| new perspectives in clostridium difficile disease pathogenesis. | clostridium difficile is associated with a spectrum of clinical manifestations ranging from asymptomatic carriage to severe life-threatening pseudomembranous colitis. current perspectives indicate that c difficile pathogenesis is a multifactorial disease process dictated by pathogenic toxin production, gut microbial dysbiosis, and altered host inflammatory responses. this article summarizes recent findings underpinning the cellular and molecular mechanisms regulating bacterial virulence and shed ... | 2015 | 25573674 |
| costs associated with health care-associated infections in cardiac surgery. | health care-associated infections (hais) are the most common noncardiac complications after cardiac surgery and are associated with increased morbidity and mortality. current information about their economic burden is limited. | 2015 | 25572505 |
| clostridium difficile from food and surface samples in a belgian nursing home: an unlikely source of contamination. | this study investigates the contamination of foods and surfaces with clostridium difficile in a single nursing home. c. difficile pcr-ribotype 078 was found in one food sample and in none of the tested surfaces. these results indicate that food and surfaces are an unlikely source of c. difficile infection in this setting. | 2015 | 25571851 |
| [risk factors for clostridium difficile-associated diarrhea among cancer patients]. | the aim of this study was to investigate the prevalence of clostridium difficile (c. difficile) infection and the risk factors for acquisition of c. difficile-associated diarrhea (cdad) among cancer patients who received chemotherapy or radiation therapy. | 2014 | 25567310 |
| clostridium difficile infection: risk factors, diagnosis and management. | clostridium difficile infection (cdi) is the leading cause of death due to gastrointestinal infections in the us and is the most common cause of nosocomial diarrhea. the emergence of a hypervirulent strain in the early 2000s has been associated with a dramatic increase in the number and severity of cases in the us, canada, and several other countries. most cases are related to antibiotic use, but sporadic cases occur in otherwise healthy individuals with no risk factors. morbidity and mortality ... | 2015 | 25567105 |
| the gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. | rapid environmental transition and modern lifestyles are likely driving changes in the biodiversity of the human gut microbiota. with clear effects on physiologic, immunologic, and metabolic processes in human health, aberrations in the gut microbiome and intestinal homeostasis have the capacity for multisystem effects. changes in microbial composition are implicated in the increasing propensity for a broad range of inflammatory diseases, such as allergic disease, asthma, inflammatory bowel dise ... | 2015 | 25567038 |
| dysfunctional families: clostridium scindens and secondary bile acids inhibit the growth of clostridium difficile. | c. difficile infection is a deadly disease that is influenced by the microbiome. in a recent article in nature, buffie et al. (2014) demonstrate that the ability of c. scindens to synthesize secondary bile acids is crucial to providing resistance to c. difficile infection. | 2015 | 25565200 |
| the potential for emerging therapeutic options for clostridium difficile infection. | clostridium difficile is mainly a nosocomial pathogen and is a significant cause of antibiotic-associated diarrhea. it is also implicated in the majority of cases of pseudomembranous colitis. recently, advancements in next generation sequencing technology (ngs) have highlighted the extent of damage to the gut microbiota caused by broad-spectrum antibiotics, often resulting in c. difficile infection (cdi). currently the treatment of choice for cdi involves the use of metronidazole and vancomycin. ... | 2014 | 25564777 |
| the intestinal microbiota: its role in health and disease. | the intestinal microbiota (previously referred to as "intestinal flora") has entered the focus of research interest not only in microbiology but also in medicine. huge progress has been made with respect to the analysis of composition and functions of the human microbiota. an "imbalance" of the microbiota, frequently also called a "dysbiosis," has been associated with different diseases in recent years. crohn's disease and ulcerative colitis as two major forms of inflammatory bowel disease, irri ... | 2015 | 25563215 |
| seek and you shall find: prevalence of clostridium difficile in wuhan, china. | clostridium difficile infection (cdi) is one of the leading health care acquired-infections in the united states, but much of the epidemiology and burden of disease is unknown in china. the aim of this study was to determine the prevalence and possible risk factors of cdi among hospitalized patients with diarrhea in wuhan, china. the overall prevalence of cdi was 28% (31/111). the findings of this study suggest the prevalence of cdi in hospitalized patients with diarrhea is higher then what has ... | 2015 | 25557771 |
| clostridium difficile infection among kidney transplant recipients: frequency, clinical presentation, and outcome. | the objective of this study was to evaluate the frequency of clostridium difficile infection (cdi) among kidney transplant recipients and describe the clinical picture in correlation with the presence of certain risk factors. we included kidney transplant recipients with a functioning graft, who were admitted during the period 1/2012-12/2013, and patients with esrd who were admitted to undergo kidney transplantation (ktx) from a deceased or a living donor in the same period. patients were screen ... | 2015 | 25556694 |
| long-term effects of an antimicrobial stewardship programme at a tertiary-care teaching hospital. | antimicrobial stewardship has been shown to reduce unnecessary antibiotic use, but there are few data on the long-term benefits of such a programme. antimicrobial use over a 13-year period since implementing an antimicrobial stewardship programme (asp) at our institution was examined. nosocomial rates of clostridium difficile infection (cdi) and antimicrobial susceptibility patterns of common nosocomial micro-organisms over the same period were also reviewed. total antimicrobial use decreased by ... | 2015 | 25554468 |
| evaluation of the bd max cdiff assay for the detection of toxigenic clostridium difficile in human stool specimens. | the becton dickinson (bd) pcr-based geneohm cdiff assay has demonstrated a high sensitivity and specificity for detecting clostridium difficile. recently, the bd max platform, using the same principles as bd geneohm, has become available in australia. this study aimed to investigate the sensitivity and specificity of bd max cdiff assay for the detection of toxigenic c. difficile in an australian setting. between december 2013 and january 2014, 406 stool specimens from 349 patients were analysed ... | 2015 | 25551308 |
| overview of management of acute renal failure and its evaluation; a case analysis. | the annual incidence is about 150 per million in the uk, but this figure is six times greater in the >80 years old group. prerenal azotemia is considered as the most serious reason in community or hospital acquired acute renal failure (arf). a 67-year-old middle age male was admitted to the hospital with a chief complaint of generalized weakness, volume depletion and dysuria. he has treated with metronidazole for diarrhoea caused by clostridium difficile considered as the precipitating factor fo ... | 2015 | 28197469 |
| clinical conundrums in management of sepsis in the elderly. | in 2012, surviving sepsis campaign came out with updated international guidelines for management of severe sepsis and septic shock. paradoxically, there are no specific guidelines for management of sepsis in the elderly, although the elderly are more predisposed to sepsis, and morbidity and mortality related to sepsis. sepsis in the elderly is, more often than not, complicated by clinical conundrums such as congestive heart failure (chf), atrial fibrillation (af), chronic kidney disease (ckd), a ... | 2017 | 27847897 |
| typhlocolitis associated with clostridium difficile ribotypes 078 and 110 in neonatal piglets from a commercial irish pig herd. | clostridium difficile is a recognised cause of typhlocolitis and diarrhoea in neonatal pigs but has never been confirmed in association with pathology and disease in irish pigs. | 2015 | 27547375 |
| the epidemiological and clinical analysis of clostridium difficile infections in patients hospitalized due to the infection at the department of infectious diseases in bytom. | clostridium difficile infections are becoming a more serious problem as hospital-acquired infections and the consequence of common antibiotic therapy, also on an out-patient basis. | 2015 | 27139349 |
| fecal microbiota transplantation: a review of emerging indications beyond relapsing clostridium difficile toxin colitis. | the symbiotic relationship between gut microbiota and humans has been forged over many millennia. this relationship has evolved to establish an intimate partnership that we are only beginning to understand. gut microbiota were once considered pathogenic, but the concept of gut microbiota and their influence in human health is undergoing a major paradigm shift, as there is mounting evidence of their impact in the homeostasis of intestinal development, metabolic activities, and the immune system. ... | 2015 | 27099570 |
| implementation of a clinical decision support alert for the management of clostridium difficile infection. | clostridium difficile infections are common in hospitalized patients and can result in significant morbidity and mortality. it is imperative to optimize the management of c. difficile infections to help minimize disease complications. antimicrobial stewardship techniques including guidelines, order sets and other clinical decision support functionalities may be utilized to assist with therapy optimization. we implemented a novel alert within our electronic medical record to direct providers to t ... | 2015 | 27025646 |
| a review of management of clostridium difficile infection: primary and recurrence. | clostridium difficile infection (cdi) is a potentially fatal illness, especially in the elderly and hospitalized individuals. the recurrence and rates of cdi are increasing. in addition, some cases of cdi are refractory to the currently available antibiotics. the search for improved modalities for the management of primary and recurrent cdi is underway. this review discusses the current antibiotics, fecal microbiota transplantation (fmt) and other options such as immunotherapy and administration ... | 2015 | 27025632 |
| antimicrobial resistance and reduced susceptibility in clostridium difficile: potential consequences for induction, treatment, and recurrence of c. difficile infection. | clostridium difficile infection (cdi) remains a substantial burden on healthcare systems and is likely to remain so given our reliance on antimicrobial therapies to treat bacterial infections, especially in an aging population in whom multiple co-morbidities are common. antimicrobial agents are a key component in the aetiology of cdi, both in the establishment of the infection and also in its treatment. the purpose of this review is to summarise the role of antimicrobial agents in primary and re ... | 2015 | 27025625 |
| fecal microbiota transplantation: expanding horizons for clostridium difficile infections and beyond. | fecal microbiota transplantation (fmt) methodology has been progressively refined over the past several years. the procedure has an extensive track record of success curing clostridium difficile infection (cdi) with remarkably few adverse effects. it achieves similar levels of success whether the cdi occurs in the young or elderly, previously normal or profoundly ill patients, or those with cdi in inflammatory bowel disease (ibd). while using fmt to treat cdi, however, we learned that using the ... | 2015 | 27025624 |
| antimicrobial use, human gut microbiota and clostridium difficile colonization and infection. | clostridium difficile infection (cdi) is the most important cause of nosocomial diarrhea. broad-spectrum antimicrobials have profound detrimental effects on the structure and diversity of the indigenous intestinal microbiota. these alterations often impair colonization resistance, allowing the establishment and proliferation of c. difficile in the gut. studies involving animal models have begun to decipher the precise mechanisms by which the intestinal microbiota mediates colonization resistance ... | 2015 | 27025623 |
| doxycycline and tigecycline: two friendly drugs with a low association with clostridium difficile infection. | clostridium difficile infection (cdi) is known to be associated with prior exposure to many classes of antibiotics. standard therapy for cdi (i.e., metronidazole and vancomycin) is associated with high recurrence rates. although tetracycline derivatives such as tetracycline, doxycycline or tigecycline are not the standard therapeutic choices for cdi, they may serve as an alternative or a component of combination therapy. previous tetracycline or doxycycline usage had been shown to have less asso ... | 2015 | 27025622 |
| the antimicrobial stewardship approach to combating clostridium difficile. | clostridium difficile remains a major public health threat and continues to contribute to excess morbidity, mortality and healthcare costs. antimicrobial stewardship programs have demonstrated success in combating c. difficile, primarily through antibiotic restrictive strategies. as the incidence and prevalence of c. difficile associate disease continues to increase both in the hospital and community setting, additional stewardship approaches are needed. this manuscript reviews stewardship inter ... | 2015 | 27025621 |
| [intestinal microbiota transplantation for the treatment of clostridium difficile infection]. | the infections caused by c. difficile, responsible for the antibiotic-associated diarrhea and pseudomembranous colitis, are the growing health problem. an increasing number of c. difficile infection (cdi) cases and the phenomenon of multidrug-resistance of bacteria forces to find new, effective therapeutic methods. intestinal microbiota transplantation ("fecal bacteriotherapy") is a promising remedy for patients suffering from recurrent, severe, not susceptible to standard treatments intestinal ... | 2015 | 27019915 |
| fecal transplantation treatment of antibiotic-induced, noninfectious colitis and long-term microbiota follow-up. | fecal microbiota transplantation (fmt) is an effective treatment for recurrent clostridium difficile infection (cdi) and is considered as a treatment for other gastrointestinal (gi) diseases. we followed up the relief of symptoms and long-term, over-a-year microbiota stabilization in a 46-year-old man, who underwent fmt for antibiotic-induced, non-cdi colitis nine months after being treated for cdi by fmt. fecal and mucosal microbiota was analyzed before the second fmt and during 14 months after ... | 2014 | 25548572 |
| probiotics for antibiotic-associated diarrhea: do we have a verdict? | probiotics use has increased tremendously over the past ten years. this was coupled with a surge of data relating their importance in clinical practice. antibiotic-associated diarrhea, whose frequency has risen recently, was one of the earliest targets with data published more than ten years ago. unfortunately, available trials suffer from severe discrepancies associated with variability and heterogeneity of several factors. most published randomized controlled trials and subsequent meta-analyse ... | 2014 | 25548477 |
| new role for human α-defensin 5 in the fight against hypervirulent clostridium difficile strains. | clostridium difficile infection (cdi), one of the most common hospital-acquired infections, is increasing in incidence and severity with the emergence and diffusion of hypervirulent strains. cdi is precipitated by antibiotic treatment that destroys the equilibrium of the gut microbiota. human α-defensin 5 (hd5), the most abundant enteric antimicrobial peptide, is a key regulator of gut microbiota homeostasis, yet it is still unknown if c. difficile, which successfully evades killing by other hos ... | 2015 | 25547793 |
| effects of tigecycline and vancomycin administration on established clostridium difficile infection. | the glycylcycline antibiotic tigecycline was approved in 2005 for the treatment of complicated skin and soft tissue infections and complicated intra-abdominal infections. tigecycline is broadly active against both gram-negative and gram-positive microorganisms, including clostridium difficile. tigecycline has a low mic against c. difficile in vitro and thus may represent an alternate treatment for c. difficile infection (cdi). to assess the use of tigecycline for treatment of established cdi, 5- ... | 2015 | 25547352 |
| chondroitin sulfate proteoglycan 4 functions as the cellular receptor for clostridium difficile toxin b. | as a gram-positive, spore-forming anaerobic bacillus, clostridium difficile (c. difficile) is responsible for severe and fatal pseudomembranous colitis, and poses the most urgent antibiotic resistance threat worldwide. epidemic c. difficile is the leading cause of antibiotic-associated diarrhoea globally, especially diarrhoea due to the emergence of hypervirulent strains associated with high mortality and morbidity. tcdb, one of the key virulence factors secreted by this bacterium, enters host c ... | 2015 | 25547119 |
| fecal microbiota transplantation for recurrent clostridium difficile infection in pediatric patients: encouragement wrapped in caution. | | 2015 | 25546336 |
| emergency department visits related to clostridium difficile infection: results from the nationwide emergency department sample, 2006 through 2010. | the objective was to estimate emergency department (ed) visits for clostridium difficile infection in the united states for the years 2006 through 2010. | 2015 | 25545404 |
| draft genome sequence of clostridium butyricum strain nor 33234, isolated from an elderly patient with diarrhea. | clostridium butyricum is one of the species frequently present in patients' stool samples. however, the identification of this species is sometimes difficult. here, we present the draft genome of clostridium butyricum nor 33234, which was isolated from a patient with suspected clostridium difficile infection-associated diarrhea and resembles clostridium clostridioforme in biochemical tests. | 2014 | 25540356 |
| proton pump inhibitors increase the risk for hospital-acquired clostridium difficile infection in critically ill patients. | proton pump inhibitors (ppi) have been linked to clostridium difficile infection (cdi) but there are few data specific to icu patients. we evaluated duration of ppi exposure as a potential risk factor for hospital-acquired cdi in the icu. | 2014 | 25540023 |
| antibiotic policies in acute english nhs trusts: implementation of 'start smart-then focus' and relationship with clostridium difficile infection rates. | the objective of this study was to establish how antibiotic prescribing policies at national health service (nhs) hospitals match the england department of health 'start smart-then focus' recommendations and relate to clostridium difficile infection (cdi) rates. | 2015 | 25538165 |
| clostridium difficile infection in thailand. | clostridium difficile is the aetiological agent in ca. 20% of cases of antimicrobial-associated diarrhoea in hospitalised adults. diseases caused by this organism range from mild diarrhoea to occasional fatal pseudomembranous colitis. the epidemiology of c. difficile infection (cdi) has changed notably in the past decade, following epidemics in the early 2000s of pcr ribotype (rt) 027 infection in north america and europe, where there was an increase in disease severity and mortality. another ma ... | 2015 | 25537687 |
| dynamics and establishment of clostridium difficile infection in the murine gastrointestinal tract. | clostridium difficile infection (cdi) following antibiotic therapy is a major public health threat. while antibiotic disruption of the indigenous microbiota underlies the majority of cases of cdi, the early dynamics of infection in the disturbed intestinal ecosystem are poorly characterized. this study defines the dynamics of infection with c. difficile strain vpi 10463 throughout the gastrointestinal (gi) tract using a murine model of infection. after inducing susceptibility to c. difficile col ... | 2015 | 25534943 |
| antisecretory factor peptide af-16 inhibits the secreted autotransporter toxin-stimulated transcellular and paracellular passages of fluid in cultured human enterocyte-like cells. | both the endogenous antisecretory factor (af) protein and peptide af-16, which has a sequence that matches that of the active n-terminal region of af, inhibit the increase in the epithelial transport of fluid and electrolytes induced by bacterial toxins in animal and ex vivo models. we conducted a study to investigate the inhibitory effect of peptide af-16 against the increase of transcellular passage and paracellular permeability promoted by the secreted autotransporter toxin (sat) in a culture ... | 2015 | 25534938 |
| fluoroquinolone resistance does not impose a cost on the fitness of clostridium difficile in vitro. | point mutations conferring resistance to fluoroquinolones were introduced in the gyr genes of the reference strain clostridium difficile 630. only mutants with the substitution thr-82→ile in gyra, which characterizes the hypervirulent epidemic clone iii/027/nap1, were resistant to all fluoroquinolones tested. the absence of a fitness cost in vitro for the most frequent mutations detected in resistant clinical isolates suggests that resistance will be maintained even in the absence of antibiotic ... | 2015 | 25534738 |
| multicenter, randomized clinical trial to compare the safety and efficacy of lff571 and vancomycin for clostridium difficile infections. | clostridium difficile infection causes serious diarrheal disease. although several drugs are available for treatment, including vancomycin, recurrences remain a problem. lff571 is a semisynthetic thiopeptide with potency against c. difficile in vitro. in this phase 2 exploratory study, we compared the safety and efficacy (based on a noninferiority analysis) of lff571 to those of vancomycin used in adults with primary episodes or first recurrences of moderate c. difficile infection. patients were ... | 2015 | 25534727 |
| pharmacokinetics of lff571 and vancomycin in patients with moderate clostridium difficile infections. | clostridium difficile infection causes diarrheal disease with potentially fatal complications. although treatments are available, including vancomycin, metronidazole, and fidaxomicin, the recurrence of disease after therapy remains a problem. lff571 is a novel thiopeptide antibacterial that shows in vitro potency against c. difficile that is comparable to or greater than that of other clinically used antibiotics. here, we compare the pharmacokinetics (pk) of lff571 and vancomycin in patients wit ... | 2015 | 25534724 |
| fidaxomicin therapy in critically ill patients with clostridium difficile infection. | fidaxomicin use to treat proven clostridium difficile infection (cdi) was compared between 20 patients receiving care in critical care units (ccus) and 30 patients treated on general medical floors. at baseline, the ccu patients had more initial cdi episodes, more severe and complicated disease, and more concurrent broad-spectrum antibiotic coverage. on multivariate analysis, the response to fidaxomicin therapy among the critically ill patients was comparable to that among patients in the genera ... | 2015 | 25534722 |
| use of a daily disinfectant cleaner instead of a daily cleaner reduced hospital-acquired infection rates. | documenting effective approaches to eliminate environmental reservoirs and reduce the spread of hospital-acquired infections (hais) has been difficult. this was a prospective study to determine if hospital-wide implementation of a disinfectant cleaner in a disposable wipe system to replace a cleaner alone could reduce hais over 1 year when housekeeping compliance was ≥80%. | 2015 | 25534117 |
| [clostridium difficile infections in internal medicine departments. addendum]. | | 2015 | 25533745 |
| clostridium difficile infection and inflammatory bowel disease: what gastroenterologists and surgeons should know. | over the past two decades there has been a dramatic increase worldwide in both incidence and severity of clostridium difficile infection (cdi). paralleling the rising incidence of cdi in the general population, there has been an even higher increase in the incidence of cdi among patients with inflammatory bowel disease (ibd). cdi may mimic a flare of ibd as symptoms and laboratory parameters are often similar, and therefore, screening for cdi is recommended at every flare in such patients. enzym ... | 2015 | 25532244 |
| epidemiology and predictors of recurrence of clostridium difficile infection in a north italian tertiary care hospital. | | 2014 | 25532010 |
| rheological properties of erythrocytes in patients infected with clostridium difficile. | clostridium difficile infection (cdi) is a bacterial infection of the digestive tract. acute infections are accompanied by increased risk for venous thromboembolism (vte). to date, there have been no studies of the rheological properties of blood during the course of digestive tract infections. the aim of our study was to examine the effects of cdi on red blood cell (rbc) rheology, specifically rbc deformability, rbc aggregation, and plasma viscosity. in addition, the activity of glucose 6 phosp ... | 2014 | 25531703 |
| human neutrophils are activated by a peptide fragment of clostridium difficile toxin b presumably via formyl peptide receptor. | clostridium difficile may induce antibiotic-associated diarrhoea and, in severe cases, pseudomembranous colitis characterized by tremendous neutrophil infiltration. all symptoms are caused by two exotoxins: tcda and tcdb. we describe here the activation of isolated human blood neutrophils by tcdb and, moreover, by toxin fragments generated by limited proteolytical digestion. kinetics and profiles of tcdb-induced rise in intracellular-free ca(2+) and reactive oxygen species production were simila ... | 2015 | 25529763 |
| use of mcherry red fluorescent protein for studies of protein localization and gene expression in clostridium difficile. | fluorescent proteins are powerful reporters in biology, but most require o2 for chromophore maturation, making them inherently difficult to use in anaerobic bacteria. clostridium difficile, a strict anaerobe with a genomic gc content of only 29%, is the leading cause of hospital-acquired diarrhea in developed countries, and new methods for studying this pathogen are sorely needed. we recently demonstrated that a cyan fluorescent protein called cfpopt that has been codon optimized for production ... | 2015 | 25527559 |
| effect of airborne hydrogen peroxide on spores of clostridium difficile. | contamination of surfaces by spores of clostridium difficile is a major factor influencing the spread of healthcare-associated c. difficile infection. the aim of this study was to test the effect of an automated room disinfection system that provides an aerosol of 7.5 % hydrogen peroxide (h2o2) disinfectant, on spores of two different strains of c. difficile, and to evaluate the impact of biological soiling on the efficacy of h2o2 disinfection. | 2015 | 25527140 |
| microbial bile acid metabolic clusters: the bouncers at the bar. | colonization resistance refers to the ability of the colonic microbiota to prevent invasion by pathogens including clostridium difficile. in a recent article, buffie et al. (2014) have demonstrated that a single metabolic cluster present in the normal, colonic microflora is responsible for preventing c. difficile invasion of healthy hosts. | 2014 | 25525784 |
| evaluation of the cepheid xpert c. difficile/epi and meridian bioscience illumigene c. difficile assays for detecting clostridium difficile ribotype 033 strains. | clostridium difficile pcr ribotype 033 (rt033) is found in the gastrointestinal tracts of production animals and, occasionally, humans. the illumigene c. difficile assay (meridian bioscience, inc.) failed to detect any of 52 c. difficile rt033 isolates, while all strains signaled positive for the binary toxin genes but were reported as negative for c. difficile by the xpert c. difficile/epi assay (cepheid). | 2015 | 25520452 |
| emphysematous cystitis due to recurrent clostridium difficile infection. | a 78-year-old woman with long-standing obstipation presented herself to the hospital with diarrhoea and progressive abdominal cramping since 2 days. acute abdomen developed and an emergency exploratory laparotomy was indicated, which showed no signs of bowel ischaemia. after admission to the internal ward, stool clostridium difficile pcr was tested positive. hence the diagnosis of pseudomembranous colitis became apparent. abdominal imaging demonstrated multiple gas foci in the wall of the bladde ... | 2014 | 25519862 |
| changes to clinician attire have done more harm than good. | the introduction of 'bare below the elbows' policies to facilitate handwashing led to the disappearance of the white coat from medical and surgical wards. while rates of key healthcare acquired infections in hospitals, e.g. clostridium difficile and methicillin-resistant staphylococcus aureus bacteraemia, have fallen, argument continues around the contribution of hand hygiene and dress codes to these changes. conversely, the number of complaints against clinicians continues to rise, and respect ... | 2014 | 25516900 |
| characterization of drug-product-related impurities and variants of a therapeutic monoclonal antibody by higher energy c-trap dissociation mass spectrometry. | mass spectrometry (ms) characterization of recombinant monoclonal antibody (mab) drugs and their degraded and/or post-translationally modified counterparts, drug-product-related impurities and variants, is critical for successful development of biotherapeutics. specifically in this study, drug-product-related impurities of an anti-clostridium difficile igg1 mab drug substance were profiled by cation-exchange liquid chromatography (cex) followed by the cex peaks being fraction-collected for ms ch ... | 2015 | 25513708 |
| subinhibitory concentrations of lff571 reduce toxin production by clostridium difficile. | lff571 is a novel semisynthetic thiopeptide antibacterial that is undergoing investigation for safety and efficacy in patients with moderate clostridium difficile infections. lff571 inhibits bacterial protein synthesis by interacting with elongation factor tu (ef-tu) and interrupting complex formation between ef-tu and aminoacyl-trna. given this mechanism of action, we hypothesized that concentrations of lff571 below those necessary to inhibit bacterial growth would reduce steady-state toxin lev ... | 2015 | 25512411 |
| letter: clinical predictors of clostridium difficile infection - advanced age and residential status are important factors for prediction and prevention - authors' reply. | | 2015 | 25511771 |
| letter: clinical predictors of clostridium difficile infection - advanced age and residential status are important factors for prediction and prevention. | | 2015 | 25511770 |
| prospective audit and feedback in antimicrobial stewardship: is there value in early reviewing within 48 h of antibiotic prescription? | antimicrobial stewardship programme (asp) methodologies are not well defined, with most preferring to wait ≥72-96 h following antibiotic prescription before reviewing patients. however, we hypothesise that early asp reviews and interventions are beneficial and do not adversely impact patient safety. this study aimed to evaluate the impact of early asp interventions within 48 h of antibiotic prescription on patient outcomes and safety. a prospective review of asp interventions made within 48 h of ... | 2015 | 25511192 |
| total synthesis of the tiacumicin b (lipiarmycin a3/fidaxomicin) aglycone. | tiacumicin b (lipiarmycin a3, fidaxomicin) is an atypical macrolide antibiotic which is used for the treatment of clostridium difficile infections. tiacumicin b is also a potent inhibitor of mycobacterium tuberculosis, but due to its limited oral bioavailability is unsuitable for systemic therapy. to provide a basis for structure-activity studies that might eventually lead to improved variants of tiacumicin b, we have developed an efficient approach to the synthesis of the tiacumicin b aglycone. ... | 2015 | 25510439 |
| real-time cell analysis for monitoring cholera toxin-induced human intestinal epithelial cell response. | the pathogenic mechanism of vibrio cholerae manifests as diarrhea and causes life-threatening dehydration. here, we observe the human intestinal epithelial cells (hiec) response to cholera toxin (ct) by a real-time cell analysis (rtca) platform, and disclose the difference from ct-induced cytotoxicity and others in hiec. an hiec cell of 1.0 × 10(5) cells/ml was characterized as the suitable concentration for each well. for experimentation, the assay requires an inoculation of ct dissolved in dul ... | 2015 | 25510171 |
| international patents granted for clostridium difficile program. | | 2014 | 25507269 |
| characterization of comorbid factors in hip fracture related in-hospital mortality. | it is important to delineate factors which influence in-hospital mortality rates following a hip fracture. the current study aimed to identify the nature and frequency of comorbidities prevalent in this patient cohort. a retrospective chart review of cases of in-patient mortality following admission for a hip fracture was performed. these cases (n=127) were characterized for comorbidities, complications, medical status indicators, and other contributory factors. cardiovascular 104 (81.9%), respi ... | 2014 | 25507116 |
| faecal microbiota transplantation. | the use of faeces for the treatment of gastrointestinal diseases was described in 4th century chinese medicine for the treatment of severe diarrhoea.1 more recently there has been renewed interest in this unconventional biological therapy, particularly for the treatment of recurrent clostridium difficile infection (cdi) and to a lesser extent inflammatory bowel diseases (ibd). faecal microbiota transplantation† (fmt) involves the introduction of enteric bacteria from the faeces of healthy donors ... | 2014 | 25505015 |
| global transcriptional response of clostridium difficile carrying the cd38 prophage. | clostridium difficile is one of the most dangerous pathogens in hospital settings. most strains of c. difficile carry one or more prophages, and some of them, like cd38-2 and cd119, can influence the expression of toxin genes. however, little is known about the global host response in the presence of a given prophage. in order to fill this knowledge gap, we used high-throughput rna sequencing (rna-seq) to conduct a genome-wide transcriptomic analysis of the epidemic c. difficile strain r20291 ca ... | 2015 | 25501487 |
| impacts of infection with different toxigenic clostridium difficile strains on faecal microbiota in children. | increasing evidence suggests that altered intestinal microbial composition and function result in an increased risk of clostridium difficile-associated diarrhoea (cdad); however, the specific changes of intestinal microbiota in children suffering from cdad and their associations with c. difficile strain toxigenicity are poorly understood. high-throughput pyrosequencing showed that reduced faecal bacterial diversity and dramatic shifts of microbial composition were found in children with cdad. th ... | 2014 | 25501371 |
| fecal microbiota transplantation for gastrointestinal diseases. | fecal microbiota transplantation (fmt) is a treatment to restore the normal microbial composition of the gut by introducing fecal microbiota obtained from a healthy donor into a diseased individual. there has been a growing interest in the use of fmt as a treatment of various diseases including clostridium difficile infection (cdi), inflammatory bowel disease, and irritable bowel syndrome. despite the increasing application of fmt, there are no standard protocols. many aspects of fmt procedures ... | 2014 | 25500625 |
| essential oils have different effects on human pathogenic and commensal bacteria in mixed faecal fermentations compared with pure cultures. | a static batch culture system inoculated with human faeces was used to determine the influence of essential oil compounds (eocs) on mixed faecal microbiota. bacteria were quantified using quantitative pcr of 16s rrna genes. incubation for 24 h of diluted faeces from six individuals caused enrichment of bifidobacterium spp., but proportions of other major groups were unaffected. thymol and geraniol at 500 p.p.m. suppressed total bacteria, resulting in minimal fermentation. thymol at 100 p.p.m. ha ... | 2015 | 25500493 |
| investigational new treatments for clostridium difficile infection. | significant progress has been made by industry and academia in the past two years to address the medical threats posed by clostridium difficile infection. these developments provide an excellent example of how patient need has driven a surge of innovation in drug discovery. indeed, only two drugs were approved for the infection in the past 30 years but there are 13 treatment candidates in clinical trials today. what makes the latter number even more remarkable is the diversity in the strategies ... | 2015 | 25499664 |
| non-selective and selective enrichment media for the recovery of clostridium difficile from chopped beef. | clostridium difficile exists within the intestines of animals and in meat products. enrichment of c. difficile in an appropriate medium is necessary for the detection of c. difficile in meat products. non-selective media (brain heart infusion medium [tbhi] and cooked meat medium containing sodium taurocholate [tcm]) and selective media (cycloserine-cefoxitin-fructose medium [tccfb] and c. difficile moxalactam-norfloxacin medium containing antibiotics and sodium taurocholate [tcdmn]) can be used ... | 2015 | 25499549 |
| the potential use of cholestyramine to reduce the risk of developing clostridium difficile-associated diarrhoea in patients receiving long-term intravenous ceftriaxone. | intravenous pharmacotherapy with the third-generation cephalosporin ceftriaxone is unfortunately associated with a relatively high incidence of clostridium difficile-associated diarrhoea. cholestyramine (colestyramine) is an anion-binding resin which can bind luminal c.difficile toxin a (tcda) and toxin b (tcdb) and which may be beneficial in the treatment of recurrent antibiotic-associated pseudomembranous colitis. we therefore hypothesised that concomitant oral cholestyramine might reduce the ... | 2015 | 25497389 |
| clostridium difficile toxin b inhibits the secretory response of human mast cell line-1 (hmc-1) cells stimulated with high free-ca²⁺ and gtpγs. | clostridium difficile toxins a and b (tcda and tcdb) belong to the class of large clostridial cytotoxins and inactivate by glucosylation some low molecular mass gtpases of the rho-family (predominantly rho, rac and cdc42), known as regulators of the actin cytoskeleton. tcda and b also represent the main virulence factors of the anaerobic gram-positive bacterium that is the causal agent of pseudomembranous colitis. in our study, tcdb was chosen instead of tcda for the well-known higher cytotoxic ... | 2015 | 25497110 |
| clostridium difficile infection aggravates colitis in interleukin 10-deficient mice. | to investigate the effect of clostridium difficile (c. difficile) infection in an interleukin 10-deficient (il-10(-/-)) mouse model of inflammatory bowel disease. | 2014 | 25493020 |
| europe-wide call to combat c. difficile. | experts from across europe gathered last week to discuss ways to control and improve diagnosis and treatment of clostridium difficile, after research found an estimated 40,000 cases are missed annually. | 2014 | 25492752 |
| practice parameters for the management of clostridium difficile infection. | | 2015 | 25489690 |
| prevalence of clostridium difficile infection presenting to us eds. | the objective of the study is to determine the prevalence of clostridium difficile infection (cdi) presenting to emergency departments (eds) in the united states. secondary objectives included defining the burden of cdi. | 2015 | 25488337 |
| mechanisms of protection against clostridium difficile infection by the monoclonal antitoxin antibodies actoxumab and bezlotoxumab. | clostridium difficile infection (cdi) represents the most prevalent cause of antibiotic-associated gastrointestinal infections in health care facilities in the developed world. disease symptoms are caused by the two homologous exotoxins, tcda and tcdb. standard therapy for cdi involves administration of antibiotics that are associated with a high rate of disease recurrence, highlighting the need for novel treatment paradigms that target the toxins rather than the organism itself. a combination o ... | 2015 | 25486992 |
| prevalence and characterization of clostridium difficile in beef and mutton meats of isfahan region, iran. | clostridium difficile (c. difficile) is a frequent cause of nosocomial infections. during last few years, the mortality rate of c. difficile infection (cdi) increased in healthcare facilities. this organism has become a major public health concern in developed nations. because of the increasing incidence of acquired-cdi (ca-cdi) and notable genetic overlap between c. difficile isolates from animals and humans, meat has defined as one of the probable transmission route of c. diffiicle to humans. | 2014 | 25485054 |
| adult vaccination. | vaccination of children has had a major impact on the morbidity and mortality of many infectious diseases globally. however, with age, immune responses to vaccines can be less robust, which can be further enhanced by underlying diseases that are common in the older adult. in many countries around the globe booster vaccinations against diphtheria, tetanus, and pertussis are recommended for adults. for the older adult, vaccination against pneumococcal diseases, influenza and herpes zoster are also ... | 2015 | 25483533 |
| clostridium difficile virulence factors: insights into an anaerobic spore-forming pathogen. | the worldwide emergence of epidemic strains of clostridium difficile linked to increased disease severity and mortality has resulted in greater research efforts toward determining the virulence factors and pathogenesis mechanisms used by this organism to cause disease. c. difficile is an opportunist pathogen that employs many factors to infect and damage the host, often with devastating consequences. this review will focus on the role of the 2 major virulence factors, toxin a (tcda) and toxin b ... | 2014 | 25483328 |
| faecal shedding of antimicrobial-resistant clostridium difficile strains by dogs. | to longitudinally assess the shedding of antimicrobial resistant clostridium difficile strains by clinically healthy dogs raised at breeding facilities. | 2015 | 25483272 |
| influence of sequence mismatches on the specificity of recombinase polymerase amplification technology. | recombinase polymerase amplification (rpa) technology relies on three major proteins, recombinase proteins, single-strand binding proteins, and polymerases, to specifically amplify nucleic acid sequences in an isothermal format. the performance of rpa with respect to sequence mismatches of closely-related non-target molecules is not well documented and the influence of the number and distribution of mismatches in dna sequences on rpa amplification reaction is not well understood. we investigated ... | 2015 | 25481659 |
| detection of clostridium difficile toxin genes by pcr: sequence variation may cause false-negative results. | | 2015 | 25480881 |
| analysis of interventions to reduce the incidence of clostridium difficile infection at a london teaching hospital trust, 2003-2011. | since 2008 there has been a substantial fall in the incidence of clostridium difficile infection (cdi) in the uk, though it is unclear what contribution local and governmental interventions have made to this reduction. | 2015 | 25480022 |
| low vitamin d level and impact on severity and recurrence of clostridium difficile infections. | clostridium difficile infection (cdi) has recently markedly increased, incurring greater health care-associated costs and hospitalizations especially in vitamin d deficient patients. accordingly, the aim of this study was to evaluate the relationship between low vitamin d levels and the severity and recurrence of cdi. | 2015 | 25479065 |
| implementation of polymerase chain reaction to rule out clostridium difficile infection is associated with reduced empiric antibiotic duration of therapy. | the polymerase chain reaction (pcr) test has higher sensitivity and a faster turnaround time than the enzyme immunoassay (eia) for identification of clostridium difficile, although the clinical implications of these variables are not well described. | 2014 | 25477583 |
| the importance of considering different healthcare settings when estimating the burden of clostridium difficile. | traditional surveillance methods may underestimate the true burden of clostridium difficile infection (cdi) because they fail to capture cases brought to medical attention in outpatient settings or diagnosed during non-face-to-face patient-provider interactions. | 2015 | 25477426 |
| development of a sporicidal test method for clostridium difficile. | disinfectants with claimed activity against clostridium difficile must be evaluated to ensure efficacy against the spores that comprise an environmental source of patient infection. unfortunately there is, at present, no generally accepted method for evaluating these disinfectants. in the absence of such a method, laboratories have to adapt protocols that were not designed for products used in medical environments and consequently may use inappropriate test organisms, exposure times, and pass cr ... | 2015 | 25477061 |
| the impact of horizontal gene transfer on the biology of clostridium difficile. | clostridium difficile infection (cdi) is now recognised as the main cause of healthcare associated diarrhoea. over the recent years there has been a change in the epidemiology of cdi with certain related strains dominating infection. these strains have been termed hyper-virulent and have successfully spread across the globe. many c. difficile strains have had their genomes completely sequenced allowing researchers to build up a very detailed picture of the contribution of horizontal gene transfe ... | 2014 | 25476764 |
| survival of clostridium difficile spores at low temperatures. | clostridium difficile's presence has been reported in meat products stored typically at low temperatures. this study evaluated the viability in phosphate buffer saline (pbs) of spores from epidemic c. difficile strain r20291 (4.6 log cfu/ml) and m120 (7.8 log cfu/ml). viability was assessed during 4 months at -80 °c, -20 °c, 4 °c (refrigeration), and 23 °c (room temperature), and after 10 freeze (-20 °c)/thaw (+23 °c) cycles. although spore viability decreased, significant viability was still ob ... | 2015 | 25475288 |
| [recommendations for the use of faecal microbiota transplantation "stool transplantation": consensus of the austrian society of gastroenterology and hepatology (öggh) in cooperation with the austrian society of infectious diseases and tropical medicine]. | the intestinal microbiota has a pivotal role in the maintenance of health of the human organism, especially in the defense against pathogenic microorganisms. alterations in the microbiota, also termed dysbiosis, seem to be involved in the pathogenesis of a variety of intestinal and extraintestinal diseases. fecal microbiota transplantation (fmt), also known as stool transplantation, is a therapeutic procedure aiming at restoring an altered intestinal microbiota by administration of stool microor ... | 2014 | 25474284 |
| vitamin d deficiency is associated with community-acquired clostridium difficile infection: a case-control study. | clostridium difficile infection (cdi) is increasingly recognized as an important community acquired pathogen causing disease (ca-cdi). vitamin d [25(oh)d] has immune modulatory effects and plays an important role in intestinal immunity. the role of vitamin d in ca-cdi has not been examined previously. | 2014 | 25471926 |
| molecular epidemiology and antimicrobial susceptibility of clostridium difficile isolated from a university teaching hospital in japan. | clostridium difficile infection control strategies require an understanding of its epidemiology. in this study, we analysed the toxin genotypes of 130 non-duplicate clinical isolates of c. difficile from a university hospital in tokyo, japan. multilocus sequence typing (mlst) and eburst analysis were performed for these isolates and nine strains previously analysed by polymerase chain reaction (pcr) ribotyping. minimum inhibitory concentrations (mics) were determined for six antibiotics, and the ... | 2015 | 25471195 |
| clostridium perfringens enterotoxin and clostridium difficile toxin a/b do not play a role in acute haemorrhagic diarrhoea syndrome in dogs. | although an association between clostridial pathogens and canine idiopathic acute haemorrhagic diarrhoea syndrome (ahds) has been described, the relevance of those bacteria and their toxins remains unclear. the aim of this study was to evaluate the association between severity of clinical signs and presence of clostridium perfringens enterotoxin (cpe) and clostridium difficile toxin a/b (cdt a/b) in faeces of dogs with ahds. faecal samples of 54 dogs with idiopathic ahds were tested by qualitati ... | 2015 | 25467148 |
| restrictive reporting of selected antimicrobial susceptibilities influences clinical prescribing. | cascade and restrictive reporting are useful strategies to enhance antibiotic stewardship programs. | 2016 | 25466592 |
| tigecycline for the treatment of severe and severe complicated clostridium difficile infection. | clostridium difficile infection (cdi) is a common cause of nosocomial diarrhea. metronidazole and vancomycin are the primary treatment options for cdi, but increasing rates of antimicrobial resistance and severe, refractory disease have prompted the need for alternative agents. tigecycline has previously demonstrated favorable in vitro activity against c. difficile isolates, but clinical data on its use in the treatment of cdi are severely lacking. the objective of this study was to describe our ... | 2014 | 25466443 |
| portable uv light as an alternative for decontamination. | we evaluated the capability of a commercially available hand-held device that emits ultraviolet (uv) light to disinfect plain surfaces. eight bacterial species were tested, including clostridium difficile ribotype 027 and 3 other spore-forming species. even bacterial spores could be successfully inactivated within a few seconds of irradiation. uv light may provide an alternative for the decontamination of medical products, such as mobile phones or tablet computers, that cannot be treated otherwi ... | 2014 | 25465267 |
| comparative performance of the genexpert c. difficile pcr assay and c. diff quik chek complete kit assay for detection of clostridium difficile antigen and toxins in symptomatic community-onset infections. | to evaluate the performance of the genexpert c. difficile assay and c. diff quik chek complete (qcc) kit for the detection of toxins from fecal specimens and cooked meat broth (cmb) culture using toxigenic stool culture as reference method, for the diagnosis of c. difficile infection (cdi) in a community setting. | 2014 | 25462186 |
| novel receptors for bacterial protein toxins. | while bacterial effectors are often directly introduced into eukaryotic target cells by various types of injection machines, toxins enter the cytosol of host cells from endosomal compartments or after retrograde transport via golgi from the er. a first crucial step of toxin-host interaction is receptor binding. using optimized protocols and new methods novel toxin receptors have been identified, including metalloprotease adam 10 for staphylococcus aureus α-toxin, laminin receptor lu/bcam for esc ... | 2015 | 25461573 |