| single domain antibody coated gold nanoparticles as enhancer for clostridium difficile toxin detection by electrochemical impedance immunosensors. | this work presents a sandwich-type electrochemical impedance immunosensor for detecting clostridium difficile toxin a (tcda) and toxin b (tcdb). single domain antibody conjugated gold nanoparticles were applied to amplify the detection signal. gold nanoparticles (au nps) were characterized by transmission electron microscopy and uv–vis spectra. the electron transfer resistance (ret) of the working electrode surface was used as a parameter in the measurement of the biosensor. with the increase of ... | 2015 | 25460611 |
| development of fecal microbiota transplantation suitable for mainstream medicine. | fecal microbiota transplantation has emerged as an increasingly common treatment for patients with refractory clostridium difficile infection. although it can be relatively simple to perform, a number of challenges need to be overcome before this procedure is widely accepted in mainstream clinical practice. most of the solutions to these challenges already exist, but some need further optimization and testing. standardized fecal microbiota is being developed as a therapeutic agent, although it c ... | 2015 | 25460566 |
| underdiagnosis of clostridium difficile across europe: the european, multicentre, prospective, biannual, point-prevalence study of clostridium difficile infection in hospitalised patients with diarrhoea (euclid). | variations in testing for clostridium difficile infection can hinder patients' care, increase the risk of transmission, and skew epidemiological data. we aimed to measure the underdiagnosis of c difficile infection across europe. | 2014 | 25455988 |
| hidden burden of undiagnosed clostridium difficile infection. | | 2014 | 25455970 |
| [fecal microbiota transplantation]. | bacteria can no longer be seen as an enemy. nowadays, there is enough evidence to place the microbiota as a key element in human homeostasis. despite initial skepticism, fecal microbiota transplantation (fmt) is a real therapeutic alternative for patients with recurrent clostridium difficile infection. moreover, this procedure has shown promising results in ulcerative colitis and other non-gastrointestinal disorders. there is still a lack of knowledge and clinical trials with long- term follow-u ... | 2015 | 25454597 |
| missed diagnosis of clostridium difficile infection; a prospective evaluation of unselected stool samples. | clostridium difficile infection (cdi) is the leading cause of hospital-acquired diarrhoea in developed countries, however a high proportion of cdi episodes go undiagnosed, either because physicians do not request identification of toxigenic c. difficile or microbiologists do not perform the appropriate tests. | 2015 | 25452039 |
| broad coverage of genetically diverse strains of clostridium difficile by actoxumab and bezlotoxumab predicted by in vitro neutralization and epitope modeling. | clostridium difficile infections (cdis) are the leading cause of hospital-acquired infectious diarrhea and primarily involve two exotoxins, tcda and tcdb. actoxumab and bezlotoxumab are human monoclonal antibodies that neutralize the cytotoxic/cytopathic effects of tcda and tcdb, respectively. in a phase ii clinical study, the actoxumab-bezlotoxumab combination reduced the rate of cdi recurrence in patients who were also treated with standard-of-care antibiotics. however, it is not known whether ... | 2015 | 25451052 |
| severity and frequency of community-onset clostridium difficile infection on an australian tertiary referral hospital campus. | clostridium difficile infection (cdi) is increasingly being found in populations without traditional risk factors. we compared the relative frequency, risk factors, severity, and outcomes of community-onset cdi with hospital-acquired infection. | 2014 | 25449250 |
| outbreak of clostridium difficile ribotype 027 in a residential home. | this article reports a significant outbreak of clostridium difficile ribotype 027 infection in a residential care home in the uk. five of six affected residents died within one month of diagnosis. investigation of the facility revealed problems with hand hygiene and environmental cleaning. affected residents had received a mean of 2.7 antibiotic courses in the two months preceding diagnosis. it is important to recognize that c. difficile outbreaks can occur in residential homes. there is a need ... | 2014 | 25447200 |
| development of antimicrobial resistance in the normal anaerobic microbiota during one year after administration of clindamycin or ciprofloxacin. | thirty healthy subjects (15 males and 15 females) were randomly assigned in three groups and clindamycin (150 mg qid) or ciprofloxacin (500 mg bid) or placebo was given for a 10-day period. skin, nasal, saliva, faeces samples were collected at day - 1, day 11, 1 month, 2 months, 4 months and 12 months post administration for microbiological analysis. ciprofloxacin or clindamycin had no impact on the anaerobic skin microbiota and the proportions of antibiotic resistant anaerobic bacteria were sim ... | 2015 | 25445201 |
| long-term efficacy of a self-disinfecting coating in an intensive care unit. | cleaning and disinfecting fomites can effectively remove/kill pathogens on surfaces, but studies have shown that more than one-half the time, surfaces are not adequately cleaned or are recontaminated within minutes. this study evaluated a product designed to create a long-lasting surface coating that provides continuous disinfecting action. | 2014 | 25444265 |
| sporicides for clostridium difficile—do they do what it says on the tin? | | 2015 | 25443502 |
| invited commentary on clostridium difficile increases the risk for venous thromboembolism. | | 2014 | 25441599 |
| excess length of stay and mortality due to clostridium difficile infection: a multi-state modelling approach. | the burden of healthcare-associated infections, such as healthcare-acquired clostridium difficile (ha-cdi), can be expressed in terms of additional length of stay (los) and mortality. however, previous estimates have varied widely. although some have considered time of infection onset (time-dependent bias), none considered the impact of severity of ha-cdi; this was the primary aim of this study. | 2014 | 25441017 |
| characterization of a multidrug resistant c. difficile meat isolate. | clostridium difficile is a pathogen of significant public health concern causing a life-threatening, toxin-mediated enteric disease in humans. the incidence and severity of the disease associated with c. difficile have increased in the us with the emergence of hypervirulent strains and community associated outbreaks. the detection of genotypically similar and identical c. difficile strains implicated from human infections in foods and food animals indicates the potential role of food as a source ... | 2015 | 25440554 |
| clostridium difficile infection: prevention, treatment, and surgical management. | clostridium difficile is increasing in both incidence and severity. although metronidazole and vancomycin remain the gold standard for medical management, and surgical colectomy the gold standard for surgical management, new treatment alternatives, including the creation of a diverting loop ileostomy along with colonic lavage and vancomycin enemas, are being investigated that may lead to changes in the current treatment algorithms. the most exciting development in the treatment options for c dif ... | 2014 | 25440127 |
| review of the emerging treatment of clostridium difficile infection with fecal microbiota transplantation and insights into future challenges. | clostridium difficile infection (cdi) is one of the most common health care-associated infections in the united states. currently, there are no standardized methods to prepare or deliver the fecal microbiota transplantation (fmt). various methods are used to prepare the fmt, which is usually administered via nasogastric tube, colonoscopy, or by enema. several clinical trials are underway to assess the true efficacy and safety of fmt for cdi. these trials include cdi studies assessing fmt via col ... | 2014 | 25439277 |
| the impact of proton pump inhibitors on the human gastrointestinal microbiome. | potent gastric acid suppression using proton pump inhibitors (ppis) is common in clinical practice but may have important effects on human health that are mediated through changes in the gastrointestinal microbiome. in the esophagus, ppis change the normal bacterial milieu to decrease distal esophageal exposure to inflammatory gram-negative bacteria. in the stomach, ppis alter the abundance and location of gastric helicobacter pylori and other bacteria. in the small bowel, ppis cause polymicrobi ... | 2014 | 25439276 |
| [clostridium difficile in visceral surgery]. | for surgeons the early identification of patients with clostridium difficile infections (cdi) is important, because the incidence and virulence of this potentially life-threatening disease are increasing. | 2015 | 25432576 |
| total synthesis of the protected aglycon of fidaxomicin (tiacumicin b, lipiarmycin a3). | fidaxomicin, also known as tiacumicin b or lipiarmycin a3, is a novel macrocyclic antibiotic that is used in hospitals for the treatment of clostridium difficile infections. this natural product has also been shown to have excellent bactericidal activity against multidrug-resistant mycobacterium tuberculosis. in spite of its attractive biological activity, no total synthesis has been reported to date. the enantioselective synthesis of the central 18-membered macrolactone is reported herein. the ... | 2015 | 25431322 |
| recurrent clostridium difficile infection treated with home fecal transplantation: a case report. | clostridium difficile infection causes severe diarrhea, abdominal pain and weight loss. a course of metronidazole is the initial treatment; however up to 40% of patients have at least one recurrence. some patients have recurrent infections requiring further treatment with vancomycin, others need multiple courses of expensive treatment. fecal transplantation has been proposed as an effective treatment option for patients with recurrences. we report the case of a patient with recurrent clostridium ... | 2014 | 25430511 |
| right hemicolectomy in a severely anemic jehovah's witness patient with an extremely low preoperative hemoglobin level and the decision to operate. | severe anemia is associated with high mortality, and patients with this condition are typically treated with packed blood red cells. patients of jehovah's witness faith, however, do not accept blood transfusion therapy. the authors report the case of a jehovah's witness patient who presented with lower gastrointestinal bleeding secondary to clostridium difficile colitis. because the patient refused blood transfusion therapy, he underwent a right hemicolectomy with a preoperative hemoglobin level ... | 2014 | 25429083 |
| a new type of toxin a-negative, toxin b-positive clostridium difficile strain lacking a complete tcda gene. | toxins a and b are the main virulence factors of clostridium difficile and are the targets for molecular diagnostic tests. here, we describe a new toxin a-negative, toxin b-positive, binary toxin cdt (clostridium difficile transferase)-negative (a(-) b(+) cdt(-)) toxinotype (xxxii) characterized by a variant type of pathogenicity locus (paloc) without tcda and with atypical organization of the paloc integration site. | 2015 | 25428159 |
| which severity indices for clostridium difficile infection. | | 2015 | 25426981 |
| prolonged use of a proton pump inhibitor reduces microbial diversity: implications for clostridium difficile susceptibility. | the role of the gut microbiome in arresting pathogen colonization and growth is important for protection against clostridium difficile infection (cdi). observational studies associate proton pump inhibitor (ppi) use and cdi incidence. we hypothesized that ppi use affected the distal gut microbiome over time, an effect that would be best explored by time-longitudinal study of healthy subjects on ppi in comparison to treatment-naïve cdi subjects. this study enrolled nine healthy human subjects and ... | 2014 | 25426290 |
| antibiotic stewardship in orthopaedic surgery: principles and practice. | a thorough knowledge of the principles of antibiotic stewardship is a crucial part of high-quality orthopaedic surgical care. these principles include (1) determining appropriate indications for antibiotic administration, (2) choosing the correct antibiotic based on known or expected pathogens, (3) determining the correct dosage, and (4) determining the appropriate duration of treatment. antibiotic stewardship programs have a multidisciplinary staff that can help guide antibiotic selection and d ... | 2014 | 25425612 |
| antibiotic susceptibility of clostridium difficile is similar worldwide over two decades despite widespread use of broad-spectrum antibiotics: an analysis done at the university hospital of zurich. | clostridium difficile infection (cdi) remains a major health problem worldwide. antibiotic use, in general, and clindamycin and ciprofloxacin, in particular, have been implicated in the pathogenesis of cdi. here, we hypothesized that antibiotics that are highly active in vitro against c. difficile are less frequently associated with cdi than others. the primary goals of our study were to determine if antibiotic susceptibility and cdi are associated and whether the antimicrobial susceptibility of ... | 2014 | 25425433 |
| is fecal microbiota transplantation (fmt) an effective treatment for patients with functional gastrointestinal disorders (fgid)? | despite its high prevalence and significant effect on quality of life, the etiology of functional gastrointestinal disorders (fgid), and specifically irritable bowel syndrome (ibs), has yet to be fully elucidated. while alterations in immunity, motility, and the brain-gut axis have been implicated in disease pathogenesis, the intestinal microbiota are increasingly being shown to play a role and numerous studies have demonstrated significant differences from normal in the intestinal flora of pati ... | 2015 | 25424663 |
| stability and recovery of dificid(®) (fidaxomicin) 200-mg crushed tablet preparations from three delivery vehicles, and administration of an aqueous dispersion via nasogastric tube. | fidaxomicin is approved for the treatment of adults with clostridium difficile-associated diarrhea, many of whom have difficulty swallowing an intact tablet. the study objective was to evaluate the stability and recovery of crushed dificid(®) (fidaxomicin) 200-mg tablets dispersed in water, applesauce, or ensure(®) brand liquid nutritional supplement, and to determine the recovery of fidaxomicin from the administration of an aqueous dispersion of a crushed dificid(®) tablet through a nasogastric ... | 2014 | 25424419 |
| safety issues and drug-drug interactions with commonly used quinolones. | quinolones are widely used antimicrobials with good efficacy and favourable safety. recently, forms of quinolone toxicity such as peripheral neuropathy, retinal detachment or qtc-prolongation have attracted attention. | 2015 | 25423877 |
| proton pump inhibitors and histamine-2 receptor antagonists in the intensive care setting: focus on therapeutic and adverse events. | histamine-2 receptor antagonists (h2ra) and proton pump inhibitors (ppi) are frequently used to prevent stress-related mucosal bleeding (srmb). a paucity of data implicates these agents with pneumonia and clostridium difficile infection (cdi). | 2015 | 25423448 |
| lack of evidence for an unmet need to treat clostridium difficile infection in infants aged <2 years: expert recommendations on how to address this issue. | the role of clostridium difficile in causing disease in infants is unclear, and the existence of c. difficile infection (cdi) in this population is controversial. as part of the drug licensing process for new cdi therapies, a pediatric investigation plan is required to define studies in infants aged <2 years. this assumes an unmet medical need, even though clinical trials in this age group may not be feasible. three pharmaceutical companies developing cdi treatments came together to seek advice ... | 2015 | 25422389 |
| concomitant pseudomembranous colitis in colonic resection for acute diverticulitis. | diverticulitis and clostridium difficile infection (cdi) are common conditions in the surgical population. however, they are usually 2 distinct clinical entities. here, we report the case of acute diverticulitis with concomitant pseudomembranous colitis, presumably due to cdi. the clinical course as well as gross and microscopic pathology findings are discussed. a literature search revealed a single previous report of these findings concomitant in a surgical specimen. a brief discussion of the p ... | 2015 | 25421617 |
| diagnosis of clostridium difficile: real-time pcr detection of toxin genes in faecal samples is more sensitive compared to toxigenic culture. | the diagnosis of clostridium difficile infection (cdi) requires the detection of toxigenic c. difficile or its toxins and a clinical assessment. we evaluated the performance of four nucleic acid amplification tests (naats) detecting toxigenic c. difficile directly from faeces compared to routine toxigenic culture. in total, 300 faecal samples from danish hospitalised patients with diarrhoea were included consecutively. culture was performed in duplicate (routine and 'expanded toxigenic culture': ... | 2015 | 25421216 |
| occurrence of clostridium difficile in seasoned hamburgers and seven processing plants in iran. | the recent increment of the incidence of community associated clostridium difficile infection (ca)-cdi has led to speculation that this disease is associated to foodborne transmission. therefore it is critical to establish the community sources of cdi in order to implement the appropriate interventions. the present study was conducted to evaluate the prevalence of c. difficile in seasoned hamburger and examine the sources of c. difficile dispersal in hamburger processing plants. a total of 211 s ... | 2014 | 25420512 |
| international patents granted for clostridium difficile program. | | 2014 | 25420285 |
| clostridium difficile infection in hospitalized patients with cystic fibrosis. | | 2014 | 25419780 |
| disproportionate rise in clostridium difficile-associated hospitalizations among us youth with inflammatory bowel disease, 1997-2011. | our aim was to characterize the temporal changes in burden that clostridium difficile infection (cdi) added to the hospital care of children and young adults with inflammatory bowel disease (ibd) in the united states. | 2015 | 25419679 |
| antimicrobial peptide resistance mechanisms of gram-positive bacteria. | antimicrobial peptides, or amps, play a significant role in many environments as a tool to remove competing organisms. in response, many bacteria have evolved mechanisms to resist these peptides and prevent amp-mediated killing. the development of amp resistance mechanisms is driven by direct competition between bacterial species, as well as host and pathogen interactions. akin to the number of different amps found in nature, resistance mechanisms that have evolved are just as varied and may con ... | 2014 | 25419466 |
| 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 | 25417388 |
| report into clostridium difficile deaths at vale of leven reveals poor care and lack of leadership. | an inquiry into the deaths of patients from clostridium difficile at the vale of leven hospital in scotland has criticised nurses for providing substandard care. | 2014 | 26982537 |
| visual detection of bacterial pathogens via pna-based padlock probe assembly and isothermal amplification of dnazymes. | we have developed a self-reporting isothermal system for visual bacterial pathogen detection with single base resolution. the new dna diagnostic is based on combination of peptide nucleic acid (pna) technology, rolling circle amplification (rca) and dnazymes. pnas are used as exceedingly selective chemical tools that bind genomic dna at a predetermined sequence under nondenaturing conditions. after assembly of the pna-dna construct a padlock probe is circularized on the free strand. the probe in ... | 2014 | 25415469 |
| whole genome sequencing reveals potential spread of clostridium difficile between humans and farm animals in the netherlands, 2002 to 2011. | farm animals are a potential reservoir for human clostridium difficile infection (cdi), particularly pcr ribotype 078 which is frequently found in animals and humans. here, whole genome single-nucleotide polymorphism (snp) analysis was used to study the evolutionary relatedness of c. difficile 078 isolated from humans and animals on dutch pig farms. all sequenced genomes were surveyed for potential antimicrobial resistance determinants and linked to an antimicrobial resistance phenotype. we sequ ... | 2014 | 25411691 |
| dna microarray-based pcr ribotyping of clostridium difficile. | this study presents a dna microarray-based assay for fast and simple pcr ribotyping of clostridium difficile strains. hybridization probes were designed to query the modularly structured intergenic spacer region (isr), which is also the template for conventional and pcr ribotyping with subsequent capillary gel electrophoresis (seq-pcr) ribotyping. the probes were derived from sequences available in genbank as well as from theoretical isr module combinations. a database of reference hybridization ... | 2015 | 25411174 |
| risk factors associated with clostridium difficile infection in adult oncology patients. | clostridium difficile infection (cdi) prevention is particularly important for cancer patients, because diarrhea often results in dose reductions or delays of chemotherapy or radiotherapy. we conducted this study to better ascertain the incidence, susceptibility, and risk factors for cdi in cancer patients receiving chemotherapy at our hospital. | 2015 | 25410088 |
| electrical injuries. biological values measurements as a prediction factor of local evolution in electrocutions lesions. | taking into account the incidence and the severity of electrocutions, we consider it extremely necessary to find effective, appropriate and particularized therapeutic solutions aimed at improving the survival, decreasing the mortality, ensuring a superior functional and aesthetic effect and facilitating the social reintegration. given the severity of the general condition of the electrically injured patient and the fact that any worsening of the lesions has a systemic echo, the selection of the ... | 2014 | 25408731 |
| predictors and outcomes of readmission for clostridium difficile in a national sample of medicare beneficiaries. | rates of clostridium difficile (cd) infections are increasing. elderly patients may be at particular risk of recurrent cd infection. little is known about the risk for cd readmission specifically in this age group. | 2015 | 25408315 |
| tigecycline for the treatment of clostridium difficile infection refractory to metronidazole in haematopoietic stem cell transplant recipients. | | 2015 | 25407220 |
| clostridium difficile infection: guideline-based diagnosis and treatment. | clostridium difficile (c. difficile) is the pathogen that most commonly causes nosocomial and antibiotic-associated diarrheal disease. optimized algorithms for diagnosis, treatment, and hygiene can help lower the incidence, morbidity, and mortality of c. difficile infection (cdi). | 2014 | 25404529 |
| critical roles of clostridium difficile toxin b enzymatic activities in pathogenesis. | tcdb is one of the key virulence factors of clostridium difficile that is responsible for causing serious and potentially fatal colitis. the toxin contains at least two enzymatic domains: an effector glucosyltransferase domain for inactivating host rho gtpases and a cysteine protease domain for the delivery of the effector domain into host cytosol. here, we describe a novel intrabody approach to examine the role of these enzymes of tcdb in cellular intoxication. by screening a single-domain heav ... | 2015 | 25404023 |
| antibiotic self-stewardship: trainee-led structured antibiotic time-outs to improve antimicrobial use. | antibiotic use is an important quality improvement target. nearly 50% of antibiotic use is unnecessary or inappropriate. to combat overuse, the centers for disease control and prevention (cdc) proposed "time-outs" to reevaluate antibiotics. | 2014 | 25402404 |
| the effect of clostridium difficile infection on cardiac surgery outcomes. | clostridium difficile (cd) is a common cause of healthcare-associated infectious colitis that complicates about 1% of all hospital stays in the u.s. the impact of cd on outcomes after coronary artery bypass grafting (cabg) and valvular surgery (vs) is not well known. | 2015 | 25402213 |
| clostridium difficile infection in the postcolectomy patient. | clostridium difficile infection (cdi) after total colectomy has been increasingly recognized over the past decade. c. difficile enteritis (cde) is a rare occurrence, whereas c. difficile pouchitis (cdp) has been reported in approximately 10% of symptomatic patients seen at a referral center for pouch dysfunction. similar to colonic cdi in the general population, antibiotic use and comorbid diseases may be risk factors for cde. in contrast, the postoperative use of antibiotics does not seem to be ... | 2014 | 25401722 |
| quantitative fecal lactoferrin as a biomarker for severe clostridium difficile infection in hospitalized patients. | the incidence and severity of clostridium difficile infection (cdi) have increased over the past decade, especially among hospitalized patients. in this study, we determined the value of published criteria for severe cdi in predicting 3 month mortality, as well as the utility of fecal lactoferrin as a biomarker for severe cdi. | 2014 | 25401164 |
| the role of gr-1(+) cells and tumour necrosis factor-α signalling during clostridium difficile colitis in mice. | the host response to clostridium difficile infection in antibiotic-treated mice is characterized by robust recruitment of gr-1(+) cells, increased expression of inflammatory cytokines including tumour necrosis factor-α (tnf-α), and the development of severe epithelial damage. to investigate the role of gr-1(+) cells and tnf-α during c. difficile colitis, we treated infected mice with monoclonal antibodies against gr-1 or tnf-α. mice were challenged with vegetative cells of c. difficile strain vp ... | 2015 | 25399934 |
| the molecular basis of clostridium difficile disease and host response. | clostridium difficile infection (cdi) ranges from asymptomatic colonization to severe colitis and death. the physiologic and molecular mechanisms determining disease outcome are thus far poorly understood. here, we review recent advances in the relationship between host response to infection and disease outcome. furthermore, we review recent studies on the relationship between intestinal microbial ecology and pathogenesis of cdi. | 2015 | 25394235 |
| comparison of genomera c. difficile and xpert c. difficile as confirmatory tests in a multistep algorithm for diagnosis of clostridium difficile infection. | we compared two multistep diagnostic algorithms based on c. diff quik chek complete and, as confirmatory tests, genomera c. difficile and xpert c. difficile. the sensitivity, specificity, positive predictive value, and negative predictive value were 87.2%, 99.7%, 97.1%, and 98.3%, respectively, for the genomera-based algorithm and 89.7%, 99.4%, 95.5%, and 98.6%, respectively, for the xpert-based algorithm. genomera represents an alternative to xpert as a confirmatory test of a multistep algorith ... | 2015 | 25392360 |
| alert microorganisms isolated from patients hospitalized in małopolskie province in 2010-2012. | healthcare centers undertake supervisory activities to control health care-associated infections (hcais) by elaborating procedures, identifying alert microorganisms and analyzing data collected. the aim of the study was to analyze the prevalence of alert microorganisms in hospital wards in 2010-2012. | 2014 | 25391008 |
| factors associated with clostridium difficile diarrhea in a hospital in beijing, china. | clostridium difficile is the most common cause of hospital-acquired diarrhea in patients treated with antibiotics, chemotherapeutic agents, and other drugs that alter the normal equilibrium of the intestinal flora. a better understanding of the risk factors for c. difficile-associated disease (cdad) could be used to reduce the incidence of cdad and the costs associated with its treatment. the aim of this study was to identify the risk factors for cdad in a cohort of chinese patients in a beijing ... | 2014 | 25387676 |
| intestinal microbiota in health and disease: role of bifidobacteria in gut homeostasis. | the pool of microbes inhabiting our body is known as "microbiota" and their collective genomes as "microbiome". the colon is the most densely populated organ in the human body, although other parts, such as the skin, vaginal mucosa, or respiratory tract, also harbour specific microbiota. this microbial community regulates some important metabolic and physiological functions of the host, and drives the maturation of the immune system in early life, contributing to its homeostasis during life. alt ... | 2014 | 25386066 |
| toxin-mediated paracellular transport of antitoxin antibodies facilitates protection against clostridium difficile infection. | the exotoxins tcda and tcdb are the major virulence factors of clostridium difficile. circulating neutralizing antitoxin antibodies are protective in c. difficile infection (cdi), as demonstrated, in part, by the protective effects of actoxumab and bezlotoxumab, which bind to and neutralize tcda and tcdb, respectively. the question of how systemic igg antibodies neutralize toxins in the gut lumen remains unresolved, although it has been suggested that the fc receptor fcrn may be involved in acti ... | 2015 | 25385797 |
| infection: microbiota reconstitution for resistance to clostridium difficile infection--fight fire with fire? | | 2015 | 25385229 |
| clostridium difficile isolates with high linezolid mics harbor the multiresistance gene cfr. | we studied the molecular mechanisms of linezolid resistance in 9 isolates of toxigenic clostridium difficile with high linezolid mics. the activity of linezolid was determined against 891 clinical isolates of toxigenic c. difficile. the mic50 and mic90 of linezolid were 0.75 μg/ml and 1.5 μg/ml, respectively. nine strains (1%) showed high linezolid mics (6 μg/ml to 16 μg/ml) and also were resistant to clindamycin, erythromycin, and chloramphenicol. these strains were selected for molecular studi ... | 2015 | 25385106 |
| the complexity and diversity of the pathogenicity locus in clostridium difficile clade 5. | the symptoms of clostridium difficile infection are caused by two closely related toxins, tcda and tcdb, which are encoded by the 19.6 kb pathogenicity locus (paloc). the paloc is variably present among strains, and in this respect it resembles a mobile genetic element. the c. difficile population structure consists mainly of five phylogenetic clades designated 1-5. certain genotypes of clade 5 are associated with recently emergent highly pathogenic strains causing human disease and animal infec ... | 2014 | 25381663 |
| hyperimmune bovine colostrum as a novel therapy to combat clostridium difficile infection. | clostridium difficile is a primary cause of antibiotic-associated diarrhea that typically develops when gut microbiota is altered. conventional treatment for c. difficile infection (cdi) is additional antimicrobial administration, which further disrupts normal intestinal microbiota, often resulting in poor treatment outcomes. | 2015 | 25381448 |
| strategies to prevent clostridium difficile infections in acute care hospitals: 2014 update. | | 2014 | 25376069 |
| long-term clinical outcome of clostridium difficile infection in hospitalized patients: a single center study. | antibiotic usage and increasingly aging populations have led to increased incidence of clostridium difficile infection (cdi) in worldwide. recent studies in korea have also reported increasing cdi incidence; however, there have been no reports on the long-term outcomes of cdi. we therefore investigated the long-term clinical outcomes of patients with cdi, including delayed recurrence, associated risk factors and mortality. | 2014 | 25374496 |
| risk factors for delayed recurrence of clostridium difficile infection. | | 2014 | 25374490 |
| icu-onset clostridium difficile infection in a university hospital in china: a prospective cohort study. | a prospective study was conducted to investigate the incidence, clinical profiles and outcome of icu-onset cdi in a 50-bed medical icu at a university hospital in china. stools were collected from patients who developed icu-onset diarrhea and was screened for tcda (toxin a gene) and tcdb (toxin b gene) by pcr. cdi cases were compared with the icu-onset non-cdi diarrhea cases for demographics, comorbidities, potential risk factors, major laboratory findings and outcomes. stool samples from cdi ca ... | 2014 | 25372033 |
| real-time microfluidic recombinase polymerase amplification for the toxin b gene of clostridium difficile on a slipchip platform. | clostridium difficile is one of the key bacterial pathogens that cause infectious diarrhoea both in the developed and developing world. isothermal nucleic acid amplification methods are increasingly used for identification of toxinogenic infection by clinical labs. for this purpose, we developed a low-cost microfluidic platform based on the slipchip concept and implemented real-time isothermal recombinase polymerase amplification (rpa). the on-chip rpa assay targets the clostridium difficile tox ... | 2015 | 25371968 |
| the role of local and systemic cytokines in patients infected with clostridium difficile. | it is widely accepted that the pathogenesis of clostridium difficile infection (cdi) is multifactorial, dependent on pathogen virulence factors produced by the organism as well as disorders of the gastrointestinal tract, the alteration in intestinal flora and the immune response of the host. in particular, the immune response in the course of cdi and the involvement of cytokines in the pathogenesis of cdi is not fully understood. the aim of our study was to evaluate the relationship between proi ... | 2014 | 25371529 |
| jama patient page. clostridium difficile infection. | | 2014 | 25369506 |
| [sensory aphasia during therapy with metronidazole--an important differential diagnosis of acute cerebral ischemia]. | a 74-year old man was admitted after neurosurgical treatment of a lumbar vertebral fracture. he had a slight paresis of the right leg in combination with bladder dysfunction. | 2014 | 25369045 |
| comparison of supplemented brucella agar and modified clostridium difficile agar for antimicrobial susceptibility testing of clostridium difficile. | antimicrobial susceptibility testing (ast) of clostridium difficile is increasingly important because of the rise in resistant strains. the standard medium for the ast of c. difficile is supplemented brucella agar (sba), but we found that the growth of c. difficile on sba was not optimal. because active growth is critical for reliable ast, we developed a new, modified c. difficile (mcd) agar. c. difficile grew better on mcd agar than on sba. | 2014 | 25368819 |
| evaluation of a focused virtual library of heterobifunctional ligands for clostridium difficile toxins. | a focused library of virtual heterobifunctional ligands was generated in silico and a set of ligands with recombined fragments was synthesized and evaluated for binding to clostridium difficile toxins. the position of the trisaccharide fragment was used as a reference for filtering docked poses during virtual screening to match the trisaccharide ligand in a crystal structure. the peptoid, a diversity fragment probing the protein surface area adjacent to a known binding site, was generated by a m ... | 2015 | 25367771 |
| factors affecting treatment and recurrence of clostridium difficile infections. | the antimicrobial agents vancomycin and metronidazole have been used to treat clostridium difficile infections (cdis). however, it remains unclear why patients are at risk of treatment failure and recurrence. therefore, this study retrospectively examined 98 patients with cdis who were diagnosed based on the detection of toxin-positive c. difficile to determine the risk factors affecting drug treatment responses and the recurrence of cdi. no significant difference was observed in the cure rate o ... | 2014 | 25366486 |
| cost-effectiveness analysis of treatment strategies for initial clostridium difficile infection. | clostridium difficile infection (cdi) is costly. current guidelines recommend metronidazole as first-line therapy and vancomycin as an alternative. recurrence is common. faecal microbiota transplantation (fmt) is an effective therapy for recurrent cdi (rcdi). this study explores the cost-effectiveness of fmt, vancomycin and metronidazole for initial cdi. we constructed a decision-analytic computer simulation using inputs from published literature to compare fmt with a 10-14-day course of oral me ... | 2014 | 25366338 |
| a hospital-based study of the clinical characteristics of clostridium difficile infection in children. | clostridium difficile infection (cdi) is an increasingly important cause of morbidity in hospitalized children. we describe the recent epidemiology of pediatric cdi at a children's hospital, compare community-associated (ca) and hospital-associated (ha) infections and identify risk factors for severe disease. | 2014 | 25361022 |
| development of taqman-based quantitative pcr for sensitive and selective detection of toxigenic clostridium difficile in human stools. | clostridium difficile is the main cause of nosocomial diarrhea, but is also found in asymptomatic subjects that are potentially involved in transmission of c. difficile infection. a sensitive and accurate detection method of c. difficile, especially toxigenic strains is indispensable for the epidemiological investigation. | 2014 | 25360662 |
| cost-effectiveness of fecal microbiota transplant in treating clostridium difficile infection in canada. | | 2014 | 27202489 |
| cost-effectiveness of fidaxomicin therapy for clostridium difficile infection in hungary. | | 2014 | 27202484 |
| economic evaluation of fidaxomicin for the treatment of clostridium difficile infections (cdi) also known as clostridium difficile-associated diarrhoea (cdad) in spain. | | 2014 | 27202478 |
| cost-effectiveness of fidaxomicin for the treatment of clostridium difficile infection (cdi) in sweden. | | 2014 | 27202472 |
| the burden of clostridium difficile (cdi) infection in hospitals, in denmark, finland, norway and sweden. | | 2014 | 27202459 |
| fidaxomicin therapy for patients with clostridium difficile infection: a systematic literature review and meta-analysis. | | 2014 | 27202426 |
| cdad-daysyms™: a new patient-reported outcome tool for clostridium difficile-associated diarrhoea. | | 2014 | 27201895 |
| cost-utility analysis of fidaxomicin compared to vancomycin in the management of severe clostridium difficile infection in poland. | | 2014 | 27200779 |
| epidemiology of clostridium difficile infection in two tertiary-care hospitals in perth, western australia: a cross-sectional study. | the epidemiology of clostridium difficile infection (cdi) has changed over time and between countries. it is therefore essential to monitor the characteristics of patients at risk of infection and the circulating strains to recognize local and global trends, and improve patient management. from december 2011 to may 2012 we conducted a prospective, observational epidemiological study of patients with laboratory-confirmed cdi at two tertiary teaching hospitals in perth, western australia to determ ... | 2014 | 25356346 |
| simple faecal preparation and efficacy of frozen inoculum in faecal microbiota transplantation for recurrent clostridium difficile infection--an observational cohort study. | faecal microbiota transplantation (fmt) is an effective treatment for recurrent clostridium difficile infection (rcdi). the finding of suitable donor, donor screening and preparation of faecal transplants are challenging in clinical work. | 2015 | 25355279 |
| clostridium difficile infection: current, forgotten and emerging treatment options. | clostridium difficile infection (cdi) has increased in incidence and severity, and is now among the most common nosocomial infections. several agents are available for the initial treatment of cdi, some of which are rarely used, and none of which is clearly superior for initial clinical cure. fidaxomicin appears to offer a benefit in terms of preventing recurrent disease, although the cost-benefit ratio is debated. recurrent cdi is a major challenge, occurring after 15-30% of initial episodes. t ... | 2014 | 25350805 |
| [high hospital standardized mortality ratio does not always indicate low quality]. | hospital standardized mortality ratio (hsmr) is increasingly used to assess quality of care. at frederiksberg hospital hsmr increased significantly during the first and second quarter in 2012. we therefore reviewed records of all deceased, including patients deceased during the comparative period in 2011 (n = 413). information about cancer and infection with clostridium difficile was specifically noted. we found that the increasing hsmr reflected an increase in the number of terminal cancer pati ... | 2014 | 25350706 |
| significant publications on infectious diseases pharmacotherapy in 2013. | the most important articles on infectious diseases (id) pharmacotherapy published in the peer-reviewed literature in 2013, as nominated and selected by panels of pharmacists and others with id expertise, are summarized. | 2014 | 25349243 |
| update on the pathogenesis and management of pouchitis. | pouchitis is an inflammatory complication after restorative proctocolectomy and ileal pouch-anal anastomosis (ipaa). ipaa is the surgical treatment of choice in patients with ulcerative colitis (uc) who require colectomy. initial episodes of acute pouchitis generally respond to antibiotics but significant numbers of cases eventually become dependent on or refractory to antibiotics. management of chronic antibiotic refractory pouchitis is challenging and can ultimately lead to pouch failure. the ... | 2014 | 25348740 |
| systemically administered igg anti-toxin antibodies protect the colonic mucosa during infection with clostridium difficile in the piglet model. | the use of anti-toxin human monoclonal antibodies (hmab) as treatment for c. difficile infection has been investigated in animal models and human clinical trials as an alternative to or in combination with traditional antibiotic therapy. while hmab therapy appears to be a promising option, how systemically administered igg antibodies protect the colonic mucosa during clostridium difficile infection is unknown. using the gnotobiotic piglet model of clostridium difficile infection, we administered ... | 2014 | 25347821 |
| [experience with fecal transplantation in the treatment of clostridium difficile infection]. | during the past years a dramatic change has been observed in the epidemiology of clostridium difficile infections. | 2014 | 25344853 |
| implementing an intensified antibiotic stewardship programme targeting cephalosporin and fluoroquinolone use in a 200-bed community hospital in germany. | prescription of third-generation cephalosporins and fluoroquinolones has been linked to an increasing incidence of gram-negative bacteria producing extended-spectrum beta-lactamases, methicillin-resistant staphylococcus aureus and nosocomial infection with clostridium difficile. antibiotic stewardship (abs) programmes offer evidence-based tools to control antibiotic prescription rates and thereby influence the incidence of nosocomial infection and contain the development of multidrug-resistant b ... | 2015 | 25344419 |
| acid suppression therapy does not predispose to clostridium difficile infection: the case of the potential bias. | an adverse effect of acid-suppression medications on the occurrence of clostridium difficile infection (cdi) has been a common finding of many, but not all studies. we hypothesized that association between acid-suppression medications and cdi is due to the residual confounding in comparison between patients with infection to those without, predominantly from non-tested and less sick subjects. we aimed to evaluate the effect of acid suppression therapy on incidence of cdi by comparing patients wi ... | 2014 | 25343667 |
| utility of clostridium difficile toxin b for inducing anti-tumor immunity. | clostridium difficile toxin b (tcdb) is a key virulence factor of bacterium and induces intestinal inflammatory disease. because of its potent cytotoxic and proinflammatory activities, we investigated the utility of tcdb in developing anti-tumor immunity. tcdb induced cell death in mouse colorectal cancer ct26 cells, and the intoxicated cells stimulated the activation of mouse bone marrow-derived dendritic cells and subsequent t cell activation in vitro. immunization of balb/c mice with toxin-tr ... | 2014 | 25340750 |
| fecal microbiota transplantation in inflammatory bowel disease: beyond the excitement. | the purpose of this article is to perform a systematic review of the literature on the use of fecal microbiota transplantation (fmt) in inflammatory bowel disease (ibd).there is an increasing interest of both physicians and patients in assessing the possible role of the fmt in the treatment of ibd.electronic and manual bibliographic searches were performed to identify original reports in which subjects with ibd were treated with fmt. because of the scarcity of studies with adequate sample size, ... | 2014 | 25340496 |
| development and validation of a clostridium difficile risk assessment tool. | the incidence of clostridium difficile infection has increased rapidly during the past decade, increasing lengths of stays in the hospital, costs, and mortality rates. to address this increased incidence, we performed a retrospective case-control study using known risk factors to develop a tool to determine which patients are at risk for infection. multivariate analysis generated a combination of risk factors associated with development of infection including prior admission, endoscopy within 30 ... | 2014 | 25340415 |