other than direct transcriptional analyses (e.g., quantitative real-time pcr and ... | 2015 | 25576237 |
| clostridium difficile infection targets. | | 2015 | 25575770 |
| fidaxomicin use and clinical outcomes for clostridium difficile-associated diarrhea. | fidaxomicin has been scrutinized because of its high acquisition cost. real-world experience is needed to determine whether fidaxomicin has value in patients with clostridium difficile-associated diarrhea (cdad) and certain risk factors. | 2015 | 25574116 |
| fecal microbiota transplantation broadening its application beyond intestinal disorders. | intestinal dysbiosis is now known to be a complication in a myriad of diseases. fecal microbiota transplantation (fmt), as a microbiota-target therapy, is arguably very effective for curing clostridium difficile infection and has good outcomes in other intestinal diseases. new insights have raised an interest in fmt for the management of extra-intestinal disorders associated with gut microbiota. this review shows that it is an exciting time in the burgeoning science of fmt application in previou ... | 2015 | 25574083 |
| fecal transplant policy and legislation. | fecal microbiota transplantation (fmt) has garnered significant attention in recent years in the face of a reemerging clostridium difficile (c. difficile) epidemic. positive results from the first randomized control trial evaluating fmt have encouraged the medical community to explore the process further and expand its application beyond c. difficile infections and even the gastrointestinal domain. however promising and numerous the prospects of fmt appear, the method remains limited in scope to ... | 2015 | 25574076 |
| treatment of clostridium difficile infections. | vancomycin and metronidazole were historically considered equivalent therapies for the management of clostridium difficile infections (cdi); however, recent data confirm more favorable outcomes with vancomycin. fidaxomicin is a narrow spectrum antibiotic that has an advantage in reducing recurrence rates compared with vancomycin, possibly owing to its sparing effect on normal colonic microbiota. data are limited for guiding management of cdi recurrences, particularly multiple recurrences. severa ... | 2015 | 25573676 |
| environmental interventions to control clostridium difficile. | the control of clostridium difficile infection is paramount. c difficile spores are difficult to eradicate and can survive on surfaces for prolonged periods of time. hand washing with either plain or antimicrobial soap is effective in removing c difficile spores from hands. patients should be placed in private rooms and under contact precautions to prevent transmission to other patients. regular hospital germicides are not sporicidal and hypochlorite solutions are required for surface disinfecti ... | 2015 | 25573675 |